Complete cytogenetic response and major molecular response as surrogate outcomes for overall survival in first-line treatment of chronic myelogenous leukemia: A case study for technology appraisal on the basis of surrogate outcomes evidence

Objectives In 2012, the National Institute for Health and Care Excellence assessed dasatinib, nilotinib, and standard-dose imatinib as first-line treatment of chronic phase chronic myelogenous leukemia (CML). Licensing of these alternative treatments was based on randomized controlled trials assessing complete cytogenetic response (CCyR) and major molecular response (MMR) at 12 months as primary end points. We use this case study to illustrate the validation of CCyR and MMR as surrogate outcomes for overall survival in CML and how this evidence was used to inform National Institute for Health and Care Excellence’s recommendation on the public funding of these first-line treatments for CML. Methods We undertook a systematic review and meta-analysis to quantify the association between CCyR and MMR at 12 months and overall survival in patients with chronic phase CML. We estimated life expectancy by extrapolating long-term survival from the weighted overall survival stratified according to the achievement of CCyR and MMR. Results Five studies provided data on the observational association between CCyR or MMR and overall survival. Based on the pooled association between CCyR and MMR and overall survival, our modeling showed comparable predicted mean duration of survival (21–23 years) following first-line treatment with imatinib, dasatinib, or nilotinib. Conclusions This case study illustrates the consideration of surrogate outcome evidence in health technology assessment. Although it is often recommended that the acceptance of surrogate outcomes be based on randomized controlled trial data demonstrating an association between the treatment effect on both the surrogate outcome and the final outcome, this case study shows that policymakers may be willing to accept a lower level of evidence (i.e., observational association).

Chickpeas! Varietal performance, wet feet and root rot, virus and salinity effects in 2012, Ascochyta management, seed quality, issues in central Queensland and effects of desiccating too early with glyphosate on seed germination

Take home messages: Plant only high quality seed that has been germ and vigour tested and treated with a registered seed dressing Avoid poorly drained paddocks and those with a history of lucerne, medics or chickpea Phytophthora root rot, PRR; do not grow Boundary if you even suspect a PRR risk Select best variety suited to soil type, farming system and disease risk Beware Ascochyta: follow recommendations for your variety and district Minimise risk of virus by retaining stubble, planting on time and at optimal rate, controlling weeds and ensuring adequate plant nutrition Test soil to determine risk of salinity and sodicity – do not plant chickpeas if ECe > 1.0-1.3 dS/m. Beware early desiccation of seed crops – know how to tell when 90-95% seeds are mature

Surviving the effects of barotrauma: assessing treatment options and a ‘natural’ remedy to enhance the release survival of line caught pink snapper (Pagrus auratus)

A new technique to ameliorate the effects of barotrauma was tested based on observations of pink snapper, Pagrus auratus (Forster), inadvertently piercing their everted stomach with their teeth and releasing trapped swim bladder gases. This technique was termed buccal venting and involved piercing the everted stomach protruding into the buccal cavity or out of the mouth with a 16-gauge hypodermic needle (a practice previously not encouraged). Short-term (~3 days) survival of buccal-vented fish was not significantly different from laterally vented fish nor untreated controls. Both buccal and lateral venting techniques were shown to cause no harm and allowed fish to return to depth. The short-term (1–3 days) post-release survival of line caught snapper was 88% with no significant difference in survival across three depth ranges tested (37–50, 51–100 and 101–180 m). Survival of sublegal pink snapper (<35 cm TL) was not significantly different (P > 0.05) from that of legal-sized fish (≥35 cm TL). Healing of the swim bladder was observed in 27% of pink snapper dissected after ≤3 days in captivity, and healing of stomachs was observed in 64% of pink snapper that had been buccal vented. Relatively high post-release survival rates of line caught pink snapper may offer some protection for snapper stocks where high fishing pressure and legal size restrictions result in the majority of the catch having to be released.

Miraculous Survival 1939-1982

Description of war years in France and Spain, including experiences in internment camps, life in hiding, etc.; emigration to USA.

Survival analysis of time-to-event data in respiratory health research studies

This article provides a review of techniques for the analysis of survival data arising from respiratory health studies. Popular techniques such as the Kaplan–Meier survival plot and the Cox proportional hazards model are presented and illustrated using data from a lung cancer study. Advanced issues are also discussed, including parametric proportional hazards models, accelerated failure time models, time-varying explanatory variables, simultaneous analysis of multiple types of outcome events and the restricted mean survival time, a novel measure of the effect of treatment.

Infection of mungbean seed by Macrophomina phaseolina is more likely to result from localized pod infection than from systemic plant infection

The ubiquitous fungal pathogen Macrophomina phaseolina is best known as causing charcoal rot and premature death when host plants are subject to post-flowering stress. Overseas reports of M.phaseolina causing a rapid rot during the sprouting of Australian mungbean seed resulted in an investigation of the possible modes of infection of seed. Isolations from serial portions of 10 mungbean plants naturally infected with the pathogen revealed that on most plants there were discrete portions of infected tissue separated by apparently healthy tissue. The results from these studies, together with molecular analysis of isolates collected from infected tissue on two of the plants, suggested that aerial infection of aboveground parts by different isolates is common. Inoculations of roots and aboveground parts of mungbean plants at nine temperaturexsoil moisture incubation combinations and of detached green pods strongly supported the concept that seed infection results from infection of pods by microsclerotia, rather than from hyphae growing systemically through the plant after root or stem infection. This proposal is reinforced by anecdotal evidence that high levels of seed infection are common when rainfall occurs during pod fill, and by the isolation of M.phaseolina from soil peds collected on pods of mungbean plants in the field. However, other experiments showed that when inoculum was placed within 130mm of a green developing pod and a herbicide containing paraquat and diquat was sprayed on the inoculated plants, M.phaseolina was capable of some systemic growth from vegetative tissue into the pods and seeds.

Soil seed bank dynamics in response to an extreme flood event in a riparian habitat

A significantly increased water regime can lead to inundation of rivers, creeks and surrounding floodplains- and thus impact on the temporal dynamics of both the extant vegetation and the dormant, but viable soil-seed bank of riparian corridors. The study documented changes in the soil seed-bank along riparian corridors before and after a major flood event in January 2011 in southeast Queensland, Australia. The study site was a major river (the Mooleyember creek) near Roma, Central Queensland impacted by the extreme flood event and where baseline ecological data on riparian seed-bank populations have previously been collected in 2007, 2008 and 2009. After the major flood event, we collected further soil samples from the same locations in spring/summer (November–December 2011) and in early autumn (March 2012). Thereafter, the soils were exposed to adequate warmth and moisture under glasshouse conditions, and emerged seedlings identified taxonomically. Flooding increased seed-bank abundance but decreased its species richness and diversity. However, flood impact was less than that of yearly effect but greater than that of seasonal variation. Seeds of trees and shrubs were few in the soil, and were negatively affected by the flood; those of herbaceous and graminoids were numerous and proliferate after the flood. Seed-banks of weedy and/or exotic species were no more affected by the flood than those of native and/or non-invasive species. Overall, the studied riparian zone showed evidence of a quick recovery of its seed-bank over time, and can be considered to be resilient to an extreme flood event.

Harvest weed seed control: is there a role in northern region farming systems?

Harvest weed seed control (HWSC) is a new approach which targets weed seed removal and/or destruction during the crop harvest operation. The success of HWSC is dependant upon weed seed retention at harvest. To identify and define the potential value of HWSC in northern farming systems, we conducted a field survey. In total 1400 transects across 70 paddocks assessed weed distribution, density and seed production at harvest time in wheat, chickpea and sorghum crops. Seventy weed species were identified, of which many had large seed numbers retained at crop harvest. The most prevalent included common sowthistle, flaxleaf fleabane, awnless barnyard grass, wild oat, and African turnip weed. Our field survey has shown there is a role for HWSC in the northern farming system. Therefore the efficacy of specific HWSC systems on problematic weeds should be evaluated in the northern region.

Evaluation of restoration of vegetation infested with cat's claw creeper vine (Dolichandra unguis-cati): soil seed bank response to herbicide and physical removal

Cat’s claw creeper vine, Dolichandra unguis-cati (L.) L.G.Lohmann (formerly known as Macfadyena unguis-cati (L.) A.H.Gentry), a Weed of National Significance (WoNS), is a structural woody parasite that is highly invasive along sensitive riparian corridors and native forests of coastal and inland eastern Australia. As part of evaluation of the impact of herbicide and mechanical/physical control techniques on the long-term reduction of biomass of the weed and expected return of native flora, we have set-up permanent vegetation plots in: (a) infested and now chemically/physically treated, (b) infested but untreated and (c) un-infested patches. The treatments were set up in both riparian and non-riparian habitats to document changes that occur in seed bank flora over a two-year post-treatment period. Response to treatment varied spatially and temporally. However, following chemical and physical removal treatments, treated patches exhibited lower seed bank abundance and diversity than infested and patches lacking the weed, but differences were not statistically significant. Thus it will be safe to say that spraying herbicides using the recommended rate does not undermine restoration efforts.

Reducing seed viability of flaxleaf fleabane, feathertop Rhodes grass and awnless barnyard grass

In the sub-tropical grain region of Australia, cotton and grains systems are now dominated by flaxleaf fleabane (Conyza bonariensis (L.) Cronquist), feathertop Rhodes grass (Chloris virgata Sw.) and awnless barnyard grass (Echinochloa colona (L.) Link). While control of these weed species is best achieved when they are young, previous studies have shown a potential for reducing seed viability and minimising seed bank replenishment by applying herbicides when plants are reproductive. Pot trials were established over two growing seasons to examine the effects of 2,4-D, 2,4-D + picloram, glyphosate and glufosinate which had been successful on other species, along with paraquat and haloxyfop (grasses only). Herbicides were applied at ¾ field rates in an attempt not to kill the plants. Flaxleaf fleabane plants were sprayed at two growth stages (budding and flowering) and the grasses were sprayed at two stages (late tillering/booting and flowering). Spraying flaxleaf fleabane at flowering reduced seed viability to 0% (of untreated) in all treatments except glyphosate (51%) and 2,4-D + picloram (8%). Seed viability was not reduced with the first and second regrowths with the exception of 2,4-D + picloram where viability was reduced to 20%. When sprayed at budding only 2,4-D + picloram reduced seed viability in both trials. Spraying the grasses at late tillering/booting did not reduce viability except for glufosinate on awnless barnyard grass (50%). Applying herbicides at flowering resulted in 0% seed viability in awnless barnyard grass from glufosinate, paraquat and glyphosate and 0% viability in feathertop Rhodes grass for glufosinate. These herbicides were less effective on heads that emerged and flowered after spraying, only slightly reducing seed viability. These trials have shown that attempts to reduce seed viability have potential, however flaxleaf fleabane and feathertop Rhodes grass are able to regrow and will need on-going monitoring and control measures.

Sorghum genotypes differ in high temperature responses for seed set

Significant genotypic differences in tolerance of pollen germination and seed set to high temperatures have been shown in sorghum. However, it is unclear whether differences were associated with variation in either the threshold temperature above which reproductive processes are affected, or in the tolerance to increased temperature above that threshold. The objectives of this study were to (a) dissect known differences in heat tolerance for a range of sorghum genotypes into differences in the threshold temperature and tolerance to increased temperatures, (b) determine whether poor seed set under high temperatures can be compensated by increased seed mass, and (c) identify whether genotypic differences in heat tolerance in a controlled environment facility (CEF) can be reproduced in field conditions. Twenty genotypes were grown in a CEF under four day/night temperatures (31.9/21.0 °C, 32.8/21.0 °C, 36.1/21.0 °C, and 38.0/21.0 °C), and a subset of six genotypes was grown in the field under four different temperature regimes around anthesis. The novelty of the findings in this study related to differences in responsiveness to high temperature—genotypic differences in seed set percentage were found for both the threshold temperature and the tolerance to increased maximum temperature above that threshold. Further, the response of seed set to high temperature in the field study was well correlated to that in the CEF (R2 = 0.69), although the slope was significantly less than unity, indicating that heat stress effects may have been diluted under the variable field conditions. Poor seed set was not compensated by increased seed mass in either CEF or field environments. Grain yield was thus closely related to seed set percentage. This result demonstrates the potential for development of a low-cost field screening method to identify high-temperature tolerant varieties that could deliver sustainable yields under future warmer climates.

Spatial variation of climate and the impact of disturbances on local climate and forest recovery in northern Finland

The structure and function of northern ecosystems are strongly influenced by climate change and variability and by human-induced disturbances. The projected global change is likely to have a pronounced effect on the distribution and productivity of different species, generating large changes in the equilibrium at the tree-line. In turn, movement of the tree-line and the redistribution of species produce feedback to both the local and the regional climate. This research was initiated with the objective of examining the influence of natural conditions on the small-scale spatial variation of climate in Finnish Lapland, and to study the interaction and feedback mechanisms in the climate-disturbances-vegetation system near the climatological border of boreal forest. The high (1 km) resolution spatial variation of climate parameters over northern Finland was determined by applying the Kriging interpolation method that takes into account the effect of external forcing variables, i.e., geographical coordinates, elevation, sea and lake coverage. Of all the natural factors shaping the climate, the geographical position, local topography and altitude proved to be the determining ones. Spatial analyses of temperature- and precipitation-derived parameters based on a 30-year dataset (1971-2000) provide a detailed description of the local climate. Maps of the mean, maximum and minimum temperatures, the frost-free period and the growing season indicate that the most favourable thermal conditions exist in the south-western part of Lapland, around large water bodies and in the Kemijoki basin, while the coldest regions are in highland and fell Lapland. The distribution of precipitation is predominantly longitudinally dependent but with the definite influence of local features. The impact of human-induced disturbances, i.e., forest fires, on local climate and its implication for forest recovery near the northern timberline was evaluated in the Tuntsa area of eastern Lapland, damaged by a widespread forest fire in 1960 and suffering repeatedly-failed vegetation recovery since that. Direct measurements of the local climate and simulated heat and water fluxes indicated the development of a more severe climate and physical conditions on the fire-disturbed site. Removal of the original, predominantly Norway spruce and downy birch vegetation and its substitution by tundra vegetation has generated increased wind velocity and reduced snow accumulation, associated with a large variation in soil temperature and moisture and deep soil frost. The changed structural parameters of the canopy have determined changes in energy fluxes by reducing the latter over the tundra vegetation. The altered surface and soil conditions, as well as the evolved severe local climate, have negatively affected seedling growth and survival, leading to more unfavourable conditions for the reproduction of boreal vegetation and thereby causing deviations in the regional position of the timberline. However it should be noted that other factors, such as an inadequate seed source or seedbed, the poor quality of the soil and the intensive logging of damaged trees could also exacerbate the poor tree regeneration. In spite of the failed forest recovery at Tunsta, the position and composition of the timberline and tree-line in Finnish Lapland may also benefit from present and future changes in climate. The already-observed and the projected increase in temperature, the prolonged growing season, as well as changes in the precipitation regime foster tree growth and new regeneration, resulting in an advance of the timberline and tree-line northward and upward. This shift in the distribution of vegetation might be decelerated or even halted by local topoclimatic conditions and by the expected increase in the frequency of disturbances.