BACKGROUND: The impact of racial and regional disparity on younger patients with gastric cancer (GC) remains unclear.
OBJECTIVE: To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.
METHODS: From 2000 to 2018, GC patients aged less than 40 years were enrolled from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was performed based on the Gene Expression Omnibus database. Survival analysis was conducted via Kaplan-Meier estimates and Cox proportional hazards models.
RESULTS: A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes (P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black datasets (P < 0.01). After stratification by pathological Tumor-Node-Metastasis (pTNM) stage, a survival advantage was observed in China with pathological stage I, III, and IV (all P < 0.01), whereas younger GC patients with stage II showed no difference (P = 0.16). In multivariate analysis, predictors in China involved period of diagnosis, linitis plastica, and pTNM stage, while race, diagnostic period, sex, location, differentiation, linitis plastica, signet ring cell, pTNM stage, surgery, and chemotherapy were confirmed in the United States group. Prognostic nomograms for younger patients were established, with the area under the curve of 0.786 in the China group and of 0.842 in the United States group. Moreover, three gene expression profiles (GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients among different regions.
CONCLUSIONS: Except for younger cases with pTNM stage II, a survival advantage was observed in the China group with pathological stage I, III, and IV compared to the United States group, which might be partly due to differences in surgical approaches and the improvement of the cancer screening in China. The nomogram model provided an insightful and applicable tool to evaluate the prognosis of younger patients in China and the United States. Furthermore, biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behavior and survival disparity in the subpopulations.

The classification of wastes regarding hazardous property HP 14 (ecotoxicity) is essential for proper waste management. In the EU, HP 14 has been estimated based on waste chemical composition rather than using biotests, and guidelines for experimental assessment are still lacking. This study aims at evaluating the potential ecotoxicological impacts of weathered coal fly ash (CFA) from a landfill, as a case study to assess the current EU methodology used to classify wastes regarding HP 14. A large amount of CFA is still landfilled, but its valorisation would be of interest. The analysis was based on the chemical composition of CFA (in ClassifyMyWaste software), and on a battery of five biotests applied to eluates, with Lepidium sativum, Aliivibrio fischeri, Raphidocelis subcapitata, Lemna minor and Daphnia magna. Through chemical analysis, most of the simulations with data from the literature indicated \"Possible Hazard\", including the sample of this work. Biotests revealed low impairment for most endpoints. D. magna was the most sensitive organism, but the inhibitory effect was significantly reduced after pH adjustment of the eluate. The test with A. fischeri does not seem to be adequate to assess CFA due to the high variability observed in results. The methodology involving a simple battery of bioassays was proven to be enlightening, providing relevant results for HP 14 assessment. The chosen battery of biotests (excluding the A. fischeri test) may be a good starting point to represent the aquatic environment in this context. In short, it seems that weathered CFA can be considered non-hazardous, and therefore the material under analysis could be valorised in practical applications without significant ecotoxic effect on the environment.

In this work we propose the voltammetric analysis of contraceptive hormones ethinylestradiol (EE) and cyproterone acetate (CPA) using solid amalgam electrode fabricated with silver nanoparticles. To the best of our knowledge, this is the first report describing the simultaneous determination of these two compounds and also the first report of the use of amalgam electrode for analysis of EE and CPA. The voltammetric behavior of both substances was investigated by their reduction. An irreversible electrochemical process involving two protons and two electrons was found for each compound. The analytical assays were carried out using staircase voltammetry (SCV). Due to this, aiming to improve the analytical sensitivity, the cationic surfactant cetyltrimethylammonium bromide was also used. The instrumental and experimental parameters were studied and optimized to achieve the best conditions for the analysis. Under the optimum conditions, the voltammetric signals of EE and CPA showed dependence on the concentration range from 6.4 × 10-7 to 7.8 × 10-6 mol L-1 and from 1.0 × 10-6 to 1.0 × 10-5 mol L-1, respectively. The limits of detection obtained were 1.03 × 10-7 mol L-1 for EE and 2.99 × 10-7 mol L-1 for CPA. The analytical usefulness of the method was evaluated through its application on the simultaneous determination of EE and CPA in pharmaceutical formulations and urine samples. The two analytes were successfully quantified in these samples with good precision and the values found presented satisfactory concordance with the reference values, suggesting acceptable analytical efficiency for the approach described here.