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To investigate the role of clinical parameters and immunohistochemical (IHC) biomarkers in their feasibility to predict the effect of neo-adjuvant chemotherapy (NAC) in patients with muscle-invasive urothelial bladder cancer (MIBC). The first 76 consecutive patients with MIBC treated with NAC and radical cystectomy in two University hospitals in Finland between 2008 and 2013 were chosen for this study. After excluding patients with non-urothelial cancer, less than two cycles of chemotherapy, no tissue material for IHC analysis or non-muscle-invasive bladder cancer in re-review, 59 patients were included in the final analysis. A tissue microarray block was constructed from the transurethral resection samples and IHC stainings of Ki-67, p53, Her-2 and EGFR were made. The correlations between histological features in transurethral resection samples and immune-histochemical stainings were calculated. The associations of clinicopathological parameters and IHC stainings with NAC response were evaluated. Factors affecting survival were estimated. The complete response rate after NAC was 44%. A higher number of chemotherapy cycles was associated with better response to neo-adjuvant chemotherapy. No response to neo-adjuvant chemotherapy and female gender was associated with decreased cancer-specific survival. The IHC stainings used failed to show an association with neo-adjuvant chemotherapy response and overall or cancer specific survival. Patients who do not respond to neo-adjuvant chemotherapy do significantly worse than responders. This study could not find clinical tools to distinguish responders from non-responders. Further studies preferably with larger cohorts addressing this issue are warranted to improve the selection of patients for neo-adjuvant chemotherapy. [ABSTRACT FROM AUTHOR]

In December 2022, representatives adopted the Kunming-Montreal Global Biodiversity Framework (GBF). The overarching goal of the agreement is to halt biodiversity loss and restore natural ecosystems – and a much-cited target is the "30x30" target of protecting and restoring 30% of Earth by 2030. Salt marshes are highly productive coastal ecosystems relevant for both biodiversity and climate change mitigation but have experienced historical major losses and are among the habitats in need of protection and restoration. Currently, there is little knowledge about how salt marshes are valued from a societal perspective, which has important management implications. This is particularly the case in the Nordic region where awareness of these habitats is low. Using survey data from Norway, Sweden, Finland, Denmark, and Germany, this study contributes understanding how citizens value salt marshes by examining support for different management initiatives framed as contributing to the goal of either biodiversity protection or climate change mitigation. Generally, both respondents primed with information about the importance of salt marshes for biodiversity and for climate change mitigation were supportive of the management initiatives despite having little previous knowledge of salt marshes. For one initiative, respondents who were informed of the importance of salt marshes for biodiversity were slightly more likely to support the management initiative than those informed about the importance of salt marshes for climate change mitigation. Our study provides guidance for assessment of trade-offs from a human valuation perspective, thus supporting policy makers when considering arguments for salt marsh management within the context of the 30x30 targets for protected areas. • When salt marshes were framed as important ecosystems, there was public support for management initiatives. • Respondents primed with information on the potential importance of salt marshes for climate change mitigation were not more supportive of management initiatives. • Initiatives with the least direct monetary contribution gained the most public support. • Public support for salt marsh management initiatives differed based on country and, in some cases, age and gender. [ABSTRACT FROM AUTHOR]

Purpose: To investigate national trends of surgical treatment for benign prostatic obstruction (BPO)., Methods: The Care Register for Healthcare in Finland was used to investigate the annual numbers and types of surgical procedures, operation incidence and duration of hospital stay between 2004 and 2018 in Finland. Procedures were classified using the Nordic Medico-Statistical Committee Classification of Surgical Procedures coding. Trends in incidence were analyzed with two-sided Cochran-Armitage test. Trends in duration of hospital stay and patient age were analyzed with linear regression., Results: Transurethral resection of the prostate (TURP) was the most common operation type during the study period, covering over 70% of operations for BPO. Simultaneous with the implementation of photoselective vaporization of the prostate (PVP), the incidence of TURP, minimally invasive surgical therapies, transurethral vaporization of the prostate (TUVP) and open prostatectomies decreased (p < 0.05). The mean operation incidence rate in the population between 2004 and 2018 was 263 per 100,000. The duration of hospital stay shortened (p < 0.05), and the average age of operated patients increased by 2 years (p < 0.0001)., Conclusion: The implementation of PVP did not challenge the dominating position of TURP in Finland, but it has probably influenced the overall use of other surgical therapies, excluding transurethral incision of the prostate.  The results might suggest that the conservative treatment is accentuated, patient selection is more thorough, and surgical intervention might be placed at a later stage of BPO.