Exposure to magnetic fields and childhood acute lymphocytic leukemia in São Paulo, Brazil

Background: Epidemiological studies have identified increased risks of leukemia in children living near power lines and exposed to relatively high levels of magnetic fields. Results have been remarkably consistent, but there is still no explanation for this increase. in this study we evaluated the effect of 60 Hz magnetic fields on acute lymphocytic leukemia (ALL) in the State of São Paulo, Brazil. Methods: This case-control study included ALL cases (n = 162) recruited from eight hospitals between January 2003 and February 2009. Controls (n = 565) matched on gender, age, and city of birth were selected from the São Paulo Birth Registry. Exposure to extremely low frequency magnetic fields (ELF MF) was based on measurements inside home and distance to power lines. Results: for 24 h measurements in children rooms, levels of ELF MF equal to or greater than 0.3 microtesla (mu T), compared to children exposed to levels below 0.1 mu T showed no increased risk of ALL (odds ratio [OR] 1.09; 95% confidence interval [95% CI] 0.33-3.61). When only nighttime measurements were considered, a risk (OR 1.52; 95% CI 0.46-5.01) was observed. Children living within 200 m of power lines presented an increased risk of ALL (OR 1.67; 95% CI 0.49-5.75), compared to children living at 600 m or more of power lines. for those living within 50 m of power lines the OR was 3.57 (95% CI 0.41-31.44). Conclusions: Even though our results are consistent with the small risks reported in other studies on ELF MF and leukemia in children, overall our results do not provide support for an association between magnetic fields and childhood leukemia, but small numbers and likely biases weaken the strength of this conclusion. (C) 2011 Elsevier B.V. All rights reserved.Univ São Paulo, Fac Saude Publ, Dept Epidemiol, BR-01255 São Paulo, BrazilAssoc Brasileira Compatibilidade Eletromagnet, São Paulo, BrazilHosp Amaral Carvalho, Jau, BrazilUniv São Paulo, Fac Med, BR-14049 Ribeirao Preto, BrazilUniversidade Federal de São Paulo, Inst Oncol Pediat, São Paulo, BrazilHosp Infantil Darcy Vargas, São Paulo, BrazilSanta Casa Misericordia São Paulo, São Paulo, BrazilHosp Santa Marcelina, São Paulo, BrazilUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USAUniversidade Federal de São Paulo, Inst Oncol Pediat, São Paulo, BrazilWeb of Scienc

Cerebral small vessel disease genomics and its implications across the lifespan

White matter hyperintensities (WMH) are the most common brain-imaging feature of cerebral small vessel disease (SVD), hypertension being the main known risk factor. Here, we identify 27 genome-wide loci for WMH-volume in a cohort of 50,970 older individuals, accounting for modification/confounding by hypertension. Aggregated WMH risk variants were associated with altered white matter integrity (p = 2.5×10-7) in brain images from 1,738 young healthy adults, providing insight into the lifetime impact of SVD genetic risk. Mendelian randomization suggested causal association of increasing WMH-volume with stroke, Alzheimer-type dementia, and of increasing blood pressure (BP) with larger WMH-volume, notably also in persons without clinical hypertension. Transcriptome-wide colocalization analyses showed association of WMH-volume with expression of 39 genes, of which four encode known drug targets. Finally, we provide insight into BP-independent biological pathways underlying SVD and suggest potential for genetic stratification of high-risk individuals and for genetically-informed prioritization of drug targets for prevention trials.Peer reviewe

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

The high-resolution map of Oxia Planum, Mars; the landing site of the ExoMars Rosalind Franklin rover mission

This 1:30,000 scale geological map describes Oxia Planum, Mars, the landing site for the ExoMars Rosalind Franklin rover mission. The map represents our current understanding of bedrock units and their relationships prior to Rosalind Franklin’s exploration of this location. The map details 15 bedrock units organised into 6 groups and 7 textural and surficial units. The bedrock units were identified using visible and near-infrared remote sensing datasets. The objectives of this map are (i) to identify where the most astrobiologically relevant rocks are likely to be found, (ii) to show where hypotheses about their geological context (within Oxia Planum and in the wider geological history of Mars) can be tested, (iii) to inform both the long-term (hundreds of metres to ∼1 km) and the short-term (tens of metres) activity planning for rover exploration, and (iv) to allow the samples analysed by the rover to be interpreted within their regional geological context.The ExoMars Rosalind Franklin Mission is a partnership between ESA and NASA. The Rosalind Franklin Rover has eight instruments in its ‘Pasteur’ Payload, with Principal Investigators from seven countries all of whom we would like to thank for there support of this project. We would like to acknowledge the following funding bodies, people and institutions supporting the lead authors of this work. We thank the UK Space Agency (UK SA) for funding P. Fawdon, on grants; ST/W002736/1, ST/L00643X/1 and ST/R001413/1, MRB on grants; ST/T002913/1, ST/V001965/1, ST/R001383/1, ST/R001413/1, P. Grindrod on grants; ST/L006456/1, ST/R002355/1, ST/V002678/1 and J. Davis on grants ST/K502388/1, ST/R002355/1, ST/V002678/1 through the ongoing Aurora space exploration programme. C. Orgel was supported by the ESA Research Fellowship Program. Alessandro Frigeri: was funded by the Italian Space Agency (ASI) grant ASI-INAF number 2017-412-H.0 (ExoMars/Ma_MISS) and D. Loizeau was funded by the H2020-COMPET-2015 programme (grant 687302), C. Quantin-Nataf was supported by the French space agency CNES, I. Torres was supported by an ESA Young Graduate Traineeship, A. Nass was supported by Helmholtz Metadata Projects (#ZT-I-PF-3-008). We thank NASA and the HiRISE camera team for data collection support throughout the ExoMars landing site selection and charectorisation process. The USGS for the HiRISE DTM data and maintaining the ISIS and SOCET SET DEM workflows. The authors wish to thank the CaSSIS spacecraft and instrument engineering teams. CaSSIS is a project of the University of Bern and funded through the Swiss Space Office via ESA's PRODEX programme. The instrument hardware development was also supported by the Italian Space Agency (ASI) (ASI-INAF agreement no. I/2020-17-HH.0), INAF/Astronomical Observatory of Padova, and the Space Research Center (CBK) in Warsaw. Support from SGF (Budapest), the University of Arizona (Lunar and Planetary Lab.) and NASA are also gratefully acknowledged. Operations support from the UK Space Agency under grant ST/R003025/1 is also acknowledged. This research has made use of the USGS Integrated Software for Imagers and Spectrometers (ISIS) Technical support for setup of the Multi-Mission Geographic Information System for concurrent team mapping was provided by F. Calef (III) and T. Soliman at NASA JPL and S. de Witte at ESA-ESTEC.This work was supported by Agencia Estatal de Investigación [grant number ID2019-107442RB-C32, MDM-2017-0737]; Agenzia Spaziale Italiana [grant number 2017-412-H.0]; Bundesministerium für Wirtschaft und Technologie [grant number 50 QX 2002]; Centre National de la Recherche Scientifique; Centre National d’Etudes Spatiales; Euskal Herriko Unibertsitatea [grant number PES21/88]; Istituto Nazionale di Astrofisica [grant number I/ 060/10/0]; Ministerio de Economía y Competitividad [grant number PID2019-104205GB-C21]; Ministry of Science and Higher Education of the Russian Federation [grant number AAAA-A18-118012290370-6]; National Aeronautics and Space Administration [grant number NNX15AH46G]; Norges Forskningsråd [grant number 223272]; European Union's Horizon 2020 (H2020-COMPET-2015) [grant number 687302 (PTAL)]; Sofja Kovalevskaja Award of the Alexander von Humboldt Foundation; MINECO [grant number PID2019-107442RB-C32]; The Open University [grant number Space Strategic Research Area]; European Union's Horizon 2020 research and innovation programme [grant number 776276]; H2020-COMPET-2015 [grant number 687302]; The Research Council of Norway, Centres of Excellence funding scheme [grant number 223272]; Helmholtz Metadata Projects [grant number ZT-I-PF-3-008]; The Research Council of Norway [grant number 223272]; Swiss Space Office via ESA's PRODEX programme; Ines Torres was supported by an ESA Young Graduate Traineeship; Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung [grant number 200021_197293]; Science and Technology Facilities Council [grant number 1967420]; UK Space Agency [grant number ST/K502388/1, ST/R002355/1, ST/V002678/1]. The ExoMars Rosalind Franklin Mission is a partnership between ESA and NASA. The Rosalind Franklin Rover has eight instruments in its ‘Pasteur’ Payload, with Principal Investigators from seven countries all of whom we would like to thank for there support of this project. We would like to acknowledge the following funding bodies, people and institutions supporting the lead authors of this work. We thank the UK Space Agency (UK SA) for funding P. Fawdon, on grants; ST/W002736/1, ST/L00643X/1 and ST/R001413/1, MRB on grants; ST/T002913/1, ST/V001965/1, ST/R001383/1, ST/R001413/1, P. Grindrod on grants; ST/L006456/1, ST/R002355/1, ST/V002678/1 and J. Davis on grants ST/K502388/1, ST/R002355/1, ST/V002678/1 through the ongoing Aurora space exploration programme. C. Orgel was supported by the ESA Research Fellowship Program. Alessandro Frigeri: was funded by the Italian Space Agency (ASI) grant ASI-INAF number 2017-412-H.0 (ExoMars/Ma_MISS) and D. Loizeau was funded by the H2020-COMPET-2015 programme (grant 687302), C. Quantin-Nataf was supported by the French space agency CNES, I. Torres was supported by an ESA Young Graduate Traineeship, A. Nass was supported by Helmholtz Metadata Projects (#ZT-I-PF-3-008). We thank NASA and the HiRISE camera team for data collection support throughout the ExoMars landing site selection and charectorisation process. The USGS for the HiRISE DTM data and maintaining the ISIS and SOCET SET DEM workflows. The authors wish to thank the CaSSIS spacecraft and instrument engineering teams. CaSSIS is a project of the University of Bern and funded through the Swiss Space Office via ESA's PRODEX programme. The instrument hardware development was also supported by the Italian Space Agency (ASI) (ASI-INAF agreement no. I/2020-17-HH.0), INAF/Astronomical Observatory of Padova, and the Space Research Center (CBK) in Warsaw. Support from SGF (Budapest), the University of Arizona (Lunar and Planetary Lab.) and NASA are also gratefully acknowledged. Operations support from the UK Space Agency under grant ST/R003025/1 is also acknowledged. This research has made use of the USGS Integrated Software for Imagers and Spectrometers (ISIS) Technical support for setup of the Multi-Mission Geographic Information System for concurrent team mapping was provided by F. Calef (III) and T. Soliman at NASA JPL and S. de Witte at ESA-ESTEC.Peer reviewe

The high-resolution map of Oxia Planum, Mars; the landing site of the ExoMars Rosalind Franklin rover mission

This 1:30,000 scale geological map describes Oxia Planum, Mars, the landing site for the ExoMars Rosalind Franklin rover mission. The map represents our current understanding of bedrock units and their relationships prior to Rosalind Franklin’s exploration of this location. The map details 15 bedrock units organised into 6 groups and 7 textural and surficial units. The bedrock units were identified using visible and near-infrared remote sensing datasets. The objectives of this map are (i) to identify where the most astrobiologically relevant rocks are likely to be found, (ii) to show where hypotheses about their geological context (within Oxia Planum and in the wider geological history of Mars) can be tested, (iii) to inform both the long-term (hundreds of metres to ∼1 km) and the short-term (tens of metres) activity planning for rover exploration, and (iv) to allow the samples analysed by the rover to be interpreted within their regional geological context

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Burden of injury along the development spectrum : associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

Background The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.Peer reviewe