Global Burden of Disease Cancer Collaboration 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 equ...

The present study investigated the relation between academic performance and ratings of executive functioning in children aged 6–11 from four countries: Sweden, Spain, Iran, and China. Ratings of executive functioning were made by both parents and teachers using the Childhood Executive Functioning Inventory (CHEXI). The results showed that the Chinese sample was generally rated as having more executive deficits compared to the other samples. The finding that executive functioning deficits are exacerbated in China is most likely the result of cultural biases. Boys were generally rated as having poorer executive functioning compared to girls, except in Iran where parents, but not teachers, rated girls as having poorer executive functioning compared to boys. However, this opposite pattern of results found for Iran is not likely to reflect true gender differences in executive functioning. Despite some differences in the levels of executive functioning across countries, both the inhibition and working memory subscales of the CHEXI were related to academic achievement in all four countries, except for CHEXI parent ratings in China. Altogether, the results indicate that the CHEXI may be used as a screening measure for early academic difficulties, although cultural biases clearly have to be taken into consideration.

Objectives Obstructive sleep apnea (OSA) is a major health problem that has been associated with endocrine dysfunction in the hypothalamic‐pituitary‐gonadal (HPG) and hypothalamic‐pituitary‐adrenal (HPA) axes. This study investigated cortisol, testosterone, and the testosterone/cortisol ratio in patients with OSA compared to normal sleepers. Methods Thirty‐nine OSA patients diagnosed by overnight polysomnography (PSG) were divided into three groups, including ten mild OSA patients, 16 patients with moderate OSA, and 13 patients with severe OSA according to the apnea‐hypopnea index (AHI). In addition, 13 normal sleepers with normal PSG findings were recruited as the control group. Serum levels of cortisol, testosterone, and sex hormone‐binding globulin (SHBG) were measured using enzyme‐linked immunosorbent assay (ELISA). Results There were no significant differences between the normal sleepers and the three subtypes of OSA in terms of total and free testosterone levels (P > .1). The results showed significantly higher levels of cortisol in the severe OSA group compared to the normal sleepers and the two other subtypes of OSA (P < .01). In addition, the testosterone/cortisol (T/C) ratio was significantly lower among the severe OSA compared to the moderate OSA patients (P = .01). A significant correlation was observed between minimal SpO2 and AHI (r=−0.69, P < .01), cortisol and AHI (r = .47, P < .01) and cortisol and minimal SpO2 (r = −.26, P = .06). Conclusion According to the findings, OSA is linked to HPA axis activity in severe OSA patients but not among the mild and moderate subtypes of the disorder.

Background: We compared the density and duration of sleep spindles topographically in stage 2 and 3 of non-rapid eye movement sleep (N2 and N3) among adults diagnosed with Obstructive Sleep Apnea Syndrome (OSAS) and healthy controls.Materials and Methods: Thirty-one individuals with OSAS (mean age: 48.50 years) and 23 healthy controls took part in the study. All participants underwent a whole night polysomnography. Additionally, those with OSAS were divided into mild, moderate and severe cases of OSAS.Results: For N2, sleep spindle density did not significantly differ between participants with and without OSAS, or among those with mild, moderate and severe OSAS. For N3, post-hoc analyses revealed significantly higher spindle densities in healthy controls and individuals with mild OSAS than in those with moderate or severe OSAS. Last, in N2 a higher AHI was associated with a shorter sleep spindle duration.Conclusion: OSAS is associated with a significantly lower spindle density in N3 and a shorter spindle duration in N2. Our results also revealed that, in contrast to moderate and severe OSAS, the sleep spindle characteristics of individuals with mild OSAS were very similar to those of healthy controls.

Context: Preforming an adequate and effective dialysis is essential to improve patients' quality-of-life and decrease the complications of kidney failure. However, evidence regarding the effectiveness of dialysis among Iranian patients undergoing hemodialysis is inconclusive. The current study aimed at evaluating the effectiveness of dialysis in Iranian patients undergoing hemodialysis using a systematic approach. Evidence Acquisition: In the current meta-analysis, the search was performed using the keywords "Adequacy of Dialysis" and "Hemodialysis Adequacy" in SID, MagIran, ISI/Web of Science, PubMed, and Scopus databases from inception to July 2018. According to the heterogeneity of the studies, the data were analyzed using the random effects model with STATA version 14. Results: The mean urea kinetic modeling (Kt/V) and urea reduction ratio (URR) in Iranian patients undergoing hemodialysis were 1.11% (95% confidence interval (CI): 1.03-1.81) and 59.94% (95% CI: 58.33-61.54), respectively. There was no correlation between indices of dialysis adequacy, sample size, mean age of samples, and year of the paper publication. However, Kt/V and URR in articles with high methodological quality were higher than the ones with moderate methodological quality. Conclusions: The mean adequacy of dialysis indices among Iranian patients was below the standard levels and it is necessary to consider measures to improve dialysis efficacy.

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The 1987 to 2019 Tennant Creek earthquake sequence comprises three 1988 surface-rupturing mainshocks (moment magnitude (Mw 6.2, 6.3, and 6.5) that occurred within a 12-hour period, a preceding foreshock sequence commencing in 1987, and a prolonged aftershock sequence including a Mw 5.0 earthquake on the 1st August 2019. Each surface rupturing event produced a distinct scarp; the south-dipping Kunayungku scarp, north-dipping Lake Surprise west scarp and south-dipping Lake Surprise east scarp. Fault geometries were confirmed by trenches across the rupture traces, levelling surveys across the rupture traces, newly acquired satellite-derived high-resolution elevation data, and well-located aftershocks. Focal mechanisms and modelling using available seismic data support the hypothesis that the first mainshock ruptured the Kunayungku fault, the second mainshock ruptured the Lake Surprise west fault (and potentially rupturing across multiple other blind faults), and the third mainshock ruptured the Lake Surprise east fault. Trenching across all three ruptures found no evidence of prior rupture along the Lake Surprise east and Kunayungku faults. Potential evidence of prior rupture on the Lake Surprise west scarp has been reported. However, we consider this evidence to be circumstantial and to equally support an alternative interpretation; that the pre-1988 topography relates to a paleo-channel along underlying bedrock topography. Surface rupture locations and orientations are strongly aligned to underlying linear geophysical anomalies, suggesting strong control of bedrock structure on contemporary seismicity. Almost 31 years after the initial sequence, a Mw 5.0 aftershock was recorded near the western tip of the West Lake Surprise rupture. InSAR fault modelling suggests this occurred on a shallow blind fault (&lt; 2 km depth to top of fault). This structure is also aligned with linear geophysical anomalies, providing further support that pre-existing basement structures are providing strong controls on the location and geometry of faulting in this intraplate stable continental region.

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