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Introduction: Countries with large economies are observing a growing number of culturally and linguistically diverse (CALD) older adults, many of whom will be affected by cancer. Little is known about the experiences and factors that influence cancer treatment decision-making in this population. The purposes of this scoping review are: (1) to summarize the published literature on cancer treatment-related decision-making with this population; and (2) to identify potential differences in how cancer treatment decisions are made compared to non-CALD older adults with cancer., Materials and Methods: We conducted a scoping review following Arksey and O'Malley and Levac methods, Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Guidelines. We conducted a comprehensive multidatabase search, screening 1,139 titles/abstracts. Following data abstraction, we analyzed the data using tabular and narrative summary., Results: We extracted data from six studies that met the inclusion criteria: four quantitative and two qualitative; five from the United States and one from Canada. Three themes were identified: (1) barriers to decision-making, (2) the influence of family and friends on decisionmaking, and (3) differences in uptake and types of treatment received between CALD and non-CALD older adults., Discussion: This comprehensive review of treatment decision-making among CALD older adults with cancer highlights the paucity of research in this area. The findings are limited to North American populations and may not represent experiences in other regions of the world. Future research should focus on studying their treatment-related decision-making experiences to improve the quality of care for this vulnerable population., Competing Interests: Declaration of Competing Interest BL has received honoraria from AstraZeneca outside of the submitted work. LAC has received payment for expert testimony, for travel to attend a meeting, and is an elected board of directors for the Advanced Practitioner Society for Hematology and Oncology (unpaid). LN and RJ are elected members of the board of directors for the Canadian Association of Nurses in Oncology (unpaid). CME, SP, KK, RJ, KK, PSB, JL, YZ, MP, CB, FK, JLK, TR, EB, CK, LK, and KRH have no disclosures., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Although indications for immune checkpoint inhibitors (ICIs) have dramatically increased in the past decade, ICIs have been associated with autoinflammatory immune-related adverse events, which can resemble autoimmune diseases (ADs). Little is known about the impact of baseline AD on mortality in cancer patients treated with ICIs. Here, we identified 17 497 patients with preexisting autoimmune diagnoses prior to treatment with antiprogrammed cell death receptor-1 or antiprogrammed cell death ligand-1 therapy and 17 497 matched controls through the TriNetX Diamond network of more than 200 million patients across the United States and Europe. Using a Cox proportional hazards model, we found that patients with history of AD were not at higher risk of mortality than non-AD patients (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1 to 1.07; P = .05). Additionally, history of Hashimoto disease (HR = 0.75, 95% CI = 0.62 to 0.90; P = .002) and vitiligo (HR = 0.52, 95% CI = 0.34 to 0.81; P = .003) were statistically significantly associated with decreased mortality. This suggests that underlying AD need not be a contraindication to inclusion in clinical trials and administration of ICI for treatment of cancer., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: It is expected that graduating general surgery residents be confident in performing common abdominal wall hernia repairs. The objective of our study was to assess the confidence of senior surgical residents in these procedures and to identify factors that correlate with confidence., Methods: We performed a cross-sectional survey of PGY-4 and PGY-5 general surgery residents at ACGME-accredited programs in the United States in the spring of 2019. Respondents rated their confidence level in 12 hernia procedures on a Likert scale from 1 (not confident) to 5 (extremely confident). Respondents were classified as "Not Confident" (Not Confident, Minimally Confident, Neutral responses) or "Confident" (Confident, Extremely Confident responses). Resident characteristics, program characteristics, and operative experience were collected, and we calculated the area under the curve to screen which factors discriminated between those confident versus not. Multivariable Poisson regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) to identify which factors were most predictive., Results: A total of 93 surveys were completed. Respondents reported low confidence rates (25%-60%) in the following hernia repairs: minimally invasive (MIS) inguinal, femoral, tissue (nonmesh) inguinal, pediatric inguinal, and abdominal wall reconstruction. High confidence rates (>80%) were reported for open umbilical, open ventral, and MIS ventral hernia repairs. For MIS inguinal hernia repair, PGY-5 level was associated with a twofold increase in confidence (PR = 2.01; 95% CI = 1.34-3.30), and dedicated research years were associated with low confidence (PR = 0.67; 95% CI = 0.43-1.04). In general, higher operative volumes of a specific repair were associated with increased confidence in that procedure., Conclusions: Senior surgical residents reported low confidence in performing a variety of essential hernia repairs (particularly MIS inguinal, femoral, and tissue inguinal). Addressing factors associated with low confidence may help increase resident confidence., (Copyright © 2020 Elsevier Inc. All rights reserved.)

While generality is often desirable in ecology, customized models for individual species are thought to be more predictive by accounting for context specificity. However, fully customized models require more information for focal species. We focus on pest spread and ask: How much does predictive power differ between generalized and customized models? Further, we examine whether an intermediate "semi-generalized" model, combining elements of a general model with species-specific modifications, could yield predictive advantages. We compared predictive power of a generalized model applied to all forest pest species (the generalized dispersal kernel or GDK) to customized spread models for three invasive forest pests (beech bark disease [Cryptococcus fagisuga], gypsy moth [Lymantria dispar], and hemlock woolly adelgid [Adelges tsugae]), for which time-series data exist. We generated semi-generalized dispersal kernel models (SDK) through GDK correction factors based on additional species-specific information. We found that customized models were more predictive than the GDK by an average of 17% for the three species examined, although the GDK still had strong predictive ability (57% spatial variation explained). However, by combining the GDK with simple corrections into the SDK model, we attained a mean of 91% of the spatial variation explained, compared to 74% for the customized models. This is, to our knowledge, the first comparison of general and species-specific ecological spread models' predictive abilities. Our strong predictive results suggest that general models can be effectively synthesized with context-specific information for single species to respond quickly to invasions. We provided SDK forecasts to 2030 for all 63 United States pests in our data set., (© 2019 by the Ecological Society of America.)

Background: The use of complementary and alternative medicine (CAM) therapies have been reported for the management of arthritis. However, little is known about CAM use among adults with self-reported doctor-diagnosed arthritis., Objectives: To determine (1) the prevalence and type of CAM use, (2) the difference in characteristics between CAM users and non-CAM users, and (3) the factors related to CAM use, among U.S. adults with self-reported doctor-diagnosed arthritis., Design: Secondary analysis of the 2012 National Health Interview Survey (NHIS) data., Setting: The NHIS is a cross-sectional survey that gathers health-related data on the civilian, noninstitutionalized U.S., Participants: The NHIS 2012 uses a complex, multistage sampling design and oversamples minorities to achieve population representation; it included 34 525 adults, with 7179 adults having arthritis., Methods: Data were analyzed using Stata 15.1 survey syntax. The potential factors related to CAM use included sociodemographics and health-related characteristics., Main Outcome Measurements: CAM modalities were categorized into six groups: natural products, manipulative therapies, mind-body therapies, special diets, movement therapies, and other practitioner-based CAM modalities., Results: Of the adults with arthritis, 2428 (weighted estimate of 36.2% of U.S. adult population) had used CAM within the last year. Adults with arthritis reported greater use of CAM than those without, particularly the use of natural products, manipulative therapies and other practitioner-based CAM modalities. Factors associated with higher CAM use included being female, residing in regions other than the U.S. South, having a college degree or higher, reporting very good/excellent self-rated health status, and having current symptoms of joint stiffness/pain., Conclusion: As more than one-third of U.S. adults with arthritis seek CAM therapies, open and nonjudgmental conversations between conventional medicine providers, CAM providers, and patients should be encouraged to ensure patient health care needs are being met., Level of Evidence: III., (© 2019 American Academy of Physical Medicine and Rehabilitation.)

Background and : This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. objectives : Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients' health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods : This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results : Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18-64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions : A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients' health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention., Competing Interests: FLB has received speaker’s fees and expenses from the British Acupuncture Council and the Acupuncture Association of Chartered Physiotherapists. The authors declare no other conflicts of interest.

Background: Special diets are frequently used by the public but reasons for use and characteristics of users remain unclear., Aim: To determine prevalence of the use of special diets, the individual characteristics associated with their use and reasons for use., Methods: The secondary analysis used data from the 2012 National Health Interview Survey (NHIS), a cross-sectional household interview survey of a nationally representative sample of non-hospitalized US adult populations ( n = 34,525). The dependent variables in this secondary analysis were the use of a special diet (vegetarian, macrobiotic, Atkins, Pritikin, and Ornish) ever and during the past 12 months. Independent variables included sociodemographic, clinical and behavioral variables. Prevalence of special diet use and reasons for use were analyzed descriptively. Associations between independent and dependent variables were analyzed using Chi-square tests and logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated., Results: Lifetime and 12-month prevalence of using special diets were 7.5% (weighted n = 17.7 million) and 2.9% (weighted n = 6.9 million), respectively. Individuals using special diets in the past 12 months were more likely female (OR = 1.45; 95% CI = 1.21-1.74), not married (OR = 0.76; 95% CI = 0.63-0.91), college-educated (OR = 1.98; 95% CI = 1.25-3.11) and depressed (OR = 1.50; 95% CI = 1.14-1.98). They more likely also used herbal products (OR = 2.35; 95%CI = 1.84-2.99), non-vitamin (OR = 1.82; 95% CI = 1.45-2.27) and vitamin supplements (OR = 1.57; 95% CI = 1.24-1.99). Diets were mainly used to improve overall health (76.7%) or for general wellness/prevention (70.4%)., Conclusions: Special diets are mainly used for unspecific health reasons by those who are females, have a college degree or with depression, and commonly used in conjunction with herbs and dietary supplements.

In order to efficiently manage nonindigenous species (NIS), predictive tools are needed to prioritize locations where they are likely to become established and where their impacts will be most severe. While predicting the impact of a NIS has generally proved challenging, forecasting its abundance patterns across potential recipient locations should serve as a useful surrogate method of estimating the relative severity of the impacts to be expected. Yet such approaches have rarely been applied in invasion biology. We used long-term monitoring data for lakes within the state of Minnesota and artificial neural networks to model both the occurrence as well as the abundance of a widespread aquatic NIS, common carp (Cyprinus carpio). We then tested the ability of the resulting models to (1) interpolate to new sites within our main study region, (2) extrapolate to lakes in the neighboring state of South Dakota, and (3) assessed the relative contribution of each variable to model predictions. Our models correctly identified over 83% of sites where carp are either present or absent and explained 73% of the variation in carp abundance for validation lakes in Minnesota (i.e., lakes not used to build the model). When extrapolated to South Dakota, our models correctly classified carp occurrence in 79% of lakes and explained 32% of the variation in carp abundance. Variables related to climate and water quality were found to be the most important predictors of carp distribution. These results demonstrate that ecological niche-based modeling techniques can be used to forecast both the occurrence and abundance patterns of invasive species at a regional scale. Models also yielded sensible predictions when extrapolated to neighboring regions. Such predictions, when combined, should provide more useful estimates of the overall risk posed by NIS on potential recipient systems.

The Ecological Society of America has evaluated current U.S. national policies and practices on biological invasions in light of current scientific knowledge. Invasions by harmful nonnative species are increasing in number and area affected; the damages to ecosystems, economic activity, and human welfare are accumulating. Without improved strategies based on recent scientific advances and increased investments to counter invasions, harm from invasive species is likely to accelerate. Federal leadership, with the cooperation of state and local governments, is required to increase the effectiveness of prevention of invasions, detect and respond quickly to new potentially harmful invasions, control and slow the spread of existing invasions, and provide a national center to ensure that these efforts are coordinated and cost effective. Specifically, the Ecological Society of America recommends that the federal government take the following six actions: (1) Use new information and practices to better manage commercial and other pathways to reduce the transport and release of potentially harmful species; (2) Adopt more quantitative procedures for risk analysis and apply them to every species proposed for importation into the country; (3) Use new cost-effective diagnostic technologies to increase active surveillance and sharing of information about invasive species so that responses to new invasions can be more rapid and effective; (4) Create new legal authority and provide emergency funding to support rapid responses to emerging invasions; (5) Provide funding and incentives for cost-effective programs to slow the spread of existing invasive species in order to protect still uninvaded ecosystems, social and industrial infrastructure, and human welfare; and (6) Establish a National Center for Invasive Species Management (under the existing National Invasive Species Council) to coordinate and lead improvements in federal, state, and international policies on invasive species. Recent scientific and technical advances provide a sound basis for more cost-effective national responses to invasive species. Greater investments in improved technology and management practices would be more than repaid by reduced damages from current and future invasive species. The Ecological Society of America is committed to assist all levels of government and provide scientific advice to improve all aspects of invasive-species management.

Purpose: One of the features of thyroid carcinoma is its predilection for women of reproductive age relative to men. An increased risk has also been documented in women who have used estrogens for gynecologic reasons. The aim of this study was to explore the mechanism by which sex hormones contribute to the development of thyroid carcinoma, which is not well understood at present., Materials and Methods: In this study, we investigated the effects of estradiol and testosterone on cell proliferation in a human thyroid papillary carcinoma cell line (KAT5) by MTT assay. We also studied the expression of estrogen receptors and the levels of anti-apoptotic Bcl-xL protein, pro-apoptotic Bax protein, and messenger RNA in the cells by Western blot and reverse transcriptase polymerase chain reaction analysis., Results: The results showed that estradiol promotes cell proliferation when compared with cells treated with testosterone and untreated cells, and that the growth-promoting effect of estradiol was attenuated by tamoxifen. The expression of Bcl-xL was markedly increased in a dose-dependent manner, resulting in an elevated ratio of Bcl-xL to Bax., Discussion: We conclude that estradiol promotes KAT5 cell proliferation and that the underlying mechanism may be associated with up-regulation of Bcl-xL expression. The data provide insight into the molecular mechanism underlying the epidemiologic data that shows a two- to threefold increased prevalence of thyroid carcinoma in women relative to men. From the therapeutic point of view, the finding that estradiol enhances anti-apoptotic signaling pathways may be significant in the search for novel prevention and treatment strategies of thyroid carcinomas.