Introduction A shift in focus towards risk stratification and survivorship in early stage endometrial cancer (EC) has led to the replacement of hospital follow‐up (HFU) with patient‐initiated follow‐up (PIFU) schemes. Methods A mixed methods study was undertaken prospectively to investigate utility and patient satisfaction with a newly introduced PIFU scheme. Results Two hundred and twenty‐eight women were enrolled onto PIFU in the first 18 months, median age 65 years (range 42–90 years). Twenty‐four (10.5%) women were non‐British White ethnicity. Forty‐five women contacted the Clinical Nurse Specialist (CNS) at least once (19.7%), the primary reason being vaginal bleeding/discharge (42%). Contact was greater in first six months on the scheme compared to the second 6 months, and women who made contact were significantly younger than those who did not (57 years vs. 65 years, p < 0.001). Conclusions PIFU appears to be well received by the majority of women. Although many of the CNS contacts were due to physical symptoms, a number were for psychological support or reassurance. Younger women had greater CNS contact indicating that they may benefit from a greater level support. Patient feedback of the PIFU scheme was positive, with many women reporting that it enabled them to have more control over their own health.

Background Lynch syndrome is a rare familial cancer syndrome caused by pathogenic variants in the mismatch repair genes MLH1, MSH2, MSH6, or PMS2, that cause predisposition to various cancers, predominantly colorectal and endometrial cancer. Data are emerging that pathogenic variants in mismatch repair genes increase the risk of earlyonset aggressive prostate cancer. The IMPACT study is prospectively assessing prostate-specific antigen (PSA) screening in men with germline mismatch repair pathogenic variants. Here, we report the usefulness of PSA screening, prostate cancer incidence, and tumour characteristics after the first screening round in men with and without these germline pathogenic variants. MethodsThe IMPACT study is an international, prospective study. Men aged 40-69 years without a previous prostate cancer diagnosis and with a known germline pathogenic variant in the MLH1, MSH2, or MSH6 gene, and age-matched male controls who tested negative for a familial pathogenic variant in these genes were recruited from 34 genetic and urology clinics in eight countries, and underwent a baseline PSA screening. Men who had a PSA level higher than 3•0 ng/mL were offered a transrectal, ultrasound-guided, prostate biopsy and a histopathological analysis was done. All participants are undergoing a minimum of 5 years' annual screening. The primary endpoint was to determine the incidence, stage, and pathology of screening-detected prostate cancer in carriers of pathogenic variants compared with non-carrier controls. We used Fisher's exact test to compare the number of cases, cancer incidence, and positive predictive values of the PSA cutoff and biopsy between carriers and non-carriers and the differences between disease types (ie, cancer vs no cancer, clinically significant cancer vs no cancer). We assessed screening outcomes and tumour characteristics by pathogenic variant status. Here we present results from the first round of PSA screening in the IMPACT study. This study is registered with ClinicalTrials.gov, NCT00261456, and is now closed to accrual.

Salinity significantly impacts the growth, development, and reproductive biology of various crops such as vegetables. The cultivable area is reduced due to the accumulation of salts and chemicals currently in use and is not amenable to a large extent to avoid such abiotic stress factors. The addition of microbes enriches the soil without any adverse effects. The effects of microbial consortia comprising Bacillus sp., Delftia sp., Enterobacter sp., Achromobacter sp., was evaluated on the growth and mineral uptake in tomatoes (Solanum Lycopersicum L.) under salt stress and normal soil conditions. Salinity treatments comprising Ec 0, 2, 5, and 8 dS/m were established by mixing soil with seawater until the desired Ec was achieved. The seedlings were transplanted in the pots of the respective pH and were inoculated with microbial consortia. After sufficient growth, these seedlings were transplanted in soil seedling trays. The measurement of soil minerals such as Na, K, Ca, Mg, Cu, Mn, and pH and the Ec were evaluated and compared with the control 0 days, 15 days, and 35 days after inoculation. The results were found to be non-significant for the soil parameters. In the uninoculated seedlings’ (control) seedling trays, salt treatment significantly affected leaf, shoot, root dry weight, shoot height, number of secondary roots, chlorophyll, and mineral contents. While bacterized seedlings sown under saline soil significantly increased leaf (105.17%), shoot (105.62%), root (109.06%) dry weight, leaf number (75.68%), shoot length (92.95%), root length (146.14%), secondary roots (91.23%), and chlorophyll content (−61.49%) as compared to the control (without consortia). The Na and K intake were higher even in the presence of the microbes, but the beneficial effect of the microbe helps plants sustain in the saline environment. The inoculation of microbial consortia produced more secondary roots, which accumulate more minerals and transport substances to the different parts of the plant; thus, it produced higher biomass and growth. Results of the present study revealed that the treatment with microbial consortia could alleviate the deleterious effects of salinity stress and improve the growth of tomato plants under salinity stress. Microbial consortia appear to be the best alternative and cost-effective and sustainable approach for managing soil salinity and improving plant growth under salt stress conditions.

Among the biotic and abiotic stress affecting the physical, chemical, and biological properties of soil, salinity is a major threat that leads to the desertification of cultivable land throughout the world. The existence of diverse and versatile microbial populations inhabiting the nutrient-rich soil and varied soil conditions affects the soil dynamism. A normal soil constitutes 600 million bacteria belonging to about 20,000 species, which is reduced to 1 million with 5,000–8,000 species in stress conditions. Plant growth-promoting rhizobacteria (PGPR) are in symbiotic association with the plant system, which helps in combating the abiotic stress and increases the overall productivity and yield. These microorganisms are actively associated with varied cellular communication processes through quorum sensing and secondary metabolites such as the production of Indole-3-acetic acid (IAA), exopolysaccharide (EPS) siderophore, ammonia, ACC deaminase, and solubilization of phosphate. The present study focused on the isolation, identification, and characterization of the microorganisms isolated from the seacoast of Dandi, Navsari. Twelve isolates exhibited PGP traits at a high salt concentration of 15–20%. AD9 isolate identified as Bacillus halotolerans showed a higher ammonia production (88 ± 1.73 μg/mL) and phosphate solubilization (86 ± 3.06 μg/mL) at 15% salt concentration, while AD32* (Bacillus sp. clone ADCNO) gave 42.67 ±1.20 μg/mL IAA production at 20% salt concentration. AD2 (Streptomyces sp. clone ADCNB) and AD26 (Achromobacter sp. clone ADCNI) showed ACC deaminase activity of 0.61 ± 0.12 and 0.60 ± 0.04 nM α-ketobutyrate/mg protein/h, respectively. AD32 (Bacillus sp. clone ADCNL) gave a high siderophore activity of 65.40 ± 1.65%. These isolates produced salinity ameliorating traits, total antioxidant activities, and antioxidant enzymes viz. superoxide dismutase (SOD), Glutathione oxidase (GSH), and catalase (CAT). Inoculation of the multipotent isolate that produced PGP traits and salinity ameliorating metabolites promoted the plant growth and development in rice under salinity stress conditions. These results in 50% more root length, 25.00% more plant dry weight, and 41% more tillers compared to its control.

ObjectiveRisk stratification has resulted in patient-initiated follow-up being introduced for low-risk endometrial cancer in place of routine hospital follow-up. The financial benefit to the patient and the healthcare economy of patient-initiated follow-up, as compared with hospital follow-up, has yet to be explored. In this study, we explored the potential impact for both the healthcare economy and patients of patient-initiated follow-up.MethodsWomen diagnosed with low-risk endometrial cancer enrolled on a patient-initiated follow-up scheme between November 2014 and September 2018 were included. Data on the number of telephone calls to the nurse specialists and clinic appointments attended were collected prospectively. The number of clinic appointments that would have taken place if the patient had continued on hospital follow-up, rather than starting on patient-initiated follow-up, was calculated and costs determined using standard National Health Service (NHS) reference costs. The time/distance traveled by patients from their home address to the hospital clinic was calculated and used to determine patient-related costs.ResultsA total of 187 patients with a median of 37 (range 2–62) months follow-up after primary surgery were enrolled on the scheme. In total, the cohort were scheduled to attend 1673 appointments with hospital follow-up, whereas they only attended 69 clinic appointments and made 107 telephone contacts with patient-initiated follow-up. There was a 93.5% reduction in costs from a projected £194 068.00 for hospital follow-up to £12 676.33 for patient-initiated follow-up. The mean patient-related costs were reduced by 95.6% with patient-initiated follow-up. The total mileage traveled by patients for hospital follow-up was 30 891.4 miles, which was associated with a mean traveling time per patient of 7.41 hours and clinic/waiting time of 7.5 hours compared with 1165.8 miles and 0.46 hours and 0.5 hours, respectively, for patient-initiated follow-up.ConclusionThe introduction of a patient self-management follow-up scheme for low-risk endometrial cancer was associated with financial/time saving to both the patient and the healthcare economy as compared with hospital follow-up.