Taxing Combat

When you are being shot at or dodging landmines you are in a combat zone. Diplomatic niceties aside, these brave warriors are in danger because of the policies of their Government and we must take care of them. Quite frankly, we must act to insure that we do not have a repeat of what happened in Somalia. In Somalia, the families of the soldiers who lost their lives could not receive the benefits that should have gone to them under the Tax Code because the President never declared it a combat zone. We don’t know exactly where we’re at in the world militarily and what we’re doing . . . . If you don’t think it’s a generational struggle, you don’t understand the war . . . . It is spreading throughout the world . . . . [W]e’re going to follow the terrorists wherever they go. We’re going to use whatever means we need to with partners to destroy them. And whatever time it takes, it takes. And most people are not ready for that, but I am

Progression of Contralateral Hearing Loss in Patients With Sporadic Vestibular Schwannoma

Background and Introduction:Vestibular schwannomas (VSs) are the most common tumors of the cerebellopontine angle, typically presenting unilaterally with ipsilateral sensorineural hearing loss (SNHL). The mechanism of tumor-induced hearing loss has recently been shown to be related to secreted tumor factors, in addition to mechanical compression of the adjacent auditory nerve, and these factors may percolate through CSF or blood to affect contralateral hearing as well. Methods:This is a retrospective study of medical records for patients treated for VS at Mass Eye and Ear from January 1994 through October 2018. Included patients had unilateral VS and sequential audiometry allowing for longitudinal assessment of hearing over time. Mass Eye and Ear's audiology database was used to select age- and sex-matched case controls, also with sequential audiometry, from the non-VS population. Subgroup analysis was performed by age, sex, baseline hearing, and tumor size at initial diagnosis. Hearing loss progression was performed using Kaplan-Meier analysis to account for variable follow-up times. Results:A total of 661 patients were identified with VS and sequential audiometry. The population was predominantly female vs. male (368 vs. 293,p= 0.0035), driven primarily by younger patients with Koos 4 tumors (76 female vs. 49 male,p= 0.016). Patients with normal baseline hearing bilaterally (N= 241) demonstrated no significant difference in hearing loss progression in VS-contralateral vs. control ears. Patients with abnormal baseline VS-ipsilateral hearing (N= 190), however, demonstrated significantly higher likelihood of reaching moderate SNHL in VS-contralateral ears. Subgroup analysis by age, sex, and baseline tumor size did not yield any subgroup-specific trends for hearing loss progression. Discussion and Conclusion:This is the largest study to date tracking long-term bilateral hearing outcomes in patients with VS, and demonstrates that, in patients with abnormal hearing in the VS-ipsilateral ear, there exists a long-term risk of progression to moderate hearing loss in the contralateral ear as well. Combined with the absence of significant changes in word understanding in the affected ears, these findings may provide clues to the nature of tumor-secreted factors involved in VS-associated hearing loss. Female predominance within the VS patient population is confirmed, driven mostly by younger female patients with Koos 4 tumors

Objective dyspnea evaluation on COVID-19 patients learning from exertion-induced dyspnea scores

Objective: Dyspnea is one of the most common symptoms for many pulmonary diseases including COVID-19. Clinical assessment of dyspnea is mainly performed by subjective self-report, which has limited accuracy and is challenging for continuous monitoring. The objective of this research study is to determine if dyspnea progression in COVID patients can be assessed using a non-invasive wearable sensor and if the findings are comparable to a learning model of physiologically induced dyspnea on healthy subjects. Methods: Non-invasive wearable respiratory sensors were employed to retrieve continuous respiratory characteristics with user comfort and convenience. Overnight (~16h) respiratory waveforms were collected on 12 COVID-19 patients, and a benchmark on 13 healthy subjects with exertion-induced dyspnea were also performed for blind comparison. The learning model was built from the respiratory features with self report on 32 healthy subjects under exertion and airway blockage. Results: High similarity between dyspnea on COVID patients and physiologically induced dyspnea on healthy subjects was established. COVID patients have consistently high objective dyspnea scores in comparison with normal breathing of healthy subjects. We also exhibited continuous dyspnea scoring capability for 12-16 hours on patients. Conclusion: This paper validates the viability to use our objective dyspnea scoring for clinical dyspnea assessment on COVID patients. Significance: The proposed system can help the identification of dyspneic exacerbation in conditions such as COVID, leading to early intervention and possibly improving their outcome. This approach can be potentially applied to other pulmonary disorders such as asthma, emphysema, and pneumonia

Avelumab Alone or in Combination With Chemotherapy Versus Chemotherapy Alone in Platinum-Resistant or Platinum-Refractory Ovarian Cancer (JAVELIN Ovarian 200): An Open-Label, Three-Arm, Randomised, Phase 3 Study

The majority of patients with ovarian cancer will experience relapse and develop platinum-resistant disease after being treated with frontline platinum-based chemotherapy. Treatment options for platinum-resistance or platinum-refractory disease are very limited, usually involving nonplatinum chemotherapy, and they are associated with poor objective response rates and life expectancy

A tomato xylem sap protein represents a new family of small cysteine-rich proteins with structural similarity to lipid transfer proteins

AbstractThe coding sequence of a major xylem sap protein of tomato was identified with the aid of mass spectrometry. The protein, XSP10, represents a novel family of extracellular plant proteins with structural similarity to plant lipid transfer proteins. The XSP10 gene is constitutively expressed in roots and lower stems. The decline of XSP10 protein levels in tomato infected with a fungal vascular pathogen may reflect breakdown or modification by the pathogen

Detection of Group 1 Coronaviruses in Bats in North America

Bats of 2 species harbor group 1 coronaviruses