King Saud University

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

IMPORTANCE: Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE: To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW: Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS: In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (-6.1% [95% uncertainty interval (UI), -10.6% to -1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE: As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017

Importance Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study

The Medicago genome provides insight into the evolution of rhizobial symbioses

Sequencing of Medicago truncatula, a model organism of legume biology, shows that genome duplications had a role in the evolution of endosymbiotic nitrogen fixation. Legumes are unusual among plants in that they can carry out endosymbiotic nitrogen fixation with rhizobial bacteria. The genome of Medicago truncatula (also known as barrel medic or barrel clover), a well-established model for the study of legume biology, has now been sequenced. Genome analysis shows that M. truncatula has undergone several rounds of whole-genome duplication, and that the duplication that took place approximately 58 million years ago played an important part in the evolution of endosymbiotic nitrogen fixation. Legumes (Fabaceae or Leguminosae) are unique among cultivated plants for their ability to carry out endosymbiotic nitrogen fixation with rhizobial bacteria, a process that takes place in a specialized structure known as the nodule. Legumes belong to one of the two main groups of eurosids, the Fabidae, which includes most species capable of endosymbiotic nitrogen fixation1. Legumes comprise several evolutionary lineages derived from a common ancestor 60 million years ago (Myr ago). Papilionoids are the largest clade, dating nearly to the origin of legumes and containing most cultivated species2. Medicago truncatula is a long-established model for the study of legume biology. Here we describe the draft sequence of the M. truncatula euchromatin based on a recently completed BAC assembly supplemented with Illumina shotgun sequence, together capturing ∼94% of all M. truncatula genes. A whole-genome duplication (WGD) approximately 58 Myr ago had a major role in shaping the M. truncatula genome and thereby contributed to the evolution of endosymbiotic nitrogen fixation. Subsequent to the WGD, the M. truncatula genome experienced higher levels of rearrangement than two other sequenced legumes, Glycine max and Lotus japonicus. M. truncatula is a close relative of alfalfa (Medicago sativa), a widely cultivated crop with limited genomics tools and complex autotetraploid genetics. As such, the M. truncatula genome sequence provides significant opportunities to expand alfalfa’s genomic toolbox.

A Multicountry Study on Nursing Students’ Self‐Perceived Competence and Barriers to Evidence‐Based Practice

BACKGROUND: Nursing education and training are essential in the attainment of evidence-based practice (EBP) competence in nursing students. Although there is a growing literature on EBP among nursing students, most of these studies are confined to a single cultural group. Thus, cross-cultural studies may provide shared global perspectives and theoretical understandings for the advancement of knowledge in this critical area. AIMS: This study compared self-perceived EBP competence among nursing students in four selected countries (India, Saudi Arabia, Nigeria, and Oman) as well as perceived barriers to EBP adoption. METHODS: A descriptive, cross-sectional, and comparative survey of 1,383 nursing students from India, Saudi Arabia, Nigeria, and Oman participated in the study. The Evidence-Based Practice Questionnaire (EBP-COQ) and the BARRIERS scale were used to collect data during the months of January 2016 to August 2017. RESULTS: Cross-country comparisons revealed significant differences in EBP competence (F = 24.437, p < .001), knowledge (F = 3.621, p = .013), skills (F = 9.527, p < .001), and attitudes (F = 74.412, p < .001) among nursing students. Three variables including nursing students' gender (β = .301, p < .001), type of institution, (β = -0.339, p = .001), and type of nursing student (β = .321, p < .001) were associated with EBP competence. Barriers to EBP adoption included having no authority to change patient care policies (M = 1.65, SD = 1.05), slow publication of evidence (M = 1.59, SD = 1.01), and paucity of time in the clinical area to implement the evidence (M = 1.59, SD = 1.05). LINKING EVIDENCE TO ACTION: Both academe and hospital administration can play a pivotal role in the successful acquisition of EBP competence in nursing students.

Exploring the peakon solitons molecules and solitary wave structure to the nonlinear damped Kortewege–de Vries equation through efficient technique

Abstract This work examined solitary wave solutions to the nonlinear damped Korteweg–de Vries equation by employing the new auxiliary equation approach. The physical structure to the secured solutions visualized in dark solitons, bright solitons, periodic solitons, kink and anti-kink wave solitons, peakon bright and dark solitons, and dispersive solitary waves. The physical interpretation of constructed solutions is visually portrayed using two-dimensional, three-dimensional, and contour plots on the basis of numerical simulation, which help comprehend the physical features of nonlinear behaviour for the solitary waves. The explored solutions will be play important role in Mathematical physics, ion-acoustic waves, dust-acoustic waves, and plasma physics. This study has demonstrated that our suggested method is more beneficial, successful, strong and effective for studying analytically various nonlinear partial differential equations (NLPDEs) that arise in mathematical physics, engineering, plasma physics, and many other scientific fields.

Exploring the optical soliton and solitary wave solutions for the nonlinear Akbota equation via improved expansion approach

In the present research, we explored the various kinds of optical solitons and many other solitary wave solutions for the nonlinear Akbota equation by utilizing the symbolic computational simulation on the basis of the improved F-expansion approach. The nonlinear Akbota equation has applications in physics and engineering. The examined solitary wave and soliton solutions have interesting physical structures, including anti-kink wave solitons, bright solitons, kink wave solitons, dark solitons, periodic wave solitons, peakon bright solitons, peakon dark solitons, mixed bright–dark periodic solitons, mixed solitons in bright–dark form, and solitary wave structures. The newly extracted soliton solutions in this study shed light on the fact that the utilized approach is more efficient, concise, powerful, effective, straightforward, and simple, and we can also utilize it for other higher order nonlinear complex models. The extracted solutions will be helpful to understand the nonlinear phenomena in various areas of nonlinear sciences and engineering, including quantum physics, laser optics, nonlinear optics, optical fibers, ocean engineering, and electronic engineering. The physical interpretation of the extracted solutions is visualized in two-dimensional, three-dimensional, and contour graphics based on numerical simulation by using the computer software Mathematica. The presented research will be helpful for further investigation of analytical solitary wave and soliton solutions to the complex, higher order nonlinear evolution equations.

Proton transparency and neutrino physics: New methods and modeling

Extracting accurate results from neutrino oscillation and cross section experiments requires accurate simulation of the neutrino-nucleus interaction. The rescattering of outgoing hadrons (final state interactions) by the rest of the nucleus is an important component of these interactions. We present a new measurement of proton transparency (defined as the fraction of outgoing protons that emerge without significant rescattering) using electron-nucleus scattering data recorded by the CLAS detector at Jefferson Laboratory on helium, carbon, and iron targets. This analysis uses a new data-driven method to extract the transparency. It defines transparency as the ratio of electron-scattering events with a detected proton to quasi-elastic electron-scattering events where a proton should have been knocked out. Our results are consistent with previous measurements that determined the transparency from the ratio of measured events to theoretically predicted events. We find that the GENIE event generator, which is widely used by oscillation experiments to simulate neutrino-nucleus interactions, needs to better describe both the nuclear ground state and proton rescattering in order to reproduce our measured transparency ratios, especially at lower proton momenta.