Comorbidity as a prognostic variable in multiple myeloma: comparative evaluation of common comorbidity scores and use of a novel MM–comorbidity score

Comorbidities have been demonstrated to affect progression-free survival (PFS) and overall survival (OS), although their impact in multiple myeloma (MM) patients is as yet unsettled. We (1) assessed various comorbidities, (2) compared established comorbidity indices (CIs; Charlson comorbidity index (CCI), hematopoietic cell transplantation-specific comorbidity index (HCT-CI)), Kaplan Feinstein (KF) and Satariano index (SI) and (3) developed a MM-CI (Freiburger comorbidity index, FCI) in 127 MM patients. Univariate analysis determined moderate or severe pulmonary disease (hazard ratio (HR): 3.5, P<0.0001), renal impairment (via estimated glomerular filtration rate (eGFR); HR: 3.4, P=0.0018), decreased Karnofsky Performance Status (KPS, HR: 2.7, P=0.0004) and age (HR: 2, P=0.0114) as most important variables for diminished OS. Through multivariate analysis, the eGFR ⩽30 ml/min/1.73m2, impaired lung function and KPS ⩽70% were significant for decreased OS, with HRs of 2.9, 2.8 and 2.2, respectively. Combination of these risk factors within the FCI identified significantly different median OS rates of 118, 53 and 25 months with 0, 1 and 2 or 3 risk factors, respectively, (P<0.005). In light of our study, comorbidities are critical prognostic determinants for diminished PFS and OS. Moreover, comorbidity scores are important treatment decision tools and will be valuable to implement into future analyses and clinical trials in MM

Insights into the abundance and diversity of abyssal megafauna in a polymetallic-nodule region in the eastern Clarion-Clipperton Zone

There is growing interest in mining polymetallic nodules in the abyssal Clarion-Clipperton Zone (CCZ) in the Pacific. Nonetheless, benthic communities in this region remain poorly known. The ABYSSLINE Project is conducting benthic biological baseline surveys for the UK Seabed Resources Ltd. exploration contract area (UK-1) in the CCZ. Using a Remotely Operated Vehicle, we surveyed megafauna at four sites within a 900 km2 stratum in the UK-1 contract area, and at a site ~250 km east of the UK-1 area, allowing us to make the first estimates of abundance and diversity. We distinguished 170 morphotypes within the UK-1 contract area but species-richness estimators suggest this could be as high as 229. Megafaunal abundance averaged 1.48 ind. m−2. Seven of 12 collected metazoan species were new to science, and four belonged to new genera. Approximately half of the morphotypes occurred only on polymetallic nodules. There were weak, but statistically significant, positive correlations between megafaunal and nodule abundance. Eastern-CCZ megafaunal diversity is high relative to two abyssal datasets from other regions, however comparisons with CCZ and DISCOL datasets are problematic given the lack of standardised methods and taxonomy. We postulate that CCZ megafaunal diversity is driven in part by habitat heterogeneity.This open access work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0

Seascape ecology : identifying research priorities for an emerging ocean sustainability science

Seascape ecology, the marine-centric counterpart to landscape ecology, is rapidly emerging as an interdisciplinary and spatially explicit ecological science with relevance to marine management, biodiversity conservation, and restoration. While important progress in this field has been made in the past decade, there has been no coherent prioritisation of key research questions to help set the future research agenda for seascape ecology. We used a 2-stage modified Delphi method to solicit applied research questions from academic experts in seascape ecology and then asked respondents to identify priority questions across 9 interrelated research themes using 2 rounds of selection. We also invited senior management/conservation practitioners to prioritise the same research questions. Analyses highlighted congruence and discrepancies in perceived priorities for applied research. Themes related to both ecological concepts and management practice, and those identified as priorities include seascape change, seascape connectivity, spatial and temporal scale, ecosystem-based management, and emerging technologies and metrics. Highest-priority questions (upper tercile) received 50% agreement between respondent groups, and lowest priorities (lower tercile) received 58% agreement. Across all 3 priority tiers, 36 of the 55 questions were within a ±10% band of agreement. We present the most important applied research questions as determined by the proportion of votes received. For each theme, we provide a synthesis of the research challenges and the potential role of seascape ecology. These priority questions and themes serve as a roadmap for advancing applied seascape ecology during, and beyond, the UN Decade of Ocean Science for Sustainable Development (2021-2030)

Remote sensing of three-dimensional coral reef structure enhances predictive modeling of fish assemblages

LiDAR (light detection and ranging) allows for the quantification of three-dimensional seascape structure, which is an important driver of coral reef communities. We hypothesized that three-dimensional LiDAR-derived covariables support more robust models of coral reef fish assemblages, compared to models using 2D environmental co variables. Predictive models of coral reef fish density, diversity, and biomass were developed using linear mixed effect models. We found that models containing combined 2D and 3D covariables outperformed models with only 3D covariables, followed by models containing only 2D covariables. Areas with greater three-dimensional structure provide fish more refuge from predation and are crucial to identifying priority management locations that can potentially enhance reef resilience and recovery. Two-dimensional seascape metrics alone do not adequately capture the elements of the seascape that drive reef fish assemblage characteristics, and the application of LiDAR data in this work serves to advance seascape ecology theory and practice in the third dimension

Bridging climate science, law, and policy to advance coastal adaptation planning

Rising seas, more frequent storms and other climate-driven coastal hazards necessitate adaptation planning measures to protect people and property. To date, coastal vulnerability assessments have prioritized the most exposed areas of coastline, but there is a gap between recognized climate science and the feasibility or suitability considerations relevant for implementing coastal adaptation strategies—including legal, policy, financial, or engineered approaches—to address coastal threats. This paper sets forth a methodology for bridging the gap between climate science, law and coastal adaptation policies. This methodology seeks to connect spatial analysis methods with attributes of coastal adaptation strategies that make them inherently place-based—ranging from engineered solutions, to legal strategies and financial tools—to determine where they are legally feasible and suitable. Both spatial and non-spatial limiting and enabling conditions of coastal adaptation policies drive these determinations. The methodology integrates a spatial framework using feasibility statements derived by 1) coupling these conditions and features with spatial information (e.g., zoning, land use/land cover, geomorphologic features), and 2) identifying suitability conditions through synthesizing policy considerations for each coastal adaptation strategy

Prioritizing reef resilience through spatial planning following a mass coral bleaching event

Following the recent 2014–2017 global coral bleaching event, managers are seeking interventions to promote long-term resilience beyond monitoring coral decline. Here, we applied a spatial approach to investigate one potential intervention, mapping areas where local management could build coral reef resilience using herbivore management. Although herbivore management is a top recommendation in resilience-based management, site-specific attributes are thought to affect its success, and thus strategizing placement and design of these areas are crucial. Using Marxan, we mapped and prioritized potential Herbivore Management Areas (HMAs), where herbivores are protected but other types of fishing are allowed, in the main Hawaiian Islands. Through four scenarios, we found multiple hotspots along the west coast of Hawai‘i Island and around the islands of Moloka‘i, Lana‘i, Maui, and Kaho‘olawe where HMAs may have the best chance for success based on habitat, ecologically critical areas, life history, and social considerations. We further analyzed top results and found that a subset of characteristics including habitat types, biomass of herbivore functional groups, and temperature variability were significantly different from surrounding areas and thus contain potential drivers for selection. This unique approach can serve as an example for coral reef management in Hawai‘i, on other Pacific Islands, and beyond, as it provides practical guidance on how to apply a resilience-building tool at a local level, incorporating site-specific biological and socioeconomic considerations