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The article focuses on the parasite investigations conducted by the U.S. Department of Agriculture (USDA) from 1886 to 1987 at the National Agricultural Library (NAL). Eric P. Hoberg, Agricultural Research Service zoologist, reveals that the USDA records are important in illuminating the history of parasitology in North America and globally. The original line drawings that were completed by USDA scientists Willard W. Becklund and M. L. Walker are also included in the scientific papers.

The effects of future land use and land cover change on the chemical composition of the atmosphere and air quality are largely unknown. To investigate the potential effects associated with future changes in vegetation driven by atmospheric CO2 concentrations, climate, and anthropogenic land use over the 21st century, we performed a series of model experiments combining a general circulation model with a dynamic global vegetation model and an atmospheric chemical-transport model. Our results indicate that climate-and CO2-induced changes in vegetation composition and density between 2100 and 2000 could lead to decreases in summer afternoon surface ozone of up to 10 ppb over large areas of the northern mid-latitudes. This is largely driven by the substantial increases in ozone dry deposition associated with increases in vegetation density in a warmer climate with higher atmospheric CO2 abundance. Climate-driven vegetation changes over the period 2000-2100 lead to general increases in isoprene emissions, globally by 15% in 2050 and 36% in 2100. These increases in isoprene emissions result in decreases in surface ozone concentrations where the NOx levels are low, such as in remote tropical rainforests. However, over polluted regions, such as the northeastern United States, ozone concentrations are calculated to increase with higher isoprene emissions in the future. Increases in biogenic emissions also lead to higher concentrations of secondary organic aerosols, which increase globally by 10% in 2050 and 20% in 2100. Summertime surface concentrations of secondary organic aerosols are calculated to increase by up to 1 µgm-3 and double for large areas in Eurasia over the period of 2000-2100. When we use a scenario of future anthropogenic land use change, we find less increase in global isoprene emissions due to replacement of higher-emitting forests by lower-emitting cropland. The global atmospheric burden of secondary organic aerosols changes little by 2100 when we account for future land use change, but both secondary organic aerosols and ozone show large regional changes at the surface. [ABSTRACT FROM AUTHOR]

The article provides information on Africanized honey bees (AHBs) which have been found spreading in four U.S. states--Florida, Oklahoma, Arkansas and Louisiana--since fall 2005. No one can say for sure why AHBs suddenly started spreading again, but there are several factors that are likely to have played a part, explains Agricultural Research Service (ARS) entomologist Gloria DeGrandi-Hoffman. One reason why AHBs have been found in new places is that more people are looking for them today then ever before. Another factor that may be contributing to this new surge in AHB spread is what's known as "human-assisted transport" --AHBs hitching rides on trucks, ships, and railroad cars from Central and South America to the U.S.

The article summarizes the results of the analysis conducted by the U.S. Centers for Disease Control & Prevention to measure the prevalence of alcohol and drug use among persons killed in motor-vehicle crashes in West Virginia from 2004 and 2005. The analysis determined that the prevalence of drug use was similar to the prevalence of a blood alcohol concentration among persons killed in motor-vehicle crashes. It also suggested that drug use contributes substantially to driver impairment in West Virginia.

The article cites the contributions of scientists from the U.S. Agricultural Research Service (ARS) to the solution of international agricultural problems. Some of the issues with which ARS scientists had helped solve include the alleged presence of Karnal bunt in U.S. durum wheat in 2004 and the allegations that the country released crop-destroying insects called Thrips palmi in 1996. ARS scientists have also taken on a special role in international efforts to deal with avian influenza.

The article discusses the significance of the partnerships of the U.S. Agricultural Research Service (ARS) with universities and colleges in the U.S. to agricultural research. ARS and the land-grant schools are complementary research systems. ARS, as the in-house research SOL GOLDBERG (D133-1) arm of U.S. Department of Agriculture (USDA), usually has a broad focus or national scope, tackling research with diverse approaches and contexts. The agency is funded by congressional appropriations that can support multi-year, long-term projects not suited to annual or short-term grants. Land-grant schools focus more on solving important local and regional problems. Partnering with ARS from within USDA is the Cooperative State Research, Education, and Extension Service, which provides grants that support many collaborations between land-grant schools and ARS. The list of accomplishments that have come from partnerships between ARS and land-grant schools is virtually endless. One even resulted in the ultimate scientific kudo. Five ARS and three Cornell University scientists teamed up to become the first to determine the molecular structure of RNA in 1965. Corn variety B76, which came out of a joint ARS-Iowa State University program in the 1970s and 1980s, remains the basis for nearly every seed-parent line of corn in the U.S. INSET: A Share of the Collaborations.

Focuses on the experiments of the U.S. Agricultural Research Service on transmissible spongiform encephalopathies (TSE). First case of mad cow disease in the U.S.; Types of TSE and early research on the disease; Investigation of the infection process of TSE; Studies on possible genetic resistance to the disease.

Provides information on Africanized honey bees (AHB), also known as killer bees. History of the AHB and its hybridization; Discussion of breeding between AHB and European honey bees (EHB); Research on the spread and invasion of AHB; Safety precautions against AHB; Study conducted by entomologist Frank A. Eischen on the resistance of AHB to Varroa mites; Challenge of beekeepers in maintaining EHB hives with AHBs surrounding them; Traits that make AHBs undesirable for beekeepers;

Celebrates the efforts of the U. S. Agricultural Research Service's (ARS) Pacific Basin Agricultural Research Center in Hilo, Hawaii in dealing with fruit flies that have been devastating Hawaiian farms and gardens. Reason ARS entomologist Roger Vargas was researching fruit fly control methods; Comments from Vargas; Examples of fruit fly control techniques developed by the ARS laboratory in Hilo. INSET: Gardeners Help Farmers.

Deals with the contributions of the Agricultural Research Service agency under the U.S. Department of Agriculture to agricultural progress, in connection to its 50th anniversary in 2003. Accomplishments of the division; Contributions to food safety; Help extended to the decision-making of regulatory agencies. INSETS: More Food Safety Milestones;More Animal Research Milestones;More ARS Crop Improvements;More Natural Resources Milestones

Discusses the boll weevil eradication program in the U.S. Total yield losses and control costs due to the insect pests; Percentage of the program which is funded by cotton growers; Use of biology against the boll weevil; Number of jobs provided by the cotton industry. INSETS: BOLL WEEVIL ERADICATION IN THE UNITED STATES AND MEXICO;FEAR NO WEEVIL;What a Difference No Boll Weevil Makes.

Presents information on the Beltsville Agricultural Research Center (BARC) in Beltsville, Maryland. Contributions to agricultural research; Information on BARC researchers; Establishment of the research facility.

Focuses on the plant exploration and collecting efforts under the direction of the United States Agricultural Research Service's National Germplasm Resources Laboratory. Significance of plant exploring and collecting; Plant exploring as an international affair; History of the collecting program of the United States Department of Agriculture (USDA); Information on the USDA plant introduction stations. INSETS: High-impact acquisitions;Exploration in the 1990s.

The article focuses on the five Biomass Research Centers created in 2010 by U.S. Department of Agriculture Secretary Tom Vilsack. The centers focus on a regional approach to feedstock production in order to help the Agricultural Research Service and the Forest Service establish a successful bioenergy industry. The Northern-East, the Western, the Northwestern, the Southeastern and the Central-East regional centers are discussed along with their research priorities, focus and challenges.

The article reports on the inclusion of blueberry research notes by botanist Frederick Coville to the Rare and Special Collections at the National Agricultural Library (NAL) in Beltsville, Maryland. Complete descriptions of blueberry plant parentage and penciled entries of Coville's work are included in the research note material. The notes provide insight into the expanse of blueberry transformation from its wild origin into a domesticated crop. His records start with the comparison of plant growth in alkaline, neutral and acid soil.

The article reports on an agricultural risk assessment which reveals the possibility that U.S. apples could carry Erwinia amylovora and spread fire blight disease to Japan. The risk assessment, conducted by Agricultural Research Service plant pathologist Rodney Roberts, was a major element in more than 20 years of ARS research, and it supported the Office of the U.S. Trade Representative (USTR) and the U.S. apple industry in their successful dismantling of the Japanese trade barriers. While fumigation of apples with methyl bromide took care of the codling moth problem, Japan continued to refuse U.S. apples on the basis of perceived danger from fire blight.

Reports on the biomass-based industrial products developed by U.S. Agricultural Research Service scientists. Details of an absorbent product; Information on a material from starch that could be used to make biodegradable packing peanuts; Development of high-value fibers from chicken feathers.

The article focuses on the efforts of the U.S. Agricultural Research Service's (ARS) National Plant Germplasm System (NPGS) to collect germplasm of agronomically important plants and their relatives. According to David Ellis, a curator and plant physiologist at the National Center for Genetic Resources Preservation (NCGRP), NPGS is a stockroom for tools to address problems such as pathogen mutation or the advent of new pests in the U.S. It relates the role of germplasm collection and preservation in protecting the genetic variation in agriculture and in the wild.

The article discusses the global efforts of several research institutes to fight Ug99, a stem rust which attacks wheat and barley. The Ug99 was first reported in Uganda in the year 1999 and has spread to Kenya, Ethiopia, Yemen, Sudan, and Iran. According to the article, stem rust has been the most destructive disease of wheat and barley. The U.S. Agricultural Research Service became a founding partner in the Borlaug Global Rust Initiative, which also included the International Maize and Wheat Improvement Center, the International Center for Agricultural Research in the Dry Areas, the Food and Agriculture Organization of the United Nations, and Cornell University. The contributions from the Bill and Melinda Gates Foundation to fight Ug99 are discussed.

The article discusses the work of U.S. Agricultural Research Service (ARS) chemist Ruth Benerito, who developed a process while working in the ARS laboratories in New Orleans, Louisiana in the 1950s that led to permanent-press cotton and stain- and flame-resistant fabrics. The "cross-linking" process that Benerito's team developed was based on treating cotton fibers with agents that strengthen the hydrogen bonds between chainlike and cellulose molecules. The improvements in cotton flame retardants since Benerito's research including biomedical treatments and wound dressing are discussed.

This article presents news from the U.S. Centers for Disease Control and Prevention (CDC). A study by the center looked at alcohol and other drug use among the victims of fatal automobile crashes in West Virginia during 2004-2005. CDC analyzed data which determined that the prevalence of drug use was similar to the prevalence of a blood alcohol concentration around 0.08 g/dL among people killed in motor vehicle accidents in the state. Of the 784 fatalities recorded it was found that 663 had alcohol test results, 660 had drug test results and 685 had both. The findings of this report are subject to at least four limitations and cannot accurately be applied to all states.

Background & Aims: Biologic therapies may effectively treat Crohn's disease (CD), and pediatric patients who discontinue multiple biologics risk exhausting treatment options. The frequency and context of biologic discontinuation have not been well-characterized. We aimed to determine patterns of biologic use, discontinuation, and evaluation in pediatric patients with CD., Methods: Pediatric patients with CD at 7 U.S. centers (2010-2020) were identified. Prospective ImproveCareNow registry data were supplemented with medical record abstraction. Biologics included monoclonal antibody and small molecule medications. Therapeutic drug monitoring (TDM) was considered induction if <14 weeks after biologic start, proactive if later during quiescent disease, and reactive during active disease., Results: Of 823 patients included (median age, 13.0 years; 40% female), 86% started biologics (78% infliximab, 21% adalimumab, <1% others). Twenty-six percent used concomitant immunomodulators for ≥12 months. Most (85%) measured TDM including 47% induction, 69% proactive, and 24% reactive. Twenty-nine percent discontinued their first biologic after median 793 days because of inefficacy (34%), anti-drug antibodies (8%), adverse events (8%), or non-adherence (12%). If inefficacy, 86% underwent pre-discontinuation evaluation. If infliximab or adalimumab inefficacy and TDM was done, 62% had levels <10 μg/mL. Proactive TDM and concomitant immunomodulators were associated with 60% and 32% reduced biologic discontinuation., Conclusions: Most children with CD are treated with biologics; 25%-37% discontinue biologics, resulting in 1 in 12 using >2 biologics during pediatric care. Half of patients discontinued biologics without trial of high-dose therapy and 14% without any evaluation. Concomitant immunomodulator use and proactive TDM decreased risk of biologic discontinuation. Strategies are needed to preserve biologic efficacy and prevent biologic discontinuation., (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Objective: This proof-of-concept study was conducted to establish the feasibility of compiling Federal Interagency Traumatic Brain Injury Research (FITBIR) data pertaining to depression and suicide risk, with the secondary goal of improving understanding regarding these outcomes. FITBIR is a national repository of participant-level traumatic brain injury (TBI) data designed to address methodological limitations (e.g., small sample size, heterogeneity of injuries)., Method: FITBIR studies with TBI severity and measures related to depression and suicidal ideation were identified. Data were harmonized across relevant studies and grouped to identify "probable depression" and suicidal ideation, resulting in a large, combined sample. Rates of probable depression and suicidal ideation were described across the available studies, considering the influence of demographic and/or injury-related factors on outcomes., Results: Cross-sectional studies meeting criteria included four studies with depression outcomes and two with suicidal ideation outcomes. Two studies reported data appropriate for comparative analyses on depression. Combined results suggested that approximately 71% of participants were categorized as having probable depression. Participants with a history of mild TBI had 2.54 greater odds of probable depression (95% confidence interval [1.93, 3.34]) than those without a history of TBI., Conclusions: Methods, harmonization code, and meta-databases related to TBI, probable depression, and suicidal ideation are now publicly available on the FITBIR website. Even with limited data, harmonization of FITBIR studies can serve as the basis for ongoing TBI and mental health research. Analyses will be more robust in the future as more studies with relevant outcome data are added to the FITBIR database. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Surgical fixation of distal biceps tendon ruptures can restore supination strength and minimize biceps fatigue, resulting in high patient satisfaction rates. Surgical approaches can vary (single incision vs. double incision), and the number of fixation techniques has increased in recent years. The reported rate of postoperative complications after surgical repair of distal biceps tendon injuries is high, ranging from 15% to 35%. The purpose of this study was to assess the trends and postoperative complication profile among newly trained surgeons who performed distal biceps tendon repairs utilizing the American Board of Orthopaedic Surgery database., Methods: The American Board of Orthopaedic Surgery database was retrospectively queried for patients treated with distal biceps tendon repair by part II examination candidates between 2017 and 2020. Distal biceps tendon repairs were isolated using the Current Procedural Terminology code 24,342. Distal triceps tendon injuries were excluded with International Classification of Diseases code S46.3∗∗. Patient demographics, intraoperative data, and surgeon fellowship training were collected. Surgeon-reported postoperative 90-day complications, including general anesthetic, medical, and surgical complications, rates of readmission, and rates of reoperation were recorded. Comparisons of rates among patient groups organized by surgeon fellowship training were performed using the chi-squared test., Results: A total of 2089 distal biceps tendon repairs were included in the analysis. The average patient age was 47.5 yr, and 97.3% of patients were men. The majority of cases was performed by surgeons with fellowship training in sports medicine, hand/upper extremity, and shoulder and elbow, with 867 (41.5%) cases performed by sports medicine-trained surgeons, 740 (35.4%) by hand/upper extremity-trained surgeons, and 313 (15.0%) by shoulder and elbow-trained surgeons. In total, 608 (29.1%) patients experienced an anesthetic (0.2%), medical (1.1%), or surgical (28.2%) complication. The most common surgical complications were nerve injury (20.6%), failure of tendon repair or fixation (2.4%), and infection (1.7%). The overall reoperation rate was 2.4%. There were no significant differences in complication or reoperation rates among subspecialty training received., Discussion and Conclusion: Among newly trained surgeons, those with fellowship training in sports medicine, hand/upper extremity, and shoulder and elbow performed the most distal biceps tendon repairs, and there was no difference in complication rates among subspecialty training received. Complication rates after distal biceps tendon repair performed by newly trained surgeons were similar to those previously reported in large cohort studies, with nerve injury as the most common complication., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Substance misuse persists and is undertreated across the United States (Substance Abuse and Mental Health Services Administration, 2021). Further enhancing the skill sets and capacity of interprofessional members of primary care teams to include proficiency in the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model could help to alleviate the "treatment gap" (those requiring treatment, but not receiving it) by enhancing interprofessional teams at the pregraduate level (e.g., health educators, health coaches) to expand capacity and meet the volume of patients with substance use-related needs., Method: In this study, SBIRT knowledge, training satisfaction, and efficacy were evaluated among undergraduate and graduate health and behavioral health students before and after exposure to a series of online training modules., Results: On completion of the training, there were positive percent increases in overall mean knowledge and self-efficacy when compared with pretraining. At posttraining, graduate level students, regardless of discipline, reported greater knowledge than undergraduate students; there were no differences in efficacy or satisfaction among the groups. Additional analysis at the graduate level evaluated differences between behavioral health and medical trainees. No differences were found in knowledge or efficacy between groups at posttest, despite medical trainees reporting significantly lower efficacy at pretest., Discussion: The findings of this study reinforce the need and potential to incorporate SBIRT training into higher education curricula for interprofessional health care professions to begin expanding the integrated care team's knowledge and efficacy in the provision of SBIRT to address the treatment gap. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The United States Department of Health and Human Services launched the Advancing American Kidney Health Initiative in 2019, which included a goal of transforming dialysis care from an in-center to a largely home-based dialysis program. A substantial motivator for this transition is the potential to reduce costs of ESKD care with peritoneal dialysis. Studies demonstrating that peritoneal dialysis is less costly than in-center hemodialysis have often focused on the perspective of the payer, whereas less consideration has been given to the costs of those who are more directly involved in treatment decision making, including patients, caregivers, physicians, and dialysis facilities. We review comparisons of peritoneal dialysis and in-center hemodialysis costs, focusing on costs incurred by the people and organizations making decisions about dialysis modality, to highlight the financial barriers toward increased adoption of peritoneal dialysis. We specifically address misaligned economic incentives, underappreciated costs for key stakeholders involved in peritoneal dialysis delivery, differences in provider costs, and transition costs. We conclude by offering policy suggestions that include improving data collection to better understand costs in peritoneal dialysis, and sharing potential savings among all stakeholders, to incentivize a transition to peritoneal dialysis., (Copyright © 2022 by the American Society of Nephrology.)

Introduction . Despite the amount of orthopaedic research evaluating access to care based on insurance status, no study quantifies the effects of insurance status on the care of acute Achilles tendon ruptures. Methods . Using Current Procedural Terminology codes, we identified all patients who underwent surgical management of Achilles tendon rupture between December 31, 2013, and December 31, 2018, and followed-up at either a county hospital-based orthopaedic surgery clinic and/or private university-based clinic. Inclusion criteria included patients who (1) underwent surgical management of an Achilles tendon rupture during this time period and (2) were at least 18 years of age at the time of surgery. A univariate 2-tailed t test was used to compare various groups. Statistical significance was set at P < 0.05. Results . When compared to adequately insured patients (private and Medicare), underinsured patients (uninsured and Medicaid) experienced a significantly greater time from the date of injury to first clinic visit (14.5 days vs 5.2 days, P < .001), first clinic visit to surgery (34.6 days vs 4.8 days, P < .002), injury to surgery date (48.9 days vs 9.8 days, P < .001), initial presentation to when magnetic resonance imaging was obtained (48.1 days vs 1.9 days, P < .002). Conclusions . Disparities in access to care for Achilles tendon ruptures are intimately related to insurance status. Uninsured and Medicaid patients are subject to institutional delays and decreased access to care when compared to patients with private insurance. Levels of Evidence: Level III: Prognostic, retrospective.

Background: The Open Payments Program, as designated by the Physician Payments Sunshine Act, is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization., Objectives: The authors sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation., Methods: The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution., Results: A total 61,000,728 unique payments totaling $11,815,248,549 were identified over the 6-year study period; 9089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (P = 0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (P = 0.0840). Cash and cash equivalents proved to be the most common form of payment; stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014 and 2019 (mean $76,420.75). California had the greatest number of plastic surgeons who received payments (1452 surgeons)., Conclusions: Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past 6 years, geographic trends in industry payments have remained stable., (© 2021 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.)

Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus endemic in many areas around the world. HTLV-1 can induce the development of adult T-cell leukemia (ATL) or myelopathy/tropical spastic paraparesis (HAM/TSP). We report a patient who presented to our outpatient clinic with massive splenomegaly, weight loss, urinary retention, and lower extremity weakness for the previous 3 years. The patient was found to have positive HTLV-1 by ELISA and Western blot from peripheral blood. Evaluation of the spleen demonstrated T-cell large granular lymphocyte leukemia consistent with ATL. In addition to progressive lower extremity weakness, hyperreflexia and clonus, cerebral spinal fluid was positive for HTLV-1 by ELISA and had a reversed CD4-to-CD8 ratio consistent with HAM/TSP. These findings suggest HTLV-1 induced ATL and HAM/TSP presenting simultaneously in the same patient.

Background: The impact of socioeconomic status (SES) has been described for screening and accessing treatment for colon cancer. However, little is known about the "downstream" effect in patients who receive guideline-concordant treatment. This study assessed the impact of SES on cancer-specific survival (CSS) and overall survival (OS) for stage III colon cancer patients., Methods: The SEER Census Tract-Level SES Dataset from 2004 to 2015 was used to identify stage III colon adenocarcinoma patients who received curative-intent surgery and adjuvant chemotherapy. The predictor variable was census tract SES. SES was analyzed as quintiles. The outcome variables were OR and CSS. Statistical analysis included chi square tests for association, Kaplan-Meier, Cox, Fine and Gray regression for survival analysis., Results: In total, 27,222 patients met inclusion criteria. Lower SES was associated with younger age, Black or Hispanic race/ethnicity, Medicaid/uninsured, higher T stage, and lower grade tumors. CSS at the 25th percentile was 54 months for the lowest SES quintile and 80 for the highest. Median OS was 113 months for the lowest SES quintile and not reached for highest. The 5-year CSS rate was 72.4% for the lowest SES quintile compared to 78.9% in the highest (p < 0.001). The 5-year OS rate was 66.5% for the lowest SES quintile and 74.6% in the highest (p < 0.001)., Conclusion: This is the first study to evaluate CSS and OS in an incidence-based cohort of stage III colon cancer patients using a granular, standardized measure of SES. Despite receipt of guideline-based treatment, SES was associated with disparities in CSS and OS., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Recent advances in forensic science, especially the use of DNA technology, have revealed that faulty forensic analyses may have contributed to miscarriages of justice. In this study we build on recent research on the general public's perceptions of the accuracy of 10 forensic science techniques and of each stage in the investigation process. We find that individuals in the United States hold a pessimistic view of the forensic science investigation process, believing that an error can occur about half of the time at each stage of the process. We find that respondents believe that forensics are far from perfect, with accuracy rates ranging from a low of 55% for voice analysis to a high of 83% for DNA analysis, with most techniques being considered between 65% and 75% accurate. Nevertheless, respondents still believe that forensic evidence is a key part of a criminal case, with nearly 30% of respondents believing that the absence of forensic evidence is sufficient for a prosecutor to drop the case and nearly 40% believing that the presence of forensic evidence - even if other forms of evidence suggest that the defendant is not guilty - is enough to convict the defendant., (Copyright © 2020 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.)

Intravascular large B-cell lymphoma (IVLBCL) is a rare entity, with a generally aggressive course that may vary based on geographic presentation. While a United States (US) registry study showed relatively good outcomes with IVLBCL, clinicopathological and treatment data were unavailable. We performed a detailed retrospective review of cases identified at 8 US medical centres, to improve understanding of IVLBCL and inform management. We compiled data retrieved via an Institutional Review Board-approved review of IVLBCL cases identified from 1999 to 2015 at nine academic institutions across the US. We characterized the cohort's clinical status at time of diagnosis, presenting diagnostic and clinical features of the disease, treatment modalities used and overall prognostic data. Our cohort consisted of 54 patients with varying degrees of clinical features. Adjusting for age, better performance status at presentation was associated with increased survival time for the patients diagnosed in vivo (hazard ratio: 2·12, 95% confidence interval 1·28, 3·53). Based on the data we have collected, it would appear that the time interval to diagnosis is a significant contributor to outcomes of patients with IVLBCL., (© 2019 British Society for Haematology and John Wiley & Sons Ltd.)

Background: Bariatric centers face pressure to reduce hospitalization to contain costs, and some centers have sought to develop "fast-track" protocols. There is limited data to identify which patients require a longer hospital stay after gastric bypass, and therefore would be inappropriate for fast tracking. The objectives of this study were to determine (1) whether most patients in the United States who underwent laparoscopic gastric bypass required>1 day of hospitalization to recover; (2) whether hospital length of stay can be predicted by factors known before or after the operation., Methods: We reviewed all laparoscopic gastric bypass operations reported to the American College of Surgeons National Surgical Quality Improvement Program in 2011. Revision and open procedures were excluded. Patient and procedural characteristics, length of stay, readmissions, and 30-day morbidity and mortality were reviewed. Predictors of longer hospitalization (defined as≥3 days) were identified by multivariate analysis., Results: Of 9,593 laparoscopic gastric bypass operations, median length of stay was 2 days (range 0-544) and 26% of patients required≥3 days of hospitalization. In multivariate analysis, longer hospitalization was predicted by diabetes, chronic obstructive pulmonary disease, bleeding diathesis, renal insufficiency, hypoalbuminemia, prolonged operating time, and resident involvement with the procedure, but not by patient age, sex, body mass index, and other co-morbidities., Conclusion: Patient characteristics and operative details predict length of hospitalization after laparoscopic gastric bypass. Such data can be used to identify patients inappropriate for fast-track protocols., (Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

No established guidelines currently exist to assist orthopedic surgeons in determining when a patient may safely control a motor vehicle after undergoing simple right knee arthroscopy. Despite this lack of concrete evidence, premature postoperative driving could expose orthopedic surgeons to legal liability and, more importantly, patients to danger and further injury. Through questionnaires directed at physicians, patients, and insurance companies, the authors attempted to identify common postoperative management trends among orthopedic surgeons in an effort to better identify patterns that could help direct practice for the optimized treatment of patients after right knee arthroscopy.Although 29.7% of physicians always incorporated postoperative driving instructions during routine preoperative consultation, 57% of physicians brought up these conversations half of the time or less. In addition, when the preoperative discussions were conducted, approximately 23.6% of physicians never initiated the conversation. The majority of physicians recommended driving after narcotics were discontinued (70%), when the patient felt they could subjectively control their vehicle (57.1%), and when postoperative symptoms would allow safe driving (38.8%); these achievements were most commonly reached at 1 week postoperatively. After simple right knee arthroscopy, the common consensus indicates that patients may safely return to driving 1 week postoperatively when they are narcotic-free and feel safe to control their vehicle., (Copyright 2013, SLACK Incorporated.)

Leber congenital amaurosis (LCA) is the earliest and most severe retinal degeneration (RD), and the most common cause of incurable blindness diagnosed in children. It is occasionally the presenting symptom of multisystemic ciliopathies which diagnosis will require a specific care of patients. Nineteen LCA genes are currently identified and three of them account for both non-syndromic and syndromic forms of the disease. RD3 (LCA12) was implicated as a LCA gene based on the identification of homozygous truncating mutations in two LCA families despite the screening of large cohorts of patients. Here we provide a comprehensive survey of RD3 mutations and of their clinical expression through the screening of a cohort of 852 patients originating worldwide affected with LCA or early-onset and severe RD. We identified three RD3 mutations in seven unrelated consanguineous LCA families - i.e., a 2 bp deletion and two nonsense mutations - predicted to cause complete loss of function. Five families originating from the Southern Shores of the Mediterranean segregated a similar mutation (c.112C>T, p.R38*) suggesting that this change may have resulted from an ancient founder effect. Considering the low frequency of RD3 carriers, the recurrence risk for LCA in non-consanguineous unions is negligible for both heterozygote and homozygote RD3 individuals. The LCA12 phenotype in our patients is highly similar to those of patients with mutant photoreceptor-specific guanylate cyclase (GUCY2D/LCA1). This observation is consistent with the report of the role of RD3 in trafficking of GUCYs and gives further support to a common mechanism of photoreceptor degeneration in LCA12 and LCA1, i.e., inability to increase cytoplasmic cGMP concentration in outer segments and thus to recover the dark-state. Similar to LCA1, LCA12 patients have no extraocular symptoms despite complete inactivation of both RD3 alleles, supporting the view that extraocular investigations in LCA infants with RD3 mutations should be avoided.

Predictive analytics is an advanced business intelligence tool that can help healthcare financial executives mine data resulting in high-value, actionable improvements for their revenue cycle. Predictive analytic solutions can help hospitals increase revenues and improve their decision-making ability to increase revenue and staff productivity. Automation technology can help hospital business offices eliminate manual work on claims, saving time and costly labor while increasing accuracy.

Aim: To determine the prevalence of glaucoma in patients with obstructive sleep apnoea., Design: Cross-sectional case series., Participants: One hundred patients with moderate to severe obstructive sleep apnoea., Testing: Within 48 h of the polysomnographic diagnosis of obstructive sleep apnoea, patients underwent the following tests: intraocular pressure, gonioscopy, automated perimetry, stereoscopic biomicroscopy, and fundascopic assessment for the presence of glaucomatous optic nerve changes., Main Outcome Measures: The prevalence of glaucoma in patients with obstructive sleep apnoea and the associations between patient characteristics and both glaucoma and intraocular pressure., Results: Glaucoma was diagnosed in 27 of 100 patients yielding an estimated prevalence of 27% (95% CI 19-37%). The presence of glaucoma did not correlate with sex, body mass index (BMI), or AHI, but did appear to be associated with age (P=0.014). There was no evidence of a relationship between intraocular pressure and either the apnoea plus hypopnoea index or age., Conclusion: The prevalence of glaucoma in patients with obstructive sleep apnoea is an estimated 27%. Sex, age, body mass index or apnoea plus hypopnoea index are not factors influencing the presence of glaucoma in this population of patients.

Objective: This article presents some limited results from the Medical Library Association (MLA) Benchmarking Network survey conducted in 2002. Other uses of the data are also presented., Methods: After several years of development and testing, a Web-based survey opened for data input in December 2001. Three hundred eighty-five MLA members entered data on the size of their institutions and the activities of their libraries. The data from 344 hospital libraries were edited and selected for reporting in aggregate tables and on an interactive site in the Members-Only area of MLANET. The data represent a 16% to 23% return rate and have a 95% confidence level., Results: Specific questions can be answered using the reports. The data can be used to review internal processes, perform outcomes benchmarking, retest a hypothesis, refute a previous survey findings, or develop library standards. The data can be used to compare to current surveys or look for trends by comparing the data to past surveys., Conclusions: The impact of this project on MLA will reach into areas of research and advocacy. The data will be useful in the everyday working of small health sciences libraries as well as provide concrete data on the current practices of health sciences libraries.

Objective: This article explores the development and implementation of the Medical Library Association (MLA) Benchmarking Network from the initial idea and test survey, to the implementation of a national survey in 2002, to the establishment of a continuing program in 2004. Started as a program for hospital libraries, it has expanded to include other nonacademic health sciences libraries., Methods: The activities and timelines of MLA's Benchmarking Network task forces and editorial board from 1998 to 2004 are described., Results: The Benchmarking Network task forces successfully developed an extensive questionnaire with parameters of size and measures of library activity and published a report of the data collected by September 2002. The data were available to all MLA members in the form of aggregate tables. Utilization of Web-based technologies proved feasible for data intake and interactive display. A companion article analyzes and presents some of the data. MLA has continued to develop the Benchmarking Network with the completion of a second survey in 2004., Conclusions: The Benchmarking Network has provided many small libraries with comparative data to present to their administrators. It is a challenge for the future to convince all MLA members to participate in this valuable program.

The demographic, behavior, and background characteristics of 4,804 participants in 17 national demonstration projects for HIV medical and/or psychosocial support services were coded for an index of "service need" or possible under-representation in the traditional healthcare system. Fifteen items were coded including status as a person of color, lack of private insurance, unemployment/disability, problem drinking, crack cocaine use, heroin use, other illicit drug use, less than 12 years of education, criminal justice system involvement, children requiring care while the patient receives services, sex work, being the sex partner of an injection drug user, unstable housing, primary language not English, and age less than 21 or over 55 years. Most (87.7%) of the program participants had four or more of these factors present. Through CHAID modeling, those groups with the highest levels of service need and vulnerability were identified. These data suggest that these projects, designed to attract and serve individuals potentially underrepresented in the health services system, had in fact achieved that goal. Implications of the changing demographics of the HIV epidemic for the health service delivery system are discussed.

To assess the prevalence of mutations associated with decreased antiretroviral drug susceptibility, specimens were tested from persons infected with human immunodeficiency virus (HIV) during 1993-1998. Subjects were drug naive and were attending sexually transmitted disease clinics in 6 US cities. All were enrolled consecutively and had tested negative for HIV during the 2 years before enrollment. Plasma specimens from patients having >/=1 reverse transcriptase (RT) or primary protease mutation were tested phenotypically with a recombinant virus assay. Of 99 patients, 6 (6%) had mutations associated with zidovudine resistance, 2 (2%) had mutations associated with nonnucleoside RT inhibitor resistance, and 1 (1%) had a primary protease mutation. Overall, the prevalence of resistance-associated primary mutations was 5%, although high levels of decreased drug susceptibility (IC(50)s >/=10 times that of a reference virus) were observed in just 1%. These findings confirm the transmission of these mutations to drug-naive persons.