Crisis in the Making: What is Wrong with Pennsylvania Public Health Law

There are few areas of government enterprise where the need to “get it right” is so critical as formulating and executing laws affecting the public health. When the government sets out to exercise its police power 1 to control the spread of disease, its goal is to accomplish an immensely important practical task; and its success is to a great degree  objectively determinable—the spread of disease is either curtailed or not. However, the manner in which the government’s goal is reached reflects not only its pragmatic concerns but also a society’s political, social, and legal values

Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths

Background: Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquired pneumonia (CAP), but underlying mechanisms are unknown. Persistence of the prothrombotic state that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activated during CAP persist at hospital discharge, when patients appear to have recovered clinically, and are associated with higher mortality, particularly due to cardiovascular causes. Methods: In a cohort of survivors of CAP hospitalization from 28 US sites, we measured D-Dimer, thrombin-antithrombin complexes [TAT], Factor IX, antithrombin, and plasminogen activator inhibitor-1 at hospital discharge, and determined 1-year all-cause and cardiovascular mortality. Results: Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis) and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinically recovered. D-dimer and TAT levels were elevated at discharge in 78.8% and 30.1% of all subjects, and in 51.3% and 25.3% of those without severe sepsis. Higher D-dimer and TAT levels were associated with higher risk of all-cause mortality (range of hazard ratios were 1.66-1.17, p = 0.0001 and 1.46-1.04, p = 0.001 after adjusting for demographics and comorbid illnesses) and cardiovascular mortality (p = 0.009 and 0.003 in competing risk analyses). Conclusions: Elevations of TAT and D-dimer levels are common at hospital discharge in patients who appeared to have recovered clinically from pneumonia and are associated with higher risk of subsequent deaths, particularly due to cardiovascular disease. © 2011 Yende et al

Null mutation for Macrophage Migration Inhibitory Factor (MIF) is associated with less aggressive bladder cancer in mice

<p>Abstract</p> <p>Background</p> <p>Inflammatory cytokines may promote tumorigenesis. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine with regulatory properties over tumor suppressor proteins involved in bladder cancer. We studied the development of bladder cancer in wild type (WT) and MIF knockout (KO) mice given N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN), a known carcinogen, to determine the role of MIF in bladder cancer initiation and progression.</p> <p>Methods</p> <p>5-month old male C57Bl/6 MIF WT and KO mice were treated with and without BBN. Animals were sacrificed at intervals up to 23 weeks of treatment. Bladder tumor stage and grade were evaluated by H&E. Immunohistochemical (IHC) analysis was performed for MIF and platelet/endothelial cell adhesion molecule 1 (PECAM-1), a measure of vascularization. MIF mRNA was analyzed by quantitative real-time polymerase chain reaction.</p> <p>Results</p> <p>Poorly differentiated carcinoma developed in all BBN treated mice by week 20. MIF WT animals developed T2 disease, while KO animals developed only T1 disease. MIF IHC revealed predominantly urothelial cytoplasmic staining in the WT control animals and a shift toward nuclear staining in WT BBN treated animals. MIF mRNA levels were 3-fold higher in BBN treated animals relative to controls when invasive cancer was present. PECAM-1 staining revealed significantly more stromal vessels in the tumors in WT animals when compared to KOs.</p> <p>Conclusion</p> <p>Muscle invasive bladder cancer with increased stromal vascularity was associated with increased MIF mRNA levels and nuclear redistribution. Consistently lower stage tumors were seen in MIF KO compared to WT mice. These data suggest that MIF may play a role in the progression to invasive bladder cancer.</p

Physical properties of near-Earth asteroid (2102) Tantalus from multiwavelength observations

Between 2010 and 2017 we have collected new optical and radar observations of the potentially hazardous asteroid (2102) Tantalus from the ESO NTT and Danish telescopes at the La Silla Observatory and from the Arecibo planetary radar. The object appears to be nearly spherical, showing a low amplitude light-curve variation and limited large-scale features in the radar images. The spin-state is difficult to constrain with the available data; including a certain light-curve subset significantly changes the spin-state estimates, and the uncertainties on period determination are significant. Constraining any change in rotation rate was not possible, despite decades of observations. The convex lightcurve-inversion model, with rotational pole at λ = 210 ± 41○ and β = −30 ± 35○, is more flattened than the two models reconstructed by including radar observations: with prograde (λ = 36 ± 23○, β = 30 ± 15○), and with retrograde rotation mode (λ = 180 ± 24○, β = −30 ± 16○). Using data from WISE we were able to determine that the prograde model produces the best agreement in size determination between radar and thermophysical modelling. Radar measurements indicate possible variation in surface properties, suggesting one side might have lower radar albedo and be rougher at centimetre-to-decimetre scale than the other. However, further observations are needed to confirm this. Thermophysical analysis indicates a surface covered in fine-grained regolith, consistent with radar albedo and polarisation ratio measurements. Finally, geophysical investigation of the spin-stability of Tantalus shows that it could be exceeding its critical spin-rate via cohesive forces

High-precision photometry by telescope defocussing - VI. WASP-24, WASP-25 andWASP-26*

We present time series photometric observations of 13 transits in the planetary systems WASP-24, WASP-25 and WASP-26. All three systems have orbital obliquity measurements, WASP-24 andWASP-26 have been observed with Spitzer, andWASP-25 was previously comparatively neglected. Our light curves were obtained using the telescope-defocussing method and have scatters of 0.5-1.2 mmag relative to their best-fitting geometric models. We use these data to measure the physical properties and orbital ephemerides of the systems to high precision, finding that our improved measurements are in good agreement with previous studies. High-resolution Lucky Imaging observations of all three targets show no evidence for faint stars close enough to contaminate our photometry. We confirm the eclipsing nature of the star closest to WASP-24 and present the detection of a detached eclipsing binary within 4.25 arcmin of WASP-26

KELT-21b: A Hot Jupiter Transiting the Rapidly Rotating Metal-poor Late-A Primary of a Likely Hierarchical Triple System

We present the discovery of KELT-21b, a hot Jupiter transiting the V = 10.5 A8V star HD 332124. The planet has an orbital period of P = 3.6127647 ± 0.0000033 days and a radius of 1.586-0.040+0.039 RJ. We set an upper limit on the planetary mass of at confidence. We confirmed the planetary nature of the transiting companion using this mass limit and Doppler tomographic observations to verify that the companion transits HD 332124. These data also demonstrate that the planetary orbit is well-aligned with the stellar spin, with a sky-projected spin-orbit misalignment of λ = -5.6-1.91.7. The star has Teff = 7598-8481 K, Mz.ast; = 1.458-0.028+0.029 M⊙, Rz.ast; = 1.638 ± 0.034 R⊙ and v sin I∗ = 146 km s-1, the highest projected rotation velocity of any star known to host a transiting hot Jupiter. The star also appears to be somewhat metal poor and α-enhanced, with [Fe/H] = -405-0.033+0.032 and [α/Fe] = 0.145 ± 0.053; these abundances are unusual, but not extraordinary, for a young star with thin-disk kinematics like KELT-21. High-resolution imaging observations revealed the presence of a pair of stellar companions to KELT-21, located at a separation of 1.″2 and with a combined contrast of ΔKs = 6.39 ± 0.06 with respect to the primary. Although these companions are most likely physically associated with KELT-21, we cannot confirm this with our current data. If associated, the candidate companions KELT-21 B and C would each have masses of ∼0.12 M⊙, a projected mutual separation of ∼20 au, and a projected separation of ∼500 au from KELT-21. KELT-21b may be one of only a handful of known transiting planets in hierarchical triple stellar systems

High-precision photometry by telescope defocussing - VIII.WASP-22, WASP-41,WASP-42 andWASP-55

We present 13 high-precision and four additional light curves of four bright southernhemisphere transiting planetary systems: WASP-22, WASP-41, WASP-42 and WASP-55. In the cases of WASP-42 and WASP-55, these are the first follow-up observations since their discovery papers. We present refined measurements of the physical properties and orbital ephemerides of all four systems. No indications of transit timing variations were seen. All four planets have radii inflated above those expected from theoretical models of gas-giant planets; WASP-55 b is the most discrepant with a mass of 0.63MJup and a radius of 1.34 RJup. WASP-41 shows brightness anomalies during transit due to the planet occulting spots on the stellar surface. Two anomalies observed 3.1 d apart are very likely due to the same spot. We measure its change in position and determine a rotation period for the host star of 18.6 ± 1.5 d, in good agreement with a published measurement from spot-induced brightness modulation, and a sky-projected orbital obliquity of λ = 6 ± 11°. We conclude with a compilation of obliquity measurements from spot-tracking analyses and a discussion of this technique in the study of the orbital configurations of hot Jupiters