Global Environmental Change: What Can Health Care Providers and the Environmental Health Community Do About It Now?

The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon- and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available “planetary health” metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations

An Overview of the Methylxanthines and their Regulation in the Horse

Caffiene, theophylline and theobromine are naturally occurring members of the methylxanthine family;pentoxfylline, dyphylline and enprofylline are structurally related synthetic pharmaceuticals. Caffiene has predominantly central nervous system effects, theophylline, dyphylline and enprofylline have predominantly bronchodilator effects, while theobromine is associated with diuretic responses. Pentoxfylline is thought to increase red cell deformability and facillitate blood flow through capillary beds. The methylxanthines are not highly potent agents; they are typically administered in gram doses and they tend to have relatively long half-lives. They remain detectable in plasma and urine for relatively long periods. Similarly, traces of the naturally occurring members of this family are not uncommonly identified in forensic samples. In this review we report on the detection, actions, uses and regulatory control of this group of agents in performance horses

Loss of monomorphic and polymorphic HLA antigens in metastatic breast and colon carcinoma.

MHC class I antigens are intimately involved in intercellular communication, and recognition by cytotoxic T cells. Thus tumour cells that fail to express them may be at a growth or metastatic advantage. A series of ten colorectal and ten breast carcinomas, and their respective lymph node metastases, were examined immunohistologically using monoclonal antibodies (mAb) against both monomorphic and A2 polymorphic determinants, and beta-2-microglobulin (beta 2m). Four colon polypoid adenomas stained positively throughout, but 6/10 primary tumours had partial or complete loss of expression of monomorphic determinants using mAb W6/32: two node and the liver metastasis showed less, four more expression. Similar results were seen for beta 2m. HLA-A2 expression was absent or reduced in 4/4 colon tumours and all their metastases. Among the breast tumours, W6/32 staining was absent or reduced in 2/10, and node deposits showed two with less reactivity than their primary. Beta 2m staining was reduced or absent in 8/10 primaries and all the node metastases; in every case in which beta 2m was detected in the primary tumour their corresponding lymph node metastasis showed a decreased expression. HLA-A2 expression was absent or reduced in 3/4 primary breast carcinomas, and all their metastases. These results show that individual human colon and breast carcinomas often have a reduced HLA class I antigen expression, which apparently confers a metastatic advantage

Black Holes, Mergers, and the Entropy Budget of the Universe

Vast amounts of entropy are produced in black hole formation, and the amount of entropy stored in supermassive black holes at the centers of galaxies is now much greater than the entropy free in the rest of the universe. Either mergers involved in forming supermassive black holes are rare,or the holes must be very efficient at capturing nearly all the entropy generated in the process. We argue that this information can be used to constrain supermassive black hole production, and may eventually provide a check on numerical results for mergers involving black holes

Machine Learning Using a Single-Lead ECG to Identify Patients With Atrial Fibrillation-Induced Heart Failure

AIMS: Atrial fibrillation (AF) and heart failure often co-exist. Early identification of AF patients at risk for AF-induced heart failure (AF-HF) is desirable to reduce both morbidity and mortality as well as health care costs. We aimed to leverage the characteristics of beat-to-beat-patterns in AF to prospectively discriminate AF patients with and without AF-HF. METHODS: A dataset of 10,234 5-min length RR-interval time series derived from 26 AF-HF patients and 26 control patients was extracted from single-lead Holter-ECGs. A total of 14 features were extracted, and the most informative features were selected. Then, a decision tree classifier with 5-fold cross-validation was trained, validated, and tested on the dataset randomly split. The derived algorithm was then tested on 2,261 5-min segments from six AF-HF and six control patients and validated for various time segments. RESULTS: The algorithm based on the spectral entropy of the RR-intervals, the mean value of the relative RR-interval, and the root mean square of successive differences of the relative RR-interval yielded an accuracy of 73.5%, specificity of 91.4%, sensitivity of 64.7%, and PPV of 87.0% to correctly stratify segments to AF-HF. Considering the majority vote of the segments of each patient, 10/12 patients (83.33%) were correctly classified. CONCLUSION: Beat-to-beat-analysis using a machine learning classifier identifies patients with AF-induced heart failure with clinically relevant diagnostic properties. Application of this algorithm in routine care may improve early identification of patients at risk for AF-induced cardiomyopathy and improve the yield of targeted clinical follow-up

Intense high-frequency gyrotron-based microwave beams for material processing

Microwave processing of materials has traditionally utilized frequencies in the 0.915 and 2.45 GHz regions. Microwave power sources are readily available at these frequencies but the relatively long wavelengths can present challenges in uniformly heating materials. An additional difficulty is the poor coupling of ceramic based materials to the microwave energy. Los Alamos National Laboratory scientists, working in conjunction with the National Center for Manufacturing Sciences (NCMS), have assembled a high-frequency demonstration processing facility utilizing gyrotron based RF sources. The facility is primarily intended to demonstrate the unique features available at frequencies as high as 84 GHz. The authors can readily provide quasi-optical, 37 GHz beams at continuous wave (CW) power levels in the 10 kW range. They have also provided beams at 84 GHz at 10 kW CW power levels. They are presently preparing a facility to demonstrate the sintering of ceramics at 30 GHz. This paper presents an overview of the present demonstration processing facility and describes some of the features they have available now and will have available in the near future

Weight change associated with antiepileptic drugs

Aim To investigate antiepileptic drug (AED)-related weight changes in patients with epilepsy through a retrospective observational study. Method We analysed the anonymised electronic primary care records of 1.1 million adult patients in Wales. We included patients aged 18 years and over with a diagnosis of epilepsy, whose body weight had been measured up to 12 months before starting, and between 3 and 12 months after starting, one of five AEDs. We calculated the weight difference after starting the AED for each patient. Results 1423 patients were identified in total. The mean difference between body weight after and before starting each AED (together with 95% CI and p values for no difference) were: carbamazepine (CBZ) 0.43 (−0.19 to 1.05) p=0.17; lamotrigine (LTG) 0.31 (−0.38 to 1.00) p=0.38; levetiracetam (LEV) 1.00 (0.16 to 1.84) p=0.02; sodium valproate (VPA) 0.74 (0.10 to 1.38) p=0.02; topiramate (TPM) −2.30 (−4.27 to −0.33) p=0.02. Conclusions LEV and VPA were associated with significant weight gain, TPM was associated with significant weight loss, and LTG and CBZ were not associated with significant weight change

The Extended Blue Continuum and Line Emission around the Central Radio Galaxy in Abell 2597

We present results from detailed imaging of the centrally dominant radio elliptical galaxy in the cooling flow cluster Abell 2597, using data obtained with the Wide Field and Planetary Camera 2 (WFPC2) on the Hubble Space Telescope (HST). This object is one of the archetypal "blue-lobed" cooling flow radio elliptical galaxies, also displaying a luminous emission-line nebula, a compact radio source, and a significant dust lane and evidence of molecular gas in its center. We show that the radio source is surrounded by a complex network of emission-line filaments, some of which display a close spatial association with the outer boundary of the radio lobes. We present a detailed analysis of the physical properties of ionized and neutral gas associated with the radio lobes, and show that their properties are strongly suggestive of direct interactions between the radio plasma and ambient gas. We resolve the blue continuum emission into a series of knots and clumps, and present evidence that these are most likely due to regions of recent star formation. We investigate several possible triggering mechanisms for the star formation, including direct interactions with the radio source, filaments condensing from the cooling flow, or the result of an interaction with a gas-rich galaxy, which may also have been responsible for fueling the active nucleus. We propose that the properties of the source are plausibly explained in terms of accretion of gas by the cD during an interaction with a gas-rich galaxy, which combined with the fact that this object is located at the center of a dense, high-pressure ICM can account for the high rates of star formation and the strong confinement of the radio source.Comment: Astrophysical Journal, in press, 34 pages, includes 6 PostScript figures. Latex format, uses aaspp4.sty and epsf.sty file