Numerous controlled experiments find that elevated ground-level ozone concentrations ([O3]) damage crops and reduce yield. There have been no estimates of the actual yield losses in the field in the United States from [O3], even though such estimates would be valuable for projections of future food production and for cost-benefit analyses of reducing ground-level [O3]. Regression analysis of historical yield, climate, and [O3] data for the United States were used to determine the loss of production due to O3 for maize (Zea mays) and soybean (Glycine max) from 1980 to 2011, showing that over that period production of rain-fed fields of soybean and maize were reduced by roughly 5% and 10%, respectively, costing approximately $9 billion annually. Maize, thought to be inherently resistant to O3, was at least as sensitive as soybean to O3 damage. Overcoming this yield loss with improved emission controls or more tolerant germplasm could substantially increase world food and feed supply at a time when a global yield jump is urgently needed.

<h3>Importance</h3>Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together.<h3>Objective</h3>To determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. As a secondary analysis, we investigated hospital length of stay.<h3>Design</h3>We identified patients who underwent colectomy for colon cancer in the 2005-2008 American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side. Preoperative, intraoperative, and postoperative factors were compared. Multivariable techniques were used to assess the impact of the side of colectomy on operative outcome measures, adjusting for covariates.<h3>Setting</h3>Hospitals within the American College of Surgeons National Surgical Quality Improvement Program database.<h3>Patients</h3>We identified 4875 patients who underwent elective laparoscopic or open colectomy for right-sided or left-sided colon cancer in the database.<h3>Main Outcomes and Measures</h3>Major complications and surgical site infection (SSI) rates.<h3>Results</h3>In the 4875 colectomies studied, a laparoscopic approach was used in 42% of cases and at similar frequency in right-sided and left-sided colectomies. Thirty-day mortality (1.5%) was similar in both groups. Major complications were seen in 17% of patients in each group. Superficial SSI was more likely to occur in patients who underwent left-sided colectomy (8.2% vs 5.9%). Among patients with postoperative sepsis or deep or organ space SSIs, more patients in the left-sided colectomy group underwent reoperation compared with the right-sided colectomy group (56% vs 30%). Laparoscopic right-sided colectomy patients were more likely to have a prolonged hospital length of stay than laparoscopic left-sided colectomy patients (odds ratio, 1.39; 95% CI, 1.09-1.78).<h3>Conclusions and Relevance</h3>The outcomes after colectomy for cancer are comparable in right-sided and left-sided resections, except for in the case of superficial SSI, which is less common in right-sided resections. Further research on SSI after colectomy should incorporate right vs left side as a potential preoperative risk factor.

OBJECTIVE To test whether depressive symptoms are related to subsequent C-reactive protein (CRP) levels and/or whether CRP levels are related to subsequent depressive symptoms in mid-life women. METHODS Women enrolled in the Study of Women's Health Across the Nation (SWAN) were followed for 7years and had measures of CES-Depression scores and CRP seven times during the follow-up period. Women were pre- or early peri-menopausal at study entry and were of Caucasian, African American, Hispanic, Japanese, or Chinese race/ethnicity. Analyses were restricted to initially healthy women. RESULTS Longitudinal mixed linear regression models adjusting for age, race, site, time between exams, and outcome variable at year X showed that higher CES-D scores predicted higher subsequent CRP levels and vice versa over a 7-year period. Full multivariate models adjusting for body mass index, physical activity, medications, health conditions, and other covariates showed that higher CRP levels at year X predicted higher CES-D scores at year X+1, p=0.03. Higher depressive symptoms predicted higher subsequent CRP levels at marginally significant levels, p=0.10. CONCLUSIONS Higher CRP levels led to higher subsequent depressive symptoms, albeit the effect was small. The study demonstrates the importance of considering bi-directional relationships for depression and other psychosocial factors and risk for heart disease.

OBJECTIVE To examine the cross-sectional associations among race, depressive symptoms, and aortic and coronary calcification in a sample of middle-aged women. Depressive symptoms have been associated with atherosclerotic indicators of coronary heart disease (CHD) in white women. Few studies have examined these associations in samples including African American women, or explored whether any observed associations differ by race. METHODS Participants were 508 (38% African American, 62% white) women. Aortic and coronary calcification were measured by electron beam tomography and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariable linear and logistic regression models were conducted to test associations. RESULTS In linear regression models adjusted for race, depressive symptoms were associated with a greater amount of aortic calcification (beta = 0.03, p = .01), and there was a significant race x depressive symptoms interaction (beta = 0.07, p = .006). Findings for depressive symptoms (odds ratio (OR) = 1.03, 95% Confidence Interval (CI) = 1.0-1.06, p = .07), and the race x depressive symptoms interaction (OR = 1.1, 95% CI = 1.01-1.18, p = .01) were similar in race-adjusted multinomial logistic regression models predicting high levels of aortic calcification. Race-specific models revealed a significant association between depressive symptoms and aortic calcification in African American, but not white women. Additional adjustments for education, study site, and CHD risk factors did not alter these results. Depressive symptoms were not associated with coronary calcification for women of either racial group. CONCLUSIONS African American women may be particularly vulnerable to the effects of depressive symptoms on early atherosclerotic disease.

OBJECTIVE To test whether depressive symptoms are related to inflammatory and hemostatic markers in women approaching menopause. METHODS A total of 3292 women enrolled in the Study of Women's Health Across the Nation (SWAN) were followed for five years and had measures of Center for Epidemiologic Studies-Depression and high sensitivity C-reactive protein, Factor VIIc, fibrinogen, plasminogen activator inhibitor Type 1(PAI-1), and tissue-type plasminogen activator antigen (tPA-ag) up to four times during the follow-up period. Women were pre- or early perimenopausal status at study entry and were of Caucasian, African American, Hispanic, Japanese, or Chinese race/ethnicity. RESULTS Unadjusted longitudinal mixed regression models showed that over a 5-year period, higher depressive symptoms were related to higher fibrinogen, PAI-1, and tPA-ag levels, all p < .0001. Taking into account health history, medication use, ethnicity, aging, and menopausal status, the depressive symptoms were related to fibrinogen, p < .01, and PAI-1, p < .05. Depressive symptoms were related only to fibrinogen in models that also included body mass index, p < .05. CONCLUSIONS Depressive symptoms may be associated with cardiovascular risk in perimenopausal women in part through hypercoagulability. This is the first study to test the association of depressive symptoms and hemostatic and inflammatory markers across time.

BACKGROUND The influence of menopausal status on depressive symptoms is unclear in diverse ethnic groups. This study examined the longitudinal relationship between changes in menopausal status and the risk of clinically relevant depressive symptoms and whether the relationship differed according to initial depressive symptom level. METHODS 3302 African American, Chinese, Hispanic, Japanese, and White women, aged 42-52 years at entry into the Study of Women's Health Across the Nation (SWAN), a community-based, multisite longitudinal observational study, were evaluated annually from 1995 through 2002. Random effects multiple logistic regression analyses were used to determine the relationship between menopausal status and prevalence of low and high depressive symptom scores (CES-D <16 or > or =16) over 5 years. RESULTS At baseline, 23% of the sample had elevated CES-D scores. A woman was more likely to report CES-D > or =16 when she was early peri-, late peri-, postmenopausal or currently/formerly using hormone therapy (HT), relative to when she was premenopausal (OR range 1.30 to 1.71). Effects were somewhat stronger for women with low CES-D scores at baseline. Health and psychosocial factors increased the odds of having a high CES-D and in some cases, were more important than menopausal status. LIMITATIONS We used a measure of current depressive symptoms rather than a diagnosis of clinical depression. Thus, we can only make conclusions about symptoms current at annual assessments. CONCLUSION Most midlife women do not experience high depressive symptoms. Those that do are more likely to experience high depressive symptom levels when perimenopausal or postmenopausal than when premenopausal, independent of factors such as difficulty paying for basics, negative attitudes, poor perceived health, and stressful events.

BACKGROUND We analyzed data from a single menstrual cycle from 630 women, aged 43 to 53 years, in the Daily Hormone Study component of the Study of Women's Health Across the Nation to determine whether hormone levels are associated with trouble sleeping as women enter the menopausal transition. METHODS Women recorded whether they had trouble sleeping the previous night. Morning urine specimens were obtained for daily determinations of levels of luteinizing hormone, follicle-stimulating hormone, estradiol metabolites (ie, estrone conjugates), and the progesterone metabolite (pregnanediol glucuronide). Women were categorized as premenopausal or early perimenopausal by bleeding patterns. RESULTS Average adjusted odds of reporting trouble sleeping were 29% higher in perimenopausal than in premenopausal women. The highest percentages of women in both menopausal groups reported trouble sleeping in the beginning or at the end of their cycle. After controlling for covariates, pregnanediol glucuronide level was associated with increased trouble sleeping in perimenopausal women and follicle-stimulating hormone level was associated with increased trouble sleeping in premenopausal women. Mood and vasomotor symptoms were the strongest and most consistent cocontributors to trouble sleeping. CONCLUSION In this community-based sample of middle-aged women, the most trouble sleeping was observed at the beginning and end of the menstrual cycle.

OBJECTIVE To examine depression and 3-year change in insulin resistance and risk of diabetes and whether associations vary by race. RESEARCH DESIGN AND METHODS We analyzed data from 2,662 Caucasian, African-American, Hispanic, Japanese-American, and Chinese-American women without a history of diabetes from the Study of Women's Health Across the Nation. We estimated regression coefficients and odds ratios to determine whether depression (Center for Epidemiological Studies Depression Scale score > or =16) predicted increases in homeostasis model assessment of insulin resistance (HOMA-IR) and greater risk of incident diabetes, respectively, over 3 years. RESULTS Mean baseline HOMA-IR was 1.31 (SD 0.86) and increased 0.05 units per year for all women (P <0.0001). A total of 97 incident cases of diabetes occurred. Depression was associated with absolute levels of HOMA-IR (P <0.04) but was unrelated to changes in HOMA-IR; associations did not vary by race. The association between depression and HOMA-IR was eliminated after adjustment for central adiposity (P=0.85). Depression predicted a 1.66-fold greater risk of diabetes (P <0.03), which became nonsignificant after adjustment for central adiposity (P=0.12). We also observed a depression-by-race interaction (P <0.05) in analyses limited to Caucasians and African Americans, the only groups with enough diabetes cases to reliably test this interaction. Race-stratified models showed that depression predicted 2.56-fold greater risk of diabetes in African Americans only, after risk factor adjustment (P=0.008). CONCLUSIONS Depression is associated with higher HOMA-IR values and incident diabetes in middle-aged women. These associations are mediated largely through central adiposity. However, African-American women with depression experience increased risk of diabetes independent of central adiposity and other risk factors.

Background. Despite the established effectiveness of expedited partner therapy (EPT) in partner treatment of bacterial sexually transmitted infections (STI), the practice is underutilized. Objective. To estimate the relative effectiveness of strategies to increase EPT uptake (numbers of partners treated for chlamydia). Methods. We developed a care cascade model of cumulative probabilities to estimate the number of partners treated under strategies to increase EPT uptake in Minnesota. The care cascade model used data from clinical trials, population-based studies, and Minnesota chlamydia surveillance as well as in-depth interviews of health providers who regularly treat STI patients and a statewide survey of health providers across Minnesota. Results. Several strategies could improve EPT uptake among providers, including facilitating treatment payment (additional 1,932 partners treated) and implementing electronic health record reminders (additional 1,755 partners treated). Addressing concerns about liability would have the greatest effect, resulting in 2,187 additional partners treated. Conclusions. Providers expressed openness to offering EPT under several scenarios, which reflect differences in knowledge about EPT, its legality, and potential risks to patients. While addressing concerns about provider liability would have the greatest effect on number of partners treated, provider education and procedural changes could make a substantial impact. Highlights Addressing provider concerns about expedited partner therapy (EPT) legality and its potential risks would result in the most partners treated for chlamydia. EPT alerts and electronic EPT prescriptions may also streamline partner treatment. Provider education about the legality of EPT and its potential risks and training in counseling patients on EPT could also increase uptake.