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Background: Appendiceal tumors are considered to be a relatively rare tumor of the gastrointestinal tract and the prognosis is unclear. This study comprehensively investigated trends in the epidemiology and survival of appendiceal tumors in the United States over the past approximately 20 years. Methods: Patients with pathologically confirmed appendiceal tumors from 2000 to 2017 were selected from the Surveillance, Epidemiology and End Results (SEER) database. Age-adjusted incidence rates were calculated by SEER*Stat 8.4.0. The Kaplan-Meier method was used to analyze survival and prognostic factors were investigated by a multivariate Cox proportional risk model. Results: Ultimately, 13,546 patients with appendiceal tumors between 2000 and 2017 were included. The annual incidence of colonic adenocarcinoma and mucinous adenocarcinoma remained relatively stable. Interestingly, the annual incidence of appendiceal neuroendocrine tumors (aNETs) increased significantly, from 0.03 to 0.90 per 100,000 person-years, with the most dramatic increase in the number of patients with localized disease. Patients with aNETs showed a significant improvement in survival between 2009–2017, compared to the period 2000–2008. Moreover, this improvement in survival over time was seen at all stages (localized, regional, distant) of aNETs. However, this improved survival over time was not seen in colonic and mucinous adenocarcinoma. Conclusions: The incidence of appendiceal neoplasms has increased significantly over the past nearly two decades, which is mainly due to the increased incidence and significant migration to earlier stages in aNETs. We must note that despite the increased incidence of aNETs, survival rates have improved at different disease stages. [ABSTRACT FROM AUTHOR]

This document presents findings from a study on the age at diagnosis of type 1 diabetes in adults in the United States. The study found that nearly 4 in 10 adults with type 1 diabetes were diagnosed after the age of 30, with a median age at diagnosis of 24 years. The age at diagnosis was higher for men and racial/ethnic minority adults. The study suggests that traditional markers used to differentiate type 1 and type 2 diabetes, such as body mass index, may have limited utility in diagnosing adult-onset type 1 diabetes. The document also highlights the need for tools that combine clinical features and biomarkers to improve the accuracy of diagnosis for adults with type 1 diabetes. [Extracted from the article]

Overeating for non-homeostatic needs contributes to childhood obesity. However, validated measures or eating motives and cross-cultural comparisons are limited. This study aimed to validate the Kids-Palatable Eating Motives Scale (K-PEMS) and its association with body mass index z score (BMIz) in China, and further assess its generalization across Chinese and American youth. Data were from participants aged 8–18 years from Hangzhou, China (n = 426) and Birmingham, AL, U.S (n = 73). The K-PEMS had sound reliability and validation (Cronbach's α = 0.920 and all factor loadings >0.50) in the Chinese sample. Multi-group nested models CFAs showed that the ∆CFI of model comparisons of measurement weights and structural covariance, variance, and means were ⩽0.01, and ∆TLI of measurement intercepts ⩽0.05. Linear regressions revealed that frequency of consuming palatable foods and drinks for Coping, Reward Enhancement, and Conformity, but not Social motives, were positively associated with BMIz. The K-PEMS had good cross-cultural generalization and could be useful in treating obesity by identifying specific motives for consuming excessive calories. [ABSTRACT FROM AUTHOR]

We aimed to assess the associations of peripheral neuropathy (PN) with vision and hearing impairment among adults aged ≥40 years who attended the lower-extremity disease exam for the National Health and Nutrition Examination Survey (United States, 1999–2004). Overall, 11.8% (standard error (SE), 0.5) of adults had diabetes, 13.2% (SE, 0.5) had PN (26.6% (SE, 1.4) with diabetes, 11.4% (SE, 0.5) without diabetes), 1.6% (SE, 0.1) had vision impairment, and 15.4% (SE, 1.1) had hearing impairment. The prevalence of vision impairment was 3.89% (95% CI: 2.99, 5.05) among adults with PN and 1.29% (95% CI: 1.04, 1.60) among adults without PN (P < 0.001). After adjustment, PN was associated with vision impairment overall (odds ratio (OR) = 1.48, 95% confidence interval (CI): 1.03, 2.13) and among adults without diabetes (OR = 1.80, 95% CI: 1.17, 2.77) but not among adults with diabetes (P for interaction = 0.018). The prevalence of hearing impairment was 26.5% (95% CI: 20.4, 33.7) among adults with PN and 14.2% (95% CI: 12.4, 16.3) among adults without PN (P < 0.001). The association of PN with moderate/severe hearing impairment was significant overall (OR = 2.55, 95% CI: 1.40, 4.64) and among adults without diabetes (OR = 3.26, 95% CI: 1.80, 5.91). Overall, these findings suggest an association between peripheral and audiovisual sensory impairment that is unrelated to diabetes. [ABSTRACT FROM AUTHOR]

Objective: Confirmatory testing is recommended for diabetes diagnosis in clinical practice. However, national estimates of undiagnosed diabetes are based on single elevated test measures, potentially resulting in overestimation. Our objective was to update trends in undiagnosed diabetes using definitions consistent with clinical practice.Research Design and Methods: We included 30,492 adults (aged ≥20 years) from the National Health and Nutrition Examination Survey (1988-2020). Among adults without diagnosed diabetes, confirmed undiagnosed diabetes was defined as having both elevated levels of fasting plasma glucose (FPG) (≥126 mg/dL) and elevated glycated hemoglobin (HbA1c; ≥6.5%), and persistent undiagnosed diabetes was defined as having elevated HbA1c or FPG levels, adjusted for the within-person variability in HbA1c and FPG tests.Results: From the periods 1988-1994 to 2017 to March 2020, there was an increase in the prevalence of diagnosed diabetes (from 4.6% to 11.7%), but no change in prevalence of persistent undiagnosed diabetes (from 2.23% to 2.53%) or confirmed undiagnosed diabetes (from 1.10% to 1.23%). Consequently, the proportion of all undiagnosed diabetes cases declined from 32.8% to 17.8% (persistent undiagnosed diabetes) and from 19.3% to 9.5% (confirmed undiagnosed diabetes). Undiagnosed diabetes was more prevalent in older and obese adults, racial/ethnic minorities, and those without health care access. Among persons with diabetes, Asian Americans and those without health care access had the highest proportion of undiagnosed cases, with rates ranging from 23% to 61%.Conclusions: From 1988 to March 2020, the proportion of undiagnosed diabetes cases declined substantially, suggesting major improvements in diabetes screening and detection. Undiagnosed diabetes currently affects 1-2% of US adults; up to 90% of all cases are diagnosed. [ABSTRACT FROM AUTHOR]

Videoconferencing (VC) software was widely adopted by organizations during the COVID-19 pandemic to maintain business communication during the suspension of business travel. In the post-pandemic age, will organizations continue to use VC software, and how will VC continuance influence the number of business trips? We conceptualize business travel as a communication problem and conduct an empirical study to investigate the use of VC during the COVID-19 pandemic and its impact on future business travel. We identify the technology–organization–environment framework as a theoretical tool to guide our research design. Using a sample of business managers in Hong Kong and the United States and the seemingly unrelated regression methodology, we identify the relative advantage, top management, and competition intensity factors that support VC continuance and business trip reduction in the post-pandemic age. This study enhances research on information systems continuance and provides practical implications for business trip planning. • VC adoption during COVID-19 pandemic influences business trips in post-pandemic age • Technological, organizational, and environmental factors determine VC continuance • Business trip reduction in post-pandemic age relates to TOE factors • The TOE framework enriches IS continuance research • Empirical results are valid in both contexts of Hong Kong and the United States [ABSTRACT FROM AUTHOR]

Using an original dataset of 4,183 former J-1 Visa holders from 81 countries—all of whom had worked in the U.S.—I examine how skilled return migrants, as cross-border brokers, transfer knowledge about organizational practices from abroad to their home countries. I hypothesize that returnees’ knowledge transfer success depends on their embeddedness in both their home- and host-country workplaces and develop and test theory about the organizational and cultural conditions that activate or suppress skilled returnees’ ability to broker knowledge across borders. Findings show that not only do host- and home-country embeddedness increase knowledge transfer success, but they also interact positively. At the organizational level, however, the presence of other returnees in a home-country workplace decreases the positive effect of a returnee’s host-country embeddedness, whereas the similarity of a returnee’s industry background to the home-country industry increases it. At the country level, high xenophobia in a given home country diminishes the positive effect of host-country embeddedness but increases the positive effect of home-country embeddedness. These findings inform an interpersonal perspective on knowledge transfer, contributing to work on brokerage, organizational learning, employee mobility, and the globalization of expert knowledge. [ABSTRACT FROM PUBLISHER]

Objective: To characterize national trends and characteristics of adults with diabetes receiving American Diabetes Association (ADA) guideline-recommended care.Research Design and Methods: We performed serial cross-sectional analyses of 4,069 adults aged ≥20 years with diabetes who participated in the 2005-2018 National Health and Nutrition Examination Survey (NHANES).Results: Overall, the proportion of U.S. adults with diabetes receiving ADA guideline-recommended care meeting all five criteria by self-report in the past year (having a primary doctor for diabetes and one or more visits for this doctor, HbA1c testing, an eye examination, a foot examination, and cholesterol testing) increased from 25.0% in 2005-2006 to 34.1% in 2017-2018 (P-trend = 0.004). For participants with age ≥65 years, it increased from 29.3% in 2005-2006 to 44.2% in 2017-2018 (P-trend = 0.001), whereas for participants with age 40-64 and 20-39 years, it did not change significantly during the same time period: 25.2% to 25.8% (P-trend = 0.457) and 9.9% to 26.0% (P-trend = 0.401), respectively. Those who were not receiving ADA guideline-recommended care were more likely to be younger, of lower socioeconomic status, uninsured, newly diagnosed with diabetes, not on diabetes medication, and free of hypercholesterolemia.Conclusions: Receipt of ADA guideline-recommended care increased only among adults with diabetes aged ≥65 years in the past decade. In 2017-2018, only one of three U.S. adults with diabetes reported receiving ADA guideline-recommended care, with even a lower receipt of care among those <65 years of age. Efforts are needed to improve health care delivery and equity in diabetes care. Insurance status is an important modifiable determinant of receiving ADA guideline-recommended care. [ABSTRACT FROM AUTHOR]

Background: Growing evidence indicates that peripheral neuropathy (PN) is common even in the absence of diabetes. However, the clinical sequelae of PN have not been quantified in the general population.Objective: To assess the associations of PN with all-cause and cardiovascular mortality in the general adult population of the United States.Design: Prospective cohort study.Setting: NHANES (National Health and Nutrition Examination Survey), 1999 to 2004.Participants: 7116 adults aged 40 years or older who had standardized monofilament testing for PN.Measurements: Cox regression to evaluate the associations of PN with all-cause and cardiovascular mortality after adjustment for demographic and cardiovascular risk factors, overall and stratified by diabetes status.Results: The overall prevalence of PN (±SE) was 13.5% ± 0.5% (27.0% ± 1.4% in adults with diabetes and 11.6% ± 0.5% in adults without diabetes). During a median follow-up of 13 years, 2128 participants died, including 488 of cardiovascular causes. Incidence rates (per 1000 person-years) of all-cause mortality were 57.6 (95% CI, 48.4 to 68.7) in adults with diabetes and PN, 34.3 (CI, 30.3 to 38.8) in adults with PN but no diabetes, 27.1 (CI, 23.4 to 31.5) in adults with diabetes but no PN, and 13.0 (CI, 12.1 to 14.0) in adults with no diabetes and no PN. In adjusted models, PN was significantly associated with all-cause mortality (hazard ratio [HR], 1.49 [CI, 1.15 to 1.94]) and cardiovascular mortality (HR, 1.66 [CI, 1.07 to 2.57]) in participants with diabetes. In those without diabetes, PN was significantly associated with all-cause mortality (HR, 1.31 [CI, 1.15 to 1.50]), but the association between PN and cardiovascular mortality was not statistically significant after adjustment (HR, 1.27 [CI, 0.98 to 1.66]).Limitation: Prevalent cardiovascular disease was self-reported, and PN was defined by monofilament testing only.Conclusion: Peripheral neuropathy was common and was independently associated with mortality in the U.S. population, even in the absence of diabetes. These findings suggest that decreased sensation in the foot may be an underrecognized risk factor for death in the general population.Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases and National Heart, Lung, and Blood Institute of the National Institutes of Health. [ABSTRACT FROM AUTHOR]

Introduction: Prostate cancer (PCa) is the most commonly diagnosed cancer and the third leading cause of cancer-related death in males in the United States. Despite the initial efficacy of androgen deprivation therapy in prostate cancer (PCa) patients, most patients progress to castration-resistant prostate cancer. However, the mechanisms underlying the androgen-independent progression of PCa remain largely unknown. Methods: In this study, we established a PCa cell line (LNCaP-AI) by maintaining LNCaP cells under androgen-depleted conditions. To explore the cellular and molecular mechanisms of androgen-independent growth of PCa, we analyzed the gene expression patterns in androgen-independent prostate cancer (AIPC) compared with that in androgen-dependent prostate cancer (ADPC). KEGG pathway analysis revealed that Wnt signaling pathways were activated after androgen deprivation therapy (ADT). In vitro experiments showed that the inhibition of Wnt pathway reduced AIPC cell growth by inhibiting cell cycle progression and promoting apoptosis. Furthermore, WNT5A, LEF1 were identified as direct targets of AR by chromatin immunoprecipitation (ChIP) assay and public ChIP-seq datasets analysis. Results: In the present study, we found a regulatory mechanism through which crosstalk between androgen receptor (AR) and Wnt signals promoted androgen-independent conversion of PCa. The Wnt pathway was inhibited by androgen in androgen-dependent prostate cancer cells, but this blocking effect was not elicited in androgen-independent prostate cancer (AIPC) cells. Moreover, Wnt pathway genes WNT5A and LEF1 were directly downregulated by AR. In vitro experiments showed that inhibition of the Wnt pathways repressed AIPC cell growth by inhibiting cell cycle progression and promoting apoptosis. We found that WNT5A and LEF1 were downregulated in low-grade PCa but upregulated in metastatic PCa. Conclusion: In summary, we revealed that crosstalk between AR and Wnt signaling pathways promotes androgen-independent growth of PCa, which may provide novel therapeutic opportunities for castration-resistant prostate cancer. [ABSTRACT FROM AUTHOR]

Research Summary : Does embeddedness in global social networks elevate or diminish individuals' propensity to found new ventures? I analyze entrepreneurial entry among a large, cross‐country sample of skilled return migrants, all of whom had worked abroad in the United States before returning to 98 different home countries. My findings reveal that maintaining stronger cross‐border social ties—that is, relationships to former colleagues abroad—leads returnees to be more likely to found new ventures in their homelands. However, the positive effects of cross‐border social ties diminish with greater institutional distance between the returnee's home country and the United States. The findings have implications for research at the intersection of social networks, international migration, and entrepreneurship. Managerial Summary When it comes to founding a venture, social networks are often critical in helping prospective entrepreneurs identify new market opportunities and resources. Which types of networks are most beneficial in helping people become entrepreneurs, however, still remains a question. This paper asks whether having social connections to individuals across countries makes one more likely to become an entrepreneur, and if so why? Studying skilled return migrants, I find that returnees who maintain stronger social ties to those they met while working abroad are more likely to start companies, but only if there is sufficient similarity between the market environments of the returnee's home country and the country where the returnee worked abroad. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Data on the virologic response and tolerability of direct‐acting antivirals (DAAs) are lacking in older people because these individuals are underrepresented in clinical trials. This study aimed to assess the effectiveness and tolerability of DAA regimens in older individuals in a large cohort of real‐life clinical practice. METHODS: In this retrospective study, patients with chronic hepatitis C infection between 2017 and 2018 were divided into patients aged 65 years and older and those younger than 65 years. We evaluated the sustained virologic response rates (SVRs) in both groups. Further subgroup analyses on the SVRs for patients aged 65 to 74, 75 to 84, and 85 years and older were performed. We also analyzed the predictors of treatment response in older individuals. RESULTS: Among 1151 eligible patients, 516 were in the older group and 635 were in the younger group. The overall treatment response in the entire cohort was 97.7%. A significantly higher percentage of patients presented with advanced stages of fibrosis in the older group (53.1% vs 39.5%; P = <.001). The SVR rates were similar between the two groups (98.3% vs 97.7%; P =.18). In multivariate models, age was not predictive of SVR after adjusting for confounders. Subgroup analyses in the age groups of 65 to 74, 75 to 84, and older than 85 years showed similar treatment response rates (97.4%, 97.2%, and 86.7, respectively; P =.06) and advanced fibrosis (50.8%, 61.5%, and 53.3%, respectively; P =.14). CONCLUSION: Although older people exhibit a significantly higher frequency of fibrosis, DAAs produce high rates of SVR in all age groups, and the age of the patient does not seem to have a significant impact on the efficacy of DAAs including patients in the oldest age category (≥75 y). Treatment should not be withheld in older individuals. J Am Geriatr Soc 68:379–387, 2020 [ABSTRACT FROM AUTHOR]

Examination of changes in hypertension awareness, treatment, and control (i.e., the hypertension control cascade) by population subgroup can inform targeted efforts to improve hypertension control and reduce disparities. We analyzed 1999–2016 data from the National Health and Nutrition Examination Survey and examined trends across 6-year periods in hypertension awareness, treatment, and control by age, sex, and race/ethnicity. We included 39,589 participants (16,141 with hypertension). Hypertension awareness, treatment, and control increased from 1999 to 2016 among all age groups. However, there were few changes after 2010. Across all time periods, awareness, treatment, and control were higher among younger women (ages 25–44 years) than among younger men, while control was higher among older men (ages ≥65 years) than among older women. Hypertension control was persistently lower for blacks than for whites of all ages, and awareness, treatment, and control were lower among younger Hispanics. There have been few changes in hypertension awareness, treatment, and control since 2010. Disparities in hypertension control by sex highlight the need for effective interventions among younger men and older women. Concerted efforts are also needed to reduce persistent racial/ethnic disparities, particularly to improve treatment control among blacks and to further address gaps at all stages among younger Hispanics. [ABSTRACT FROM AUTHOR]

When do protest organizations borrow issues or claims that are outside their traditional domains? Sociologists have examined the consequences of borrowing claims across movement boundaries, but not the antecedents of doing so. We argue that movement boundaries are strong when there is consensus about the core claims of a social movement, which we measure by cohesion and focus. Cohesion and focus enhance the legitimacy of a movement and impede member organizations from adopting claims associated with other movements. Analyzing movement organizational activity at U.S.-based protest events from 1960 to 1995, we find that a social movement organization is less likely to adopt claims from other movements when the social movement in which it is embedded exhibits high cohesion and focus. However, when movement organizations do borrow claims, they are more likely to do so by borrowing from movements that themselves exhibit high cohesion and focus. We describe the application of our findings to organization theory, social movements, and field theoretic approaches to understanding social action. [ABSTRACT FROM AUTHOR]

Background: Peripheral neuropathy and erectile dysfunction are common conditions that have both been linked to cardiovascular disease and its risk factors, especially diabetes. The aim of this study was to assess the association of large-fiber peripheral neuropathy with erectile dysfunction in adult US males with and without diabetes.Methods: We included all men aged ≥40 years from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) with data on erectile dysfunction and peripheral neuropathy (n = 1213, including 206 men with diabetes). Erectile dysfunction was assessed by a single question during a self-paced, computer-assisted self-interview. Peripheral neuropathy was evaluated using standardized 10-g monofilament testing, which assesses lower extremity sensation. We used logistic regression to examine the association of peripheral neuropathy with erectile dysfunction overall and stratified by diabetes status, adjusting for demographic and cardiovascular risk factors.Results: The prevalence of peripheral neuropathy was 26.1% (51.2% in men with diabetes and 22.5% in men without diabetes). There was a significant independent association of peripheral neuropathy with erectile dysfunction overall (odds ratio [OR] 1.71, 95% confidence interval [CI], 1.20-2.43) and among US adult men without diabetes (OR 1.68; 95% CI, 1.11-2.56). The association in adults with diabetes was not statistically significant (OR 1.29; 95% CI, 0.39-4.26), possibly owing to limited power in this subgroup.Conclusions: Our study suggests that decreased lower extremity sensation, even in the absence of diabetes, is common and a novel risk factor for erectile dysfunction. [ABSTRACT FROM AUTHOR]

Background: A common belief is that one quarter to one third of all diabetes cases remain undiagnosed. However, such prevalence estimates may be overstated by epidemiologic studies that do not use confirmatory testing, as recommended by clinical diagnostic criteria.Objective: To provide national estimates of undiagnosed diabetes by using a confirmatory testing strategy, in line with clinical practice guidelines.Design: Cross-sectional study.Setting: National Health and Nutrition Examination Survey results from 1988 to 1994 and 1999 to 2014.Participants: U.S. adults aged 20 years and older.Measurements: Confirmed undiagnosed diabetes was defined as elevated levels of fasting glucose (≥7.0 mmol/L [≥126 mg/dL]) and hemoglobin A1c (≥6.5%) in persons without diagnosed diabetes.Results: The prevalence of total (diagnosed plus confirmed undiagnosed) diabetes increased from 5.5% (9.7 million adults) in 1988 to 1994 to 10.8% (25.5 million adults) in 2011 to 2014. Confirmed undiagnosed diabetes increased during the past 2 decades (from 0.89% in 1988 to 1994 to 1.2% in 2011 to 2014) but has decreased over time as a proportion of total diabetes cases. In 1988 to 1994, the percentage of total diabetes cases that were undiagnosed was 16.3%; by 2011 to 2014, this estimate had decreased to 10.9%. Undiagnosed diabetes was more common in overweight or obese adults, older adults, racial/ethnic minorities (including Asian Americans), and persons lacking health insurance or access to health care.Limitation: Cross-sectional design.Conclusion: Establishing the burden of undiagnosed diabetes is critical to monitoring public health efforts related to screening and diagnosis. When a confirmatory definition is used, undiagnosed diabetes is a relatively small fraction of the total diabetes population; most U.S. adults with diabetes (about 90%) have received a diagnosis of the condition.Primary Funding Source: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and National Heart, Lung, and Blood Institute. [ABSTRACT FROM AUTHOR]

This cross-sectional study using NHANES data assesses the proportion of asymptomatic US adults eligible for screening based on new vs current US Preventive Services Task Force and American Diabetes Association screening guidelines, overall and among those with prediabetes or undiagnosed diabetes. [ABSTRACT FROM AUTHOR]

Social movement researchers argue that tactical innovation occurs as a response to changes external to movements, such as police repression and shifts in political authority, or is due to internal movement processes, such as the characteristics of movement organizations and actors. In this study, we locate the roots of tactical innovation in the multiplicity of movement claims articulated at protest events. With data on more than 23,000 protest events that took place in the United States between 1960 and 1995, we develop novel measures of two forms of tactical innovation and the relationships between protest event claims. Our results show that multi-issue protest events are more likely to use novel recombinations of tactics, and protest events with more peripheral movement claims tend to introduce new protest tactics. Our approach brings together work on social movement dynamics, innovation, and field theoretic approaches to theorize about the relationship between the tools and content of activism. [ABSTRACT FROM AUTHOR]

We evaluated the ability of chip-based digital PCR (dPCR) to quantify enterococci, the fecal indicator recommended by the United States Environmental Protection Agency (USEPA) for water-quality monitoring. dPCR uses Poisson statistics to estimate the number of DNA fragments in a sample with a specific sequence. Underestimation may occur when a gene is redundantly encoded in the genome and multiple copies of that gene are on one DNA fragment. When genomic DNA (gDNA) was extracted using two commercial DNA extraction kits, we confirmed that dPCR could discern individual copies of the redundant 23s rRNA gene in the enterococcal genome. dPCR quantification was accurate when compared to the nominal concentration inferred from fluorometer measurements (linear regression slope = 0.98, intercept = 0.03, R² = 0.99, and p value <0.0001). dPCR quantification was also consistent with quantitative PCR (qPCR) measurements as well as cell counts for BioBall reference standard and 24 environmental water samples. qPCR and dPCR quantification of enterococci in the 24 environmental samples were significantly correlated (linear regression slope =1.08, R2 of 0.96, and p value <0.0001); the group mean of the qPCR measurements was 0.19 log units higher than that of the dPCR measurements. At environmentally relevant concentrations, dPCR quantification was more precise (i.e., had narrower 95% confidence intervals than qPCR quantification). We observed that humic acid caused a similar level of inhibition in both dPCR and qPCR, but calcium inhibited dPCR to a lesser degree than qPCR. Inhibition of dPCR was partially relieved when the number of thermal cycles was increased. Based on these results, we conclude that dPCR is a viable option for enumerating enterococci in ambient water. [ABSTRACT FROM AUTHOR]

High-performance computing has facilitated development of biomass production models that capture the key mechanisms underlying production at high spatial and temporal resolution. Direct responses to increasing [ CO2] and temperature are important to long-lived emerging woody bioenergy crops. Fast-growing willow ( S alix spp.) within short rotation coppice ( SRC) has considerable potential as a renewable biomass source, but performance over wider environmental conditions and under climate change is uncertain. We extended the bioenergy crop modeling platform, Bio Cro, to SRC willow by adding coppicing and C3 photosynthesis subroutines, and modifying subroutines for perennation, allocation, morphology, phenology and development. Parameterization with measurements of leaf photosynthesis, allocation and phenology gave agreement of modeled with measured yield across 23 sites in Europe and North America. Predictions for the continental USA suggest yields of ≥17 Mg ha−1 year−1 in a 4 year rotation. Rising temperature decreased predicted yields, an effect partially ameliorated by rising [ CO2]. This model, based on over 100 equations describing the physiological and biophysical mechanisms underlying production, provides a new framework for utilizing mechanism of plant responses to the environment, including future climates. As an open-source tool, it is made available here as a community resource for further application, improvement and adaptation. [ABSTRACT FROM AUTHOR]

How has the recent shift toward multidisciplinary research affected intellectual cohesion in academia? We answer this question through an examination of collaborations and knowledge flows among researchers. We examine the relevant case of Stanford University during a period of intense investment in multidisciplinary research, using a novel measure of knowledge flows in the short-cycled movement of published references from one researcher to another. We describe intellectual cohesion and its trajectory among 1,007 faculty members between 1997 and 2006, and then examine the social-structural antecedents of dyadic knowledge flows that help explain macro-level patterns. Results show that university collaborations have grown denser and more integrated across faculty members and their institutional divisions. However, this integration is led by "star" researchers and is accompanied by a greater centralization of knowledge flows around these individuals. Results illustrate important shifts in the nature of academic research, and contribute to a dynamic view of intellectual cohesion. [ABSTRACT FROM AUTHOR]

We recently described the isolation of a novel influenza virus from swine exhibiting respiratory disease in the United States that is distantly related to human influenza C virus. Based on genetic, biochemical and morphological analysis, the virus was provisionally classified as C/swine/Oklahoma/1334/2011 (C/OK). To further understand the genetics and evolution of this novel pathogen, we performed a comprehensive analysis of its sequence and phylogeny. The results demonstrated that C/OK and human influenza C viruses share a conserved array of predicted functional domains in the viral RNA genome replication and viral entry machinery but vary at key functional sites. Furthermore, our evolutionary analysis showed that homologous genes of C/OK and human influenza C viruses diverged from each other an estimated several hundred to several thousand years ago. Taken together, the findings described in this study support and extend our previous observations that C/OK is a genetically and evolutionarily distinct influenza virus in the family Orthomyxoviridae. [ABSTRACT FROM AUTHOR]

Hybrid poplar (Populus spp.) is an important biomass crop being evaluated for cellulosic ethanol production. Predictions of poplar growth, rotation period, and soil carbon sequestration under various growing conditions, soils, and climates are critical for farmers and managers planning to establish short-rotation forestry (SRF) plantations. In this study, we used an ecoinformatics workflow, the Predictive Ecosystem Analyzer (PEcAn), to integrate literature data and field measurements into the Ecosystem Demography 2 (ED2) model to estimate yield potential of poplar plantations. Within PEcAn 164 records of seven different traits from the literature were assimilated using a Bayesian meta-analysis. Next, variance decomposition identified seven variables for further constraint that contributed >80% to the uncertainty in modeled yields: growth respiration, dark respiration, quantum efficiency, mortality coefficient, water conductance, fine-root allocation, and root turnover rate. Assimilation of observed yields further constrained uncertainty in model parameters (especially dark respiration and root turnover rate) and biomass estimates. Additional measurements of growth respiration, mortality, water conductance, and quantum efficiency would provide the most efficient path toward further constraint of modeled yields. Modeled validation demonstrated that ED2 successfully captured the interannual and spatial variability of poplar yield observed at nine independent sites. Site-level analyses were conducted to estimate the effect of land use change to SRF poplar on soil C sequestration compared to alternate land uses. These suggest that poplar plantations became a C sink within 18 years of conversion from corn production or existing forest. Finally, poplar yields were estimated for the contiguous United States at a half degree resolution in order to determine potential productivity, estimate the optimal rotation period, and compare poplar to perennial grass yields. This regional projection suggests that poplar yield varies considerably with differences in soil and climate, reaching as much as 18 Mg·ha-1·yr-1 in eastern, southern, and northwest regions. In New England, the upper Midwest, and northern California, yields are predicted to exceed those of the highly productive C4 perennial grass, Miscanthus. In these poplar-productive regions, 4-11 year rotations give the highest potential yields. In conclusion, poplar plantations are predicted to have a high yield potential across a wide range of climates and soils and could be sustainable in soil C sequestration. [ABSTRACT FROM AUTHOR]

Eastern forests of the US are valued both as a carbon sink and a wood resource. The amount of biomass that can be harvested sustainably from this biome for bioenergy without compromising the carbon sink is uncertain. Using past literature and previously validated models, we assessed four scenarios of biomass harvest in the eastern US: partial harvests of mixed hardwood forests, pine plantation management, short-rotation woody cropping systems, and forest residue removal. We also estimated the amount and location of abandoned agricultural lands in the eastern US that could be used for biomass production. Greater carbon storage was estimated to result from partial harvests and residue removals than from plantation management and short-rotation cropping. If woody feedstocks were cultivated with a combination of intensive management on abandoned lands and partial harvests of standing forest, we estimate that roughly 176 Tg biomass y-1 (~330,000 GWh or ~16 billion gallons of ethanol) could be produced sustainably from the temperate forest biome of the eastern US. This biomass could offset up to ~63 Tg C y-1 that are emitted from fossil fuels used for heat and power generation while maintaining a terrestrial C sink of ~8 Tg C y-1. [ABSTRACT FROM AUTHOR]

To examine the relationship between obesity and functional impairment and the influence of comorbidity, joint pain, and mental health on this association, we used US adult respondents (N = 430,912) to the 2007 Behavioral Risk Factor Surveillance Survey (BRFSS-07). Functional impairment was indicated if a respondent was either (i) limited in any way or in any activities because of physical, mental, or emotional problems, or (ii) had any health problem that required using special equipment such as a cane, wheelchair, special bed, or special telephone. Approximately 62.8% of respondents were overweight or obese and 20.3% were functionally impaired. The unadjusted relationship between obesity and functional impairment revealed a classical J-shaped pattern with odds ratios (95% confidence interval) compared to the normal weight group: 1.63 (1.54-1.73), 1.22 (1.20-1.25), 1.77 (1.73-1.81), 2.43 (2.36-2.51), and 4.12 (3.97-4.27) for underweight, overweight, obesity class I, II, and III, respectively. Although inclusion of different combinations of sociodemographic and medical covariates substantially attenuated the unadjusted association, the collective inclusion of all covariates in a single model did not eliminate the significant J-shaped association resulting in the following corresponding adjusted odds ratios: 1.19 (1.13-1.25), 1.01 (0.99-1.04), 1.23 (1.19-1.27), 1.38 (1.32-1.44), and 1.92 (1.82-2.02). The attenuation was mostly influenced by medical comorbidity. In conclusion, functional impairment is associated with obesity, primarily due to medical comorbidity conditions. The significant residual association highlights the importance of sustainable obesity prevention and treatment at both the individual and public level as functional impairment can create burdens at individual, familial, and societal levels. [ABSTRACT FROM AUTHOR]

Background: An estimated 12% of females in the United States will develop breast cancer in their lifetime. Although, there are advances in treatment options including surgery and chemotherapy, breast cancer is still the second most lethal cancer in women. Thus, there is a clear need for better methods to predict prognosis for each breast cancer patient. With the advent of large genetic databases and the reduction in cost for the experiments, researchers are faced with choosing from a large pool of potential prognostic markers from numerous breast cancer gene expression profile studies. Methods: Five microarray datasets related to breast cancer were examined using gene set analysis and the cancers were categorized into different subtypes using a scoring system based on genetic pathway activity. Results: We have observed that significant genes in the individual studies show little reproducibility across the datasets. From our comparative analysis, using gene pathways with clinical variables is more reliable across studies and shows promise in assessing a patient's prognosis. Conclusions: This study concludes that, in light of clinical variables, there are significant gene pathways in common across the datasets. Specifically, several pathways can further significantly stratify patients for survival. These candidate pathways should help to develop a panel of significant biomarkers for the prognosis of breast cancer patients in a clinical setting. [ABSTRACT FROM AUTHOR]

Using the US banking industry data during 1991-2000, this paper carries out a cluster analysis to segment banks into distinct strategic groups in terms of their product mix and allocation of inputs. We then investigate the production technology and cost structures for banks in each strategic group. A system of cost function and derived share equations is used to estimate the technology for each group. The distributions of returns to scale and technical change for each strategic group are also examined. Our results support the presence of seven distinct strategic groups and heterogeneous technologies in the US banking industry. We also find variations in returns to scale and technical change across strategic groups and over time. By allowing technologies to differ across strategic groups, our results show the presence of increasing, constant, and decreasing returns to scale in different strategic groups. In contrast, if one follows the conventional cost function approach which assumes a single homogeneous technology, one would conclude erroneously that the US banking industry is characterized by decreasing returns to scale. Based on these findings we conclude that the results based on a single homogeneous technology are likely to misrepresent the US banking industry. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine neighborhood effects on the physical and socioemotional health of children from immigrant families, after controlling for parents' demographic characteristics, socioeconomic status, acculturation, and health care issues. Design: Pooled cross-sectional data were merged with community profiles. Setting: The United States in 2013, 2014, and 2015. Participants: 10,399 children from immigrant families in the 2013-2015 National Health Interview Surveys and the U.S. Census Data. Measures: Both objective and subjective measures of neighborhood environments were assessed, including neighborhood physical disorder, socioeconomic status, demographic composition, community resources, and social trust. Analysis: Descriptive statistics, logistic regression models. Results: About half of the sampled children were male (51%); 68% were white; 56% were of Hispanic; and 34% were school-aged. Three neighborhood factors—neighborhood trust, area-level poverty rate, and the presence of primary care physician—were identified as significant predictors for child health outcomes. Foreign-born population, green space, and food desert were not significant. At the individual level, parents' racial and ethnic minority status, non-marital status, and healthcare issues were found to be risk factors. Families' financial resources and parental education were identified as protective factors of socioemotional health. Conclusion: Intervention approaches to build on neighborhood trust may have broad potential to improve child outcomes. Programs focusing on immigrant families with children in high poverty neighborhoods should be a high priority. [ABSTRACT FROM AUTHOR]

Introduction: Coparenting in unmarried families is a protective factor for positive adolescent adjustment. Although the relations between coparenting and adolescent outcomes have been investigated, it remains unclear whether the specific patterns of maternal and paternal coparenting are associated with adolescent behavioral outcomes., Methods: The present study includs a longitudinal cohort of 1143 triads of unmarried parents and their adolescents to examine the associations between different patterns of coparenting and adolescent behavioral problems and delinquency. The data were drawn from the Future of Families and Child Wellbeing Study in the United States. Our study used six waves of publicly available data at children's birth, ages 1, 3, 5, 9, and 15., Results: The latent profile analyses identified four coparenting profiles of maternal and paternal coparenting perceived by the other unmarried parent. Comparing average levels of coparenting between mothers and fathers, the profiles were entitled Low Mom-Low Dad, High Mom-Medium Dad, Low Mom-Medium Dad, and High Mom-High Dad. Parents characteristics, such as cohabitation and marital status, predicted the likelihood of being in cooperative coparenting profiles. Furthermore, all the identified coparenting profiles predicted adolescent externalizing behavioral problems; only the high mom cooperative coparenting profiles predicted adolescent internalizing behavioral problems; none of the coparenting profiles predicted adolescent delinquency., Conclusions: Our study adds empirical evidence for coparenting research by revealing that coparenting patterns vary in unmarried families and that cooperative coparenting benefits child behavioral outcomes. The findings encourage introducing different coparenting training programs targeting unmarried parents' diverse needs, thus promoting positive adolescent adjustment., (© 2024 Foundation for Professionals in Services to Adolescents.)

Background: Guidelines recommend antihypertensive medication for adults with both stage 1 hypertension (systolic blood pressure, 130-139 mm Hg or diastolic blood pressure, 80-89 mm Hg) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk ≥10%. Cardiac biomarkers could facilitate a more targeted approach to the treatment of stage 1 hypertension., Methods: We studied 1999 to 2004 National Health and Nutrition Examination Survey participants aged ≥20 years with untreated stage 1 hypertension without heart failure or ASCVD. We measured hs-cTnI (high-sensitivity cardiac troponin I), hs-cTnT (high-sensitivity cardiac troponin T) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) in stored serum. We used the Pooled Cohort Equations to predict 10-year ASCVD risk. All participants had linked mortality follow-up through December 31, 2019., Results: Overall, 17.5% of US adults (32.2 million) had untreated stage 1 hypertension. Among these 32.2 million persons, 15.7% had ASCVD risk ≥10%, 5.6% had elevated hs-cTnI, 4.7% had elevated hs-cTnT, and 9.5% had elevated NT-proBNP. Among adults aged 65 to 79 years with untreated stage 1 hypertension, 80.5% had ASCVD risk ≥10%, 13.0% had elevated hs-cTnI, 15.2% had elevated hs-cTnT, and 29.4% had elevated NT-proBNP. Less than half of the adults aged ≥80 years with untreated stage 1 hypertension had elevated biomarkers. The cardiovascular disease mortality rates among all adults with untreated stage 1 hypertension and with either ASCVD risk ≥10%, elevated hs-cTnI, elevated hs-cTnT, or elevated NT-proBNP were 7.51, 7.74, 8.75, and 5.87 per 1000 person-years, respectively., Conclusions: Cardiac biomarkers may be more selective for informing risk-based treatment decisions in stage 1 hypertension, particularly among adults aged ≥65 years., Competing Interests: Disclosures R. Christenson has received grant support from Roche Diagnostics, Fujirebio Diagnostics, Beckman Coulter, Siemens Healthcare Diagnostics, Ortho Clinical Diagnostics, Becton Dickinson, Abbott Diagnostics, Mitsubishi, and Horiba Medical; and has consulting agreements with PixCell, Beckman Coulter, Quidel, Siemens Healthineers, and Roche Diagnostics. E. Selvin receives payments from Wolters Kluwer for chapters and laboratory monographs in UpToDate on measurements of glycemic control and screening tests for type 2 diabetes. The other authors report no conflicts.

Background: Screening for fentanyl has been adopted by many clinical laboratories to detect illicit drug use and monitor medication adherence. However, compared to other urine drug testing, fentanyl screening assays are relatively new and therefore their clinical performances are largely unknown. This study extensively evaluated the clinical performance, positive cutoff, and interference profile of SEFRIA fentanyl immunoassay in real patient settings., Methods: The FDA-cleared cutoff of 1.0 was verified with 21 urine samples with low or undetectable levels of fentanyl. After assay implementation, all screened-positive samples were confirmed by liquid chromatography-tandem mass spectrometry. A new cutoff was derived from the numeric values of the false positive (FP) screening results. The FP rates before and after implementing the new cutoff were compared. Interferences were identified by an untargeted drug analysis and confirmed by spiking experiments., Results: A total of 3951 screening results were reviewed in the first two months of the assay utilization, 410 were screened-positive, and 157 (38 %) were FP. After a new cutoff of 1.3 was implemented, the FP rate was reduced to 17 % based on 11119 screening results. Trazodone, labetalol, and haloperidol were identified as major interferents, accounting for 56 % of the FP results using the cutoff of 1.3., Conclusion: By applying the new cutoff and including an interference comment to positive screening results, the FP rate was reduced from initial 38 % to 7.5 % (17 % times 56 %)., Competing Interests: Declaration of Competing Interest No conflict of interest declared., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Humans and equines are two dead-end hosts of the mosquito-borne West Nile virus (WNV) with similar susceptibility and pathogenesis. Since the introduction of WNV vaccines into equine populations of the United States of America (USA) in late 2002, there have been only sporadic cases of WNV infection in equines. These cases are generally attributed to unvaccinated and under-vaccinated equines. In contrast, due to the lack of a human WNV vaccine, WNV cases in humans have remained steadily high. An average of 115 deaths have been reported per year in the USA since the first reported case in 1999. Therefore, the characterization of protective immune responses to WNV and the identification of immune correlates of protection in vaccinated equines will provide new fundamental information about the successful development and evaluation of WNV vaccines in humans. This review discusses the comparative epidemiology, transmission, susceptibility to infection and disease, clinical manifestation and pathogenesis, and immune responses of WNV in humans and equines. Furthermore, prophylactic and therapeutic strategies that are currently available and under development are described. In addition, the successful vaccination of equines against WNV and the potential lessons for human vaccine development are discussed.

Background: In persons with diabetes, annual screening for peripheral neuropathy (PN) using monofilament testing is the standard of care. However, PN detected by monofilament testing is common in older adults, even in the absence of diabetes. We aimed to assess the association of PN with risk of falls and fractures in older adults., Methods: We included participants in the Atherosclerosis Risk in Communities (ARIC) Study who underwent monofilament testing at visit 6 (2016-2017). Incident falls and fractures were identified based on ICD-9 and ICD-10 codes from active surveillance of all hospitalizations and linkage to Medicare claims. We used Cox models to assess the association of PN with falls and fractures (combined and as separate outcomes) after adjusting for demographics and risk factors for falls., Results: There were 3617 ARIC participants (mean age 79.4 [SD 4.7] years, 40.8% male, and 21.4% Black adults), of whom 1242 (34.3%) had PN based on monofilament testing. During a median follow-up of 2.5 years, 371 participants had a documented fall, and 475 participants had a documented fracture. The incidence rate (per 1000 person-years) for falls or fractures for participants with PN versus those without PN was 111.1 versus 74.3 (p < 0.001). The age-, sex-, and race-adjusted 3-year cumulative incidence of incident fall or fracture was significantly higher for participants with PN versus those without PN (26.5% vs. 18.4%, p < 0.001). After adjusting for demographics, PN remained independently associated with falls and fractures (HR 1.48, 95% CI 1.26, 1.74). Results were similar for models including traditional risk factors for falls, when falls and fractures were analyzed as separate outcomes, and after adjustment for competing risk of death., Conclusions: PN, as measured by monofilament testing, is common in older adults and associated with risk of falls and fracture. Screening with monofilament testing may be warranted to identify older adults at high risk for falls., (© 2023 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)

The dietary inflammatory index (DII) has been reported to be related to chronic diseases as a novel inflammatory marker. However, the correlation between DII score and hyperuricemia in adults in the United States is still unclear. Therefore, our goal was to explore the correlation between them. A total of 19,004 adults were enrolled in the National Health and Nutrition Examination Survey from 2011 to 2018. DII score was calculated according to 28 dietary items obtained by 24-hour dietary interview data. Hyperuricemia was defined by serum uric acid level. We used multilevel logistic regression models and subgroup analysis to determine whether the 2 were associated. DII scores were positively associated with serum uric acid and the risk of hyperuricemia. Per unit increased in DII score was associated with a 3 mmol/L increase in serum uric acid in males (β 3.00, 95% confidence interval (CI) 2.05-3.94) and 0.92mmol/L in females (β 0.92, 95% CI 0.07-1.77), respectively. Compared with the lowest tertile of DII score, the rise of DII grade increased the risk of hyperuricemia among the whole participants (T2: odds ratio (OR) 1.14, 95% CI 1.03, 1.27; T3: OR 1.20 [1.07, 1.34], P for trend = .0012) and males [T2: 1.15 (0.99, 1.33), T3: 1.29 (1.11, 1.50), P for trend = .0008]. For females, the correlation between DII score and hyperuricemia was statistically significant in the subgroup stratified by body mass index (BMI) (BMI < 30, OR 1.08, 95% CI 1.02-1.14, P for interaction = .0134), which indicates that the association depends on BMI. In the United States male population, the DII score has a positive correlation with hyperuricemia. Anti-inflammatory dietary intake can be beneficial for lower serum uric acid., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

50 New drugs including 36 chemical entities and 14 biologics were approved by the U.S. Food and Drug Administration during 2021. Among the marketed drugs, 31 new small molecule agents (29 small molecule drugs and 2 diagnostic agents) with privileged structures and novel clinical applications represent as promising leads for the development of new drugs with the similar indications and improved therapeutic efficacy. This review is mainly focused on the clinical applications and synthetic methods of 29 small molecule drugs newly approved by the FDA in 2021. We believed that insight into the synthetic approaches of drug molecules would provide creative and practical inspirations for the development of more efficient and practical synthetic technologies to meet with new drug discovery., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Purpose: Endoscopic retrograde cholangiopancreatography (ERCP) has been used in clinical practice for over 50 years. This study aims to investigate the current state of research in the field of ERCP., Methods: Web of Science database was searched using the term "ERCP" for articles published between 1994 and 2018. The total number of articles from the top 20 countries with the most published articles was determined. The top 5 countries were compared in terms of output per capita, number of articles published in top journals, cumulative impact factor (IF), and average IF. All annual data were subjected to time-trend analysis. The frequently used terms in the titles and abstracts of all articles were retrieved to conduct co-occurrence analysis to determine the research focus of ERCP., Results: A total of 9960 articles on ERCP were published between 1994 and 2018, of which 8778 articles were from the top 20 producing countries. There was a significant positive correlation between the output and GDP of each country (R = 0.870, P = .001). The United States of America (USA), Japan, Germany, Italy, and China were the top 5 producing countries with 3190 (32.0%), 868 (8.7%), 658 (6.6%), 512 (5.1%) and 488 (4.9%) articles published, respectively. The USA, Japan, Italy, and China were trending upwards in the total outputs and outputs per capita, while Germany were trending downwards. For average IF, Germany had a downwards trend, while the other 4 countries remained stable. Overall, the USA had the highest output per capita (97.5/10 million) and the highest average IF (6.454). China had the lowest output per capita (3.5/10 million) and average IF (3.125). The ERCP procedures for sphincter of Oddi dysfunction, the combination of ERCP, and laparoscopic cholecystectomy have been the research focus of ERCP., Conclusions: Except for Germany, research on ERCP will continue to increase in the top-producing countries. The outputs per capita and quality of articles from developed countries are higher than those from developing countries., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

We are in an emerging era of gene-based therapeutics with significant promise for rare genetic disorders. The potential is particularly significant for genetic central nervous system disorders that have begun to achieve Food and Drug Administration approval for select patient populations. This review summarizes the discussions and presentations of the National Institute of Mental Health-sponsored workshop "Gene-Based Therapeutics for Rare Genetic Neurodevelopmental Psychiatric Disorders," which was held in January 2021. Here, we distill the points raised regarding various precision medicine approaches related to neurodevelopmental and psychiatric disorders that may be amenable to gene-based therapies., Competing Interests: Declaration of interests B.L.D. serves an advisory role and/or receives sponsored research support from Homology Medicines, Saliogen Therapeutics, Patch Bio, Moment Bio, Panorama Medicines, Resilience, Spirovant Sciences, Novartis (NBIR), Roche, and Sanofi. G.G. is a scientific co-founder of Voyager Therapeutics and Aspa Therapeutics and holds equity in these companies. G.G. is an inventor on patents with potential royalties licensed to Voyager Therapeutics, Aspa Therapeutics, RegenxBio, and other biopharmaceutical companies. A.M.B. is a beneficiary of a licensing agreement with Axovant Gene Therapies (royalties) and is an inventor on a patent pending related to a GALC Vector: Optimized GALC Genes and Expression Cassettes and Their Use (PCT/US2019/067727). J.D.B. is a consultant for BridgeBio Pharma and received sponsored research support from Takeda California, Inc. G.R.C. is a previous employee of Sio Gene Therapies. S.J.G. received royalty income from Abeona Therapeutics and Taysha Gene Therapies. R.J.K. is an employee of Biogen. A.S. is an employee and shareholder of BridgeBio Pharma. H.Y.Z. is co-founder of Cajal Neuroscience, on the Board of Directors of Regeneron Pharmaceuticals, Inc., the Scientific Advisory Board of The Column Group, and the Institutional Advisory Board of VIB. T.R.F. is a paid consultant for Ferring Ventures, SA. S.T.-W. is an employee of Novartis. M.S. received sponsored research support from Novartis, Biogen, Astellas, Aeovian, Bridgebio, and Aucta and has served on scientific advisory boards for Novartis, Roche, Regenxbio, SpringWorks Therapeutics, Jaguar Therapeutics, and Alkermes., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Current equations for estimated glomerular filtration rate (eGFR) that use serum creatinine or cystatin C incorporate age, sex, and race to estimate measured GFR. However, race in eGFR equations is a social and not a biologic construct., Methods: We developed new eGFR equations without race using data from two development data sets: 10 studies (8254 participants, 31.5% Black) for serum creatinine and 13 studies (5352 participants, 39.7% Black) for both serum creatinine and cystatin C. In a validation data set of 12 studies (4050 participants, 14.3% Black), we compared the accuracy of new eGFR equations to measured GFR. We projected the prevalence of chronic kidney disease (CKD) and GFR stages in a sample of U.S. adults, using current and new equations., Results: In the validation data set, the current creatinine equation that uses age, sex, and race overestimated measured GFR in Blacks (median, 3.7 ml per minute per 1.73 m 2 of body-surface area; 95% confidence interval [CI], 1.8 to 5.4) and to a lesser degree in non-Blacks (median, 0.5 ml per minute per 1.73 m 2 ; 95% CI, 0.0 to 0.9). When the adjustment for Black race was omitted from the current eGFR equation, measured GFR in Blacks was underestimated (median, 7.1 ml per minute per 1.73 m 2 ; 95% CI, 5.9 to 8.8). A new equation using age and sex and omitting race underestimated measured GFR in Blacks (median, 3.6 ml per minute per 1.73 m 2 ; 95% CI, 1.8 to 5.5) and overestimated measured GFR in non-Blacks (median, 3.9 ml per minute per 1.73 m 2 ; 95% CI, 3.4 to 4.4). For all equations, 85% or more of the eGFRs for Blacks and non-Blacks were within 30% of measured GFR. New creatinine-cystatin C equations without race were more accurate than new creatinine equations, with smaller differences between race groups. As compared with the current creatinine equation, the new creatinine equations, but not the new creatinine-cystatin C equations, increased population estimates of CKD prevalence among Blacks and yielded similar or lower prevalence among non-Blacks., Conclusions: New eGFR equations that incorporate creatinine and cystatin C but omit race are more accurate and led to smaller differences between Black participants and non-Black participants than new equations without race with either creatinine or cystatin C alone. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.)., (Copyright © 2021 Massachusetts Medical Society.)

Peripheral neuropathy is associated with substantial morbidity, but risk factors other than diabetes are largely uncharacterized. The aim of this study was to describe the prevalence and risk factors for peripheral neuropathy in adults with and without diabetes from two different population-based studies in the US. We performed a cross-sectional analysis of 5200 black and white participants from NHANES (1999-2004, age 40-85 years) and 3362 black and white participants from the ARIC Study (2016-2017, age 70-89 years) who underwent monofilament testing for peripheral neuropathy using a shared protocol. We used logistic regression to quantify age, sex, and race-adjusted risk factor associations for peripheral neuropathy among middle-aged (40-69 years) and older (≥ 70 years) adults. The age, sex, and race-adjusted prevalence of peripheral neuropathy (decreased sensation on monofilament testing) was 10.4% for middle-aged adults in NHANES, 26.8% for older adults in NHANES, and 39.2% for older adults in ARIC. Diabetes was an important risk factor, but more strongly associated with peripheral neuropathy in middle-aged (OR ~ 5 for long-standing diabetes) compared to older adults (ORs ~ 1.5-2). Male sex (ORs ~ 2), black race (ORs ~ 1.3-1.5), and greater height (ORs ~ 1.5-3) were robust risk factors for peripheral neuropathy. Other risk factors included body mass index, education, and peripheral artery disease. The burden of peripheral neuropathy defined by abnormal monofilament testing among older adults is substantial, even among adults without diabetes. Studies are needed to understand the etiology and prognosis of peripheral neuropathy in the absence of diabetes., (© 2021. The Author(s).)

Objective: To provide nationally representative prevalence estimates of disability associated with prior head injury with loss of consciousness in the United States and to examine associations between prior head injury and disability., Methods: This was a cross-sectional analysis of 7,390 participants ≥40 years of age in the 2011-2014 National Health and Nutrition Examination Surveys (NHANES). Head injury with loss of consciousness was assessed by self-report. Domains of disability were assessed with a standardized structured questionnaire and measured grip strength. Logistic and linear regression models adjusted for demographic, socioeconomic/behavioral, and medical comorbidity variables were used. Multiple imputation was used to account for missing covariate data., Results: Mean age of participants was 58 years; 53% were female; 71% were non-Hispanic White; and 16% had a history of head injury with loss of consciousness. Overall, participants with a history of head injury had higher prevalence of disability in at least 1 domain of functioning compared to individuals without head injury (47.4% vs 38.6%, p < 0.001), with the highest prevalence of disability in the domains of mobility and work productivity. In fully adjusted models, head injury was significantly positively associated with disability in all domains assessed on the standardized questionnaire (all p < 0.05). Participants with head injury had greater grip strength (all p < 0.05)., Conclusions: We found that 47.4% of individuals ≥40 years of age in the United States with a history of head injury are living with disability in at least 1 domain of functioning, corresponding to 11.4 million affected individuals. This significant burden of disability suggests that efforts are needed to improve functioning among individuals with head injury., (© 2021 American Academy of Neurology.)

Background: Documenting current trends in diabetes treatment and risk-factor control may inform public health policy and planning., Methods: We conducted a cross-sectional analysis of data from adults with diabetes in the United States participating in the National Health and Nutrition Examination Survey (NHANES) to assess national trends in diabetes treatment and risk-factor control from 1999 through 2018., Results: Diabetes control improved from 1999 to the early 2010s among the participants but subsequently stalled and declined. Between the 2007-2010 period and the 2015-2018 period, the percentage of adult NHANES participants with diabetes in whom glycemic control (glycated hemoglobin level, <7%) was achieved declined from 57.4% (95% confidence interval [CI], 52.9 to 61.8) to 50.5% (95% CI, 45.8 to 55.3). After major improvements in lipid control (non-high-density lipoprotein cholesterol level, <130 mg per deciliter) in the early 2000s, minimal improvement was seen from 2007-2010 (52.3%; 95% CI, 49.2 to 55.3) to 2015-2018 (55.7%; 95% CI, 50.8 to 60.5). From 2011-2014 to 2015-2018, the percentage of participants in whom blood-pressure control (<140/90 mm Hg) was achieved decreased from 74.2% (95% CI, 70.7 to 77.4) to 70.4% (95% CI, 66.7 to 73.8). The percentage of participants in whom all three targets were simultaneously achieved plateaued after 2010 and was 22.2% (95% CI, 17.9 to 27.3) in 2015-2018. The percentages of participants who used any glucose-lowering medication or any blood-pressure-lowering medication were unchanged after 2010, and the percentage who used statins plateaued after 2014. After 2010, the use of combination therapy declined in participants with uncontrolled blood pressure and plateaued for those with poor glycemic control., Conclusions: After more than a decade of progress from 1999 to the early 2010s, glycemic and blood-pressure control declined in adult NHANES participants with diabetes, while lipid control leveled off. (Funded by the National Heart, Lung, and Blood Institute.)., (Copyright © 2021 Massachusetts Medical Society.)

The 2021 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease (CKD) recommends a target systolic blood pressure under 120 mmHg based on standardized office blood pressure measurement. Here, we examined the potential implications of this new guideline for blood pressure lowering with antihypertensive medication among adults in the United States with CKD compared to the 2012 KDIGO guideline (target blood pressure 130/80 mmHg or under with albuminuria or 140/90 mmHg or under without albuminuria) and the 2017 American College of Cardiology/American Heart Association (target blood pressure under 130/80 mmHg) guideline. Additionally, we determined implications of the 2021 KDIGO guideline for angiotensin converting enzyme inhibitor (ACEi) or angiotensin II-receptor blocker (ARB) use for those with albuminuria (recommended at systolic blood pressure of 120 mmHg or over) compared to the 2012 KDIGO guideline (recommended at blood pressures over 130/80 mmHg). Data were analyzed from 1,699 adults with CKD (estimated glomerular filtration rate 15-59 ml/min/1.73m 2 or a urinary albumin-to-creatinine ratio of 30 mg/g or more) in the 2015-2018 National Health and Nutrition Examination Survey and averaged up to three standardized blood pressure measurements. Among adults with CKD, 69.5% were eligible for blood pressure lowering according to the 2021 KDIGO guideline, compared with 49.8% as per 2012 KDIGO or 55.6% as per 2017 American College of Cardiology/American Heart Association guidelines. Among those with albuminuria, 78.2% were eligible for ACEi/ARB use by the 2021 KDIGO guideline compared with 71.0% by the 2012 KDIGO guideline. However, only 39.1% were taking an ACEi/ARB. Thus, our findings highlight opportunities to improve blood pressure management and reduce cardiovascular risk among adults in the United States with CKD., (Copyright © 2021 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Objectives: Minority patients are under-screened for chronic hepatitis C (CHC) in the USA, and limited data exist for minority patients with advanced fibrosis., Methods: In this cross-sectional study, CHC patients who were prescribed direct-acting antiviral agents were divided into White patients and minority patient groups. Primary measurements were the mean fibrosis scores and percentages of patients with stage III-IV fibrosis (late presenters) for the two groups., Results: Among the 1421 patients with self-reported ethnicity, 697 were White patients, and 724 were minority patients (484 Hispanic, 175 Black, 65 Asians). Compared to the White, minority patients had significantly higher mean fibrosis score (p < 0.001) and a higher percentage of late presenters (p < 0.001). In subgroup analyses, the mean fibrosis scores for Hispanic, Black and Asian patients were 2.58 ± 1.38, 2.28 ± 1.41 and 2.28 ± 1.40, respectively., Conclusions: Minority populations with CHC in the USA experience disparities in access to treatment in the early stages of liver fibrosis. Public health strategies are necessitated to address the inequality, as late presenters are at risk of hepatocellular carcinoma.

Background: The optimal approach to screening and diagnosis of prediabetes and diabetes in youth is uncertain., Methods: We conducted a cross-sectional analysis of 14 119 youth aged 10 to 19 years in the 1999-2016 NHANES. First, we examined the performance of American Diabetes Association risk-based screening criteria. Second, we evaluated the performance of current clinical definitions of prediabetes and diabetes based on hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), either HbA1c or FPG, or both HbA1c and FPG (confirmatory definition) to identify youth at high cardiometabolic risk., Results: Overall, 25.5% of US youth (10.6 million in 2016) were eligible for screening. Sensitivity and specificity of the screening criteria for detecting any hyperglycemia were low for both HbA1c ≥5.7% (sensitivity = 55.5%, specificity = 76.3%) and FPG ≥100 mg/dL (sensitivity = 35.8%, specificity = 77.1%). Confirmed undiagnosed diabetes (HbA1c ≥6.5% and FPG ≥126 mg/dL) was rare, <0.5% of youth. Most (>85%) cases of diabetes were diagnosed. Associations with cardiometabolic risk were consistently stronger and more specific for HbA1c-defined hyperglycemia (specificity = 98.6%; sensitivity = 4.0%) than FPG-defined hyperglycemia (specificity = 90.1%; sensitivity = 19.4%)., Conclusions: One-quarter of US youth are eligible for screening for diabetes and prediabetes; however, few will test positive, especially for diabetes. Most cases of diabetes in US youth are diagnosed. Regardless of screening eligibility, we found that HbA1c is a specific and useful nonfasting test to identify high-risk youth who could benefit from lifestyle interventions to prevent diabetes and cardiovascular risk in adulthood., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Although largemouth bass Micropterus salmoides has shown its extremely economic, ecological, and aquacultural significances throughout the North American and Asian continents, systematic evaluation of genetic variation and structure of wild and cultured populations of the species is yet to be documented. In this study, we investigated the genetic structure of M. salmoides from 20 wild populations and five cultured stocks across the United States and China using eight microsatellite loci, which are standard genetic markers for population genetic analysis. Our major findings are as follows: (1) the result of Fst showed largemouth bass had high genetic differentiation, and the gene flow indicated the genetic exchange among wild populations is difficult; (2) AMOVA showed that 14.05% of the variation was among populations, and 85.95% of the variation was within populations; (3) The majority of largemouth bass populations had a significant heterozygosity excess, which is likely to indicate a previous population bottleneck; (4) Allelic richness was lower among cultured populations than among wild populations; (5) Effective population size in hatcheries could promote high levels of genetic variation among individuals and minimize loss of genetic diversity; China's largemouth bass originated from northern largemouth bass of USA. The information provides valuable basis for development of appropriate conservation policies for fisheries and aquaculture genetic breeding programs in largemouth bass.

Objective: To compare the feeding pattern of preterm infants between two hospitals in China and the United States., Methods: A retrospective cohort study was conducted. Infants <32 weeks were enrolled from Cincinnati Children's Hospital Center Cincinnati University Hospital (CCHMC group) between January 2011 and January 2012 and Peking Union Medical College Hospital (PUMCH group) between January 2011 and May 2012. Enteral and parenteral feeding data of the two groups was compared., Results: Eighty-two infants in the CCHMC group and 74 infants in the PUMCH group were enrolled. The gestational age and birth weight of infants in the CCHMC group were smaller than the PUMCH group (P<0.01). The total dosage of amino acid (58±30 g/kg vs 24.0(19.6, 32.8) g/kg; P<0.01) and fat [35±16 g/kg vs 14.0(11.0, 22.5) g/kg; P<0.01], in the PUMCH group were higher than the CCHMC group. The duration of parenteral nutrition in the PUMCH group was longer than the CCHMC group[(24±10 d vs 8.0(6.0, 11.0) d; P<0.01]. The breast feeding rate in the CCHMC group was higher (94% vs 10%; P<0.01) than in the PUMCH group. The time for achieving full enteral feeding in the CCHMC group was shorter [12.0(10.0, 14.0) d vs 22.4±9.3 d, P<0.01] than in the PUMCH group. The incidences of necrotizing enterocolitis (13% vs 3%; P<0.05) and sepsis (32% vs 12%; P<0.01) in the CCHMC group were higher than in the PUMCH group., Conclusions: Preterm infants in the PUMCH group have a prolonged duration of parenteral nutrition and an increased incidence of sepsis compared to the CCHMC group. Fortified human milk feeding and more aggressive enteral feeding proposal in PUMCH is recommended.

We have recently reported the isolation of a novel virus, provisionally designated C/swine/Oklahoma/1334/2011 (C/OK), with 50% overall homology to human influenza C viruses (ICV), from a pig in Oklahoma. Deep RNA sequencing of C/OK virus found a matrix 1 (M1) protein expression strategy that differed from that of ICV. The novelty of C/OK virus prompted us to investigate whether C/OK virus could exist in a nonswine species. Significantly, we found that C/OK virus was widespread in U.S. bovine herds, as demonstrated by reverse transcription (RT)-PCR and serological assays. Genome sequencing of three bovine viruses isolated from two herds in different states further confirmed these findings. To determine whether swine/bovine C/OK viruses can undergo reassortment with human ICV, and to clarify the taxonomic status of C/OK, in vitro reassortment and serological typing by agar gel immunodiffusion (AGID) were conducted. In vitro reassortment using two human ICV and two swine and bovine C/OK viruses demonstrated that human ICV and C/OK viruses were unable to reassort and produce viable progeny. Antigenically, no cross-recognition of detergent split virions was observed in AGID between human and nonhuman viruses by using polyclonal antibodies that were reactive to cognate antigens. Taken together, these results demonstrate that C/OK virus is genetically and antigenically distinct from ICV. The classification of the new virus in a separate genus of the Orthomyxoviridae family is proposed. The finding of C/OK virus in swine and bovine indicates that this new virus may spread and establish infection in other mammals, including humans. IMPORTANCE Influenza C viruses (ICV) are common human pathogens, infecting most people during childhood and adolescence, and typically cause mild respiratory symptoms. While ICV have been isolated from both pigs and dogs, humans are thought to be the natural viral reservoir. Previously, we characterized an ICV-like virus isolated from pigs exhibiting symptoms of influenza virus-like illness. Here, we show molecular and serological data demonstrating widespread circulation of similar viruses in bovines. Deep RNA sequencing, phylogenetic analysis, and in vitro reassortment experiments demonstrate that animal ICV-like viruses are genetically distinct from human ICV. Antigenically, we show that ICV-like viruses are not recognized by ICV antibodies. En masse, these results suggest that bovine influenza virus warrants classification as a new genus of influenza virus. The finding of this novel virus that can infect multiple mammalian species warrants further research into its role in human health.