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While musculoskeletal pain (MSP) stands as the most prevalent health condition among Veterans, timely and high-quality care is often hindered due to access barriers. Team Red, White & Blue (Team RWB), a nonprofit organization dedicated to promoting a healthier lifestyle among Veterans, aimed to assess innovative approaches to veteran care. This is a single-arm pilot study investigating the feasibility, clinical outcomes, engagement, and satisfaction of a remote multimodal digital care program among Veterans with MSP. The impact of deployment experience on outcomes was explored as a secondary aim. From 75 eligible Veterans, 61 started the program, reporting baseline pain frequently comorbid with mental distress. Program acceptance was suggested by the high completion rate (82%) and engagement levels, alongside high satisfaction (9.5/10, SD 1.0). Significant improvements were reported in all clinical outcomes: pain (1.98 points, 95%CI 0.13; 3.84, p = 0.036); mental distress, with those reporting at least moderate baseline depression ending the program with mild symptoms (8.50 points, 95%CI: 6.49; 10.51, p = 0.012); daily activity impairment (13.33 points, 95%CI 1.31; 25.34, p = 0.030). Deployed Veterans recovered similarly to their counterparts. Overall, the above results underscore the potential of a remote digital intervention to expand Veterans' access to timely MSP care. [ABSTRACT FROM AUTHOR]

Background: Outcomes for patients with peripheral T-cell lymphoma (PTCL) who fail to achieve complete response (CR) or relapse after front-line therapy are poor with lack of prospective outcomes data. Objectives: COMPLETE is a prospective registry of 499 patients enrolled at academic and community sites in the United States detailing patient demographics, treatment and outcomes for patients with aggressive T cell lymphomas. We report results for patients with primary refractory and relapsed disease. Methods: Primary refractory disease was defined as an evaluable best response to initial treatment (induction ± maintenance or consolidation/transplant) other than CR, and included a partial response, progressive disease, or no response/stable disease. Relapsed disease was defined as an evaluable best response to initial treatment of CR, followed by disease progression at a later date, irrespective of time to progression. Patients were included in the analysis if initial treatment began within 30 days of enrollment and treatment duration was ≥4 days. Results: Of 420 evaluable patients, 97 met the definition for primary refractory and 58 with relapsed disease. In the second-line setting, relapsed patients received single-agent therapies more often than refractory patients (52 vs. 28%; p = 0.01) and were more likely to receive single-agent regimens (74 vs. 53%; p = 0.03). The objective response rate to second-line therapy was higher in relapsed patients (61 vs. 40%; p = 0.04) as was the proportion achieving a CR (41 vs. 14%; p = 0.002). Further, relapsed patients had longer overall survival (OS) compared to refractory patients, with a median OS of 29.1 versus 12.3 months. Conclusions: Despite the availability of newer active single agents, refractory patients were less likely to receive these therapies and continue to have inferior outcomes compared to those with relapsed disease. PTCL in the real world remains an unmet medical need, and improvements in front-line therapies are needed. [ABSTRACT FROM AUTHOR]

Summary: Using VAR models for the USA, we find that a contractionary monetary policy shock has a persistent negative impact on the level of commercial bank assets, but increases the assets of shadow banks and securitization activity. To explain this “waterbed” effect, we propose a standard New Keynesian model featuring both commercial and shadow banks, and we show that the model comes close to explaining the empirical results. Our findings cast doubt on the idea that monetary policy can usefully “get in all the cracks” of the financial sector in a uniform way. [ABSTRACT FROM AUTHOR]

We find that capital renting makes up one-fifth of U.S. capital expenditures, and it increases during downturns. Further, we present cross-country evidence that output losses after financial crises are smaller where renting is more prevalent. To understand these findings, we build a general equilibrium model with borrowing constraints and with the option to rent or buy capital. The countercyclicality of rentals occurs because their supply increases, as renting serves as an additional means of savings when credit markets malfunction. Moreover, demand also shifts toward rentals as they become relatively cheaper. By absorbing excess savings, renting mitigates financial crises. [ABSTRACT FROM AUTHOR]

We present a reconceptualized framework for opportunity to learn (OTL) in school mathematics that builds on previous conceptualizations of OTL and includes features related to both quantity (i.e., time) and quality. Our framework draws on existing literature and on our own observational research of mathematics teaching practices. Through the presentation of two teaching vignettes, we highlight key features of mathematics instruction that seem to differentiate students' OTL. These features are nested under four key dimensions in our OTL framework: the teacher's mathematical knowledge for teaching (MKT), how time is utilized in the lesson, the mathematical tasks implemented with students, and the nature of the mathematical talk in which students engage. We discuss implications for the use of the framework as well as its shortcomings. [ABSTRACT FROM AUTHOR]

There is no doubt that the US is embedded in a weak economy. Bond markets are now saying that neither inflation rates approaching 2 percent targets or real interest rates substantially above zero are on the horizon anytime in the foreseeable future. Growth forecasts are being revised downwards in most places, and there is growing evidence in the US that inflation expectations are becoming unanchored to the downside. That, along with widening credit spreads and a stronger dollar as Europe and Japan plunge more deeply into the world of negative rates is alarming and suggests that we are at risk of another recession. Presidential candidates on both sides of the aisle have laid out their positions on major issues ranging from taxes, minimum wage, the federal debt, to issues such as immigration, military strategy, and climate change. While candidates' policy positions differ generally, it is not clear what their priorities are when it comes to most of these issues. In this paper, we apply text analytics to analyze hundreds of thousands of words that appeared in policy releases, interviews, or debate transcripts related to all of the 2016 presidential candidates. Among other things, we find that macroeconomic policy or 'what to do about recessions' has been largely ignored by presidential candidates in this year's election. Perhaps not surprisingly, Donald Trump's positions are focused on Mexico and China while Hillary Clinton's positions are heavily focused on gender and social factors. This appears to present a contrast from Bill Clinton's campaign in the early 1990s, which was focused on America's declining economy, emphasizing a basic but effective slogan, 'It's the Economy, Stupid!' [ABSTRACT FROM AUTHOR]

In the ever-more connected and intertwined world, driven by specialization, economies of scale, and outsourcing, results are obtained through extensive communication and collaboration in international environment. We are witnessing successful complex business endeavors that rely on unobstructed and creative exchange of information and synergy of skills and resources. These processes are accomplished in international environment to a greater extent than ever. This calls for a deeper understanding of intercultural processes and communication for the purpose of achieving business results. This article aims to provide the guidance in negotiating with American partners, based on a number of structured interviews. Attempt was made to link major intercultural theories with practical experience of Austrian companies and individuals working with their United States (US) partners, as well as with self-assessment of a number of American business people. According to the best of our knowledge, there is a shortage of articles that deal with specific features of negotiating with American partners. [ABSTRACT FROM AUTHOR]

There is growing concern in the United States over the 'residual' flood risk behind leveed floodplains, which is commonly assessed based on one-dimensional ( 1D) river flow models. These models fail to capture the complex flow dynamics that typically characterise floodplain inundation. Here, we demonstrate methodologies for mechanistically simulating a levee breach and flow into a levee district along the Middle Mississippi River using a hybrid 1D/two-dimensional ( 1D2D) flow model that combines a 1D model of the river channel with a two-dimensional ( 2D) overland-flow model for the leveed floodplain. This 2D modelling documents the complexity of flow over a large and topographically diverse leveed floodplain, including distribution and timing of inundation as well as the resulting public-safety threats. In relation to safety threats, three distinct flood phases can be recognised: (1) a flash flood phase, (2) a flow redistribution phase and (3) an equilibrium phase. The flash flood phase presents imminent threats to human life and safety, whereas subsequent phases determine inundation areas and depths, and therefore infrastructure damages. 2D modelling of levee-breach flooding provides input data necessary for: (1) specific local evacuation and mitigation planning in the Metro East area, and (2) methodologies for analyses of residual risk facing other levee-protected floodplain areas. [ABSTRACT FROM AUTHOR]

This study modelled flood losses (economic damages) along the Middle Mississippi River (MMR) (1) using current US government estimates of flow frequencies and (2) using frequencies based on the original, unaltered discharge measurements. The official flood frequencies were quantified in the Upper Mississippi River System Flow Frequency Study (UMRSFFS), but as a last step in that study, early discharges along the MMR were reduced by up to 54% to reflect a purported bias in early measurements. Subsequently, early discharge measurements were rigorously tested, and no such bias was found. Here, flood damages were quantified using a combination of one-dimensional hydraulic modelling and flood-loss modelling. For all recurrence intervals, damages were much less using the UMRSFFS flow frequencies compared with the frequencies based on the original discharge measurements, with differences ranging up to 79% (100-year event) and $2.9bn (200-year event). Annualized losses in the study area based on the UMRSFFS frequencies were just $41.6m versus $125.6m using the raw frequencies (an underestimation of 67%). These totals do not include flood losses elsewhere along the MMR, including in metropolitan St Louis. In summary, a seemingly small methodological adjustment - in this case, a single hidden adjustment, not documented anywhere within the UMRSFFS - can have dramatic societal impacts in terms of underestimation of flood probabilities and flood risk. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Summary: One-dimensional hydraulic modeling and flood-loss modeling were used to test the effectiveness of levee setbacks for flood-loss reduction along the Middle Mississippi River (MMR). Four levee scenarios were assessed: (1) the present-day levee configuration, (2) a 1000m levee setback, (3) a 1500m levee setback, and (4) an optimized setback configuration. Flood losses were estimated using FEMA’s Hazus-MH (Hazards US Multi-Hazard) loss-estimation software on a structure-by-structure basis for a range of floods from the 2- to the 500-year events. These flood-loss estimates were combined with a levee-reliability model to calculate probability-weighted damage estimates. In the simplest case, the levee setback scenarios tested here reduced flood losses compared to current conditions for large, infrequent flooding events but increased flood losses for smaller, more frequent flood events. These increases occurred because levee protection was removed for some of the existing structures. When combined with buyouts of unprotected structures, levee setbacks reduced flood losses for all recurrence intervals. The “optimized” levee setback scenario, involving a levee configuration manually planned to protect existing high-value infrastructure, reduced damages with or without buyouts. This research shows that levee setbacks in combination with buyouts are an economically viable approach for flood-risk reduction along the study reach and likely elsewhere where levees are widely employed for flood control. Designing a levee setback around existing high-value infrastructure can maximize the benefit of the setback while simultaneously minimizing the costs. The optimized levee setback scenario analyzed here produced payback periods (costs divided by benefits) of less than 12years. With many aging levees failing current inspections across the US, and flood losses spiraling up over time, levee setbacks are a viable solution for reducing flood exposure and flood levels. [Copyright &y& Elsevier]

Analyzes the decision of the U.S. Supreme Court in the case Cholla Ready Mix Inc. versus Civish. Application of the Religion Clauses of the First Amendment in analyzing the case; Details of the case; Jurisprudence of the Supreme Court on the Religion Clauses.

This review addresses the challenges and progress in sensor development and radiometric correction for agricultural applications with particular emphasis on activities within the U.S. Department of Agriculture (USDA) Agricultural Research Service (ARS). Examples of sensor development include on-site development of sensors and platforms, participation in cooperative research and development agreements (CRADA) with commercial companies, and membership on NASA science teams. Examples of progress made in sensor radiometric correction suitable for agriculture are presented for both laboratory and field environments. The direction of future sensor development includes integrated sensors and systems, sensor standardization, and new sensor technologies measuring fluorescence and soil electrical conductivity, and utilizing Light Detection and Ranging (lidar), hyperspectral, and multiband thermal wavelengths. The upcoming challenges include definition of the core spectral regions for agriculture and the sensor specifications for a dedicated, orbiting agricultural sensor, determination of an operational approach for reflectance and temperature retrieval, and enhanced communication between image providers, research scientists, and users. This review concludes with a number of avenues through which USDA could promote sensor development and radiometric correction for agricultural applications. These include developing a network of large permanent calibration targets at USDA ARS locations; investing in new technologies; pooling resources to support large-scale field experiments; determining ARS-wide standards for sensor development, calibration, and deployment; and funding interagency agreements to achieve common goals. [ABSTRACT FROM AUTHOR]

In the Northern Channel Islands of California, preservation of paleoshoreline features both as uplifted landforms onshore and subsided depositional features offshore has allowed precise measurement of late Quaternary fold growth relative to sea level and has helped to disentangle the relative contributions of tectonic forcing and isostatic response. We precisely measured several hundred points on uplifted Pleistocene coastal terraces of Santa Cruz and Anacapa islands, the elevations of which document anticlinal growth of the islands since at least 400 ka. We also interpreted a dense grid of seismic-reflection profiles that image a complex of eustatic lowstand deltas that record regional subsidence surrounding the uplifting structure. We combined onshore uplift with offshore subsidence measurements to produce a quantitative mass balance of structural growth since 400 ka. The data outlined above were then used to test the hypothesis that subsidence around the Northern Channel Islands represents the flexural isostatic response to tectonic loading of the islands. Calculations of cumulative uplifted mass and cumulative subsided mass across the structure closely match the values predicted for density-driven isostatic compensation and local flexural support, although the wavelength of flexure predicted for the study area suggests that an additional component of flexural support may extend distally 10s of kilometers into the surrounding offshore basins. In the Northern Channel Islands, isostatic subsidence is explicitly manifested because erosional mass removal is small, because the crust here is relatively thin and weak, and most importantly because sea level provides an absolute datum against which to measure vertical deformation. An explicit treatment of the interplay between crustal thickening, erosional denudation, surface uplift, and isostatic response helps to illustrate the conditions under which isostatic subsidence may or may not be a significant process. Where surface denudation rates approach the rate of rock uplift, for example, isostatic subsidence will approach zero. In contrast, failure to recognize isostatic subsidence in earthquake-hazard studies can lead to order-of-magnitude errors in slip-rate and hazard estimates. [ABSTRACT FROM AUTHOR]

Summary • The simulation model DEMETER was used here to investigate which mechanisms led to a larger CO2 effect on biomass production and yield of a spring wheat crop under drought compared with unlimited water supply. • Field data of the free-air CO2 enrichment (FACE) wheat experiments in Arizona (1993–94) were used to test the model. The influence of a particular mechanism leading to a higher CO2 effect under drought was investigated by eliminating the influence of the other causes on the simulation results on selected days during the growing seasons. • A larger CO2 effect under drought was caused in the model by the lower potential transpiration rate, higher root biomass and the nonlinear functional dependence of net assimilation rate on leaf internal CO2 concentration. The contribution of the different mechanisms changed in significance during the growing season depending on the degree of soil water limitation. The model successfully described the qualitative and quantitative behaviour of the crop under elevated CO2 . • A well-tested simulation model can be a useful tool in understanding the complex interactions underlying observed ecosystem responses to stress under elevated CO2 . [ABSTRACT FROM AUTHOR]

Presents a study which developed and tested a multifaceted curriculum for use in introductory earth science classes from the secondary-school to the introductory undergraduate level in Illinois. Project-based curriculum; Greenhouse demonstration; Conclusions.

Summary • The likely consequences of future high levels of atmospheric CO2 concentration on wheat (Triticum aestivum L.) grain nutritional and baking quality were determined. • Two free-air CO2 enrichment (FACE; 550 mmol mol-1 ) experiments were conducted at ample (Wet) and limiting (Dry) levels of irrigation, and a further two experiments at ample (High-N) and limiting (Low-N) nitrogen concentrations. Harvested grain samples were subjected to a battery of nutritional and bread-making quality tests. • The Dry treatment improved grain quality slightly (protein +2%; bread loaf volume +3%). By contrast, Low-N decreased quality drastically (protein -36%; loaf volume -26%). At ample water and N, FACE decreased quality slightly (protein -5%; loaf volume -2%) in the irrigation experiments and there was no change in the nitrogen experiments. At Low-N, FACE tended to make the deleterious effects of Low-N worse (protein -33% and -39%, at ambient CO2 and FACE, respectively; loaf volume -22% and -29% at ambient CO2 and FACE, respectively). • The data suggest that future elevated CO2 concentrations will exacerbate the deleterious effects of low soil nitrogen on grain quality, but with ample nitrogen fertilizer, the effects will be minor. [ABSTRACT FROM AUTHOR]

Summary • Sorghum bicolor was exposed to free-air CO2 enrichment (FACE) and drought at the Maricopa Agricultural Center, AZ, USA, in summer 1998. We predicted that bundle sheath leakiness (Φ) would be insensitive to FACE under well-irrigated (wet) conditions, but would be lower in FACE compared with control-CO2 treatments when irrigation was withheld (dry). • Leaf and air δ13 C values and leaf p i /p a from gas exchange were measured to estimate carbon isotope discrimination (Δ) and F. Midday leaf water potential (Ψ) and photosynthetic rate were simultaneously measured to evaluate the influence of plant water status on Φ and the association between Φ and carbon gain. • Irrigation treatments affected Ψ, p i /p a , Δ and Φ in control CO2 and FACE rings. Differences in leaf Δ between wet- and dry-treatment plots resulted from changes in Φ and to stomatal influences on p i /p a . FACE had very little effect on Ψ, Δ and Φ in wet-treatment plots. However, Φ and Δ in dry plots were higher in control than in FACE rings. • FACE ameliorated the effects of drought on bundle sheath leakiness and Δ by reducing transpiration, prolonging soil water availability and enhancing plant water status. Direct effects of CO2 enrichment on C4 photosynthetic metabolism in Sorghum apparently are minimal and indirect effects depend on soil water supply. [ABSTRACT FROM AUTHOR]

Looks at investigations of the Santa Cruz Island fault, in California, with reference to indications made by offset of terraces and other landforms. Information on the Santa Cruz Island fault; Similarities between the Santa Cruz Island fault, the Malibu Coast fault, the Santa Monica fault, the Hollywood fault and the Raymond fault; Comments about the left-lateral surface faults along the southern margin of the western Transverse Ranges.

Reports the results of a telephone-assisted foreign language study at the Ohio State University in Ohio. Key components of the system; Impact on instructors and students; Theoretical significance to the study and teaching of languages.

Describes the characteristics, pattern of deformation, rate of extension and total seismic energy on the Volcanic Tableland in the Owens Valley, California. Geological setting; Surface faulting parameter analysis; Accommodation zones.

Interagency programs have made it possible for scientists from the USDA, Agricultural Research Service (ARS) to conduct remote sensing research with researchers from various federal, state, and private organizations since 1965. Cumulative results from these cooperative studies have established the scientific basis for using remotely acquired imagery to better understand and manage the Earth's agricultural and natural resources. Examples of these partnerships include the 1965 Statement of Agreement between USDA and NASA that formally began ARS's remote sensing research, the Large Area Crop Inventory Experiment (LACIE, 1974), the ARS Wheat Yield Project (1976), Agriculture and Resources Inventory Surveys Through Aerospace Remote Sensing (AgRISTARS, 1980), the China Wheat Project (1983), and AG 20/20 (1999). This paper provides a brief overview of these collaborations. [ABSTRACT FROM AUTHOR]

Presents information on the upgrade made by the United States Environmental Protection Agency (EPA) at a municipal water treatment plant in Northwest Texas. Approximate number of customers served by the water supplier; Remarks of the EPA about trihalomethane; Key goal for the upgrade.

The article offers information on the nonprofit organization YouCubed in the U.S. It mentions its aim in ameliorating mathematical instruction and provision of professional development to educators. It also notes its leader Jo Boaler who is also a Mathematics Education professor at Stanford University as well as the Common Core State Standards in Mathematics (CCSM).

This article discusses the U.S. flood-control policy. The great Midwestern flood of 1993 broke flow records along 1600 km of the Mississippi and Missouri rivers and caused up to $16 billion in damages. Formal reviews of U.S. flood-control policy, both before and after the 1993 flood, concluded that the optimum strategy for reducing flood losses is to limit or even reduce infrastructure on floodplains. It has been asserted that flood-control structures prevented $19 billion in damages during the 1993 flood; however, most infrastructure on the floodplain would not be there were it not for the historic reliance on levees.

Background: Cutaneous T-cell lymphomas are rare non-Hodgkin lymphomas with substantial morbidity and mortality in advanced disease stages. We compared the efficacy of mogamulizumab, a novel monoclonal antibody directed against C-C chemokine receptor 4, with vorinostat in patients with previously treated cutaneous T-cell lymphoma.Methods: In this open-label, international, phase 3, randomised controlled trial, we recruited patients with relapsed or refractory mycosis fungoides or Sézary syndrome at 61 medical centres in the USA, Denmark, France, Italy, Germany, the Netherlands, Spain, Switzerland, the UK, Japan, and Australia. Eligible patients were aged at least 18 years (in Japan, ≥20 years), had failed (for progression or toxicity as assessed by the principal investigator) at least one previous systemic therapy, and had an Eastern Cooperative Oncology Group performance score of 1 or less and adequate haematological, hepatic, and renal function. Patients were randomly assigned (1:1) using an interactive voice web response system to mogamulizumab (1·0 mg/kg intravenously on a weekly basis for the first 28-day cycle, then on days 1 and 15 of subsequent cycles) or vorinostat (400 mg daily). Stratification was by cutaneous T-cell lymphoma subtype (mycosis fungoides vs Sézary syndrome) and disease stage (IB-II vs III-IV). Since this study was open label, patients and investigators were not masked to treatment assignment. The primary endpoint was progression-free survival by investigator assessment in the intention-to-treat population. Patients who received one or more doses of study drug were included in the safety analyses. This study is ongoing, and enrolment is complete. This trial was registered with ClinicalTrials.gov, number NCT01728805.Findings: Between Dec 12, 2012, and Jan 29, 2016, 372 eligible patients were randomly assigned to receive mogamulizumab (n=186) or vorinostat (n=186), comprising the intention-to-treat population. Two patients randomly assigned to mogamulizumab withdrew consent before receiving study treatment; thus, 370 patients were included in the safety population. Mogamulizumab therapy resulted in superior investigator-assessed progression-free survival compared with vorinostat therapy (median 7·7 months [95% CI 5·7-10·3] in the mogamulizumab group vs 3·1 months [2·9-4·1] in the vorinostat group; hazard ratio 0·53, 95% CI 0·41-0·69; stratified log-rank p<0·0001). Grade 3-4 adverse events of any cause were reported in 75 (41%) of 184 patients in the mogamulizumab group and 76 (41%) of 186 patients in the vorinostat group. The most common serious adverse events of any cause were pyrexia in eight (4%) patients and cellulitis in five (3%) patients in the mogamulizumab group; and cellulitis in six (3%) patients, pulmonary embolism in six (3%) patients, and sepsis in five (3%) patients in the vorinostat group. Two (67%) of three on-treatment deaths with mogamulizumab (due to sepsis and polymyositis) and three (33%) of nine on-treatment deaths with vorinostat (two due to pulmonary embolism and one due to bronchopneumonia) were considered treatment-related.Interpretation: Mogamulizumab significantly prolonged progression-free survival compared with vorinostat, and could provide a new, effective treatment for patients with mycosis fungoides and, importantly, for Sézary syndrome, a subtype that represents a major therapeutic challenge in cutaneous T-cell lymphoma.Funding: Kyowa Kirin. [ABSTRACT FROM AUTHOR]

Microaggressions are brief and commonplace daily verbal behavioral or environmental indignities (whether intentional or unintentional) that communicate hostility, insensitivity and negativity to an individual or group. Microaggressions communicate beliefs about who is expected to participate in and succeed infields of study. Microaggressions can play a significant role in how Blackfaculty perceive and experience participation, engagement, retention and advancement. The authors adopt a broad definition of computing to include information systems, information sciences, and computer science. The Computer Research Association (CRA) Taulbee Survey, fo r instance, indicates that Black faculty represent 1.3 percent of computing sciences faculty at PhD-gr anting departments, and only 0.6 percent are full professors. Because Black faculty are woefully underrepresented in the field, issues of career fit and progression, institutional fit, social and professional isolation, mentoring and career support are paramount. Understanding microaggressive experiences and coping strategies will advance knowledge and facilitate the development of theoretically-informed interventions for building the resilience of Black faculty and cultivating supportive institutional environments that encourage their retention and career advancement. The authors employ "big data" text-mining analytic methods to uncover and explore themes related to microaggressions experienced by Black faculty as discussed in scholarly and academic publications. The results uncovered five topics (jobs and race, gender and race, family, tenure, and dialogue) and three major themes (media coverage, post-aggression, and prevalence). The authors conclude with policy and research implications of these results. [ABSTRACT FROM AUTHOR]

IMbrave150 has established the superiority of atezolizumab plus bevacizumab over sorafenib in patients with unresectable hepatocellular carcinoma (HCC). We generated a prospectively maintained database including patients treated with atezolizumab plus bevacizumab for unresectable HCC across Europe, Asia and USA. Clinico-pathologic characteristics were assessed for their prognostic influence on overall survival (OS) and progression-free survival (PFS) in univariable and multivariate analyses. Overall response rate by RECIST v1.1 and treatment-related adverse events (TRAEs) per CTCAE v.5.0 were reported. Out of 433 patients, 296 Child-Pugh A and ECOG performance status01 patients received atezolizumab plus bevacizumab in first line and were included. Patients were mostly male (82.7%), cirrhotic (75%) with history of viral hepatitis (65.9%). Overall, 68.9% had Barcelona Clinic Liver Cancer C-stage HCC with portal vein tumour thrombosis (PVTT, 35%) and extrahepatic spread (EHS, 51.7%). After a median follow-up of 10.0 months (95% confidence interval (CI): 9.4–10.4), median OS and PFS were 15.7 (95% CI: 14.5-NE) and 6.9 months (95% CI: 6.1–8.3), respectively. In the response-evaluable patients (n = 273), overall response rate was 30.8%. Overall, 221 patients (74.6%) developed TRAEs, with 70 (23.6%) reporting grade 3 or higher TRAEs; 25 (8.4%) patients had bleeding events. OS was independently associated with baseline Albumin-bilirubin (ALBI) grade and PVTT. Shorter PFS was associated with AFP≥ 400 ng/ml, worse ALBI and presence of EHS. This global observational study confirms the reproducible safety and efficacy of atezolizumab plus bevacizumab in routine clinical practice. Within Child-Pugh-A criteria, the presence of PVTT and higher ALBI grade identify patients with poorer survival. • Atezolizumab plus bevacizumab (A + B) is the standard of care for patients with unresectable hepatocellular carcinoma. • We report data from a large cohort of patients treated with A + B in real-life. • Effectiveness and safety of the combination is reproducible in daily practice. • Liver function and macro-vascular invasion is with overall survival. • Radiological response predicts better outcomes. [ABSTRACT FROM AUTHOR]

Importance: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in the United States are still emerging., Objective: To elucidate SARS-CoV-2 seroprevalence and symptom onset in a culturally linked community across 5 states in the United States., Design, Setting, and Participants: This cross-sectional study included adults (aged ≥18 years) recruited from the orthodox Jewish community across 5 states (California, Connecticut, Michigan, New Jersey, and New York) in 3 geographically distinct areas of the United States between May 13 and July 6, 2020. Participants completed an online survey and underwent SARS-CoV-2 antibody testing., Main Outcomes and Measures: Seroprevalence and date of symptom onset of SARS-CoV-2., Results: Overall, 9507 adults (mean [SD] age, 39.6 [15.0] years; 3777 [39.7%] women) completed the SARS-CoV-2 survey, of whom 6665 (70.1%) had immunoglobin G anti-SARS-CoV-2 antibody levels assessed. A high seroprevalence of SARS-CoV-2 antibodies was observed across all communities, with the highest proportion of positive testing observed in New Jersey (1080 of 3323 [32.5%]) and New York (671 of 2196 [30.6%]). Most individuals with a positive SARS-CoV-2 immunoglobin G antibody test reported a date of symptom-onset between March 9 and March 31, 2020 (California: 135 of 154 [87.7%]; Connecticut: 32 of 34 [94.1%]; Michigan: 44 of 50 [88.0%]; New Jersey: 964 of 1168 [82.5%]; New York: 571 of 677 [84.3%]). This start date was coincident with the Jewish festival of Purim, celebrated March 9 to 10, 2020, with extensive intracommunity spread in the weeks following (mean and mode of peak symptom onset, March 20, 2020), occurring in the absence of strong general and culture-specific public health directives., Conclusions and Relevance: This cross-sectional study of orthodox Jewish adults across the US found that socioculturally bound communities experienced early parallel outbreaks in discrete locations, notably prior to substantive medical and governmental directives. Further research should clarify optimal national, local, community-based, and government policies to prevent outbreaks in social and cultural communities that traditionally gather for holidays, assemblies, and festivals.

An accurate urine test for diverse populations with active tuberculosis could be transformative for preventing TB deaths. Urinary liporabinomannan (LAM) testing has been previously restricted to HIV co-infected TB patients. In this study we evaluate urinary LAM in HIV negative, pediatric and adult, pulmonary and extrapulmonary tuberculosis patients. We measured 430 microbiologically confirmed pretreatment tuberculosis patients and controls from Peru, Guinea Bissau, Venezuela, Uganda and the United States using three monoclonal antibodies, MoAb1, CS35, and A194, which recognize distinct LAM epitopes, a one-sided immunoassay, and blinded cohorts. We evaluated sources of assay variability and comorbidities (HIV and diabetes). All antibodies successfully discriminated TB positive from TB negative patients. ROAUC from the average of three antibodies' responses was 0.90; 95% CI 0.87-0.93, 90% sensitivity, 73.5% specificity (80 pg/mL). MoAb1, recognizing the 5-methylthio-D-xylofuranose(MTX)-mannose(Man) cap epitope, performed the best, was less influenced by glycosuria and identified culture positive pediatric (N = 19) and extrapulmonary (N = 24) patients with high accuracy (ROAUC 0.87, 95% CI 0.77-0.98, 0.90 sensitivity 0.80 specificity at 80 pg/mL; ROAUC = 0.96, 95% CI 0.92-0.99, 96% sensitivity, 80% specificity at 82 pg/mL, respectively). The MoAb1 antibody, recognizing the MTX-Man cap epitope, is a novel analyte for active TB detection in pediatric and extrapulmonary disease.