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COVID-19 has resulted in significant disruptions in cancer care. The Illinois Cancer Collaborative (ILCC), a statewide multidisciplinary cancer collaborative, has developed expert recommendations for triage and management of colorectal cancer when disruptions occur in usual care. Such recommendations would be applicable to future outbreaks of COVID-19 or other large-scale disruptions in cancer care.

From 1979 to 2022, the summer monsoon precipitation has increased by a substantial 40% over Northwest India compared to the 1980s. This wetting trend aligns with the future projections of the Coupled Model Intercomparison Project 6 (CMIP6). The observationally constrained reanalysis data indicates that significant sea surface warming in the western equatorial Indian Ocean and the Arabian Sea is likely driving this increase in rainfall by enhancing the cross‐equatorial monsoonal flow and associated evaporation. We demonstrate that the strengthening of the cross‐equatorial monsoon winds is due to the rapid warming of the Indian Ocean and the enhanced Pacific Ocean trade winds, which result from the poleward shift and expansion of the Hadley cell. These strengthened winds boost the latent heat flux (evaporation), leading to increased moisture transport to Northwest India. Plain Language Summary: From 1979 to 2022, the summer monsoon precipitation has increased by a substantial 40% over Northwest India compared to the 1980s. The analysis suggests that a noticeable warming of the sea surface in the western equatorial Indian Ocean and the Arabian Sea could be causing this increase in rainfall. This warming strengthens the winds crossing the equator in the Indian Ocean and increases evaporation. The study also shows that the monsoon winds are strengthened due to the rapid warming of the Indian Ocean and the enhanced Pacific Ocean trade winds. These stronger winds cause more evaporation, which means more moisture is carried from the ocean to the land, leading to increased monsoon rainfall. Key Points: Large increase in summer monsoon precipitation over Northwest IndiaThe strengthening of the monsoon winds and the Indian Ocean warming drives increasing evaporationPoleward shift and expansion of high‐pressure belts and the Indian Ocean warming are responsible for the strengthening of winds [ABSTRACT FROM AUTHOR]

The year 2021 marked a decade of holopelagic sargassum (morphotypes Sargassum natans I and VIII, and Sargassum fluitans III) stranding on the Caribbean and West African coasts. Beaching of millions of tons of sargassum negatively impacts coastal ecosystems, economies, and human health. Additionally, the La Soufrière volcano erupted in St. Vincent in April 2021, at the start of the sargassum season. We investigated potential monthly variations in morphotype abundance and biomass composition of sargassum harvested in Jamaica and assessed the influence of processing methods (shade-drying vs. frozen samples) and of volcanic ash exposure on biochemical and elemental components. S. fluitans III was the most abundant morphotype across the year. Limited monthly variations were observed for key brown algal components (phlorotannins, fucoxanthin, and alginate). Shade-drying did not significantly alter the contents of proteins but affected levels of phlorotannins, fucoxanthin, mannitol, and alginate. Simulation of sargassum and volcanic ash drift combined with age statistics suggested that sargassum potentially shared the surface layer with ash for ~50 d, approximately 100 d before stranding in Jamaica. Integrated elemental analysis of volcanic ash, ambient seawater, and sargassum biomass showed that algae harvested from August had accumulated P, Al, Fe, Mn, Zn, and Ni, probably from the ash, and contained less As. This ash fingerprint confirmed the geographical origin and drift timescale of sargassum. Since environmental conditions and processing methods influence biomass composition, efforts should continue to improve understanding, forecasting, monitoring, and valorizing sargassum, particularly as strandings of sargassum show no sign of abating. [ABSTRACT FROM AUTHOR]

ImportanceAlthough consensus statements support the preoperative treatment of borderline resectable pancreatic cancer, no prospective, quality-controlled, multicenter studies of this strategy have been conducted. Existing studies are retrospective and confounded by heterogeneity in patients studied, therapeutic algorithms used, and outcomes reported.ObjectiveTo determine the feasibility of conducting studies of multimodality therapy for borderline resectable pancreatic cancer in the cooperative group setting.Design, setting, and participantsA prospective, multicenter, single-arm trial of a multimodality treatment regimen administered within a study framework using centralized quality control with the cooperation of 14 member institutions of the National Clinical Trials Network. Twenty-nine patients with biopsy-confirmed pancreatic cancer preregistered, and 23 patients with tumors who met centrally reviewed radiographic criteria registered. Twenty-two patients initiated therapy (median age, 64 years [range, 50-76 years]; 55% female). Patients registered between May 29, 2013, and February 7, 2014.InterventionsPatients received modified FOLFIRINOX treatment (85 mg/m2 of oxaliplatin, 180 mg/m2 of irinotecan hydrochloride, 400 mg/m2 of leucovorin calcium, and then 2400 mg/m2 of 5-fluorouracil for 4 cycles) followed by 5.5 weeks of external-beam radiation (50.4 Gy delivered in 28 daily fractions) with capecitabine (825 mg/m2 orally twice daily) prior to pancreatectomy.Main outcomes and measuresFeasibility, defined by the accrual rate, the safety of the preoperative regimen, and the pancreatectomy rate.ResultsThe accrual rate of 2.6 patients per month was superior to the anticipated rate. Although 14 of the 22 patients (64% [95% CI, 41%-83%]) had grade 3 or higher adverse events, 15 of the 22 patients (68% [95% CI, 49%-88%]) underwent pancreatectomy. Of these 15 patients, 12 (80%) required vascular resection, 14 (93%) had microscopically negative margins, 5 (33%) had specimens that had less than 5% residual cancer cells, and 2 (13%) had specimens that had pathologic complete responses. The median overall survival of all patients was 21.7 months (95% CI, 15.7 to not reached) from registration.Conclusions and relevanceThe successful completion of this collaborative study demonstrates the feasibility of conducting quality-controlled trials for this disease stage in the multi-institutional setting. The data generated by this study and the logistical elements that facilitated the trial's completion are currently being used to develop cooperative group trials with the goal of improving outcomes for this subset of patients.Trial registrationclinicaltrials.gov Identifier: NCT01821612.

The East Asian summer monsoon rainfall provides water security and socio‐economic benefit for over 20% of the global population. However, the sources of this rainfall and how it is carried to the East Asian landmass are still uncertain. To address this, atmospheric water sources and pathways associated with the East Asian summer rainfall are identified and quantified in this study using atmospheric water trajectories, calculated with a novel Lagrangian framework. Evaporated water from the East Asian landmass is found to be the major contributor to East Asian rainfall, amounting to local recycling. The results further indicated that the south Indian Ocean is a major non‐local source for rainfall over southern East Asia during June to August. The role of the south Indian Ocean as a source of atmospheric water is one of the major findings of the study and would help in better understanding and predicting the East Asian summer rainfall. Evaporated waters from the Pacific Ocean (particularly the far‐west Pacific Ocean) dominate the non‐local contribution to precipitation over northern East Asia during June to September and over southern East Asian rainfall during September. The spatial structure of the East Asian rainfall is reported to be determined by the atmospheric waters that are evaporated and transported from the non‐local sources. The role of the north Indian Ocean and the South Asian landmass as a source of water for East Asian precipitation is minimal and restricted to southern East Asia. The cross‐equatorial Somali jet and equatorial trade winds associated with the western North Pacific subtropical high are important pathways for East Asian precipitation sourced over the south Indian Ocean and the Pacific Ocean respectively. In contrast, minor roles are attributed to the Bay of Bengal as a source, and midlatitude westerlies as a transport pathway, for East Asian precipitation. [ABSTRACT FROM AUTHOR]

BackgroundMethodological limitations of prior studies have prevented progress in the treatment of patients with borderline resectable pancreatic adenocarcinoma. Shortcomings have included an absence of staging and treatment standards and pre-existing biases with regard to the use of neoadjuvant therapy and the role of vascular resection at pancreatectomy.MethodsIn this manuscript, we review limitations of studies of borderline resectable PDAC reported to date, highlight important controversies related to this disease stage, emphasize the research infrastructure necessary for its future study, and present a recently-approved Intergroup pilot study (Alliance A021101) that will provide a foundation upon which subsequent well-designed clinical trials can be performed.ResultsWe identified twenty-three studies published since 2001 which report outcomes of patients with tumors labeled as borderline resectable and who were treated with neoadjuvant therapy prior to planned pancreatectomy. These studies were heterogeneous in terms of the populations studied, the metrics used to characterize therapeutic response, and the indications used to select patients for surgery. Mechanisms used to standardize these and other issues that are incorporated into Alliance A021101 are reviewed.ConclusionsRigorous standards of clinical trial design incorporated into trials of other disease stages must be adopted in all future studies of borderline resectable pancreatic cancer. The Intergroup trial should serve as a paradigm for such investigations.