RESUMEN
Mortality risk declined over time. Patients with fragility hip fracture experienced an approximate ninefold excess mortality, peaking shortly after fracture, in comparison with that of the general population. Continuous efforts in lowering the occurrence of hip fracture have the potential to improve the survival of the elderly population in China. PURPOSE: Hip fractures in older adults often lead to an elevated risk of death. However, few studies investigated mortality risk following hip fracture in mainland China. This retrospective cohort study aimed to evaluate the crude mortality and excess mortality after fragility hip fractures in Lishui residents aged 50 years and older. METHODS: Patients having a fragility hip fracture between October 2013 and August 2019 were identified from the Lishui District Inpatient Data Collection and followed up until August 2020. Death information was ascertained from the linked death registry records. We calculated the follow-up mortality rate and corresponding 95% confidence intervals (CIs) as well as the standard mortality ratios (SMRs) in comparison with the mortality rates of Lishui residents. RESULTS: During the study period, a total of 808 patients (63.4% females) with an average age of 75 years were admitted for fragility hip fractures. The 1st, 2nd, and 3rd year follow-up mortality rates were 16.51, 6.06, and 5.03 per 100 person-year, respectively. The SMRs were 8.46 (6.94, 9.97), 5.74 (4.86, 6.63), and 4.63 (3.98, 5.27) for the 1st, 2nd, and 3rd year following fragility hip fracture. CONCLUSION: Although mortality risk declined over time, patients with fragility hip fracture experienced an approximate ninefold excess mortality, peaking shortly after fracture, in comparison with that of the general population. Continuous efforts in lowering the occurrence of hip fracture have the potential to improve the survival of the elderly population in China.
Asunto(s)
Fracturas de Cadera , Osteoporosis , Fracturas Osteoporóticas , Fracturas de Cadera/etiología , Fracturas de Cadera/mortalidad , China/epidemiología , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Fracturas Osteoporóticas/mortalidad , Osteoporosis/complicacionesAsunto(s)
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , Lesiones Precancerosas , Humanos , Carcinoma de Células Escamosas de Esófago/diagnóstico , Carcinoma de Células Escamosas de Esófago/epidemiología , Carcinoma de Células Escamosas de Esófago/patología , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/epidemiología , Neoplasias Esofágicas/patología , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/epidemiología , Lesiones Precancerosas/patología , Diagnóstico PrecozRESUMEN
BACKGROUND: Although endoscopic screening for esophageal cancer has been performed in high-risk areas in China for decades, there is limited and inconsistent evidence regarding the starting age for individuals participating in screening. The aim of this study is to investigate the optimal starting age of esophageal cancer screening. METHODS: This study is based on a multicenter prospective cohort consisting 338,017 permanent residents aged 40-69 years in six high-risk areas of esophageal cancer in China. The participation rate, detection rate, hazard ratios (HRs), cumulative incidence and mortality and number needed to screen (NNS) were calculated in each age group. Screening burden, benefit and risk were compared among screening strategies with different initiation ages to explore the optimal starting age for population-based screening in high-risk areas. RESULTS: Individuals aged 50-69 had a higher participation rate, a higher detection rate and improved screening effectiveness than those aged 40-49. The endoscopic screening had no significant effect on reducing the incidence of esophageal cancer in individuals under 55 and mortality in individuals under 45. Increasing the starting age to 50 years reduced the screening demand and NNS by 40% and 55%, and resulted in 12% of detectable positive cases, 16% of preventable incident cases, and 14% of preventable deaths being missed. CONCLUSIONS: Postponing the starting age of endoscopic screening to 50 years might yield a more-favorable balance between screening benefit and burden in high- risk areas with limited resources.
Asunto(s)
Detección Precoz del Cáncer , Neoplasias Esofágicas , Humanos , Estudios Prospectivos , Detección Precoz del Cáncer/métodos , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/epidemiología , Incidencia , China/epidemiología , Tamizaje Masivo/métodosRESUMEN
Object detection in drone aerial imagery has been a consistent focal point of research. Aerial images present more intricate backgrounds, greater variation in object scale, and a higher occurrence of small objects compared to standard images. Consequently, conventional object detection algorithms are often unsuitable for direct application in drone scenarios. To address these challenges, this study proposes a drone object detection algorithm model based on YOLOv5, named SMT-YOLOv5 (Small Target-YOLOv5). The enhancement strategy involves improving the feature fusion network by incorporating detection layers and implementing a weighted bidirectional feature pyramid network. Additionally, the introduction of the Combine Attention and Receptive Fields Block (CARFB) receptive field feature extraction module and DyHead dynamic target detection head aims to broaden the receptive field, mitigate information loss, and enhance perceptual capabilities in spatial, scale, and task domains. Experimental validation on the VisDrone2021 dataset confirms a significant improvement in the target detection accuracy of SMT-YOLOv5. Each improvement strategy yields effective results, raising the average precision by 12.4 percentage points compared to the original method. Detection improvements for large, medium, and small targets increase by 6.9%, 9.5%, and 7.7%, respectively, compared to the original method. Similarly, applying the same improvement strategies to the low-complexity YOLOv8n results in SMT-YOLOv8n, which is comparable in complexity to SMT-YOLOv5s. The results indicate that, relative to SMT-YOLOv8n, SMT-YOLOv5s achieves a 2.5 percentage point increase in average precision. Furthermore, comparative experiments with other enhancement methods demonstrate the effectiveness of the improvement strategies.
RESUMEN
Purpose: This study investigated the association of retinal fractal dimension (FD) and blood vessel tortuosity (BVT) with renal function [assessed by estimated glomerular filtrate rate (eGFR)] in healthy Chinese adults using swept-source optical coherence tomographic angiography (SS-OCTA). Materials and methods: This cross-sectional study was conducted among ocular treatment-naïve healthy participants from Guangzhou, China. FD and BVT in the superficial capillary plexus and deep capillary plexus were measured by SS-OCTA with a 3 × 3 macula model. eGFR was calculated using the Xiangya equation, and impaired renal function (IRF) was defined as eGFR = 90 mL/min/1.73 m2. Linear regression was performed to evaluate the relationships between SS-OCTA metrics and renal function. Results: A total of 729 participants with a mean age of 57.6 ± 9.1 years were included in the final analysis. Compared to participants with normal renal function, those with IRF had lower FD both in the superficial capillary plexus (1.658 ± 0.029 vs. 1.666 ± 0.024, p = 0.001) and deep capillary plexus (1.741 ± 0.016 vs. 1.746 ± 0.016, p = 0.0003), while the deep BVT was larger in participants with IRF than those with normal renal function (1.007 ± 0.002 vs. 1.006 ± 0.002, p = 0.028). The superficial FD was linearly and positively associated with eGFR after adjusting for confounders (ß = 0.2257; 95% CI 0.0829-0.3685; p = 0.002), while BVT was not associated with eGFR (all p ≥ 0.05). Conclusion: The patients with IRF had lower FD and larger BVT than those with normal renal function. The superficial FD decreased linearly with renal function deterioration. Our study suggests that the retinal microvasculature can represent a useful indicator of subclinical renal microvascular abnormalities and serve as a useful non-invasive assessment to predict and monitor the progression of renal function.
RESUMEN
The objective of this study was to describe and compare the dynamic microbiota characteristics in the gastrointestinal (GI) tract in Chinese participants via high-throughput sequencing techniques. The study collected saliva, esophageal swab, cardia biopsy, noncardia biopsy, gastric juice, and fecal specimens from 40 participants who underwent upper GI tract cancer screening in Linzhou (Henan, China) in August 2019. The V4 region of 16S rRNA genes was amplified and sequenced using the Illumina MiniSeq platform. The observed amplicon sequence variants (ASVs) gradually decreased from saliva to esophageal swab, cardia biopsy, noncardia biopsy, and gastric juice specimens and then increased from gastric juice to fecal specimens (P < 0.05). Each GI site had its own microbial characteristics that overlapped those of adjacent sites. Characteristic genera for each site were as follows: Neisseria and Prevotella in saliva, Streptococcus and Haemophilus in the esophagus, Helicobacter in the noncardia, Pseudomonas in gastric juice, Faecalibacterium, Roseburia, and Blautia in feces, and Weissella in the cardia. Helicobacter pylori-positive participants had decreased observed ASVs (cardia, P < 0.01; noncardia, P < 0.001) and Shannon index values (cardia, P < 0.001; noncardia, P < 0.001) compared with H. pylori-negative participants both in cardia and noncardia specimens. H. pylori infection played a more important role in the microbial composition of noncardia than of cardia specimens. In gastric juice, the gastric pH and H. pylori infection had similar additive effects on the microbial diversity and composition. These results show that each GI site has its own microbial characteristics that overlap those of adjacent sites and that differences and commonalities between and within microbial compositions coexist, providing essential foundations for the continuing exploration of disease-associated microbiota. IMPORTANCE Upper gastrointestinal (UGI) tract cancer is one of the most common cancers worldwide, while limited attention has been paid to the UGI microbiota. Microbial biomarkers, such as Fusobacteria nucleatum and Helicobacter pylori, bring new ideas for early detection of UGI tract cancer, which may be a highly feasible method to reduce its disease burden. This study revealed that each gastrointestinal site had its own microbial characteristics that overlapped those of adjacent sites. There were significant differences between the microbial compositions of the UGI sites and feces. Helicobacter pylori played a more significant role in the microbial composition of the noncardia stomach than in that of the cardia. Gastric pH and Helicobacter pylori had similar additive effects on the microbial diversity of gastric juice. These findings played a key role in delineating the microbiology spectrum of the gastrointestinal tract and provided baseline information for future microbial exploration covering etiology, primary screening, treatment, outcome, and health care products.
Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Neoplasias , Endoscopía Gastrointestinal , Tracto Gastrointestinal , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/genética , Humanos , ARN Ribosómico 16S/genéticaRESUMEN
BACKGROUND: Early diagnosis and treatment of esophageal squamous cell dysplasia (ESCdys) and esophageal squamous cell carcinoma (ESCC) could significantly reduce the incidence and mortality of ESCC. This pilot study aimed to investigate whether P16/CDKN2A methylation could serve as a cytologic biomarker for early detection of ESCdys and ESCC. METHODS: Paired esophageal biopsy and cytology specimens (exfoliated cells) were obtained from subjects at different stages of ESCC development. The methylation status of P16 gene in these two specimen types was determined using a 115-bp MethyLight assay. Categorical data were compared by the Chi-square test. Logistic regression was performed to assess adjusted odds ratios of P16 methylation associated with ESCC and ESCdys. Prediction models for identifying individuals at risk of ESCC and high-grade ESCdys (high-grade intraepithelial neoplasia, HGIN) were developed by multivariable logistic regression. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. Internal validation of the prediction models was performed using the 1000-bootstrap resample. RESULTS: A total of 105 subjects with diagnoses ranging from normal mucosa through ESCC were included in this study. An increase in P16 methylation frequency was observed with increasing severity of esophageal lesions (p for trend <0.001). In the adjusted logistic regression models, P16 methylation in cytology specimens was positively associated with ESCC and ESCdys risk, whereas P16 methylation in biopsy specimens was only associated with a higher risk of developing ESCC. The predictive capacity of base model I (AUC, 0.816) for ESCC and HGIN was significantly increased by adding P16 methylation in cytology specimens (model III; AUC, 0.882; p = 0.043), but not P16 methylation in biopsy specimens (model II; AUC, 0.850; p = 0.225). Bootstrap validation showed optimism-corrected AUC of 0.789 for model I, 0.822 for model II, and 0.854 for model III. CONCLUSION: P16 methylation as a cytologic marker was associated with the ESCC development and has the potential for application in minimally invasive ESCC screening.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , Humanos , Carcinoma de Células Escamosas de Esófago/diagnóstico , Carcinoma de Células Escamosas de Esófago/genética , Genes p16 , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/metabolismo , Proyectos Piloto , Estudios de Factibilidad , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Metilación de ADN , Biomarcadores/metabolismoRESUMEN
BACKGROUND: Gastric and esophageal cancer (GEC) have made a great contribution to the cancer burden in China. This study aims to report GEC incidence and mortality trends in 2000-2015 and their predictions to 2030. METHODS: We collected GEC data from 22 cancer registries for Joinpoint temporal trend analysis between 2000 and 2015 and average annual percent change was calculated. Based on the historical changes, combined with the 2015 GEC national incidence and mortality rate, the rate from 2016 to 2030 was predicted grouped by sex and age. The crude rate, standardized rate, and cumulative rate were calculated. The number of cases were obtained by multiplying the United Nations' World Population Prospects and the predicted rate of corresponding years. Attribution changes between 2015 and 2030 were apportioned into demographics and risk factors. RESULTS: There were decreasing trends of age-standardized incidence rate world (ASIRW) and age-standardized mortality rate world (ASMRW) during 2000-2015 in China (p < 0.05), the decline was more significant for the age group of 40-49 years in men and the age group of 50-59 years in women. It was predicted that in 2030, about 549,724 new cases and 394,576 deaths of GEC would occur in China. Compared with 2015, the numbers of new GEC cases and deaths in 2030 decreased by 15.24% and 17.62%, respectively. From 2020 to 2030, GEC ASIRW and ASMRW were predicted to decline from 24.98 to 17.47 and from 17.41 to 11.82 per 100,000, respectively. The number of new cases decreased by about 15.24% with changing demographic (44.48%) and risk (-59.72%) and the number of deaths decreased by about 17.62% with changing demographic (47.18%) and risk (-64.80%). CONCLUSIONS: Although GEC incidence and mortality rates showed downward trends, the disease burden remains heavy in China. The current prevention and control strategy are effective which need to be carried on.
Asunto(s)
Neoplasias Esofágicas , Neoplasias Gástricas , Adulto , China/epidemiología , Neoplasias Esofágicas/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Rural , Neoplasias Gástricas/epidemiología , Población UrbanaRESUMEN
BACKGROUND: Family clustering of esophageal cancer (EC) has been found in high-risk areas of China. However, the relationships between cancer family history and esophageal cancer and precancerous lesions (ECPL) have not been comprehensively reported in recent years. This study aimed to provide evidence for identification of high-risk populations. METHODS: This study was conducted in five high-risk areas in China from 2017 to 2019, based on the National Cohort of Esophageal Cancer. The permanent residents aged 40 to 69 years were examined by endoscopy, and pathological examination was performed for suspicious lesions. Information on demographic characteristics, environmental factors, and cancer family history was collected. Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL. RESULTS: Among 33,008 participants, 6143 (18.61%) reported positive family history of EC. The proportion of positive family history varied significantly among high-risk areas. After adjusting for risk factors, participants with a family history of positive cancer, gastric and esophageal cancer or EC had 1.49-fold (95% confidence interval [CI]: 1.36-1.62), 1.52-fold (95% CI: 1.38-1.67), or 1.66-fold (95% CI: 1.50-1.84) higher risks of ECPL, respectively. Participants with single or multiple first-degree relatives (FDR) of positive EC history had 1.65-fold (95% CI: 1.47-1.84) or 1.93-fold (95% CI: 1.46-2.54) higher risks of ECPL. Participants with FDRs who developed EC before 35, 45, and 50 years of age had 4.05-fold (95% CI: 1.30-12.65), 2.11-fold (95% CI: 1.37-3.25), and 1.91-fold (95% CI: 1.44-2.54) higher risks of ECPL, respectively. CONCLUSIONS: Participants with positive family history of EC had significantly higher risk of ECPL. This risk increased with the number of EC positive FDRs and EC family history of early onset. Distinctive genetic risk factors of the population in high-risk areas of China require further investigation. TRIAL REGISTRATION: ChiCTR-EOC-17010553.
Asunto(s)
Neoplasias Esofágicas , Lesiones Precancerosas , Neoplasias Gástricas , Estudios de Casos y Controles , China/epidemiología , Neoplasias Esofágicas/epidemiología , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/patología , Humanos , Lesiones Precancerosas/epidemiología , Lesiones Precancerosas/genética , Lesiones Precancerosas/patología , Factores de RiesgoRESUMEN
Risk prediction models for gastric cancer could identify high-risk individuals in the general population. The objective of this study was to systematically review the available evidence about the construction and verification of gastric cancer predictive models. We searched PubMed, Embase, and Cochrane Library databases for articles that developed or validated gastric cancer risk prediction models up to November 2021. Data extracted included study characteristics, predictor selection, missing data, and evaluation metrics. Risk of bias (ROB) was assessed using the Prediction model Risk Of Bias Assessment Tool (PROBAST). We identified a total of 12 original risk prediction models that fulfilled the criteria for analysis. The area under the receiver operating characteristic curve (AUC) ranged from 0.73 to 0.93 in derivation sets (n = 6), 0.68 to 0.90 in internal validation sets (n = 5), 0.71 to 0.92 in external validation sets (n = 7). The higher-performing models usually include age, salt preference, Helicobacter pylori, smoking, body mass index, family history, pepsinogen, and sex. According to PROBAST, at least one domain with a high ROB was present in all studies mainly due to methodologic limitations in the analysis domain. In conclusion, although some risk prediction models including similar predictors have displayed sufficient discriminative abilities, many have a high ROB due to methodologic limitations and are not externally validated efficiently. Future prediction models should adherence to well-established standards and guidelines to benefit gastric cancer screening. PREVENTION RELEVANCE: Through systematical reviewing available evidence about the construction and verification of gastric cancer predictive models, we found that most models have a high ROB due to methodologic limitations and are not externally validated efficiently. Future prediction models are supposed to adherence to well-established standards and guidelines to benefit gastric cancer screening.
Asunto(s)
Helicobacter pylori , Neoplasias Gástricas , Sesgo , Detección Precoz del Cáncer , Humanos , Medición de Riesgo , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiologíaRESUMEN
Objective: The risk prediction model is an effective tool for risk stratification and is expected to play an important role in the early detection and prevention of esophageal cancer. This study sought to summarize the available evidence of esophageal cancer risk predictions models and provide references for their development, validation, and application. Methods: We searched PubMed, EMBASE, and Cochrane Library databases for original articles published in English up to October 22, 2021. Studies that developed or validated a risk prediction model of esophageal cancer and its precancerous lesions were included. Two reviewers independently extracted study characteristics including predictors, model performance and methodology, and assessed risk of bias and applicability with PROBAST (Prediction model Risk Of Bias Assessment Tool). Results: A total of 20 studies including 30 original models were identified. The median area under the receiver operating characteristic curve of risk prediction models was 0.78, ranging from 0.68 to 0.94. Age, smoking, body mass index, sex, upper gastrointestinal symptoms, and family history were the most commonly included predictors. None of the models were assessed as low risk of bias based on PROBST. The major methodological deficiencies were inappropriate date sources, inconsistent definition of predictors and outcomes, and the insufficient number of participants with the outcome. Conclusions: This study systematically reviewed available evidence on risk prediction models for esophageal cancer in general populations. The findings indicate a high risk of bias due to several methodological pitfalls in model development and validation, which limit their application in practice.
Asunto(s)
Neoplasias Esofágicas , HumanosRESUMEN
BACKGROUND: Breast cancer is the most commonly diagnosed cancer and leading cause of cancer death among women worldwide but has patterns and trends which vary in different countries. This study aimed to evaluate the global patterns of breast cancer incidence and mortality and analyze its temporal trends for breast cancer prevention and control. METHODS: Breast cancer incidence and mortality data in 2020 were obtained from the GLOBOCAN online database. Continued data from the Cancer Incidence in Five Continents Time Trends, the International Agency for Research on cancer mortality and China National Central Cancer Registry were used to analyze the time trends from 2000 to 2015 through Joinpoint regression, and annual average percent changes of breast cancer incidence and mortality were calculated. Association between Human Development Index and breast cancer incidence and mortality were estimated by linear regression. RESULTS: There were approximately 2.3 million new breast cancer cases and 685,000 breast cancer deaths worldwide in 2020. Its incidence and mortality varied among countries, with the age-standardized incidence ranging from the highest of 112.3 per 100,000 population in Belgium to the lowest of 35.8 per 100,000 population in Iran, and the age-standardized mortality from the highest of 41.0 per 100,000 population in Fiji to the lowest of 6.4 per 100,000 population in South Korea. The peak age of breast cancer in some Asian and African countries were over 10 years earlier than in European or American countries. As for the trends of breast cancer, the age-standardized incidence rates significantly increased in China and South Korea but decreased in the United States of America (USA) during 2000-2012. Meanwhile, the age-standardized mortality rates significantly increased in China and South Korea but decreased in the United Kingdom, the USA, and Australia during 2000 and 2015. CONCLUSIONS: The global burden of breast cancer is rising fast and varies greatly among countries. The incidence and mortality rates of breast cancer increased rapidly in China and South Korea but decreased in the USA. Increased health awareness, effective prevention strategies, and improved access to medical treatment are extremely important to curb the snowballing breast cancer burden, especially in the most affected countries.
Asunto(s)
Neoplasias de la Mama , Neoplasias de la Mama/epidemiología , Niño , China/epidemiología , Análisis de Datos , Femenino , Humanos , Incidencia , Sistema de Registros , Estados UnidosRESUMEN
In our study, we aimed to assess the long-term risk of gastric cardia adenocarcinoma (GCA) for patients with different histological cardia lesions to inform future guidelines for GCA screening in China. We conducted a population-based prospective study among 9740 subjects who underwent upper endoscopy screening during 2005 to 2009 and followed until December 2017. Cumulative incidence and mortality rates of GCA were calculated by the baseline histological diagnoses, and the hazard ratios (HRs), overall and by age and sex, were analyzed by Cox proportional hazards models. During a median follow-up of 10 years, we identified 123 new GCA cases (1.26%) and 31 GCA deaths (0.32%). The age-standardized incidence and mortality rates of GCA were 128.71/100 000 and 35.69/100 000 person-years, and cumulative incidence rate in patients with cardia high-grade dysplasia (CHGD), cardia low-grade dysplasia (CLGD) and atrophic carditis (AC)/cardia intestinal metaplasia (CIM) was 25%, 3.05% and 1.58%, respectively. The progression rate and cancer risk of GCA increased monotonically with each step in Correa's cascade. Individuals aged 50 to 69 years had 4.4 times higher GCA incidence than those aged 40 to 49 years. Patients with CLGD had a significantly higher 3-year GCA incidence than the normal group, while patients with AC/CIM had a comparable GCA risk during 3-year follow-up but a higher risk at 5-year intervals. Our results suggested a postponed starting age of 50 years for GCA screening, immediate treatment for patients with CHGD, a 3-year surveillance interval for patients with CLGD, and a lengthened surveillance interval of 5 years for patients with AC/CIM.
Asunto(s)
Adenocarcinoma/diagnóstico , Cardias/patología , Vigilancia de la Población/métodos , Lesiones Precancerosas/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/etnología , Adulto , Factores de Edad , Anciano , Pueblo Asiatico/estadística & datos numéricos , China/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Lesiones Precancerosas/etnología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Neoplasias Gástricas/etnología , Análisis de SupervivenciaRESUMEN
OBJECTIVE: To summarize the colorectal cancer (CRC) burden and trend in the world, and compare the difference of CRC burden between other countries and China. METHODS: Incidence and mortality data were extracted from the GLOBOCAN2018 and Cancer Incidence in Five Continents. Age-specific incidence trend was conducted by Joinpoint analysis and average annual percent changes were calculated. RESULTS: About 1.85 million new cases and 0.88 million deaths were expected in 2018 worldwide, including 0.52 million (28.20%) new cases and 0.25 million (28.11%) deaths in China. Hungary had the highest age-standardized incidence and mortality rates in the world, while for China, the incidence and mortality rates were only half of that. CRC incidence and mortality were highly correlated with human development index (HDI). Unlike the rapid increase in Republic of Korea and the downward trend in Canada and Australia, the age-standardized incidence rates by world standard population in China and Norway were rising gradually. The age-specific incidence rate in the age group of 50-59 years in China was increasing rapidly, while in Republic of Korea and Canada, the fastest growing age group was 30-39 years. CONCLUSIONS: The variations of CRC burden reflect the difference of risk factors, as well as levels of HDI and screening (early detection activities). The burden of CRC in China is high, and the incidence of CRC continues to increase, which may lead to a sustained increase in the burden of CRC in China in the future. Screening should be expanded to control CRC, and focused on young people in China.
RESUMEN
OBJECTIVE: To investigate what extent lead-time bias is likely to affect endoscopic screening effectiveness for esophageal cancer in the high-risk area in China. METHODS: A screening model based on the epidemiological cancer registry data, yielding a population-level incidence and mortality rates, was carried out to simulate study participants in the high-risk area in China, and investigate the effect of lead-time bias on endoscopic screening with control for length bias. RESULTS: Of 100,000 participants, 6,150 (6.15%) were diagnosed with esophageal squamous dysplasia during the 20-year follow-up period. The estimated lead time ranged from 1.67 to 5.78 years, with a median time of 4.62 years [interquartile range (IQR): 4.07-5.11 years] in the high-risk area in China. Lead-time bias exaggerated screening effectiveness severely, causing more than a 10% overestimation in 5-year cause-specific survival rate and around a 43% reduction in cause-specific hazard ratio. The magnitude of lead-time bias on endoscopic screening for esophageal cancer varied depending on the screening strategies, in which an inverted U-shaped and U-shaped effects were observed in the 5-year cause-specific survival rate and cause-specific hazard ratio respectively concerning a range of ages for primary screening. CONCLUSIONS: Lead-time bias, usually causing an overestimation of screening effectiveness, is an elementary and fundamental issue in cancer screening. Quantification and correction of lead-time bias are essential when evaluating the effectiveness of endoscopic screening in the high-risk area in China.
RESUMEN
OBJECTIVE: Esophageal squamous cell carcinoma (ESCC) is one of the dominant malignances worldwide, but currently there is less focus on the microbiota with ESCC and its precancerous lesions. METHODS: Paired esophageal biopsy and swab specimens were obtained from 236 participants in Linzhou, China. Data from 16S ribosomal RNA gene sequencing were processed using quantitative insights into microbial ecology (QIIME2) and R Studio to evaluate differences. The Wilcoxon rank sum test and Kruskal-Wallis rank sum test were used to compare diversity and characteristic genera by specimens and participant groups. Ordinal logistic regression model was used to build microbiol prediction model. RESULTS: Microbial diversity was similar between biopsy and swab specimens, including operational taxonomic unit (OTU) numbers and Shannon index. There were variations and similarities of esophageal microbiota among different pathological characteristics of ESCC. Top 10 relative abundance genera in all groups include Streptococcus, Prevotella, Veillonella, Actinobacillus, Haemophilus, Neisseria, Alloprevotella, Rothia, Gemella and Porphyromonas. Genus Streptococcus, Haemophilus, Neisseria and Porphyromonas showed significantly difference in disease groups when compared to normal control, whereas Streptococcus showed an increasing tendency with the progression of ESCC and others showed a decreasing tendency. About models based on all combinations of characteristic genera, only taken Streptococcus and Neisseria into model, the prediction performance was the ideal one, of which the area under the curve (AUC) was 0.738. CONCLUSIONS: Esophageal biopsy and swab specimens could yield similar microbial characterization. The combination of Streptococcus and Neisseria has the potential to predict the progression of ESCC, which is needed to confirm by large-scale, prospective cohort studies.
RESUMEN
Photoelectrocatalysis (PEC) produces high-efficiency electron-hole separation by applying a bias voltage between semiconductor-based electrodes to achieve high photocatalytic reaction rates. However, using PEC to treat polluted gas in a gas-phase reaction is difficult because of the lack of a conductive medium. Herein, we report an efficient PEC system to oxidize NO gas by using parallel photoactive composites (TiO2 nanoribbons-carbon nanotubes) coated on stainless-steel mesh as photoanodes in a gas-phase chamber and Pt foil as the working electrode in a liquid-phase auxiliary cell. Carbon nanotubes (CNTs) were utilized as conductive scaffolds to enhance the interaction between TiO2 and stainless-steel skeletons for accelerated photogenerated electron transfer. Such a PEC system exhibited super-high performance for the treatment of indoor NO gas (550 ppb) with high selectivity for nitrate under UV-light irradiation owing to the conductive, intertwined network structure of the photoanode, fast photocarrier separation, and longer photogenerated hole lifetime. The photogenerated holes were proven to be the most important active sites for directly driving PEC oxidation of indoor NO gas, even in the absence of water vapor. This work created an efficient PEC air-purification filter for treating indoor polluted air under ambient conditions.
Asunto(s)
Nanotubos de Carbono , Óxido Nítrico , Electrodos , Oxidación-Reducción , TitanioRESUMEN
Thiocyanate-based perovskite (SCN-PVSK) photodetectors have been fabricated by introducing lead thiocyanate precursor. Incorporating SCN groups into CH3NH3PbI3 can significantly improve the device stability in air. Compared with pure CH3NH3PbI3 films, SCN-PVSK films have larger grain size and reduced trap states. The perovskite layers can be prepared by a simple solution method in air. Solvent effects on the crystallization of SCN-PVSK films have also been investigated. It is found that highly uniform, pinhole-free perovskite films can be obtained utilizing the N,N-dimethylformamide (DMF) solution of Pb(SCN)2. The SCN-PVSK based photodetectors performed a high responsivity of 12.3 A/W and a decent detectivity over 1.3 × 1013 Jones. More important, the SCN-PVSK based two-terminal photodetectors, without encapsulation, have shown great stability with 92% of the initial photocurrent being retained after storage in air (relative humidity >50%) for 10 days, whereas the value is only 10% for pure CH3NH3PbI3 devices tested under the same conditions.
RESUMEN
An innovative flexible reticular photoanode (CdS-nanorods/CNTs coated on stainless iron mesh) was designed for efficiently driving photoelectrocatalytic (PEC) hydrogen (H2) evolution under visible-light irradiation. Such CdS-NRs/CNTs-based flexible photoanodes exhibited a record-breaking H2 evolution rate (728 mmol h-1 g-1) among the reported CdS-based photoanodes under visible-light irradiation owing to the photoelectron transport channels (CNTs) and high separation efficiency of electrons and holes.
RESUMEN
The outstanding performances of nanostructured all-inorganic CsPbX3 (X = I, Br, Cl) perovskites in optoelectronic applications can be attributed to their unique combination of a suitable bandgap, high absorption coefficient, and long carrier lifetime, which are desirable for photodetectors. However, the photosensing performances of the CsPbI3 nanomaterials are limited by their low charge-transport efficiency. In this study, a phototransistor with a bilayer structure of an organic semiconductor layer of 2,7-dioctyl [1] benzothieno[3,2-b] [1] benzothiophene and CsPbI3 nanorod layer was fabricated. The high-quality CsPbI3 nanorod layer obtained using a simple dip-coating method provided decent transistor performance of the hybrid transistor device. The perovskite layer efficiently absorbs light, while the organic semiconductor layer acts as a transport channel for injected photogenerated carriers and provides gate modulation. The hybrid phototransistor exhibits high performance owing to the synergistic function of the photogating effect and field effect in the transistor, with a photoresponsivity as high as 4300 A W-1, ultra-high photosensitivity of 2.2 × 106, and excellent stability over 1 month. This study provides a strategy to combine the advantages of perovskite nanorods and organic semiconductors in fabrication of high-performance photodetectors.