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Changing drought regimes are a rising threat to biodiversity, yet their impacts on wildlife vary greatly. Acknowledging the factors associated with these consequences brings novel insights into species vulnerability resulting from extreme climatic events and facilitates effective mitigation of climate change risks.Based on 319 observations from 29 peer‐reviewed studies on birds—a well‐monitored taxonomic group—we extract the responses of demographic metrics to droughts for 204 species across eight terrestrial biomes to examine the consequences of droughts. According to relevant studies, we chose the factors potentially moderating bird demography under droughts and compiled the data for these factors from published datasets. A meta‐analysis is performed to determine the drought effect on bird demography at individual and population levels, accounting for the influence of species traits, timescale and severity of droughts, as well as biome features.The results show that droughts have an overall negative effect on bird demography, and the effect is mediated by different factors at each level. For individuals exposed to droughts, declines in demographic rates are found to be related to narrower extents of occurrence of species, and a significant overall reduction in demographic rates is identified for individuals residing in deserts and xeric shrublands. At the population level, declines in abundance or reproductive performance are generally identified for invertivores, frugivores, nectarivores and omnivores; short‐lived species with small clutch sizes also show greater susceptibilities under the impacts of droughts. Our findings additionally suggest that the demographic vulnerability of bird individuals and populations could be affected by the duration and magnitude of drought episodes.Although our results are subject to publication bias, these conclusions advance the assessment of vulnerability to extreme climatic events that used to be based on equally weighted species traits and support bird conservation by prioritizing the declining populations of species with drought‐susceptible traits. [ABSTRACT FROM AUTHOR]

Purpose: Whether the longevity of total knee arthroplasty (TKA) differs between postoperative phenotypes has not been investigated. This study aims to examine which phenotype has a worse long‐term survival rate than the reference phenotype (neutral alignment‐parallel joint line), and whether joint‐line obliquity (JLO) affects the survivorship of TKA. Methods: A total of 945 knees that underwent primary TKAs for primary osteoarthritis from January 2000 to January 2009 were included. These were classified into nine postoperative phenotypes based on the combined assessment of the hip–knee–ankle (HKA) angle and JLO, measured on standing radiographs. The 5‐, 10‐ and 15‐year survival rates were analysed using Kaplan–Meier methods and log‐rank tests. The long‐term survival rates of each phenotype were compared with the reference phenotype. Results: There were 55 aseptic mechanical failures within a period of 10.4 ± 5.0 years. The most frequently observed phenotypes were the reference phenotype (n = 527), neutral alignment‐lateral joint‐line inclination (n = 162), varus alignment‐lateral joint‐line inclination (n = 104) and varus alignment‐parallel joint line (n = 101). The overall failure rate for each phenotype was 3.6%, 3.7%, 18.3% and 7.9%, respectively. Only the 10‐ and 15‐year survival rates of the varus alignment‐lateral joint‐line inclination phenotype were significantly different from those of the reference phenotype (97%–93% vs. 90%–69%; p = 0.017, <0.001). Conclusion: The lateral joint‐line inclination phenotype had an inferior long‐term survival rate after varus‐aligned TKA. This suggested that alignment and JLO affected the long‐term survival rate of patients who underwent TKA. Level of Evidence: Level III, retrospective cohort study. [ABSTRACT FROM AUTHOR]

The increasing demand for hydrocolloids with specific functionality has led researchers to seek new hydrocolloid sources. One of the methods to enhance the viability of probiotics under stressful conditions is microencapsulation, to deliver these bacteria to the body in sufficient numbers and utilize their health -promoting effects. The aim of this study is to investigate the feasibility of Lactobacillus acidophilus microencapsulation by ammonium gum (AMG) and its enrichment using nanoselenium, and determine its viability under stressful conditions. AMG was extracted from the mucilage of Dorema Ammoniacum plant using a solvent and then precipitated by alcohol. 1%, 5%, and 10% w/v solutions of AMG were prepared, and then nanoselenium particles synthesized at a concentration of 1.5% were added to the bacterial suspension with an average count of 6.85×1011 log CFU g -1 . The results showed that with an increase in the concentration of gum, the encapsulation efficiency significantly increased from 66% to 81%. The viability rate for 1%, 5%, and 10% concentrations of AMG under refrigeration conditions was 62.43%, 72.37%, and 81.83%, respectively. Under simulated gastric conditions at the pH levels used in this study, the counts of viable cells after 3 h of incubation for 5% and 10% concentrations of AMG remained higher than 7 log CFU g -1 . After 6 h of incubation in a 10 g L -1 solution, the free cells showed a decrease to 5.93 log CFU g -1, while for microencapsulated cells at concentrations of 1%, 5%, and 10%, it was only 3.93 log CFU g -1, 3.15 log CFU g -1, and 1.9 log CFU g -1, respectively. The results showed that AMG has very good encapsulation properties, which can be used in many food formulations for these purposes. [ABSTRACT FROM AUTHOR]

The identification of cancer subtypes is crucial for advancing precision medicine, as it facilitates the development of more effective and personalized treatment and prevention strategies. With the development of high-throughput sequencing technologies, researchers now have access to a wealth of multi-omics data from cancer patients, making computational cancer subtyping increasingly feasible. One of the main challenges in integrating multi-omics data is handling missing data, since not all biomolecules are consistently measured across all samples. Current computational models based on multi-omics data for cancer subtyping often struggle with the challenge of weakly paired omics data. To address this challenge, we propose a novel unsupervised cancer subtyping model named Subtype-MVCC. This model leverages graph convolutional networks to extract and represent low-dimensional features from each omics data type, using intra-view and inter-view contrastive learning approaches. By incorporating a weighted average fusion strategy to unify the dimension of each sample, Subtype-MVCC effectively handles weakly paired multi-omics datasets. Comprehensive evaluations on established benchmark datasets demonstrate that Subtype-MVCC outperforms nine leading models in this domain. Additionally, simulations with varying levels of missing data highlight the model's robust performance in handling weakly paired omics data. The clinical relevance and survival outcomes associated with the identified subtypes further validate the interpretability and reliability of the clustering results produced by Subtype-MVCC. • Subtype-MVCC is a novel unsupervised cancer subtyping model. • GCNs with dual contrast explore omics-specific learning and cross-omics learning. • Weighted fusion enables Subtype-MVCC to deal with weakly paired multi-omics data. • Clinical and survival analyses support the interpretability of clustering results. [ABSTRACT FROM AUTHOR]

N‐myc downstream regulated gene 1 (NDRG1) is a member of the NDRG family, of which four members (NDRG1, NDRG2, NDRG3, and NDRG4) have been identified. NDRG1 is repressed by c‐MYC and N‐MYC proto‐oncogenes. NDRG1 is translated into a 43 kDa protein that is associated with the regulation of cellular stress responses, proliferation, and differentiation. In this study, we aimed to clarify the relationship between progression of glioblastoma (GB) IDH‐wildtype and NDRG1 expression in tumor cells. We assessed the expression of NDRG1 in 41 GBs using immunostaining and evaluated its prognostic significance. NDRG1 expression by GBs was evaluated using Histoscore, which showed high and low scores in 23 and 18 cases, respectively. NDRG1‐positive cells were strongly expressed in Ki‐67 labeled proliferating tumor cells and CD105 positive proliferating microvessels around the area of palisading necrosis. Statistical analyses showed lower survival rates in the high‐score group than the low‐score group (P < 0.01). This study indicated that overexpression of NDRG1 by GB reflects tumor angiogenesis and poor patient prognosis. [ABSTRACT FROM AUTHOR]

Advancements in neoadjuvant regimens for esophageal adenocarcinoma have enabled some patients to achieve complete pathologic response at time of esophagectomy. There are currently limited data detailing this trend or the implications of complete pathologic response on survival. The National Cancer Database was used to identify 16,169 patients with esophageal adenocarcinoma that received trimodal therapy including esophagectomy between 2006 and 2020. Of these, 11.4% had complete pathologic response at esophagectomy. Patient factors, staging characteristics, and survival trends were evaluated. In patients diagnosed between 2016 and 2020, the rate of complete pathologic response was 17.5%. Female sex (OR 1.295, 95% CI 1.134–1.481, p  = 0.0001), Black race (OR 1.729, 95% CI 1.362–2.196, p  = 0.0002), Hispanic ethnicity (OR 1.418, 95% CI 1.073–1.875, p  = 0.0141), and later era of diagnosis (2016–2020 OR 2.898, 95% CI 2.508–3.349, p  < 0.0001) were independent predictors of complete pathologic response. Clinical stage II disease was associated with an increased probability of complete pathologic response (OR 1.492, 95% CI 1.19–1.871) while clinical stage III disease had a decreased probability of complete pathologic response (OR 0.762, 95% CI 0.621–0.936, p  < 0.0001). Complete pathologic response conveyed a strong survival benefit, with a median survival of 86.4 months (95% CI 73.9–102.1) versus 30.7 months (95% CI 29.8–31.7, p  < 0.0001) in those without complete pathologic response. Four-year median survival was also higher in those with complete pathologic response (63.3%, 95% CI 60.8–66.0% vs. 39.2%, 95% CI 38.4–40.1%, p  < 0.0001). In summary, complete pathologic response is associated with a profound survival advantage in patients with esophageal adenocarcinoma. Such knowledge carries implications for patient counseling, prognostication, and surveillance and demonstrates a need for improved identification of complete clinical response prior to esophagectomy. [ABSTRACT FROM AUTHOR]

Objective To assess the real-world effectiveness of targeting biologic DMARDs (bDMARDs) in rheumatoid arthritis (RA) patients negative for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). Methods We retrospectively selected 81 seronegative and 404 seropositive RA patients receiving treatment with abatacept, anti-TNF alpha or tocilizumab. Effectiveness was evaluated by analysing drug survival using Kaplan–Meyer analysis over 10-year follow-up. Survival rates were compared by log rank test, and hazard ratios (HRs) of therapy discontinuation were estimated through multivariate Cox regression. Results Clinical characteristics were similar between the two groups, except for a significantly higher percentage of inadequate responders to prior bDMARDs in the seronegative RA patients (P  = 0.02). Among seronegative RA, tocilizumab demonstrated a survival rate of 73.9% with a mean survival time (MST) of 76.8 months (95% CI 61–92), which was significantly higher than abatacept [37.5%, MST 37.1 months (95% CI 22–51; P  = 0.01)]. Anti-TNF alpha therapy fell in the middle [50.0%, MST 63.5 months (95% CI 47–79)] but the difference was not significant. Nevertheless, seropositive RA patients did not show significantly different drug survival rates. Negative predictors of drug discontinuation were RF/ACPA positivity (HR 0.56) and sex male (HR 0.58), but treatment with abatacept (HR 1.88) or anti-TNF alpha (HR 1.79), no co-therapy with conventional DMARDs (HR 1.74), absence of bone erosions (HR 1.41) and higher HAQ (HR 1.58) were positive predictors. Conclusions To confirm these preliminary findings and to explore the hypothesis of a distinctive therapeutic algorithm in seronegative RA, prospective studies on larger cohorts are needed. [ABSTRACT FROM AUTHOR]

Introduction: Prevalence of unexpected positive intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) is reported to be 8.32% with largely varying findings in individual studies (5.92–62.07%) due to a heterogeneity in preoperative diagnostic work-up and diagnostic criteria for periprosthetic joint infection (PJI). When diagnosed as unsuspected PJI, re-revision rate is reported to be as high as 18.45% compared to 2.94% in patients with UPIC classified as contamination (p = 0.0237). We performed a monocentric retrospective analysis of revision TKA surgery to determine prevalence of UPIC, risk of developing a subsequent PJI and re-revision rate after 24 months compared to those without UPIC. Materials and methods: All presumed aseptic total knee revision procedures from 2008 until 2017 were retrospectively reviewed. Single stage femorotibial revisions of TKA with at least 3 intraoperative cultures and a minimum follow-up of 24 months were included, whereas partial revisions or revisions from unicompartimental knee prosthesis to TKA were excluded. Demographic data were collected as well as initial reason for revision, preoperative aspiration results, micro-organism identified and postoperative antibiotics' administration. Primary outcome was survival rate after 24 months with differentiation based on UPIC interpretation: sterile, contamination, unsuspected PJI. Results: Of 256 included cases, 75 (29.3%) were found to have at least 1 UPIC during revision surgery, 72% of whom a single UPIC was found. Thirty-four cases (13.28%) were interpreted as unsuspected PJI and therefore treated with antibiotics. In total, 13 of the 256 patients (5.08%) had to be re-revised during follow-up with 7 PJI (2.73%), none of them developing reinfection defined as PJI with the same microorganism. A statistically significant trend towards earlier failure in the unsuspected PJI group compared to the contaminant group was not observed. However, a higher incidence of re-revisions attributed to septic reasons was noted in the former group. Conclusions: Presence of UPIC in presumed aseptic revision TKA does not correlate with a lower survival rate, but a higher incidence of subsequent PJI was observed in cases interpreted as unsuspected PJI. [ABSTRACT FROM AUTHOR]

Introduction: The total number of total knee arthroplasty performed is rising, and the number of revisions is rising accordingly. Periprosthetic joint infection emerged in recent years as a leading cause of total knee revisions. Bone loss is a real challenge when facing septic knee revisions since radical debridement is crucial to overcome infection. Many devices have already demonstrated to reliably address bone loss and guarantee enhanced fixation. However, the role of balancing metaphyseal fixation and its interplay with the level of constraint has not been elucidated yet. Material and methods: An institutional arthroplasty registry was retrospectively reviewed looking for patients who underwent two-stage revision of the knee and metaphyseal cones implantation. Patients were divided into two groups based on the presence of cones only on one side (femoral or tibial, Group U) or both femoral and tibial side (Group B). Failure, aseptic loosening, and revision rates were compared between groups, as were values of patient-reported outcome measure. Kaplan–Meier analysis was used to assess survival of implants. Results: A total of 65 patients were included in the analysis and were evaluated at a mean final follow-up of 4 years (range, 2–7). Mean age was 67 (range, 43–81) years. Mean BMI was 27.4 (range, 20–37) kg/m2. The overall mean KSS, OKS, ROM significantly increased from baseline values to last follow-up (p < 0.001). Kaplan–Meier analysis demonstrated that patients included in Group U had a significantly lower rate of implant survival compared to those included in Group B. Conclusions: Patients undergoing revision total knee arthroplasty for periprosthetic infection present considerable rates of complication and failure. Management of bone loss represents a concern for the surgeon, who must achieve a stable fixation. Our study demonstrated that implants characterized by an unbalanced metaphyseal fixation are at higher risk of aseptic loosening and consequent revision, especially when coupled with hinged inserts. [ABSTRACT FROM AUTHOR]

The article discusses the outcomes of using a cemented modular rotational-hinge design in a two-stage replacement for chronic knee periprosthetic joint infection. The study found an infection control rate of 87.2% and an implant survival rate of 92.3% after a mean follow-up of 4.3 years. Factors associated with increased risk of infection control failure included obesity, history of cancer, and the need for debridement after the second stage. The study suggests that the use of a cemented modular rotational-hinge design may be associated with high rates of infection control and low incidence of aseptic loosening or modular component failure. [Extracted from the article]

Introduction: Options for soft tissue coverage in revision total knee arthroplasty (rTKA) range from primary wound closure to complex muscle flap reconstructions. The purpose of this study was to investigate the institutional experience of wound coverage options for complex soft tissue defects in rTKA. Materials and methods: 77 patients undergoing rTKA with complex wound closure by a single plastic surgeon were retrospectively reviewed. The average follow-up was 30.1 months. In 18 (23.4%) patients, an intraoperative decision for primary closure was made. Fifty-nine patients (76.6%) received either a local fasciocutaneous (N = 18), a medial gastrocnemius (N = 37), a free latissimus dorsi (N = 3) or a lateral gastrocnemius flap (N = 1). Revision-free survival and complication rates were assessed and risk factors were analyzed with Cox-regression analysis. Results: Medial gastrocnemius flaps had significant lower cumulative revision-free survival rates than local fasciocutaneous flaps (P = 0.021) and primary closures (P < 0.001) (42.5% vs. 71.5% vs. 100%,respectively). Comparing the most common complex closure procedures medial gastrocnemius flaps had the highest rate of prolonged wound healing (29.7%) and infection/reinfection (40.5%). Infection-associated flap procedures had significant lower cumulative revision-free survival rates (30.5%) than non-infection associated flap procedures (62.8%,P = 0.047). A history of more than two prior surgeries (HR = 6.11,P < 0.001) and an age ≥ 65 years (HR = 0.30,P = 0.018) significantly increased the risk of revision. Conclusions: The results of this study indicate that primary closure -if possible- should be preferred to early proactive muscle flap coverage. Even in the hands of an experienced plastic surgeon muscle flaps have high revision and complication rates. The study highlights the need to clarify flap indications and to investigate alternative approaches. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Materials and Methods Results Conclusions Tumor budding was suggested as a valuable prognostic factor in oral squamous cell carcinoma (OSCC) but lacks a standardized scoring system. This study evaluates tumor budding in OSCC using the scoring system recommended by the International Tumor Budding Consensus Conference (ITBCC) 2016.The study included 114 patients with resected OSCC. Tumor budding was evaluated according to ITBCC criteria and assigned to three categories (low, intermediate, and high tumor budding). The associations between tumor budding and clinicopathological parameters were examined and survival rate analyses were performed by the Kaplan–Meier method. The prognostic value of tumor budding was assessed by Cox regression analysis.Significant correlations of tumor budding with clinicopathological parameters including lymph node metastasis, grade, stage, perineural and lymphovascular invasion, and local recurrence were found. Intermediate and high tumor budding were significantly and independently associated with worse disease‐free survival. High tumor budding was identified as an independent prognostic factor for disease‐specific and overall survival.The ITBCC scoring system represents a simple, feasible, and reproducible method to evaluate tumor budding in OSCC. Tumor budding, according to ITBCC criteria, showed its prognostic value in resected OSCC, and its incorporation into the histopathological reporting guidelines should be considered. [ABSTRACT FROM AUTHOR]

ABSTRACT Cancer presents a significant global health burden. Traditional treatment modalities, especially radiotherapy and chemotherapy, have improved survival, but they have long‐term consequences. Treatment‐induced malignancies, a growing concern, pose risks to survivors. Often with limited treatment options, these tumors tend to have a worse survival rate. A thorough understanding of the main risk groups is critical for lifelong follow‐up and personalized care strategies. This review provides an update on the knowledge of treatment‐induced malignancies of the head and neck in cancer survivors; specifically, it discusses the risks, histological considerations, diagnosis and treatment strategies, follow‐up recommendations, and future perspectives. [ABSTRACT FROM AUTHOR]

Survival benefit from anticancer treatments, even if modest, improves a patient's chances of accessing future innovations, thereby creating real option value. There is no empirical evidence on the impact of potential future innovations on oncologists' treatment recommendations. We conducted a national online survey of practicing medical and hematological oncologists. We presented a hypothetical metastatic cancer patient with median survival of 6 months under 4 decision-making scenarios with varying expected efficacy and time to arrival of future innovations. We assessed the likelihood of discussing future innovations with their patients and the likelihood that future innovations would influence their current treatment recommendation, as well as factors associated with these 2 outcomes using multivariate logistic regressions. A total of 201 oncologists completed the survey. When future innovations were expected to improve survival by 6 months and be available in 6 months, 76% of oncologists were likely or very likely to discuss the innovations with their patients, and 68% reported they would influence their current treatment recommendations. A 1-month increase in the expected survival improvement of future innovation was associated with a 1.17 greater odds (95% CI 1.1-1.25) of reporting likely or very likely to discuss future innovations with their patients, whereas a 1-month increase in the expected time to arrival was associated with a 0.91 lower odds (95% CI 0.88-0.94). Given that potential future innovations seem to influence oncologists' treatments recommendations, evidence to inform clinical guidelines and value assessments should consider data on real option value impacts to support informed treatment decision making. • This nationwide survey provided the first evidence on how future innovations and real option value influence oncologists' current treatment recommendations in the metastatic cancer setting. • Most oncologists would discuss future innovations with their patients, and promising future innovations would influence most on their treatment recommendations. • Even when anticipated time to arrival of a future innovation is 2 times the current median survival and the efficacy is expected to be modest, nearly one-half of oncologists would still discuss and consider future innovations. [ABSTRACT FROM AUTHOR]

Aims: We assessed the juvenile climatic niche breadth of a relict mountain species by comparing field observations and transplant experiments within and beyond the elevational limits of its distribution range. Location: Lebanon – Near East – Mediterranean region. Methods: We studied the survival and growth of the Cedar of Lebanon (Cedrus libani) to determine the lower and upper elevational range limits of its juvenile stage through an experimental setup with and without water supplementation and with potentially competing species as a control. The experiment included eight common gardens at elevations ranging from 110 to 2330 m, within and far beyond the warm and cold limits of Cedar distribution observed under natural conditions. Results: We observed unexpectedly high survival and growth rates of Cedar at elevations well below the range of its natural distribution in Lebanon. Below the observed warm limit, water stress at very low elevations and competition at low and medium elevations limited juvenile survival. In contrast, cold temperature and water stress limited survival at elevations slightly above the observed upper natural limit. The experimental setup demonstrated that the elevation range suitable for Cedar growth and survival was twice as wide as the range within which Cedar is observed under natural conditions. Main Conclusions: High survival rates experimentally observed beyond the warm limit of the natural distribution range of the Cedar of Lebanon raise hope for its resilience to ongoing climate warming. If this pattern were frequent among montane species, it would challenge predictions of massive extinction with climate change and pave the way for promoting adaptive actions such as competition management to improve their survival. [ABSTRACT FROM AUTHOR]

Glioblastoma multiforme (GBM), the most aggressive intracranial neoplasm, remains incurable at present, primarily due to drug resistance, which significantly contributes to elevated recurrence rates and dismal prognosis. Signal transducer and activator of transcription 3 (STAT3) is a critical gene closely associated with GBM drug resistance and the progression of GBM stem cells (GSCs), making it a promising therapeutic target. In this study, we developed cancer cell membrane-cloaked biomimetic nanoparticles to deliver STAT3 siRNA to reverse drug resistance in homologous GBM. These biomimetic nanoparticles leverage homotypic targeting, rapid endosome escape, and fast siRNA release, leading to efficient in vitro STAT3 knockdown in both temozolomide-resistant U251-TR cells and X01 GSCs. Moreover, benefited from the membrane functionalization, significant prolonged blood circulation, improved blood brain barrier (BBB) penetration and GBM tumor accumulation are achieved by these siRNA biomimetic nanoparticles. Importantly, these nanoparticles effectively inhibit tumor proliferation, significantly extending median survival time in orthotopic U251-TR (43.5 d versus 20 d for PBS control) and X01 GSC-bearing mouse xenografts (52 d versus 19.5 d for PBS control). Altogether, this biomimetic siRNA platform offers a promising strategy for gene therapy targeting drug-resistant GBM. We developed glioblastoma (GBM) cell membrane camouflaged biomimetic nanomedicines that achieves efficient blood brain barrier (BBB) penetration, homologous tumor cell targeting, potent gene silencing and effective tumor inhibition in orthotopic drug resistant U251 and GBM stem cell bearing mice when delivers the STAT3 siRNA. [Display omitted] [ABSTRACT FROM AUTHOR]

Although there have been advances in treating pediatric patients with acute myeloid leukemia (AML) in developed countries, outcomes in low- to middle-income countries remain poor. The goal of this study was to investigate the outcomes in children with AML who were treated at a tertiary care center in Thailand. We divided the study into 4 research periods based on the chemotherapy protocols employed. The 5-year probabilities of event-free survival (pEFS) rates for periods 1–4 were 19.0%, 20.6%, 17.4%, and 37.3% (p value = 0.32), while the 5-year probabilities of overall survival (pOS) rates were 19.0%, 24.7%, 18.7%, and 42.5% (p value = 0.18), respectively. The multivariable model indicated an improvement in 5-year pOS between periods 1 and 4 (p value = 0.04). Age, white blood cell count, and study period were significant predictors of survival outcomes. The pOS of AML patients improved over time, increasing from 19.0% to 42.5%. [ABSTRACT FROM AUTHOR]

Background and aims: Pancreatic ductal adenocarcinoma (PDAC) often presents as acute pancreatitis (AP). However, data on the clinical outcomes of PDAC initially presenting as AP are limited. We aimed to assess the clinical features of PDAC that manifest as AP. Methods: We reviewed the PDAC database at the Asan Medical Center between 2010–2016. Our study included 77 patients with PDAC who presented with AP (PDAC-AP group) and 154 age-gender-matched PDAC patients as controls (PDAC-other group). Patients' demographics, disease characteristics, and outcomes were compared between both groups. Results: Acute pancreatitis was an initial symptom in 1.12% of the patients with PDAC (77 of 6,821). Approximately 81.8% of the patients had clinically mild pancreatitis, and 91% were diagnosed with PDAC within two months of presentation with AP. Main tumor size was significantly smaller in the PDAC-AP group than in the PDAC-other group (PDAC-AP: 2.59 ± 1.21 cm vs. PDAC-other: 3.73 ± 1.78 cm, p < 0.01). The PDAC-AP group patients were diagnosed earlier than those in the PDAC-other group (PDAC-AP: stage 1–2, 80.6% vs. PDAC-other: 46.7%, p < 0.01). The proportion of resectable PDAC was significantly higher in the PDAC-AP group (PDAC-AP: 64.9% vs. PDAC-other: 50%, p < 0.01). Overall survival was significantly longer in the PDAC-AP group than in the PDAC-other group (30.2 months vs. 19.9 months, p = 0.03). Conclusions: In patients who presented with clinical AP, PDAC was identified at an earlier stage, and these patients showed better survival rates. These results suggest that AP may be an early sign of PDAC. [ABSTRACT FROM AUTHOR]

Background: Pediatric hepatocellular carcinoma (HCC) presents significant challenges due to its aggressive nature, with survival depending on complete resection. We aimed to assess outcomes between liver resection (LR) and liver transplantation (LT). Methods: A total of 25 patients were retrieved, four of whom were classified as palliative at diagnosis. A subanalysis comparing cirrhotic liver (n = 14) versus de novo (n = 11) HCC was performed to identify confounding variables. Further evaluation focused on the 21 children with histologically confirmed HCC who underwent LR (n = 7) versus LT (n = 14). Kaplan–Meier survival curves were constructed. Results: The mean age was 7.8 ± 6.1 years for patients with cirrhotic liver and 12.1 ± 3.5 years for de novo HCC. Our group observed overall total survival rates of 100%, 85%, and 77% at 12, 36, and 60 months, respectively. De novo tumors had a higher recurrence rate and a poorer prognosis (p = 0.039 and p = 0.045). The disease‐free survival at 60 months in our cohort was significantly lower among the LR group compared to the LT group (14% vs. 82%; p = 0.0081). Recurrence after initial management (n = 8) showed location differences between LR and LT. Preoperative alpha‐fetoprotein (AFP) was elevated in 71% of children, but did not correlate with recurrence or compromised survival. Elevated AFP 3 months post‐operation affected the course negatively (p = 0.044). Tumor number and diameter exhibited a trend towards poorer outcomes. Conclusions: These findings emphasize the need for comprehensive pediatric surgical guidelines for HCC. We recommend LT over LR in pediatric cases. Extrahepatic disease post‐neoadjuvant chemotherapy remains the only absolute contraindication. [ABSTRACT FROM AUTHOR]

Background: Certolizumab is an Fc‐free PEGylated tumor necrosis factor‐alpha (TNFα) inhibitor recently approved for the treatment of moderate‐to‐severe plaque psoriasis, although there is limited real‐world evidence on the effectiveness and safety in patients with plaque psoriasis treated with certolizumab. The objective of this article is to determine the effectiveness, drug survival, and safety, including pregnancy, childbirth, and lactation, of certolizumab in moderate‐to‐severe plaque psoriasis under real‐world conditions. Methods: This is a retrospective, multicenter, observational study performed in 15 hospitals in Spain. It evaluates the effectiveness and safety of certolizumab in plaque psoriasis in the clinical practice setting. Results: A total of 67 patients (73% female) were evaluated with a mean baseline Psoriasis Area Severity Index (PASI) of 8.9. At Week 12, the mean PASI was 2.3 (n = 67), 1.3 (n = 57) at Week 24 and 1.3 at Week 52 (n = 34). Absolute PASI < 3 was achieved in 69, 86, and 92% of patients at Weeks 12, 24, and 52, respectively, as observed. For its part, using the under‐response imputation analysis, PASI < 3 at Weeks 12, 24, and 52 were achieved by 69, 73, and 49% of the patients, respectively. A total of 35 patients (52%) had concomitant psoriatic arthritis, and, in 24 of them, Disease Activity in Psoriatic Arthritis Score (DAPSA) was recorded at baseline, with a mean value of 17.9 which decreased to 8.2 at Week 12 (n = 22) and to 3.6 at Week 24 (n = 18). Certolizumab treatment was discontinued in 14 out of 67 patients (21%), due to lack/loss of cutaneous or articular effectiveness (n = 11) or patient decision (n = 2) or adverse event in only one patient who developed active tuberculosis. A lower baseline PASI [hazard ratio (HR): 1.12 (1.02–1.23); P = 0.023] and a more significant reduction in PASI at Week 12 [HR: 1.16 (1.07–1.27); P < 0.001] and Week 52 [HR: 1.47 (1.11–1.96); P = 0.007] was shown to be significantly related with better survival for the entire follow‐up period. Fourteen patients were treated during pregnancy and/or lactation without reporting adverse events in either the patient or the newborn. Conclusions: Certolizumab consistently showed high effectiveness and drug survival rates in this real‐life cohort. The safety demonstrated in clinical trials during pregnancy and lactation seems to be confirmed in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Imatinib therapy is the gold standard for the treatment of unresectable and metastatic gastrointestinal stromal tumors (GISTs). However, few studies have reported the long-term outcomes of the treatment. Methods: Seventy patients who underwent imatinib therapy for unresectable and metastatic GISTs were enrolled between 2001 and 2009, and follow-up data were collected until October 2023. One hundred and sixty-eight months had passed since the final enrollment. The outcome measures were patient survival and the status of GIST and imatinib therapy. The cumulative incidence of disease progression (PD) and the chronological changes in PD hazard rate (HR) were also analyzed. Results: The 5-, 10-, 15-, and 20-year overall survival rates were 64.3%, 30.0%, 16.8%, and 12.2%, respectively. Sixty of the 70 enrolled patients died before the data cutoff date: 47 (78.3%) patients died of GIST progression while the remaining 13 (21.7%) died of diseases other than GISTs. The cumulative incidence of PD logarithmically increased, and PD continued even after 10 years of treatment. PD HR decreased over time to reach the lowest value at 9.6 years after the initiation of treatment (HR 0.00027; 95% CI 0.00007–0.00174) and after that formed a small peak at 13 years (HR 0.00144; 95% CI 0.00043–0.00436). Conclusions: Imatinib therapy showed high clinical efficacy in terms of long-term survival in GIST patients. However, patients undergoing imatinib therapy were at continuous risk of PD even after the 10-year treatment. Long-term treatment and follow-up beyond 10 years are necessary for unresectable and metastatic GIST patients. [ABSTRACT FROM AUTHOR]

We propose a model-free variable screening method for the optimal treatment regime with high-dimensional survival data. The proposed screening method provides a unified framework to select the active variables in a prespecified target population, including the treated group as a special case. Based on this framework, the optimal treatment regime is exactly the optimal classifier that minimizes a weighted misclassification error rate, with weights associated with survival outcome variables, the censoring distribution and a prespecified target population. Our main contribution involves reformulating the weighted classification problem into a classification problem within a hypothetical population, where the observed data can be viewed as a sample obtained from outcome-dependent sampling, with the selection probability inversely proportional to the weights. Consequently, we introduce the weighted Kolmogorov–Smirnov approach for selecting active variables in the optimal treatment regime, extending the conventional Kolmogorov–Smirnov method for binary classification. Additionally, the proposed screening method exhibits two levels of robustness. The first level of robustness is achieved because the proposed method does not require any model assumptions for the survival outcome on treatment and covariates, whereas the other is attained as the form of treatment regimes is allowed to be unspecified even without requiring convex surrogate loss, such as logit loss or hinge loss. As a result, the proposed screening method is robust to model misspecifications, and nonparametric learning methods such as random forests and boosting can be applied to those selected variables for further analysis. The theoretical properties of the proposed method are established. The performance of the proposed method is examined through simulation studies and illustrated by a lung cancer dataset. [ABSTRACT FROM AUTHOR]

Pathological response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant chemotherapy (NAT) has been associated with oncological outcome. The aim of the study was to investigate factors associated with favourable tumour regression in patients undergoing pancreatic resection for PDAC. Patients who received NAT before undergoing PDAC resection at two institutions were reviewed. Tumour regression grading (TRG) was scored according to the College of American Pathologists (CAP) system. Interactions between chemotherapy, tumour and surgical factors with TRG were explored. 54 patients were identified, with 12 (22%) displaying a favourable response to NAT. The type of chemotherapy agent received, the number of cycles or a dose reduction during NAT course was not significantly different between the groups. The time from diagnosis to chemotherapy and time from end of chemotherapy to surgery were also similar between the groups. A favourable TRG was associated with greater disease-free survival median 33.2 months vs. 10.3 months; p = 0.0) but not overall survival (median 43.8 months vs. 32.3 months; p = 0.200), which may be due to small sample size. Chemotherapy factors were not significantly related to a favourable response to NAT. Future studies should seek to identify modifiable factors associated with a favourable TRG. [ABSTRACT FROM AUTHOR]

Objective: Pulmonary hypertension (PH) is a severe complication of systemic lupus erythematosus (SLE). This study investigated the clinical features of patients with SLE-PH in China based on disease manifestations and organ involvement to define precise treatment of SLE and early prevention of complications. Methods: In total, 205 SLE-PH patients were included in this study. A cluster analysis was applied according to six clinical and serological variables to define different subgroups of patients. The survival rates of SLE-PH patients and risk factors that influenced prognosis were also compared and a clinical prediction model was developed for the diagnosis of associated lupus nephritis (LN). Results: Patients were clustered in five groups. Patients in cluster 1 had severe renal damage (all patients had LN and had the highest creatinine and urea nitrogen and the lowest eGFR levels). Patients in cluster 2 had mild renal damage (more than half of the patients had associated LN and 87.5% had increased urinary protein levels but presented a lower degree of renal damage than those in the first group. Patients in cluster 3 had low-grade proteinuria (all patients had 24h urinary protein < 0.5g). Patients in cluster 4 had hematuria or urinary tubular damage (26% of patients had associated LN, but none of the patients had proteinuria. In cluster 5, patients barely had any major organ involvement. The clinical prediction model for a diagnosis of SLE-PH-LN was anti-dsDNA antibodies > 364.64 IU/mL and neutrophil-to-leukocyte ratio (NLR) > 5.55. Conclusion: Our findings provide evidence indicating that SLE-PH presents varying clinical phenotypes and the treatment varies accordingly, suggesting the need for individualized treatment. Key Points • Clustered grouping of patients with SLE-PH is associated with renal injury. • This may be because PH and LN share a common pathogenesis. • The clinical prediction model for a diagnosis of SLE-PH-LN was anti-dsDNA antibodies >364.64 IU/mL and NLR >5.55. [ABSTRACT FROM AUTHOR]

The United Kingdom (UK) and world's population is aging with patients living longer, often with many co-morbidities. It is expected that patients of extreme old age would have poor outcomes following trauma; however, this assumption is not clearly evidenced. This study aims to present the outcomes of patients aged 100 or older admitted to a single hospital trust following admission for orthopaedic trauma. A prospective cohort of patients aged 100 years and over admitted to the trauma and orthopaedic departments of two hospitals within the same trust between 2008 and 2022 was reviewed. Age was median 101 years (100–106 years). Outcome measures were length of stay, survival, complications and change in accommodation. 80 patients met the inclusion criteria (71female, 9 male). Mean age at discharge was 102.5 years with survival mean 4.2 years. 2 patients with peri-prosthetic fracture survived a further 5 years. Mean length of stay was 17 days. 57 patients returned to their original place of residence. 72 patients (90 %) survived the acute hospital admission. Survival rates for patients aged over 100 years were high and most returned to the previous place of residence. This study supports the surgical management of trauma and helps inform patients and families expectations for mortality risk. • Inpatient stay was a median 15 (1–49) days. o Survival following discharge was median 11 months (0.5–96 months). • Median survival from time of admission was 2 years (95 % CI 0.6–1.1 years). [ABSTRACT FROM AUTHOR]

The study examines the characteristics and outcomes of foot-originating malignant bone tumors via Surveillance Epidemiology and End Results (SEER) database analysis. A retrospective review of 14,695 malignant bone tumor cases from 2000 to 2019 was conducted. Of the eligible cases, 147 (2.3 %) were foot-origin tumors, typically smaller and more commonly treated with surgery than those in other locations. These tumors were more frequently treated with surgical resection, with a higher proportion undergoing amputation. In contrast, foot-origin tumors were less often managed with chemotherapy and radiation. Foot-origin tumors exhibited higher survival rates compared to non-foot-origin tumors as shown in univariate analysis, although multivariate analysis did not reflect significant differences. Foot-originating malignant bone tumors tend to be smaller and are frequently surgically treated, correlating with favorable survival outcomes. These findings point to early detection as a potential factor in the improved survival rates, not necessarily the tumor's origin. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer poses a significant global health challenge. We aim to use period analysis to assess the changes in gastric cancer treatment at our center over the past 15 years. This study reflects the current state of gastric cancer treatment at our center and provides valuable data to support clinical advancements. Method: We used period analysis to evaluate the survival status of 3915 patients with gastric cancer at Nanfang Hospital, Southern Medical University, over a 15-year period spaning from 2008 to 2022. The 5-year relative survival rates were analyzed. Result: Our findings indicate that the 5-year relative survival rate at our center from 2018 to 2022 is 71.4%. From 2018 to 2022, the 5-year relative survival rates for patients aged < 40, 40–54, 55–69, and ≥ 70 reached 67.5%, 73.5%, 72.0%, and 67.1%, respectively. For stage IV patients, the 5-year relative survival rate reached 29% in 2018–2022. For stage I-III patients, the 5-year relative survival rate reached 89.7% in 2018–2022. The five-year relative survival rate for patients who underwent laparoscopic surgery at our center rose from 50.3% in 2008–2012 to 71.4% in 2018–2022. Overall, there has been a notable increase in the 5-year relative survival rates, regardless of age, gender, region, or tumor stage. Conclusion: Period analysis over the past 15 years shows significant improvement in the 5-year survival rate for gastric cancer at our center. This progress is due to standardized surgical techniques, perioperative management, and immunotherapy, providing robust data for evaluating the efficacy of recent treatments. [ABSTRACT FROM AUTHOR]

Introduction: There are limited real-world data on outcomes in patients with non-cystic fibrosis bronchiectasis (NCFBE). This study assessed clinical characteristics and survival in patients with NCFBE by baseline exacerbation rate. Methods: Patients with bronchiectasis (≥ 1 inpatient or ≥ 2 outpatient claims with a bronchiectasis diagnosis code, or one outpatient claim with bronchiectasis code and a chest computed tomography scan) were from the 100% Medicare Fee-for-Service database (Jan 2014–Dec 2020). Patients had continuous enrollment ≥ 12 months pre-index (baseline) and post-index (follow-up), with index a random bronchiectasis claim preceded by ≥ 12 months bronchiectasis history. Patients with cystic fibrosis were excluded. Patients were stratified by exacerbations during baseline (0, 1, or ≥ 2). Follow-up exacerbation rate and all-cause mortality were assessed. Controls were identified using a multistep direct matching approach. Time to death from index was estimated by Kaplan–Meier analyses. Results: Exacerbation analysis included 92,529 patients with NCFBE and 92,529 matched controls. Exacerbations were common (43% had ≥ 1 exacerbation), with patients with more baseline exacerbations more likely to have ≥ 2 exacerbations during follow-up (11.4%, 24.2%, and 46.8% of patients with 0, 1, and ≥ 2 baseline exacerbations, respectively). Survival analysis included 110,298 patients with NCFBE and 110,298 controls. Time to death was shorter in patients with more baseline exacerbations (P < 0.0001). Five-year survival was 55.3%, 62.6%, and 65.4% for patients with ≥ 2, 1, and 0 baseline exacerbations, respectively, compared with 64.1% for controls. Conclusions: In these patients with NCFBE, exacerbations were common. History of exacerbations was associated with future exacerbations and increased all-cause mortality. [ABSTRACT FROM AUTHOR]

Purpose: Acetabular defect reconstruction can be a complex and challenging surgical procedure, with stable long-term fixation of the implants remaining the ultimate goal. The purpose of this study was (1) to evaluate the radiological and clinical outcome of complex acetabular reconstruction surgery with the use of modular tantalum TM augments in combination with cemented revision cups; (2) to investigate blood tantalum concentrations in these patients; and (3) to report complications and mechanisms of failure related to this procedure at mid-term follow-up (mean 4.5 years). Methods: We retrospectively reviewed 29 patients (29 hips) with severe acetabular bone loss (Paprosky type III A) reconstructed using a modular tantalum TM augment in combination with a cemented cup. We evaluated the implant survival and the radiological and clinical outcomes after a mean follow-up of 4.5 years (SD 2.2; range 8.4 – 2.1 years) using patient reported outcome scores (PROMs). Blood samples were analysed regarding tantalum concentration and compared with a control group. Results: The cumulative survival rate at 4.5 years with the endpoint "revision of the acetabular component for any reason" was 96.2% (95% Confidence Interval 75.7–99.5). The PROMs improved significantly up to the latest follow-up, and radiographic data showed only one patient with signs of initial implant migration with a broken screw and a change of the position of the augment and the cup. Mean blood tantalum concentrations were significantly higher in the study group (0.16 µg/L) compared to the control group (0.002 µg/L) (P < 0.001). Conclusions: This study has demonstrated good mid-term (mean 4.5 years) clinical and radiological outcomes of modular tantalum TM augments in combination with a cemented cup for the reconstruction of major acetabular defects. Mean blood tantalum concentrations were increased in patients with stable tantalum implants compared to healthy controls. [ABSTRACT FROM AUTHOR]

Purpose: There is relatively little information on the long-term clinical results of patients aged < 50 years with a contemporary total hip arthroplasty (THA), although a high rate of revision is projected for this group. Therefore, the purpose of this study was to evaluate the long-term results (a minimum of 21 years) of a metaphyseal-engaging anatomic cementless total hip prosthesis in patients aged < 50 years at the time of their THA. Methods: This study included 360 patients (498 hips), specifically 212 men and 148 women. The mean age of the patients at the time of their THA was 45.8 ± 8.1 years. The predominant diagnosis was osteonecrosis (56%). Demographic data, the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the University of California, Los Angeles (UCLA) activity score were recorded. Radiographic evaluation and dual-energy X-ray absorptiometry (DEXA) scanning were used to evaluate implant fixation, bone remodelling, and osteolysis. The mean follow-up was 25.2 year (range 21–28 years). Results: At the latest follow-up, the mean Harris hip, WOMAC, and UCLA activity scores were 93, 10, and 6.7 points, respectively. No patients had thigh pain. All hips had osseous integration of the acetabular and femoral components. No patient had grade 3 stress shielding. The 28-year survival rate was 98.2% (95% confidence interval [CI] 95–100%) for the acetabular components and 98.8% (95% CI 95–100%) for the femoral components. Overall, 90% of the patients were satisfied with the THA results. Conclusion: The results suggest that a metaphyseal-engaging anatomic cementless femoral stem with alumina-on-alumina ceramic articulation provide outstanding long-term fixation and substantial pain relief well into the 3rd decade after surgery. Furthermore, there was no alumina ceramic fracture or osteolysis. Moreover, approximately 90% of the patients were satisfied with the results of their THA. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prognostic factors and survival outcomes of patients with surgically treated high‐grade neuroendocrine carcinoma of the cervix (NECC). Methods: This multicenter, retrospective study involved 98 cervical cancer patients with stage IA2–IIA2 and IIIC1/2p high‐grade NECC. We divided the patients into two groups based on histology: the pure and mixed groups. All clinicopathologic variables were retrospectively evaluated. Cox regression and Kaplan–Meier methods were used for analysis. Results: In our study, 60 patients were in the pure group and 38 patients were in the mixed group. Cox multivariate analysis showed that mixed histology was a protective factor impacting overall survival (OS) (P = 0.026) and progression free survival (PFS) (P = 0.018) in surgically treated high‐grade NECC. Conversely, survival outcomes were negatively impacted by ovarian preservation (OS: HR, 20.84; 95% CI: 5.02–86.57, P < 0.001), age >45 years (OS: HR, 4.50; 95% CI: 1.0–18.83, P = 0.039), tumor size >4 cm (OS: HR, 6.23; 95% CI: 2.34–16.61, P < 0.001), parity >3 (OS: HR, 4.50; 95% CI: 1.02–19.91, P = 0.048), and perineural invasion (OS: HR, 5.21; 95% CI: 1.20–22.53, P = 0.027). Kaplan–Meier survival curves revealed notable differences in histologic type (OS: P = 0.045; PFS: P = 0.024), chemotherapy (OS: P = 0.0056; PFS: P = 0.0041), ovarian preservation (OS: P = 0.00031; PFS: P = 0.0023), uterine invasion (OS: P < 0.0001; PFS: P < 0.0001), and depth of stromal invasion (OS: P = 0.043; PFS: P = 0.022). Conclusion: Patients with mixed histologic types who undergo surgery for high‐grade NECC have a better prognosis. Meanwhile, ovarian preservation, tumor size >4 cm, parity >3, age >45 years and perineural invasion were poor prognostic predictors. Therefore, patients with high‐risk factors should be considered in clinical practice. Synopsis: Patients with surgically treated NECC who had mixed histologic types, underwent ovariectomy, and received adjuvant EP chemotherapy had a better prognosis. [ABSTRACT FROM AUTHOR]

Objective: To assess the stage distribution and stage‐related disease‐specific survival rates for endometrial cancer using the FIGO (the International Federation of Gynecology & Obstetrics) 2009 and 2023 staging systems. Further, we sought to evaluate the prognostic utility of additional covariates beyond the FIGO 2023 stage. Methods: Endometrial carcinomas were molecularly classified by the Proactive Molecular Risk Classifier for Endometrial Cancer and staged according to FIGO 2009 and 2023 criteria. Disease‐specific survival was calculated as the time from surgery to death from endometrial cancer. Results: Data from 604 patients were analyzed. Median follow‐up time was 81 months. A total of 118 stage shifts (19.5%) occurred between the FIGO 2009 and FIGO 2023 systems, with upshifts accounting for 107 (90.7%) of these changes. Within the FIGO 2023 system, molecular classification resulted in restaging of 69 patients (11.4%). Shifts that could alter adjuvant therapy decisions were identified in 23 patients (3.8%). The FIGO 2023 system effectively categorized endometrial cancers into prognostic subgroups. The FIGO 2023 stage, tumor size, positive peritoneal cytology, and mismatch repair deficiency were associated with disease‐specific survival in a multivariable analysis, whereas age and adjuvant therapy were not. Conclusion: The FIGO 2023 staging system for endometrial cancer appears highly prognostic. Prognostic assessment of the patients can be further enhanced by readily accessible covariates. A stage shift between the FIGO 2009 and 2023 systems occurs in about one‐fifth of patients. The implementation of molecular classification within the FIGO 2023 system bears implications for decisions regarding adjuvant therapy. Synopsis: The FIGO 2023 staging system for endometrial cancer alters stage distribution compared with the FIGO 2009 system, and bears implications for decisions regarding adjuvant therapy. [ABSTRACT FROM AUTHOR]

Objective: Sex differences in the association between cardiovascular risk factors and the incident all‐cause dementia and the subtype Alzheimer's disease (AD) risk are unclear. Methods: Framingham Heart Study (FHS) participants (n = 4,171, 54% women, aged 55 to 69 years) were included at baseline and followed up to 40 years. The Framingham Stroke Risk Profile (FSRP) was dichotomized into 2 levels (cutoff: 75th percentile of the FSRP z‐scores). Cause‐specific hazard models, with death as a competing event, and restricted mean survival time (RMST) model were used to analyze the association between FSRP levels and incident all‐cause dementia and AD. Interactions between FSRP and sex were estimated, followed by a sex‐stratified analysis to examine the sex modification effect. Results: High FSRP was significantly associated with all‐cause dementia (hazard ratio [HR] = 1.25, robust 95% confidence interval [CI] = 1.21 to 1.29, p < 0.001) and AD (HR = 1.58, robust 95% CI = 1.57 to 1.59, p < 0.001) in cause‐specific hazard models. High FSRP was significantly associated with incident dementia (HR = 2.81, robust 95% CI = 2.75 to 2.87, p < 0.001) and AD (HR = 2.96, robust 95% CI = 2.36 to 3.71, p < 0.001) in women, but not in men. Results were consistent in the RMST models. Current diabetes and high systolic blood pressure as FSRP components were significantly associated with dementia and AD in women but not in men. Interpretation: High FSRP in mid‐ to early late life is a critical risk factor for all‐cause dementia and AD, particularly in women. Sex‐specific interventions and further research to elucidate underlying mechanisms are warranted. ANN NEUROL 2024;96:1124–1134 [ABSTRACT FROM AUTHOR]

Background: Cardiac arrest is associated with high mortality rates and severe neurological impairments. One of the underlying mechanisms is global ischemia‐reperfusion injury of the body, particularly the brain. Strategies to mitigate this may thus improve favorable neurological outcomes. The use of extracorporeal cardiopulmonary membrane oxygenation (ECMO) during CA has been shown to improve survival, but available systems are vastly unable to deliver goal‐oriented resuscitation to control patient's individual physical and chemical needs during reperfusion. Recently, controlled automated reperfusion of the whoLe body (CARL), a pulsatile ECMO with arterial blood‐gas analysis, has been introduced to deliver goal‐directed reperfusion therapy during the post‐arrest phase. Methods: This review focuses on the device profile and use of CARL. Specifically, we reviewed the published literature to summarize data regarding its technical features and potential benefits in ECPR. Results: Peri‐arrest, mitigating severe IRI with ECMO, might be the next step toward augmenting survival rates and neurological recovery. To this end, CARL is a promising extracorporeal oxygenation device that improves the early reperfusion phase after resuscitation. [ABSTRACT FROM AUTHOR]

PURPOSE: This study aimed to define genomic differences between perihilar cholangiocarcinoma (PCA) and distal cholangiocarcinoma (DCA) and identify genomic determinants of survival. MATERIALS AND METHODS: Consecutive patients with ECA with tissue for targeted next-generation sequencing were analyzed, stratified by anatomic site (PCA/DCA), disease extent, and treatment. Associations between genomic alterations, clinicopathologic features, and outcomes were analyzed using Cox proportional hazards regression to compare survival. RESULTS: In total, 224 patients diagnosed between 2004 and 2022 (n = 127 PCA; n = 97 DCA) met inclusion criteria. The median survival was 29 months (43 after resection and 17 from diagnosis for unresectable disease). Compared with PCA, DCA was enriched in TP53alt (alterations; 69% v 33%; Q < 0.01), epigenetic pathway alterations (45% v 29%; Q = 0.041), and had more total altered pathways (median 3 v 2; Q < 0.01). KRASalt frequency was similar between PCA (36%) and DCA (37%); however, DCA was enriched in KRAS G12D (19% v 9%; P =.002). No other clinicopathologic or genomic variables distinguished subtypes. In resected patients, no genomic alterations were associated with outcome. However, in unresectable patients, CDKN2Aalt (hazard ratio [HR], 2.59 [1.48 to 4.52]) and APCalt (HR, 5.11 [1.96 to 13.3]) were associated with reduced survival. For the entire cohort, irresectability (HR, 3.13 [2.25 to 4.36]), CDKN2Aalt (HR, 1.80 [1.80 to 2.68]), and APCalt (HR, 2.00 [1.04 to 3.87]) were associated with poor survival. CONCLUSION: CDKN2Aalt and APCalt were associated with poor survival in ECA, primarily in advanced disease. As PCA and DCA were genetically similar, coanalysis of PCA and DCA in future genomic studies is reasonable. [ABSTRACT FROM AUTHOR]

PURPOSE: There is limited information about the clinical utility of targeted next-generation sequencing (NGS) panel testing to inform decision making for patients with advanced solid tumors. The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (OCTANE) is a prospective study that enrolled more than 4,500 patients with solid tumor for NGS panel testing. We performed a retrospective survey of medical oncologists to evaluate the impact of NGS testing on treatment decisions. METHODS: Patients and treating oncologists were identified at the Princess Margaret Cancer Center between 2016 and 2021. Tumor-only sequencing was performed using a gene panel of either 555 or 161 cancer genes. Oncologists were asked to review testing results and complete a survey indicating whether NGS testing affected treatment decisions. The primary outcome of this study was rate of treatment change on the basis of mutation results. Patient, test, and physician factors were evaluated for association with treatment changes using univariate analyses and a mixed-effects model. RESULTS: Of the 582 surveys sent, 394 (67.7%) were completed. We found that 188 (47.7%) patients had testing results classified as actionable by the oncologist and 62 (15.7%) patients were matched to treatment, of whom 37 (60%) were enrolled in a clinical trial, 13 (21%) received an approved drug, four (6%) were prescribed off-label therapy, and eight (13%) avoided ineffective treatment. Patient, test, and physician characteristics were not significantly associated with treatment change. There was no difference in overall survival between patients who received matched treatment versus those who did not (P =.55, median survival not reached). CONCLUSION: OCTANE testing led to a change in drug treatment in 15.7% of patients, supporting the clinical utility of NGS panel testing for patients with advanced solid tumors. [ABSTRACT FROM AUTHOR]

PURPOSE: Observational clinicogenomic data sets, consisting of tumor next-generation sequencing (NGS) data linked to clinical records, are commonly used for cancer research. However, in real-world practice, oncologists frequently request NGS in search of treatment options for progressive cancer. The extent and impact of this dynamic on analysis of clinicogenomic research data are not well understood. METHODS: We analyzed clinicogenomic data for patients with non–small cell lung, colorectal, breast, prostate, pancreatic, or urothelial cancers in the American Association for Cancer Research Biopharmaceutical Consortium cohort. Associations between baseline and time-varying clinical characteristics and time from diagnosis to NGS were measured. To explore the impact of informative cohort entry on biomarker inference, statistical interactions between selected biomarkers and time to NGS with respect to overall survival were calculated. RESULTS: Among 7,182 patients, time from diagnosis to NGS varied significantly by clinical factors, including cancer type, calendar year of sequencing, institution, and age and stage at diagnosis. NGS rates also varied significantly by dynamic clinical status variables; in an adjusted model, compared with patients with stable disease at any given time after diagnosis, patients with progressive disease by imaging or oncologist assessment had higher NGS rates (hazard ratio for NGS, 1.61 [95% CI, 1.45 to 1.78] and 2.32 [95% CI, 2.01 to 2.67], respectively). Statistical interactions between selected biomarkers and time to NGS with respect to survival, potentially indicating biased biomarker inference results, were explored. CONCLUSION: To evaluate the appropriateness of a data set for a particular research question, it is crucial to measure associations between dynamic cancer status and the timing of NGS, as well as to evaluate interactions involving biomarkers of interest and NGS timing with respect to survival outcomes. Cancer researchers working with observational genomic data should examine the sensitivity of their findings to the timing of genomic sequencing. [ABSTRACT FROM AUTHOR]

PURPOSE: Real-world data (RWD) collected on patients treated as part of routine clinical care form the basis of cancer clinical registries. Capturing accurate death data can be challenging, with inaccurate survival data potentially compromising the integrity of registry-based research. Here, we explore the utility of data linkage (DL) to state-based registries to enhance the capture of survival outcomes. METHODS: We identified consecutive adult patients with brain tumors treated in the state of Victoria from the Brain Tumour Registry Australia: Innovation and Translation (BRAIN) database, who had no recorded date of death and no follow-up within the last 6 months. Full name and date of birth were used to match patients in the BRAIN registry with those in the Victorian Births, Deaths and Marriages (BDM) registry. Overall survival (OS) outcomes were compared pre- and post-DL. RESULTS: Of the 7,346 clinical registry patients, 5,462 (74%) had no date of death and no follow-up recorded within the last 6 months. Of the 5,462 patients, 1,588 (29%) were matched with a date of death in BDM. Factors associated with an increased number of matches were poor prognosis tumors, older age, and social disadvantage. OS was significantly overestimated pre-DL compared with post-DL for the entire cohort (pre- v post-DL: hazard ratio, 1.43; P <.001; median, 29.9 months v 16.7 months) and for most individual tumor types. This finding was present independent of the tumor prognosis. CONCLUSION: As revealed by linkage with BDM, a high proportion of patients in a brain cancer clinical registry had missing death data, contributed to by informative censoring, inflating OS calculations. DL to pertinent registries on an ongoing basis should be considered to ensure accurate reporting of survival data and interpretation of RWD outcomes. [ABSTRACT FROM AUTHOR]

PURPOSE: The standard practice for limited-stage hepatocellular carcinoma (HCC) is the resection or the use of local ablative techniques, such as radiofrequency ablation (RFA). The outcome after RFA depends on a complex interaction between the patient's general condition, hepatic function, and disease stage. In this study, we aimed to explore using a machine learning model to predict the response. PATIENTS AND METHODS: A retrospective study was conducted for patients with RFA for a localized HCC between 2018 and 2022. The collected clinical, radiologic, and laboratory data were explored using Python and XGBoost. They were split into a training set (70%) and a validation set (30%). The primary end point of this study was to predict the probability of achieving favorable outcomes 12 months after RFA. Favorable outcomes were defined as the patient was alive and HCC was controlled. RESULTS: One hundred and eleven patients were eligible for the study. Males were 78 (70.3%) with a median age of 57 (range of 43-81) years. Favorable outcome was seen in 62 (55.9%) of the patients. The 1-year survival rate and control rate were 94.6%, and 61.3%, respectively. The final model harbored an accuracy and an AUC of 90.6% and 0.95, respectively, for the training set, while they were 78.9% and 0.80, respectively, for the validation set. CONCLUSION: Machine learning can be a predictive tool for the outcome after RFA in patients with HCC. Further validation by a larger study is necessary. [ABSTRACT FROM AUTHOR]

PURPOSE: Multiple myeloma (MM) is a prevalent hematologic malignancy in older adults, who often experience physical disability, increased health care usage, and reduced treatment tolerance. Home health (HH) services are frequently used by this group, but the relationship between disability, HH use, and MM treatment receipt is unclear. This study examines the connections between disability, treatment receipt, and survival outcomes in older adults with newly diagnosed MM using a nationwide data set. METHODS: The SEER-Medicare data set was used to identify adults aged 66 years and older diagnosed with MM from 2010 to 2017, who used HH services the year before diagnosis. Disability was assessed with the Outcome and Assessment Information Set, using a composite score derived from items related to ability to complete activities of daily living. Mortality, therapy receipt, and health care utilization patterns were evaluated. RESULTS: Of 37,280 older adults with MM, 6,850 (18.2%) used HH services before diagnosis. Moderate disability at HH assessment resulted in similar MM-directed therapy receipt as mild disability, with comparable health care usage after diagnosis to severe disability. HH users had a higher comorbidity burden and higher mortality (adjusted risk ratio for 3-year mortality: 1.59 [95% CI, 1.55 to 1.64]). Severe functional disability before diagnosis was strongly related to postdiagnosis mortality. CONCLUSION: Among older adults with MM receiving HH services, disability is a predictor of early mortality. Moderately disabled individuals undergo similar therapy intensity as the mildly disabled but experience increased acute care utilization. Previous HH use could identify patients with MM requiring intensive support during therapy initiation. Study links disability in older patients with myeloma to higher mortality and health care use. #MMsm. [ABSTRACT FROM AUTHOR]

PURPOSE: Pancreatic cancer currently holds the position of third deadliest cancer in the United States and the 5-year survival rate is among the lowest for major cancers at just 12%. Thus, continued research efforts to better understand the clinical and molecular underpinnings of pancreatic cancer are critical to developing both early detection methodologies as well as improved therapeutic options. This study introduces Pancreatic Cancer Action Network's (PanCAN's) SPARK, a cloud-based data and analytics platform that integrates patient health data from the PanCAN's research initiatives and aims to accelerate pancreatic cancer research by making real-world patient health data and analysis tools easier to access and use. MATERIALS AND METHODS: The SPARK platform integrates clinical, molecular, multiomic, imaging, and patient-reported data generated from PanCAN's research initiatives. The platform is built on a cloud-based infrastructure powered by Velsera. Cohort exploration and browser capabilities are built using Velsera ARIA, a specialized product for leveraging clinicogenomic data to build cohorts, query variant information, and drive downstream association analyses. Data science and analytic capabilities are also built into the platform allowing researchers to perform simple to complex analysis. RESULTS: Version 1 of the SPARK platform was released to pilot users, who represented diverse end users, including molecular biologists, clinicians, and bioinformaticians. Included in the pilot release of SPARK are deidentified clinical (including treatment and outcomes data), molecular, multiomic, and whole-slide pathology images for over 600 patients enrolled in PanCAN's Know Your Tumor molecular profiling service. CONCLUSION: The pilot release of the SPARK platform introduces qualified researchers to PanCAN real-world patient health data and analytical resources in a centralized location. Access & use real-world #pancreaticcancer #healthdata through @PanCAN's SPARK cloud-based platform. [ABSTRACT FROM AUTHOR]

Translocating amphibians to alternative, suitable habitat is a climate adaptation strategy aimed at minimizing the risk of extinction due to projected global warming and drying. Projected conditions could undermine their physiological performance, and thus survival and reproduction. Translocations minimize risks of extinction by increasing spatial redundancy across climate-resilient habitats, particularly for dispersal-limited species. However, outcomes of amphibian translocation attempts are poorly documented, and their effectiveness remains unclear. We released and tracked 34 Eleutherodactylus coqui to determine early postrelease survival of a control (nontranslocated) group (n = 14) and experimental (translocated) group (n = 20) moved 0.8 km from their capture location in west-central Puerto Rico in 2021. We defined "initial" as the first 17 d postrelease, a period during which we hypothesized that experimental individuals would have lower survival rates because they transitioned from known-familiar to novel-unfamiliar habitat. We found no evidence in the data to support our hypothesis. Daily survival rates were better explained by a model with no group effect but negatively influenced by in situ temperature. However, the effect of in situ temperature (proxy of operative temperature) was weak (95% confidence intervals overlapped 0). After 17 d, all but one of the recaptured frogs lost weight for a combined weight loss of 0.28 ± 0.13 g. However, weight loss was significantly higher in translocated frogs (0.81 ± 0.33 g). Average daily movements did not hinder survival even though experimental individuals traveled farther (∼ eight times) than control ones. Our findings suggested that managed translocations have the potential to become a useful conservation tool, not an additive source of mortality. We outline challenges that remain before translocations of Eleutherodactylus species can be broadly applied. [ABSTRACT FROM AUTHOR]

Infiltrative lipomas represent a subcategorisation of rarer, potentially more aggressive, lipoma‐related neoplasms. Twenty‐one dogs treated with conventionally fractionated radiotherapy (CFRT) for infiltrative lipomas were included in this retrospective study. One patient had no prior surgical excision, 11 patients had one prior surgery and 9 patients had two or more surgeries prior to CFRT. Five patients (24%) had microscopic disease and 16 patients (76%) had macroscopic disease prior to treatment. A complete response or no regrowth was seen in 10 patients (48%), stable disease in 6 patients (29%) and progressive disease or regrowth in 5 patients (24%). Response to treatment of macroscopic tumours was significantly different between dogs that had one prior surgery versus two or more (p = 0.01). Dogs with a single surgery were most likely to result in stable disease compared with dogs with two or more surgeries resulting in a complete response. The dog without surgery developed progressive disease at 211 days, dogs with one surgery had a median progression or recurrence at 1369 days and dogs with two or more surgeries developed progression or recurrence at 826 days (p = 0.04). Twelve dogs were alive at the time of analysis. Overall median survival time (MST) was 1694 days. The prior number of surgeries did not significantly affect MST. While survival time is comparable to previous reports, the number of patients with progressive disease or recurrence of previous microscopic disease requires more investigation into the most appropriate protocol, dose and treated field size. [ABSTRACT FROM AUTHOR]

Canine lymphoma, the most prevalent haematopoietic tumour in dogs, presents significant challenges in veterinary oncology. This study investigates the prognostic value of the neutrophil‐to‐lymphocyte ratio (NLR) in small‐sized dogs (≤10 kg) with multicentric lymphoma. In this retrospective study, we examined medical records and haematological data from 35 dogs to assess the association between NLR and two key outcomes: time‐to‐progression (TTP) and lymphoma‐specific survival (LSS) using Cox proportional hazards models. Our findings revealed a significant correlation between elevated NLR and a worse prognosis, as evidenced by TTP (p = 0.005) and LSS (p = 0.001). NLR is linked to increased hazard ratios (HRs) for the time‐to‐progression rate (TTPR) at 180, 360 and 540 days (p = 0.001, p = 0.003 and p = 0.005, respectively) and the lymphoma‐specific survival rate (LSSR) at the same intervals (p = 0.016, p = 0.001 and p = 0.001, respectively). Cutoff value of 3.764 for NLR was established, above which there is a significantly increased risk of early disease progression and decreased survival. Additionally, our analysis indicates that dogs with substage b exhibited earlier progression than those with substage a, evident in overall (p = 0.026) and TTPR at 180 days (p = 0.004), 360 days (p = 0.018), 540 days (p = 0.026) and LSSR at 180 days (p = 0.033). The results underscore the potential of NLR as a prognostic marker in cases of dogs ≤10 kg with multicentric lymphoma, suggesting that higher NLR is associated with a poorer prognosis. [ABSTRACT FROM AUTHOR]

Assessment of recurrence risk after liver resection (LR) is critical in hepatocellular carcinoma (HCC), particularly with the advent of effective adjuvant therapy. The aim of this study was to analyze the clinical and pathological factors associated with recurrence, aggressive recurrence, and survival after LR. We performed a retrospective study in which all single HCC (BCLC-0/A) patients treated with LR between February 2000 and November 2020 were included. The main clinical variables were recorded. Histological features were blindly evaluated by two independent pathologists. Aggressive recurrence was defined as those that exceeded the Milan criteria at 1st recurrence. A total of 218 patients were included (30% BCLC 0 and 70% BCLC A), median (IQR) tumor size of 28 (19-42 mm). The prevalence of microvascular invasion and/or satellitosis (mVI/S) was 39%, with a kappa-index between both pathologists of 0.8. After a median follow-up of 49 (23-85) months, 61/218 (28%) patients died, 32/218 (15%) underwent liver transplantation, 127 (58%) developed HCC recurrence. The prevalence of aggressive recurrence was 35% (44/127 Milan-out, with 20 cases at advanced stage), and the 5-year survival rate was 81%. The presence of mVI/S was the only independent predictor of recurrence (hazard ratio [HR] 1.83, 95% CI 1.28-2.61, p < 0.001), aggressive recurrence (HR 3.31, 95% CI 1.74–6.29, p < 0.001) and mortality (HR 2.23, 95% CI 1.27–3.91, p = 0.005). The macrotrabecular-massive subtype was significantly associated with a higher prevalence of mVI/S, Edmonson Steiner grade III-IV, AFP values and vessels that encapsulate tumor clusters, but not with recurrence, aggressive recurrence, or overall survival. The presence of mVI/S was the only independent risk factor for aggressive recurrence and mortality. This has important implications for early-stage patient management, especially in the setting of adjuvant immunotherapy or ab initio LT. Assessment of recurrence risk after liver resection is crucial in patients with hepatocellular carcinoma. Patients with a high risk of recurrence are candidates for liver transplantation as an ab initio indication or for the potential use of adjuvant therapy. Aggressive recurrences, defined as those exceeding the Milan criteria at first recurrence, have a significant impact on overall survival (OS). Fifty-eight percent of patients experienced hepatocellular carcinoma recurrence, with a prevalence of aggressive recurrence at the first occurrence standing at 35%. After a median follow-up of 49 (23-85) months, 61 (28%) patients died, and 32 (15%) underwent liver transplantation, resulting in a 5-year OS rate of 81%. Microvascular invasion and/or satellitosis was present in 39% of our cohort and was the only independent predictor of recurrence, aggressive recurrence, and OS on multivariate analysis. This is important as it could be used to guide therapeutic management. [Display omitted] • Fifty-eight percent of patients experienced HCC recurrence, 35% of them exceeding Milan criteria (aggressive recurrences). • Exceeding the Milan criteria at first recurrence had a significant impact on overall survival. • After a 49-month median follow-up, the 5-year overall survival rate was 81%. • Microvascular invasion and/or satellitosis was the only independent predictor of (aggressive) recurrence and overall survival. [ABSTRACT FROM AUTHOR]

Background: Little progress has been made in determining the prognostic factors for children and adolescents with high‐grade mature B‐cell non‐Hodgkin lymphoma (HG B‐NHL). Based on the important role of body mass index (BMI) in cancer, this study explored the effect of BMI on the prognosis of patients with HG B‐NHL. Methods: Patients aged <18 years with newly diagnosed HG B‐NHL were enrolled. Patients were divided into normal, overweight, obese, and emaciated BMI groups according to the growth criteria for children and adolescents. Results: In total, 435 patients were enrolled in this study. There were 329 (75.6%), 46 (10.6%), 13 (3.0%), and 47 (10.8%) patients stratified into the normal, overweight, obese, and emaciated BMI groups, respectively. The event‐free survival and overall survival rates of the entire cohort were 89.3% and 92.4%, respectively. The 5‐year event‐free survival rate for the patients with obese BMI was worse than those with overweight BMI (76.2% vs. 95.6%, p =.04). The 5‐year overall survival rate for the patients with emaciated BMI was worse than those with normal (84.5% vs. 93.1%, p =.04) or overweight BMI (84.5% vs. 97.7%, p =.03). Cox multivariate analysis showed that obese or emaciated BMI at diagnosis was associated with an increased risk of death (p = 0.04; HR, 2.26) and was identified as an independent adverse prognostic factor in pediatric HG B‐NHL. Conclusion: Obese or emaciated BMI at diagnosis is associated with poor prognosis in pediatric HG B‐NHL and can be used for risk stratification. Obese or emaciated body mass index at diagnosis is associated with poor prognosis in pediatric high‐grade mature B‐cell non‐Hodgkin lymphoma and can be used for risk stratification. [ABSTRACT FROM AUTHOR]

Purpose: Poor functional status is associated with pediatric lung transplant (LTx) waitlist mortality. We investigate how pre-transplant functional status affects post-LTx survival. Methods: A retrospective analysis was performed using The United Network for Organ Sharing (UNOS) Registry data. Pediatric first-time lung transplant candidates between ages 1 and 18 years with reported Lansky Play-Performance Scores (LPPS) at the time of waitlist and/or transplant were included from 2005 and 2021. Functional status by the LPPS scores is defined as severe limitation for LPPS score 10–40, mild limitation for LPPS score 50–70, and normal activity for LPPS score 80–100. Univariate analyses, multivariable Cox regression, and Kaplan–Meier plots were used to assess the impact of functional status on 1-year post-LTx survival. Results: There were 913 and 610 patients at the time of LTx listing and transplant with LPPS scores, respectively. Poor functional status as determined by the LPPS score at the time of LTx, but not at the time of waitlist, was associated with worse 1-year post-LTx outcome (p value 0.0025 vs. 0.071). Multivariable survival analysis using Cox proportional hazards regression identified that a severely limited functional status at the time of LTx was the most profound risk factor for worse 1-year post-LTx survival outcomes when compared to a normal functional status (HR 2.16; 95% CI 1.15–4.07, p value 0.017). Conclusions: Children with severely limited functional status at the time of LTx have worse 1-year post-LTx outcome. It is important to develop strategies to optimize the functional status of children for improved post-LTx outcomes. [ABSTRACT FROM AUTHOR]

The effects of different concentrations of wet biofloc on Nile tilapia, Oreochromis niloticus, were investigated in this study. The aim was to assess the impact on growth, survival, body composition, digestive enzyme activity, liver enzyme activity, and mucosal innate immunity. The experiment consisted of five treatments: a control group (C) which received 100% commercial feed and 50% daily water exchange without biofloc and four treatments where portions of the commercial feed were replaced with wet biofloc (BFT25, 25%; BFT50, 50%; BFT75, 75%; and BFT100, 100%) with limited water exchange. Nile tilapia fingerlings weighing 1.3 g and with a density of 1 ind./L were held for 38 days in fiberglass tanks containing 130 L of water with a salinity of 8 g/L. The results showed that the control group had the highest levels of total ammonium nitrogen (TAN) and nitrite nitrogen (NO2) (P < 0.05). Among the BFT treatments, fingerlings fed with 25% wet biofloc had significantly higher total biomass (741.51 g) and survival (99.74%) (P < 0.05). In terms of carcass quality, the BFT25 treatment had the highest protein (58.77% DW) and lipid (25.06% DW) content. The analysis of bioflocs in the biofloc treatments revealed protein levels ranging from 26.84 to 31.85 (% DW), lipid levels ranging from 1.68 to 2.51 (U/mg protein), and ash levels ranging from 31.85 to 36.44 (% DW). Furthermore, the BFT25 treatment resulted in improved digestive and liver enzyme activity, with the highest levels of protease (17.81 U/mg protein), lipase (2.48 U/mg protein), amylase (80.66 U/mg protein), and liver enzyme ALP (0.176 U/mg protein). In terms of mucosal immunity, the BFT25 treatment exhibited the highest levels of lysozyme (Lys. 34.33 U/mL/min) and immunoglobulin (Ig. 51.66 mg/100 mL), while the BFT100 treatment had the lowest levels (Lys. 17.33 U/mL/min, Ig. 37 mg/100 mL). Based on these findings, it has been demonstrated that Nile tilapia can be fed wet biofloc (developed under the conditions of this study) up to 25% of their commercial feed without compromising their growth performance, survival, body composition, digestive enzyme activity, liver enzyme activity, or mucosal immunity. [ABSTRACT FROM AUTHOR]

The Pacific oyster, Crassostrea gigas, is an important cultured species in the northern coastal areas of China. In recent years, the triploid oyster was popular worldwide because of its fast growth and high meat quality and has rapidly occupied a large portion of the oyster market. As a multi-generation selection strain, "Haida No.2" of C. gigas has good growth performance. At the same time, we have successfully obtained the triploid and tetraploid "Haida No.2." This study was conducted to evaluate the performance of the triploid of "Haida No.2" under different rearing environments. The results showed that there was no significant difference in fertilization rate and hatching rate between diploids and triploids, and so did the survival rate at the larval stage, while the cumulative survival rate of triploids was significantly lower than that of diploids. At grow-out stage, the growth and survival rate of triploids were significantly higher than diploids on day 420 at two sites; meanwhile, the triploid rate was slight decline but still kept a high level (96–98%) on 420 days at two sites. However, high gametogenesis and subsequent mass spawning of triploid females were observed at two sites (32% at Rongcheng and 54% at Rushan), and the fecundity of triploid females relative to diploid females was high (23.73% at Rongcheng and 41.15% at Rushan) under different rearing environments. Our results showed that the triploid of "Haida No.2" had better performance at grow-out stage than diploids. However, the phenomenon of high gametogenesis of triploid and spawning is not favorable for the industrialization of triploid oysters, and the mechanism of high gametogenesis of triploids needs further study. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of kaffir lime (KL), Citrus hystrix, leaf powder on growth performance, digestive enzyme activities, blood and antioxidant parameters, and disease resistance in African catfish, Clarias gariepinus. A total of 450 healthy juveniles (10.5 g) were randomly distributed into five groups and fed diets containing 0% (control), 1%, 2%, 3%, and 4% of KL for eight weeks. At the end of the feeding trial, 10 healthy fish from each group were challenged with Edwardsiella tarda infection. The study findings demonstrated significant differences in all growth parameters, including final weight, weight gain, specific growth rate, feed conversion rate, hepatosomatic percentage, and viscerosomatic index between dietary KL and control groups, with the group fed 2% and 3% KL exhibiting superior performance (p < 0.05). Dietary KL significantly increased white blood cells, red blood cells, hemoglobin, and hematocrit (p < 0.05) in African catfish, with the highest values observed in the 2% and 3% KL groups. Meanwhile, there were no significant differences in mean corpuscular hemoglobin and mean corpuscular hemoglobin concentrations between treatments. Furthermore, dietary KL significantly increased digestive enzyme activities, including lipase, amylase, and protease (p < 0.05), and the highest activities were observed in fish fed 2% and 3% KL. Antioxidative responses, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) in KL-treated fish, were also significantly higher than the control group (p < 0.05). Finally, the highest and the lowest cumulative survival rates following a challenge with E. tarda were 3% KL and control groups, respectively. Based on the study results, 2% or 3% dietary KL could improve the growth and health of African catfish, thus enhancing aquaculture production. [ABSTRACT FROM AUTHOR]