Sustainable coffee: A review of the diverse initiatives and governance dimensions of global coffee supply chains.

With a global footprint of 10 million hectares across 12.5 million farms, coffee is among the world's most traded commodities. The coffee industry has launched a variety of initiatives designed to reduce coffee's contribution to climate change and biodiversity loss and enhance the socio-economic conditions of coffee producers. We systematically reviewed the literature on the sustainability and governance of coffee production and developed a typology of eleven sustainability initiatives. Our review shows that coffee sustainability research has focused primarily on the economic outcomes of certification schemes. The typology expands our knowledge of novel sustainability initiatives being led by coffee farming communities themselves, allowing for an improved consideration of power dynamics in sustainability governance. Sustainability initiatives governed by local actors can improve sustainability outcomes by empowering local decision makers to assess direct risks and benefits of sustainable practices to the local environment, economy, and culture.

A Detailed Histologic and Molecular Assessment of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma.

Diffuse sclerosing variant papillary thyroid carcinoma (DS-PTC) is characterized clinically by a predilection for children and young adults, bulky neck nodes, and pulmonary metastases. Previous studies have suggested infrequent BRAFV600E mutation but common RET gene rearrangements. Using strict criteria, we studied 43 DS-PTCs (1.9% of unselected PTCs in our unit). Seventy-nine percent harbored pathogenic gene rearrangements involving RET, NTRK3, NTRK1, ALK, or BRAF; with the remainder driven by BRAFV600E mutations. All 10 pediatric cases were all gene rearranged (P = .02). Compared with BRAFV600E-mutated tumors, gene rearrangement was characterized by psammoma bodies involving the entire lobe (P = .038), follicular predominant or mixed follicular architecture (P = .003), pulmonary metastases (24% vs none, P = .04), and absent classical, so-called "BRAF-like" atypia (P = .014). There was no correlation between the presence of gene rearrangement and recurrence-free survival. Features associated with persistent/recurrent disease included pediatric population (P = .030), gene-rearranged tumors (P = .020), microscopic extrathyroidal extension (P = .009), metastases at presentation (P = .007), and stage II disease (P = .015). We conclude that DS-PTC represents 1.9% of papillary thyroid carcinomas and that actionable gene rearrangements are extremely common in DS-PTC. DS-PTC can be divided into 2 distinct molecular subtypes and all BRAFV600E-negative tumors (1.5% of papillary thyroid carcinomas) are driven by potentially actionable oncogenic fusions.