Cancer survival statistics in China 2019-2021:a multicenter,population-based study

Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survival for all cancers combined and 25 specific cancer types in China from 2019 to 2021.Methods:We conducted standardized data collection and quality control for cancer registries across 32 provincial-level regions in China,and included 6,410,940 newly diagnosed cancer patients from 281 cancer registries during 2008-2019,with follow-up data on vital status available until December 2021.We estimated the age-standardized 5-year relative survival overall and by site,age group,and period of diagnosis using the International Cancer Survival Standard Weights,and quantified the survival changes to assess the progress in cancer control.Results:In 2019-2021,the age-standardized 5-year relative survival for all cancers combined was 43.7%(95%confidence interval[CI],43.6-43.7).The 5-year relative survival varied by cancer type,ranging from 8.5%(95%CI,8.2-8.7)for pancreatic cancer to 92.9%(95%CI,92.4-93.3)for thyroid cancer.Eight cancers had 5-year survival of over 60%,including cancers of the thyroid,breast,testis,bladder,prostate,kidney,uterus,and cervix.The 5-year relative survival was generally lower in males than in females.From 2008 to 2021,we observed significant survival improvements for cancers of the lung,prostate,bone,uterus,breast,cervix,nasopharynx,larynx,and bladder.The most significant improvement was in lung cancer.Conclusions:Progress in cancer control was evident in China.This highlights the importance of a comprehensive approach to control and prevent cancer.

Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates

Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of PCa.We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality rates.Methods:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser enucleation.Patients were stratified according to postoperative diagnosis(PCa vs.BPH).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was performed.Results:Overall,34542 patients were included.Of all,2008(5.8%)had a diagnosis of PCa.The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were found.Additionally,all tests failed to show an interaction between post-operative diagnosis and surgical technique used.Conclusion:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts.Moreover,the diagnosis seems to not influence surgical technique outcomes.

Ensemble of Population-Based Metaheuristic Algorithms

No optimization algorithm can obtain satisfactory results in all optimization tasks.Thus,it is an effective way to deal with the problem by an ensemble ofmultiple algorithms.This paper proposes an ensemble of population-based metaheuristics(EPM)to solve single-objective optimization problems.The design of the EPM framework includes three stages:the initial stage,the update stage,and the final stage.The framework applies the transformation of the real and virtual population to balance the problem of exploration and exploitation at the population level and uses an elite strategy to communicate among virtual populations.The experiment tested two benchmark function sets with fivemetaheuristic algorithms and four ensemble algorithms.The ensemble algorithms are generally superior to the original algorithms by Friedman’s average ranking andWilcoxon signed ranking test results,demonstrating the ensemble framework’s effect.By solving the iterative curves of different test functions,we can see that the ensemble algorithms have faster iterative optimization speed and better optimization results.The ensemble algorithms cannot fall into local optimumby virtual populations distribution map of several stages.The ensemble framework performs well from the effects of solving two practical engineering problems.Some results of ensemble algorithms are superior to those of metaheuristic algorithms not included in the ensemble framework,further demonstrating the ensemble method’s potential and superiority.

The Distribution Population-based Genetic Algorithm for Parameter Optimization PID Controller

Enlightened by distribution of creatures in natural ecology environment, the distributionpopulation-based genetic algorithm (DPGA) is presented in this paper. The searching capability ofthe algorithm is improved by competition between distribution populations to reduce the search zone.This method is applied to design of optimal parameters of PID controllers with examples, and thesimulation results show that satisfactory performances are obtained.

Factors associated with gastric adenocarcinoma and dysplasia in patients with chronic gastritis:a population-based study

Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.

Favorable clinical outcome of nonalcoholic liver cirrhosis patients with coronary artery disease:A population-based study

AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.

A population-based follow-up study on gallstone disease among type 2 diabetics in Kinmen,Taiwan

AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.

Global pattern and trends of colorectal cancer survival: a systematic review of population-based registration data

This review will describe the global patterns and trends of colorectal cancer survival,using data from the population-based studies or cancer registration.We performed a systematic search of China National Knowledge Infrastructure(CNKI),Wanfang Data,PubMed,Web of Science,EMBASE,and SEER and collected all population-based survival studies of colorectal cancer(up to June 2020).Estimates of observed and relative survival rates of colorectal cancer by sex,period,and country were extracted from original studies to describe the temporal patterns and trends from the late 1990s to the early 21st century.Globally,5-year observed survival rates were higher in Seoul,Republic of Korea(1993–1997;56.8%and 54.3%for colon and rectum cancers,respectively),Zhejiang province(2005–2010;52.9%for colon cancer),Tianjin(1991–1999;52.5%for colon cancer),Shanghai(2002–2006;50.0%for rectum cancer)of China,and in Japan(1993–1996,59.6%for colorectal cancer).Five-year relative survival rates of colorectal cancer in the Republic of Korea(2010–2014),Queensland,Australia(2005–2012),and the USA(2005–2009)ranked at relatively higher positions compared to other countries.In general,colorectal cancer survival rates are improving over time worldwide.Sex disparities in survival rates were also observed in the colon,rectum,and colorectal cancers in most countries or regions.The poorest age-specific 5-year relative survival rate was observed in patients>75 years of age.In conclusion,over the past 3 decades,colorectal cancer survival has gradually improved.Geographic variations,sex differences,and age gradients were also observed globally in colorectal cancer survival.Further studies are therefore warranted to investigate the prognostic factors of colorectal cancer.

Have patients with esophagitis got an increased risk of adenocarcinoma? Results from a population-based study

AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.

Prevalence and predictors of hospitalization in Crohn's disease in a prospective population-based inception cohort from 2000-2012

AIM: To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem province.METHODS: Data of 331 incident Crohn's disease(CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed(median age at diagnosis: 28; IQR: 21-40 years). Both in- and outpatient records were collected and comprehensively reviewed.RESULTS: Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%,53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures(37%), surgery or disease activity(27% and 21%). Non-inflammatory disease behavior at diagnosis(HR = 1.32, P = 0.001) and perianal disease(HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change(HR = 2.38, P = 0.002) and need for steroids(HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate analyses.Early CD-related hospitalization(within the year of diagnosis) was independently associated with need for immunosuppressives(OR = 2.08, P = 0.001) and need for surgeries(OR = 7.25, P < 0.001) during the disease course.CONCLUSION: Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and rehospitalization.

Cost-benefit analysis of screening for diabetic retinopathy among Chinese type 2 diabetes: decision from different perspectives of a population-based study

The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.

Population-Based and Personalized Design of Total Knee Replacement Prosthesis for Additive Manufacturing Based on Chinese Anthropometric Data

At present,most total knee replacement(TKR)prostheses on the market are designed according to the sizes of Caucasians.However,extensive studies have indicated that human anatomies differ among different ethnicities.A number of reports have indicated that Chinese TKR patients do not match with available prostheses.In this study,computed tomography(CT)images of 52 knees of Chinese men and women were used for anthropometric measurements.Index and geometric measurements were definedand used for correlation analysis.Key parameters from the measurement results were identified.Detailed geometries of knees were measured as coordinates.A deformable three-dimensional(3D)knee modelbased on anatomical coordinates correlating with the identified key parameters was generated.A pros-thesis was then designed according to the analyzed results.Surface matching analysis,bone resectionanalysis,and cadaveric trials were conducted and compared with commercial products to validate theproposed design.The femoral component designed by this study resulted in the highest accuracy(rootmean square point-to-surface(RMS PS),(1.08±0.20)mm)and lowest amount of resected bone volume(27412mm^(3))in comparison with two commercial knee prostheses.This study suggests a new approachfor population-based patient-specific femoral prosthesis design With a single,easilty acquired dimen-sion-namely,epicondyle width(ECW)-as input,a patient-specific femoral prosthesis can be designed according to the analyzed measured data and manufactured by additive manufacturing(AM)methods.Meanwhile,the reconstructed femoral condylar surface was compared with the femoral condylar surfacein the original CT scanning data The average RMS PS distance of the reconstructed femoral condylar surface among all data was(1.10±0.18)mm,which is comparable to other statistical shape modeling methods using multiple radiographs as input data.There is a need to develop an anthropometric-based knee prosthesis for the Chinese population.Based on the anthropometry of the Chinese population,our new design fits Chinese patients better and reserves more bone volume compared with current commercial prostheses,which is an essential step toward AM for personalized knee prostheses.

Uptake of prostate cancer screening and associated factors among Chinese men aged 50 or more: a population-based survey

Objective: To investigate the uptake rate of prostate specific antigen(PSA) testing among Hong Kong Chinese males aged 50 or above, and identify factors associated with the likelihood of undergoing a PSA test.Methods: A population-based telephone survey was conducted in Hong Kong in 2007. The survey covered demographic information, perceived health status, use of complementary therapy, cancer screening behavior, perceived susceptibility to cancer and family history of cancer. Descriptive statistics, percentages and logistic regression analysis were used for data analysis.Results: A total of 1,002 men aged 50 or above took part in the study(response rate =67%), and the uptake rate of PSA testing was found to be 10%. Employment status, use of complementary therapy, perceiving regular visits to a doctor as good for health and the recommendations of health professionals were significant factors associated with PSA testing.Conclusion: The uptake rate of PSA testing in the study population was very low. Among all the factors identified, recommendations from health professionals had the strongest association with the uptake of PSA testing, and they should therefore take an active role in educating this population about cancer prevention and detection.

Combined Influence of Insulin Resistance and Inflammatory Biomarkers on Type 2 Diabetes:A Population-based Prospective Cohort Study of Inner Mongolians in China

This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.

Internet-based data inclusion in a population-based European collaborative follow-up study of inflammatory bowel disease patients: Description of methods used and analysis of factors influencing response rates

AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the influence of demographic and disease related patient characteristics on response rates. METHODS： Thirteen years ago, the European Collaborative study group of IBD （EC-IBD） initiated a population-based prospective inception cohort of 2 201 uniformly diagnosed IBD patients within 20 well- described geographical areas in 11 European countries and Israel. For the 10-year follow-up of this cohort, an electronic patient questionnaire （ePQ） and electronic physician per patient follow-up form （ePpPFU） were designed as two separate data collecting instruments and made available through an Internet-based website. Independent demographic and clinical determinants of ePQ participation were analyzed using multivariate logistic regression.total number of 1 505 （64%） available IBD patients, originating from 13 participating centers from nine different countries, both ePQ and ePpPFU were completed. Patients older than 40 years at ePQ completion （OR： 1.53 （95% CI： 1.14-2.05）） and those with active disease during the 3 mo previous to ePQ completion （OR： 3.32 （95%CI： 1.57-7.03）） were significantly more likely to respond. CONCLUSION： An Internet-based data acquisition tool appeared successful in sustaining a unique Western- European and Israelian multi-center 10-year clinical follow-up study project in patients afflicted with IBD.

Short-term effect of physical activity on sleep health:A population-based study using accelerometry

Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.

Nomograms for Predicting Cancer-Specific Survival of Patients with Gingiva Squamous Cell Carcinoma:A Population-Based Study

The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.

MCWOA Scheduler:Modified Chimp-Whale Optimization Algorithm for Task Scheduling in Cloud Computing

Cloud computing provides a diverse and adaptable resource pool over the internet,allowing users to tap into various resources as needed.It has been seen as a robust solution to relevant challenges.A significant delay can hamper the performance of IoT-enabled cloud platforms.However,efficient task scheduling can lower the cloud infrastructure’s energy consumption,thus maximizing the service provider’s revenue by decreasing user job processing times.The proposed Modified Chimp-Whale Optimization Algorithm called Modified Chimp-Whale Optimization Algorithm(MCWOA),combines elements of the Chimp Optimization Algorithm(COA)and the Whale Optimization Algorithm(WOA).To enhance MCWOA’s identification precision,the Sobol sequence is used in the population initialization phase,ensuring an even distribution of the population across the solution space.Moreover,the traditional MCWOA’s local search capabilities are augmented by incorporating the whale optimization algorithm’s bubble-net hunting and random search mechanisms into MCWOA’s position-updating process.This study demonstrates the effectiveness of the proposed approach using a two-story rigid frame and a simply supported beam model.Simulated outcomes reveal that the new method outperforms the original MCWOA,especially in multi-damage detection scenarios.MCWOA excels in avoiding false positives and enhancing computational speed,making it an optimal choice for structural damage detection.The efficiency of the proposed MCWOA is assessed against metrics such as energy usage,computational expense,task duration,and delay.The simulated data indicates that the new MCWOA outpaces other methods across all metrics.The study also references the Whale Optimization Algorithm(WOA),Chimp Algorithm(CA),Ant Lion Optimizer(ALO),Genetic Algorithm(GA)and Grey Wolf Optimizer(GWO).

Impact of Diabetes Mellitus on the Treatment Outcomes of Chemotherapy in Women with Breast Cancer——A Population-Based Prospective Cohort Study

There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.

Receded near point of convergence as a predictor of mild cognitive impairment in the general geriatric population:results from a population-based study

AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.