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Gulf War Illness (GWI), a chronic multisymptom illness with a complex and uncertain etiology and pathophysiology, is highly prevalent among veterans deployed to the 1990-1991 GW. We examined how GWI phenotypes varied by demographic and military characteristics among GW-era veterans. Data were from the VA's Cooperative Studies Program 2006/Million Veteran Program (MVP) 029 cohort, Genomics of GWI. From June 2018 to March 2019, 109,976 MVP enrollees (out of a total of over 676,000) were contacted to participate in the 1990-1991 GW-era Survey. Of 109,976 eligible participants, 45,169 (41.1%) responded to the 2018-2019 survey, 35,902 respondents met study inclusion criteria, 13,107 deployed to the GW theater. GWI phenotypes were derived from Kansas (KS) and Centers for Disease Control and Prevention (CDC) GWI definitions: (a) KS Symptoms (KS Sym+), (b) KS GWI (met symptom criteria and without exclusionary health conditions) [KS GWI: Sym+/Dx-], (c) CDC GWI and (d) CDC GWI Severe. The prevalence of each phenotype was 67.1% KS Sym+, 21.5% KS Sym+/Dx-, 81.1% CDC GWI, and 18.6% CDC GWI severe. These findings affirm the persistent presence of GWI among GW veterans providing a foundation for further exploration of biological and environmental underpinnings of this condition.

Background: The Million Veteran Program (MVP) participants represent 100 years of US history, including significant social and demographic changes over time. Our study assessed two aspects of the MVP: (i) longitudinal changes in population diversity and (ii) how these changes can be accounted for in genome-wide association studies (GWAS). To investigate these aspects, we divided MVP participants into five birth cohorts (N-range = 123,888 [born from 1943 to 1947] to 136,699 [born from 1948 to 1953]). Results: Ancestry groups were defined by (i) HARE (harmonized ancestry and race/ethnicity) and (ii) a random-forest clustering approach using the 1000 Genomes Project and the Human Genome Diversity Project (1kGP + HGDP) reference panels (77 world populations representing six continental groups). In these groups, we performed GWASs of height, a trait potentially affected by population stratification. Birth cohorts demonstrate important trends in ancestry diversity over time. More recent HARE-assigned Europeans, Africans, and Hispanics had lower European ancestry proportions than older birth cohorts (0.010 < Cohen's d < 0.259, p < 7.80 × 10−4). Conversely, HARE-assigned East Asians showed an increase in European ancestry proportion over time. In GWAS of height using HARE assignments, genomic inflation due to population stratification was prevalent across all birth cohorts (linkage disequilibrium score regression intercept = 1.08 ± 0.042). The 1kGP + HGDP-based ancestry assignment significantly reduced the population stratification (mean intercept reduction = 0.045 ± 0.007, p < 0.05) confounding in the GWAS statistics. Conclusions: This study provides a characterization of ancestry diversity of the MVP cohort over time and compares two strategies to infer genetically defined ancestry groups by assessing differences in controlling population stratification in genome-wide association studies. [ABSTRACT FROM AUTHOR]

River morphological change is the complex evolution of riverbed states, which can lead to serious riverbank failures, and is a worldwide concern. However, revealing the cause of the evolution, in particular, the potential morphological scouring by eddy currents, is difficult. Accordingly, we propose a comprehensive combination of 2D and 3D simulations to reveal the eddy currents. We selected the Vam Nao, part of the Mekong River, with semi-tidal effects and confluence flows as the case study. We created two unstructured 40 m × 40 m triangular meshes using inverse distance interpolation. This study used the Saint–Venant equations (TELEMAC2D) and Navier–Stokes equations (TELEMAC3D) to reveal the eddy currents for 2009, 2017, and 2018. TELEMAC2D (the simplified form of TELEMAC3D) was assessed for 15 days, 3 months, and 1 year, which met a satisfactory level. The eddy currents' appearance was verified by local knowledge. We found recirculating currents near the riverbank to the East (right at the riverbank failures), whose velocity was approximately half and 1/3–1/4 of the mainstream flow velocity in the dry and flood seasons, respectively. Our study approach performed well in revealing the eddy currents, which can aid in assessing potential riverbank failures and can be applicable to similar contexts. [ABSTRACT FROM AUTHOR]

Background: This article investigated whether robotic‐assisted liver surgery versus laparoscopic liver surgical treatment of hepatocellular carcinoma (HCC) has similar or different short‐ and long‐term clinical outcomes. Methods: A total of 3049 patients from the National Cancer Database who received minimally invasive surgery (ie, robotic or laparoscopic surgery) for stage I HCC cancers between 2010 to 2015, of which 123 had robotic and 2926 had laparoscopic surgeries performed, were identified. Logistic regression was applied to evaluate short‐term outcomes. Cox proportional hazards models were applied to estimate all‐cause mortality at 1‐year, 3‐years, and 5‐years after surgery, adjusting for potential confounders. Propensity score‐matched analyses were conducted to compare long‐term outcomes between robotic and laparoscopic surgeries. Results: Robotic surgery was associated with improved overall survival, with 1‐, 3‐, and 5‐year survival rates (SRs) of 0.92, 0.75, and 0.63 compared with laparoscopic surgery SRs of 0.86, 0.60, and 0.45, respectively (P value <.01). Multivariate analyses showed that robotic compared with laparoscopic surgery had significantly lower 5‐year total mortality (hazard ratio [HR], 0.64 and 95% confidence interval [CI], 0.45%‐0.93% for intent‐to‐treat; HR, 0.62 and 95% CI, 0.42%‐0.91% for end‐treatment analyses). Similar results were found in propensity score matched analyses; robotic surgery was associated with improved overall survival compared with laparoscopic surgery (HR, 0.64 and 95% CI, 0.43%‐0.96% for intent‐to‐treat; HR, 0.59 and 95% CI, 0.39%‐0.90% for end‐treatment). Conclusions: Robotic surgery is not inferior to laparoscopic surgery in treating early‐stage HCC and may be associated with improved long‐term survival. In this largest study to date, the authors find that robotic surgery is not inferior to laparoscopic surgery in treating early‐stage hepatocellular carcinoma. In fact, patients treated with robotic surgery have a higher 5‐year overall survival rate compared with those treated with laparoscopic surgery. [ABSTRACT FROM AUTHOR]

Background: Osteosarcoma is a rare bone tumor that is the most frequently diagnosed among children and adolescents, although this cancer affects people of all ages. This study aims to augment the current literature by examining the incidence of osteosarcoma by its subsites on a national level., Methods: Data from central cancer registries in the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) programs for diagnosis years 1999-2008 and covering 90.1 percent of the US population were analyzed. Analyses included cases of malignant primary osteosarcomas, which were further segmented by topography, appendicular (C40) and axial (C41), to assess differences between these sites. Descriptive statistics, including estimated age-adjusted incidence rates standardized to the 2000 US standard population, were calculated using SEER*Stat 7.0.5 software., Results: Approximately 7,104 cases of malignant primary osteosarcomas were identified during 1999-2008, of which 5,379 were appendicular and 1,725 were axial. The incidence of malignant primary osteosarcomas differed by age, gender, race, ethnicity, region, grade, and stage. These differences in incidence persisted when malignant primary osteosarcomas were categorized by topography codes., Conclusions: These analyses provide a better understanding of the incidence of malignant osteosarcoma which cover 90.1 percent of the US population from 1999-2008. This study provides a more detailed understanding of age, gender, race, and ethnicity by primary site for malignant osteosarcoma incidence on a national level in the United States. More importantly, differences between appendicular and axial sites were observed overall by selected demographic characteristics, in particular regional variations.

Osteosarcoma, the most common primary bone tumor, occurs most frequently in adolescents. Chromosomal aneuploidy is common in osteosarcoma cells, suggesting underlying chromosomal instability. Telomeres, located at chromosome ends, are essential for genomic stability; several studies have suggested that germline telomere length (TL) is associated with cancer risk. We hypothesized that TL and/or common genetic variation in telomere biology genes may be associated with risk of osteosarcoma. We investigated TL in peripheral blood DNA and 713 single nucleotide polymorphisms (SNPs) from 39 telomere biology genes in 98 osteosarcoma cases and 69 orthopedic controls. For the genotyping component, we added 1363 controls from the Prostate, Lung, Colorectal, and Ovarian Cancer ScreeningTrial. Short TL was not associated with osteosarcoma risk overall (OR 1.39, P=0.67), although there was a statistically significant association in females (OR 4.35, 95% Cl 1.20-15.74, P=0.03). Genotype analyses identified seven SNPs in TERF1 significantly associated with osteosarcoma risk after Bonferroni correction by gene. These SNPs were highly linked and associated with a reduced risk of osteosarcoma (OR 0.48-0.53, P=0.0001-0.0006). We also investigated associations between TL and telomere gene SNPs in osteosarcoma cases and orthopedic controls. Several SNPs were associated with TL prior to Bonferroni correction; one SNP in NOLA2 and one in MEN1 were marginally non-significant after correction (P(adj)=0.057 and 0.066, respectively). This pilot-study suggests that females with short telomeres may be at increased risk of osteosarcoma, and that SNPs in TERF1 are inversely associated with osteosarcoma risk.

Objective: This study compares directly coded Summary Stage 2000 (SS2000) with that of Collaborative Stage (CS) Derived Summary Stage 2000 (DeSS2000) for cases of uterine cancer diagnosed in the years 2001-2005 using population-based cancer registry data., Methods: Data included in this study were from central cancer registries that participated in the Surveillance, Epidemiology, and End Results (SEER) Program or the National Program of Cancer Registries (NPCR) and met data quality criteria for 2001-2005 covering approximately 80% of the US population. The data for diagnosis years 2001-2003 (pre-CS) were compared with those for diagnosis years 2004-2005 (post-CS) to review any shifts in staging between the pre- and post-CS years., Results: Slight decreases were observed in the percent of cases staged as in situ and localized uterine cancer with a corresponding slight increase in percent of regional and distant uterine cancer cases. In contrast to the findings in 2001-2003, no regional, (not otherwise specified) uterine cancer cases were reported in 2004-2005. Lastly, in the unstaged/unknown group of uterine cases, there was a slight decrease in the percent of cases., Discussion: The lack of no regional, NOS, and the decrease in unstaged cases indicate improvement in staging of uterine cancer diagnosed in 2004-2005. These findings suggest that the CS DeSS2000 data are of high quality for uterine cancer and can be used to study the stage distribution of the cancer.