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This study uses DAYCENT model to investigate the sensitivity of soil organic carbon (SOC) at an intensely cultivated site in the U.S. Midwest under an ensemble of scenario climates predicted by IPCC models. The model ensemble includes three IPCC models (Canadian, French, German), three emission scenarios (B1, A1B, A2) and three time periods (late 20th, mid-21st, late 21st century). DAYCENT shows that SOC at the site would decline by 0.3–2.6kgm−2 (5–35%) depending on the models and scenarios from late 20th to mid-21st century despite a larger increase of future net primary production (NPP) than respiration. The future SOC decrease is mostly attributable to harvest loss. The wide spread in future SOC decline rates are in part because SOC decrease (by respiration) is directly proportional to SOC itself. Any uncertainty in absolute SOC in DAYCENT would translate directly into its trend, unlike other variables such as temperature whose trends are independent of their values themselves, contrasting the reliability of SOC trend with temperature change. [Copyright &y& Elsevier]

This special report demonstrates the feasibility of long-term prediction of intercontinental dispersal of Phakopsora pachyrhizi spores, the causal agent of the devastating Asian soybean rust (SBR) that invaded the continental United States in 2004. The climate-dispersion integrated model system used for the prediction is the combination of the particle transport and dispersion model (HYSPLIT_4) with the regional climate prediction model (MM5). The integrated model system predicts the trajectory and concentration of P pachyrhizi spores based on three-dimensional wind advection and turbulent transport while incorporating simple viability criteria for aerial spores. The weather input of the model system is from a seasonal global climate prediction. The spore source strength and distribution were estimated from detected SBR disease severity and spread. The model system was applied to the known P. pachyrhizi spore dispersal between and within continents while focusing on the disease entry into the United States. Prediction validation using confirmed disease activity demonstrated that the model predicted the 2004 U.S. entry months in advance and reasonably forecast disease spread from the south coast states in the 2005 growing season. The model also simulated the dispersal from Africa to South America and from southern South America to Columbia across the equator. These validations indicate that the integrated model system, when furnished with detailed source distribution, can be a useful tool for P. pachyrhizi and possibly other airborne pathogen prediction. [ABSTRACT FROM AUTHOR]

In the shadow of globalization, international newsmaking remains inherently ethnocentric, nationalistic, and even state-centered. Major U.S. media frame the transfer of Hong Kong from British to Chinese sovereignty in terms of four dominant ideological packages, that is, the United States (a) is a "new guardian" of Hong Kong (b) in an emerging cold war between the West and China, whereas Hong Kong (c) will suffer from the erosion of freedom and democracy under Chinese rule on the one hand, and (d) will be a "Trojan horse" to spearhead China's political and economic change on the other. In sum, the media rally around the "star-spangled banner" to bang the democracy drum in consonance with elite consensus and foreign policy. Their news net is narrowly cast. To rescue the handover from being a dull media event, the media seek to hype up their stories. Even the lighthearted pieces flaunt ideological messages. [ABSTRACT FROM AUTHOR]

A combined observational and numerical modeling methodology was employed to examine the interaction of large-scale quasi-stationary waves with regional forcing in the drought of 1988 and flood of 1993 in the north-central United States. The study implements and tests a new lateral boundary condition closure approach enabling regional climate modeling sensitivity studies to account for anomalies external to the simulated domain. Thirty-day regional simulations of the continental United States using the MM5 regional model successfully reproduced the anomalous drought and flood conditions. In an additional set of simulations the observed large-scale quasi-stationary wave anomalies in the dynamic and thermodynamic fields were filtered out through adjustment of the observationally based lateral boundary conditions. In these filtered simulations the simulated meteorological fields over the drought/flood areas for both years tended toward those for normal years, suggesting that the proposed filtering technique can be used as a tool to test the regional response to external forcing. Comparisons of the control and filtered simulations illustrated the significant influence of large-scale anomalies on the strength and geographical distribution of the low-level jet and related impacts on rainfall in the central United States. [ABSTRACT FROM AUTHOR]

This article assesses the epidemic potential of soybean rust (Phakopsora pachyrhizi) in the United Slates. In the assessment, there are three critical components of uncertainty: (i) suitability of climate conditions in production areas for soybean rust epidemics; (ii) likelihood of establishment of the fungus in North America; and (iii) the seasonal dispersal potential of the pathogen from overwintering regions to major soybean production regions. Assessments on the first and second components suggest soybean rust epidemics are likely in the United States, and the certainty of the third component is yet to be determined. Comparison of epidemiological factors for soybean rust in soybean production regions between China and the United States shows a complicated picture with the United States having factors that both increase and decrease risk. Future investigation of risk components—incipience in the field and long-distance dispersal—is needed. [ABSTRACT FROM AUTHOR]

The simplified local density/Peng–Robinson model (SLD-PR) was modified to improve its predictive capability when dealing with near-critical and supercritical adsorption systems of the type encountered in coalbed methane recovery and CO2 sequestration. The goal was to develop efficient equation-of-state (EOS) computational frameworks for representing adsorption behavior, as well as to improve our understanding of the phenomenon. The ability of the modified SLD-PR to correlate accurately data for supercritical adsorption systems is demonstrated using adsorption measurements on activated carbon, Illinois #6 coal, Fruitland coal, and Lower Basin Fruitland coal. The results indicate that the modified SLD-PR model, which incorporates a modified repulsive parameter “b” for the PR EOS, is capable of modeling the adsorption of pure methane, nitrogen, and CO2 at coalbed conditions. Inclusion of a slit geometry in the adsorbent matrix yields results superior to our previous two-dimensional EOS models for the adsorbates considered. The results also indicate that accounting for the adsorption surface structure within the SLD-EOS framework is effective in improving modeling capability for high-pressure adsorption phenomena. An explanation is offered as to why the adsorbed-phase densities are close to the EOS reciprocal co-volumes. Further, the model (a) generates direct estimates for the adsorbed-phase densities (which facilitate reliable prediction of absolute gas adsorption) and (b) readily describes the observed maximum in Gibbs-adsorption isotherms of CO2 at the temperatures and pressures encountered in coalbeds. [Copyright &y& Elsevier]

Routine preventive care (RPC) services are recommended for people with HIV, who have higher risk of certain preventable conditions. We used a pooled cross-section of patient-years to examine receipt of 5 annual RPC services among Medicaid enrollees in the US South. Data were person-level administrative claims (Medicaid Analytic eXtract, 2008-2012) and county-level characteristics for 16 Southern states plus District of Columbia. Generalized estimating equations estimated the probability of lipid, glucose, syphilis, and cervical cancer (women only) screenings and influenza vaccination. We also examined service receipt among subgroups including enrollees requiring more general or HIV-specific care, in managed care, < 45 years and, separately, Non-Hispanic Black and Non-Hispanic White enrollees. The sample included 57,695 adult Medicaid enrollees with HIV (187,275 enrollee-years) that were majority 45-54 years (38.0%), female (53.6%), Non-Hispanic Black (54.3%), and urban (90.2%). Enrollees received lipid, syphilis, and cervical cancer screenings and influenza vaccination in < 50% and glucose screening in 71.7% of total enrollment-years. The adjusted probability was low (< 50%) for all services except glucose screening (estimated probability 81%; 95% confidence interval 78%, 83%). Findings were similar across subgroups. There is consistent, suboptimal receipt of RPC services among people with HIV. Approaches are needed to increase uptake of RPC services., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: Less than 50% of people with HIV (PWH) in the United States are retained in care, a key step along the HIV care continuum. We examined the impact of geographic access to care on retention in care for urban and rural PWH., Methods: We used Medicaid claims and clinician data (Medicaid Analytic eXtract and MAX Provider Characteristics, 2009-2012) for 13 Southern states plus the District of Columbia. We calculated drive time from the enrollees' ZIP Code Tabulation Area to their usual source of care. We used generalized estimating equations to examine the association between drive time to care >30 min (versus ≤30 min) and retention in care, overall and stratified by rurality. In sensitivity analysis, we examined the definition of retention in care, states included in the analysis, and enrollee- and care-related characteristics., Findings: The sample included 49,596 PWH. Overall, the association between drive time >30 min and retention was significant, but small (adjusted odds ratio [aOR] 1.01, 95% confidence interval [CI] 1.00, 1.01) and was not significant in urban areas; however, the significance and direction of the association differed in sensitivity analysis. In rural areas, driving >30 min to care was associated with 7% higher odds of retention in care (aOR 1.07, 95% CI 1.05, 1.08) and this association remained significant and positive in nearly all sensitivity analyses., Conclusions: For PWH in rural areas, greater drive time is consistently associated with greater retention in care. Disentangling the mechanisms of this relationship is a future research priority., (© 2024 The Author(s). The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.)

Background and Aims: The applicability of the proposed metabolic dysfunction-associated steatotic liver disease (MASLD) definition has not been validated. We aimed to characterize the profiles and long-term survival of people meeting the criteria for MASLD, but not that of metabolic dysfunction-associated fatty liver disease (MAFLD), i.e. MASLD only., Methods: Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, 7791 adult participants were included and categorized into four distinct groups: no SLD, non-MAFLD MASLD, MASLD-MAFLD, and cryptogenic SLD (steatosis without metabolic dysfunction)., Results: Participants in the MASLD-only group were younger and had better metabolic profiles and fibrosis degree compared to those with MASLD-MAFLD and those with no SLD. Their profiles were comparable to those with cryptogenic SLD. Similarly, the MASLD-only group tend to have lower cumulative incidence of all-cause and cardiovascular mortality. Clustering analysis showed that MASLD only clusters differently from individuals with MASLD-MAFLD., Conclusions: MASLD only is a distinct clinical group with substantial heterogeneity compared to those captured using the MAFLD criteria., Competing Interests: Declarations. Conflict of interest: The authors declare no conflict of interest., (© 2024. Asian Pacific Association for the Study of the Liver.)

Introduction and Objectives: Fatty liver disease is a multisystem disease. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a more accurate indicator of chronic kidney disease (CKD) than nonalcoholic fatty liver disease (NAFLD). However, the relationship between recently defined metabolic dysfunction-associated steatotic liver disease (MASLD) and CKD is currently unclear. The objective of this cross-sectional study was to investigate the prevalence of CKD and albuminuria among individuals diagnosed with either MAFLD or MASLD., Patients and Methods: This study involved 5,492 participants who provided biochemical marker and liver ultrasound data from the U.S. National Health and Nutrition Examination Survey (2017-2020). Multiple logistic regression analyses were conducted to assess the independent associations of nonoverlapping MAFLD and MASLD with the presence of CKD or albuminuria (urinary albumin-to-creatinine ratio ≥ 3 mg/mmol)., Results: MAFLD and MASLD were identified in 47% and 44.5% of the participants, respectively. Individuals with MAFLD-only had a greater prevalence of CKD (24.7% vs. 8.3 %, P < 0.006) and albuminuria (18.6% vs. 5%, P < 0.01) than did those with MASLD-only. Importantly, after adjusting for factors such as sex, age, ethnicity, and alcohol use, it was demonstrated that individuals in the MAFLD-only group had a 4.73-fold greater likelihood of having prevalent CKD than those in the MASLD-only group (P < 0.03)., Conclusions: The MAFLD criteria better identify patients with CKD than do the MASLD criteria. Therefore, it is suggested that the MASLD criteria be reconsidered, as currently, the justification for changing from MAFLD to MASLD criteria may not be appropriate., Competing Interests: Conflicts of interest None., (Copyright © 2024 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)

Background and Aim: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been proposed as an alternative for the validated definition of metabolic dysfunction-associated fatty liver disease (MAFLD). We compared the abilities of MAFLD and MASLD to predict the risk of atherosclerotic cardiovascular disease (ASCVD)., Methods: Six thousand and ninety six participants from the 2017 to 2020 National Health and Nutrition Examination Survey cohort who received a thorough medical health check-up were chosen for the study. The associations between fatty liver status and coronary risk surrogates, such as 10-year ASCVD risk and self-reported cardiovascular events, were analysed., Results: MAFLD and MASLD were identified in 2911 (47.7%) and 2758 (45.2%) patients, respectively. MAFLD (odds ratio [OR]: 2.14, 95% confidence interval [CI], 1.78-2.57, p < .001) was more strongly independently associated with high ASCVD risk than MASLD (OR: 1.82, 95% CI, 1.52-2.18, p < .001) was in comparison with the absence of each condition. However, compared with MAFLD, MASLD alone was not associated with increased ASCVD risk. Multiple logistic regression revealed that MAFLD alone was significantly more strongly associated with a high risk of ASCVD (OR: 2.82; 95% CI: 1.13-7.01; p < .03) than MASLD alone., Conclusions: Although both MAFLD and MASLD were associated with different ASCVD risks, MAFLD predicted the ASCVD risk better than MASLD. The higher predictive ability of MAFLD compared to MASLD was attributed to metabolic dysfunction rather than moderate alcohol use., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Metabolic dysfunction-associated steatotic liver disease (MASLD) (previously called nonalcoholic fatty liver disease, NAFLD) is associated with cardiometabolic risk factors and chronic kidney disease (CKD). However, evidence is lacking regarding whether the severity of fibrosis is affected by these risk factors and diseases and to what degree. We aimed to determine the correlation between these factors and vibration-controlled transient elastography-determined liver stiffness measurements (LSMs) and controlled attenuation parameter (CAP) values in a sample of the US population. Data from the 2017-2018 cycle of the National Health and Nutrition Examination Survey were pooled. The association between LSM and cardiometabolic risk factors and CKD was assessed using generalized linear or logistic regression analyses. In multivariate regression analyses, CAP and BMI were adjusted as confounders. Of 3647 participants, 2079 (57.1%) had NAFLD/MASLD [weighted prevalence 54.8%; 95% confidence interval (CI) 51.8-57.9%]; the weighted prevalence of significant fibrosis (LSM ≥ 7.9 kPa) was 9.7% (95% CI 8.2-11.3%). Log LSM was associated with higher levels of homeostatic model assessment of insulin resistance ( β  = 2.19; P  = 0.017), hepatic steatosis (CAP > 248 dB/m) [odds ratio (OR) 3.66; 95% CI 2.22-6.02], type 2 diabetes (OR 2.69; 95% CI 1.72-4.20), and CKD (OR 1.70; 95% CI 1.24-2.34). These correlations did not change notably after adjustments were made for waist circumference, CAP, and BMI. LSM and CAP, although influenced by waist circumference and BMI, are good indicators of hepatic fibrosis and steatosis. LSM is associated with insulin resistance, diabetes, and CKD independent of hepatic steatosis and obesity., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background and Aims: The association of the triglyceride-glucose (TyG) index, a promising novel biomarker for insulin resistance, with the risk of endometriosis has not been investigated to date. This nationwide study aimed to explore the association between the TyG index and the endometriosis risk., Methods: Data were obtained from the National Health and Nutrition Examination Survey (1999-2006). Female participants who provided complete data on the TyG index and endometriosis were enrolled in the analysis. Multivariate logistic regression analyses were utilized to assess the association of the TyG index with endometriosis, adjusted by multiple potential confounders. Meanwhile, in-depth subgroup analyses were conducted., Results: A total of 1,590 eligible participants were included, among whom 135 (8.5%) women were diagnosed with endometriosis. The fully adjusted multivariate logistic model showed TyG index was significantly associated with the endometriosis risk (odds ratio [OR] Q4 versus Q1 2.04, 95% confidence interval [CI]: 1.15-3.62; P for trend=0.013). In subgroup analyses, the significantly positive association between TyG index and the risk of endometriosis was also found in parous women (OR Q4 versus Q1 2.18, 95% CI: 1.20-3.96), women without diabetes (OR Q4 versus Q1 2.12, 95% CI: 1.19-3.79), women who smoke currently (OR Q4 versus Q1 3.93, 95% CI: 1.33-11.58), women who drink currently (OR Q4 versus Q1 2.54, 95% CI: 1.27-5.07), and in women who use oral contraceptives (OR Q4 versus Q1 1.91, 95% CI: 1.04-3.51). Additionally, significantly increasing trends in the odds of endometriosis across the quartiles of the TyG index were observed in the above-mentioned subgroups (all P for trend<0.05)., Conclusions: This population-based study found that a higher TyG index, representing an increased level of insulin resistance, was associated with a higher risk of endometriosis among the US population. Our findings suggested TyG index might be a promising tool for the risk assessment of endometriosis. Prospective studies are warranted to further verify these findings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liu, Wang, Ji, Kong, Pan, Xu, Geng and Miao.)

In the United States, people living with HIV (PLWH) in rural areas fare worse along the HIV care continuum than their urban counterparts; this may be due in part to limited geographic access to care. We estimated drive time to care for PLWH, focusing on urban-rural differences. Adult Medicaid enrollees living with HIV and their usual care clinicians were identified using administrative claims data from 14 states (Medicaid Analytic eXtract, 2009-2012). We used geographic network analysis to calculate one-way drive time from the enrollee's ZIP code tabulation area centroid to their clinician's practice address, then examined urban-rural differences using bivariate statistics. Additional analyses included altering the definition of rurality; examining subsamples based on the state of residence, services received, and clinician specialty; and adjusting for individual and county characteristics. Across n  = 49,596 PLWH, median drive time to care was 12.8 min (interquartile range 26.3). Median drive time for rural enrollees (43.6 (82.0)) was nearly four times longer than for urban enrollees (11.9 (20.6) minutes, p  < 0.0001), and drive times exceeded one hour for 38% of rural enrollees (versus 12% of urban, p  < 0.0001). Urban-rural disparities remained in all additional analyses. Sustained efforts to circumvent limited geographic access to care are critical for rural areas.

Background: A reliable risk prediction model is critically important for identifying individuals with high risk of developing lung cancer as candidates for low-dose chest computed tomography (LDCT) screening. Leveraging a cutting-edge machine learning technique that accommodates a wide list of questionnaire-based predictors, we sought to optimize and validate a lung cancer prediction model., Methods: We developed an Optimized early Warning model for Lung cancer risk (OWL) using the XGBoost algorithm with 323,344 participants from the England area in UK Biobank (training set), and independently validated it with 93,227 participants from UKB Scotland and Wales area (validation set 1), as well as 70,605 and 66,231 participants in the Prostate, Lung, Colorectal, and Ovarian cancer screening trial (PLCO) control and intervention subpopulations, respectively (validation sets 2 & 3) and 23,138 and 18,669 participants in the United States National Lung Screening Trial (NLST) control and intervention subpopulations, respectively (validation sets 4 & 5). By comparing with three competitive prediction models, i.e., PLCO modified 2012 (PLCO m2012 ), PLCO modified 2014 (PLCO all2014 ), and the Liverpool Lung cancer Project risk model version 3 (LLPv3), we assessed the discrimination of OWL by the area under receiver operating characteristic curve (AUC) at the designed time point. We further evaluated the calibration using relative improvement in the ratio of expected to observed lung cancer cases (RI EO ), and illustrated the clinical utility by the decision curve analysis., Findings: For general population, with validation set 1, OWL (AUC = 0.855, 95% CI: 0.829-0.880) presented a better discriminative capability than PLCO all2014 (AUC = 0.821, 95% CI: 0.794-0.848) (p < 0.001); with validation sets 2 & 3, AUC of OWL was comparable to PLCO all2014 (AUC PLCOall2014 -AUC OWL < 1%). For ever-smokers, OWL outperformed PLCO m2012 and PLCO all2014 among ever-smokers in validation set 1 (AUC OWL  = 0.842, 95% CI: 0.814-0.871; AUC PLCOm2012  = 0.792, 95% CI: 0.760-0.823; AUC PLCOall2014  = 0.791, 95% CI: 0.760-0.822, all p < 0.001). OWL remained comparable to PLCO m2012 and PLCO all2014 in discrimination (AUC difference from -0.014 to 0.008) among the ever-smokers in validation sets 2 to 5. In all the validation sets, OWL outperformed LLPv3 among the general population and the ever-smokers. Of note, OWL showed significantly better calibration than PLCO m2012 , PLCO all2014 (RI EO from 43.1% to 92.3%, all p < 0.001), and LLPv3 (RI EO from 41.4% to 98.7%, all p < 0.001) in most cases. For clinical utility, OWL exhibited significant improvement in average net benefits (NB) over PLCO all2014 in validation set 1 (NB improvement: 32, p < 0.001); among ever smokers of validation set 1, OWL (average NB = 289) retained significant improvement over PLCO m2012 (average NB = 213) (p < 0.001). OWL had equivalent NBs with PLCO m2012 and PLCO all2014 in PLCO and NLST populations, while outperforming LLPv3 in the three populations., Interpretation: OWL, with a high degree of predictive accuracy and robustness, is a general framework with scientific justifications and clinical utility that can aid in screening individuals with high risks of lung cancer., Funding: National Natural Science Foundation of China, the US NIH., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Retention in HIV care remains a national challenge. Addressing structural barriers to care may improve retention. We examined the association between physician reimbursement and retention in HIV care, including racial differences., Methods: We integrated person-level administrative claims (Medicaid Analytic eXtract, 2008-2012), state Medicaid-to-Medicare physician fee ratios (Urban Institute, 2008, 2012), and county characteristics for 15 Southern states plus District of Columbia. The fee ratio is a standardized measure of physician reimbursement capturing Medicaid relative to Medicare physician reimbursement across states. Generalized estimating equations assessed the association between the fee ratio and retention (≥2 care markers ≥90 days apart in a calendar year). Stratified analyses assessed racial differences. We varied definitions of retention, subsamples, and definitions of the fee ratio, including the fee ratio at parity., Results: The sample included 55,237 adult Medicaid enrollees with HIV (179,002 enrollee years). Enrollees were retained in HIV care for 76.6% of their enrollment years, with retention lower among non-Hispanic Black (76.1%) versus non-Hispanic White enrollees (81.3%, P < 0.001). A 10-percentage point increase in physician reimbursement was associated with 4% increased odds of retention (adjusted odds ratio 1.04, 95% confidence interval: 1.01 to 1.07). In stratified analyses, the positive, significant association occurred among non-Hispanic Black (1.08, 1.05-1.12) but not non-Hispanic White enrollees (0.87, 0.74-1.02). Findings were robust across sensitivity analyses. When the fee ratio reached parity, predicted retention increased significantly overall and for non-Hispanic Black enrollees., Conclusion: Higher physician reimbursement may improve retention in HIV care, particularly among non-Hispanic Black individuals, and could be a mechanism to promote health equity., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Integrated care has gained popularity in recent decades and is advocated by the World Health Organization. This study examined the global progress, current foci, and the future of integrated care., Methods: We conducted a scientometric analysis of data exported from the Web of Science database. Publication number and citations, co-authorship between countries and institutions and cluster analysis were calculated and clustered using Histcite12.03.07 and VOS viewer1.6.4., Results: We retrieved 6127 articles from 1997 to 2016. We found the following. (1) The United States, United Kingdom, and Canada had the most publications, citations, and productive institutions. (2) The top 10 cited papers and journals were crucial for knowledge distribution. (3) The 50 author keywords were clustered into 6 groups: digital medicine and e-health, community health and chronic disease management, primary health care and mental health, healthcare system for infectious diseases, healthcare reform and qualitative research, and social care and health policy services., Conclusions: This paper confirmed that integrated care is undergoing rapid development: more categories are involved and collaborative networks are being established. Various research foci have formed, such as economic incentive mechanisms for integration, e-health data mining, and quantitative studies. There is an urgent need to develop performance measurements for policies and models., Competing Interests: The authors declare no conflicts of interest., (Thieme. All rights reserved.)

Hepatic involvement by a T-cell neoplasm is rare and often challenging to diagnose in liver biopsies. We collected 40 cases of T-cell neoplasms diagnosed in the liver from five large academic institutions to assess the clinicopathologic features. The patients included 11 women and 29 men, with a median age of 54 (range: 2-75) years and a high mortality rate (31/37, 83.8%). Fourteen (35%) patients were diagnosed with hepatosplenic T-cell lymphoma (HSTCL), 13 (32.5%) peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), and 13 (32.5%) other types of T-cell neoplasms. Patients with HSTCL were much younger and had worse survival than PTCL-NOS and other T-cell neoplasms (P < 0.05). On imaging studies, 20 cases (50%) showed abnormalities, including 10 with mass lesions that correlated with normal or cholestatic pattern enzyme elevation. Histomorphological analysis revealed four main patterns; with the exception of mass forming lesions (pattern 4; n = 8), cases with sinusoidal predominant (pattern 1; n = 12), portal predominant with sinusoidal infiltrates (pattern 2; n = 13) or lobular aggregates (pattern 3; n = 5) demonstrated small to medium lymphocytes resembling a reactive/inflammatory process. In addition, we described two cases of T-cell large granular lymphocytic leukemia that mimicked HSTCL, and a case of aggressive post-transplant lymphoproliferative disorder that developed after chronic Epstein-barr virus (EBV) infection, suggesting the importance of EBV testing in some lymphoma cases. As the largest cohort of T-cell neoplasms in liver, our study provides critical data on disease frequency, distribution, and clinicopathologic features that are essential for accurate diagnosis., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: A diagnosis of cancer is associated with increased risks of suicidal ideation and suicide attempts. Genital-system cancer comprises nearly a third of all cancers in males. We used the SEER database to identify the incidence of and risk factors for suicide death in male patients with genital-system cancer in the United States., Method: Patients were selected from the SEER database, and X-tile software was used to find the best cutoffs for stratifying age. Logistic regression was used to identify independent risk factors for suicide death. Only variables that were statistically significant in the univariate logistic regression models were analyzed in multivariate logistic regression models., Result: This study found that age (18-66 vs ≥ 76 years: OR = 3.300, P < 0.001; 67-75 vs ≥ 76 years: OR = 1.832, P < 0.001), being unmarried (OR = 1.332, P = 0.010), being divorced, separated, or widowed (OR = 1.338, P = 0.002), caucasian (OR = 2.074, P = 0.003) and not receiving surgery or having an unknown surgery status (OR = 1.405, P < 0.001) significantly increased the risk of suicide death. A particularly important finding was that a time of <1 year after the diagnosis was related to an increased risk of suicide death (<1 vs ≥ 10 years: OR = 1.761, P = 0.008)., Conclusion: We found that a number of factors significantly increased the risk of suicide. Importantly, a time of <1 year after the diagnosis was related to an increased risk of suicide death, which indicates the importance of identifying and treating people at risk of suicide as early as possible. These can help clinicians to understand suicidal patients and provide them with appropriate support., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The endophytic fungal community associated with the native cactus Opuntia humifusa in the United States was investigated and its potential for providing antifungal compounds. A hundred-eight endophytic fungal isolates were obtained and identified by molecular methods into 17 different taxa of the genera Alternaria, Aureobasidium, Biscogniauxia, Cladosporium, Cryptococcus, Curvularia, Diaporthe, Epicoccum, Paraconiothyrium, Pestalotiopsis and Phoma. The most frequent species associated with O. humifusa were Alternaria sp. 3, Aureobasidium pullulans and Diaporthe sp. The fungal community of O. humifusa had a high richness and diversity; additionally, the species richness obtained indicates that the sample effort was enough to recover the diversity pattern obtained. Six extracts of endophytes showed antifungal properties and (1)H NMR analyses of the extracts of Alternaria sp. 5 Ohu 8B2, Alternaria sp. 3 Ohu 30A, Cladosporium funiculosum Ohu 17C1 and Paraconiothyrium sp. Ohu 17A indicated the presence of functional groups associated with unsaturated fatty-acid olefinic protons and fatty acid methylene and methyl protons. GC-FID analysis of these extracts confirmed the presence of a mixture of different fatty acids. The (1)H NMR analyses of Biscogniauxia mediterranea Ohu 19B extracts showed the presence of aromatic compounds. From the extract of B. mediterranea we isolated the compound 5-methylmellein that displayed moderate antifungal activity against the phytopathogenic fungi Phomopsis obscurans. Our results suggest that native medicinal cacti of the United States can live symbiotically with rich and diverse endophytic communities and may be a source of bioactive molecules, including those able to inhibit or control plant disease pathogens., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

Background: Neuromuscular (NM) spinal deformities necessitating surgical intervention present a difficult challenge to the medical community. Underlying comorbidities lead to extended hospital stays, significant complications, and social challenges in the extensive perioperative period. In response to this problem, a therapeutic algorithm, the Care Pathway for Spinal Surgery (CAPSS) has been developed at our institution to address this complex medical issue., Methods: In 1999, a multidisciplinary team developed a treatment protocol, CAPSS, that emphasized perioperative work up and operative scheduling under the direction of a dedicated care coordinator. A case series analysis was conducted to compare the surgical outcomes from before and after CAPSS implementation. Statistical analyses were performed on a carefully paired subset of NM patients (N=9). Outcome measures were hospital length of stay (LOS), pediatric intensive care unit LOS, number of days intubated, surgical estimated blood loss, postoperative curve magnitude, percent curve correction, and perioperative complications., Results: Statistical analyses indicated that the use of CAPSS provided significant reduction in overall LOS, pediatric intensive care unit LOS, and perioperative complication rate within this patient group., Conclusions: CAPSS is an effective method to improve perisurgical care within the NM patients with spinal deformity necessitating operative stabilization., Level of Evidence: III-Retrospective comparative study.

The purpose of this article is to report final results of the evaluation of a chi-square ratio test proposed by the US Food and Drug Administration (FDA) for demonstrating equivalence of aerodynamic particle size distribution (APSD) profiles of nasal and orally inhaled drug products. A working group of the Product Quality Research Institute previously published results demonstrating some limitations of the proposed test. In an effort to overcome the test's limited discrimination, the group proposed a supplemental test, a population bioequivalence (PBE) test for impactor-sized mass (ISM). In this final report the group compares the chi-square ratio test to the ISM-PBE test and to the combination of both tests. The basis for comparison is a set of 55 realistic scenarios of cascade impactor data, which were evaluated for equivalence by the statistical tests and independently by the group members. In many instances, the combined application of these 2 tests appeared to increase the discriminating ability of the statistical procedure compared with the chi-square ratio test alone. In certain situations the chi-square ratio test alone was sufficient to determine equivalence of APSD profiles, while in other situations neither of the tests alone nor their combination was adequate. This report describes all of these scenarios and results. In the end, the group did not recommend a statistical test for APSD profile equivalence. The group did not investigate other in vitro tests, in vivo issues, or other statistical tests for APSD profile comparisons. The studied tests are not intended for routine quality control of APSD.

The purpose of this article is 2-fold: (1) to document in the public domain the considerations that led to the development of a regulatory statistical test for comparison of aerodynamic particle size distribution (APSD) of aerosolized drug formulations, which was proposed in a US Food and Drug Administration (FDA) draft guidance for industry; and (2) to explain the background and process for evaluation of that test through a working group involving scientists from the FDA, industry, academia, and the US Pharmacopeia, under the umbrella of the Product Quality Research Institute (PQRI). The article and the referenced additional statistical information posted on the PQRI Web site explain the reasoning and methods used in the development of the APSD test, which is one of the key tests required for demonstrating in vitro equivalence of orally inhaled and nasal aerosol drug products. The article also describes the process by which stakeholders with different perspectives have worked collaboratively to evaluate properties of the test by drawing on statistical models, historical and practical information, and scientific reasoning. Overall, this article provides background information to accompany the companion article's discussion of the study's methods and results.

The purpose of this article is to present the thought process, methods, and interim results of a PQRI Working Group, which was charged with evaluating the chi-square ratio test as a potential method for determining in vitro equivalence of aerodynamic particle size distribution (APSD) profiles obtained from cascade impactor measurements. Because this test was designed with the intention of being used as a tool in regulatory review of drug applications, the capability of the test to detect differences in APSD profiles correctly and consistently was evaluated in a systematic way across a designed space of possible profiles. To establish a "base line," properties of the test in the simplest case of pairs of identical profiles were studied. Next, the test's performance was studied with pairs of profiles, where some difference was simulated in a systematic way on a single deposition site using realistic product profiles. The results obtained in these studies, which are presented in detail here, suggest that the chi-square ratio test in itself is not sufficient to determine equivalence of particle size distributions. This article, therefore, introduces the proposal to combine the chi-square ratio test with a test for impactor-sized mass based on Population Bioequivalence and describes methods for evaluating discrimination capabilities of the combined test. The approaches and results described in this article elucidate some of the capabilities and limitations of the original chi-square ratio test and provide rationale for development of additional tests capable of comparing APSD profiles of pharmaceutical aerosols.

A collection of 20 strains of Helicobacter pylori from several regions of the world was studied to better understand the population genetic structure and diversity of this species. Sequences of fragments from seven housekeeping genes (atpA, efp, mutY, ppa, trpC, ureI, yphC ) and two virulence-associated genes (cagA, vacA) showed high levels of synonymous sequence variation (mean percentage Ks of 10-27%) and lower levels of non-synonymous variation (mean percentage Ka of 0.2-5.6%). Cluster analysis of pairwise differences between alleles revealed the existence of two weakly clonal groupings, which included half of the strains investigated. All six strains isolated from Japanese and coastal Chinese were assigned to the 'Asian' clonal grouping, probably reflecting descent from a distinct common ancestor. The clonal groupings were not totally uniform; recombination, as measured by the homoplasy test and compatibility matrices, was extremely common within all genes tested, except cagA. The fact that clonal descent could still be discerned despite such frequent recombination possibly reflects founder effects and geographical separation and/or selection for particular alleles of these genes.