Federal Reserve Bank of Cleveland

Policymakers and economists sometimes examine the components of inflation to better understand inflation's behavior. We study the primary components of core PCE inflation for evidence of residual seasonality. To do this, we examine the average one-month percent changes in three categories of seasonally adjusted price data that have been discussed by policymakers: goods excluding food and energy, services excluding energy and housing, and housing. Inflation for goods excluding food and energy and services excluding energy and housing tends to be economically and statistically higher in January than in November and December. Housing inflation does not exhibit residual seasonality. When assessing if inflation has been high or low over short stretches of time, policymakers and economists may want to account for residual seasonality in goods excluding food and energy and services excluding energy and housing.

The aim of this study was to perform a detailed clinical and pathologic analysis of biopsies from 180 BE patients with the goal of understanding the clinical significance and outcome of patients diagnosed with crypt dysplasia (CD). Biopsies from 58 progressors and 122 nonprogressors (372 biopsies) were graded by 3 gastrointestinal pathologists. A consensus biopsy diagnosis (agreement by ≥2 pathologists) was used for outcome analysis. The overall diagnostic agreement among all 3 observers was high (0.75) and was observed in 83.9% cases, with a moderate level of agreement (0.44) noted for CD. BE progressors had a significantly higher proportion of index biopsies with CD (17% vs. 2%) and LGD (9% vs. 0%; overall P <0.0001) compared with nonprogressors. Compared with an index consensus biopsy diagnosis of NDBE, a consensus biopsy diagnosis of IND, CD, and LGD had significantly increased odds of developing HGD/EAC by univariable (OR: 4.05; P <0.0001) as well as multivariable analysis (OR: 10.3; P =0.01). Furthermore, Kaplan-Meier analysis showed that patients diagnosed with CD or LGD on an index biopsy had a higher probability of developing HGD/EAC than those with NDBE ( P <0.0001), and the timeline for progression among patients with CD was found to be intermediate between those diagnosed with NDBE and LGD. BE patients with an index biopsy diagnosis of CD are more likely to develop HGD/EAC compared with those without dysplasia, and these patients may benefit from surveillance and management strategies, similar to LGD.

Early hemorrhagic death in acute promyelocytic leukemia (APL) remains a major, preventable cause of mortality. Although guidelines recommend empiric all-trans retinoic acid (ATRA) at first suspicion of APL, real-world initiation varies. We conducted a multicenter retrospective cohort study within the TriNetX U.S. Collaborative Network to evaluate the impact of early ATRA initiation. Adults with laboratory-confirmed APL (PML-RARA) presenting to the emergency department (ED) were categorized by ATRA initiation within 24 h (early) versus after 24 h (delayed). The primary outcome was 30-day mortality; secondary outcomes included major hemorrhage, ICU admission, thrombosis, and sepsis. Among 596 patients, 137 (23%) received early ATRA. After 1:1 propensity score matching (n = 137 per group), early ATRA was associated with lower 30-day mortality (10.2% vs 26.2%) and reduced major hemorrhage, while other outcomes did not differ. The absolute mortality risk reduction was 16%, yielding a number-needed-to-treat of seven. Early ED ATRA initiation substantially improved survival in PML-RARA–confirmed APL.

Aim Given the chronic nature of acne, two 6-month studies were conducted to evaluate the long-term efficacy and tolerability of clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide (BPO) 3.1% gel (CAB)—the only approved triple-combination acne topical—and its effects on scarring/dyspigmentation in participants with moderate to severe acne. Materials and methods Data were pooled from 2 identical, open-label, single-center studies conducted in participants (N = 50) aged ≥12 years with Investigator’s Global Assessment (IGA) score of 3/4. Endpoints included change from baseline in IGA score, inflammatory/noninflammatory lesions, skin appearance (dryness, postinflammatory hyperpigmentation [PIH], postinflammatory erythema [PIE]), and scarring. Adverse events and tolerability (itching, burning, redness, swelling) were assessed. Results At week 24, 67% of participants achieved treatment success, and significant reductions from baseline in inflammatory (88%) and noninflammatory (68%) lesions were observed (p < 0.001, both). Significant reductions in scarring (33%), investigator- and participant-assessed PIH (71%; 78%, respectively), and PIE (77%; 77%, respectively) were demonstrated (p < 0.001, all). Most participants (>70%) reported no tolerability issues throughout the studies. Seven adverse events occurred; 4 were related to CAB, and 3 led to study discontinuation (BPO allergy [n = 2], irritant contact dermatitis to BPO [n = 1]). Conclusions These findings suggest that CAB is an appropriate and effective topical option for the long-term treatment of acne vulgaris.

Primary gender-affirming vaginoplasty (GAV) may be limited by insufficient natal genital skin and the burdensome requirement for preoperative hair removal in transfeminine individuals. To address these challenges, we introduce the robotic-assisted "tubularized augmented peritoneal cap (TAPCap)" technique, incorporating decellularized fish skin xenografts (FSXs) for primary full-depth GAV. Thirty-two consecutive transfeminine individuals who underwent primary TAPCap vaginoplasty using FSX between July 2023 and April 2025 were retrospectively chart reviewed. Collected data included baseline medical and surgical history, intraoperative data, and postoperative results. The robotic surgical technique involved using a peritoneal cap to line the proximal neovagina, tubularized FSX for the mid-vaginal segment, and penile skin to form the introitus. All 32 patients underwent robotic TAPCap vaginoplasty with FSX without intraoperative complications. The 30-day postoperative complication rate greater than Clavien-Dindo grade II was 6.2%, with a 3.1% readmission rate. At the conclusion of surgery, median vaginal depth was 16 cm. At a median follow-up of 147 days, 93.8% of patients remained adherent to dilation, and final median depth and width of the neovaginal canal were 14.25 cm and 3.18 cm, respectively. Vaginal stenosis occurred in 15.6% of patients, and 9.4% underwent revision of the neovaginal canal. TAPCap vaginoplasty with FSX is a practical approach that may reduce reliance on genital skin and eliminate the need for preoperative hair removal. Early outcomes suggest adequate neovaginal dimensions and low revision rates. Further studies are required to evaluate the long-term viability of graft integration and its cost-effectiveness.

We investigate the behavior of BLS monthly revisions to payroll growth at turning points. We find some evidence corroborating claims by former BLS commissioners and market analysts that revisions around turning points tend to be procyclical and more serially correlated. Furthermore, we do see large revisions before turning points. However, the ability to use revisions to forecast business cycles' turning points seems limited. First, we do see lots of false positives: large revisions occur without a subsequent recession. Second, even within-sample, other indicators, such as initial jobless claims, the Chicago Fed National Activity Index, and the Aruoba-Diebold-Scotti Index, do a better job at detecting recessions. Finally, out-of-sample forecasting performance of revisions is poor.

ABSTRACTAimsWhile suboptimal medication adherence is a widely recognized problem for people with bipolar disorder (BD), it is less clear how individual characteristics are associated with varying levels of adherence and how specific adherence barriers impact behaviors. This interim analysis from an ongoing randomized controlled trial (RCT) examined associations between patient‐reported adherence, adherence barriers, and mood symptoms among poorly adherent individuals with BD.MethodsRCT participants were adults age ≥ 18 years old with BD Type 1 or 2, difficulties with medication adherence, and actively symptomatic as measured by Brief Psychiatric Rating Scale (BPRS) score ≥ 36, Young Mania Rating Scale (YMRS) > 8, or Montgomery Asberg Depression Rating Scale (MADRS) > 8. Adherence was assessed using the self‐reported Tablets Routine Questionnaire (TRQ) and grouped into 3 clinically relevant groups: those with TRQs < 20% (good adherence), ≥ 20% and < 50% (fair adherence), and ≥ 50% (poor adherence). Adherence barriers were assessed with the Oxford Bipolar Knowledge Questionnaire (OBQ), Self‐Report Habit Index (SRHI), Communication Styles Scale (CSS), and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES 8A).ResultsAnalysis was derived from screening and baseline data on the first 129 randomized participants. Mean age was 42.18 (SD = 13.04) years, with 76.74% (n = 99) female and 41.09% (n = 53) non‐White. The mean past 7‐day percentage of days with missed BD medications using TRQ was 34.34% (SD = 30.32) at screening and 24.82% (SD = 27.70) at baseline. The average time between screening visit and baseline was 18.90 (SD = 12.46) days. Comparing adherence groups, MADRS and BPRS were significantly higher in those with worse adherence both at screening and baseline (p < 0.05 for all). With respect to BD adherence barriers, only SRHI was significantly inversely correlated with TRQ at screening (p < 0.001) and both SRHI and SOCRATES 8A (Taking steps sub‐scale) were significantly inversely correlated with TRQ at baseline (p = 0.001 and p = 0.022, respectively).ConclusionsPoorly adherent individuals with BD have significantly more severe global psychopathology and worse depressive severity. Significant adherence barriers include lifestyle routines that do not promote regular medication‐taking and engagement in reducing the use of substances. Given the extensive burden of poor adherence in BD, adherence promotion efforts should target specific and actionable barriers.Trial RegistrationClinicalTrials.gov identifier: NCT04622150