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Introduction: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL). Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings in patients with active and treated MCL. Results: A total of 30 patients with MCL and kidney biopsies were identified, with a median age of 67 (range 48–87) years, 73% of whom were men. A total of 20 patients had active MCL at the time of biopsy, of whom 14 (70%) presented with acute kidney injury (AKI), proteinuria and/or hematuria, and biopsy findings potentially attributable to lymphoma. Of the 14, 11 had immune complex (IC) or complement-mediated (C3) disease including proliferative glomerulonephritis (GN) with monotypic Ig deposits (PGNMID [2]), C3GN, (2), secondary membranous nephropathy (MN [3]), tubular basement membrane (TBM) deposits (2), and modest lupus-like GN (2). Lymphomatous infiltration was present in 8 of the 20 patients, 5 with coincident IC or C3 lesions. A total of 6 patients with available follow-up were treated for MCL, all with clinical remission of GN (2 PGNMID, 2 C3GN, and 2 MN). Conclusion: MCL is associated with diverse monoclonal and polyclonal glomerular and extra-glomerular IC and C3 disease. For patients with active MCL and kidney dysfunction requiring biopsy, 70% had findings due or potentially due to lymphoma, including 55% with IC or C3 disease and 40% had lymphomatous kidney infiltration. IC and C3GN in the setting of active MCL was responsive to lymphoma-directed therapy.

Forest fire is one of the most common natural hazards occurring in the Western Ghats region of Kerala and is one of the reasons for forest degradation. This natural disaster causes considerable damage to the biodiversity of this region during the dry fire season. The area selected for the present study, Eravikulam National Park, which is predominantly of grassland vegetation, is also prone to forest fires. This study aims to delineate the forest fire risk zones in Eravikulam National Park using remote sensing (RS) data and geographic information system (GIS) techniques. In the present study, methods such as Analytic Hierarchy Process (AHP) and Frequency Ratio (FR) were used to derive the weights, and the results were compared. We have used seven factors, i.e. land cover types, normalized difference vegetation index, normalized difference water index, slope angle, slope aspect, distance from the settlement, and distance from the road to prepare the fire risk zone map. The area of the prepared risk zone maps is divided into three zones, namely low, moderate, and high. From the study, it was found that the fire occurring in this area is due to natural as well as anthropogenic factors. The prepared forest fire risk zone maps are validated using the fire incidence data for the period from January 2003 to June 2019 collected from the records of the Forest Survey of India. The investigation revealed that 72% and 24% of the fire incidences occurred in the high risk zone of the maps prepared using the AHP and FR methods, respectively, which ascertained the superiority of the AHP method over the FR method for forest fire risk zone mapping. The receiver operating characteristic (ROC) curve analysis gives an area under the ROC curve (AUC) value of 0.767 and 0.567 for the AHP and FR methods, respectively. The risk zone maps will be useful for staff of the forest department, planners, and officials of the disaster management department to take effective preventive and mitigation measures.

Cotonou, the economic capital of Benin, is suffering from the impacts of climate change, particularly evident through recurrent floods. To effectively manage these floods and address this issue, it is crucial to have a deep understanding of return periods and hydroclimatic parameters (such as intensity-duration-frequency (IDF) curves and related coefficients), which are essential for designing stormwater drainage structures. Determining return periods and these parameters requires statistical analysis of extreme events, and this analysis needs to be regularly updated in response to climate change. The objective of this study was to determine the necessary return periods and hydroclimatic parameters to improve stormwater drainage systems in the city and its surroundings areas. This required annual maximum precipitation series of 1, 2, 3, 6, 12, and 24 h for 20 years length (1999–2018) as well as flood record data. The intensity series, derived by dividing the amount of rainfall by its duration, was adjusted using Gumbel’s law. IDF curves were constructed based on Montana and Talbot models, and their coefficients were determined according to the corresponding return periods. In 2010, which witnessed devastating floods in the country, the return period for the most intense rainfall events was 40 years, followed by 2013 with a return period of 13.4 years. Consequently, the commonly used 10-year return period for the design of stormwater drainage structures in Cotonou is insufficient. The Talbot model produced the lowest mean square errors for each quantile series and coefficients of determination closest to one, indicating that the parameters obtained from this model are well suited for designing hydraulic structures in Cotonou. The hydroclimatic parameters presented in this study will contribute to the improved design of hydraulic structures in the city of Cotonou.

Introduction: Membranous nephropathy (MN) is a common cause of adult nephrotic syndrome in the US. The typical ultrastructural finding is of global uniformly dense subepithelial electron-dense immune complex deposits along glomerular basement membranes (GBM). However, early reports described deposits with a unique microspherular substructure. There was variability in what was identified as microspherular, sometimes overlapping with other entities such as podocyte infolding glomerulopathy (PIG). Currently, the nature, composition, and clinical significance of these microspherular deposits (MSD) remain unknown. Method: We report the clinicopathologic features of a series of MN cases with MSD, with detailed ultrastructural charactarization as well as PLA2R and THSD7A immunohistochemical and IgG subclass staining characteristics. The proportion of MSD to overall deposits segregated into two groups: global MSD with >50% MSD (n=14) and segmental MSD with

Fabry Disease is an X-linked disorder due to a pathogenic variant of the GLA gene that codes for the alpha-galctosidase enzyme. The reduced or absent activity of the enzyme results in lysosomal accumulation of globotriosylceramide, and its derivative, globotriaosylsphingosine in a variety of cells leading to a variety of complications including cardiac, renal, and cerebrovascular disorders. Early diagnosis is critically important for the selection of therapeutic treatments, which are essential for improving outcomes. Here we present a case of Fabry Disease diagnosed at the time of ESKD presentation. A 40-year-old man with a history of seizures, presented with increased serum creatinine, nephrotic rage proteinuria and new onset hypertension. A renal biopsy revealed numerous, whorled, and lamellated cytoplasmic inclusions in podocytes, glomerular peritubular capillary endothelial cells, mesangial cells, arterial myocytes and interstitial macrophages. Ultrastructural analysis confirmed the presence of glycosphingolipid inclusions and enlarged lysosomes packed with multi-lamellated structures ("zebra" bodies). The findings were suggestive of a lysosomal storage disorder and testing for alpha-galactosidase A levels revealed near-absent enzyme activity, confirming the diagnosis of advanced Fabry disease. The diagnosis of FD can be challenging as the manifestations of the disease are non-specific, and patients can present early with classical symptoms or late with non-classical patterns of involvement. We will discuss strategies to identify the disorder early by reviewing the classical and non-classical presentations and further outline currently available and potential future treatment options.

C3 glomerulopathy (C3G) is a rare disease resulting from dysregulation of the alternative complement pathway, resulting in the deposition of complement component 3 (C3) in the kidney. It encompasses two major subgroups: dense deposit disease (DDD) and C3 glomerulonephritis (C3GN). Although the alternative complement pathway is typically a very tightly controlled system, dysregulation can be a result of genetic mutations in fluid phase or membrane-bound inhibitors or accelerators. In addition, de-novo/acquired autoantibodies against any of the regulatory proteins can alter complement activation either by negating an inhibitor or activating an accelerator. Triggering events can be complex; however, the final pathway is characterized by the uncontrolled deposition of C3 in glomeruli and the formation of the membrane attack complex. Light microscopic findings can be quite heterogeneous with a membranoproliferative pattern (MPGN) most commonly encountered. Diagnostic confirmation of C3G is based on a characteristic pattern of glomerular immunofluorescence staining, with C3 dominant deposits that are at least 2 orders of intensity greater than staining for any immunoglobulin or C1q. Electron microscopy is necessary for diagnosing DDD in particular, but can also help to distinguish C3GN from other glomerular disease mimickers.

Background--Presence of prominent left ventricular trabeculation satisfying criteria for left ventricular noncompaction (LVNC) on routine cardiac magnetic resonance examination is frequently encountered; however, the clinical and prognostic significance of these findings remain elusive. This registry aimed to assess LVNC prevalence by 4 current criteria and to prospectively evaluate an association between diagnosis of LVNC by these criteria and adverse events. Methods and Results--There were 700 patients referred for cardiac magnetic resonance: 42% were women, median age was 70 years (range, 45-71 years), mean left ventricular ejection fraction was 51% (±17%), and 32% had late gadolinium enhancement on cardiac magnetic resonance. The cohort underwent diagnostic assessment for LVNC by 4 separate imaging criteria--referenced by their authors as Petersen, Stacey, Jacquier, and Captur, with LVNC prevalence of 39%, 23%, 25% and 3%, respectively. Primary clinical outcome was combined end point of time to death, ischemic stroke, ventricular tachycardia/ventricular fibrillation, and heart failure hospitalization. Secondary clinical outcomes were (1) all-cause mortality and (2) time to the first occurrence of any of the following events: cardiac death, ischemic stroke, ventricular tachycardia/ventricular fibrillation, or heart failure hospitalization. During a median follow-up of 7 years, there were no statistically significant differences in assessed outcomes noted between patients with and without LVNC irrespective of the applied criteria. Conclusions--Current criteria for the diagnosis of LVNC leads to highly variable disease prevalence in patients referred for cardiac magnetic resonance. The diagnosis of LVNC, by any current criteria, was not associated with adverse clinical events on nearly 7 years of follow-up. Limited conclusions can be made for Captur criteria due to low observed prevalence. [ABSTRACT FROM AUTHOR]

W.C.Cheng validly published the name Juniperus pingii W.C.Cheng in 1944 by providing a validating Latin diagnosis in de Ferré (1944), but he failed to cite any specimen. He repeated the publication of the name in 1947 with the same Latin diagnosis; he thus published an isonym “J. pingii” under Art. 6 Note 2. Cheng (1947) lectotypified the name J. pingii when he designated W.C.Cheng 1015 as the “type” of the isonym. Farjon (2005) overlooked this early designation and his lectotypification of the name with the illustration from the 1944 protologue is not effective as the W.C.Cheng 1015 specimen is extant.

Abstract Background, context and purpose In spite of the mixed evidence for their impact, survivorship Care Plans (SCPs) are recommended to enhance quality of care for cancer survivors. Data on the feasibility of SCPs in bladder cancer (BC) is sparse. Using a mixed-methods approach, this study describes the iterative development, acceptability and feasibility of BC specific SCP (BC-SCP) in clinical settings. Methods In Phase I, we developed the BC-SCP. In Phase II, we conducted four focus groups with 19 patients and 15 providers to examine its acceptability and usability challenges. Data analyses using the Atlas.ti program, informed refinement of the BC-SCP. In Phase III, we conducted feasibility testing of the refined BC-SCP with 18 providers from 12 health-centers. An encounter survey was completed after each assessment to examine the feasibility of the BC-SCP. Chi-square and Fisher Exact tests were used for comparative analyses. Results During phase I, we observed high patient and provider acceptability of the BC-SCP and substantial engagement in improving its content, design, and structure. In Phase II, providers completed 59 BC-SCPs. Mean time for BC-SCP completion was 12.3 min. Providers reported that BC-SCP content was clear, did not hamper clinic flow and was readily completed with easy-to-access information. Comparative analyses to examine differences in SCP completion time by patient clinico-demographic characteristics and provider type revealed no significant differences. Conclusions Our BC-SCP has clinical relevance, and can be used in an active practice setting. However, considerable progress will be necessary to achieve implementation of and sharing the BC-SCP with patients and care providers, particularly within the electronic medical record. In summary, BC-SCPs are essential to improve the follow up care of BC survivors. Clinical resources are required to ensure appropriate implementation of BC-SCPs. Trial registration Study HUM00056082.

One of the consequences of climate change is the increasing rainfall intensity and frequency leading to flooding. Lately, some major cities in West Africa have been experiencing high frequency of flooding due to extreme rainfall. This study investigated the temporal trends in flash flood and extreme rainfall events in Bamako, Mali for the period 1982–2019. Rainfall observation data from both Mali Meteorological Agency and Climate Hazards Group Infrared Precipitation, and flood ground information’ collected from the Mali Civil protection service were used for this study. Five rainfall extreme indices established by Expert Team for Climate Change Detection Monitoring and Indices (ETCCDI) were analyzed to characterize extreme rainfall intensity and frequency indices. The Gumbel extreme value distribution was used to estimate the return period of flood and extreme rainfall for the period of 5 to 100 years based on the annual maximum daily rainfall. All the five extreme rainfall indices displayed an upward trends except the consecutive wet days (CWD) that showed a decreasing trend. Both the intensity and frequency of extreme rainfall were found to have increased over the study period. The analysis of the flood reports showed an increasing trend in Bamako from 1982 to 2019. The returned period revealed that about 58% of flood events in Bamako are caused by normal rainfall, with 33.3% being caused by extreme rainfall. It was also determined that most flood events were recorded in the years that had higher number of extremely wet days. The findings from this study have demonstrated that floods in Mali are prevalent and adaptation and mitigation strategies are needed.

Landslides are prevalent in the Western Ghats, and the incidences that happened in 2021 in the Koottickal area of the Kottayam district (Western Ghats) resulted in the loss of 10 lives. The objectives of this study are to assess the landslide susceptibility of the high-range local self-governments (LSGs) in the Kottayam district using the analytical hierarchy process (AHP) and fuzzy-AHP (F-AHP) models and to compare the performance of existing landslide susceptible maps. This area never witnessed any massive landslides of this dimension, which warrants the necessity of relooking into the existing landslide-susceptible models. For AHP and F-AHP modeling, ten conditioning factors were selected: slope, soil texture, land use/land cover (LULC), geomorphology, road buffer, lithology, and satellite image-derived indices such as the normalized difference road landslide index (NDRLI), the normalized difference water index (NDWI), the normalized burn ratio (NBR), and the soil-adjusted vegetation index (SAVI). The landslide-susceptible zones were categorized into three: low, moderate, and high. The validation of the maps created using the receiver operating characteristic (ROC) technique ascertained the performances of the AHP, F-AHP, and TISSA maps as excellent, with an area under the ROC curve (AUC) value above 0.80, and the NCESS map as acceptable, with an AUC value above 0.70. Though the difference is negligible, the map prepared using the TISSA model has better performance (AUC = 0.889) than the F-AHP (AUC = 0.872), AHP (AUC = 0.867), and NCESS (AUC = 0.789) models. The validation of maps employing other matrices such as accuracy, mean absolute error (MAE), and root mean square error (RMSE) also confirmed that the TISSA model (0.869, 0.226, and 0.122, respectively) has better performance, followed by the F-AHP (0.856, 0.243, and 0.147, respectively), AHP (0.855, 0.249, and 0.159, respectively), and NCESS (0.770, 0.309, and 0.177, respectively) models. The most landslide-inducing factors in this area that were identified through this study are slope, soil texture, LULC, geomorphology, and NDRLI. Koottickal, Poonjar-Thekkekara, Moonnilavu, Thalanad, and Koruthodu are the LSGs that are highly susceptible to landslides. The identification of landslide-susceptible areas using diversified techniques will aid decision-makers in identifying critical infrastructure at risk and alternate routes for emergency evacuation of people to safer terrain during an exigency.

Wildfires are one of the gravest and most momentous hazards affecting rich forest biomes worldwide; India is one of the hotspots due to its diverse forest types and human-induced reasons. This research aims to identify wildfire risk zones in two contrasting climate zones, the Wayanad Wildlife Sanctuary in the Western Ghats and the Kedarnath Wildlife Sanctuary in the Himalayas, using geospatial tools, analytical hierarchy process (AHP), and fuzzy-AHP models to assess the impacts of various conditioning factors and compare the efficacy of the two models. Both of the wildlife sanctuaries were severely battered by fires in the past, with more than 100 fire incidences considered for this modeling. This analysis found that both natural and anthropogenic factors are responsible for the fire occurrences in both of the two sanctuaries. The validation of the risk maps, utilizing the receiver operating characteristic (ROC) method, proved that both models have outstanding prediction accuracy for the training and validation datasets, with the F-AHP model having a slight edge over the other model. The results of other statistical validation matrices such as sensitivity, accuracy, and Kappa index also confirmed that F-AHP is better than the AHP model. According to the F-AHP model, about 22.49% of Kedarnath and 17.12% of Wayanad fall within the very-high risk zones. The created models will serve as a tool for implementing effective policies intended to reduce the impact of fires, even in other protected areas with similar forest types, terrain, and climatic conditions.