Understanding the Intergenerational Impact of Migration: An Adult Mortality Advantage for the Children of Forced Migrants?

BACKGROUND: Children of immigrants often have excess mortality rates, in contrast to the low mortality typically exhibited by their parents' generation. However, prior research has studied children of immigrants who were selected for migration, thereby rendering it difficult to isolate the intergenerational impact of migration on adult mortality. METHODS: We use semiparametric survival analysis to carry out a total population cohort study estimating all-cause and cause-specific mortality among all adult men and women from age of 17 years among all men and women born in 1953-1972 and resident in Finland in 1970-2020. We compare children of forced migrants from ceded Karelia, an area of Finland that was ceded to Russia during the Second World War, with the children of parents born in present-day Finland. RESULTS: Children with two parents who were forced migrants have higher mortality than children with two parents born in Northern, Southern, and Western Finland, but similar or lower mortality than the subpopulation of children whose parents were born in the more comparable areas of Eastern Finland. For women and men, a mortality advantage is largest for external causes and persists after controlling for socioeconomic factors. CONCLUSION: Our findings suggest that forced migration can have a beneficial impact on the mortality of later generations, at least in the case where forced migrants are able to move to contextually similar locations that offer opportunities for rapid integration and social mobility. The findings also highlight the importance of making appropriate comparisons when evaluating the impact of forced migration.

Diuretic Strategies in Acute Decompensated Heart Failure: A Narrative Review.

Background: Heart failure is a common condition with considerable associated costs, morbidity, and mortality. Patients often present to hospital with dyspnea and edema. Inadequate inpatient decongestion is an important contributor to high readmission rates. There is little evidence concerning diuresis to guide clinicians in caring for patients with acute decompensated heart failure. Contemporary diuretic strategies have been defined by expert opinion and older landmark clinical trials. Objective: To present a narrative review of contemporary recommendations, along with their underlying evidence and pharmacologic rationale, for diuretic strategies in inpatients with acute decompensated heart failure. Data Sources: PubMed, OVID, and Embase databases were searched from inception to December 22, 2022, with the following search terms: heart failure, acute heart failure, decompensated heart failure, furosemide, bumetanide, ethacrynic acid, hydrochlorothiazide, indapamide, metolazone, chlorthalidone, spironolactone, eplerenone, and acetazolamide. Study Selection: Randomized controlled trials and systematic reviews involving at least 100 adult patients (> 18 years) were included. Trials involving torsemide, chlorothiazide, and tolvaptan were excluded. Data Synthesis: Early, aggressive administration of a loop diuretic has been associated with expedited symptom resolution, shorter length of stay, and possibly reduced mortality. Guidelines make recommendations about dose and frequency but do not recommend any particular loop diuretic over another; however, furosemide is most commonly used. Guidelines recommend that the initial furosemide dose (on admission) be 2-2.5 times the patient's home dose. A satisfactory diuretic response can be defined as spot urine sodium content greater than 50-70 mmol/L at 2 hours; urine output greater than 100-150 mL/h in the first 6 hours or 3-5 L in 24 hours; or a change in weight of 0.5-1.5 kg in 24 hours. If congestion persists after the maximization of loop diuretic therapy over the first 24-48 hours, an adjunctive diuretic such as thiazide or acetazolamide should be added. If decongestion targets are not met, continuous infusion of furosemide may be considered. Conclusions: Heart failure with congestion can be managed with careful administration of high-dose loop diuretics, supported by thiazides and acetazolamide when necessary. Clinical trials are underway to further evaluate this strategy.

Contexte: L'insuffisance cardiaque est une maladie courante entraînant des coûts, une morbidité et une mortalité considérables. Les patients se présentent souvent à l'hôpital avec une dyspnée et un oedème. Une décongestion inadéquate des patients hospitalisés contribue largement aux taux élevés de réadmission. Il existe peu de données probantes concernant la diurèse pour guider les cliniciens dans la prise en charge des patients atteints d'insuffisance cardiaque aiguë décompensée. Les stratégies diurétiques contemporaines ont été définies par l'opinion d'experts et des essais cliniques de référence plus anciens. Objectif: Présenter une revue narrative des recommandations contemporaines, ainsi que leurs données probantes sous-jacentes et leur justification pharmacologique, pour les stratégies diurétiques chez les patients hospitalisés souffrant d'insuffisance cardiaque aiguë décompensée. Sources des données: Les bases de données PubMed, OVID et Embase ont été consultées depuis leur création jusqu'au 22 décembre 2022, avec les termes de recherche suivants: insuffisance cardiaque, insuffisance cardiaque aiguë, insuffisance cardiaque décompensée, furosémide, bumétanide, acide éthacrynique, hydrochlorothiazide, indapamide, métolazone, chlorthalidone, spironolactone, éplérénone et acétazolamide. Choix de l'étude: Les essais contrôlés randomisés et les revues systématiques portant sur au moins 100 patients adultes (plus de 18 ans) ont été inclus. Les essais impliquant le torsémide, le chlorothiazide et le tolvaptan ont été exclus. Synthèse des données: L'administration précoce et agressive d'un diurétique de l'anse a été associée à une résolution accélérée des symptômes, à une durée de séjour plus courte et éventuellement à une mortalité réduite. Les lignes directrices font des recommandations sur la dose et la fréquence, mais ne recommandent pas un diurétique de l'anse particulier plutôt qu'un autre; cependant, le furosémide est le plus couramment utilisé. Les lignes directrices recommandent que la dose initiale de furosémide à l'admission soit de 2 à 2,5 fois la dose à domicile du patient. Une réponse diurétique satisfaisante peut être définie comme une teneur ponctuelle en sodium dans l'urine supérieure à 50 à 70 mmol/L après 2 heures; débit urinaire supérieur à 100 à 150 mL/h au cours des 6 premières heures ou à 3 à 5 L en 24 heures; ou un changement de poids de 0,5 à 1,5 kg en 24 heures. Si la congestion persiste après la maximisation du traitement par diurétique de l'anse au cours des premières 24 à 48 heures, un diurétique d'appoint tel que le thiazidique ou l'acétazolamide doivent être ajoutés. Si les objectifs de décongestion ne sont pas atteints, une perfusion continue de furosémide peut être envisagée. Conclusions: L'insuffisance cardiaque accompagnée de congestion peut être gérée par l'administration prudente de diurétiques de l'anse à haute dose, appuyés par des thiazidiques et de l'acétazolamide si nécessaire. Des essais cliniques sont en cours pour évaluer davantage cette stratégie.

Differential impact of test performance characteristics on burden-to-benefit tradeoffs for blood-based colorectal cancer screening: A microsimulation analysis.

OBJECTIVES: To inform the development and evaluation of new blood-based colorectal cancer (CRC) screening tests satisfying minimum United States (US) coverage criteria, we estimated the impact of the different test performance characteristics on long-term testing benefits and burdens. METHODS: A novel CRC-Microsimulation of Adenoma Progression and Screening (CRC-MAPS) model was developed, validated, then used to assess different screening tests for CRC. We compared multiple, hypothetical blood-based CRC screening tests satisfying minimum coverage criteria of 74% CRC sensitivity and 90% specificity, to measure how changes in a test's CRC sensitivity, specificity, and adenoma sensitivity (sizes 1-5 mm, 6-9 mm, ≥10 mm) affect total number of colonoscopies (COL), CRC incidence reduction (IR), CRC mortality reduction (MR), and burden-to-benefit ratios (incremental COLs per percentage-point increase in IR or MR). RESULTS: A blood test meeting minimum US coverage criteria for performance characteristics resulted in 1576 lifetime COLs per 1000 individuals, 46.7% IR and 59.2% MR compared to no screening. Tests with increased CRC sensitivity of 99% ( + 25%) vs. increased ≥10 mm adenoma sensitivity of 13.6% ( + 3.6%) both yielded the same MR, 62.7%. Test benefits improved the most with increases in all-size adenoma sensitivity, then size-specific adenoma sensitivities, then specificity and CRC sensitivity, while increases in specificity or ≥10 mm adenoma sensitivity resulted in the most favorable burden-to-benefit tradeoffs (ratios <11.5). CONCLUSIONS: Burden-to-benefit ratios for blood-based CRC screening tests differ by performance characteristic, with the most favorable tradeoffs resulting from improvements in specificity and ≥10 mm adenoma sensitivity.

Delivery of Immobilized IFN-γ With PCN-333 and Its Effect on Human Mesenchymal Stem Cells.

Interferon-gamma (IFN-γ) plays a vital role in modulating the immunosuppressive properties of human mesenchymal stem/stromal cells (hMSCs) used in cell therapies. However, IFN-γ suffers from low bioavailability and degrades in media, creating a challenge when using IFN-γ during the manufacturing of hMSCs. Metal-organic frameworks (MOFs), with their porous interiors, biocompatibility, high loading capacity, and ability to be functionalized for targeting, have become an increasingly suitable platform for protein delivery. In this work, we synthesize the MOF PCN-333(Fe) and show that it can be utilized to immobilize and deliver IFN-γ to the local extracellular environment of hMSCs. In doing so, the cells proliferate and differentiate appropriately with no observed side effects. We demonstrate that PCN-333(Fe) MOFs containing IFN-γ are not cytotoxic to hMSCs, can promote the expression of proteins that play a role in immune response, and are capable of inducing indoleamine 2,3-dioxygenase (IDO) production similar to that of soluble IFN-γ at lower concentrations. Overall, using MOFs to deliver IFN-γ may be leveraged in the future in the manufacturing of therapeutically relevant hMSCs.

Parental age gaps among immigrants and their descendants: Adaptation across time and generations?

Age gaps between partners have undergone dramatic changes in high-income countries over the past century. Yet, there has been little focus on age gaps for immigrants and their descendants. This is an important omission because age gaps can be interpreted as a macro-level indicator of intergenerational adaptation. We examine the age gaps of biological parents (childbearing partners) among immigrants and their descendants in Sweden, a country with high gender equality and a stable mean age gap. Using longitudinal, whole-population data, we examine changes in age gaps for cohorts born 1950-86. Cohort trends in age gaps often follow very different patterns for male and female immigrants, with limited evidence of adaptation across cohorts. However, there is considerable evidence of adaptation towards the Swedish norm among the second generation, including from direct comparison between immigrants and their children. The largest differences between women and men are seen among the first generation with a Swedish-born partner.

Providing a detailed estimate of mortality using a simulation-based collision risk model.

Marine renewables could form a significant part of the green energy mix. However, a potential environmental impact of tidal energy converters (TECs) is collision risk between a device and animal, which has been a significant barrier in the consenting process. While it is important to understand the number of collisions of an animal with the device, the relative speed at which an animal collides with the device, and the point on the animal where collision occurs, will determine whether a collision is fatal, which is important in understanding population-level impacts. Using a simulation-based collision risk model, this paper demonstrates a novel method for producing estimates of mortality. Extracting both the speed and the location of collisions between an animal and TEC, in this instance a seal and horizontal axis turbine, collision speed and location of collision are used to produce probabilities of mortality. To provide a hypothetical example we quantified the speed and position at which a collision occurs to estimate mortality and, using collision position, we determine all predicted collisions with the head of the animal as fatal, for example, whilst deeming other collisions non-fatal. This is the first collision risk model to incorporate speed at the point of contact and the location where the collision occurs on the animal, to estimate the probability of mortality resulting from a collision. The hypothetical scenarios outline how these important variables extracted from the model can be used to predict the proportion of fatal events. This model enables a comprehensive approach that ultimately provides advancements in collision risk modelling for use in the consenting process of TECs. Furthermore, these methods can easily be adapted to other renewable energy devices and receptors, such as wind and birds.

Radiofrequency and microwave ablation for treatment of recurrent gynecologic malignancies.

OBJECTIVE: Radiofrequency ablation and microwave ablation are used to vaporize tumors not amenable to surgical resection. We sought to evaluate the safety and efficacy of radiofrequency and microwave ablation for the treatment of isolated lesions in patients with recurrent gynecologic malignancy. METHODS: Patients with gynecologic malignancies treated with radiofrequency or microwave ablation at a university-affiliated cancer center from April 2007 to January 2020 were evaluated. Clinical records were reviewed for number of prior chemotherapy regimens, response to ablation, time to progression, and location of progression. RESULTS: Thirty-two patients received ablative therapy for treatment of isolated recurrences. Seventeen (53%) patients had ovarian cancer, seven (22%) had endometrial cancer, and eight (25%) had cervical cancer. Thirteen (41%) patients received radiofrequency ablation and 19 (59%) received microwave ablation. Patients had a median of 2 (range 1-12) prior lines of chemotherapy. Sixteen (50%) patients achieved a partial or complete response with two patients experiencing no progression at time of submission. Six (19%) patients had stable disease and 10 (31%) patients had progression at time of initial follow-up imaging. Median progression-free survival for the cohort was 7.3 months (range 1.4-64.7). No significant improvement in median progression-free survival was seen with the addition of adjuvant systemic therapy to radiofrequency or microwave ablation (6.9 vs 7.7 months; HR 0.7, 95% CI 0.3 to 1.7). Clinical benefit, defined as absence of definitive progression at the site of ablation or new target lesions at 4 months, was seen in 22 (68.8%) patients. No major complications occurred, with two patients reporting pain or weakness at the site of ablation. CONCLUSION: Radiofrequency and microwave ablation demonstrated that 68.8% (n=22) of patients experienced clinical benefit at 4 months. Ablative therapy may be considered for the treatment of isolated lesions in patients with recurrent gynecologic malignancies.

A rare case of follicular dendritic sarcoma of the vagina.

Follicular dendritic sarcoma of the vagina is an exceptionally rare malignancy. Here, we present a reproductive-aged female with no pertinent past medical history who initially presented with a protruding vaginal mass. Pathology from initial excision was consistent with follicular dendritic sarcoma of the vagina. This was ultimately treated with wide radical resection of the mass leading to iatrogenic vaginal stenosis.

Forced Migration and the Childbearing of Women and Men: A Disruption of the Tempo and Quantum of Fertility?

It is well known that migrant fertility is associated with age at migration, but little is known about this relationship for forced migrants. We study an example of displacement in which the entire population of Finnish Karelia was forced to move elsewhere in Finland in the 1940s. This displacement was unique because of its size and scale, because we have data on almost the whole population of both men and women who moved, and because of the similarity between origin and destination. These aspects enable us to investigate the disruptive impact of forced migration, net of other factors such as adaptation and selection. For all ages at migration from one to 20, female forced migrants had lower levels of completed fertility than similar women born in present-day Finland, which suggests a permanent impact of migration. However, women born in the same year as the initial forced migration showed no difference, which may indicate the presence of a counterbalancing fertility-increasing effect, as observed elsewhere for people born during a humanitarian crisis. There is less evidence of an impact for men, which suggests a gendered impact of forced migration-and its timing-on fertility. Results are similar after controlling for social and spatial mobility, indicating that there may be no major trade-off between reproduction and these forms of mobility.

Automated pneumothorax triaging in chest X-rays in the New Zealand population using deep-learning algorithms.

INTRODUCTION: The primary aim was to develop convolutional neural network (CNN)-based artificial intelligence (AI) models for pneumothorax classification and segmentation for automated chest X-ray (CXR) triaging. A secondary aim was to perform interpretability analysis on the best-performing candidate model to determine whether the model's predictions were susceptible to bias or confounding. METHOD: A CANDID-PTX dataset, that included 19,237 anonymized and manually labelled CXRs, was used for training and testing candidate models for pneumothorax classification and segmentation. Evaluation metrics for classification performance included Area under the receiver operating characteristic curve (AUC-ROC), sensitivity and specificity, whilst segmentation performance was measured using mean Dice and true-positive (TP)-Dice coefficients. Interpretability analysis was performed using Grad-CAM heatmaps. Finally, the best-performing model was implemented for a triage simulation. RESULTS: The best-performing model demonstrated a sensitivity of 0.93, specificity of 0.95 and AUC-ROC of 0.94 in identifying the presence of pneumothorax. A TP-Dice coefficient of 0.69 is given for segmentation performance. In triage simulation, mean reporting delay for pneumothorax-containing CXRs is reduced from 9.8 ± 2 days to 1.0 ± 0.5 days (P-value < 0.001 at 5% significance level), with sensitivity 0.95 and specificity of 0.95 given for the classification performance. Finally, interpretability analysis demonstrated models employed logic understandable to radiologists, with negligible bias or confounding in predictions. CONCLUSION: AI models can automate pneumothorax detection with clinically acceptable accuracy, and potentially reduce reporting delays for urgent findings when implemented as triaging tools.

The gendered impacts of delayed parenthood: A dynamic analysis of young adulthood.

Young adulthood is a dynamic and demographically dense stage in the life course. This poses a challenge for research on the socioeconomic consequences of parenthood timing, which most often focuses on women. We chart the dynamics of delayed parenthood and its implications for educational and labor market trajectories for young adult women and men using a novel longitudinal analysis approach, the parametric g-formula. This method allows the estimation of both population-averaged effects (among all women and men) and average treatment effects (among mothers and fathers). Based on high-quality data from Finnish registers, we find that later parenthood exacerbates the educational advantage of women in comparison to men and attenuates the income advantage of men in comparison to women across young adult ages. Gender differences in the consequences of delayed parenthood on labor market trajectories are largely not explained by changes in educational trajectories. Moreover, at the time of entering parenthood, delayed parenthood improves the incomes of fathers more than those of mothers, thereby exacerbating existing gender differences. The results provide population-level evidence on how the delay of parenthood has contributed to the strengthening of women's educational position relative to that of men. Further, the findings on greater increases in fathers' than mothers' incomes at the time of entering parenthood, as followed by postponement, may help explain why progress in achieving gender equality in the division of paid and unpaid work in families has been slow.

Same-day discharge after robotic surgery for endometrial cancer.

To assess the safety of same-day discharge (SDD) following robotic-assisted endometrial cancer staging and identify risk factors for postoperative admission in a diverse population. A review of patients who underwent robotic-assisted endometrial cancer staging from April 1, 2017 to April 1, 2019 was performed. Patients were evaluated for SDD if they met the following criteria: tolerating oral intake, voiding spontaneously, ambulating, negative orthostatic vitals, postoperative hemoglobin ≤ 2 g/dL from baseline, pain controlled on oral medications, and desire to be discharged. Risk factors for admission were identified. One hundred eighty-seven patients were identified. SDD criteria were met in 158, of which 132 (83.5%) were discharged same day. Median length of stay was 4.5 h. Reasons for admission despite meeting criteria were late surgery time (n = 15), abnormal vitals (n = 9), and personal concerns (n = 2), with risk factors being age ≥ 68 years (OR 2.72; 95% CI, 1.13-6.59), start time 1400 or later (OR = 11.25; 95% CI, 4.35-29.10), ASA ≥ 4 (OR 23.82; 95% CI, 2.54-223.15), history of CVA/MI (OR 5.61; 95% CI, 1.07-29.52), and operative time ≥ 120 min (OR = 3.83; 95% CI 1.36-10.77). Of the SDD cohort, 2 patients (1.3%) presented to the emergency room within 30 days (postoperative day 5 and 23). SDD following robotic-assisted endometrial cancer staging is safe and feasible. Age ≥ 68 years, surgery start time after 1400, ASA ≥ 4, history of CVA/MI, and operative time ≥ 120 min appear predictive of inpatient admission despite meeting SDD criteria.

Age variations and population over-coverage: Is low mortality among migrants merely a data artefact?

The migrant mortality advantage has been observed extensively, but its authenticity is debated. In particular, concerns persist that the advantage is an artefact of the data, generated by the problems of recording mobility among foreign-born populations. Here, we build on the intersection of two recent developments: the first showing substantial age variation in the advantage-a deep U-shaped advantage at peak migration ages-and the second showing high levels of population over-coverage, the principal source of data artefact, at the same ages. We use event history analysis of Sweden's population registers (2010-15) to test whether this over-coverage can explain age variation in the migrant mortality advantage. We document its U-shape in Sweden and, crucially, demonstrate that large mortality differentials persist after adjusting for estimated over-coverage. Our findings contribute to ongoing debate by demonstrating that the migrant mortality advantage is real and by ruling out one of its primary mechanisms.

Curation of the CANDID-PTX Dataset with Free-Text Reports.

Supplemental material is available for this article. Keywords: Conventional Radiography, Thorax, Trauma, Ribs, Catheters, Segmentation, Diagnosis, Classification, Supervised Learning, Machine Learning © RSNA, 2021.

The Fertility of Immigrants From Low-Fertility Settings: Adaptation in the Quantum and Tempo of Childbearing?

Immigrant women who have lived longer in a destination often have relatively low levels of fertility, which is sometimes taken as evidence of the adaptation of behavior. This evidence is almost exclusively based on studies of immigrants from high-fertility settings, while the fertility of immigrants from low-fertility settings has been largely overlooked. Research has also rarely studied the fertility of immigrants who migrated as children, despite the methodological advantages of applying such an approach. This study focuses on women who grew up in Sweden with a migration background from low-fertility origins. We expect that Sweden's welfare regime makes it easier for women to combine childbearing and working life, regardless of migration background, thereby facilitating an adaptation of fertility behavior toward that prevailing in Sweden. We find evidence of adaptation in terms of birth timing for at least half of the country-origin groups that we study, but very little evidence of adaptation in terms of completed fertility. Further, we find that, in comparison with ancestral Swedes, completed fertility differentials are larger for second-generation individuals than for immigrants who arrived during childhood. This is evidence against the notion of "straight-line" adaptation for immigrants and the children of immigrants who are born in Sweden.

Educational Differences in Cohort Fertility Across Sub-national Regions in Europe.

Educational differences in female cohort fertility vary strongly across high-income countries and over time, but knowledge about how educational fertility differentials play out at the sub-national regional level is limited. Examining these sub-national regional patterns might improve our understanding of national patterns, as regionally varying contextual conditions may affect fertility. This study provides for the first time for a large number of European countries a comprehensive account of educational differences in the cohort fertility rate (CFR) at the sub-national regional level. We harmonise data from population registers, censuses, and large-sample surveys for 15 countries to measure women's completed fertility by educational level and region of residence at the end of the reproductive lifespan. In order to explore associations between educational differences in CFRs and levels of economic development, we link our data to regional GDP per capita. Empirical Bayesian estimation is used to reduce uncertainty in the regional fertility estimates. We document an overall negative gradient between the CFR and level of education, and notable regional variation in the gradient. The steepness of the gradient is inversely related to the economic development level. It is steepest in the least developed regions and close to zero in the most developed regions. This tendency is observed within countries as well as across all regions of all countries. Our findings underline the variability of educational gradients in women's fertility, suggest that higher levels of development may be associated with less negative gradients, and call for more in-depth sub-national-level fertility analyses by education.

Collision risk modelling for tidal energy devices: A flexible simulation-based approach.

The marine renewable energy industry is expanding as countries strive to reach climate targets as set out in the Paris Agreement. For tidal energy devices, the potential risk for animals to collide with a device, particularly its moving parts such as rotor blades, is often a major barrier in the consenting process. Theoretical work surrounding collision risk has commonly made use of a formulaic modelling approach. However, whilst providing a platform to assess conventional horizontal axis tidal turbines, the frameworks applied lack the flexibility to incorporate novel device designs or more complex animal movement parameters (e.g. dive trajectories). To demonstrate the novel simulation-based approach to estimating collision probabilities a hypothetical case study was used to demonstrated how the approach can assess the influence that variations in ecological and behavioural data had on collision probabilities. To do this, a tidal kite moving in a 3D figure-of-eight trajectory and a seal-shaped object were modelled and variations to angle of approach, speed and size of the animal were made. To further improve the collision risk estimates, results of the simulations were post-processed by integrating a hypothetical dive profile. The simulations showed how variation in the input parameters and additional post-processing influence collision probabilities. Our results demonstrate the potential for using this simulation-based approach for assessing collision risk, highlighting the flexibility it offers by way of incorporating empirical data or expert elicitation to better inform the modelling process. This framework, where device type, configuration and animal-related parameters can be varied with relative simplicity, on a case-by-case basis, provides a more tailored tool for assessing a diverse range of interactions between marine renewable energy developments and receptors. In providing a robust and transparent quantitative approach to addressing collision risk this flexible approach can better inform the decision-making process and aid progress with respect to developing a renewable energy industry in a sustainable manner. Therefore, the approach outlined has clear applications that are relevant to many stakeholders and can contribute to our ability to ensure we achieve sustainable growth in the marine renewable energy industry as part of a global strategy to combat climate change.

Integrin-Linked Kinase Is a Novel Therapeutic Target in Ovarian Cancer.

OBJECTIVE: The objective of this study is to identify and validate novel therapeutic target(s) in ovarian cancer. BACKGROUND: Development of targeted therapeutics in ovarian cancer has been limited by molecular heterogeneity. Although gene expression datasets are available, most of them lack appropriate pair-matched controls to define the alterations that result in the transformation of normal ovarian cells to cancerous cells. METHODS: We used microarray to compare the gene expression of treatment-naïve ovarian cancer tissue samples to pair-matched normal adjacent ovarian tissue from 24 patients. Ingenuity Pathway Analysis (IPA) was used to identify target pathways for further analysis. Integrin-linked kinase (ILK) expression in SKOV3 and OV90 cells was determined using Western blot. ILK was knocked down using CRISPR/Cas9 constructs. Subcutaneous xenograft study to determine the effect of ILK knockdown on tumor growth was performed in NOD SCID gamma mice. RESULTS: Significant upregulation of the ILK pathway was identified in 22 of the 24 cancer specimens, identifying it as a potential player that could contribute to the transformation of normal ovarian cells to cancerous cells. Knockdown of ILK in SKOV3 cells resulted in decreased cell proliferation and tumor growth, and inhibition of downstream kinase, AKT (protein kinase B). These results were further validated using an ILK-1 chemical inhibitor, compound 22. CONCLUSION: Our initial findings validate ILK as a potential therapeutic target for molecular inhibition in ovarian cancer, which warrants further investigation.