Lining Up: Ensuring Equal Access to the Right to Vote

Election Day 2012 marked the convergence of three historic factors: the re-election of the country’s first African-American president, an unprecedented spate of suppressive voting laws passed or proposed in a majority of states, and a demonstration of the resolve and dedication of American voters who turned out and voted despite efforts to deter participation. New restrictive voting measures threatened to obstruct voter participation and inclusion on Election Day. State legislatures introduced or passed restrictive photo ID laws and other suppressive legislation that presented hurdles to voters—disproportionately voters of color and the poor—who lacked the documents, funds or time to obtain the newly-required ID to vote. Additionally, measures reducing early voting periods inconvenienced many voters, including African Americans, who in states like Florida, rely more heavily on the early voting period than other racial groups. This report discusses the fight back in the war on voting, the problems experienced by voters of color when voting in 2012, and recommends needed reforms. The report also highlights that in 2013, various state legislatures are continuing to propose restrictive voting measures. Released in the wake of the Supreme Court’s June 2013 decision in Shelby County v. Holder finding the Section 5 coverage formula of the Voting Rights Act unconstitutional, the Lawyers’ Committee and Advancement Project’s report chronicles the impact of restrictive voting laws on voters of color in the 2012 election. The report includes heroic stories culled from litigation documents, reports called into the 866-OUR-VOTE hotline, and interviews of real people adversely affected by restrictive voter laws and their efforts to exercise the right to vote. Considering that at least 36 states introduced restrictive voting laws in 2013, this report demonstrates the continued need for, and enforcement of, federal and state laws protecting the right to vote, coupled with voter vigilance to ensure the right to vote is not undermined. This report not only highlights the challenges that voters of color face, but also provides real solutions for progress and increased voter participation. It makes the case for the need for improvements in election administration and continued outreach, education, advocacy, and litigation in order to defend the right to vote for people of color

Evolutionary characterization of lung adenocarcinoma morphology in TRACERx

Lung adenocarcinomas (LUADs) display a broad histological spectrum from low-grade lepidic tumors through to mid-grade acinar and papillary and high-grade solid, cribriform and micropapillary tumors. How morphology reflects tumor evolution and disease progression is poorly understood. Whole-exome sequencing data generated from 805 primary tumor regions and 121 paired metastatic samples across 248 LUADs from the TRACERx 421 cohort, together with RNA-sequencing data from 463 primary tumor regions, were integrated with detailed whole-tumor and regional histopathological analysis. Tumors with predominantly high-grade patterns showed increased chromosomal complexity, with higher burden of loss of heterozygosity and subclonal somatic copy number alterations. Individual regions in predominantly high-grade pattern tumors exhibited higher proliferation and lower clonal diversity, potentially reflecting large recent subclonal expansions. Co-occurrence of truncal loss of chromosomes 3p and 3q was enriched in predominantly low-/mid-grade tumors, while purely undifferentiated solid-pattern tumors had a higher frequency of truncal arm or focal 3q gains and SMARCA4 gene alterations compared with mixed-pattern tumors with a solid component, suggesting distinct evolutionary trajectories. Clonal evolution analysis revealed that tumors tend to evolve toward higher-grade patterns. The presence of micropapillary pattern and ‘tumor spread through air spaces’ were associated with intrathoracic recurrence, in contrast to the presence of solid/cribriform patterns, necrosis and preoperative circulating tumor DNA detection, which were associated with extra-thoracic recurrence. These data provide insights into the relationship between LUAD morphology, the underlying evolutionary genomic landscape, and clinical and anatomical relapse risk

Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic

Abstract Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P &amp;lt; 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P &amp;lt; 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P &amp;lt; 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection. </jats:sec