Physicians performing interventional procedures are chronically exposed to ionizing radiation, which is known to pose increased cancer risks. We recently reported 9 cases of brain cancer in ...interventional cardiologists. Subsequently, we received 22 additional cases from around the world, comprising an expanded 31 case cohort. Data were transmitted to us during the past few months. For all cases, where possible, we endeavored to obtain the baseline data, including age, gender, tumor type, and side involved, specialty (cardiologist vs radiologist), and number of years in practice. These data were obtained from the medical records, interviews with patients, when possible, or with family members and/or colleagues. The present report documented brain and neck tumors occurring in 31 physicians: 23 interventional cardiologists, 2 electrophysiologists, and 6 interventional radiologists. All physicians had worked for prolonged periods (latency period 12 to 32 years, mean 23.5 ± 5.9) in active interventional practice with exposure to ionizing radiation in the catheterization laboratory. The tumors included 17 cases (55%) of glioblastoma multiforme (GBM), 2 astrocytomas (7%), and 5 meningiomas (16%). In 26 of 31 cases, data were available regarding the side of the brain involved. The malignancy was left sided in 22 (85%), midline in 1, and right sided in 3 operators. In conclusion, these results raise additional concerns regarding brain cancer developing in physicians performing interventional procedures. Given that the brain is relatively unprotected and the left side of the head is known to be more exposed to radiation than the right, these findings of disproportionate reports of left-sided tumors suggest the possibility of a causal relation to occupational radiation exposure.
Snow provides essential resources/services in the form of water for human use, and climate regulation in the form of enhanced cooling of the Earth. In addition, it supports a thriving winter outdoor ...recreation industry. To date, the financial evaluation of the importance of snow is incomplete and hence the need for accelerated snow research is not as clear as it could be. With snow cover changing worldwide in several worrisome ways, there is pressing need to determine global, regional, and local rates of snow cover change, and to link these to financial analyses that allow for rational decision making, as risks related to those decisions involve trillions of dollars.
Plain Language Summary
Snow is critical in sustaining human life. It provides water and plays a key role in the climate through its unrivaled power to cool the Earth. It is also changing rapidly. To date, a full financial evaluation of the importance of snow in our lives has not been made, but computations here and elsewhere indicate it is on the order of trillions of dollars. Against this value, the current costs of scientific research are trivial. We provide a strong rationale and guidelines for accelerated snow research that will allow society to make major impending decisions related to snow resources on the soundest base and best scientific knowledge.
Key Points
Snow is a critical but often‐unappreciated resource used by humans, and it is changing due to global warming in worrisome ways
Work presented here suggests the valuation across many years of western US snow resources exceeds a trillion dollars
More research is needed to help society make sound decisions on expensive major climate‐driven snow resource changes
Numerous volatile organic compounds (VOCs) exist in Earth's atmosphere, most of which originate from biogenic emissions. Despite VOCs' critical role in tropospheric chemistry, studies for evaluating ...their atmosphere-ecosystem exchange (emission and deposition) have been limited to a few dominant compounds owing to a lack of appropriate measurement techniques. Using a high—mass resolution proton transfer reaction—time of flight—mass spectrometer and an absolute value eddy-covariance method, we directly measured 186 organic ions with net deposition, and 494 that have bidirectional flux. This observation of active atmosphere-ecosystem exchange of the vast majority of detected VOCs poses a challenge to current emission, air quality, and global climate models, which do not account for this extremely large range of compounds. This observation also provides new insight for understanding the atmospheric VOC budget.
Postoperative cognitive dysfunction (POCD) is a common complication of the surgical experience and is common in the elderly and patients with preexisting neurocognitive disorders. Animal and human ...studies suggest that neuroinflammation from either surgery or anesthesia is a major contributor to the development of POCD. Moreover, a large and growing body of literature has focused on identifying potential risk factors for the development of POCD, as well as identifying candidate treatments based on the neuroinflammatory hypothesis. However, variability in animal models and clinical cohorts makes it difficult to interpret the results of such studies, and represents a barrier for the development of treatment options for POCD. Here, we present a broad topical review of the literature supporting the role of neuroinflammation in POCD. We provide an overview of the cellular and molecular mechanisms underlying the pathogenesis of POCD from pre-clinical and human studies. We offer a brief discussion of the ongoing debate on the root cause of POCD. We conclude with a list of current and hypothesized treatments for POCD, with a focus on recent and current human randomized clinical trials.
Placental Pathology in COVID-19 Shanes, Elisheva D; Mithal, Leena B; Otero, Sebastian ...
American journal of clinical pathology,
06/2020, Volume:
154, Issue:
1
Journal Article
Peer reviewed
Open access
Abstract
Objectives
To describe histopathologic findings in the placentas of women with coronavirus disease 2019 (COVID-19) during pregnancy.
Methods
Pregnant women with COVID-19 delivering between ...March 18, 2020, and May 5, 2020, were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma.
Results
Sixteen placentas from patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were examined (15 with live birth in the third trimester, 1 delivered in the second trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), particularly abnormal or injured maternal vessels, and intervillous thrombi. Rates of acute and chronic inflammation were not increased.
The placenta from the patient with intrauterine fetal demise showed villous edema and a retroplacental hematoma.
Conclusions
Relative to controls, COVID-19 placentas show increased prevalence of decidual arteriopathy and other features of MVM, a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive despite the association of MVM with hypertensive disorders and preeclampsia. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.
The ability to predict the effect of mutations on protein stability is important for a wide range of tasks, from protein engineering to assessing the impact of SNPs to understanding basic protein ...biophysics. A number of methods have been developed that make these predictions, but assessing the accuracy of these tools is difficult given the limitations and inconsistencies of the experimental data. We evaluate four different methods based on the ability of these methods to generate consistent results for forward and back mutations, and examine how this ability varies with the nature and location of the mutation. We find that, while one method seems to outperform the others, the ability of these methods to make accurate predictions is limited.
We present the fourth in a series of catalogs of gamma-ray bursts (GRBs) observed with Fermi's Gamma-ray Burst Monitor (Fermi-GBM). It extends the six year catalog by four more years, now covering ...the 10 year time period from trigger enabling on 2008 July 12 to 2018 July 11. During this time period GBM triggered almost twice a day on transient events, 2356 of which we identified as cosmic GRBs. Additional trigger events were due to solar flare events, magnetar burst activities, and terrestrial gamma-ray flashes. The intention of the GBM GRB catalog series is to provide updated information to the community on the most important observables of the GBM-detected GRBs. For each GRB the location and main characteristics of the prompt emission, the duration, peak flux, and fluence are derived. The latter two quantities are calculated for the 50-300 keV energy band, where the maximum energy release of GRBs in the instrument reference system is observed and also for a broader energy band from 10-1000 keV, exploiting the full energy range of GBM's low-energy detectors. Furthermore, information is given on the settings of the triggering criteria and exceptional operational conditions during years 7 to 10 in the mission. This fourth catalog is an official product of the Fermi-GBM science team, and the data files containing the complete results are available from the High-Energy Astrophysics Science Archive Research Center.
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer related deaths. Patients with advanced HCC are treated with sorafenib. A recent randomized controlled trial demonstrated a ...survival benefit for regorafenib treatment in patients with advanced HCC who had progressed on sorafenib. We aimed to evaluate the cost-effectiveness of this approach.
To evaluate the cost effectiveness of regorafenib, we used a Markov model that incorporates health outcomes, measured by life-years and quality-adjusted life-years (QALYs). Drug costs were based on 2017 discounted prices. Model robustness was validated by probabilistic sensitivity analyses using Monte Carlo simulations.
The use of regorafenib results in a gain of 19.76 weeks of life (0.38 Life Years) as compared to placebo. When adjusted for quality of life, using regorafenib produced a gain of 0.25 quality adjusted life years (QALYs). The incremental cost-effectiveness ratio for regorafenib compared with best supportive care was between $201,797 and $268,506 per QALY.
The modest incremental benefit at a relatively high incremental cost of regorafenib treatment suggests that it is not cost-effective at commonly accepted willingness to pay thresholds.
ABSTRACT Type Ia supernovae (SNe Ia) that are multiply imaged by gravitational lensing can extend the SN Ia Hubble diagram to very high redshifts (z 2), probe potential SN Ia evolution, and deliver ...high-precision constraints on H0, w, and m via time delays. However, only one, iPTF16geu, has been found to date, and many more are needed to achieve these goals. To increase the multiply imaged SN Ia discovery rate, we present a simple algorithm for identifying gravitationally lensed SN Ia candidates in cadenced, wide-field optical imaging surveys. The technique is to look for supernovae that appear to be hosted by elliptical galaxies, but that have absolute magnitudes implied by the apparent hosts' photometric redshifts that are far brighter than the absolute magnitudes of normal SNe Ia (the brightest type of supernovae found in elliptical galaxies). Importantly, this purely photometric method does not require the ability to resolve the lensed images for discovery. Active galactic nuclei, the primary sources of contamination that affect the method, can be controlled using catalog cross-matches and color cuts. Highly magnified core-collapse SNe will also be discovered as a byproduct of the method. Using a Monte Carlo simulation, we forecast that the Large Synoptic Survey Telescope can discover up to 500 multiply imaged SNe Ia using this technique in a 10 year z-band search, more than an order of magnitude improvement over previous estimates. We also predict that the Zwicky Transient Facility should find up to 10 multiply imaged SNe Ia using this technique in a 3 year R-band search-despite the fact that this survey will not resolve a single system.
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