A Risk Screening of Potential Invasiveness of Alien and Neonative Marine Fishes in the Mediterranean Sea: Implications for Sustainable Management

Biological invasions have posed a major threat to global and regional biodiversity. The Mediterranean Sea, one of the major biodiversity hotspots in the world, has long suffered multiple and frequent invasion events. This paper represents the screening results of the potential invasiveness of 23 introduced marine fish species, which are classified as neonative and alien. To predict the invasiveness potential of species under current and predicted climate conditions, the Aquatic Species Invasiveness Screening Kit (AS-ISK) is applied. Thresholds have been constituted to classify low, medium and high-risk species by receiver operative characteristic curve analysis (ROC). The calibrated basic and climate-change threshold assessment scores used to classify species from low, to medium to high risk were computed between 27.5 and 33.0 respectively. Based on these thresholds, under current climatic conditions, 15 species were high risk, while the remaining species were medium risk, and the Chaetodipterus faber and the Holocentrus adscensionis switched from the medium-risk to the high-risk group under future climatic conditions. The highest score belonged to Fistularia petimba, followed by Siganus fuscescens, Abudefduf spp., Acanthurus monroviae and Lutjanus argentimaculatus. This study focused on the species that have not been assessed for their invasiveness potential, and the results can provide important insights into their sustainable management in the future.

Download Full-text

Sernbo score predicts survival after intracapsular hip fracture in the elderly

Annals of The Royal College of Surgeons of England ◽

10.1308/003588413x13511609954653 ◽

2013 ◽

Vol 95 (1) ◽

pp. 29-33 ◽

Cited By ~ 20

Author(s):

EJC Dawe ◽

E Lindisfarne ◽

T Singh ◽

I McFadyen ◽

P Stott

Keyword(s):

Hip Fracture ◽

High Risk ◽

Risk Group ◽

Characteristic Curve ◽

Social Situation ◽

High Risk Group ◽

Low Risk ◽

Risk Of Death ◽

Intracapsular Hip Fracture ◽

The Mean

Introduction The Sernbo score uses four factors (age, social situation, mobility and mental state) to divide patients into a high-risk and a low-risk group. This study sought to assess the use of the Sernbo score in predicting mortality after an intracapsular hip fracture. Methods A total of 259 patients with displaced intracapsular hip fractures were included in the study. Data from prospectively generated databases provided 22 descriptive variables for each patient. These included operative management, blood tests and co-mobidities. Multivariate analysis was used to identify significant predictors of mortality. Results The mean patient age was 85 years and the mean follow-up duration was 1.5 years. The one-year survival rate was 92% (±0.03) in the low-risk group and 65% (±0.046) in the high-risk group. Four variables predicted mortality: Sernbo score >15 (p=0.0023), blood creatinine (p=0.0026), ASA (American Society of Anaesthesiologists) grade >3 (p=0.0038) and non-operative treatment (p=0.0377). Receiver operating characteristic curve analysis showed the Sernbo score as the only predictor of 30-day mortality (area under curve 0.71 [0.65–0.76]). The score had a sensitivity of 92% and a specificity of 51% for prediction of death at 30 days. Conclusions The Sernbo score identifies patients at high risk of death in the 30 days following injury. This very simple score could be used to direct extra early multidisciplinary input to high-risk patients on admission with an intracapsular hip fracture.

Download Full-text

Immune-Related Four-lncRNA Signature for Patients with Cervical Cancer

BioMed Research International ◽

10.1155/2020/3641231 ◽

2020 ◽

Vol 2020 ◽

pp. 1-15

Author(s):

Jianfeng Zheng ◽

Benben Cao ◽

Xia Zhang ◽

Zheng Niu ◽

Jinyi Tong

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Immune Cell ◽

Risk Group ◽

Pearson Correlation ◽

Characteristic Curve ◽

Risk Groups ◽

High Risk Group ◽

Low Risk ◽

Gynecological Malignancy

Cervical cancer (CC) is a common gynecological malignancy for which prognostic and therapeutic biomarkers are urgently needed. The signature based on immune-related lncRNAs (IRLs) of CC has never been reported. This study is aimed at establishing an IRL signature for patients with CC. A cohort of 326 CC and 21 normal tissue samples with corresponding clinical information was included in this study. Twenty-eight IRLs were collected according to the Pearson correlation analysis between the immune score and lncRNA expression ( p < 0.01 ). Four IRLs (BZRAP1-AS1, EMX2OS, ZNF667-AS1, and CTC-429P9.1) with the most significant prognostic values ( p < 0.05 ) were identified which demonstrated an ability to stratify patients into the low-risk and high-risk groups by developing a risk score model. It was observed that patients in the low-risk group showed longer overall survival (OS) than those in the high-risk group in the training set, valid set, and total set. The area under the curve (AUC) of the receiver operating characteristic curve (ROC curve) for the four-IRL signature in predicting the one-, two-, and three-year survival rates was larger than 0.65. In addition, the low-risk and high-risk groups displayed different immune statuses in GSEA. These IRLs were also significantly correlated with immune cell infiltration. Our results showed that the IRL signature had a prognostic value for CC. Meanwhile, the specific mechanisms of the four IRLs in the development of CC were ascertained preliminarily.

Download Full-text

Gene scoring model to predict recurrence in low- and intermediate-risk uterine endometrial cancer: Establishment of uterine print.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5590 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5590-5590

Author(s):

Tatsuyuki Chiyoda ◽

Yoichi M Ito ◽

Fumio Kataoka ◽

Wataru Yamagami ◽

Hiroyuki Nomura ◽

...

Keyword(s):

Gene Expression ◽

High Risk ◽

Expression Profiles ◽

Characteristic Curve ◽

High Risk Group ◽

Internal Controls ◽

Rank Test ◽

Test Cases ◽

Intermediate Risk ◽

Scoring Model

5590 Background: Endometrial cancers (ECs) classified as low-, intermediate-, and high-risk, based on clinical and pathological features (CPF: Lurain, 2007) associated with 5%, 15%, and 25% risk of recurrence, respectively. The need for adjuvant chemotherapy in intermediate-risk patients is controversial. We examined whether gene expression profiling can more accurately predict the prognosis of ECs, excluding the CPF-based high-risk group. Methods: Tumor specimens were obtained from 136 ECs including 14 recurrences, excluding high-risk cases. Gene expression profiles were achieved using a custom array consisting of 85 genes associated with EC recurrence and 20 internal controls that were previously screened. We established the gene scoring model (GSM) for recurrence by the logistic regression model in randomly selected 68 ECs including 7 recurrences, and evaluated the accuracy of GSM in other 68 ECs including 7 recurrences. This process was repeated 100 times. We calculated the mean accuracy of GSM and compared it with the accuracy of CPF. We also compared GSM and CPF with respect to progression-free survival (PFS) by use of the log-rank test. Results: Median age of all cases was 58 (29-86) years, and stage, histologic grade, and risk classification based on CPF were as follows: (I, 107; II, 15; III, 14), (G1, 69; G2, 57; G3, 10), and (low, 67; intermediate, 69). The median follow-up period was 1830 (1626-3444) days. The GSM was established based on the expression of 4 genes (PRCC, SPC25, PXDN, and LBXCOR1) and 10 internal controls. The area under the receiver operating characteristic curve of GSM to predict recurrence was 0.87 in 68 test cases. Based on the CPF, 68 cases were classified as 30 low-risk and 38 intermediate-risk, and the sensitivity and specificity of CPF was 86% and 48% each in the 68 test cases. When sensitivity of GSM was fixed at 86%, specificity of 67% was achieved, and 68 cases were classified as 42 risk (-) and 26 risk (+). PFS was significantly related with GSM (p = 0.006); however, it was not related with CPF (p = 0.09). Conclusions: GSM can predict the prognosis of ECs (low- and intermediate-risk) more precisely than CPF.

Download Full-text

A Five-MicroRNA Signature Predicts the Prognosis in Nasopharyngeal Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.723362 ◽

2021 ◽

Vol 11 ◽

Author(s):

Shixiong Wu ◽

Cen Zhang ◽

Jing Xie ◽

Shuang Li ◽

Shuo Huang

Keyword(s):

Overall Survival ◽

High Risk ◽

Nasopharyngeal Carcinoma ◽

Receiver Operating Characteristic Curve ◽

Operating Characteristic ◽

Risk Group ◽

Characteristic Curve ◽

High Risk Group ◽

Prognostic Signature ◽

Operating Characteristic Curve

BackgroundThere is no effective prognostic signature that could predict the prognosis of nasopharyngeal carcinoma (NPC).MethodsWe constructed a prognostic signature based on five microRNAs using random forest and Least Absolute Shrinkage And Selection Operator (LASSO) algorithm on the GSE32960 cohort (N = 213). We verified its prognostic value using three independent external validation cohorts (GSE36682, N = 62; GSE70970, N = 246; and TCGA-HNSC, N = 523). Through principal component analysis, receiver operating characteristic curve analysis, and C-index calculation, we confirmed the predictive accuracy of this prognostic signature.ResultsWe calculated the risk score based on the LASSO algorithm and divided the patients into high- and low-risk groups according to the calculated optimal cutoff value. The patients in the high-risk group tended to have a worse prognosis outcome and chemotherapy response. The time-dependent receiver operating characteristic curve showed that the 1-year overall survival rate of the five-microRNA signature had an area under the curve of more than 0.83. A functional annotation analysis of the five-microRNA signature showed that the patients in the high-risk group were usually accompanied by activation of DNA repair and MYC-target pathways, while the patients in the low-risk group had higher immune-related pathway signals.ConclusionsWe constructed a five-microRNA prognostic signature, which could accurately predict the prognosis of nasopharyngeal carcinoma, and constructed a nomogram that could conveniently predict the overall survival of patients.

Download Full-text

Investigation of the Inherent Variability of the Mediterranean Sea Under Contrasting Extreme Climatic Conditions

Frontiers in Marine Science ◽

10.3389/fmars.2021.656737 ◽

2021 ◽

Vol 8 ◽

Author(s):

Angeliki Sampatakaki ◽

Vassilis Zervakis ◽

Ioannis Mamoutos ◽

Elina Tragou ◽

Alexandra Gogou ◽

...

Keyword(s):

Mediterranean Sea ◽

Thermohaline Circulation ◽

Eastern Mediterranean ◽

Internal Variability ◽

Climatic Conditions ◽

Spatiotemporal Variability ◽

Atmospheric Forcing ◽

Buoyancy Forcing ◽

Deep Layers ◽

The Mediterranean

The internal variability of the thermohaline circulation of the Mediterranean Sea is examined under contrasting extreme thermal and mass atmospheric forcing conditions. Three millennium-long numerical simulation experiments were performed under: (a) the current climatology, (b) a strong buoyancy forcing (SBF) scenario due to cold and dry conditions resembling the Younger Dryas event, and (c) a weak buoyancy forcing (WBF) scenario due to S1a sapropel deposition-like conditions (warm and wet). To isolate the inherent variability of the system, independent of interannual atmospheric forcing variability, the latter was defined as a perpetual year pertinent to each experiment. Self-diagnosed heat and salt fluxes, consistent to sea-surface characteristics of the above periods, forced three millenium-long, relaxation-free numerical experiments. These simulations were preceded by initial spin-up periods. The inherent spatiotemporal variability of the Mediterranean Sea was analyzed using the empirical orthogonal function (EOF) and spectral analysis on the simulated density fields. Our results revealed that the Mediterranean Sea exhibits high sensitivity to climatic conditions, allowing its circulation to change from anti-estuarine (for the SBF scenario, leading to a buoyancy loss to the atmosphere) to estuarine (for the WBF scenario, corresponding to a buoyancy gain from the atmosphere). In all three experiments, the interannual and decennial variabilities dominate in upper layers, and the decennial variability dominates in the Gibraltar and Sicily Straits. Under current climatic conditions the first two EOF modes express only 60% of the density variability in the deep layers. This contribution exceeds 90% under more extreme conditions. Moreover, the first EOF modes correspond to a basin-wide in-phase variability of the deep layers under the reference and WBF conditions. During SBF conditions the first modes reveal a vertical buoyancy exchange between upper and deeper layers. The second EOF mode of deep waters under both extreme scenarios showed that the western and eastern basins exchange buoyancy in decennial (for the cold/dry) and interdecennial (for the warm/humid) timescales. The residence time of the Eastern Mediterranean deep water was diagnosed to be centennial, semicentennial, and intercentennial for the cases of current period, SBF, and WBF, respectively.

Download Full-text

Patterns of local extension and nodal involvement from 1300 nasopharyngeal carcinoma patients: An imaging-based predictor of distant metastases.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e17516 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e17516-e17516

Author(s):

Dan Fan ◽

Ying Wang ◽

Yifu Tian ◽

Nancy Y. Lee ◽

Liangfang Shen

Keyword(s):

High Risk ◽

Nasopharyngeal Carcinoma ◽

Tumor Invasion ◽

Mixed Type ◽

Validation Cohort ◽

Risk Group ◽

Distant Metastases ◽

Incidence Rates ◽

High Risk Group ◽

Medium Risk

e17516 Background: Distant metastasis is a main determinant of prognosis in patients with nasopharyngeal carcinoma(NPC). We explored the patterns of disease spread in NPC patients and identified the pattern correlates with distant metastases. Methods: The imaging documents of 1300 consecutive newly diagnosed nasopharyngeal carcinoma between 2012 and 2016 were reviewed. According to the incidence rates of tumor invasion, the anatomic sites were classified into high-risk group (≥50%), medium-risk group (≥10%~ < 50%) and low-risk group ( < 10%). The location of lymph nodes was determined by 2013 updated guidelines for neck node levels. Additionally, we developed a novel classification based on tumor spreading patterns, as shown in Table. Moreover, we validated the prognostic accuracy of the classification in a validation cohort from a different institution, 241 non-metastatic NPC patients were retrospectively enrolled. Kaplan-Meier method and log-rank test were used to analyze all time-to-event data. Results: The incidence rates of tumor invasion were 0.2% ~91.2%, 95.2% cases across the midline. If anatomic sites in high-risk group or median-risk group were involved, the incidence rates in adjacent medium-risk sites or low-risk group were increased. On the contrary, the incidence rates were decreased when the adjacent high-risk sites or median-risk group were not involved. 85.9% cases had involved lymph nodes. Only 3.9% had skip metastases. The incidence rates of nodal involvement were increased when adjacent upper nodal level was involved. In validation cohort, distant metastases were present in 32/241 NPC patients (13.3%) and 3-year distant metastasis-free survival(DMFS) in local, superior, inferior, and mixed type were 95.0%, 91.3%, 89.0%, and 78.7%, respectively. Cumulative survival curves for former three patterns were relatively similar and were clearly separated from mixed type. DMFS was significantly lower for patients with mixed type pattern than for those with other patterns(P = 0.018). Conclusions: Local disease in NPC patients spreads stepwise from proximal sites to more distal sites. The frequency of metastases in the jugular lymph node chains decreased in the cranio-caudal direction. Based on the patterns of tumor extension, an imaging-based predictor of distant metastases was developed and may be used as a prognostic marker for selecting patients to further systemic treatments. [Table: see text]

Download Full-text

High Prevalence of Relapse in Australian Children with Ph-like Acute Lymphoblastic Leukemia Despite Risk Adapted Treatment

Blood ◽

10.1182/blood.v126.23.1419.1419 ◽

2015 ◽

Vol 126 (23) ◽

pp. 1419-1419 ◽

Cited By ~ 1

Author(s):

Susan L Heatley ◽

Teresa Sadras ◽

Eva Nievergall ◽

Chung Hoow Kok ◽

Phuong Dang ◽

...

Keyword(s):

High Risk ◽

Research Funding ◽

Risk Group ◽

Lymphoblastic Leukemia ◽

Risk Groups ◽

High Risk Group ◽

Event Free Survival ◽

Free Survival ◽

Kaplan Meier ◽

Medium Risk

Abstract Introduction: While remission rates for childhood acute lymphoblastic leukemia (ALL) now exceed 80%, relapsed ALL remains the leading cause of non-traumatic death in children. Recently, a high-risk group of B-progenitor ALL patients has been identified. Such cases exhibit a gene expression profile similar to that of BCR-ABL1 positive (Ph+) ALL but are BCR-ABL1 negative, and also experience poor treatment outcomes. This subset, termed Ph-like ALL, is characterised by a range of genetic alterations that activate cytokine receptor and kinase signalling, allowing potential targeting by available tyrosine kinase inhibitors (TKI). The frequency of Ph-like ALL in the Australian community and the prognosis in the setting of the first MRD (minimal residual disease) intervention trial by the Australian and New Zealand Children's Haematology/Oncology Group (ANZCHOG ALL8) is unknown. Method: We retrospectively screened 250 unselected samples that were available from children diagnosed with B-ALL, for Ph-like ALL. The children, aged between 1 and 18 years, were enrolled on the ANZCHOG ALL8 trial and recruited from 2002-2011. The criteria for stratification to the high-risk group, based upon Berlin-Frankfurt-Munster (BFM) protocols, were BCR-ABL1 or MLL t(4;11) translocation; poor prednisolone response at day 8; failure to achieve remission by day 33 or high MRD (>5 x10-4) at day 79. MRD was measured by RQ-PCR for patient-specific immunoglobulin and T-cell receptor rearrangements. All patients received a standard BFM four drug induction chemotherapy regimen including a prednisolone pre-phase and intrathecal methotrexate. High-risk patients received a further three novel intensive blocks of chemotherapy followed by transplant in most cases. Patients were screened for Ph-like ALL using a custom Taqman Low Density Array (TLDA) based upon previous reports. Fusions were then confirmed by RT-PCR for 30 known fusions, Sanger sequencing, mRNA sequencing and/or FISH. Results: Ten percent (25/250) of children in this cohort were identified as having Ph-like ALL, with most fusions converging on kinase activating pathways (Table 1). Three Ph-like ALL patients were considered high-risk, the remaining 22 (88%) were medium risk. Five children with Ph-like ALL, that did not have a fusion identified by RT-PCR, are currently under further investigation. Furthermore, 15 of the 20 (75%) of rearrangements involved CRLF2 with 10 (66%) of these children relapsing. Strikingly, 56% (14/25) of children in the ALL8 cohort who were identified as Ph-like subsequently relapsed compared to 16% (36/225) who were not, with significantly worse event free survival (p<0.0001) (Figure 1). Conclusion: Here we demonstrate a significantly higher frequency of relapse amongst Australian children with Ph-like ALL compared to non Ph-like disease despite a MRD-adjusted intensification regimen. In this cohort, these children should be classified as high-risk due to high treatment failure rates with standard/medium risk regimens. Importantly, rapid identification of these patients may guide future intervention with targeted therapies, such as TKI, matched to the causative genetic lesion in this high-risk group. Figure 1. Fusions identified in Ph-like ALL from ANZCHOG ALL8 cohort. Figure 1. Fusions identified in Ph-like ALL from ANZCHOG ALL8 cohort. Figure 2. Kaplan-Meier estimates of event free survival for patients with Ph-like ALL and non Ph-like ALL (all risk groups). Figure 2. Kaplan-Meier estimates of event free survival for patients with Ph-like ALL and non Ph-like ALL (all risk groups). Disclosures Hughes: ARIAD: Honoraria, Research Funding; Bristol-Myers Squibb: Honoraria, Research Funding; Novartis: Honoraria, Research Funding. Mullighan:Incyte: Consultancy, Honoraria; Cancer Science Institute: Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Speakers Bureau; Loxo Oncology: Research Funding. White:Novartis: Honoraria, Research Funding; BMS: Honoraria, Research Funding.

Download Full-text

Initial Experience with Determination of hTERC and MYCC Amplification in Cervical Intraepithelial Neoplasia and Cervical Carcinoma in the Czech Republic

European Oncology & Haematology ◽

10.17925/eoh.2012.08.02.92 ◽

2012 ◽

Vol 08 (02) ◽

pp. 92 ◽

Cited By ~ 2

Author(s):

Lucie Moukova ◽

Vladimira Vranova ◽

Iva Slamova ◽

Miroslava Kissova ◽

Petr Kuglik ◽

...

Keyword(s):

High Risk ◽

Cervical Intraepithelial Neoplasia ◽

Chromosomal Abnormalities ◽

Intraepithelial Neoplasia ◽

Risk Groups ◽

Hpv Infection ◽

High Risk Group ◽

Medium Risk ◽

Risk Of Progression ◽

Human Telomerase

Tumours are frequently characterised by series of cytogenetic abnormalities. Amplifications of the human telomerase gene hTERC (3q26) and myelocytomatosis-C proto-oncogeneMYCC(8q24) have been associated with cervical intraepithelial neoplasia (CIN) and carcinoma of the uterine cervix. The results of genetic analysis allow to select patients at high risk of progression from CIN to carcinoma. Our group conducted a study in which the chromosomal abnormalities found in the cytology specimens of 26 patients with either cervical cancer or CIN were analysed using the recently developed triple-colour human papillomavirus-fluorescencein situhybridisation (HPV-FISH) assay. HPV infection was proven in 22 (85 %) patients. Amplification ofMYCCandhTERCwas found in 11 (42 %) and 16 (62 %) patients, respectively. Based on these results, the patients were divided into high-risk, medium-risk and low-risk groups. The study confirmed that the HPV-FISH assay can be used as an effective diagnostic procedure to identify patients carrying high-risk HPV infection and chromosomal aberrations associated with the development of malignancy. Patients in the high-risk group would require more frequent folllow-up and aggressive therapy.

Download Full-text

Predicting complication risk in spine surgery: a prospective analysis of a novel risk assessment tool

Journal of Neurosurgery Spine ◽

10.3171/2016.12.spine16969 ◽

2017 ◽

Vol 27 (1) ◽

pp. 81-91 ◽

Cited By ~ 37

Author(s):

Anand Veeravagu ◽

Amy Li ◽

Christian Swinney ◽

Lu Tian ◽

Adrienne Moraff ◽

...

Keyword(s):

Risk Assessment ◽

High Risk ◽

Risk Stratification ◽

Spine Surgery ◽

Assessment Tool ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

Acs Nsqip ◽

Medium Risk

OBJECTIVEThe ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort.METHODSThe spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period. Prospectively collected data were used to compare the RAT to the Charlson Comorbidity Index (CCI) and the American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator. Study end point was occurrence and type of complication after spine surgery.RESULTSThe authors identified 69 patients (73 procedures) who experienced a complication over the prospective study period. Cardiac complications were most common (10.2%). Receiver operating characteristic (ROC) curves were calculated to compare complication outcomes using the different assessment tools. Area under the curve (AUC) analysis showed comparable predictive accuracy between the RAT and the ACS NSQIP calculator (0.670 [95% CI 0.60–0.74] in RAT, 0.669 [95% CI 0.60–0.74] in NSQIP). The CCI was not accurate in predicting complication occurrence (0.55 [95% CI 0.48–0.62]). The RAT produced mean probabilities of 34.6% for patients who had a complication and 24% for patients who did not (p = 0.0003). The generated predicted values were stratified into low, medium, and high rates. For the RAT, the predicted complication rate was 10.1% in the low-risk group (observed rate 12.8%), 21.9% in the medium-risk group (observed 31.8%), and 49.7% in the high-risk group (observed 41.2%). The ACS NSQIP calculator consistently produced complication predictions that underestimated complication occurrence: 3.4% in the low-risk group (observed 12.6%), 5.9% in the medium-risk group (observed 34.5%), and 12.5% in the high-risk group (observed 38.8%). The RAT was more accurate than the ACS NSQIP calculator (p = 0.0018).CONCLUSIONSWhile the RAT and ACS NSQIP calculator were both able to identify patients more likely to experience complications following spine surgery, both have substantial room for improvement. Risk stratification is feasible in spine surgery procedures; currently used measures have low accuracy.

Download Full-text