and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEWThe GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCEThe results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

No abstract

Several tumors exhibit pH gradient reversal, with acidification of extracellular pH (pHe) and alkalinization of intracellular pH (pHi). The pH gradient reversal is evident even during the preliminary stages of tumorigenesis and is crucial for survival and propagation of tumors, irrespective of their pathology, genetics and origins. Moreover, this hallmark seems to be present ubiquitously in all malignant tumors. Based on these facts, we propose a new emerging hallmark of cancer "pH gradient reversal". Normalizing pH gradient reversal through inhibition of various proton transporters such as Na(+)-H(+) exchanger (NHE), Vacuolar-type H(+)-ATPase (V-ATPase), H(+)/K(+)-ATPases and carbonic anhydrases (CAs) has demonstrated substantial therapeutic benefits. Indeed, inhibition of NHE1 is now being regarded as the latest concept in cancer treatment. A recent patent deals with the utilization of cis-Urocanic acid to acidify the pHi and induce apoptosis in tumors. Another patent reports therapeutic benefit by inhibiting Lactate Dehydrogenase - 5 (LDH-5) in various cancers. Several patents have been formulated by designing drugs activated through acidic pHe providing a cancer specific action. The purpose of this review is to analyze the available literature and help design selective therapies that could be a valuable adjunct to the conventional therapies or even replace them.

Background The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic.Methods To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0•03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1•0). FindingsIn 2019, there were 36•8 million (95% uncertainty interval [UI] 35•1-38•9) people living with HIV worldwide. There were 0•84 males (95% UI 0•78-0•91) per female living with HIV in 2019, 0•99 male infections (0•91-1•10) for every female infection, and 1•02 male deaths (0•95-1•10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28•52% decrease in incident cases, 95% UI 19•58-35•43, and a 39•66% decrease in deaths, 36•49-42•36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0•05 (95% UI 0•05-0•06) and the global incidence-to-mortality ratio was 1•94 (1•76-2•12). No regions met suggested thresholds for progress.Interpretation Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics.

Optical microscopy has emerged as a key driver of fundamental research since it provides the ability to probe into imperceptible structures in the biomedical world. For the detailed investigation of samples, a high-resolution image with enhanced contrast and minimal damage is preferred. To achieve this, an automated image analysis method is preferable over manual analysis in terms of both speed of acquisition and reduced error accumulation. In this regard, deep learning (DL)-based image processing can be highly beneficial. The review summarises and critiques the use of DL in image processing for the data collected using various optical microscopic techniques. In tandem with optical microscopy, DL has already found applications in various problems related to image classification and segmentation. It has also performed well in enhancing image resolution in smartphone-based microscopy, which in turn enablse crucial medical assistance in remote places. Graphical abstract

No abstract

BackgroundAccurate assessment of the depth of tumor invasion (DI) in microinvasive squamous cell carcinoma (MISCC) of the tongue is critical to prognosis. An arithmetic model is generated to determine a reliable method of measurement of DI and correlate this with the local recurrence.Material and MethodsTumor thickness (TT) and DI were measured in tissue sections of 14 cases of MISCC of the tongue, by manual ocular micrometer and digital image analysis at four reference points (A, B, C, and D). The comparison of TT and DI with relevant clinicopathologic parameters was assessed using Mann Whitney U test. Reliability of these methods and the values obtained were compared and correlated with the recurrence of tumors by Wilcoxon Signed Ranks Test. 3D reconstruction of the lesion was done on a Cartesian coordinate system. X face was on the YZ plane and Z face was on the XY plane of the coordinate system.ResultsComputer generated 3D model of oral mucosa in four cases that recurred showed increased DI in the Z coordinate compared to the XY coordinate. The median DI measurements between XY and Z coordinates in these cases showed no significant difference (Wilcoxon Signed Ranks Test, p = 0.068).ConclusionsThe assessment of DI in 3 dimensions is critical for accurate assessment of MISCC and precise DI allows complete removal of tumor. Key words:Depth of invasion, tumor thickness, microinvasive squamous cell carcinoma, tongue squamous cell carcinoma.

Neoplasms of diverse cellular origin arise in the oral cavity and among these oral squamous cell carcinoma (OSCC) arising from the mucosa of the oral cavity constitutes to over 90% 1, 2. Oral cancer encompasses all the malignancies originating in the oral tissues, including cancers of the lip, tongue, gingiva, floor of the mouth, buccal mucosa, palate and the retromolar trigone. It is the 6 th most common cancer worldwide 3. Oral squamous cell carcinoma is described as an invasive epithelial neoplasm with varying degrees of squamous differentiation and a propensity to early and extensive lymph node metastases, occurring predominantly in alcohol and tobacco using adults generally in the 5 th and 6 th decades of life. Globally about 5, 00,000 new cases of oral and oropharyngeal cancers are diagnosed and three quarters of these are from the developing world 7, 8, 9. Approximately 3, 89,650 cases occurred in the year 2000 out of which 2, 66,672 were in the oral cavity (ICD-9 140-5) and 1, 22,978 for the cancer of oropharynx (ICD-9 146, 8-9). This represented about 5% of all cancers for men and 2% for women 10. Oral and oropharyngeal cancers remain one of the more common cancers in the South and South East Asian countries, as opposed to Western society, where it accounts for only about 1-4% of the of reported cancers incidence 4. For example, the incidence of oral cancer in India is high, constituting about 12% of all cancer in men and 8% in women 5 ; mortality rate is equally high in this population, ranking number one in men and number three in women 6. Oral and oropharyngeal cancers therefore qualify as major public health problem, not only in India, but also globally. Worldwide, oral cancer incidence rates appear to have been stabilizing over the last decade 12 , but the greater frequency of oral cancer in certain regions and among specific populations is a cause for concern since their overall 5-year survival rate is 53% and it has not changed in the last two decades 13. With this heightened awareness, research to further investigate the detection, diagnosis and prevention or oral cancer has recently been included as one of the targeted priorities supported by the National Institute of Dental and Craniofacial Research (NIDR) in the United States 14. The overall 5-year survival rate for patients without clinically evident cervical lymph node metastases is 85%. However, patients with microscopic lymph node metastases have a survival rate of 54%. It has been estimated that 20-50% of patients without clinically evident cervical lymph node metastases do in fact have microscopic metastases and therefore poorer www.intechopen.com Oral Cancer 48 prognosis 87. Among the Indian population, the overall 5-year observed and relative survival rates were 30.5% and 39.7%, respectively. Survival steadily declined with advancing age and advanced clinical stages. 5-year observed survival was 59.1% for localized cancer, 15.7% for cancers with regional extension and 1.6% for those with distant metastasis. Those with tongue, buccal mu...