Differences In Outcomes Research Articles

Precision medicine in diabetes care.

This review highlights emerging evidence supporting the premise of precision diabetes care including but not limited to monogenic diabetes and discuss potential opportunities, challenges, and limitations for clinical adoption. Driven by a single gene mutation, monogenic diabetes remains the best use-case for precision diabetes care. However, the increasing prevalence of diabetes among adolescents and young adults in an obesogenic environment makes triaging potential patients for genetic screening clinically challenging. High-dimensional molecular biomarkers (i.e., multiomics) can improve the risk prediction for incident type 2 diabetes (T2D), over and above a well established prediction model based on clinical variables alone. Machine learning approaches using clinical variable-based clustering methods have generated novel and reproducible T2D subgroups with distinct phenotypic and omics characteristics that are associated with differential long-term outcomes. This stratification-strategy may inform clinical decisions. However, on-going discussion and research will be needed to understand the clinical utility of sub-phenotyping T2D for precision care. Precision diabetes care has extended from uncommon monogenic diabetes to T2D which will need more complex approaches like multiomics and machine-learning methods. The successful clinical translation will require cumulative evidence and close collaboration among the stake holders.

Differential statin intensity and outcomes in patients following myocardial infarction with very low low-density lipoprotein cholesterol.

Despite increasing evidence on the benefits of statin therapy for acute myocardial infarction (AMI), differential outcomes in accordance with statin intensity have not been evaluated in patients with AMI and low-density lipoprotein cholesterol (LDL-C) levels < 55 mg/dL. Therefore, this study aimed to compare the clinical outcomes of high- and moderate-intensity statin therapy in this population. A total of 752 participants with AMI and LDL-C levels < 55 mg/dL from a Korean nationwide multicenter observational cohort (2016-2020) were included and categorized into two groups: high-intensity statin group (n = 384) and moderate-intensity statin group (n = 368). The primary outcome was 1-year major adverse cardiac and cerebrovascular events (MACCEs). Propensity score matching (PSM) and Cox models were used to determine whether statin intensity independently influenced the primary outcome. Compared to the moderate-intensity statin group, the high-intensity statin group had a comparable risk of MACCE in all Cox models and PSM-adjusted analyses. The cumulative incidence of MACCE was comparable between the two groups. Statin intensity appeared to have no significant impact on clinical outcomes in AMI patients with LDL-C levels < 55 mg/dL. These results underscore the need for further investigations aimed at refining treatment strategies for this specific patient cohort, potentially reducing treatment-related burdens without compromising clinical effectiveness.

Sexuality securitized: how Russia’s invasion of Ukraine reconfigures (anti-)LGBTQ politics in Eastern Europe

ABSTRACT This article examines how the shifting security landscape following Russia’s full-scale invasion of Ukraine is reconfiguring (anti)-LGBTQ politics in Eastern Europe. Drawing on securitization theory, we unravel the changing construction of LGBTQ rights as a security issue in Ukraine and Georgia. We posit that securitization of sexuality occurs at the intersection of processes taking place at multiple scales: nation-building, in its imbrication with militarized conflicts, and EU-Russia geopolitical competition. We argue that Russia’s war has led to diverging paths regarding anti-genderism and political homophobia in each country. In Ukraine, we identify a move towards desecuritization, through the incorporation of (some) sexual minorities into the struggle against Russian invasion. In Georgia, the ruling elites’ attempts to retain power in a complex geopolitical landscape have crystallized the securitization of LGBTQ people as a threat from which society has to be protected. The article suggests that a major security crisis can result in differential and ambiguous outcomes for (anti-)LGBTQ politics, both across geopolitical locations and within a single national space. Overall, it advances our understanding of how anti-genderism and political homophobia connect with geopolitical dynamics in Eastern Europe and beyond.

Usable STEM: Student Outcomes in Science and Engineering Associated with the Iterative Science and Engineering Instructional Model

While our world consistently presents complicated, interdisciplinary problems with STEM foundations, most pre-university curricula do not encourage drawing on multidisciplinary knowledge in the sciences and engineering to create solutions. We developed an instructional approach, Iterative Science and Engineering (ISE), that cycles through scientific investigation and engineering design and culminates in constructing a solution to a local environmental challenge. Next, we created, revised, and evaluated a six-week ISE curricular program, Invasive Insects, culminating in 6th–9th-grade students building traps to mitigate local invasive insect populations. Over three Design-Based Research (DBR) cycles, we gathered and analyzed identical pre and post-test data from 554 adolescents to address the research question: what three-dimensional (3D) science and engineering knowledge do adolescents demonstrate over three DBR cycles associated with a curricular program following the Iterative Science and Engineering instructional approach? Results document students’ significant statistical improvements, with differential outcomes in different cycles. For example, most students demonstrated significant learning of 3D science and engineering argument construction in all cycles—still, students only significantly improved engineering design when they performed guided reflection on their designs and physically built a second trap. Our results suggest that the development, refinement, and empirical evaluation of an ISE curricular program led to students’ design, building, evaluation, and sharing of their learning of mitigating local invasive insect populations. To address complex, interdisciplinary challenges, we must provide opportunities for fluid and iterative STEM learning through scientific investigation and engineering design cycles.

Admission Testing in Higher Education: Changing Landscape and Outcomes from Test‐Optional Policies

AbstractAccess to admission tests was greatly restricted during the COVID‐19 pandemic resulting in widespread adoption of test‐optional policies by colleges and universities. Many institutions adopted such policies on an interim or trial basis, as many others signaled the change would be long term. Several Ivy League institutions and selective public flagship universities have returned to requiring test scores from all applicants citing their own research indicating diversity and ensuring academic success of applicants can be best served by inclusion of test scores in the admissions process. This paper reviews recent research on the impact of test‐optional policies on score‐sending behaviors of applicants and differential outcomes in college and score sending. Ultimately, test‐optional policies are neither the panacea for diversity that proponents suggested nor do they result in a decay of academic outcomes that opponents forecast, but they do have consequences, which colleges will need to weigh going forward.

Abstract 4144525: An Observation Of Racial Disparities In Patients Admitted With St Segment Elevated Myocardial Elevation

introduction: This sudy explores the multifaceted nature of racial disparities among patients admitted with STEMI, shedding light on the complex interplay of social, economic, and healthcare factors that contribute to differential outcomes among diverse populations. Methods: we examined the national inpatient sample 2017-2020 for adult admitted with st segment myocardial infarction,we compared the clincal outcome based on racial distribution.STATA 18th edition was used for analyses. Age, gender, race, hypertension, diabetes, obesity, dyslipidemia, and Elixhauser comorbidity index were identified as confounders by univariate analyses and tested further with multivariate logistic regression models. The primary outcome was mortality. Secondary outcomes were the need for intubation, cardiac arrest, length of stay (LOS), and total hospital charges. Results: There were 826315 hospitalizations with STEMI. Mean age was 64 yrs and 62% were male. Among the admitted patients, Caucasians were 593575 (72%), Blacks were 75025(9.1%),Hispanics were 69605(8.4%), Asians were 23734(2.9%). All-cause mortality in patients admitted with STEMI was 88125 where subgroup Analysis with Caucasians, Blacks ,Hispanics and Asians had 60074(10.1%) vs 9135 (12.1%) vs 7645(10.9%) and 2999(12.6%) respectively. Further subgroups analysis revealed that Blacks (13.9%, aOR 1.37 CI 1.28-1.47,P value&lt;0.001) were more likely to require intubation,followed by Asians(13.5% aOR 1.59 CI 1.43--1.76, p value &lt;0.001) ,then Hispanic (13% aOR 1.45,CI 1.35-1.56 P vale &lt;0.001)and caucasians were least likely to require intubation(9.7% ) Finally, racial subgroup showed significant primary andsecondary outcomes that are presented in Table 1. Conclusion: All obtained results revealed statistical significance and we considered Caucasian population as baseline. Mortality waa highest amongst Asians,followed by Blacks then Hispanics and least in the caucasian subgroup. Understanding these disparities is essential for improving healthcare equity and ensuring that all patients receive appropriate and equitable care regardless of their racial or ethnic background.

IMMU-46. CROSS-TALK OF INNATE IMMUNE CELLS IN GLIOBLASTOMA PATHOPHYSIOLOGY: UNDERSTANDING NLRP3 AND NLRP12

Abstract Glioblastoma (GBM) are malignant gliomas with an average survival of less than 14 months after diagnosis, despite surgery, chemotherapy, and radiotherapy. Tumor survival is aided by the heterogeneous cell populations in the tumor microenvironment. Two crucial innate immune cells of the brain, namely microglia and macrophages, favor a tumor-promoting microenvironment IN GBM. The nucleotide-binding domain leucine-rich repeat-containing receptor (NLR) family in astrocytes and microglia cells recognizes pathogen- and damage-associated molecular patterns that induce inflammation. NLRP3, upon activation, leads to cleavage and activation of Caspase-1, causing the proteolytic cleavage-mediated activation and conversion of pro-IL-1ß and pro-IL-18 to IL-1ß and IL-18, leading to pyroptosis. NLRP12 downregulates inflammatory responses in microglia and macrophages by regulating the NF-kB pathway. NLRP3 and NLRP12 have tumor-promoting and anti-tumour functions in various cancers. NLRP12 is a prognostic marker for glioblastoma, and its increased expression correlates with poor survival in GBM patients. However, the cellular and molecular mechanisms of NLRP3 and NLRP12 in GBM pathophysiology are largely unknown. This study aims to understand the effect of NLRP3 and NLRP12 expression in GBM, to interpret the pathophysiology, and to help develop future targeted therapeutic interventions. To understand the baseline expression of NLRP3 and NLRP12 in cell lines and patient-derived GBM cells, PCR, western blotting, and Immunocytochemistry were performed comparing WT and nlrp3-/- and nlrp12-/- cells. Differential expression of NLRP3 and NLRP12 in patient-derived cells can be compared to GBM, astrocyte, and microglia cell lines. This may be the underlying cause for intra and inter-tumor heterogeneity and resultant differential therapy outcomes. To understand cell-to-cell communication in GBM-like tumor microenvironments, heterocellular 3D organoids, and patient-derived tumor organoids were developed. Cell viability in 3D patient-derived tumor organoids decreased by up to 10% with Doxorubicin and 40% with Carboplatin treatment decreases compared to untreated controls. This suggests the scope of developing drugs targeting inflammation regulatory genes.

NIMG-60. SUBTYPING GLIOBLASTOMA FROM JOINT CLUSTERING OF IMAGING AND GENOMIC DATA

Abstract PURPOSE To comprehensively unravel the heterogeneity of glioblastoma, we developed a subtyping method using integrated imaging and genomic data. METHODS We assembled a retrospective cohort of 571 IDH-wildtype glioblastoma patients, obtaining pre-operative multi-parametric MRI (T1, T1-GD, T2, T2-FLAIR, DSC, DTI) scans (available for 462 patients) and targeted next-generation sequencing (NGS) data (available for 355 patients). We extracted 971 radiomic features from these MRI scans, selecting 12 significant dimensions through L21-norm minimization guided by 13 key driver genes from the five most frequently altered pathways in glioblastoma compared to healthy controls (RB1, P53, MAPK, PI3K, and RTK). Subtypes were identified using a joint clustering approach that integrated radiomics and genomics. RESULTS Our method identified three glioblastoma subtypes with distinct risk levels: high-risk (subtype 1), medium-risk (subtype 2), and low-risk (subtype 3), each characterized by their differential overall survival outcomes (Kaplan-Meier analysis, p &amp;lt; 0.05). The intensities of axial diffusivity in enhancing tumor regions and radial diffusivity in non-enhancing cores increased across three subtypes. All subtypes shared a common tendency for more frequent mutation co-occurrence pattern in [TP53,RB1] but exhibited unique molecular characteristics. For example, subtype 1 displayed a relatively high frequency of co-occurring mutations in [TP53,KDR] and [NOTCH2,MDM4]; subtype 2 had six co-occurring pairs [TP53,KDR], [PTPN11,NF1], [RB1,FUBP1], [PTEN,CIC], [PTEN,KRAS], and [NOTCH2,CDKN2A]; subtype 3 showed six co-occurring pairs [PTPN11,NF1], [PDGFRA,NF1], [NTRK1,NOTCH2], [MET,ATRX], [KRAS,KDR], and [FGFR2,DNMT3A] plus four significant patterns of mutual exclusivity in [TP53,PTPN11], [TP53,EGFR], [EGFR,RB1], and [EGFR,NF1]. CONCLUSION Our study discovered distinct glioblastoma subtypes, revealing complex patterns and structures across multiple data modalities without relying on prior clinical assumptions. This is promising to help enhance the precision of diagnosis and treatment of glioblastoma.

Evaluating Regional Variability in Road Closure Outcomes Due to Rainfall: a Logistic Regression Approach

Abstract. This study investigated the probability of road closure due to flooding. Logistic regression model was developed using the road closure data and the daily rainfall data for Houston, TX, USA during 2017 and 2018. The road network was further divided into flood prone zones. The spatial analysis revealed that the rainfall at the road segment level could be sufficiently represented by that recorded by nearest sensors. Within a 4 d window, the rainfall in the current day and 3 d prior played a more influential role in predicting road closure. The differential outcomes due to distinct regional features were explained. Finally, a watershed delineation approach substantially improved the model's predictive power and sensitivity.

Oropouche Virus Infection: Differential Clinical Outcomes and Emerging Global Concerns of Vertical Transmission and Fatal Cases

Oropouche virus (OROV), a member of the Peribunyaviridae family, has emerged as a significant arboviral threat, particularly in South and Central America. Traditionally causing mild febrile illness, recent outbreaks have revealed severe clinical outcomes, including aseptic meningitis, encephalitis, and, more recently, vertical transmission leading to congenital anomalies and fatalities. Environmental changes, including deforestation and climate shifts, have expanded the virus's geographic range, as seen in Brazil, where over 8,000 cases were reported by August 2024, compared to fewer than 831in 2023. For the first time, vertical transmission has been confirmed, with cases of fetal deaths and congenital anomalies such as microcephaly and agenesis of the corpus callosum, drawing parallels to the Zika virus outbreak in 2015–2016. Despite these alarming trends, key mechanisms of placental transmission, maternal immunity, and fetal susceptibility remain poorly understood. This perspective highlights the urgent need for a coordinated global response, focusing on enhanced surveillance in newly affected regions, vector control strategies, and research into the factors driving severe clinical outcomes. Strengthening global efforts will be crucial in mitigating the public health threat posed by OROV, particularly in light of its potential for further geographic expansion and severe clinical manifestations.

Efficacy, safety and differential outcomes of immune-chemotherapy with gemcitabine, cisplatin and durvalumab in patients with biliary tract cancers: A multicenter real world cohort.

Combined Immuno-chemotherapy consisting of gemcitabine, cisplatin and the programmed death-ligand one inhibitor durvalumab (GCD) is the new standard of care for patients with biliary tract cancers (BTC) based on positive results of the TOPAZ-1 study. We here evaluated the efficacy and safety of GCD for BTC in a German multicenter real-world patient cohort. Patients with BTC treated with GCD from 9 German centers were included. Clinicopathological baseline parameters, overall survival (OS), response rate and adverse events (AEs) were retrospectively analyzed. The prognostic impact was determined by Kaplan-Meier analyses and Cox regression models. A total of 165 patients treated with GCD between 2021 and 2024 were included in the study. Median OS and median progression-free survival were 14 months (95% CI 10.3-17.7) and 8months (95% CI 6.8-9.2), respectively. The best overall response rate was 28.5% and disease control rate was 65.5%. While extrahepatic and intrahepatic BTC showed similar outcomes, mOS was significantly shorter in patients with gall bladder cancer (GB-CA) with 9months (95% CI 5.5-12.4; p=0.02). In univariate analyses age ≥70years, Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥1, status post cholecystectomy, GB-CA and high baseline CRP values were significantly associated with OS. ECOG PS≥1 and GB-CA remained independent prognostic factors for OS in multivariable cox regression analysis. AEs have been reported in 130 patients (78.8%), including 149 grade 3-4 AEs (25.5%). One patient died of severe infectious pneumonia. Immune-related (ir)AEs occurred in 17 patients (10.3%), including 9 grade 3-4 irAEs (2.2%), which led to treatment interruption in 4 patients. Immuno-chemotherapy in patients with BTC was feasible, effective and safe in a real-life scenario. Our results were comparable to the phase 3 clinical trial results (TOPAZ-1). Reduced efficacy was noted in patients with GB-CA and/or a reduced performance status that warrants further investigation.

Regional variation of age-related blood pressure trajectories and their association with blood pressure control rates, disability-adjusted life years and death

Abstract Background/Introduction While the relationship between blood pressure (BP) changes and increasing age is well described, age-related BP trajectories may vary substantially across different populations and associated with differential CV risk and outcomes. Purpose The dataset of the May Measurement Month (MMM) international campaigns enables a unique investigation of regional, socio-economic and sex differences in age-BP trajectories and their association with major public-health outcomes. Method Global BP data from more than 4,5 million adult (≥18 years) screenees obtained during the cross-sectional MMM campaigns in 2017, 2018, 2019, and 2021 were used for analysis. Average BP and slopes of BP changes across age groups were calculated within regional, socio-economic and sex strata. BP slopes of individuals between 30 and 70 years of age were derived from adjusted linear regression models, along with baseline BP estimates at young age. These BP slopes were correlated in regression models adjusted for baseline BP at young age with country-specific all-cause rates of DALYs (Disability-Adjusted Life Years), death (both from Global Burden of Disease Study 2019), life expectancy (World Bank data SP.DYN.LE00.IN 2019) and BP control rates (NCD Risk Factor Collaboration). Results Age-related BP changes differed distinctly across global geographic regions, income levels, and between sexes. The steepest increase in BP with age was observed in populations from Africa and Europe, whereas a more gradual rise in BP with increasing age was seen in South-East Asian populations. Women had lower BP levels than men at younger ages (twenties and thirties), but subsequently experienced a more pronounced age-related BP increase resulting in diminishing sex differences across older age groups. Geographically divergent age-related BP trajectories were significantly associated with major national public health indicators. Globally, the steeper the age-related BP slope, the stronger the association with poor BP control (β = -0.46 [95% CI: -0.74; -0.19], p=0.001), increased DALY’s (β = 66155.68 [95% CI: 44847.0; 87464.36], p&amp;lt;0.001) and death rates. (β = 1017.3 [95% CI: 351.72; 1682.89], p=0.003). Conclusion Age-related BP trajectories vary considerably across global populations and contribute considerably to the variability in BP-related risks and adverse outcomes across regions. Effective public health strategies may require region-specific targeting of lifestyle and other factors contributing to adverse BP trajectories to improve health outcomes.Average blood pressure by ageAssiciations with public health metrics

Does participation in a court-based trauma-focused evaluation program influence permanency outcomes for children involved in the child welfare system?

BackgroundChildren involved in the child welfare system, especially those in out-of-home care, experience high rates of mental health symptoms. Mental health symptoms have been linked to worse permanency outcomes in this population. ObjectiveThe present study aimed to evaluate whether children who received a trauma-focused evaluation, compared to children who received usual care, experienced differential permanency outcomes, as well as other court-related outcomes (e.g., legal system involvement). Participants and settingOne-hundred and twenty-five children (58% female, Mage = 10.61) from a family court in the Northeastern United States participated in a trauma-focused evaluation program. MethodsData for the current study were collected via a retrospective chart. Participants were recruited at a family court of a Northeastern state. Between-groups differences on court-related outcomes were assessed using logistic regression and Kaplan Meier estimates. FindingsThere were no significant differences between children who received the trauma-focused evaluation program versus usual care in the likelihood for guardianship changes, termination of parental rights, new child welfare petitions or new juvenile legal petitions. The groups significantly differed in the likelihood of case closure; children who received the trauma-focused evaluation program were more likely to experience case closure compared to children who received usual care. Additionally, on average, children who received the trauma-focused evaluation program achieved case closure almost 8 months sooner. ConclusionsThe findings suggest that initiatives aimed at identifying mental health concerns and linking children placed in out-of-home to relevant mental health services care can have a significant and positive impact on permanency outcomes.

USING CCA-MRI TO PREDICT RESPONSE TO STEREOTACTIC RADIOSURGERY IN PATIENTS WITH BRAIN METASTASES

Abstract AIMS Brain metastases (BMs) from different primary cancers may have different radiosensitivity, for example melanoma and renal cell cancers are considered more radioresistant. Radiosensitivity is determined by the intrinsic radiobiological properties of tumours, which include vascularisation and oxygenation. Contrast Clearance Analysis (CCA)-MRI measures delayed contrast behaviour to offer a window into tumour vascularity. The CCA colour map shows areas of contrast accumulation (red), suggesting vascular damage, and rapid contrast clearance (blue), suggesting intact and increased vasculature. We aim to interrogate CCA-MRIs pre-stereotactic radiosurgery (SRS) for differences in contrast handling between BMs from different primaries. METHOD 10 patients, with 70 BMs, were included in the study. All had CCA-MRIs pre-SRS as part of their planning-MRIs. Radiotherapy-planning-CT scans were fused with the planning-post-contrast-T1-MRI, with consultant clinical oncologist-approved contoured targets, and the CCA-images. Threshold analysis was performed to obtain proportions of red and blue within the enhancing areas of each tumour. RESULTS There was a significant difference in the proportion of blue between BMs from different primaries (p=0.0294). In pairwise-comparisons, only the difference between lung and renal was significant (mean difference 37.65%, p=0.0390). The difference between the proportion of red was also significant overall (p=0.0084) (Figure 2). In pairwise comparisons, renal was significantly different from lung, breast and melanoma (mean difference 12.65%, p=0.0161; mean difference 12.97%, p=0.0154; and mean difference 11.29%, p=0.0169, respectively). CONCLUSION This study offers a novel insight into the vascularity of BMs from different primaries. Further research to explore if these findings can explain differential SRS outcomes is underway.

Differential associations between experiences of contraceptive care and subsequent contraceptive access and preferences among family planning patients by racial and ethnic identity: Evidence from Arizona, Iowa, and Wisconsin.

While many frameworks exist for building person-centered and equitable systems of contraceptive care, evidence indicates that the reality of patients' experiences of care is often not in alignment with these ideals. Historical and current contexts of racism in the healthcare system contribute to negative perceptions and experiences of care, as well as reduced care-seeking behavior, for those who identify as Black, Indigenous, and people of color (BIPOC). Our objective in this analysis is to examine whether people's past experiences of contraceptive care are a driver of subsequent barriers to contraceptive access, and whether this relationship differs across racial and ethnic identity. We draw on panel data from five waves of surveys collected between 2018-2023 among patients ages fifteen and older seeking family planning care at sites that receive public funding for these services in Arizona, Iowa, and Wisconsin. Overall and stratified by race/ethnicity, we examine cross-sectional and longitudinal associations between patients' experiences of high-quality, person-centered contraceptive care and three contraceptive access outcomes: use of preferred contraception, satisfaction with contraceptive method, and experience of no barriers to accessing preferred contraception. We find longitudinal associations between patients experiencing higher-quality, more person-centered contraceptive care and subsequent satisfaction with contraceptive methods. Among non-Hispanic white-identifying patients, we find similar associations between shifting to higher-quality contraceptive care and use of preferred contraception, but we find no statistical relationship between experiencing higher-quality care and subsequent contraceptive outcomes for patients who identify as Black, Indigenous, or Person of Color (BIPOC). Highlighting the dissonance between clinical guidance for quality contraceptive care and patient experiences of care, and especially whether similar experiences across racial and ethnic identity lead to differential outcomes, is a crucial step toward bringing contraceptive care systems into alignment with principles of sexual and reproductive health equity.

New Results on Differential Subordination and Superordination for Multivalent Functions Involving New Symmetric Operator

This article aims to significantly advance geometric function theory by providing a valuable contribution to analytic and multivalent functions. It focuses on differential subordination and superordination, which characterize the interactions between analytic functions. To achieve our goal, we employ a method that relies on the characteristics of differential subordination and superordination. As one of the latest advancements in this field, this technique is able to derive several results about differential subordination and superordination for multivalent functions defined by the new operator within the open unit disk . Additionally, by employing the technique, the differential sandwich outcome is achieved. Therefore, this work presents crucial exceptional instances that follow the results. The findings of this paper can be applied to a wide range of mathematical and engineering problems, including system identification, orthogonal polynomials, fluid dynamics, signal processing, antenna technology, and approximation theory. Furthermore, this work significantly advances the knowledge and understanding of the analytical functions of the unit and its interactive higher relations. The characteristics and consequences of differential subordination theory are symmetric to those of differential superordination theory. By combining them, sandwich-type theorems can be derived.

“You walk on glass if you are in that space”: Risks and harms of corruption in wildlife justice pathways in Uganda

Wildlife crime drives existential harms including biodiversity loss and climate change, disproportionately affecting the Global South. Criminal justice approaches dominate the public response, yet scant evidence exists on how corruption, an economic crime, undermines deterrence and exacerbates inequalities. This primary research study utilises a qualitative approach to examine the risks and harms of corruption within wildlife enforcement and justice in Uganda. Using a red-green criminological perspective and drawing upon semi-structured interviews with experts and practitioners from government and civil society, this paper identifies corruption risks in wildlife criminal justice and explores their related harms and consequences. The study finds wildlife enforcement in Uganda suffers from institutional corruption, including perverse incentives which distort targeting and resource prioritisation, leading to discrimination against low-level offenders. Furthermore, differential access to individualist corruption opportunities along the justice pathway enables wealthy or well-connected suspects to avoid sanctions, resulting in sentencing inequities. Despite resulting in differential outcomes for affluent and subsistence offenders, the study concludes that corruption in wildlife justice neutralises deterrence for both offender types. By creating impunity for elites, organised crime actors are attracted to the trade. Moreover, by amplifying sentencing inequalities, subsistence offenders are further impoverished, increasing re-offending. Corruption in wildlife justice thus drives significant long-term environmental, socioeconomic, and political harms, and erodes the rule of law.

S1272 Initial Endoscopic Presentations of Immune Checkpoint Inhibitor Colitis and Their Differential Disease Outcomes

S1272 Initial Endoscopic Presentations of Immune Checkpoint Inhibitor Colitis and Their Differential Disease Outcomes

S1303 Initial Histologic Presentations of Immune Checkpoint Inhibitor Colitis and Their Differential Disease Outcomes

S1303 Initial Histologic Presentations of Immune Checkpoint Inhibitor Colitis and Their Differential Disease Outcomes

S165 Differential Outcomes of ERCP in Malignant and Benign Biliary Strictures: A National Inpatient Sample Analysis

S165 Differential Outcomes of ERCP in Malignant and Benign Biliary Strictures: A National Inpatient Sample Analysis