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Enhancing the Cancer of the lung Clinical Trial Growth by Incorporating Fighting Risks.
Objective To redefine overdiagnosis and reestimate the proportion of overdiagnosis of breast cancer caused by screening based on the Surveillance, Epidemiology, and End Results (SEER, 1973-2015) Program data. Methods The breast cancer diagnosed before 1977 was defined as the no-screening cohort since America had initiated breast cancer screening from 1977. The breast cancer diagnosed in 1999 was defined as the screening cohort due to no increases in both the proportion of early-stage breast cancer until 1999 and the overall survival of early-stage breast cancer diagnosed over the three years since 1999. The magnitude of overdiagnosis was calculated as the difference in the proportions of early-stage breast cancer patients with long-time (15-year) survival to all breast cancer patients between two cohorts. Results Over 23 years before and after widespread screening in America, the proportion of early-stage breast cancer patients increased from 52.1% (16,891/32,443) to 72.7% (16,021/22,025) (P less then 0.001). The 15-year survival rate of early-stage breast cancer patients increased from 51.1% to 61.5% (P less then 0.001), while the proportions of early-stage breast cancer patients with long-time survival to all breast cancer patients increased from 26.6% (52.1%×51.1%) to 44.7% (72.7%×61.5%). Assuming no improvements in cancer screening technology and treatment technology, 18.1% (44.7%-26.6%) of breast cancer patients were overdiagnosed associated with screening. The age-specific overdiagnosis rates were 18.9%, 24.7%, 24.5%, 20.5%, and 8.3% for breast cancer patients aged 40-49, 50-59, 60-69, 70-74, and ≥75 years old, respectively. Conclusions Overdiagnosis caused by mammographic screening is probably overestimated in current screening practices. Further trials with more sophisticated designs and analyses are needed to validate our findings in the future. Objective Laryngeal cancer is an important oncologic entity, whose prognosis depends on establishing appropriate preventive and diagnostic measures, especially in populations at higher risk. Methods Epidemiologic information including worldwide incidence, prevalence, burden of health loss (disability-adjusted life year; DALYs) and mortality of larynx cancer was obtained from the Global Health Data Exchange (GHDx) database. Results The current incidence, prevalence and mortality of laryngeal cancer are estimated at 2.76 cases/year per 100,000 inhabitants, 14.33 cases/year per 100,000 inhabitants and 1.66 deaths/year per 100,000 inhabitants, respectively, averaging 3.28 million DALYs each year. Incidence and prevalence have increased by 12% and 24%, respectively during the past 3 decades, whilst mortality has declined by around 5%. The epidemiologic burden of this malignancy is approximately 5-fold higher in males and increases in parallel with ageing, peaking after 65 years of age. Both incidence and mortality rates are higher in Europe and lower in Africa, but the ratio between deaths and incidence is the highest in Africa. Incidence has gradually declined in Europe during the past 3 decades, whilst it has increased in South-East Asia and Western Pacific. Cigarette smoking and alcohol abuse contribute for about 90% of overall worldwide mortality for laryngeal cancer. Conclusions Laryngeal cancer still poses a high clinical and societal burden, with an escalating temporal trend not expected to reverse soon. Objective Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015. Methods Data submitted from 501 cancer registries were checked and evaluated according to the criteria of data quality control and 368 registries' data were qualified for the final analysis. Data were stratified by area (urban/rural), sex, age group and combined with national population data to estimate laryngeal cancer incidence and mortality in China, 2015. China population census in 2000 and Segi's population were used for age-standardized. Results The percentage of cases morphological verified (MV%) of laryngeal cancer was 74.18%. The percentage of death certificate-only cases (DCO%) was 2.10%. And the mortality to incidence (M/I) ratio was 0.55. About 25,300 new cases of laryngeal cancer were diagnosed in 2015 and 13,700 deaths were reported. The crude rate of laryngeal cancer was 1.84 per 100,000 (males and females were 3.20 and 0.42 per 100,000, respectively). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 1.18 and 1.19 per 100,000, respectively. The cumulative incidence rate (0-74 years old) was 0.15%. The crude mortality rate was 1.00 per 100,000. Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 0.61 and 0.61 per 100,000, respectively, with the cumulative rate (0-74 years old) was 0.07%. Incidence and mortality of laryngeal cancer in males were higher than those in females. And the rates in urban areas were higher than those in rural areas. Conclusions The incidence and mortality of laryngeal cancer in China were low. And the rates were significantly higher in males than in females. Risk factor control and targeted prevention should be strengthened. Objective To report the incidence and mortality rates of oral and oropharyngeal cancer in Chinese population. Methods Data were taken from a population-based cancer registry collected by the National Central Cancer Registry of China (NCCRC) in 2015. The data collected from 501 local cancer registries in China were assessed using NCCRC screening methods and criteria. Incidence and mortality rates of oral and oropharyngeal cancer were stratified by age group, gender, and area. Age-standardized incidence and mortality rates were adjusted using the Chinese standard population in 2000 and Segi's world population. Results In 2015, it was estimated that there were 51,765 oral and oropharyngeal cancer incident cases and 23,830 deaths in China. The crude incidence rate of oral and oropharyngeal cancer was 3.77/100,000, and the age-standardized incidence rate by Chinese standard population and by Segi's world standard population were 2.55/100,000 and 2.49/100,000, respectively. Selleck Santacruzamate A The crude mortality rate and the age-standardized mortality rates by Chinese standard population and by Segi's world standard population were 1.73/100,000, 1.09/100,000 and 1.08/100,000, respectively. Both incidence and mortality rates of oral and oropharyngeal cancer were higher in males and in urban areas. Residents in eastern areas had the highest incidence and mortality rates, followed by those from middle areas and western areas. The rates of oral and oropharyngeal cancer increased greatly with age, especially after the age of 40 years. Conclusions This study reports the latest incidence and mortality rates of oral and oropharyngeal cancer in China. Prevention intervention including early detection, treatment, and regular follow-ups is encouraged to be set up to reduce incidence and mortality rates of oral and oropharyngeal cancer in the future. Tension pneumocephalus (TPC) is a neurosurgical emergency that occurs when there is an expansion of trapped intracranial gas causing raised intracranial pressure. Rarely, posttraumatic TPC can occur even after 72 hours although the initial scans are normal. There are less than 20 cases of delayed TPC in the reported literature. Here, we report a case of delayed TPC that occurred 7 days after the initial injury and presented as sudden neurological deterioration. It was promptly diagnosed with a computed tomography brain and appropriate surgical intervention was performed and the outcome was good. We also did a literature review of reported cases of delayed TPC and looked out for factors that may predict its occurrence. The occurrence of an episode of cerebrospinal fluid rhinorrhea, followed by worsening of headache and sensorium in a patient with anterior cranial fossa fracture should alert a neurosurgeon to the possibility of delayed TPC.Although the concept of intersectionality has gained widespread attention in psychological research, there remains a significant gap related to the impact of intersectionality on identity formation for persons negotiating multiple minority statuses. This gap is especially pronounced among sexual and gender expansive women of Latinx and African American descent-two groups that face disparate personal and public health risks but are largely ignored in the research literature. In response to this gap, we carried out a qualitative study using constructivist grounded theory with 20 Latinx and African American sexual minority, gender expansive women to understand participants' experiences of forming an intersectional social identity. Following an exploration of identity formation related to the specific domains of race, gender identity, and sexual orientation, we prompted participants to consider how each of the specified identity domains impacted the formation and experience of an overall intersectional identity (e.g., how racial position impacted gender identity and/or sexual identity formation). Findings revealed four major themes that were critical in identity formation (a) family and cultural expectations, (b) freedom to explore identity, (c) the constant negotiation of insider/outsider status, and (d) identity integration as an act of resistance. Implications for future research and psychological services are discussed.This article provides an ethnographic perspective on urban planning by presenting the creative practices of marginalized slum residents in Recife, Northeast Brazil, who are affected by planners' decisions. It argues that such a perspective contributes to current critical urban theory in three ways. First, while many studies of urban planning follow the temporality of the timeframe of a particular project ('project time'), this analysis emphasizes the timeframe of the lives of the affected residents ('people's time'). Second, it attends to diversity, taking account of the variety of affected residents and the diverse consequences of urban planning on their lives. Third, it shows how urban interventions - similar to marriage, divorce, the birth of children and the death of loved ones - are high-impact life events for the urban poor. Finally, the article assesses the engagement between ethnography and critical urban theory and argues in favour of 'grounding' the latter better in the analysis of actual practices and experiences. © 2019 The Authors. International Journal of Urban and Regional Research Published by John Wiley & Sons Ltd under License by Urban Research Publications Limited.New imaging methods are needed to assess the activity of caries lesions on tooth surfaces. Recent studies have shown that changes in the contrast of lesions during dehydration with air at SWIR wavelengths can be used to determine if lesions are active or arrested. In this study changes in the reflectance of caries lesions during dehydration with air was monitored at 1500-1750-nm on extracted teeth using an imaging system with an InGaAs camera, a light source and a 3D printed handpiece with an integrated air nozzle suitable for clinical use. Lesion structure was also assessed with optical coherence tomography and microCT for comparison. This small preclinical study demonstrated that a 3D printed appliance with integrated air for dehydration can be used to acquire SWIR dehydration curves similar to those acquired previously for benchtop imaging systems.
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