Rising Liver Disease Mortality in the United States, 1999-2023: Temporal Trends and Disparities.

Liver cancer mortality (HCC, iCCA) is rising in the U.S., with marked sex disparities linked to hormones and risk factor exposure. This study examines recent trends in mortality by subtype, aetiology, and generation, highlighting their roles in sex-based differences. Mortality data for U.S. residents (1999-2023) were obtained from the CDC WONDER database. Age-standardised mortality rates were analysed for HCC and iCCA, with HCC deaths further classified by aetiology. Mortality trends were assessed by sex using Joinpoint regression, and age-, period-, and birth-cohort effects were evaluated with constrained generalised linear models. Between 1999 and 2023, 534 526 liver cancer deaths occurred (353 968 in men; 180 588 in women). Male mortality increased until 2013, plateaued, and declined after 2017, while female mortality continued to rise modestly. For HCC, HCV-related mortality peaked around 2013 and declined thereafter, coinciding with direct-acting antiviral introduction. Meanwhile, MASLD-related mortality rose steadily, becoming the leading reported aetiology in both sexes by 2023. ALD-related mortality also increased, while HBV-related mortality remained stable. Cohort analysis revealed excess HCC mortality among those born in the 1940s-1960s. In contrast, iCCA mortality rose continuously in both sexes and across birth cohorts, with sharp increases among women and younger adults. By 2023, iCCA accounted for 44% of female liver cancer deaths. Liver cancer mortality is declining in men but rising in women. These trends coincide with changes in HCC etiologies along with an increasing contribution of iCCA, particularly in women. Targeted prevention and equitable access to screening are pivotal to reducing mortality.

Modern causal methods are underutilized in occupational epidemiology, despite the development of robust methods to adequately control time-dependent confounding affected by prior exposure, the root of the healthy worker survivor effect. We demonstrate how to detect the healthy worker survivor effect empirically and explain how to interpret analyses that have not adjusted for it. For lymphohematopoietic cancer mortality and female breast cancer mortality, we performed pathway analyses assessing whether employment is a time-varying confounder affected by prior workplace exposure to ethylene oxide. These analyses ascertained whether the relevant causal relationships depicted in a directed acyclic graph were present. For both outcomes, workers employed longer were at lower risk. Workers exposed to higher levels of ethylene oxide were also more likely to leave work. Thus, employment is a time-varying confounder affected by prior exposure. The directions of these associations imply that healthy worker survivor effect is operating. Previously published estimates of health effects of workplace exposures to ethylene oxide on both lymphohematopoietic cancer mortality and female breast cancer mortality are underestimates of the true impacts. Applying these methods to other occupational cohorts can aid interpretations of analyses that have not adjusted for the healthy worker survivor effect.

Breast cancer remains the most frequently diagnosed malignancy and the leading cause of cancer-related death among women worldwide, with 2.3 million new cases and over 685,000 deaths annually, accounting for 12.5% of all cancers and 16% of female cancer mortality. Conventional chemotherapeutic regimens, though effective, are limited by systemic toxicity, multidrug resistance, and poor tumor selectivity. This review aims to critically evaluate recent advances in nanotechnology-driven oxaliplatin delivery systems for breast cancer, emphasizing nanocarrier design, targeting strategies, and stimuli-responsive release. Oxaliplatin, a third-generation platinum analogue, exhibits potent cytotoxicity but suffers from neurotoxicity and unfavorable pharmacokinetics. Recent advancements in nanotechnology have enabled the development of oxaliplatin-loaded nanocarriers that enhance tumor accumulation, enable pH- or redox-responsive release, and improve therapeutic efficacy. Polymeric nanoparticles, liposomes, lipid hybrids, and metallic platforms have demonstrated superior apoptosis induction, tumor growth inhibition, and reduced nephrotoxicity and neurotoxicity in preclinical breast cancer models, particularly triple-negative subtypes. Moreover, emerging multifunctional and stimuli-responsive nanoplatforms integrate imaging, targeting, and combination therapy for precision oncology. Despite promising outcomes, clinical translation is hindered by formulation instability, heterogenous biodistribution, and regulatory constraints. Future directions emphasize AI-assisted nanoparticle design, personalized nanomedicine, and synergistic chemo-immunotherapeutic strategies. The oxaliplatin nanocarriers represent a transformative step toward safer, more targeted, and effective platinum-based chemotherapy in breast cancer management.

Multiple myeloma (MM), the second most common haematological malignancy, remains incurable to date. Based on Global Burden of Disease 2021, global trends in MM incidence, mortality and disability-adjusted life-years (DALYs) were analysed and visualized. Estimated annual percentage changes (EAPCs) quantified trends and future disease burden (2022-2050) were forecasted using autoregressive integrated moving average time-series models. From 1990 to 2021, the global burden of MM incidence showed a slight increase, primarily affecting ageing populations and high/high-middle sociodemographic index (SDI) regions. This rise was more significant in males and notably in middle SDI regions (including East Asia, Central Asia and Western Sub-Saharan Africa). Mortality trends exhibited minimal overall growth; female age-standardized death rates (ASDRs) decreased, especially in high SDI regions. Across 204 countries and 21 SDI regions, MM ASDRs correlated positively with SDI, while EAPCs correlated negatively with Human Development Index (HDI), age-standardized incidence rates (ASIRs) and ASDRs. Projections indicate rising ASIRs for both sexes and increasing ASDRs and age-standardized DALY rates among males through 2050. Additionally, population-attributable fractions of MM deaths and DALYs due to high body mass index showed upward trends across all SDI regions from 1990 to 2021. Over three decades, global MM incidence has moderately increased, most affecting ageing populations and high/high-middle SDI regions. Notably, global mortality and DALY rates have declined since 2000, especially in females and high SDI regions. Initiatively, our study identified a significant negative correlation between the HDIs and EAPCs of MM incidence and mortality and takes SDI as the core external predictor to project the global MM disease burden up to 2050.

The epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) are key members of the receptor tyrosine kinase family. Under normal physiological conditions, they play crucial roles in regulating cellular homeostasis and development, including cell differentiation, proliferation, and survival. However, when dysregulated due to mutation, amplification, or overexpression, these receptors become potent drivers of tumorigenesis, especially in breast cancer (BC). BC, being the second most prevalent cancer globally, remains a major contributor to female mortality. The EGFR and HER2 overexpression are present in nearly 15–30% of all BC cases and are a hallmark of aggressive BC and drug resistance, correlating with poor prognosis. Over the years, multiple tyrosine kinase inhibitors (TKIs) have been developed, showing promising responses against previously limited treatment options. This review focuses on strategies for designing dual EGFR-HER2 inhibitors for the treatment of BC and on insights into the development of new dual inhibitors.

To evaluate sex differences in perioperative characteristics, in-hospital outcomes and long-term survival following coronary artery bypass grafting (CABG). Prospective data were collected for all patients undergoing isolated CABG at a single centre during 2001-2021. Baseline characteristics were adjusted between females and males using 1:1 propensity score matching (nearest-neighbour, without replacement). Kaplan-Meier analysis assessed long-term survival. A predefined sub-analysis assessed risk mitigation associated with using off-pump CABG (OPCABG) in females in the matched cohort. Prematching, 11 563 males and 2573 females were included. Females were older with higher prevalences of class III-IV angina, hypertension and diabetes. After matching, 2573 patients per group were analysed, with standardised mean differences <0.1 for all covariates. Females had fewer left internal mammary artery (LIMA) grafts (84% vs 88%, p<0.001), fewer total grafts (median 2 vs 3, p<0.001), higher in-hospital mortality (2.2% vs 1.3%, OR 1.74, 95% CI 1.14 to 2.71, p=0.011) and longer hospital stays (median 7 days vs 6 days, beta 0.51, 95% CI 0.12 to 0.90, p=0.01). Long-term survival was similar (stratified log-rank p=0.79). OPCABG mitigated the risk of in-hospital mortality in females (1.1% males vs 1.6% females, OR 0.69, 95% CI 0.33 to 1.43, p=0.32; 1.6% OPCABG females vs 3.0% on-pump females, OR 0.53, 95% CI 0.31 to 0.91, p=0.021). Females suffer higher in-hospital mortality and receive fewer LIMA and total number of grafts than males; however, 20-year survival is similar. OPCABG protects females from in-hospital mortality. A new female-tailored peri-operative care approach is warranted for females undergoing CABG.

ABSTRACT Purpose To examine recent trends, disparities, and geographic variation in US mortality rates using National Center for Health Statistics (NCHS) Vital Statistics Rapid Release (VSRR) provisional estimates from 2022 through 2024, with attention to ongoing effects of COVID-19 and implications for public health planning. Design Secondary analysis of nationally reported quarterly mortality data using a quantitative, descriptive epidemiological approach. Methods Quarterly provisional mortality estimates were obtained from NCHS VSRR and supplemented with demographic and geographic data from CDC WONDER and COVID-19 mortality reports. Publicly available data required no institutional approval. Temporal trends were assessed from 2022 Q1 through 2024 Q3. Mortality rates were analyzed by sex and by state to identify demographic and regional disparities. Post-pandemic patterns were evaluated to assess indirect effects of COVID-19. Findings Overall mortality declined from early 2022 through mid-2023, followed by a resurgence in 2024. Male mortality remained higher than female mortality across all quarters. Geographic disparities persisted, with elevated mortality concentrated in Appalachian and Southern states and lower rates in states with stronger healthcare infrastructure. The 2024 increase suggests continued vulnerability related to delayed chronic disease management, behavioral health challenges, and residual pandemic disruptions. Conclusions Although mortality declined after the acute phase of COVID-19, the 2024 rebound highlights ongoing health system strain and persistent inequities across the US. Clinical Relevance Findings support targeted prevention, chronic disease monitoring, and equity-focused interventions to reduce post-pandemic mortality disparities and improve population health outcomes.

Incorporation of HPV-DNA molecular test into the Brazilian healthcare system.

To develop effective health policies and prevention strategies for reducing lung cancer mortality, it is essential to understand its associations with contextual factors, yet prior studies have produced inconsistent results suggesting the associations might vary over space. Very few studies have explicitly examined gender-specific spatial variations in the associations and investigated how the spatial patterns are shaped by community socioeconomic characteristics. This study aimed to examine spatial variations and gender differences in associations of lung cancer mortality rate with contextual environmental, socioeconomic, and health factors in response to the varying socioeconomic characteristics across 159 counties in Georgia, USA for 2019-2023. Following a cross-sectional ecological study design based on county-level aggregated data, this study linked three environmental, fifteen socioeconomic, and fourteen health factors to lung cancer mortality rates for males and females, and conducted various statistical and spatial analyses including Geographically Weighted Regression (GWR) to explore the spatially varying associations of lung cancer mortality rate with those contextual factors. As an explanatory local spatial statistical technique, GWR revealed that the associations varied across space and gender, with significant links observed in fewer counties than nonsignificant ones. No significant spatial autocorrelation was detected in the residuals from the GWR models of lung cancer mortality rate for either males or females (I=-0.121, p = 0.064 for males; I=-0.110, p = 0.098 for females). Key findings include: (1) radon was a more consistent factor associated with elevated lung cancer mortality rates than PM2.5 and ozone, particularly for males in urban and suburban areas, while air pollutants were significant only in some rural counties; (2) higher socioeconomic and household vulnerabilities increased risks for both genders in rural counties, whereas higher minority populations and greater housing density were linked to lower risks, especially for males in northern urban/suburban counties; (3) prevalences of chronic diseases and smoking were significant factors associated with elevated lung cancer mortality rate for both genders, with chronic diseases showing more spatially consistent effects among females, while annual checkup was a stronger factor associated with reduced lung cancer mortality rate for females, especially in less socioeconomically vulnerable urban/suburban counties; and (4) health factors had the strongest and most spatially consistent effects on mortality rate, followed by socioeconomic and then environmental factors. These findings suggest that effective lung cancer control requires public health policies and preventive measures to be locally tailored, gender-sensitive, emphasizing chronic disease management, smoking cessation, regular preventive care, and socioeconomic development.

The study investigated the relationship between household income, malnutrition, and mortality in China based on longitudinal data collected at five-year intervals from 1995 to 2020. Accordingly, trends in adult female, adult male, and infant mortality were examined together with changes in household income and undernourishment prevalence. The results show a steady decline in mortality in every group, whereas malnutrition fell precipitously, especially after 2010. Household income was rather volatile but generally increased in later years, matching the decline in mortality. Graphical evidence suggests that there are inverse relationships between mortality and income, as well as between mortality and malnutrition. This is reflected in the correlation matrix, with all co-movements strong because of common downward trends over time. Overall, improved household welfare, enhanced nutritional status, and health system strengthening all seemed to contribute to the better health status of the population in China. Based on these results, the study recommends continued investment in nutrition programs, expanded social welfare measures to support household income, and further strengthening of maternal and child healthcare services to sustain progress in reducing mortality.

Colorectal cancer (CRC) remains a leading global malignancy with a rising obesity-attributable burden. Emerging evidence highlights concerning trends in early-onset CRC and marked regional disparities, underscoring the need for comprehensive epidemiological assessments to inform targeted prevention strategies. Using Global Burden of Disease 2023 data, we analysed high body mass index (BMI)-related CRC deaths and disability-adjusted life years (DALYs) among adults (>40 years) from 1990-2023. We analysed both absolute counts and age-standardised rates, stratifying by sex, age, region, and sociodemographic index (SDI) categories. Decomposition analysis quantified the contributions of ageing, population growth, and epidemiological factors. We used Bayesian age-period-cohort analysis to project future trends. From 1990 to 2023, the global number of high BMI-related CRC deaths increased more than 2-fold, accompanied by a corresponding marked increase in DALYs. Western Europe had the highest burden, while South Asia had the most rapid growth in deaths, as measured by the estimated annual percentage change. Generally, as SDI decreased, the corresponding numbers of deaths and DALYs decreased. Cluster analysis based on the estimated annual percentage changes in age-standardised rates of high BMI-related CRC deaths and DALYs identified distinct regional patterns, with significant decreases in these rates in Western Europe and high-income North America, contrasted by significant increases in South Asia and Central Sub-Saharan Africa. Decomposition analysis indicated that population growth was the primary driver of the rise in mortality, followed by population ageing, and these were partially offset by improvements in epidemiological risk. Projections suggest a continuing increase in the age-standardised death rates for both males and females by 2038. High BMI has become a key driver of CRC mortality and incidence worldwide. Reducing this burden requires efforts in healthy lifestyles, policy reforms, and international scientific cooperation.

Globally, the leading causes of female morbidity and mortality include endometrial, ovarian, and cervical cancers. Even while posttreatment follow-up is crucial for managing problems and detecting recurrences early, adherence is still below ideal, especially in the low-resource countries. The aim of the study was to evaluate the impact of structured counseling and call-recall interventions on follow-up compliance in gynecological cancer survivors and identify barriers contributing to nonadherence. A prospective observational study was conducted over 18 months at Northern Indian tertiary care facility. A total of 187 women who had completed primary treatment for gynecological cancers that were histologically confirmed. Small-group counseling was provided through interactive sessions and printed materials, and after 3 and 6 months, follow-up reminders were sent out through a structured call-recall system. The most common cancers were ovarian (47.1%) and cervical (28.9%), 65.2% presented in early stages. Counseling was given to 64.2%, follow-up adherence was improved significantly (P = 0.002). Mean follow-up increased from 34.3% to 53.8% postintervention (P = 0.001). Following call recall, attendance increased by 57.5% and 62.4% at 3 and 6 months, respectively. Major barriers were reported, including limited awareness, lack of career assistance, and financial limitations. Younger age, greater socioeconomic status, literacy, and early-stage disease were all substantially correlated with better compliance (P < 0.05). After counseling, 68.3% of patients expressed high satisfaction, but there were mixed reviews of the call-recall system. Among survivors of gynecological cancer, counseling and call-recall interventions significantly improved follow-up compliance. In order to maintain surveillance adherence, this approach addresses logistical, financial, and awareness-related barriers.

Type 2 diabetes (T2D) disproportionately increases cardiovascular disease risk and premature mortality in females compared to males. Exercise intolerance is a hallmark symptom of T2D and an early indicator of cardiovascular dysfunction. While both central (cardiac) and peripheral (vascular, skeletal muscle) factors contribute to exercise intolerance in T2D, skeletal muscle microvascular dysfunction is increasingly recognized as an early contributor and key therapeutic target. However, the sex-specific cardiovascular mechanisms underlying exercise intolerance remain poorly understood. Females with T2D have lower exercise capacity and are less physically active than their male counterparts, which likely contributes to their heightened cardiovascular risk and worse clinical outcomes. Emerging evidence suggests that cardiac mechanisms may play a larger role in exercise intolerance in females, although sex differences in skeletal muscle microvascular function and dysfunction are poorly characterized. This narrative review synthesizes current research on the cardiovascular determinants of exercise intolerance in T2D, with a specific focus on the skeletal muscle microvasculature, and examines how sex differences in cardiovascular physiology and pathophysiology may affect exercise capacity. We highlight gaps in sex-specific research in healthy populations and individuals with T2D that limit insight into underlying disease mechanisms and effective therapies. Closing these gaps is essential for accurate risk assessment, timely diagnosis, and designing interventions that better address the cardiovascular needs of females with T2D.

Abstract Background: Breast cancer is a major public health concern in Sierra Leone, contributing significantly to female cancer mortality. Late-stage presentation, lack of screening infrastructure, pervasive stigma, and absence of a national cancer registry hinder effective intervention [1,2]. Limited healthcare access, insufficient trained professionals, and low public awareness further exacerbate the crisis, necessitating community-based solutions and public health education [3]. Patients typically presented only when symptoms were severe, reflecting widespread unawareness, myths, traditional/religious beliefs and financial/geographic barriers to care [4]. Methods: This study presents data from community outreach and screening initiatives conducted by the Thinking Pink Breast Cancer Foundation (TP), a Sierra Leone-based nonprofit, and its collaboration with Breast Cancer Hub (BCH), a U.S.-based nonprofit established in 2017, that joined forces with TP in 2021. BCH expanded the impact through treatment aid for underprivileged patients since 2021 and launched the “One Community Per Month Campaign” in 2024, promoting monthly free screenings and awareness campaigns in schools, markets, and underserved communities. Data was collected by field teams and analyzed using descriptive statistics. Results: From 2012 to 2024, 20,968 individuals (19,719 females and 1,249 males) were screened. Of these, 5,537 showed abnormal symptoms such as pain, itching, swelling, or nipple discharge, leading to ∼26.41% abnormality. During the 2024 “One Community Per Month Campaign,” 772 individuals (683 females, 89 males) were screened, and 91 abnormal cases were identified for further evaluation. Overall, we executed 1,169 lumpectomies. A total of 164 breast cancer cases were confirmed—all at advanced stages. Among them, 100 patients underwent mastectomy, while 63 advanced cases were untraceable due to family-related challenges. Mortality was extremely high: 100 patients died (92 females, 8 males), with only one known survivor. Alarmingly, knowledge of breast cancer symptoms was negligible. None of the participants reported ever performing a Breast Self-Exam (0%) or undergoing a Clinical Breast Exam (0%). Between 2012 and 2024, none of the 4,419 individuals over 40 years (4,328 from general outreach and 168 from the 2024 One Community-Per Month campaign) had ever received a screening mammogram or breast ultrasound—reflecting a 0% prior screening rate in this high-risk group. Visits to healthcare facilities were typically initiated only after symptoms became severe. Geographic and financial barriers, lack of awareness, and limited access to diagnostic services were significant contributors to delayed care. Discussion: The findings highlight a critical public health gap in breast cancer awareness, screening, and early intervention in Sierra Leone. Late-stage diagnoses and near-total mortality among confirmed cases underscore the urgent need for national breast cancer programs. TP and BCH have pioneered community-centered approaches, providing free screenings, awareness education, and patient aid. Their collaborative model demonstrates the potential for grassroots action to drive systemic change. Continued expansion of such programs, combined with national policy support, is essential to reduce preventable deaths and improve survival outcomes in Sierra Leone.

ABSTRACT Tick pest management requires innovative approaches to overcome problems caused by the excessive use of synthetic pesticides, including resistance and environmental pollution. The use of biological agents and biosynthesized nanoparticles offers a promising alternative, reducing residue concerns while effectively controlling tick populations. The current study aimed to evaluate the synergistic effects of locally entomopathogenic fungus (EPF), Beauveria bassiana and silver nanoparticles (AgNPs) on camel tick, Hyalomma impeltatum. B. bassiana was isolated from soil millipede, Archispirostreptus syriacus and molecularly identified (sequence analysis of ITS1 and ITS4). The acaricidal effectiveness of B. bassiana conidial suspension (CS) or fungal filtrates (FF) along with AgNPs at four concentrations was separately and jointly evaluated against eggs, larvae, and females of H. impeltatum using immersion test. The percentage of larval hatchability was recorded 7 days post-treatment, whereas mortality of larvae and females was monitored daily for 4 days. The isolated fungus was identified as B. bassiana TU-33. All tested combinations showed synergistic effects against H. impeltatum eggs, larvae, and engorged females. Three days after exposure to a conidial suspension (1.5 × 10⁵ conidia/mL) combined with AgNPs (2 mg/L), complete mortality was observed, with LC₅₀ values of 0.20 mg/L for larvae and 0.22 mg/L for engorged females. At the highest conidial dose (1.5 × 10⁷ conidia/mL), egg hatchability decreased to 31.7%, while larval and female mortality reached 82.2% and 71.5%, respectively. All biological traits of engorged females were significantly altered, demonstrating the high efficacy of combining EPF with AgNPs for tick control.

Atrial fibrillation (AF) is associated with profound morbidity and mortality, including a fivefold increase in stroke risk. Left atrial appendage occlusion (LAAO) devices have emerged as an alternative approach to anticoagulation in patients with elevated bleeding risk and/or have contraindications to anticoagulation. However, females have been underrepresented in PROTECT & PREVAIL landmark trials supporting LAAO use. We aim to compare gender differences in outcomes of LAAO occlusive devices. The national readmission database (2016-2020) was utilized to identify hospitalizations for LAAO placement. Cohorts were stratified by gender as males and females. A propensity score matching (PSM) model matched both cohorts. Pearson's x2 test was applied to the matched cohorts to compare outcomes. Among 89,552 hospitalizations for LAAO placement, 41.3% of procedures were performed in females. Females were found to have a lower prevalence of co-morbidities such as diabetes, hypertension, hyperlipidemia and CKD [p < 0.001]. After propensity matching (N = 20,627), females had higher adverse events, including mortality (0.23%vs. 0.15%, p: 0.041), sudden cardiac arrest (1.77%vs. 1.37%, p: 0.001), pericardial complications (1.46%vs. 0.86%, p < 0.001), cardiac tamponade (0.94%vs. 0.54%, p < 0.001), post-procedural bleeding (0.69%vs. 0.53%, p: 0.032) & net adverse events (4.73%vs. 4.24%, p < 0.001). At six-month follow-up post-procedure, females had higher readmission rates at 30 days (9.42%vs. 8.07%, p < 0.001), 90-day and 180-day intervals (p < 0.001). In patients with hospitalizations for LAAO device placement, we observed a higher risk of net adverse events and mortality in females following the procedure compared to males. Prospective trials are warranted to identify and stratify the at-risk population with extensive preprocedural evaluation and determine ways to mitigate the sex-related disparities in clinical outcomes following the LAAO procedure.

Population-based cancer registry (PBCR) of Bhutan was established in Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) in 2014 with the support of the Ministry of Health (Bhutan) and IARC Regional Hub, Tata Memorial Centre (TMC), Mumbai, India. This PBCR provides nationwide coverage (0.7 million population). We aim to present the cancer patterns in Bhutan for the years 2014-2022 using PBCR data. Trained registry staff collect cancer patient information by visiting various sources such as hospitals and diagnostic facilities. Data is entered into CanReg5 software. Data quality and consistency are checked by the IARC Regional Hub-TMC, Mumbai. The age-specific rate and age-adjusted rate were calculated using CanReg5 software. In the 9-year period (2014-2022), the PBCR registered 5906 incidence cancer cases, of which 2659 (45%) were males and 3247 (55%) were females. The age-adjusted incidence rate for males and females was 88.3 and 113.2 per 100,000 population, respectively. Age-adjusted mortality rates for males and females were 42.7 and 44.6 per 100,000 population, respectively. The leading cancer sites among males are stomach, esophagus, liver, lung, and rectum, and for females, cervix uteri, stomach, breast, lung, and thyroid. Cancer registry will play a pivotal role in boosting and monitoring screening program initiatives in Bhutan. Through effective linkages, it will build a robust database providing a cancer profile of the Bhutanese population which can be employed to devise effective cancer control activities in Bhutan.

ABSTRACTReproduction is a fundamental aspect of a species' life history that is energetically costly, yet critical for population sustainability and genetic diversity. Wild turkeys exhibit high rates of nest loss and female mortality during reproduction, prompting females to make decisions related to spatial and movement decisions during nesting. Using GPS data from eastern wild turkeys (Meleagris gallopavo silvestris ), we assessed female movements and space use during laying and evaluated potential impacts of those metrics on nest success and female survival during incubation. We used a Bayesian logistic regression to estimate nest success and female survival based on space use, daily movements, and range overlap with conspecifics during the laying period. We found that with each increase of ~700 m in average daily distance traveled during laying, there was a 1.73% decrease in the probability of nest success. We also found that having a greater number of conspecific females with overlapping core areas had a positive influence on nest fate. Specifically, an increase of 1 overlapping female (one standard deviation) was associated with a 4.76% increase in the probability of nest success. Conversely, we found weak support that female survival was positively related to increasing average daily distances traveled. Our findings suggest that female wild turkeys perceive reproductive advantages to sharing space with conspecifics during the laying period. Conversely, our findings suggest that movements of female wild turkeys within their reproductive period may only weakly influence metrics of reproductive success during both laying and incubation.

CRISPR-Cas12a-integrated pregnancy test strip biosensors: Visual detection of telomerase and miRNA let-7a in cervical cancer diagnostics.