Wildfire Risk as a Socioecological Pathology

Wildfire risk in temperate forests has become a nearly intractable problem that can be characterized as a socioecological “pathology”: that is, a set of complex and problematic interactions among social and ecological systems across multiple spatial and temporal scales. Assessments of wildfire risk could benefit from recognizing and accounting for these interactions in terms of socioecological systems, also known as coupled natural and human systems (CNHS). We characterize the primary social and ecological dimensions of the wildfire risk pathology, paying particular attention to the governance system around wildfire risk, and suggest strategies to mitigate the pathology through innovative planning approaches, analytical tools, and policies. We caution that even with a clear understanding of the problem and possible solutions, the system by which human actors govern fire-prone forests may evolve incrementally in imperfect ways and can be expected to resist change even as we learn better ways to manage CNHS

Diagnostic challenge for ovarian malignant melanoma in premenopausal women: Primary or metastatic?

<p>Abstract</p> <p>Background</p> <p>In the ovary, metastatic malignant melanoma may be confused with primary malignant melanoma and presents a diagnosis challenge. Most cases are associated with disseminated diseases and poor prognosis. We present this case report of a metastatic ovarian malignant melanoma simulating primary ovarian cancer.</p> <p>Case report</p> <p>A 45-year-old premenopausal woman was incidentally found to have an abdominal mass, 3 years after removal of a cutaneous melanoma lesion. Ultrasound and CT scan revealed left two solid masses, which were found to be an ovarian tumor at laparotomy. Left oophorectomy was performed. Histopathology and immunohistochemistry showed melanoma metastasis to the ovary. Nine months later, the patient developed epilepsy and confusion. Magnetic Resonance Imaging showed unique Wright frontal lobe lesion. She underwent stereotactic radio surgery and dacarbazine monotherapy. For months later, the patient is died from disseminate disease progression.</p> <p>Conclusion</p> <p>Ovarian metastasis is an unusual presentation of cutaneous melanoma and the prognosis was dismal. As illustrated by this case report, a differential diagnosis of a metastatic malignant melanoma must be considered.</p

Regulatory T Cells in γ Irradiation-Induced Immune Suppression

Sublethal total body γ irradiation (TBI) of mammals causes generalized immunosuppression, in part by induction of lymphocyte apoptosis. Here, we provide evidence that a part of this immune suppression may be attributable to dysfunction of immune regulation. We investigated the effects of sublethal TBI on T cell memory responses to gain insight into the potential for loss of vaccine immunity following such exposure. We show that in mice primed to an MHC class I alloantigen, the accelerated graft rejection T memory response is specifically lost several weeks following TBI, whereas identically treated naïve mice at the same time point had completely recovered normal rejection kinetics. Depletion in vivo with anti-CD4 or anti-CD25 showed that the mechanism involved cells consistent with a regulatory T cell (T reg) phenotype. The loss of the T memory response following TBI was associated with a relative increase of CD4+CD25+ Foxp3+ expressing T regs, as compared to the CD8+ T effector cells requisite for skin graft rejection. The radiation-induced T memory suppression was shown to be antigen-specific in that a third party ipsilateral graft rejected with normal kinetics. Remarkably, following the eventual rejection of the first MHC class I disparate skin graft, the suppressive environment was maintained, with markedly prolonged survival of a second identical allograft. These findings have potential importance as regards the immunologic status of T memory responses in victims of ionizing radiation exposure and apoptosis-inducing therapies

Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe

Background: The aim of the study was to document cardiovascular clinical findings, cardiac imaging, and laboratory markers in children presenting with the novel multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) infection. Methods: This real-time internet-based survey has been endorsed by the Association for European Paediatric and Congenital Cardiologists Working Groups for Cardiac Imaging and Cardiovascular Intensive Care. Children 0 to 18 years of age admitted to a hospital between February 1 and June 6, 2020, with a diagnosis of an inflammatory syndrome and acute cardiovascular complications were included. Results: A total of 286 children from 55 centers in 17 European countries were included. The median age was 8.4 years (interquartile range, 3.8-12.4 years) and 67% were boys. The most common cardiovascular complications were shock, cardiac arrhythmias, pericardial effusion, and coronary artery dilatation. Reduced left ventricular ejection fraction was present in over half of the patients, and a vast majority of children had raised cardiac troponin when checked. The biochemical markers of inflammation were raised in most patients on admission: elevated C-reactive protein, serum ferritin, procalcitonin, N-terminal pro B-type natriuretic peptide, interleukin-6 level, and D-dimers. There was a statistically significant correlation between degree of elevation in cardiac and biochemical parameters and the need for intensive care support (P<0.05). Polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 was positive in 33.6%, whereas immunoglobulin M and immunoglobulin G antibodies were positive in 15.7% cases and immunoglobulin G in 43.6% cases, respectively, when checked. One child in the study cohort died. Conclusions: Cardiac involvement is common in children with multisystem inflammatory syndrome associated with the Covid-19 pandemic. The majority of children have significantly raised levels of N-terminal pro B-type natriuretic peptide, ferritin, D-dimers, and cardiac troponin in addition to high C-reactive protein and procalcitonin levels. In comparison with adults with COVID-19, mortality in children with multisystem inflammatory syndrome associated with COVID-19 is uncommon despite multisystem involvement, very elevated inflammatory markers, and the need for intensive care support.info:eu-repo/semantics/publishedVersio

Wildfire risk as a socioecological pathology

Wildfire risk in temperate forests has become a nearly intractable problem that can be characterized as a socioecological “pathology”: that is, a set of complex and problematic interactions among social and ecological systems across multiple spatial and temporal scales. Assessments of wildfire risk could benefit from recognizing and accounting for these interactions in terms of socioecological systems, also known as coupled natural and human systems (CNHS). We characterize the primary social and ecological dimensions of the wildfire risk pathology, paying particular attention to the governance system around wildfire risk, and suggest strategies to mitigate the pathology through innovative planning approaches, analytical tools, and policies. We caution that even with a clear understanding of the problem and possible solutions, the system by which human actors govern fire-prone forests may evolve incrementally in imperfect ways and can be expected to resist change even as we learn better ways to manage CNHS

Clinical usefulness of^99mtc-hynic-toc and¹³¹i-mibg scintigraphy in the evaluation of adrenal tumors

© 2019, University of Kragujevac, Faculty of Science. All rights reserved. Disorders and morphological abnormalities affecting the adrenal gland, could lead to profound clinical consequences, owing to its biochemical structure-activity and morphological characteristics. The recent focus on theranostic approach has led to a need for tumors characterization and early diagnosis at the molecular level. Many radiotracers have been developed with specific imaging characteristics for the adrenal tumors, by exploiting different physiological mechanisms of uptake and metabolism. The aim of present study is to provide a prospective confirmation of131I-MIBG and99mTc-HYNIC-TOC scintigraphy, for the evaluation of patients with known or suspected tumors of the adrenal region. The research is designed as a cross-sectional observational study of the clinical correlates and diagnostic accuracy of radionuclide-based imaging methods in relation to in vitro analysis, clinical manifestations and morphological characteristics of these tumors. Furthermore, the present study also evaluates the usefulness and the clinical impact of each radiopharmaceutical for the detection and management of tumors, and functional imaging modality as well. Visual scintigraphic appearance of an increased focal tracer uptake in the suspected tumor site revealed that99mTcHYNIC-TOC is highly sensitive and reliable tumor-seeking radiotracer for adrenal tumors, but does not distinguish between adenoma and pheochromocytoma, and the existence of hormone secreting adrenocortical tumor cells. However,131IMIBG scintigraphy is highly sensitive and specific method only in differentiating catecholamine-secreting adrenal tumors. Clinical significance of this research is in the accurate localization of adrenal tumors, and is of paramount importance for an algorithmic diagnostic approach and management, and provide the rationale to different therapeutic possibilities

Correlation between echocardiographic findings and biochemical markers in term newborns with moderate to severe perinatal asphyxia

Perinatal asphyxia (PA) is a condition characterized by a gas exchange disorder due to a lack of blood flow or gas exchange, with potential multiorgan dysfunction. Our study aimed to determine the correlation between biochemical markers and echocardiography findings in a group of asphyxiated newborns. The prospective cohort study included 120 neonates (52/120 with PA) treated at a tertial referral pediatric center, from 2012 to 2014. A moderate-strong positive correlation was recorded between the transtricuspid pressure gradient (TRPG) and serum lactate, and between TRPG and NT-proBNP in the PA group (P<0.001) on the 1st day of life. A moderate positive correlation was found between NT-proBNP, lactate and troponins on one side, and TRPG on the other in the PA group after the 2nd measurement. Multinomial regression analysis showed that the lactate level was an independent factor for survival on the 1st (odds ratio (OR) 41.3, 95% confidence interval (CI) 2.14–797.1) and 3rd (OR 136.4, 95% CI 2.27–8206.7) days. Our research confirmed a significant correlation between echocardiographic and biochemical parameters of the myocardial lesion and cardiac function. Due to their complementarity, the use of the biochemical and echocardiographic parameters may be conditioned by their availability

INTERNAL AND EXTERNAL RISK BASED ASSESMENT AND EVALUATION FOR THE LARGE INFRASTRUCTURE PROJECTS

The level of sensitivity to project success of large infrastructure projects is significantly greater in front-phase than in execution phase. Yet, due to focus on execution phase, methods for project assessment and on-going evaluation during front phases are insufficiently developed. On the other hand, risk management approaches has been moved from risk management towards holistic uncertainty management which is the most beneficial in front end phase of the project. This research identifies that majority of methods and techniques available does not support uncertainty management concept. The purpose of this paper is to develop and new method for risk based project assessment and evaluation inte­grating risk impact modelling using cumulative distribution curves (CDC) and multi-criteria project evaluation approach. Research is based on in-depth risk analysis of 15 large infrastructure projects using risk model of components and char­acteristics. The conclusion of the paper is verification and validation of method that combines qualitative and quantita­tive analysis using risk components, risk breakdown structure, AHP method and risk impact modelling using cumulative distribution curves (CDC) for internal and external risk based assessment and evaluation of large infrastructure projects