Four-year longitudinal associations of physical activity, waist circumference, and blood pressure in UK adolescents.

BACKGROUND: This study assessed the specific influence of physical activity (PA) and waist circumference (WC) on the 4-year growth trajectory of blood pressure in UK high-school students. METHODS: Four-year longitudinal monitoring of 1501 adolescents was conducted as part of the EoEHHS. Measurements were taken in Grades (G)7, 9, and 11. RESULTS: Systolic (SBP) and diastolic blood pressure (DBP) increased over the 4-year period (SBP G7 114.6 ± 8.9 mmHg, G9 118.1 ± 9.7 mmHg, G11 122.8 ± 7.8 mmHg; DBP G7 66.7 ± 6.6 mmHg, G9 68.0 ± 6.4 mmHg, G11 70.0 ± 5.2 mmHg). Baseline WC predicted baseline and growth in SBP, but the strongest contribution to SBP came from changes in WC (ß = 0.084, p = 0.002). Baseline PAQ-A score (ß = -0.822, p = 0.020) and changes in PAQ-A score (ß = -0.650, p = 0.019) were associated with smaller increases in DBP over the 4-year measurement period. CONCLUSIONS: Baseline and change in WC predicted the growth trajectory of SBP, while baseline and change in PA predicted the growth trajectory of DBP. PA and WC have a prognostic value in predicting changes in blood pressure in adolescents. Increasing PA during adolescence could slow the rise in DBP over time. This is meaningful for future hypertension and CVD risk reduction into adulthood. IMPACT: Hypertension in adolescents is a growing health problem that is often overlooked. Baseline and changes in waist circumference over a 4-year period predicted development of systolic blood pressure, while baseline and changes in physical activity predicted development of diastolic blood pressure. Physical activity and waist circumference have a prognostic value in predicting changes in blood pressure in adolescents and could be valuable in planning programmes to prevent hypertension in similar communities and reduce the risk of future adult hypertension.

PV Panel Model Parameter Estimation by Using Particle Swarm Optimization and Artificial Neural Network.

Photovoltaic (PV) panels are one of the popular green energy resources and PV panel parameter estimations are one of the popular research topics in PV panel technology. The PV panel parameters could be used for PV panel health monitoring and fault diagnosis. Recently, a PV panel parameters estimation method based in neural network and numerical current predictor methods has been developed. However, in order to further improve the estimation accuracies, a new approach of PV panel parameter estimation is proposed in this paper. The output current and voltage dynamic responses of a PV panel are measured, and the time series of the I-V vectors will be used as input to an artificial neural network (ANN)-based PV model parameter range classifier (MPRC). The MPRC is trained using an I-V dataset with large variations in PV model parameters. The results of MPRC are used to preset the initial particles' population for a particle swarm optimization (PSO) algorithm. The PSO algorithm is used to estimate the PV panel parameters and the results could be used for PV panel health monitoring and the derivation of maximum power point tracking (MMPT). Simulations results based on an experimental I-V dataset and an I-V dataset generated by simulation show that the proposed algorithms can achieve up to 3.5% accuracy and the speed of convergence was significantly improved as compared to a purely PSO approach.

Cross-adaptation from heat stress to hypoxia: A systematic review and exploratory meta-analysis.

Cross-adaptation (CA) refers to the successful induction of physiological adaptation under one environmental stressor (e.g., heat), to enable subsequent benefit in another (e.g., hypoxia). This systematic review and exploratory meta-analysis investigated the effect of heat acclimation (HA) on physiological, perceptual and physical performance outcome measures during rest, and submaximal and maximal intensity exercise in hypoxia. Database searches in Scopus and MEDLINE were performed. Studies were included when they met the Population, Intervention, Comparison, and Outcome criteria, were of English-language, peer-reviewed, full-text original articles, using human participants. Risk of bias and study quality were assessed using the COnsensus based Standards for the selection of health status Measurement INstruments checklist. Nine studies were included, totalling 79 participants (100 % recreationally trained males). The most common method of HA included fixed-intensity exercise comprising 9 ± 3 sessions, 89 ± 24-min in duration and occurred within 39 ± 2 °C and 32 ± 13 % relative humidity. CA induced a moderate, beneficial effect on physiological measures at rest (oxygen saturation: g = 0.60) and during submaximal exercise (heart rate: g = -0.65, core temperature: g = -0.68 and skin temperature: g = -0.72). A small effect was found for ventilation (g = 0.24) and performance measures (peak power: g = 0.32 and time trial time: g = -0.43) during maximal intensity exercise. No effect was observed for perceptual outcome measures. CA may be appropriate for individuals, such as occupational or military workers, whose access to altitude exposure prior to undertaking submaximal activity in hypoxic conditions is restricted. Methodological variances exist within the current literature, and females and well-trained individuals have yet to be investigated. Future research should focus on these cohorts and explore the mechanistic underpinnings of CA.

The Hop Cyst Nematode, Heterodera humuli: History, Distribution, and Impact on Global Hop Production.

Humulus lupulus (commonly known as hop) is an herbaceous plant that is used in brewing throughout the world. Hop cones are an essential ingredient in the production of beer, which makes hops of critical importance to global craft beverage industries. The hop cyst nematode, Heterodera humuli, is a plant-parasitic nematode with the potential to substantially limit yields of hop. H. humuli has been detected in many of the most significant regions for hop production worldwide, and infestations of H. humuli can consequently impact hop growth and limit cone production. Despite documented reports on the distribution of and damage caused by H. humuli since its description in 1934, there have been limited studies on the biology, pathogenicity, management, and consequences of infestations on hop production over time. Inconsistencies and gaps in the available information (e.g., the number of H. humuli generations per season, host status of alternate crops), exacerbate difficulties in understanding how H. humuli can be managed. Resolving the existing knowledge gaps identified within this review can lead to determining effective H. humuli management strategies for hop growers.

PV Panel Model Parameter Estimation by Using Neural Network.

Photovoltaic (PV) panels have been widely used as one of the solutions for green energy sources. Performance monitoring, fault diagnosis, and Control of Operation at Maximum Power Point (MPP) of PV panels became one of the popular research topics in the past. Model parameters could reflect the health conditions of a PV panel, and model parameter estimation can be applied to PV panel fault diagnosis. In this paper, we will propose a new algorithm for PV panel model parameters estimation by using a Neural Network (ANN) with a Numerical Current Prediction (NCP) layer. Output voltage and current signals (VI) after load perturbation are observed. An ANN is trained to estimate the PV panel model parameters, which is then fined tuned by the NCP to improve the accuracy to about 6%. During the testing stage, VI signals are input into the proposed ANN-NCP system. PV panel model parameters can then be estimated by the proposed algorithms, and the estimated model parameters can be then used for fault detection, health monitoring, and tracking operating points for MPP conditions.

A New Biological Product Shows Promising Control of the Northern Root-Knot Nematode, Meloidogyne hapla, in Greenhouse Tomatoes.

Tomato plants are susceptible to significant yield losses when infested by the northern root-knot nematode, Meloidogyne hapla. While there are many options for conventional chemical management, few of these options offer effective control for organic growers or those who seek to adopt more environmentally considerate strategies. In this study, we showed that a new, biologically based product (referred to as "MN21.2") has potential for controlling populations of the northern root-knot nematode, Meloidogyne hapla, as a pest of susceptible tomato (cv. Rutgers) in a greenhouse trial. This is significant because if this product's efficacy is supported under field conditions, it may provide organic tomato growers with a valuable tool for fighting the plant-parasitic nematode pest, M. hapla.

Implementation of Behavioral Health Integration in Small Primary Care Settings: Lessons Learned and Future Directions.

Primary care practices are in great need of practical guidance on the steps they can take to build behavioral health integration (BHI) capacities, particularly for smaller practice settings with fewer resources. 11 small primary care sites (≤ 5 providers) throughout New York State utilized a continuum framework of core components of BHI in combination with technical assistance. Surveys were collected at baseline, 6-months, and 12-months. Semi-structured interviews and focus groups were conducted during site visits, and a stakeholder roundtable was facilitated to address broader themes. Data were analyzed using qualitative thematic analysis. Practices reported successful engagement with the framework and actively participated in planning and advancing BHI operations. Greater success was observed in practices with existing on-site BHI services, identified champions for BHI, early and sustained training and involvement of providers and administrators, use of collaborative agreements with external behavioral health providers, and capacity to successfully receive reimbursements for BHI services. Advancing health information technologies was a challenge across sites. Financing and policy factors were viewed as critically important to advance integration efforts. The pilot of a continuum framework offers lessons for primary care practices and policymakers to advance integrated BH care.

COVID-19: Social Distancing and Physical Activity in United Kingdom Residents With Visual Impairments.

Introduction: The introduction of the COVID-19 lockdown and social distancing policy has the potential to restrict access to physical activity, change exercise behavior, and to increase sedentary behavior. This study was conducted with the support of British Blind Sport and evaluates the effect of the lockdown policy on adults with visual impairments in the United Kingdom (UK). Methods: An online survey based on the World Health Organization's Global Physical Activity Questionnaire was completed by 73 participants (median age 35-44 years, 59% female) to gain information on how the implementation of the lockdown policy by the UK government has affected physical activity and sedentary behavior in adults that are visually impaired. Paired sample t-tests and Wilcoxon signed rank tests were used to analyze continuous and Likert scale data, respectively. Results: The majority of participants continued to exercise during lockdown, but the nature of this activity altered with a significant change to exercising in a private indoor space (+190% (always), z = -3.871, p < 0.001), and those exercising alone (+118% (always), z = -2.595, p = 0.009). The volume of activity reduced in all cases, between -11% and -52%, with significant changes in duration of vigorous day-to-day activity, moderate day-to-day activity, travel by foot or cycle, and vigorous recreational activity. Sedentary behavior increased on average by 21% (t(59) = -2.050, p = 0.045), with a greater effect seen in females (+36%, t(35) = -2.525, p = 0.016). Discussion: Reductions in physical activity volume and increases in sedentary behavior are consequences of the UK lockdown for those with visual impairments. The health and well-being implications of these data to this specific population are of particular concern. Implications for Practitioners: Lockdown measures should be designed with consideration of the needs of people with disabilities. Innovative ways to engage these populations in physical activity are strongly encouraged.

An Ozonolysis Based Method and Applications for the Non-Lethal Modification of Insect Cuticular Hydrocarbons.

Cuticular hydrocarbons (CHCs) are important, multi-function components of the insect epicuticle. In Drosophila spp., CHCs provide protection from desiccation and serve as semiochemicals for both intra- and interspecific communication. We developed a non-lethal method for the modification of Drosophila CHCs profiles through the exposure of live insects to a high dose of ozone gas (~ 45,000 ppm). Drosophila suzukii that were treated with ozone showed a 1.63-3.10 fold reduction in unsaturated hydrocarbons with these CHCs shown to regenerate over 108 h. Changes in CHCs were correlated with significantly reduced desiccation resistance in both male and female D. suzukii at one h after ozone treatment. Interestingly, individuals treated with ozone showed increased desiccation resistance in comparison to controls at 108 h after ozone treatment. The methodology reported in this paper provides a novel approach to investigate the biosynthesis and functions of CHCs during the lifespan of an insect.

The evolution of insect metallothioneins.

Metallothioneins (MTs) are a family of cysteine-rich metal-binding proteins that are important in the chelating and detoxification of toxic heavy metals. Until now, the short length and the low sequence complexity of MTs have hindered the inference of robust phylogenies, hampering the study of their evolution. To address this longstanding question, we applied an iterative BLAST search pipeline that allowed us to build a unique dataset of more than 300 MT sequences in insects. By combining phylogenetics and synteny analysis, we reconstructed the evolutionary history of MTs in insects. We show that the MT content in insects has been shaped by lineage-specific tandem duplications from a single ancestral MT. Strikingly, we also uncovered a sixth MT, MtnF, in the model organism Drosophila melanogaster. MtnF evolves faster than other MTs and is characterized by a non-canonical length and higher cysteine content. Our methodological framework not only paves the way for future studies on heavy metal detoxification but can also allow us to identify other previously unidentified genes and other low complexity genomic features.

Impacts of Manures and Manure-Based Composts on Root Lesion Nematodes and Verticillium dahliae in Michigan Potatoes.

The interaction of the root lesion nematode Pratylenchus penetrans and the fungal plant pathogen Verticillium dahliae causes potato early die (PED) complex, which induces premature vine senescence and dramatically reduces yield in potatoes. Management of PED is often achieved through the use of soil fumigants and nematicides, but their adverse effects on soil, human and environmental health, and strict regulations worldwide require alternative control tactics. In this study, we investigated the effects of multiple composts and manures on nematode mortality and PED. In lab assays, root lesion nematodes were exposed to poultry manure, layer ash blend, Dairy Doo, or wood ash for 7 days at rates of 0, 0.1, 1, 10, and 20% by volume of product and assessed for nematode survivorship. Additionally, these products were evaluated for volatile fatty acid content to determine if fatty acid content affects nematode control. In a field trial, the composts and manures were evaluated at two different rates, high (11.2 t/ha) or low (2.8 t/ha), and populations of P. penetrans and V. dahliae were quantified. Our results show that a 1% application rate of poultry manure and layer ash blend provided the greatest nematode control in lab assays with 24.5 and 38.2% reduction, respectively, with greater control at higher rates. In the field, plots treated with poultry manure had significantly higher potato yields and significantly fewer nematodes than control plots. Taken together, our results suggest that poultry manure could be a promising amendment to control PED.

First Report of the Hop Cyst Nematode, Heterodera humuli, in Two Counties of the Yakima Valley Region, WA, USA.

Cyst nematodes are ranked as the second most damaging plant-parasitic nematode genus of crops worldwide (Jones et al. 2013). The hop cyst nematode, Heterodera humuli, has been reported to cause up to 38% reduction in dry hops per bine (Hay and Pethybridge 2003). America is the top hop producing country worldwide, with 75% of production occurring in Washington state, with the majority of this production occurring in the Yakima Valley region (USDA, 2019). In late 2019, 30 soil samples from 15 different fields were collected from the hop cvs. HBC 394, HBC 369, and YCR 14. Nematodes were extracted using an adapted centrifugal floatation method (Jenkins 1964) from 100 cc subsamples of soil. Twenty of these samples contained at least one cyst and 23 contained at least one juvenile. Body length of juveniles (n = 5) averaged + standard deviation 377.62 ± 4.76 µm which is consistent with H. humuli juvenile body measurements (Sen 1968). Three samples from Yakima County and two from Benton County were identified to the species level using sequences from the internal transcribed spacer (ITS) region of the 5.8S gene. The sequences (GenBank accession numbers MT840678 to MT840682) were amplified using forward primer 5.8S-F (5'-GTGATTCCATTCACCAHCTACCTG-3'), and reverse primer 5.8S-R (5'-TTCGCACTAATTATCGCAGTTGG-3'). Sequence comparison with available ITS (5.8S) sequences in GenBank using BLAST showed 99.85% identity to H. humuli for all five samples. Because COI sequences of H. humuli are not available, to provide an additional marker for species identification, we amplified the COI sequences by using (forward primer Hete-COI-F (5'-TTTGGDCAYCCHGARGTTTATGTT-3'), and reverse primer Hete-COI-R (5'-AYWGTAAAAAGGRRAATAAAACC-3') for these samples. Four COI sequences (GenBank accession numbers MT840683 to MT840686) were obtained. These COI sequences will be used to identify future H. humuli samples. To confirm pathogenicity, eight 1-gal pots were filled with a 90:10 play sand to potting soil mixture and one hop rhizome cv. 'Centennial' was planted in pots and maintained in a greenhouse. After above ground plant growth was observed, half the pots were inoculated with hand-picked H. humuli cysts from Yakima soil samples at a density of 10 cysts/100 cc of soil. The life cycle of H. humuli in potted experiments is 40 days (McNamara and Mende 1995). Forty-five days after inoculation, plant measurements were recorded and nematodes extracted from five 100 cc soil samples per pot as described above. Soil samples revealed that H. humuli populations had an average Reproductive Factor (RF = final nematode population/initial nematode population) of 2.08. Five cysts were crushed to determine eggs/cyst, which yielded an average of 101 eggs/cyst. Young infected hops lacked vigor, with all replicates stunted both in bine height and leaf length compared to healthy controls. Bine heights were reduced by an average of 40.4% in pots inoculated with H. humuli compared to control plants (P = 0.0016). Distribution of hop cyst within the United States is limited to the top four states for hop production: Washington, Oregon, Idaho and Michigan (Cobb 1962; Sen and Jensen 1967; Hafez et al. 2010, Warner and Bird, 2015). In 1962, Cobb reported H. humuli in Pierce County, Washington, but it had not been reported in Benton County and Yakima County until now. This is a significant finding that has the potential to impact the Washington state hop industry, valued at $475.7 million in 2019 (USDA, 2019). Due to the lack of known effective nematode control measures, the discovery of H. humuli in the major hop-growing region of Washington warrants concern.

Extended live-tracking and quantitative characterization of wound healing and cell migration with SiR-Hoechst.

Cell migration is essential to many life processes, including immune response, tissue repair, and cancer progression. A reliable quantitative characterization of the cell migration can therefore aid in the high throughput screening of drug efficacy in wound healing and cancer treatments. In this work, we report what we believe is the first use of SiR-Hoechst for extended live tracking and automated analysis of cell migration and wound healing. We showed through rigorous statistical comparisons that this far-red label does not affect migratory behavior. We observed excellent automated tracking of random cell migration, in which the motility parameters (speed, displacement, path length, directionality ratio, persistence time, and direction autocorrelation) obtained closely match those obtained from manual tracking. We also present an analysis framework to characterize the healing of a scratch wound from the perspective of single cells. The use of SiR-Hoechst is advantageous for the crowded environments in wound healing assays because as long as cell nuclei do not overlap, continuous tracking can be maintained even if there is cell-cell contact. In this paper, we report wound recovery based on the number of cells migrating into the wound over time, normalized by the initial cell count prior to the infliction of the wound. This normalized cell count approach is impervious to operator bias during the arbitration of wound edges and is also robust against variability that arises due to differences in the cell density of different samples. Additional wound healing characteristics were also defined based on the evolution of cell speed and directionality during healing. Not unexpected, the wound healing cells exhibited much higher tendency to maintain the same migratory direction in comparison to the randomly migrating cells. The use of SiR-Hoechst thus greatly simplified the automation of single cell and whole population analysis with high spatial and temporal resolution over extended periods of time.

Steroid Hormone Signaling Is Essential for Pheromone Production and Oenocyte Survival.

Many of the lipids found on the cuticles of insects function as pheromones and communicate information about age, sex, and reproductive status. In Drosophila, the composition of the information-rich lipid profile is dynamic and changes over the lifetime of an individual. However, the molecular basis of this change is not well understood. To identify genes that control cuticular lipid production in Drosophila, we performed a RNA interference screen and used Direct Analysis in Real Time and gas chromatography mass spectrometry to quantify changes in the chemical profiles. Twelve putative genes were identified whereby transcriptional silencing led to significant differences in cuticular lipid production. Amongst them, we characterized a gene which we name spidey, and which encodes a putative steroid dehydrogenase that has sex- and age-dependent effects on viability, pheromone production, and oenocyte survival. Transcriptional silencing or overexpression of spidey during embryonic development results in pupal lethality and significant changes in levels of the ecdysone metabolite 20-hydroxyecdysonic acid and 20-hydroxyecdysone. In contrast, inhibiting gene expression only during adulthood resulted in a striking loss of oenocyte cells and a concomitant reduction of cuticular hydrocarbons, desiccation resistance, and lifespan. Oenocyte loss and cuticular lipid levels were partially rescued by 20-hydroxyecdysone supplementation. Taken together, these results identify a novel regulator of pheromone synthesis and reveal that ecdysteroid signaling is essential for the maintenance of cuticular lipids and oenocytes throughout adulthood.

Identification and Gene Expression Analysis of the Pheromone Biosynthesis Activating Neuropeptide Receptor (PBANR) From the Ostrinia furnacalis (Lepidoptera: Pyralidae).

Pheromonal communication is important in insect mate finding and reproduction. Identifying components of pest insect pheromone system is a first step to disrupt pest insect reproduction. In this study, we identified and cloned the pheromone biosynthesis activating neuropeptide receptor (PBANR) from the Asian corn borer, Ostrinia furnacalis (Guenée) (Lepidoptera: Pyralidae), which is one of the most damaging pests of corn and other crops in parts of Asia and Australia. The O. furnacalis PBANR (OstfuPBANR) gene has an ORF of 1,086 bp and encoded 362 amino acids with seven transmembrane domains and had a high sequence identity to known lepidopteran PBANRs. Expression analysis showed that OstfuPBANR was highly expressed in the pheromone glands compared with other tissues, consistent with other studies. Interestingly, OstfuPBANR was expressed higher in the larval stages compared to the pupal or adult stages, suggesting that OstfuPBANR may have broad functions in larva beyond adult pheromone synthesis.

Effects of Winter Cover Crops on Rice Pests, Natural Enemies, and Grain Yield in a Rice Rotation System.

Rotations that include winter cover crops are widely used in agricultural systems and can provide numerous agroecological and economic benefits. However, the effects of winter cover crops on arthropod diversity, specifically rice pests and related natural enemies in rice rotation systems, are still largely unknown. We compared the effects of three winter cover crops, rapeseed, Brassica napus L. (Brassicales: Brassicaceae), Chinese milkvetch, Astragalus sinicus L. (Fabales: Fabaceae), and garlic, Allium sativum L. (Asparagales: Amaryllidaceae), on arthropods species diversity and evenness, densities of populations of major rice pests and major natural enemies, and grain yield in an experimental double cropping rotational rice field in Jiangxi Province, China. We did not observe any effects of cover crops on arthropod species diversity and evenness. The presence of prior cover crops also had no effect on the number of plants infested by the two major rice pests, Chilo suppressalis Walker (Lepidoptera: Pyralidae) and Cnaphalocrocis medinalis (Guenée) (Lepidoptera: Pyralidae). Our study did not show any effects of rapeseed and Chinese milkvetch on grain yield. However, grain yield was increased in the garlic treatment. Our results suggest that although the winter cover crops we tested in our study do not affect the number of rice plants infected by major rice pests, they do not negatively affect the arthropod community and grain yields in rice rotation systems. Therefore, planting of winter cover crops may increase agricultural land utilization and have an overall economic benefit in rice rotational systems.

Wax, sex and the origin of species: Dual roles of insect cuticular hydrocarbons in adaptation and mating.

Evolutionary changes in traits that affect both ecological divergence and mating signals could lead to reproductive isolation and the formation of new species. Insect cuticular hydrocarbons (CHCs) are potential examples of such dual traits. They form a waxy layer on the cuticle of the insect to maintain water balance and prevent desiccation, while also acting as signaling molecules in mate recognition and chemical communication. Because the synthesis of these hydrocarbons in insect oenocytes occurs through a common biochemical pathway, natural or sexual selection on one role may affect the other. In this review, we explore how ecological divergence in insect CHCs can lead to divergence in mating signals and reproductive isolation. We suggest that the evolution of insect CHCs may be ripe models for understanding ecological speciation.

New and emerging mechanisms of insecticide resistance.

The continuous use of insecticides over the last eight decades has led to the development of resistance to these insecticides. Research in the last few decades showed that the mechanisms underlying resistance are diverse but can generally be classified under several modes of resistance such as target-site resistance, metabolic resistance, and penetration resistance. In this review, we highlight new discoveries in insecticide resistance research made over the past few years, including an emerging new mode of resistance, sequestration resistance, where the overexpression of olfactory proteins binds and sequesters insecticides in resistant strains, as well as recent research on how posttranscriptional regulation can impact resistance. Future research will determine the generality of these emerging mechanisms across insect species.

Collaborative Care for Depression and Anxiety: Racial-Ethnic Differences in Treatment Engagement and Outcomes.

OBJECTIVE: This study aimed to examine racial-ethnic differences in engagement with and clinical outcomes of a collaborative care model (CoCM) implemented in primary care outpatient clinics in an urban academic medical center. METHODS: Adult patients (N=4,911) who screened positive for symptoms of depression, anxiety, or both on the Patient Health Questionnaire-9 or the Generalized Anxiety Disorder-7 scale and who identified as non-Hispanic Black, Hispanic, or non-Hispanic White were offered participation in a CoCM implementation. The primary outcome was treatment engagement, defined as receipt of any follow-up visit, minimally adequate 4-week follow-up (at least one visit), and minimally adequate 16-week follow-up (at least three visits) after initial assessment. Secondary outcomes were response and remission of depression or anxiety. RESULTS: After adjustment of analyses for sociodemographic covariates, Black and Hispanic participants were significantly less likely than White participants to have received any or minimally adequate follow-up. Black and Hispanic participants who received any or minimally adequate 16-week follow-up were more likely than White participants to demonstrate depression symptom response and remission of anxiety symptoms. CONCLUSIONS: This CoCM implementation appears to have been effective in treating depression and anxiety among Black and Hispanic patients. However, significant disparities in receipt of follow-up care were observed. Efforts must be made to improve the retention of patients from racial-ethnic minority groups in collaborative care.

Tumor Location Is an Independent Prognostic Factor in Completely Resected Pathological Stage I Non-Small Cell Lung Cancer: A Multicenter Retrospective Study.

Previous studies suggested that the location of the primary tumor in non-small cell lung cancer (NSCLC) is associated with clinical features and prognosis, but results are conflicting. The purpose of this study was to explore tumor location as an independent risk factor of survival for patients with completely resected pathological stage I NSCLC. This was a multicenter retrospective study conducted in Taiwan. Included patients were diagnosed with stage I NSCLC and had undergone primary tumor resection. Variables including tumor location, pathological stage, histological differentiation, and International Association for the Study of Lung Cancer (IASLC) grade were evaluated for predictive ability for disease-free survival (DFS) and overall survival (OS). A total of 208 patients were included, with 123 (59.1%) patients having a primary tumor in the upper and middle lobes. The median duration of follow-up for survivors was 60.5 months. Compared to patients with IASLC Grade 3 disease, patients with Grade 1 disease had significantly longer DFS. Tumor location and IASLC grade were independent predictors for OS in multivariate analysis. Specifically, patients with NSCLC in the lower lobe and patients who are histologically classified as IASLC Grade 3 may have poorer prognosis and require greater attention to improve outcomes.