Cause of death for patients with breast cancer: discordance between death certificates and medical files, and impact on survival estimates.

BACKGROUND: Registration and coding of cause of death is prone to error since determining the exact underlying condition leading directly to death is challenging. In this study, causes of death from the death certificates were compared to patients' medical files interpreted by experts at University Hospitals Leuven (UHL), to assess concordance between sources and its impact on cancer survival assessment. METHODS: Breast cancer patients treated at UHL (2009-2014) (follow-up until December 31st 2016) were included in this study. Cause of death was obtained from death certificates and expert-reviewed medical files at UHL. Agreement was calculated using Cohen's kappa coefficient. Cause-specific survival (CSS) was calculated using the Kaplan-Meier method and the relative survival probability (RS) using the Ederer II and Pohar Perme method. RESULTS: A total of 2862 patients, of whom 354 died, were included. We found an agreement of 84.7% (kappa-value of 0.69 (95% C.I.: 0.62-0.77)) between death certificates and medical files. Death certificates had 10.7% false positive and 4.5% false negative rates. However, five-year CSS and RS measures were comparable for both sources. CONCLUSION: For breast cancer patients included in our study, fair agreement of cause of death was seen between death certificates and medical files with similar CSS and RS estimations.

Miniature-dispenser-based bioassay to evaluate the compatibility of powder formulations used in an entomovectoring approach.

BACKGROUND: Entomovectoring as a plant protection strategy demands the design of an appropriate bioassay to assess the risks of potential side effects of the powder formulations in the dispenser towards the vectoring insect. This study reports on the development of a laboratory miniature-dispenser-based bioassay. This bioassay system was used to investigate the compatibility of five model products, Prestop-Mix, Signum, kaolin, wheat flour and cellulose, with the bumblebee, Bombus terrestris L. RESULTS: The laboratory one-way miniature-dispenser bioassay showed that the fungicides and the carrier/diluent kaolin caused a worker mortality of > 70% after 5 weeks of exposure, while worker loss with wheat flour and cellulose was no higher than in the blank control (i.e. empty miniature dispenser) (<25%). The laboratory two-way miniature-dispenser bioassay comprised separated passageways and demonstrated that only kaolin was toxic (89 ± 11%). These results were also confirmed in a flight-cage experiment. In addition, a negative effect was observed against reproduction/colony development when nests were exposed to kaolin (P < 0.05) in the two-way miniature-dispenser and flight-cage bioassays. CONCLUSIONS: In the context of entomovectoring technology, the developed laboratory two-way miniature-dispenser bioassay gives a reliable prediction of the hazards associated with powder products. Additionally, the present data indicate the possibility of using cellulose and kaolin as respective negative and positive control carriers/diluents in future risk assessment experiments. Overall, the results show that, apart from kaolin, the tested fungicides and carriers/diluents are safe to be used with B. terrestris.

Development of a new dispenser for microbiological control agents and evaluation of dissemination by bumblebees in greenhouse strawberries.

BACKGROUND: To date, in modern agriculture, biological control strategies are increasingly becoming the preferred pest management approach. However, the success of microbiological control agents (MCAs) largely depends on efficient dissemination into the crop. The pollinator-and-vector technology employs pollinating insects like bees for a better dissemination. In this study, a new dispenser for bumblebee workers of Bombus terrestris L. was developed. Binab-T-vector and Prestop-Mix were used as two typical MCA products for dissemination. RESULTS: In a first series of experiments in the laboratory for optimisation, the newly developed dispenser was a two-way type dispenser, 20 cm long, with two rectangular compartments and different entrance and exit holes. In addition, the amounts of MCA loaded on the workers were 10 times higher with the new dispenser as compared with the side-by-side passageway (SSP) dispenser. Typically, the highest amounts were recovered from the thorax and legs of the workers. In a second series of experiments under greenhouse conditions with the use of queen-right B. terrestris hives, successful dissemination in strawberry flowers was obtained at different distances from the hive (0-8 m, 8-18 m and 18-21 m), and the workers inoculated the first, second and third flowers that were consecutively visited. In addition, the new dispenser caused no adverse effects on worker foraging intensity, whereas a dramatic reduction was scored with an SSP dispenser. Finally, the data suggested that it is necessary to refill the newly developed dispenser at 3 day intervals. CONCLUSIONS: The results demonstrated that, with the use of the newly developed dispenser, bumblebee workers carried high amounts of MCA, and this resulted in a successful dissemination of MCA into strawberry flowers.

Compatibility of traditional and novel acaricides with bumblebees (Bombus terrestris): a first laboratory assessment of toxicity and sublethal effects.

BACKGROUND: This project assessed the potential hazards of different classical and novel acaricides against an important non-target and beneficial insect for the pollination of wild flowers and cultivated crops, the bumblebee Bombus terrestris (L). Twenty-three acaricides used commercially in the control of phytophagous mites (Acari) were tested in greenhouses and/or the open field. Side effects included acute mortality and also sublethal effects on nest reproduction. The different compounds were administered in the laboratory via three different worst-case field scenario routes of exposure: dermal contact and orally via the drinking of treated sugar water and via treated pollen. The compounds were tested at their respective maximum field recommended concentration (MFRC), and, when strong lethal effects were observed, a dose-response assay with a dilution series of the MFRC was undertaken to calculate LC(50) values. RESULTS: From the different acaricide classes, several chemistries caused high levels of acute toxicity in bumblebee workers, especially bifenthrin and abamectin which resulted in 100% mortality by contact. In addition, several acaricides tested were found to have a detrimental effect on drone production. For oral exposures via treated sugar water, the dose-response assay showed the LC(50) values for abamectin, bifenazate, bifenthrin and etoxazole to be 1/15 MFRC (1.17 mg AI L(-1)), 1/10 MFRC (9.6 mg AI L(-1)), 1/83 MFRC (0.36 mg AI L(-1)) and 1/13 MFRC (4.4 mg AI L(-1)) respectively, indicating that their use should be carefully evaluated. CONCLUSION: Overall, the results suggest that most of the acaricides tested are compatible with bumblebees, with the exceptions of abamectin, bifenazate, bifenthrin and etoxazole. However, the risks also depended on the type of treatment. As a result, the sugar water treatment seems to present the worst-case situation of exposure, indicating that this approach is suitable for determining the hazards of pesticides against bumblebees. Finally, it is suggested that future tier testing under more field-related conditions is required for a final decision of their risks.