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At least 19 records

Autoignition of CRC diesel surrogates at low temperature combustion conditions: Rapid compression machine experiments and modeling

As federal programs require increasingly stringent engine emissions and fuel economy standards, these ambitions can only be met if next-generation combustion technology is developed focusing on high-efficiency and low-emissions engines. Recent research has indicated the need to operate engines at higher compression ratios and with low temperature combustion (LTC) to achieve the needed gains in engine efficiency and reductions in emissions. Because there is a lack of understanding of the chemistry of diesel fuel components and their mixtures at these LTC conditions, this limits the ability to develop predictive chemical kinetic models that can be used to optimize engine combustion. The current study aims to fill in gaps in fundamental combustion data on surrogate fuel mixtures relevant to diesel fuels. Specifically, four multicomponent diesel surrogates formulated by the Coordinating Research Council (CRC) to emulate an ultra-low-sulfur research-grade #2 certification diesel fuel (CFA), namely V0a (4 components), V0b (5 components), V1 (8 components), and V2 (9 components), have been investigated in a rapid compression machine (RCM) through determination of total and first-stage ignition delay times. Autoignition characteristics of lean to rich fuel/O 2 /N 2 mixtures, for the four CRC surrogates and CFA, have been measured using an RCM at LTC relevant pressures and temperatures, in the ranges of 10–20 bar and 650–1000 K, respectively. The equivalence ratios have been varied by independently changing the oxygen mole fraction and the fuel mole fraction in the test mixtures, thereby illustrating the individual effects of oxygen concentration and fuel loading on diesel autoignition. Autoignition results of these four CRC surrogates are compared among them and with those of CFA. Some degree of agreement in autoignition response between each CRC surrogate and CFA is observed, while discrepancies are also identified and discussed. In addition, a detailed chemical kinetic model for diesel surrogates has been developed and validated against these newly-acquired RCM data. We find that this model shows reasonable agreement with the overall ignition delay time results of the current RCM experiments. Chemical kinetic analyses of the developed model were further conducted to help identify the reactions controlling the autoignition processes and the consumption of fuel components in CRC surrogates.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Materials Data on CrC by Materials Project

CrC is Halite, Rock Salt structured and crystallizes in the cubic Fm-3m space group. The structure is three-dimensional. Cr3+ is bonded to six equivalent C3- atoms to form a mixture of edge and corner-sharing CrC6 octahedra. The corner-sharing octahedral tilt angles are 0°. All Cr–C bond lengths are 2.05 Å. C3- is bonded to six equivalent Cr3+ atoms to form a mixture of edge and corner-sharing CCr6 octahedra. The corner-sharing octahedral tilt angles are 0°.

36 MATERIALS SCIENCE↗

Materials Data on CrC by Materials Project

CrC is Tungsten Carbide structured and crystallizes in the hexagonal P-6m2 space group. The structure is three-dimensional. Cr3+ is bonded to six equivalent C3- atoms to form a mixture of distorted edge, face, and corner-sharing CrC6 pentagonal pyramids. All Cr–C bond lengths are 2.04 Å. C3- is bonded to six equivalent Cr3+ atoms to form a mixture of distorted edge, face, and corner-sharing CCr6 pentagonal pyramids.

36 MATERIALS SCIENCE↗

Seismic monitoring of a small CO 2 injection using a multi-well DAS array: Operations and initial results of Stage 3 of the CO 2 CRC Otway project

Active time-lapse seismic is widely employed for monitoring CO 2 geosequestration due to its ability to track the distribution of fluids in space and time. However, standard 4D seismic monitoring suffers from several challenges, including high cost, disruption to other land uses, and, consequently, relatively large intervals between monitor surveys. Some of these challenges can be mitigated using permanently installed sources and receivers. Such an approach was tested at the CO 2 CRC Otway site by continuous offset VSP monitoring of 15,000 t of supercritical CO 2 injected into an aquifer 1,500 m deep with nine permanent seismic sources (surface orbital vibrators or SOVs) and five downhole fibre-optic receivers. This continuous monitoring is complemented by multi-well 4D VSP using a mobile vibroseis source and the same DAS receivers, which included one baseline and two monitor surveys after injection of 4,000 and 12,000 t of CO 2 . The continuous DAS-SOV monitoring detected an abrupt increase of travel times below the injection interval on the second day of injection (after injection of 300 t of CO 2 ) and tracked the growth of the areal CO 2 plume by mapping changes of reflection amplitudes. The plume is also detected by time-lapse changes of reflection amplitudes in multi-well 4D VSPs. The plume images obtained from continuous offset VSP and 4D VSP are broadly consistent with each other but with some differences due to differences in illumination, lateral variations of velocities and seismic anisotropy. Furthermore, these differences also serve as a measure of uncertainty of 4D VSP images.

4D VSP↗

Status of the Olympus experiment at CRC

The status of the Olympus Propagation Experiment of the Communications Research Centre in Ottawa, Canada, is briefly summarized. Path attenuation measurements at multiple frequencies correlated with concurrent dual polarized radar data provide a unique method to investigate propagation effects. An experiment of this type is being implemented by the Communications Research Centre (CRC) on the grounds of the National Research Council of Canada in Ottawa. Beacon receivers monitor signals from the Olympus satellite at 12.5, 19.77, and 29.66 GHz at a path elevation angle of 14.2 deg. Sky noise radiometers operating near the same frequencies and pointed along the same path provide additional propagation information. A colocated dual-polarized 9.6-GHz radar probes the precipitation state on the path, permitting identification of precipitation regimes that cause the observed impairments. The Olympus experiment configuration is displayed pictorially. Information on path propagation phenomena can be deduced by correlating the radar, beacon, and sky noise data. Melting layer effects and propagation losses for higher time percentages are prime interests. Data collected by Diversitel Communications during equipment verification tests are presented.

Rogers, David V.↗

Materials Data on U(CrC)4 by Materials Project

UCr4C4 crystallizes in the tetragonal I4/m space group. The structure is three-dimensional. U4+ is bonded in a body-centered cubic geometry to eight equivalent C4- atoms. All U–C bond lengths are 2.52 Å. Cr3+ is bonded to four equivalent C4- atoms to form a mixture of corner and edge-sharing CrC4 trigonal pyramids. There is two shorter (1.95 Å) and two longer (1.96 Å) Cr–C bond length. C4- is bonded to two equivalent U4+ and four equivalent Cr3+ atoms to form a mixture of distorted corner, edge, and face-sharing CU2Cr4 octahedra. The corner-sharing octahedra tilt angles range from 0–69°.

36 MATERIALS SCIENCE↗

Materials Data on V(CrC)2 by Materials Project

VCr2C2 crystallizes in the orthorhombic Cmcm space group. The structure is three-dimensional. V2+ is bonded to four C4- atoms to form corner-sharing VC4 tetrahedra. There is two shorter (1.98 Å) and two longer (2.01 Å) V–C bond length. Cr3+ is bonded in a 5-coordinate geometry to five C4- atoms. There are a spread of Cr–C bond distances ranging from 1.99–2.50 Å. There are two inequivalent C4- sites. In the first C4- site, C4- is bonded in a 6-coordinate geometry to two equivalent V2+ and six equivalent Cr3+ atoms. In the second C4- site, C4- is bonded to two equivalent V2+ and four equivalent Cr3+ atoms to form a mixture of corner and edge-sharing CV2Cr4 octahedra. The corner-sharing octahedral tilt angles are 53°.

36 MATERIALS SCIENCE↗

Analyzing Potential Greenhouse Gas Emissions Reductions from Plug-In Electric Vehicles: Report for CRC Project, "Carbon Return on Investment for Electrified Vehicles"

Investment in battery and electrification technologies has the potential to greatly reduce vehicular greenhouse gas (GHG) emissions, as a battery-electric vehicle (BEV) will have zero tailpipe emissions. However, there will be GHG emissions associated with production of the vehicle including its battery, and with any carbon-emitting electricity sources used to charge the vehicle. This study explores the GHG reduction benefits of different plug-in electric vehicle (PEV) designs in the context of factors such as electricity production mix, per-vehicle battery requirements, and varying battery market growth scenarios. The analyses focus on the U.S. light-duty vehicle (LDV) market, which accounts for nearly 60% of U.S. transportation sector GHG emissions - over twice as much as the next largest contributing transportation sub-sector.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

NFATc1 promotes epithelial-mesenchymal transition and facilitates colorectal cancer metastasis by targeting SNAI1

Highlights: • Metastasis remains a major cause of colorectal cancer (CRC) mortality. • In this study, we examined the role of nuclear factor of activated T cells 1 (NFATc1), which showed increased expression in metastatic CRC tissues and positively correlated with CRC clinical stages. • Mechanistically, SNAI1 was transcriptionally activated by NFATc1 and interacted with SLUG to promote EMT and CRC metastasis. • Calcineurin-NFAT inhibitor FK506 could reverse these effects, offering novel therapeutic strategies for metastatic CRC. Metastatic recurrence remains a major cause of colorectal cancer (CRC) mortality. In this study, we investigated the mechanistic role of nuclear factor of activated T cells 1 (NFATc1) in CRC metastasis. First, we explored the potential role of NFATc1 in CRC using bioinformatics and hypothesized that NFATc1 might play different roles at different stages of CRC development. Then, we examined the relative expression of NFATc1 in 25 CRC tissues and adjacent normal tissues, and further analyzed the correlation between NFATc1 expression levels and clinical stages in 120 CRC patients. The role of NFATc1 in CRC metastasis and the molecular mechanisms were investigated in both in vitro and in vivo models. Our results showed that the expression of NFATc1 was increased in metastatic CRC tissues and positively associated with clinical stages (stage I vs. stage II, III or IV) of CRC. Overexpression of NFATc1 promoted CRC cell migration, invasion, and epithelial-mesenchymal transition (EMT). Moreover, SNAI1 was verified as the direct transcriptional target of NFATc1 and interacted with SLUG to promote EMT. Remarkably, our lung and liver metastasis mouse model demonstrated that NFATc1 overexpression accelerated CRC metastasis, and treatment with FK506, a calcineurin-NFAT pathway inhibitor, could suppress CRC metastasis in vivo. Taken together, our findings suggest that NFATc1 could transcriptionally activate SNAI1, which in turn interacts with SLUG to mediate EMT to promote CRC metastasis. Thus, making NFATc1 a promising therapeutic target in the treatment of metastatic CRC.

60 APPLIED LIFE SCIENCES↗

CPT2 downregulation triggers stemness and oxaliplatin resistance in colorectal cancer via activating the ROS/Wnt/β-catenin-induced glycolytic metabolism

Highlights: • CPT2 was downregulated in CRC. • CPT2 suppressed the proliferation and glycolytic metabolism in CRC cells. • CPT2 inhibited cancer stem cell properties and oxaliplatin resistance in CRC. • CPT2 attenuated CRC tumor growth and enhanced oxaliplatin sensitivity in vivo. • CPT2 functioned via suppressing ROS/Wnt/β-catenin pathway in CRC. Carnitine palmitoyltransferase 2 (CPT2) has been demonstrated to act as a tumor promotor or suppressor in different types of cancers. However, little is known about the effect of CPT2 on colorectal cancer (CRC). In the present study, we analyzed CPT2 expression in CRC tissues and cells. CPT2 was overexpressed in CRC cell lines (SW480 and RKO), and its effects and molecular mechanism on the proliferation, glycolysis, stemness, and oxaliplatin sensitivity were investigated. The xenograft experiment was used to confirm the influence of CPT2 on CRC tumorigenesis in vivo. We found that CPT2 expression was significantly downregulated in CRC patients, and its lower expression was associated with the poor prognosis, large tumor size, advanced TNM stage, and poor histological grade differentiation of patients. Upregulation of CPT2 significantly inhibited the proliferation, glycolytic metabolism, cancer stem cell properties, and oxaliplatin resistance in CRC cells. Also, the increase of CPT2 inhibited tumorigenesis, stemness and glycolysis, while enhanced oxaliplatin sensitivity in mouse models. Mechanistically, CPT2 functioned via suppressing the activation of Wnt/β-catenin pathway through repressing ROS production. In conclusion, our results demonstrated that CPT2 was decreased in CRC, and CPT2 downregulation could trigger stemness and oxaliplatin resistance in CRC via activating the ROS/Wnt/β-catenin-induced glycolytic metabolism. This study indicates that CPT2 is a potential therapeutic target for CRC.

60 APPLIED LIFE SCIENCES↗

NMIIA promotes tumorigenesis and prevents chemosensitivity in colorectal cancer by activating AMPK/mTOR pathway

Non-muscle myosin IIA (NMIIA) has been reported to be involved in the carcinogenesis and malignant progression of various human tumors. However, the role and potential mechanism of NMIIA in the biological functions and apoptosis in colorectal cancer (CRC) remain elusive. In this study, we found that NMIIA was overexpressed in CRC tissues and significantly associated with poor survival in CRC patients. In addition, NMIIA promoted CRC cell proliferation and invasion via activating the AMPK/mTOR pathway in vitro, and NMIIA knockdown inhibited CRC growth in vivo. Meanwhile, NMIIA knockdown downregulated the CSCs markers (CD44 and CD133) expression in CRC cells. Furthermore, AMPK/mTOR pathway activation effectively reversed the NMIIA knockdown-induced inhibition of proliferation, invasion and stemness in CRC cells. Finally, NMIIA protects CRC cells from 5-FU-induced apoptosis and proliferation inhibition through the AMPK/mTOR pathway. Taken together, these results indicate that NMIIA plays a pivotal role in CRC growth and progression by regulating AMPK/mTOR pathway activation, and it may act as a novel therapeutic target prognostic factor in CRC.

60 APPLIED LIFE SCIENCES↗

KIF18b-dependent hypomethylation of PARPBP gene promoter enhances oxaliplatin resistance in colorectal cancer

Highlights: • High expression of PARPBP promotes oxaliplatin resistance of CRC. • KIF18b induces PARPBP expression by suppressing promoter methylation. • SP1 recruits DNMT3b to methylate PARPBP promoter. • KIF18b disturbs the recruitment of DNMT3b to PARPBP promoter. As the new platinum drug oxaliplatin has been widely used in clinical treatment of colorectal cancer (CRC), oxaliplatin resistance has become a burning problem. In this study, higher expression of PARP-1 binding protein (PARPBP) was detected in oxaliplatin-resistant CRC (OR-CRC) cells than in non-resistant cells. Further research showed that kinesin family member 18 b (KIF18b) induced the overexpression of PARPBP, sustaining oxaliplatin resistance in OR-CRC cells. Through exploring the PARPBP gene promoter, we found that SP1-recruited DNMT3b methylated PARPBP promoter to suppress transcription in CRC cells, and increased KIF18b attenuated the recruitment of DNMT3b to PARPBP promoter by directly interacting with SP1 in OR-CRC cells. Clinical analysis suggested a positive relationship between KIF18b and PARPBP in CRC tissues and indicated poor prognosis in CRC patients with high level of KIF18b or PARPBP. In summary, KIF18b-induced PARPBP contributes to the resistant phenotype of OR-CRC.

60 APPLIED LIFE SCIENCES↗

GRIM-19 inhibits proliferation and induces apoptosis in a p53-dependent manner in colorectal cancer cells through the SIRT7/PCAF/MDM2 axis

Colorectal cancer (CRC) is the leading deadly cancer worldwide. Gene associated with retinoid-IFN-induced mortality-19 (GRIM-19), a novel tumor suppressor, has been reported to be expressed at low levels in human CRC. However, the role of GRIM-19 in CRC progression and the corresponding detailed mechanisms are unclear. The results of this study indicated that GRIM-19 expression is related to CRC progression. Overexpression of GRIM-19 was found to inhibit CRC cell proliferation and induce apoptosis in vitro and in vivo. Our results demonstrated that GRIM-19 suppresses CRC through posttranslational regulation of p53, in which SIRT7 is activated by GRIM-19 and triggers PCAF-mediated MDM2 ubiquitination, eventually stabilizing the p53 protein. We also observed that GRIM-19 enhances the effect of oxaliplatin against CRC. In conclusion, GRIM-19 plays an important role in CRC development and is a potential biomarker and therapeutic target for clinical treatment of CRC.

60 APPLIED LIFE SCIENCES↗

Emulator-Based Bayesian Calibration of the CISNET Colorectal Cancer Models

Purpose To calibrate Cancer Intervention and Surveillance Modeling Network (CISNET)'s SimCRC, MISCAN-Colon, and CRC-SPIN simulation models of the natural history colorectal cancer (CRC) with an emulator-based Bayesian algorithm and internally validate the model-predicted outcomes to calibration targets.Methods We used Latin hypercube sampling to sample up to 50,000 parameter sets for each CISNET-CRC model and generated the corresponding outputs. We trained multilayer perceptron artificial neural networks (ANNs) as emulators using the input and output samples for each CISNET-CRC model. We selected ANN structures with corresponding hyperparameters (i.e., number of hidden layers, nodes, activation functions, epochs, and optimizer) that minimize the predicted mean square error on the validation sample. We implemented the ANN emulators in a probabilistic programming language and calibrated the input parameters with Hamiltonian Monte Carlo-based algorithms to obtain the joint posterior distributions of the CISNET-CRC models' parameters. We internally validated each calibrated emulator by comparing the model-predicted posterior outputs against the calibration targets.Results The optimal ANN for SimCRC had 4 hidden layers and 360 hidden nodes, MISCAN-Colon had 4 hidden layers and 114 hidden nodes, and CRC-SPIN had 1 hidden layer and 140 hidden nodes. The total time for training and calibrating the emulators was 7.3, 4.0, and 0.66 h for SimCRC, MISCAN-Colon, and CRC-SPIN, respectively. The mean of the model-predicted outputs fell within the 95% confidence intervals of the calibration targets in 98 of 110 for SimCRC, 65 of 93 for MISCAN, and 31 of 41 targets for CRC-SPIN.Conclusions Using ANN emulators is a practical solution to reduce the computational burden and complexity for Bayesian calibration of individual-level simulation models used for policy analysis, such as the CISNET CRC models. In this work, we present a step-by-step guide to constructing emulators for calibrating 3 realistic CRC individual-level models using a Bayesian approach.

artificial neural networks↗

Optimal Stopping Ages for Colorectal Cancer Screening

Importance Prior studies have shown that the benefits, harms, and costs of colorectal cancer (CRC) screening at older ages are associated with a patient’s sex, health, and screening history. However, these studies were hypothetical exercises and not directly informed by data on CRC risk. Objective To identify the optimal stopping ages for CRC screening by sex, comorbidity, and screening history from a cost-effectiveness perspective. Design, Setting, and Participants This economic evaluation first validated the MISCAN-Colon (Microsimulation Screening Analysis–Colon) model against community-based CRC incidence and mortality rates for 2 subcohorts of the PRECISE (Optimizing Colorectal Cancer Screening Precision and Outcomes in Community-Based Populations) cohort. Subsequently, different CRC screening scenarios were simulated in older individuals. Cohorts of US adults aged 76 to 90 years varied by sex and comorbidity status (none, low, moderate, or severe). Statistical and sensitivity analyses were performed from March 2023 to May 2024. Exposures CRC screening histories including fecal immunochemical test (FIT) or colonoscopy, such as a negative colonoscopy result from 10, 15, 20, 25, or 30 years before the index age; 1 to 5 negative FIT results within 5 years of the index age, with different patterns of recency; or a combination of negative colonoscopy and negative FIT results. Main Outcomes and Measures The main outcomes included estimated lifetime clinical outcomes, incremental costs, and quality-adjusted life-years gained (QALYG) associated with 1 additional FIT or colonoscopy. Optimal stopping age for screening, defined as the oldest age for which the incremental cost-effectiveness ratio was still below the willingness-to-pay threshold of $\$$100 000 per QALYG, was evaluated. Results The first of the 2 PRECISE subcohorts used in validating the simulation model included 25 974 adults (15 060 females [58.0%]; 54.7% aged 76 to 80 years) with a negative colonoscopy result 10 years before the index date. The second subcohort consisted of 118 269 adults (67 058 females [56.7%]; 90.5% aged 76 to 80 years) with a negative FIT result 1 year before the index date. Older age, male sex, higher comorbidity levels, and recent CRC screenings were associated with reduced incremental benefit and cost-effectiveness of additional screening. For the reference cohort of 76-year-old females without comorbidities and a negative colonoscopy result 10 years before the index age, 1 additional colonoscopy cost $\$$38 226 per QALYG. For cohorts with otherwise equivalent characteristics, associated costs increased to $\$$1 689 945 per QALYG for females at age 90 years without comorbidities and a negative colonoscopy results 10 years before the index age, $\$$51 604 per QALYG for males at age 76 years without comorbidities and a negative colonoscopy result 10 years before the index age, and $\$$108 480 per QALYG for females at age 76 years with severe comorbidities and a negative colonoscopy result 10 years before the index age and decreased to $\$$16 870 per QALYG for females without comorbidities and a negative colonoscopy result 30 years before the index age. The optimal stopping ages across different cohorts ranged from younger than 76 to 86 years for colonoscopy and younger than 76 to 88 years for FIT. Conclusions and Relevance In this economic evaluation, age, sex, screening history, comorbidity, and future screening modality were associated with the clinical outcomes, cost-effectiveness, and optimal stopping age for CRC screening. These results can inform guideline development and patient-directed informed decision-making.

Harlass, Matthias [Erasmus Erasmus University Medi↗

TRIM16 overexpression inhibits the metastasis of colorectal cancer through mediating Snail degradation

Highlights: • TRIM16 does significantly inhibit CRC cell migration and metastasis. • TRIM16 negatively regulates CRC cells EMT. • TRIM16 directly interacts with Snail. • TRIM16 promotes degradation of Snail via ubiquition proteasome pathway. Tripartite motif containing 16 (TRIM16) is a member of the tripartite motif protein family and functions as a potential tumor suppressor in several cancers. However, the specific function and clinical significance of TRIM16 in colorectal cancer (CRC) remains unclear. In this study, we observed that low TRIM16 expression was detected frequently in primary colorectal cancer (CRC) tissues and was closely associated with a better prognosis. Functional studies demonstrate that TRIM16 overexpression notably inhibits the metastasis abilities of CRC in vivo and in vitro. Mechanistically, our results demonstrated that TRIM16 directly bound and ubiquitinated Snail family transcriptional repressor 1 (Snail), an important transcriptional factor of the epithelial-mesenchymal transition (EMT) process suppressing the EMT in CRC. Additionally, our data revealed that the inhibition effect of TRIM16 on cancer metastasis was dependent on Snail degradation. Collectively, our study is the first to report that TRIM16 plays a crucial anti-tumor role in CRC tumorigenesis. We also provided novel evidence that TRIM16 might act as a prognostic and therapeutic target to assess and inhibit CRC progression.

60 APPLIED LIFE SCIENCES↗

Global disease burden linked to diet high in red meat and colorectal cancer from 1990 to 2019 and its prediction up to 2030

Background Numerous studies have already identified an association between excessive consumption of red meat and colorectal cancer (CRC). However, there has been a lack of detailed understanding regarding the disease burden linked to diet high in red meat and CRC. Objective We aim to offer evidence-based guidance for developing effective strategies that can mitigate the elevated CRC burden in certain countries. Methods We used the data from the Global Burden of Disease (GBD) Study 2019 to evaluate global, regional, and national mortality rates and disability-adjusted Life years (DALYs) related to diet high in red meat. We also considered factors such as sex, age, the socio-demographic index (SDI), and evaluated the cross-national inequalities. Furthermore, we utilized DALYs data from 204 countries and regions to measure cross-country inequalities of CRC by calculating the slope index of inequality and concentration index as standard indicators of absolute and relative inequalities. Discussion The results show that globally, the age-standardized mortality rate (ASMR) and age-standardized disability adjusted life year rate (ASDR) related to CRC due to diet high in red meat have decreased, with estimated annual percent change (EAPCs) of −0.32% (95% CI −0.37 to −0.28) and-0.18% (95% CI −0.25 to −0.11). Notably, the burden was higher among males and the elderly. The slope index of inequality rose from 22.0 (95% CI 18.1 to 25.9) in 1990 to 32.9 (95% CI 28.3 to 37.5) in 2019 and the concentration index fell from 59.5 (95% CI 46.4 to 72.6) in 1990 to 48.9 (95% CI 34.6 to 63.1) in 2019. Also, according to our projections, global ASDR and ASMR might tend to increase up to 2030. Conclusion ASMR and ASDR for CRC associated with high red meat diets declined globally from 1990 to 2019, but the absolute number of cases is still rising, with men and the elderly being more affected. CRC associated with diets high in red meat exhibits significant income inequality, placing a disproportionate burden on wealthier countries. Moreover, according to our projections, ASMR and ASDR are likely to increase globally by 2030. In order to address this intractable disease problem, understanding changes in global and regional epidemiologic trends is critical for policy makers and others.

Yang, Xuesong↗