Survival In Population Research Articles

Racial/ethnic disparities in healthcare utilization, post-operative outcomes, and overall survival for IDH-wildtype glioblastoma stratifying by MGMT promoter methylation status.

2081 Background: Glioblastoma is the most common malignant primary brain tumor and molecular profiles such as IDH1/2 and MGMT promoter methylation status have significant influence on survival outcomes. There is no "real-world" study has investigated the racial/ethnic disparities in healthcare utilization and outcomes for IDH-wildtype glioblastoma patients with MGMT promoter methylation status. Methods: A total of 21971 IDH-wildtype glioblastoma patients ( MGMT promoter-methylated: 41.5%, 9110/21971) were derived from the National Cancer Database (NCDB, 2018-2021). Race/Ethnicity was grouped into Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Asian/Pacific Islander (API), American Indian/Alaska Native (AIAN), Hispanic, and Others. Overall survival (OS) was set as primary outcome. Healthcare utilization and post-operative outcomes are secondary endpoints. Multivariable logistic regression models, Kaplan-Meier methods, and Cox proportional hazards models were performed for post-operative outcomes, healthcare utilization, and overall survival. Results: Compared to NHW, AIAN were 78% more likely to have MGMT promoter methylation after adjusting age and gender (aOR=1.78, p=0.030). API and Hispanic were significantly less likely to undergo GTR over STR comparing to NHW. The odds of receiving chemotherapy and RT for race/ethnicity minorities patients were significantly lower than NHW (Chemotherapy: NHB: aOR=0.79, AIAN: aOR=0.57, Hispanic: aOR=0.83; RT: NHB: aOR=0.88, Hispanic: aOR=0.80). The median OSs by race/ethnicity (NHW, NHB, API, AIAN, Hispanic, and Others, respectively) were: 11.5, 12.3, 14.5, 9.2, 13.6, and 15.6, months ( MGMT promoter-unmethylated, p<0.001), 15.9, 18.8, 23.7, 14.8, 19.6, and 15.5, months ( MGMT promoter-methylated, p<0.001). After adjusting the covariates, NHB, API, and Hispanic experienced significantly lower risk of death comparing to NHW (aHR=0.82, 0.66, and 0.75, all p<0.001). Similar results were validated in stratification analysis by MGMT promoter methylation status, except MGMT promoter-unmethylated AIAN experienced 70% higher risk of death than NHW (aHR=1.70, p=0.021). Conclusions: Our findings suggests that racial/ethnic disparities exist in healthcare utilization, postoperative outcomes, and overall survival in IDH-wildtype glioblastoma population.

Prognostic factors for survival in NSCLC treated with immunotherapy: An institutional analysis.

e20591 Background: Immune check point inhibitors (ICIs) are the cornerstone of treatment for patients with advanced NSCLC. However, not all patients benefit from ICIs and some develop significant immune-mediated toxicities. There is limited data regarding prognostic factors in NSCLC patients treated with ICIs. Imaging features can complement clinical variables in predicting response to ICIs. This study aims to evaluate CEA, blood leukocyte markers, and novel CT-derived radiomic features as factors predictive of survival in this patient population. Methods: In this retrospective study, clinical data from patients with advanced stage NSCLC treated with ICIs at Stony Brook University Hospital from 2016 to 2021 were collected. Baseline and subsequent CEA (carcinoembryonic antigen), ANC (absolute neutrophil count), ALC (absolute lymphocyte count), NLR (neutrophil to lymphocyte ratio), AEC (absolute eosinophil count), and AMC (absolute monocyte count) were evaluated as independent prognostic factors. 3-D segmentation of ipsilateral lung lobe was obtained using U-Net and radiologist report of tumor location. 600 stable IBSI-standardized features were extracted from the region using PyRadiomics. The discriminative ability of clinical and image-derived variables was assessed using Kaplan-Meier survival and Cox proportional hazards regression analysis. Results: This study included 80 patients. Objective response rate (ORR) was 25.0% with 1-year OS of 58.0%. PD-L1 expression ≥ 50% was significantly associated with survival (p < 0.02). Decrease in CEA (p < 0.01) and 5% increase in AEC (p = 0.027) significantly correlated with survival. Age, sex, clinical stage, ANC, ALC, NLR, AMC did not significantly predict survival. Three image biomarkers that correlated with median enhancement of tissue on chest CT, and degree of tissue heterogeneity were significant predictors of mortality (p < 0.02). A multivariable model with clinical inputs outperformed one with radiomic features only (C-index 0.70 vs. 0.64). Clinical and radiomic inputs together performed well in predicting survival (C-index 0.76). Conclusions: Changes in CEA and AEC were the strongest predictors of survival in advanced NSCLC patients treated with ICIs. This study suggests that combined clinical and radiomic biomarkers (quantifying local lobar heterogeneity) can identify patients most likely to benefit from immunotherapy. [Table: see text]

Estimating benefit from dose dense adjuvant chemotherapy for early breast cancer in the PANTHER randomized phase 3 trial.

521 Background: Adjuvant dose dense chemotherapy for early breast cancer improves patient outcomes across all subgroups compared with standard interval treatment. However, the effect of dose dense treatment based on individual patient risk and over time, and the performance of the PREDICT model at this setting are not well-studied. Methods: This is an exploratory analysis from the phase 3 PANTHER trial (NCT00798070) that compared adjuvant sequential epirubicin/cyclophosphamide (EC) and docetaxel (D) administered in either tailored dose dense (tDD EC/D, every 2 weeks) or standard interval schedule (FEC/D, every 3 weeks) to patients with high-risk resected early breast cancer. Dose tailoring in the experimental arm was performed according to a predefined algorithm based on hematologic and non-hematologic toxicity. We evaluated the performance of PREDICT in terms of calibration and discrimination in the entire cohort and subgroups of interest, conducted a subpopulation treatment effect pattern plot (STEPP) analysis and observed the relative treatment effect over time. Results: The intention-to-treat population consists of n=2003 randomized patients. Median follow-up was 10.3 years (interquartile range, 9.1 – 10.5 years). PREDICT consistently underestimated 5-year (absolute difference 1.4%) and 10-year overall survival (absolute difference 6.6%) in the entire population and across all subgroups, but mostly so in the highest risk patients where the difference between observed and predicted 10-year survival reached 20.4% for patients with tumors larger than 5 cm. Discriminatory accuracy was lower for 10-year than for 5-year survival (AUC 0.728 and 0.786, respectively), although the difference in model performance between the two treatment groups was small. In STEPP analysis, absolute benefit from tDD EC/D in the primary endpoint of breast cancer relapse free survival was stable across risk-defined overlapping subpopulations and ranged from 3.8% in the lowest risk patients to 3.6% in the highest risk ones. There was no evidence of differential treatment effect through time (pinteraction >0.1 for all time-to-event endpoints). Conclusions: In this largely node-positive population, PREDICT consistently overestimated risk for death in all patient subgroups. We could not reliably identify any subgroup not benefiting from dose dense treatment, which should be the standard of care for primary resected high-risk breast cancer. Clinical trial information: NCT00798070 .

Patterns and trends in incidence, survival, and treatment among patients with early-onset lung cancer in the U.S.: A population-based study.

e22517 Background: Lung cancer is the second leading cause of cancer-related deaths among young adults. An in-depth investigation into the demographic distribution and temporal trends in early-onset lung cancer (EOLC) incidence and survival, as well as treatment patterns, could help monitor the cancer burden, identify high-risk populations, and develop effective screening and prevention strategies. Methods: This serial cross-sectional study used data from the U.S. Cancer Statistics (USCS) and the Surveillance, Epidemiology, and End Results (SEER) program. EOLC refers to lung cancer diagnosed in individuals aged 20-49 years. USCS database (2001-2019) was used for demographic description and incidence estimation. SEER-17 registries database (2000-2019) was used for survival estimation and treatment patterns examination. Age-adjusted incidence rate per 100,000 population and cancer-specific survival were reported. Changes in rates were assessed with average annual percentage change (AAPC) using Joinpoint regression. Results: There were 4,086,435 lung cancer cases recorded between 2001 and 2019 in the U.S. (USCS: 53.3% male; median age of 70 years). EOLC accounted for 4.1% (169,132) of all lung cancer cases and was more common among females, non-Whites, with higher adenocarcinoma and advanced-stage diagnoses. During this period, the incidence of EOLC decreased from 9.0 to 4.5 per 100,000 population (APC, -4.2; P < 0.001). EOLC incidence continued to decrease across all demographic groups, except for young people aged 20-29. The rate of decline was faster among men than women, blacks than whites, squamous carcinoma than adenocarcinoma, and distant disease than localized disease. The historical higher incidence among young men vs. young women and among blacks vs. whites have been reversed in recent years. A consistent increase in survival rates of EOLC across all demographic groups from 2001 to 2017 (SEER-17) was observed. Despite the increases were more pronounced among men than women and among black individuals than white individuals, gender and racial disparities persisted. EOLC patients received more intensive treatment than late-onset patients. Still, 12.1% of EOLC cases were not treated, and this was most common among black individuals and those with distant disease. Treatment patterns for EOLC have not undergone significant changes in recent decades. Of note, the proportion of untreated patients has not decreased during the study period. Conclusions: EOLC was an uncommon type of disease with distinctive clinical features in the U.S. Substantial decreases in incidence and improves in survival were observed, whereas major treatment pattern remained relatively stable.

A Call to Arms for the Earth. Environmental Poetry in Aotearoa New Zealand and the Pacific Islands: The Case of the Anthology No Other Place to Stand

Poetry is a major artistic expression in New Zealand and Pacific culture, including a longstanding tradition of indigenous oral literature. Besides its many functions, it can also have a crucial militant role. In the present climate emergency, the potential of oral and written poetry for environmental activism has been rediscovered: “poet-performers” have risen as militant figures that write verses and act them out on websites, during public performances and in important political venues. The effects of global warming are dramatically real in the Pacific region, especially in consequence of the sea-level rise that has caused the flooding of many atolls and is threatening the survival of populations and cultures. Aotearoa has always been sensitive to environmental problems, also thanks to the prominent voice of the Māori minority in the country’s politics. It is thus not surprising the recent publication of No Other Place to Stand (2022), the first New Zealand poetry anthology to deal with climate issues from a specifically New Zealand and Pacific perspective. The book forms a dedicated platform for creative work in response to the climate crisis. Half of the contributors are indigenous and a good number under thirty, giving voice to the people of the land and to those with the most at stake for their futures. My article will provide a critical analysis of the volume against the Pacific cultural and political background.

No man’s land support the endemic Red Sea ghost crab (Ocypode saratan) in the Gulf of Eilat

Tourism pressure on the Red Sea ecosystem have posed significant threats to numerous endemic species, including the Ghost Crab Ocypode saratan, which is exclusively found along a small stretch of beach in the Eilat/Aqaba Red Sea Gulf. Due to the limited understanding of their ecology, we investigated how tourism impacts the behavior of this species. Employing a natural setup, we compared burrow dimensions, pyramid structures, and density across three distinct beach sections subjected to varying levels of human interference. Access to a secluded beach, referred to as “No Man’s Land,” provided a crucial control for our study. This facilitated a comparative analysis of ghost crab activity among beaches experiencing differing levels of human disturbances: (1) a tourist beach characterized by continual high disturbance, (2) a naval beach subject to moderate and sporadic disturbances, and (3) the isolated “no man’s land” beach devoid of human presence. Our observations revealed notable differences in ghost crab density among the three beaches. Furthermore, we observed that on the secluded beach, larger individuals tended to establish burrows farther from the waterline and construct taller sand pyramids. Given the significance of sexual selection processes, their conservation becomes imperative for the survival and potential expansion of the ghost crab population across the Gulf of Eilat/Aqaba. We propose a straight-forward and cost-effective strategy: the designation of short, secluded beach enclaves along this gulf. We believe that this approach will mitigate adverse impacts of tourisms while simultaneously benefiting various sandy beach species.

Does roundup® affect worker bees (Apis mellifera) that inhabit areas of high agrochemical pressure?

Glyphosate-based herbicides (GBHs) find wide application in conventional agroecosystems due to their effective mode of action. The impact of herbicides on bees may be underestimated due to the scarcity of studies assessing various exposure routes to GBHs, including contact and ingestion of contaminated food. This study evaluated the survival, food consumption, and body weight of honey bee populations in three different locations, characterized by different degrees of exposure to GBHs. In bioassays, honey bees were exposed to diets containing sucrose solutions infused with glyphosate, with dosages ranging from 0 to 14 mg (a.i./bee). During the experiment, the honey bee population had a period of exposure (6 h) to the syrup infused with glyphosate. Mortality counts and feeder weight measurements were performed to assess the effects. A significant reduction in syrup intake was observed in all three bee populations during the Roundup® exposure phase, leading to a decrease in GBH intake. Notably, the decrease in syrup consumption emerged as the main factor contributing to the lower body weight observed among honey bees from low- and high-impact locations, persisting into the post-exposure period. Overall, the results demonstrate that honey bees in the high-impact region are more sensitive to Roundup®. However, studies using biochemical biomarkers are still necessary to unravel how glyphosate interferes with the acquisition and expenditure of energy during periods of exposure of honey bees and which physiological changes allow them to adapt to inhabited places with high agricultural pressure.

Prediabetes: prevalence, associations with cardiovascular risk factors and contribution to survival in the Russian population

Aim. To assess the prevalence of type 2 diabetes (T2D) and prediabetes in the Russian population aged 25-64 years, as well as the association of prediabetes with risk factors (RFs) of noncommunicable disease. To study the contribution of carbohydrate metabolism disorders to mortality and the occurrence of cardiovascular events.Material and methods. We included data from cross-sectional studies ESSE-RF and ESSE-RF2. The final sample included 26418 people (10268 men and 16150 women) who signed informed consent. A modular questionnaire was used. Biochemical parameters were determined in the National Medical Research Center for Therapy and Preventive Medicine with an Abbott Architect c8000 autoanalyzer using diagnostic kits from Abbott Diagnostics (USA). Impaired fasting glycemia (IFG) was defined as a fasting plasma glucose concentration of 6,1-6,99 mmol/L. The presence of T2D was determined by interview and/or fasting plasma glucose ≥7,0 mmol/L. Obesity was defined as a body mass index of ≥30,0 kg/m2. Abdominal obesity was defined as a waist circumference of ≥102 cm in men and ≥88 cm in women. A prospective observation cohort was formed from 14 regions of ESSE-RF and ESSE-RF2 (n=22812). The vital status of each examined person was clarified once every 2 years. Information on fatal and non-fatal events was collected. Statistical processing was performed using the open-source statistical programming language and R environment (version 4.1). Associations were assessed using logistic regression. Kaplan-Meier curves were used to estimate survival. Associations with endpoints were assessed using Cox proportional hazards models.Results. In the Russian population aged 25-64 years, the prevalence of T2D and prediabetes, assessed by IFG, was 6,9% (men — 7,1%, women — 6,7%) and 6,2% (men — 7,7, women — 5,0% (p<0,001)), respectively. Age, low level of education, obesity, including abdominal obesity, hypertension, tachycardia, hyperuricemia and lipid metabolism disorders were significantly associated with prediabetes, and for men, additionally, stress. Prediabetes and T2D demonstrated a significant decrease of survival, including cardiovascular survival, and the occurrence of a composite endpoint. However, multivariate analysis adjusted for sex, age, and region of residence indicates a significant contribution of T2D, but not IFG.Conclusion. To reduce the T2D burden in the Russian Federation, patients with T2D should be identified early and RFs should be controled. Early detection of prediabetes plays a significant role in the prevention of T2D. In addition, T2D and prediabetes have common risk factors, and therefore common ways of prevention.

Identification of common genetic variants in KCNQ family genes associated with gastric cancer survival in a Chinese population.

KCNQ family genes ( KCNQ1-5), encoding voltage-gated K + (Kv) channels, have been revealed to have potential pathophysiological roles in cancers. However, the associations between genetic variants located in KCNQ family genes and gastric cancer survival remain unclear. A large-scale cohort comprising 1,135 Chinese gastric cancer patients was enrolled to identify genetic variants in KCNQ family genes associated with overall survival (OS). Based on the survival evaluation of all five members, KCNQ1 was selected for subsequent genetic analysis. Cox regression models and stepwise Cox regression models were conducted to evaluate survival-related genetic variants. We found that KCNQ1 rs10832417 was associated with increased OS in gastric cancer patients (adjusted hazard ratio (HR) = 0.84, 95% confidence interval (CI): 0.72-0.98, P = 0.023). Subsequently, a nomogram was generated to support the prognostic capacity and clinical translation of rs10832417 variants. The rs10832417 T allele was predicted to increase the minimum free energy (MFE) of the secondary structure. Furthermore, we observed that gastric cancer patients with downregulation of KCNQ1 had poor survival in multiple public datasets. The present study found that KCNQ1 rs10832417 could serve as an independent prognostic predictor of gastric cancer, yielding novel insight into the progression and survival of gastric cancer.

The impact of lead, cadmium, and mercury on the reproduction of mountain hares (Lepus timidus L., 1758) in the north of Krasnoyarsk Krai

Reproduction is key to the survival and development of a species. Anthropogenic activities release significant amounts of toxic pollutants into the environment. In this study, we aimed to determine effects of heavy metals on some reproductive parameters of the mountain hare. Female mountain hares (n = 41) were hunted in the reference and industrially polluted areas of Krasnoyarsk Krai during four seasons. Their skeletal muscles, liver, and kidneys were subjected to atomic absorption spectrometry to determine concentrations of lead, cadmium, and mercury. The contents of lead, cadmium, and mercury were significantly higher in the hares from the contaminated areas compared to the reference sites. According to the results, the exposure to lead, cadmium, and mercury had an impact on the reproductive potential of the female mountain hares. In particular, we established correlations between numbers of embryos and corpora lutea and contents of lead in the kidneys and liver, as well as cadmium in the kidneys. The number of corpora lutea and embryonic losses in the female hares from the contaminated areas were higher than those in the hared from reference areas. However, the numbers of embryos did not differ significantly between the compared areas. Our study showed that about 40% of the liver samples and 100% of the muscle tissue samples obtained from the hares in the impact zone contained high concentrations of lead and cadmium. Therefore, hunting in these industrially polluted areas may pose a toxic hazard to the indigenous peoples living there. Further research is needed to assess potential and actual fertility, offspring survival, and other important parameters of mountain hare populations exposed to different levels of chemical pollution.

Human Wildlife Conflicts: The Case of the Olive Baboon (Papio anubis) in the Mbam and Djerem National Park and the Implications for Conservation Attention

In Cameroon, studies on adverse conflicts between humans and wildlife have focused mainly on elephants and great apes. The lack of information on monkey conflicts motivated the present study in the periphery of the Mbam Djerem National Park (MDNP) where human-olive baboon conflicts exist (Papio anubis) due to the extension of agricultural land around the park. This study was carried out in two phases: questionnaire survey administered to the population bordering the protected area to determine the crop consumed by olive baboons in the fields and field visits to measure the total area of the field and the devastated areas using a GPS to assess losses per farmer and to determine the control strategies to fight crop raiding. From July 2021 to August 2022, we administered a questionnaire to 171 people, 74 of whom were farmers around the MDNP to examine the human-olive baboon conflicts. Results obtained indicated that human-olive baboons conflicts exist, we have: crop raiding, hunting of olive baboons, bullying, disturbances caused by olive baboons, and domestic animals predation by baboons. Although ecotourism and leisure were cited as other interactions. The crop raided by olive baboons is the origin of the conflicts with Human. Cassava (Manihot esculenta) is the crop most frequently raided by olive baboons in the dry season, followed by maize (Zea mays) and groundnut (Arachis hypogaea) in the rainy season. Despite the use of control strategies such as field patrols, the installation of scarecrows, the use of traps and guns, the guarding of straw huts, and the guarding of dogs. 83% of the respondents lost approximately 25% of their crop annually due to olive baboons, and 5% of the respondents lost 25 to 50% of their crop annually, 4% of the respondents lost approximately 75% of their crop and 8% lost almost nothing. Economic losses were estimated on average at 150.647 ± 21.695 FCFA with a maximum loss of 1.058.000 FCFA [1.765 USD] and a minimum loss of 16.000 FCFA [about 27 USD]. The surface areas damaged annually by olive baboons ranged from 0.2 ha to 2.3 ha. These results showed that the crop raided by olive baboons created a conflict between humans and nature that had a negative impact on the conservation of this monkey and the survival of the local population in this region. To mitigate these conflicts, we suggest sensitizing local population on the use of the gun in the inspection of crop fields and strengthening of day and night field inspection during the crop maturity period.

Capacity for recovery in Bornean orangutan populations when limiting offtake and retaining forest

AbstractAimWe assess the potential long‐term viability of orangutan populations across Borneo, considering the effects of habitat loss, and various forms of population reduction, including hunting, retaliatory killings and capture and translocation.LocationThe study focused on the island of Borneo, a region that has experienced substantial deforestation over the past four decades, resulting in the degradation and fragmentation of its lowland forests, thereby threatening the island's unique biodiversity, including orangutan populations.MethodsTo evaluate the long‐term viability of orangutan populations, we employed a spatially explicit individual‐based model. This model allowed us to simulate various scenarios, including the impact of removing habitat fragments or individuals from the population.ResultsOur findings revealed that small forest fragments facilitate orangutan movement, thereby increasing the number of individuals settling in non‐natal patches. Crucially, orangutan populations proved highly vulnerable to even small levels of offtake. Annual removal rates exceeding 2% diminished the positive role of small forest patches in sustaining population connectivity, the long‐term viability of populations and prospects for recovery.Main ConclusionsOur results suggest that orangutan populations in Borneo could potentially recover from recent declines if removal of orangutans by hunting, retaliatory killings, capture and translocation is reduced, and habitat connectivity is maintained within human‐modified landscapes. These findings emphasize the urgent need for conservation strategies that mitigate negative human–wildlife interactions, and/or help preserve habitat and fragments as stepping stones. Measures could include promoting coexistence with local communities and translocating orangutans only in rare cases where no suitable alternative exists, to ensure the long‐term survival of orangutan populations in Borneo.

Endometrial cancer survival in populations of African descent.

To examine whether the endometrial cancer (EC) survival disadvantage among Black populations is US-specific, a comparison between African-descent populations from different countries with a high development index is warranted. We analyzed 28 213 EC cases from cancer registries in Florida (2005-2018) and the French Caribbean islands of Martinique (2005-2018) and Guadeloupe (2008-2018) combined. Kaplan-Meier and all-cause Cox proportional hazards models were used to compare survival. Models were stratified by EC histology type and the main predictor examined was race/ethnicity (non-Hispanic White [NHW] and no-Hispanic Black [NHB] women in the United States versus Black women residing in the Caribbean). For endometrioid and nonendometrioid EC, after adjusting for age, histology, stage at diagnosis, receipt of surgery, period of diagnosis, and poverty level, US NHB women and Caribbean Black women had a higher risk of death relative to US NHW women. There was no difference between US NHB and Caribbean Black women (hazard ratio [HR] = 1.07; 95% CI, 0.88-1.30) with endometrioid EC. However, Caribbean Black women with nonendometrioid carcinomas had a 40% higher risk of death (HR = 1.40; 95% CI, 1.13-1.74) than US NHB women. The low EC survival among US Black women extends to foreign populations of African descent. For the aggressive nonendometrioid ECs, survival among Caribbean Black women outside of the United States is considerably worse. This article is part of a Special Collection on Gynecological Cancers.

First report of target‐site resistance to glyphosate in Amaranthus hybridus L. in the Republic of South Africa

AbstractAmaranthus hybridus L. is a major weed for summer crops. Although A. hybridus has been a known crop weed in the Republic of South Africa (RSA) for a long time, herbicide resistance has not been a problem. Nevertheless, A. hybridus populations from KwaZulu Natal (KZN) Province have caught the attention of farmers since glyphosate has been progressively becoming less effective in controlling the species. This study aimed to evaluate herbicide resistance in A. hybridus and the underlying mechanisms of resistance. Seeds from 50 glyphosate‐resistant plants were collected from fields at Bergville and Winterton in KZN and compared with a susceptible population from Hendrina (Mpumalanga Province). Glasshouse screening was conducted where glyphosate (Roundup® PowerMax) was applied at 6‐leaf stage, at doses 0, 540, 1080 (recommended dose), 2160 and 4320 g ae ha−1. Surviving plants were sampled for molecular analysis to establish any target site mutations in the EPSPS gene that confer glyphosate resistance. Dose–response assay indicated 100% control in the Hendrina population, variation in the control of the Winterton population and 100% survival in the Bergville population. Molecular analysis indicated a rare triple mutation (TAP‐IVS) in the KZN populations. This kind of mutation endows a high level of glyphosate resistance, which explains why these populations survived even the 4× dose. These findings confirmed the first cases of glyphosate‐resistant A. hybridus and established the mechanism of resistance as target site mutations in the EPSPS gene reported in the RSA. These findings will serve as a base for other herbicide resistance cases and the development of initiatives to control and minimize the spread of this weed in the RSA.

Neurotoxic effects of carbamazepine on the mosquitofish Gambusia affinis

In recent years, the presence of pharmaceuticals in the aquatic environment has gained a significant attention. Carbamazepine, a commonly prescribed antiepileptic drug, has been consistently found in aquatic environments at concentrations ranging from nanograms to micrograms, raising concerns about its potential negative impacts on aquatic organisms. The study examined the acute and chronic neurotoxic effects of environmentally relevant and sublethal concentrations of carbamazepine in the mosquitofish Gambusia affinis. After a 96-hour exposure period, the median lethal concentration (LC50) of carbamazepine for G. affinis was determined as 24 mg L − 1. For the current study, sublethal concentrations i.e., one-tenth (2.4 mg L − 1) and one-fifth (4.8 mg L − 1) of the LC50 value were chosen for assessing the neurotoxic effects along with the environmentally relevant concentration (13 ng L − 1). The research findings indicated that carbamazepine had a disruptive impact on the typical growth and behavior of the fish. During the acute exposure phase, physical deformities were observed in the fish, resulting in neonatal and postneonatal fatalities. Furthermore, the neurotoxic effects of carbamazepine were clearly demonstrated through alterations in various neurological parameters, including acetylcholinesterase, dopamine, gamma-aminobutyric acid, serotonin, monoamine oxidase, 5-hydroxyindole acetic acid, adrenaline, and nor-adrenaline. These findings raise concerns about the survival of fish populations in their natural environment.

Trends in Survival After First Myocardial Infarction in People With Diabetes.

The aim of this study was to investigate temporal trends in survival and subsequent cardiovascular events in a nationwide myocardial infarction population with and without diabetes. Between 2006 and 2020, we identified 2527 individuals with type 1 diabetes, 48 321 individuals with type 2 diabetes and 243 170 individuals without diabetes with first myocardial infarction in national health care registries. Outcomes were trends in all-cause death after 30 and 365 days, cardiovascular death and major adverse cardiovascular events (ie, nonfatal stroke, nonfatal myocardial infarction, cardiovascular death, and heart failure hospitalization). Pseudo-observations were used to estimate the mortality risk, with 95% CIs, using linear regression, adjusted for age and sex. Individuals with type 1 diabetes were younger (62±12.2 years) and more often women (43.6%) compared with individuals with type 2 diabetes (75±10.8 years; women, 38.1%), and individuals without diabetes (73±13.2 years; women, 38.4%). Early death decreased in people without diabetes from 23.1% to 17.5%, (annual change -0.48% [95% CI, -0.52% to -0.44%]) and in people with type 2 diabetes from 22.6% to 19.3% (annual change, -0.33% [95% CI, -0.43% to -0.24%]), with no such significant trend in people with type 1 diabetes from 23.8% to 21.7% (annual change, -0.18% [95% CI, -0.53% to 0.17%]). Similar trends were observed with regard to 1-year death, cardiovascular death, and major adverse cardiovascular events. During the past 15 years, the trend in survival and major adverse cardiovascular events in people with first myocardial infarction without diabetes and with type 2 diabetes have improved significantly. In contrast, a similar improvement was not seen in people with type 1 diabetes.

Clinical Utility of the Novel Oncological Criteria of Resectability for Advanced Hepatocellular Carcinoma

Introduction: Introduction of new systemic therapies for hepatocellular carcinoma (HCC) has led to the development of new oncological criteria of resectability for the resectability of HCC. This study was aimed at validating the prognosticating ability and clinical utility of the resectability classification based on the novel criteria in real-world clinical practice. Methods: This study was conducted in 1,822 patients who had undergone curative resection for HCC (population 1) and 107 patients with unresectable disease who had received lenvatinib therapy (population 2). Patients were classified into three groups according to the novel oncological criteria for resectability (R, resectable; BR1, borderline resectable 1; and BR2, borderline resectable 2), and the prognosticating ability and clinical utility of this classification based on the novel criteria were examined. Results: Multivariate analysis confirmed that classification of the patients according to the oncological resectability criteria was significantly correlated with the overall survival (OS) (BR1: hazard ratio [HR], 1.88; 95% CI, 1.38–2.55; BR2: HR, 4.12; 95% CI, 3.01–5.65) and recurrence-free survival (BR1: HR, 1.86; 95% CI, 1.44–2.41; BR2: HR, 3.62; 95% CI, 2.71–4.82) in population 1. In population 2, the resectability classification was correlated with the rates of successful additional intervention (surgery, transarterial chemoembolization, or radiotherapy) (BR1 65.7% vs. BR2 42.3%, p = 0.023) and curative-intent conversion surgery (BR1 17.1% vs. BR2 4.2%, p = 0.056) after lenvatinib therapy, and was also predictive of the OS (HR, 1.96; 95% CI, 1.13–3.38 for BR2 [vs. BR1]) and time-to-treatment failure (HR, 1.81; 95% CI, 1.04–3.17 for BR2 [vs. BR1]). Conclusion: The resectability classification based on the novel oncological criteria for resectability showed acceptable prognosticating ability in both surgically and medically treated populations with advanced HCC.

OUTCOME OF OUT OF HOSPITAL CARDIAC ARREST: ARE THERE GENDER DIFFERENCES?

Abstract Background Despite advance in resuscitation science, out of hospital cardiac arrest (OHCA) has an average survival rate of only 10 %. Ventricular fibrillation (FV) is amenable to defibrillation, but deteriorates to non shockable rhythms over time. It’Known that immediate cardiopulmonary resuscitation and eraly defibrillation increase survival after OHCA. It remains unclear whether there is an association between gender and survival. It seems that women OHCA patients are older, are less likely to have a witness arrest and they had fewer arrest in pubblic location than men . However these data are controversial. Methods We considered consecutively 6995 OHCA survivors resuscitated from emergency medical System (EMS) or bystander (BS) In Piacenza between june 1999 to decembre 2022 and we evaluated the outcome, considering sex and gender disparities Results Out of 6995 suffered from OHCA, 2983 (43%) were females with average age 81 ±13 years and 4012 (57%) males with average age of 73 ±15 years (p<0,00001).We observed with advanced age an incresead rate of woman that suffered from OHCA in comparison to man (< 44 years 177 m vs 63 w; 45–60 y 594 m vs 152 w, 61–75 y 1261m vs 530w; > 75 y 1980 m vs 2239 w).The survival of our population was 270 patients At EMS arrival 6150 patients (88%), 2779 (45%) female and 3371 (55%) male presented a non schockable rhythms (NSR):asystole or pulseless electrical activity (PEA) whilst 845 patients(12%), 170(75%) males and 56 (25%) females, presented FV .In the group with FV as initial rhythm, the survival was 26% (56/206 f 27% vs 107/647 m 26% p= 0,06). Also in this group women were slightly older (73 years f vs 67 m, p<0,00001). In all population survival decreased in females vs males (66/2984 w 2% vs 200/4012 5%f vp<0,00001).Females appeared with more non schockable rhythms (93 % f vs 84 % m, p< 0,00001)Women suffered from OHCA were found more frequently at home (2785 w 93% vs 3379 84%m p < 0,0001).Furthermore 97% males and 98% female were treated by EMS and 3 % males and 1,3% females by BS(survival males 3,6% EMS vs 51% BS and females 2 EMS%vs 26%BS). Conclusions In our OHCA population, the survival was 4% with better results in man Female were older and they had less survival, because initial rhythm registered were non shockable rhythms. They were found at home,with a delay in the first aid. This can be due to a gender disparities with advanced age.

Evaluation of sex inequity in lung-cancer-specific survival.

Whether sex is an independent prognostic factor in lung cancer survival is the subject of ongoing debate. Both large national registries and single hospital studies have shown conflicting findings. In this study, we explore the impact of sex on lung-cancer-specific survival in an unselected population that is well-characterized with respect to stage and other covariates. All patients diagnosed with lung cancer at a single hospital serving a whole and defined region in Southern Norway during the 10 years 2007-2016 were included. Follow-up data were available for at least 56 months for all patients. Analyses were adjusted for stage, treatment, performance status, smoking, age, histology, epidermal growth factor receptor/anaplastic lymphoma kinase/immunotherapy treatment and period. Differences in lung-cancer-specific survival by sex were explored using restricted mean survival times (RMST). Of the 1,261 patients diagnosed with lung cancer, 596 (47%) were females and 665 (53%) males, with mean ages of 68.5 and 69.5 years, respectively. The observed 5-year lung-cancer-specific survival rate was 27.4% (95% CI 23.7, 31.2) in females and 21.4% (95% CI 18.2, 24.8) in males. However, after adjustment for covariates, no significant differences by sex were observed. The 5-year RMST was 0.9 months shorter (95% CI -2.1, 0.31, p = 0.26) in males compared to females. In this cohort, sex was not associated with a difference in lung-cancer-specific survival after adjusting for clinical and biological factors. Imbalance in stage at diagnosis was the main contributor to the observed difference in lung-cancer-specific survival by sex.

Population Status of the Endangered Semi-Mangrove Dolichandrone spathacea on Hainan Island, China

In China, Dolichandrone spathacea is a rare and endangered semi-mangrove plant species with an extremely small population, naturally distributed only in Zhanjiang City and the east coast of Hainan Island. Despite conservation concerns, the population status of D. spathacea has received little scientific attention. In this study, we evaluated the current status of D. spathacea on Hainan Island, China, in order to propose sustainable conservation strategies for future ecological restoration of its natural population. D. spathacea on Hainan Island can be divided into four populations. All the D. spathacea populations present a state of overall dispersion, local concentration, and occasionally sporadic existence, and they exist in geographical isolation. The young, middle, and old D. spathacea plants account for 20.42%, 66.20%, and 13.38%, respectively, indicating that the D. spathacea population on Hainan Island is declining. Furthermore, instead of temporal structure, we used diameter at breast height (DBH) to establish a static life table, draw a population survival curve, and quantify the future development trend through population dynamic analysis and time-series prediction. These results suggest that the D. spathacea population in the Bamen Gulf (Wenchang) and Qingmei Harbor (Sanya) on Hainan Island is sensitive to external disturbances and possesses two main increases in mortality rate—namely, in its juvenile and mature stages—due to competition and anthropogenic interferences, which might be the most important reasons for its endangered status. Depending on the current conditions of the D. spathacea population, we should conserve and expand mature trees in situ, preserve their germplasm resources, rehabilitate their habitats to promote provenance restoration, and conduct artificial cultivation and spreading planting in order to realize the sustainable conservation and management of D. spathacea.