Trends of classification,incidence, mortality,and survival of MDS patients in Switzerland between 2001 and 2012

Myelodysplastic syndromes (MDS) are emerging disorders of the elderly with an increasing burden on healthcare systems. He we report on the first population-based, epidemiological analysis of patients diagnosed with MDS in Switzerland between 2001 and 2012. The aim of this study was to characterize the extent and limitations of currently available population-based, epidemiological data and formulate recommendations for future health services research. The investigated outcomes comprised trends of annual case frequency, classification of morphological subtypes, incidence, mortality and survival. Annual case frequency increased by 20% (from 263 to 315 cases per year), whereas age-standardized incidence-/mortality-rates remained stable (2.5/1.1 per 100′000 person-years). This observation reflects population growth as well as higher diagnostic awareness and not an increase of age-specific risk. However, it will inevitably influence the future prevalence of MDS and the impact on healthcare systems. Reporting of classification in MDS subtypes was poor with modest improvement from 20% to 39% and increased awareness for mainly higher-risk diseases. Relative survival for all patients at 5-years (RS) ranged between 37 and 40%. Significant better RS was found for younger compared to older higher-risk MDS patients (48% vs. 17%), reflecting the effect of allogeneic hematopoietic stem-cell transplantation. However, no survival advantage was found in elderly patients after introduction of hypomethylating agents as standard for care in this patient group. Our data is in line with results from other MDS and cancer registries. It allows formulating recommendations for future collaborative health services research on MDS patients with national and international partners.     

Can functional classification of tropical trees predict population dynamics after disturbance?

Question: How far can we simplify the fioristic complexity of a tropical rainforest into functional groups in order to predict tree population dynamics after logging‐induced disturbance? Location: Paracou experimental site, French Guiana. Methods: We used data from over 15 years in control and disturbed plots from a silvicultural trial started in 1984. We selected 53 common tree species assigned to five functional groups based on potential size and light requirement. For each species, we quantified: the fate, i.e. variation in population size, and dynamic processes, i.e. mortality, recruitment and growth, driving this fate. We investigated the links between dynamic processes, fate and functional groups. Results: Disturbance stimulated growth and recruitment for most species, but had a heterogeneous impact on mortality. Species fate in disturbed plots depended on recruitment and was more favourable than in control plots. The functional classification was more predictive for most separate dynamic processes than for species fate: after disturbance, significant differences were found between all functional groups for growth. Pioneer+heliophilous species showed significantly higher recruitment rates. Mortality of shade‐tolerant species slightly increased and of mid‐tolerant and heliophilous species decreased. Conclusions: A combination of three species classifications separately built from the growth, recruitment and mortality processes is more informative than a global classification combining the processes. Identifying the pioneer+heliophilous species on the basis of their growth rate is crucial to predict species fate after disturbance. We showed that potential growth rate could be used as a reliable indicator to identify this group.     

Estimation of cancer mortality attributable to excess body weight during 2006–2015 in China

BackgroundCancer is one of the most common causes of death. Excess body weight (EBW), a risk factor for cancer, is highly prevalent in China. We aimed to estimate the number and proportion of cancer deaths attributed to EBW and their changes during 2006–2015 in China.MethodsPopulation attributable fractions in 2006, 2010, and 2015 were calculated with 1) prevalence of overweight/obesity, exacted from the China Health and Nutrition Survey conducted in 8–9 provinces of China in 1997, 2000, and 2004; 2) relative risks for EBW and site-specific cancers, obtained from previous studies; 3) data on cancer deaths in 2006, 2010, and 2015, originated from the Chinese Cancer Registry Annual Report.ResultsIn 2015, EBW contributed to 45,918 (3.1% of all) cancer deaths in China, with 24,978 (2.6%) in men and 20,940 (3.8%) in women. By region, the fraction of cancer deaths attributable to EBW ranged from 1.6% (West) to 4.1% (Northeast). Cancers of liver, stomach, and colorectum were the main EBW-attributable cancers. The fractions of cancer deaths attributable to EBW were 2.4% (95%CI: 0.8–4.2%) in 2006, 2.9% (95%CI: 1.0–5.2%) in 2010, and 3.1% (95%CI: 1.0–5.4%) in 2015, respectively, and increased for all gender, region, and cancer site during 2006–2015.ConclusionsThe proportion of cancer deaths attributed to EBW was higher in women and Northeastern China, with an upward trend in the recent decade. A combination of comprehensive and individualized measures is necessary to reduce the prevalence of EBW and related cancer burden in China.     

Twenty years of melanoma in Victoria,Queensland, and South Australia (1997 – 2016)

BackgroundGiven the high incidence of melanoma in Australia alongside high mortality with later stage disease, we investigated the populations and locations most at risk, to optimise public health activities in areas where intervention is most needed. This study examines trends and identifies significant prognostic factors and potential disparities in incidence, mortality and survival between population groups in Victoria, Queensland and South Australia.MethodsThe analysis includes data from the population-based cancer registries of the three states over a twenty-year period (1997–2016). Age-standardized and age-specific incidence rates were calculated, and long-term trends analysed using Joinpoint Regression. Five-year relative survival estimates for the study population were calculated using the cohort method and multivariable flexible parametric survival models were applied for each jurisdiction to calculate adjusted excess mortality hazard ratios for the key characteristics.ResultsThere were more males with melanoma than females in all the three states. Over 60% of the cases occurred in the 40–74 years age group. Most melanomas had a Breslow thickness less than or equal to 1.0 mm. For males, Victoria and Queensland had a statistically significant increasing trend whereas in South Australia there was a decreasing trend. For females, the incidence rate trend was stable in Victoria but significantly decreasing in South Australia. In Queensland there was an increasing and statistically significant trend from 2006 to 2016. Across all three states there was a reducing incidence rate in the youngest cohort, stabilizing incidence in the 40–59-year-old age group, and increasing in the oldest cohorts. Five-year relative survival decreased with increasing age and with Breslow thickness across all three jurisdictions. Males had between 43%− 46% excess mortality compared to females in all the three states. There was higher risk with increasing age and Breslow thickness, with the largest risk among the 75 + age group and those with a Breslow thickness of > 4 mm.ConclusionIt is the first time that data from these three registries has been analysed together in a uniform way, covering more than half of the Australian population. This study compares the epidemiology of melanoma across three states and provides a better understanding of trends and factors affecting outcome for Australians with melanoma. While there has been some improvement in aspects of incidence and mortality, this has not been evenly achieved across Australia.     

How do trees die? Mode of death in northern Amazonia

Question: How do trees die in high‐mortality and low‐mortality Amazonian forest regions? Why do trees die in different ways? Location: Humid, lowland forests in Amazonian Peru and Venezuela. Methods: Patterns of multiple treefall and mode of death (standing, broken or uprooted) were recorded for trees ≥10 cm in diameter in permanent plots. Logistic regression was used to relate mode of death to tree diameter, relative growth rate and wood density. Results: Frequency of multiple death events was higher in high‐mortality northwestern (NW) than in low‐mortality northeastern (NE) Amazonia, but these events were small, averaging two trees killed per multiple death event. Breakage was the dominant known mode of death (51±8%) in the NW, with half of fatal breakages caused by other treefalls or breakages. Small and slow‐growing trees were more prone to breaking than uprooting. In NE Amazonia, the dominant known mode of death was standing (48±10%); these trees tended to be relatively large and slow growing. Broken trees in NE forests have a lower wood density than uprooted trees. Conclusions: The major mortality mechanisms differ in the two regions. In the NW it involves an interaction between physiological failure and mechanical failure (small size, slow growth and broken mode). In the NE it is mainly driven by physiological failure (large size, slow growth and standing mode). We propose that by creating different‐sized gaps the different dominant modes of death would favour species from different functional groups and so help to maintain the contrasting functional composition and mortality rates of the two regions.     

RNAi knockdown of CAPAr gene affects survival and fecundity of Bemisia tabaci (Gennadius)

Bemisia tabaci (Gennadius) Asia II 1 cause significant economic losses to cotton crop, directly by feeding on sap and indirectly through virus transmission. Although the current control methods are the combination of different tactics but still the chemical control is heavily relied. B. tabaci has gained resistance to majority of the insecticides which has made it difficult to manage this pest using synthetic chemicals. RNAi based gene silencing has been evolved as potential biochemical tool for specific gene silencing of target insect-pest and has been successfully demonstrated for Hemipteran insects. Here, we report the successful silencing of the CAPAr gene in B. tabaci which encodes for the G-protein coupled receptor (a transmembrane membrane peptide). Silencing of CAPAr gene resulted into reduced survival and fecundity of B. tabaci. Oral delivery of dsRNA mediated artificial diet corresponding to CAPAr gene resulted into significantly high adult mortality of 30.74% in treatment dsCAPAr 1.0 µg/µl after 48 hr of dsRNA feeding. A significant reduction in whitefly female fecundity was recorded for all the dsCAPAr concentrations with lowest value of 53.51 eggs per female in dsCAPAr 1.0 µg/µl. The relative gene expression of CAPAr gene further confirms the down regulation of CAPAr gene in knock down adult whiteflies. Our investigation proves the importance of CAPAr for B. tabaci survival and may be exploited as potential tool which can be strategic in integrated management programme for B. tabaci.     

Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1 mm thick

BackgroundAs the 10-year mortality for localized cutaneous melanoma more than 1.00 mm thick approaches 40% following complete resection, non-therapeutic interventions that can supplement recommended active surveillance are needed. Although guidelines recommending nutrition, physical activity and tobacco cessation for cancer survivors have been published, data describing their associations with melanoma survivorship are lacking.MethodsAnalysis of modifiable lifestyle behaviors collected on the 249 cases with melanomas more than 1.00 mm thick enrolled in the Connecticut Case–Control Study of Skin Self-Examination study was conducted. Independent associations with melanoma-specific survival were evaluated through Cox proportional hazards modeling adjusting for age, gender, Breslow thickness, ulceration and the presence of microsatellites. Independently significant variables were then combined into a single model and backwards elimination was employed until all remaining variables were significant at p < 0.05.ResultsFollowing adjustment for age, Breslow thickness and anatomic site of the index melanoma, daily fruit consumption was associated with improved melanoma-specific survival (HR = 0.54; 95% CI: 0.34–0.86) whereas at least weekly red meat consumption was associated with worse outcomes (HR = 1.84; 95% CI: 1.02–3.30). Natural red (HR = 0.44; 95% CI: 0.22–0.88) or blond (HR = 0.52; 95% CI: 0.29–0.94) hair were also favorably prognostic. Higher fish consumption was of borderline significance for improved survival only when considered independently (HR = 0.65; 95% CI: 0.40–1.05); no association was seen following adjustment for red meat and fruit consumption (p > 0.10).ConclusionsDietary choices at the time of diagnosis are associated with melanoma-specific survival in patients with melanomas more than 1.00 mm thick. Further validation of our findings in larger cohorts with repeated post-diagnostic measures is warranted to further evaluate whether dietary modification during the survivorship period can improve melanoma-specific survival.     

Growth and survival rate of the larvae ofHynobius nebulosus Tokyoensis Tago (Amphibia,Hynobiidae)

Growth and population density of the larvae, Hynobius nebulosus tokyoensisTago , were estimated in a small pond within the study site settled in Habu village of Hinodemachi, a suburb of Tokyo City, during the period from 1975 to 1980. The mortality factors which influenced the survival rate of larvae were also evaluated from the ecological point of view. Laboratory experiments on the growth of larvae and predation by newts were conducted in pararell with the field survey. The results showed that growth rate of larvae under the natural condition was very slow, as compared with that under the laboratory condition with sufficient food supply, and mean body size at metamorphosis was negatively correlated with the density at that time. This suggested that food resources were in short supply in the pond, and there occurred a severe intraspecific competition for food among larvae. The mortality rate of larvae was so high, 80–99% in each year, and the density of larvae survived until metamorphosis varied so greatly from year to year that the larval stage was the most important stage throughout the life cycle to the maintenance of a population for this salamander. The most important factors which contributed to this high mortality were the predation by the newt, Triturus pyrrhogaster pyrrhogasterBoie , and cannibalism. From the laboratory experiment, it was found that predators could attack only small larvae successfully, and successful attack rate decreased sharply as larvae grew larger. This relationship resulted in the characteristic L-shaped pattern of survivorship curve of larvae; that is, heavy mortality just after hatching period.     

Spatio-temporal variations in biological performances and summer mortality of the Pacific oyster Crassostrea gigas in Normandy (France)

Mortality and biological performances of half-grown Crassostrea gigas were studied from spring 2000 to autumn 2001 at six instrumented stations located in two areas (Gefosse and Grandcamp) of the Bay of Veys (Normandy). Shell and meat growth, condition indexes and a macroscopic maturity index were determined on oysters deployed at the six stations in order to assess spatial variability in the influence of environmental conditions. In addition, histological and biochemical analyses were performed in order to determine the sex and establish the reproductive cycle (at all six sites) and the biochemical composition (at four stations). The data set including monthly mean temperatures and data provided by examination of 2,837 oysters were analysed by Principal Component Analysis and a Hierarchical Ascending Clustering which resulted in the formation of four clusters. The highest station on the shoreline belonged to a cluster characterized notably by low total weight due to a short immersion/feeding period, whereas all other stations belonged to another single cluster. Nevertheless, various biological differences were found between these stations, e.g. the reproductive cycle was generally synchronized throughout the bay but some differences relative to spawning occurrence were observed. In 2000, oyster mortality was higher at Gefosse than at Grandcamp, the latter being a more marine area. In 2001, oyster mortalities were significantly higher and all stations were strongly affected. In the Bay of Veys, oyster biological performances and mortality thus showed spatio-temporal variations which were worthy to be discussed.     

Long term follow-up of patients with ventricular high rate events detected on remote monitoring of pacemakers

AimsPrevious data suggest ventricular high rate episodes (VHREs) on pacemakers are frequent and not associated with overall mortality on short term follow up. We sought to determine whether VHREs are associated with mortality, device upgrade, or change in ejection fraction on long term follow up.MethodsA single center, retrospective study was performed on 542 patients with permanent pacemakers followed between 2011 and 2013. Follow-up was extended to 2017 for determination of long term outcomes. “True” VHREs were defined as episodes adjudicated to be due to non-sustained ventricular tachycardia on review of electrograms and “false” VHREs were defined as supraventricular arrhythmias or noise.ResultsVHRE occurred in 202(37.2%)/542 included patients. True VHRE was detected in 148(27.3%) while 54(10%) had false VHRE. The mean age of the population was 72 ± 15 years and 46% were women. Mean follow-up was 3.3 ± 1.4 years. The baseline characteristics of the true, false and no VHRE patients were similar. There was no difference in all-cause mortality between groups (27% mortality in true VHRE, 33% in false VHRE and 29% in no VHRE). Furthermore, there was no difference between groups with regards to any device upgrade (5% any upgrades in the VHRE, 9% in false VHRE and 5% in no VHRE.) On follow up, EF declined in all groups: −4% vs −2.4% vs −3.5% for true, false and no VHRE.ConclusionVHRE are frequently encountered on remote monitoring of pacemakers and not associated with increased risk of mortality or need for downstream device upgrade.