•Racial disparities affect patients with metastatic spine disease.•African-American patients are more likely to present with cord compression and paralysis.•African-American patients are less likely ...to receive surgical intervention.•African-American patients are more likely to develop a complication, prolonged length of stay, and non-routine discharge.
Race is an important determinant of cancer outcome. The purpose of this study was to identify disparities in clinical presentation, treatment use, and in-hospital outcomes of patients with spinal metastases.
The United States National Inpatient Sample database (2004–2014) was queried to identify patients with metastatic disease and cord compression (MSCC) or spinal pathological fracture. Clinical presentation, type of intervention, and in-hospital outcomes were compared between races/ethnicities. Multivariate logistic regression analyses were performed and adjusted for differences in patient age, sex, insurance status, income quartile, hospital teaching status and size, Charlson comorbidity index, smoking status, tumor type, and neurological status.
A total of 145,809 patients were identified – 74.8 % Caucasian, 14.1 % African-American, 7.9 % Hispanic, and 3.2 % Asian. Over one-third of patients (38.1 %) presented with MSCC; 35.7 % of Caucasians, 50.3 % of AAs, 41.1 % of Hispanics, and 39.8 % of Asians (p < 0.001). Paralysis affected 8.4 % of all patients; 7.4 % of Caucasians, 12.7 % of AAs, 10.5 % of Hispanics, and 10.0 % of Asians (p < 0.001). For patients with MSCC, multivariate analysis showed that AAs were less likely to undergo surgical intervention (OR 0.71; 95 % CI, 0.62 – 0.82; p < 0.001), significantly more likely to experience a complication (OR 1.25; 95 % CI, 1.12–1.40; p < 0.001), significantly more likely to experience prolonged length of stay (OR 1.22; 95 % CI, 1.08–1.36; p = 0.001), and significantly more likely to experience a non-routine discharge (OR 1.19; 95 % CI, 1.05–1.35; p = 0.007) compared to Caucasians.
Minority groups with spinal metastatic disease may be at a disadvantage compared to Caucasians, with significant disparities found in presenting characteristics, type of intervention, and in-hospital outcomes. Continued efforts to overcome these differences are needed.
In Mexico, due to its high biological diversity, use of its resources, and a lack of knowledge about its biodiversity, Priority Marine Regions have been designated. The classification of these ...regions has served as an instrument for the large-scale conservation because the species composition is relatively homogeneous in these regions. This study reports some ecological attributes of bivalves from the Priority Marine Regions located in the Mexican Transitional Pacific ecoregion. Three samplings have been carried out in 2016–2018 in the rocky intertidal zone. In each sample per site, an area of 10 m2 was covered, and the sampling unit was 1 m2. A total of 4119 specimens were recorded, by identifying 53 species (35 genera, 18 families, and two specimens identified to genus). The richness of the species expected was calculated using non-parametric estimators, by showing acceptable completeness of the inventory. The highest species richness and diversity were recorded in the Copala-Punta Maldonado region (33 species), whereas the highest abundance and density were found in the Colola-Maruata region (30.9 individuals/m2). The best-represented species in abundance and distribution were Chama coralloides, Brachidontes adamsianus, Isognomon janus, and Choromytilus palliopunctatus. By considering their life form and degree of occurrence, studied bivalves attached to a hard substrate (epifaunal species) and restricted to habitats with particular characteristics (occasional species) were the most commonly found. The information provided here is directed to eight Marine Regions designated as a priority for conservation in Mexico, which is important for planning, decision-making, and formulating initiatives aimed at helping to co-ordinate management practice through outreach efforts to the conservation and sustainable use of bivalves as marine resources.
The present study contributes to the knowledge of epibionts recorded on sea turtles that nested on a beach in the South Pacific of Mexico. A total of 125 Lepidochelys olivacea turtles nested on Llano ...Real beach, Guerrero, Mexico, were examined. We collected 450 conspicuous organisms from 8 species from 43 turtles. The corresponding data analysis was carried out to obtain the relative abundance, the relationship between turtle sizes and the presence of organisms, the similarity of species between the sampling months, and the interspecific relationships between the epibionts and the turtles observed. Chelonibia testudinaria was the most abundant species, while Remora remora was the least abundant species. The turtles were divided into six body sections, with the greatest abundance of these organisms located in the head–neck section of turtles, and there was a significant difference in the size of the turtles that presented epibionts and those that did not. C. testudinaria showed greater similarity between sampling months, and the interspecific relationships recorded were commensalism, parasitism, amensalism, and protocooperation. This research contributes the first record of epibionts in L. olivacea nesting in Guerrero, Mexico.
The Acanthocephala constitute a group of helminth parasites that, as adults, infect all classes of vertebrates. Adults of Neoechinorhynchus brentnickoli are parasites of Dormitator latifrons, a ...commercially important fish species in Tres Palos Lagoon, Guerrero, Mexico. The aim of this study was to describe features of the reproductive biology of this acanthocephalan. Fish were collected from Laguna de Tres Palos during February 2012 to February 2013. The number of fish that were examined (n = 688) ranged from 35 (June) to 70 (August) in each collection. The prevalence of infection was more than 90% during this period and mean abundance varied significantly from 32.3 worms per fish (July 2012) to 89.3 worms per fish (March 2012). Acanthocephalans were reproductively active during the whole year. The stomach was the region of the digestive tract with the smallest percentage of helminths, and females were more abundant than males in all sections of the intestine. Larger male and female worms were always located in the more posterior sections of the digestive tract. The mean length at which 50% of individuals reached sexual maturity was 2.9 mm for females and 2.3 mm for males. Relative fecundity increased with length in females.
Se estudió la Subclase Opisthobranchia en Acapulco. Los objetivos fueron conocer la riqueza de especies, la composición de la comunidad a partir de las abundancias, disposición espacial local y la ...ubicación jerárquica de las especies, además comparar la similitud entre sitios. Se muestreó de 2009 a 2012 en 5 sitios, durante el día, en marea baja, bimensualmente. En la zona intermareal rocosa se hicieron muestreos siguiendo la línea de costa y en el submareal se efectuaron inmersiones hasta 4 m por buceo libre. Se identificaron 59 especies, 5 más identificadas hasta género. Son nuevos registros de distribución para Acapulco 28 especies. El Orden Nudibranchia fue el de mayor cantidad de familias, riqueza de especies y abundancia. La mayor riqueza de especies se encontró en la familia Dorididae y la mayor abundancia en la familia Facelinidae. Las especies más abundantes fueron Phidiana lascrucensis, Elysia diomedea, Pleurobranchus aerolatus, Glossodoris sedna y Polycera alabe. El 24,44% de las especies presentó disposición espacial local ampliada, el 32,8% disposición semirestringida y el 43,75% restringida. Se encontró que 19 especies fueron dominantes y representaron el 28,78%. Se halló la mayor similitud en abundancia en los sitios Tlacopanocha y Parque de la Reina, que presentan características de intensidad de oleaje bajo y sustratos muy heterogéneos. La riqueza de especies encontrada es de las más altas reportada para el Pacífico Americano. Se amplía considerablemente el listado de especies conocidas para Acapulco y se contribuye al conocimiento de la composición de la comunidad de la Subclase Opisthobranchia.
Subclass Opisthobranchia in Acapulco was studied. The objectives were to know the species richness, community composition based on the abundances, local spatial arrangement and hierarchical location of the species, also compare the similarity between sites. Sampling was carried out from 2009 to 2012 at 5 sites during the day, at low tide, every two months. On the rocky intertidal zone samplings were carried out along the shoreline and in the subtidal zone, sampling was carried out using snorkel conducting divings to a maximum depth of 4 m. Fifty-nine species were identified, and 5 were identified to genus level. Twenty-eight new records were determined to Acapulco. Nudibranchia has the highest value in the number of families, species richness and abundance. The highest species richness was found in the Dorididae family and the greater abundance in the Facelinidae family. The most abundant species were Phidiana lascrucensis, Elysia diomedea, Pleurobranchus aerolatus, Glossodoris sedna and Polycera alabe. Twenty four percent of the species has wide local distribution, meanwhile 32.8% was semi restricted and 43.75% restricted. Were found 19 dominant species, representing 28.78% of the total species. The greatest similarity in abundance was estimated for Tlacopanocha and Parque de la Reina sites. These sites are characterized by similar features in the low wave intensity and a heterogeneous substrate. The species richness found is the highest reported for the American Pacific. Acapulco list of known species of Subclass Opistobranchia is considerably expands and it contributes to the knowledge of the composition of the community of this Subclass.
INTRODUCTION Previous studies have shown racial/ethnic disparities in outcomes for patients with cancer, but there is limited data for patients with spinal metastases. METHODS The United States ...National Inpatient Sample database (2012-2014) was queried to identify patients with metastatic spine disease and cord compression (MSCC) or pathological fracture. Clinical presentation, type of intervention, and in-hospital outcomes were compared between races/ethnicities. Multivariate logistic regression analyses were performed and adjusted for differences in patient age, insurance status, income quartile, hospital teaching status, Charlson comorbidity index, smoking status, tumor type, and neurological status. RESULTS A total of 47,390 patients were identified - 73.5% Caucasian, 15.2% African-American, 8.0% Hispanic, and 3.3% Asian. Approximately one-third (36.2%) of patients presented with MSCC. AAs had a 78% higher chance of presenting with MSCC compared to Caucasians (OR 1.78; 95% CI, 1.59-2.00; P < .001) and an 89% higher chance of presenting with paralysis (OR 1.89; 95% CI, 1.59-2.25; P < .001). On adjusted analyses they were less likely to undergo surgical intervention (OR 0.68; 95% CI, 0.54-0.85; P = .001), significantly more likely to experience a complication (OR 1.37; 95% CI, 1.13-1.66; P = .001), and significantly more likely to experience prolonged length of stay (OR 1.24; 95% CI, 1.01-1.52; P = .035) when compared to Caucasians. CONCLUSION African-American patients with metastatic spine disease are at a disadvantage compared to Caucasians, with significantly higher rates of MSCC and paralysis, lower rates of surgical intervention, and higher rates of complications and prolonged length of stay.
INTRODUCTION Racial disparities are known to affect healthcare utilization and outcomes of cancer patients. However, there is limited data on the impact of these disparities in metastatic spinal ...tumor surgery (MSTS). METHODS The United States National Inpatient Sample database (2012-2014) was queried to identify adult patients who underwent MSTS. Total hospital charges (in 2020 US dollars and adjusted for inflation) were compared based on patient's race (Caucasian, African-American, Hispanic, and Asian/other). A multivariate logistic regression analysis was conducted with high charges (>75th percentile) as the main outcome measure; results are reported as odds ratios (OR) with 95% confidence intervals (CI). RESULTS A total of 10,695 admissions were analyzed. The median adjusted hospital charges were $160,205 dollars (interquartile range: $97,282-$256,623) per patient - this totaled $2.1 billion dollars for all patients. Adjusted charges were significantly different based on race (Kruskal-Wallis test, P < .001). After adjustment for baseline/oncological characteristics, average household income, hospital characteristics, hospital region, and performance of spinal fusion, African Americans (OR 1.98; 95% CI 1.40-2.80; P < .001) Hispanics (OR 1.87; 95% CI, 1.25-2.80; P = .002) and Asian/others (OR 1.82; 95% CI, 1.18-2.78; P = .006) were significantly more likely to incur in higher charges when compared to Caucasians. Other independent predictors of high charges included higher Charlson Comorbidity Index score (OR 1.09), pathological fracture (OR 1.33), visceral metastasis (OR 1.74), hospitals located in the western United States (OR 2.19), medium-sized hospitals (OR 1.67), large-sized hospitals (OR 1.95), and spinal fusion procedures (OR 5.30). CONCLUSION Significant disparities in healthcare utilization exist for patients undergoing MSTS based on race. All minority groups compared to Caucasians were significantly more likely to incur in high hospital charges independent of baseline comorbid conditions, oncological characteristics, hospital characteristics, and type of procedure performed. This cost variation based on race warrants further investigation.
The edible chiton Chiton articulatus is a commercially important mollusk found in the rocky intertidal zones of the Mexican tropical Pacific. Despite the intense harvesting in Acapulco Bay, Mexico, ...knowledge of its growth patterns is limited, hindering the development of effective management strategies. This study investigated the growth dynamics of C. articulatus using a multi-model inference approach based on size structure data collected in four sampling periods covering four decades. Results revealed continuous recruitment throughout the year, contributing to population resilience. The species exhibited growth plasticity, highlighting its adaptive potential. We found complex temporal patterns influenced mainly by climatic events. The El Niño event sowed higher growth rates and lower asymptotic length, while La Niña events showed the opposite pattern. This research provides insights into the growth dynamics of C. articulatus, highlighting the need for holistic management strategies for this commercially important species in the face of environmental change.
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•Continuous recruitment of Chiton articulatus contributes to population resilience.•C. articulatus shows growth plasticity under varying environmental conditions.•El Niño: faster growth, lower asymptotic lengths in C. articulatus.•La Niña: slower growth, higher maximum lengths in C. articulatus.•Holistic approach vital for C. articulatus growth dynamics and management.
The concentration of potentially toxic elements (PTE) was determined in edible tissue, digestive system, and shells of two bivalve species (Hyotissa hyotis and Spondylus limbatus) highly consumed in ...Acapulco Bay (southern Mexico) to evaluate the impact on marine ecosystems and human health risk associated with the consumption of potentially contaminated bivalves. PTE concentrations (Ba–Cd–Cu–Co–Cr–Mn–Ni–Pb–Sr–V–Zn) in edible tissues were lower than in the digestive system and shells in both bivalve species. Except for Cr, Pb, and Cd, PTE concentrations in the edible tissue of both species did not exceed international threshold limits. In addition, the biota-sediment accumulation factor values indicate bioaccumulation in edible tissues (Ni, Cd, Pb, Co, and Zn), digestive system (V, Ni, Cu, Cd, Pb, Co, and Zn), and shells (V, Cr, Pb, Co, and Mn), evidencing availability of pollutants in the Acapulco Bay. Contents of Pb and Cd found in edible tissue can threaten human health. Target Hazard Quotient values indicate that the consumption of edible tissue does not represent any risk of developing non-cancerogenic effects. However, the Target Cancer Risk values indicate a moderate risk of developing carcinogenic effects due to the accumulation of Cr and Pb and an even greater risk due to the accumulation of Cd. Additionally, although local rocks and sediments should be the only source of PTE in uncontaminated marine ecosystems, a low radiogenic Pb isotope composition was detected in the bivalve shells, which partially overlap with Pb isotope compositions of paints and gasoline, indicating anthropogenic lead sources participation in the Acapulco Bay.
•Pb and Cd concentrations in edible tissue of bivalves exceed reccomended values.•BSAF values in bivalves indicate PTE bioaccumulation and pollutantion.•Pb and Cd contents in edible tissues represent a risk of carcinogenic effects.•Pb isotope ratios in bivalves indicate PTE contribution from anthropogenic sources.•Anthropogenic activity influence PTE contents in organisms in the Acapulco Bay.
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