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Background: Meningioma incidence was reported to have risen substantially in the United States during the first decade of the 21st century. There are few reports about subsequent incidence trends. This study provides updated data to investigate trends in meningioma incidence by demographic and tumor characteristics at diagnosis in the United states from 2004 to 2015. Methods: Trends in meningioma incidence were analyzed using data from the Surveillance, Epidemiology, and End Results‐18 (SEER‐18) registry database of the National Cancer Institute. The joinpoint program was used to calculate annual percent change (APC) in incidence rates. Results: The overall incidence of meningioma increased by 4.6% (95% CI, 3.4‐5.9) annually in 2004‐2009, but remained stable from 2009 to 2015 (APC, 0; 95% CI, −0.8 to 0.8). Females (10.66 per 100 000 person‐years) and blacks (9.52 per 100 000 person‐years) had significant predominance in meningioma incidence. Incidence in many subgroups increased significantly up to 2009 and then remained stable until 2015. However, meningioma incidence in young and middle‐aged people increased significantly throughout the entire time period from 2004 to 2015 (APC: 3.6% for <20‐year‐olds; 2.5% for 20‐39‐year‐olds; 1.8% for 40‐59‐year‐olds). The incidence of WHO II meningioma increased during 2011‐2015 (APC = 5.4%), while the incidence of WHO III meningioma decreased during 2004‐2015 (APC = −5.6%). Conclusion: In this study, the incidence of meningioma was found to be stable in recent years. Possible reasons for this finding include changes in population characteristics, the widespread use of diagnostic techniques, and changes in tumor classification and risk factors in the US population. [ABSTRACT FROM AUTHOR]

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• The associations between availability of greenness and COVID-19 outcomes are examined. • Availability of greenness is associated with lower rates of COVID-19 infection. • Availability of greenness has limited effects for ameliorating COVID-19 related inequity. • The findings provide working hypotheses for effectively designing nature-based interventions. Human exposure to greenness is associated with COVID-19 prevalence and severity, but most relevant research has focused on the relationships between greenness and COVID-19 infection rates. In contrast, relatively little is known about the associations between greenness and COVID-19 hospitalizations and deaths, which are important for risk assessment, resource allocation, and intervention strategies. Moreover, it is unclear whether greenness could help reduce health inequities by offering more benefits to disadvantaged populations. Here, we estimated the associations between availability of greenness (expressed as population-density-weighted normalized difference vegetation index) and COVID-19 outcomes across the urban–rural continuum gradient in the United States using generalized additive models with a negative binomial distribution. We aggregated individual COVID-19 records at the county level, which includes 3,040 counties for COVID-19 case infection rates, 1,397 counties for case hospitalization rates, and 1,305 counties for case fatality rates. Our area-level ecological study suggests that although availability of greenness shows null relationships with COVID-19 case hospitalization and fatality rates, COVID-19 infection rate is statistically significant and negatively associated with more greenness availability. When performing stratified analyses by different sociodemographic groups, availability of greenness shows stronger negative associations for men than for women, and for adults than for the elderly. This indicates that greenness might have greater health benefits for the former than the latter, and thus has limited effects for ameliorating COVID-19 related inequity. The revealed greenness-COVID-19 links across different space, time and sociodemographic groups provide working hypotheses for the targeted design of nature-based interventions and greening policies to benefit human well-being and reduce health inequity. This has important implications for the post-pandemic recovery and future public health crises. [ABSTRACT FROM AUTHOR]

• Input, sampling and model uncertainties of i-Tree Eco output across 15 US cities are examined. • The total magnitude of uncertainty is estimated for leaf area, carbon storage, carbon sequestration, isoprene, and monoterpenes emission. • For leaf and carbon estimators, sampling uncertainty plays a dominant role; for isoprene and monoterpenes emission estimators, input, sampling and model uncertainties have similar magnitudes. • Recommendations are provided on how best to incorporate these results into i-Tree Eco. Uncertainty information associated with urban forest models are beneficial for model transparency, model development, effective communication of model output, and decision-making. However, compared with the extensive studies based on the applications of urban forest models, little attention has been paid to the uncertainty of the output from these models. In this study, bootstrap and Monte Carlo simulation were employed to explore the uncertainty of i-Tree Eco. We assess the uncertainties associated with input data, sampling methods and models throughout the processes of urban forest structure and function quantification, and we propagate and aggregate the three sources of uncertainty to derive an estimator of total uncertainty. The uncertainty magnitude is expressed as the coefficient of variation. By applying the uncertainty framework to a network of 15 cities across the United States, we find that the average magnitude of total uncertainty across 15 cities is 12.3 % for leaf area, 13.4 % for carbon storage, 11.1 % for carbon sequestration, 40.7 % for isoprene emissions, and 25.0 % for monoterpene emissions. For leaf and carbon estimators, the total uncertainty is primarily driven by sampling uncertainty; the magnitudes of all three sources of uncertainty are comparable across 15 cities. In contrast, input, sampling, and model uncertainties all contribute to the total uncertainty for isoprene and monoterpene emission estimators, and there are large variations in these three sources of uncertainty across the 15 cities. An analysis of a regression-based approach to estimate input and model error indicated only moderate improvements over using averages across sites when estimating total uncertainty. [ABSTRACT FROM AUTHOR]

Background: Conventional MRI methods detect areas of brain tissue damage, but are poor measures of the degree of injury. Advanced MRI modalities offer imaging metrics of tissue integrity and may be useful in the proof-of-concept evaluation of putative neuroprotective therapies. Previous studies have shown that DTI can be successfully implemented in a multi-center study with good comparability between centers. However, advanced imaging metrics will only be useful if they provide acceptable sample size estimates, which is currently unknown. Methods: A longitudinal MS patient population was used to estimate the sample size needed to measure a putative neuroprotective therapy. Patients were imaged at baseline, 1, 2, 6, and 12 months. Twenty regions of interest (ROIs) were placed on normal-appearance brain regions from baseline images in each subject and were coregistered longitudinally using FSL and AFNI. A hypothetical neuroprotective therapy was assumed to slow the worsening of DTI measures by 30% or 50% relative to those observed in this sample. F tests with multivariate analysis of variance were used to estimate sample size, with correlation over the repeated measured assumed to be 0.85 and α = 0.05. Results: For 30% reduction in FA, 74 subjects per group are needed for 80% power, and 94 subjects per group for 90% power. For 50% reduction in FA, 29 subjects per group were needed for 80% power, and 36 subjects per group for 90% power. Additional analyses will include power analyses for other DTI measures and different scanning intervals, as well as additional projections using longitudinal designs models. Conclusions: Using a longitudinal dataset, feasible sample size estimates are projected for using DTI in a clinical trial of a putative neuroprotective agent. DTI appears to be a feasible candidate marker of neuroprotection in MS clinical trials. Support: This study was supported by grants from the National Institutes of Health (K23 NS 47211) and the National Multiple Sclerosis Society (RG 3548A2). [Copyright &y& Elsevier]

Abstract: The great Lisbon earthquake of November 1st, 1755 with an estimated moment magnitude of 8.5–9.0 was the most destructive earthquake in European history. The associated tsunami run-up was reported to have reached 5–15 m along the Portuguese and Moroccan coasts and the run-up was significant at the Azores and Madeira Island. Run-up reports from a trans-oceanic tsunami were documented in the Caribbean, Brazil and Newfoundland (Canada). No reports were documented along the U.S. East Coast. Many attempts have been made to characterize the 1755 Lisbon earthquake source using geophysical surveys and modeling the near-field earthquake intensity and tsunami effects. Studying far field effects, as presented in this paper, is advantageous in establishing constraints on source location and strike orientation because trans-oceanic tsunamis are less influenced by near source bathymetry and are unaffected by triggered submarine landslides at the source. Source location, fault orientation and bathymetry are the main elements governing transatlantic tsunami propagation to sites along the U.S. East Coast, much more than distance from the source and continental shelf width. Results of our far and near-field tsunami simulations based on relative amplitude comparison limit the earthquake source area to a region located south of the Gorringe Bank in the center of the Horseshoe Plain. This is in contrast with previously suggested sources such as Marqués de Pombal Fault, and Gulf of Cádiz Fault, which are farther east of the Horseshoe Plain. The earthquake was likely to be a thrust event on a fault striking ~345° and dipping to the ENE as opposed to the suggested earthquake source of the Gorringe Bank Fault, which trends NE–SW. Gorringe Bank, the Madeira-Tore Rise (MTR), and the Azores appear to have acted as topographic scatterers for tsunami energy, shielding most of the U.S. East Coast from the 1755 Lisbon tsunami. Additional simulations to assess tsunami hazard to the U.S. East Coast from possible future earthquakes along the Azores–Iberia plate boundary indicate that sources west of the MTR and in the Gulf of Cadiz may affect the southeastern coast of the U.S. The Azores–Iberia plate boundary west of the MTR is characterized by strike–slip faults, not thrusts, but the Gulf of Cadiz may have thrust faults. Southern Florida seems to be at risk from sources located east of MTR and South of the Gorringe Bank, but it is mostly shielded by the Bahamas. Higher resolution near-shore bathymetry along the U.S. East Coast and the Caribbean as well as a detailed study of potential tsunami sources in the central west part of the Horseshoe Plain are necessary to verify our simulation results. [Copyright &y& Elsevier]

This study uses data on residential energy consumption from large nation-wide surveys in 1990, 1997, 2005, and 2015 to assess the racial inequality in residential energy consumption. The results indicate that the overall inequality in energy consumption/cost varies little over the past 25 years while showing widespread energy poverty in the U.S. In terms of racial differences, African-American households are more vulnerable than white and Asian households, and about one-third of them lived in energy poverty by 2015. However, the share of households in energy poverty witnessed the greatest growth among white households during 1990–2015. In addition, the energy burdens of different racial groups vary greatly with respect to energy types, end-use demands, and regions, given the differences in climate and households' socio-economic characteristics. The study suggests that besides low-income African-American households, urgent attention should be given to the increasing number of white households in energy poverty. • There is widespread energy poverty in the U.S. over the past 25 years. • African-American households are more vulnerable than white and Asian households. • Energy poverty witnessed the greatest growth among white households during 1990–2015. • Racial energy burden varies greatly regarding energy types, end-use demands, and regions. • Urgent attention should be given to the increasing number of white households in energy poverty. [ABSTRACT FROM AUTHOR]

Background: Telemedicine helps to provide the safe management of stroke patients in the emergency department (ED) and has been used worldwide. However, we had limited experience of telestroke in Taiwan. We aimed to identify the quality of telestroke and compare it with the original face-to-face consultation model., Methods: Among 178 consecutive acute ischemic stroke patients treated with intravenous tissue plasminogen activator (IVtPA) from January 1, 2018, to December 31, 2019, we compared two different consultation methods: face-to-face consultation and telestroke consultation. We collected data on demographics, the National Institutes of Health Stroke Scale (NIHSS) scores, Modified Rankin Scale (mRS) scores, time measurements (onset-to-arrival time, onset-to-telestroke activation time, and time of IVtPA administration (Door-to-Needle; DTN))., Results: The mean age to receive a telestroke consultation was 66.6 years, 36% were female, and the median NIHSS score was 9. The median time from patient arrival to telestroke consult activation was 40 min, and the median DTN time was 11 min longer than for face-to-face consults (62 min versus 51 min, p = .01). Telestroke consultation, similar to a face-to-face consultation, resulted in safe IVtPA eligibility assessments and administration with post-thrombolysis ICH in 4% overall (4% telestroke, 3% face-to-face consultation; p = .851). The 90-day outcomes were not different for mRS score, dichotomized 0-2 (60% telestroke 59% face-to-face consultation; p = .961), or for mortality (16% telestroke, 9% face-to-face consultation; p = .292)., Conclusion: In the ED, consultation via the telestroke program provides equal quality to the original face-to-face consultation model to manage ischemic stroke., Competing Interests: Conflict of interest The authors have no conflicts of interest relevant to this article., (Copyright © 2021. Published by Elsevier B.V.)

Objective: To investigate a reasonable lymph node (N) staging system for gastric cancer patients with ≤15 retrieved lymph nodes (LNs)., Methods: The clinicopathological and follow-up data of patients with ≤15 LNs were obtained from the US Surveillance, Epidemiology, and End Results (SEER) database to analyze the impact of the number of retrieved LNs and metastatic status on the prognosis. In addition, external validation was achieved with data from two medical centers in China., Results: A total of 18,139 gastric cancer patients with 1-15 retrieved LNs from the SEER database were enrolled and randomly divided into the training group and the internal validation group. A new LN staging system, mNr staging (mNr0-4; 5 stages), was established according to the number of retrieved LNs and the metastatic rate. Compared with the TNM and TNrM staging systems (established by Wang J; misclassification rates of 50.4% and 62.5%, respectively), the mTNrM staging system had a lower misclassification rate (23.4%). Furthermore, there was a significant difference in the 5-year overall survival (OS) rate between the mTNrM staging subgroups (p < 0.05); however, no significant difference was found in the 5-year OS rate of partial adjacent stages in the TNM (8th edition) and TNrM (p > 0.05) staging systems. Similar results were obtained in the external validation cohort., Conclusion: mNr and mTNrM staging systems can efficiently distinguish a survival difference in patients who undergo gastrectomy with ≤15 retrieved LNs, with more accurate predictions of the 5-year OS rate of patients compared with the TNM and TNrM staging systems., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

Purpose: To determine the indications for adjuvant chemotherapy (AC) in patients with stage IIa gastric cancer (T3N0M0 and T1N2M0) according to the 7th American Joint Committee on Cancer (AJCC)., Methods: A total of 1593 patients with T3N0M0 or T1N2M0 stage gastric cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database for the period 1988.1-2012.12. Cox multiple regression, nomogram and decision curve analyses were performed. External validation was performed using databases of the Fujian Medical University Union Hospital (FJUUH) (n = 241) and Italy IMIGASTRIC center (n = 45)., Results: Cox multiple regression analysis showed that the risk factors that affected OS in patients receiving AC were age > 65 years old, T1N2M0, LN dissection number ≤ 15, tumor size > 20 mm, and nonadenocarcinoma. A nomogram was constructed to predict 5-year OS, and the patients were divided into those predicted to receive a high benefit (points ≤ 188) or a low benefit from AC (points > 188) according to a recursive partitioning analysis. OS was significantly higher for the high-benefit patients in the SEER database and the FJUUH dataset than in the non-AC patients (Log-rank < 0.05), and there was no significant difference in OS between the low-benefit patients and non-AC patients in any of the three centers (Log-rank = 0.154, 0.470, and 0.434, respectively). The decision curve indicated that the best clinical effect can be obtained when the threshold probability is 0-92%., Conclusion: Regarding the controversy over whether T3N0M0 and T1N2M0 gastric cancer patients should be treated with AC, this study presents a predictive model that provides concise and accurate indications. These data show that high-benefit patients should receive AC.

Background: The aim of this study is to investigate trends in the incidence and survival of patients with gastric neuroendocrine neoplasms (g-NENs)., Methods: and methods: Patients diagnosed with g-NENs (n = 3523) were identified from the Surveillance, Epidemiology and End Results (SEER) database. Patients diagnosed with g-NENs (n = 199) in our department were designated as a validation dataset. Nomograms were adopted to predict disease-specific survival (DSS) and overall survival (OS)., Results: The incidence of g-NENs is steadily increasing over time at a rate higher than any other cancer [annual percentage change (APC) = 6.3%, 95% confidence interval (CI) 5.6-7.0]. The 1-, 3-, and 5-year DSS rates were 87%, 78.6% and 70.6%, respectively, and the corresponding OS rates were 84.3%, 71.9%, and 53.7%, respectively. The multivariate analysis identified age, sex, T stage, M stage, and histological type as independent prognostic factors for both DSS and OS (all P < .05). The concordance indexes of the nomograms for DSS and OS in the training dataset were superior to those of the traditional tumor-node-metastasis (TNM) staging system [0.899 and 0.849 versus 0.864 and 0.783]. Calibration plots of the nomograms showed that the probability of DSS and OS closely corresponded to the actual observations in both the SEER-based training dataset and our inpatient validation dataset., Conclusion: The incidence of g-NENs has been steadily increasing at a rapid rate over the past four decades. The nomograms based on the analysis of the SEER database were superior to the TNM staging system in predicting the clinical outcomes for g-NEN patients., (Copyright © 2018. Published by Elsevier Ltd.)

Background: The aim of this work is to compare the prognostic ability between the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification for gastric cancer (GC)., Methods: A total of 10,194 noncardia GC patients were identified from the Surveillance, Epidemiology, and End Results database from 1988 to 2008. Concordance index (C-index), bayesian information criterion (BIC), and time-dependent receiver operating characteristic (t-ROC) analyses were used. External validation was performed using a dataset (n = 2355) derived from Fujian Medical University Union Hospital., Results: Overall survival for all five AJCC N categories differed significantly when patients were subgrouped into ≤ 15 versus >15 examined lymph nodes (eLNs). The prognostic ability of the 8th edition (C-index 0.716) was not improved over the 7th edition (C-index 0.716). Subgroup analysis showed superior performance of the 8th over the 7th edition in patients with > 15 eLNs (C-index 0.742 vs. 0.735); however, the two editions showed similar performance for patients with ≤ 15 eLNs (C-index 0.713 vs. 0.713). The BIC and t-ROC analyses were consistent. To better predict the prognosis of patients with ≤ 15 eLNs, we established a novel prognostic model based on independent prognostic factors (C-index 0.735). BIC analysis showed that this new model was better than the 7th and 8th editions. Similar results were obtained from the validation set., Conclusions: The 8th edition of the AJCC TNM classification shows better prognostic ability than the 7th edition in noncardia GC patients with > 15 eLNs, but no improvement was found in patients with ≤ 15 eLNs; therefore, a novel prognostic model is proposed.

Background: The dynamic prognosis of patients who have undergone curative surgery for gastric cancer has yet to be reported. Our objective was to devise an accurate tool for predicting the conditional probability of survival for these patients., Methods: We analyzed 11,551 gastric cancer patients from the Surveillance, Epidemiology, and End Results database. Two-thirds of the patients were selected randomly for the development set and one-third for the validation set. Two nomograms were constructed to predict the conditional probability of overall survival and the conditional probability of disease-specific survival, using conditional survival methods. We then applied these nomograms to the 4,001 patients in the database from Fujian Medical University Union Hospital, Fuzhou, China, one of the most active Chinese institutes., Results: The 5-year conditional probability of overall survival of the patients was 41.6% immediately after resection and increased to 52.8%, 68.2%, and 80.4% at 1, 2, and 3 years after gastrectomy. The 5-year conditional probability of disease-specific survival "increased" from 48.9% at the time of gastrectomy to 59.8%, 74.7%, and 85.5% for patients surviving 1, 2, and 3 years, respectively. Sex; race; age; depth of tumor invasion; lymph node metastasis; and tumor size, site, and grade were associated with overall survival and disease-specific survival (P <.05). Within the Surveillance, Epidemiology, and End Results validation set, the accuracy of the conditional probability of overall survival nomogram was 0.77, 0.81, 0.82, and 0.82 at 1, 3, 5, and 10 years after gastrectomy, respectively. Within the other validation set from the Fujian Medical University Union Hospital (n = 4,001), the accuracy of the conditional probability of overall survival nomogram was 0.76, 0.79, 0.77, and 0.77 at 1, 3, 5, and 10 years, respectively. The accuracy of the conditional probability of disease-specific survival model was also favorable. The calibration curve demonstrated good agreement between the predicted and observed survival rates., Conclusion: Based on the large Eastern and Western data sets, we developed and validated the first conditional nomogram for prediction of conditional probability of survival for patients with gastric cancer to allow consideration of the duration of survivorship., (Copyright © 2018 Elsevier Inc. All rights reserved.)