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Primary cardiac lymphoma is a rare and lethal tumor. We describe a patient with right coronary artery floating sign, a specific radiologic sign. Despite rapid diagnosis and guideline-directed medical therapy, disease relapsed and the patient died. Nevertheless, this case highlights the crucial role of imaging in cardiac tumors. (Level of Difficulty: Intermediate.), Central Illustration

The type of dwelling where a child lives is an important factor when considering residential exposure to environmental agents. In this paper, we explore its role when estimating the potential effects of magnetic fields (MF) on leukemia using data from the California Power Line Study (CAPS). In this context, dwelling type could be a risk factor, a proxy for other risk factors, a cause of MF exposure, a confounder, an effect-measure modifier, or some combination. We obtained information on type of dwelling at birth on over 2,000 subjects. Using multivariable-adjusted logistic regression, we assessed whether dwelling type was a risk factor for childhood leukemia, which covariates and MF exposures were associated with dwelling type, and whether dwelling type was a potential confounder or an effect-measure modifier in the MF-leukemia relationship under the assumption of no-uncontrolled confounding. A majority of children lived in single-family homes or duplexes (70%). Dwelling type was associated with race/ethnicity and socioeconomic status but not with childhood leukemia risk, after other adjustments, and did not alter the MF-leukemia relationship upon adjustment as a potential confounder. Stratification revealed potential effect-measure modification by dwelling type on the multiplicative scale. Dwelling type does not appear to play a significant role in the MF-leukemia relationship in the CAPS dataset as a leukemia risk factor or confounder. Future research should explore the role of dwelling as an effect-measure modifier of the MF-leukemia association.

Background Despite increased recognition, frailty remains a significant public health challenge. Objective we aimed to assess the role of education and income, as well as neighborhood socioeconomic status, on physical activity and subsequent frailty in older adults. Methods Using a population-based cohort of older adults, this study examined the relationship between socioeconomic status (SES) factors, physical activity and frailty. The study included 1,799 participants (mean [SD], 74.6 (6.2), 53.3% female) from the "National Health and Nutrition Survey of Older Adults Aged 65 and Over in Israel", conducted in 2005–2006. A follow-up interview was performed 12–14 years later in a subgroup of 601 subjects (mean [SD], age 84[4]; 56% women). Self-reported leisure-time physical activity (LTPA) was measured at both baseline and follow-up. SES measures were assessed at baseline. Frailty was measured at follow-up, using the Fried's Phenotype Model. Results All SES measures were strongly and positively associated with LTPA (all p trend Conclusion Among older individuals, multiple SES measures were positively associated with LTPA, which was a strong predictor of lower subsequent frailty risk.

We study propagation effects due to the finite speed of light in ionization of extended molecular systems. We present a general quantitative theory of these effects and show under which conditions such effects should appear. The finite speed of light propagation effects are encoded in the non-dipole terms of the time-dependent Shrödinger equation and display themselves in the photoelectron momentum distribution projected on the molecular axis. Our numerical modeling for the $$\hbox {H}_{2}^{+}$$ H 2 + molecular ion and the $$\hbox {Ne}_2$$ Ne 2 dimer shows that the finite light propagation time from one atomic center to another can be accurately determined in a table top laser experiment which is much more readily accessible than the ground breaking synchrotron measurement by Grundmann et al. (Science 370:339, 2020).

Introduction Based on data from randomized controlled trials, both American and European guidelines recommend treating acute coronary syndrome (ACS) patients with second generation P2Y12 inhibitors.1,2 Direct head-to-head comparison of these agents was scarce until the recent publication of the ISAR-REACT-5 study which demonstrated the superiority of the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) over the reversible P2Y12 inhibitor in terms of 1-year composite of death, myocardial infarction (MI), and stroke.3,4,5 Given the unexpected outcomes of this trial, we sought to perform a comparison of ticagrelor and prasugrel in real-life ACS patients. Purpose To compare the outcomes of ACS (acute coronary syndrome) patients undergoing in-hospital PCI (percutaneous coronary intervention) treated with the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) versus the reversible P2Y12 inhibitor. Methods ACSIS (Acute Coronary Syndrome in Israel) is a national ACS snapshot survey conducted in all 25 cardiology departments in Israel since 2000 over a two-month period, every two to three years. Both the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) and the reversible P2Y12 inhibitor were commercially introduced in Israel in 2010. We therefore considered patients enrolled in ACSIS surveys 2010–2018 for the present analysis. Results Among 7,233 patients enrolled to the ACSIS (Acute Coronary Syndrome in Israel) registry between 2010 and 2018, we identified 1133 eligible patients treated with the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) and 825 with the reversible P2Y12 inhibitor. In hospital complication rates, including rates of stent thrombosis, were roughly similar between groups. Compared to the reversible P2Y12 inhibitor, the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) was associated with lower 1-year death in ST-elevation myocardial infarction (STEMI) patient compared to non-ST-elevation ACS (NSTE-ACS) patients (p for interaction 0.03). In propensity score matched STEMI patients (502 receiving the Irreversible thienopyridine type P2Y12 inhibitor (prodrug), 251 the reversible P2Y12 inhibitor) 30-day re-hospitalization rate (p Conclusion The Irreversible thienopyridine type P2Y12 inhibitor (prodrug) was more effective than the reversible P2Y12 inhibitor in STEMI patients, but not in NSTE-ACS patients. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): the Israeli working group on acute cardiac care of the Israel heart society

Background Invasive angiography with subsequent revascularization is a widely used treatment method in patients with coronary heart disease. Although biodegradable polymer drug eluting stents (BP-DES) have been used for almost a decade now, clinical trials regarding their long-term outcomes are both sparse and inconsistent. We aimed to compare the long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with BP-DES versus durable polymer drug eluting stents (DP-DES). Methods Among 11,517 PCIs with second generation drug eluting stents preformed in our institution between 2007 and 2019, we identified 8042 procedures performed using DP-DES and 3475 using BP-DES. The primary outcome was the composite of all-cause mortality, recurrent myocardial infarction (re-MI), target vessel revascularization (TVR) and coronary artery bypass grafting (CABG). Propensity score matching was used to create a well-balanced cohort. Results Mean follow up was 4.8 years. Of the 3,413 matched pairs, 21% were females, and the mean age was 66. At one year, the primary outcome occurred in 9.6% patients versus 8.3% (p=0.05), and TVR rate was 4.1% versus 3% (p=0.005) in patients with DP-DES and BP-DES respectively. Within 5 years, the primary outcome occurred in in 24.9% versus 24.8% (p=0.83), and the rate of TVR was 9.8% versus 9.1% (p=0.07) in patients with DP-DES and BP-DES respectively. Conclusions Similar rates of the composite outcome were observed throughout the entire follow-up. TVR rates were lower in the DP-DES group at 1-year but equalized within 5 years. Funding Acknowledgement Type of funding sources: None.

Introduction: We aimed to compare the outcomes of acute coronary syndrome (ACS) patients undergoing in-hospital percutaneous coronary intervention treated with prasugrel versus ticagrelor. Methods: Among 7,233 patients enrolled to the Acute Coronary Syndrome Israeli Survey (ACSIS) between 2010 and 2018, we identified 1,126 eligible patients treated with prasugrel and 817 with ticagrelor. Comparison between the groups was performed separately in ST-elevation myocardial infarction (STEMI) patients, propensity score matched (PSM) STEMI patients, and non-ST-elevation ACS (NSTE-ACS) patients. Results: In-hospital complication rates, including rates of stent thrombosis, were not significantly different between groups. In PSM STEMI patients, 30-day re-hospitalization rate (p < 0.05), 30-day MACE (the composite of death, MI, stroke, and urgent revascularization, p = 0.006), and 1-year mortality rates (p = 0.08) were higher in the ticagrelor group compared to the prasugrel group; in NSTE-ACS patients, outcomes were not associated with drug choice. In Cox regression analysis applied on the entire cohort, prasugrel was associated with lower 1-year mortality in STEMI patients but not in NSTE-ACS patients (p for interaction 0.03). Conclusions: Compared to ticagrelor, prasugrel was associated with superior clinical outcomes in STEMI patients, but not in NSTE-ACS patients.

PurposeResidential mobility is considered as a potential source of confounding in studies assessing environmental exposures, including in studies of electromagnetic field (EMF) exposures and childhood leukemia.MethodsWe present a hybrid simulation study where we simulate a synthetic dataset based on an existing study and use it to assess the sensitivity of EMF-leukemia associations to different scenarios of uncontrolled confounding by mobility under two major hypotheses of the infectious etiology of childhood leukemia. We then used the findings to conduct sensitivity analysis and empirically offset the potential bias due to unmeasured mobility in the California PowerLine Study dataset.ResultsAs expected, the stronger the assumed relationship between mobility and exposure and outcome, the greater the potential bias. However, no scenario created a bias strong enough to completely explain away previously observed associations.ConclusionsWe conclude that uncontrolled confounding by residential mobility had some impact on the estimated effect of EMF exposures on childhood leukemia, but that it was unlikely to be the primary explanation behind previously observed largely consistent, but unexplained associations.

Pooled analyses have suggested a small increased risk of childhood leukemia associated with distance and with exposure to high magnetic fields from power transmission lines. Because magnetic fields are correlated with distance from lines, the question of whether the risk is due to magnetic fields exposure or to some other factor associated with distance from lines is unresolved. We used data from a large records-based case-control study to examine several research questions formulated to disentangle the relationships among magnetic fields, distance from high voltage lines, and childhood leukemia risk. In models examining an interaction between distance and magnetic fields exposure, we found that neither close proximity to high voltage lines alone nor exposure to high calculated fields alone were associated with childhood leukemia risk. Rather, elevated risk was confined to the group that was both very close to high voltage lines (

Voltage imaging in cells requires high-speed recording of small fluorescent signals, often leading to low signal-to-noise ratios. Because voltage indicators are membrane-bound, their orientations are partially constrained by the plane of the membrane. We explored whether tuning the linear polarization of excitation light could enhance voltage indicator fluorescence. We tested a panel of dye and protein-based voltage indicators in mammalian cells. The dye BeRST1 showed a 73% increase in brightness between the least and most favorable polarizations. The protein-based reporter ASAP1 showed a 22% change in brightness, and QuasAr3 showed a 14% change in brightness. In very thin neurites expressing QuasAr3, improvements were anomalously large, with a 170% increase in brightness between polarization parallel vs perpendicular to the dendrite. Signal-to-noise ratios of optically recorded action potentials were increased by up to 50% in neurites expressing QuasAr3. These results demonstrate that polarization control can be a facile means to enhance signals from fluorescent voltage indicators, particularly in thin neurites or in high-background environments.

Aims We aimed to compare the long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with biodegradable polymer drug-eluting stents (BP-DES) versus durable polymer drug-eluting stents (DP-DES). Methods and results Among 11 517 PCIs with second-generation DES performed in our institution between 2007 and 2019, we identified 8042 procedures performed using DP-DES and 3475 using BP-DES. The primary outcome was target lesion failure, the composite target lesion revascularization (TLR), target vessel myocardial infarction and death. Propensity score matching was used to create a well-balanced cohort. Mean follow-up was 4.8 years. Of the 3413 matched pairs, 21% were females, and the mean age was 66 years. At 1 year, the primary outcome occurred in 8.3% patients versus 7.1% (P = 0.07), and TLR rate was 3% versus 2% (P = 0.006) in patients with DP-DES and BP-DES respectively. Within 5 years, the primary outcome occurred in 23.1% versus 23.4% (P = 0.44), and the rate of TLR was 7.2% versus 6.5% (P = 0.07) in patients with DP-DES and BP-DES, respectively. Conclusion Similar rates of the composite outcome were observed throughout the entire follow-up. target vessel revascularization rates were lower in the DP-DES group at 1 year but equalized within 5 years.

Over forty epidemiologic studies have addressed an association between measured or calculated extremely-low-frequency magnetic fields (MF) and childhood leukemia. These studies have been aggregated in a series of pooled analyses, but it has been 10 years since the last such.We present a pooled analysis combining individual-level data (24,994 cases, 30,769 controls) from four recent studies on MF and childhood leukemia.Unlike previous pooled analyses, we found no increased risk of leukemia among children exposed to greater MF: odds ratio (OR) = 1.01, for exposure ≥0.4 μT (μT) compared with exposures0.1 μT. Similarly, no association was observed in the subset of acute lymphoblastic leukemia, birth homes, studies using calculated fields, or when geocoding accuracy was ignored. In these studies, there is a decline in risk over time, also evident when we compare three pooled analyses. A meta-analysis of the three pooled analyses overall presents an OR of 1.45 (95% CI: 0.95-2.20) for exposures ≥0.4 μT.Our results are not in line with previous pooled analysis and show a decrease in effect to no association between MF and childhood leukemia. This could be due to methodological issues, random chance, or a true finding of disappearing effect.

AIMS Despite recent progress in coronary artery disease treatment, ST-segment elevation myocardial infarction (STEMI) remains a very high-risk medical condition. Whether recent patients' outcomes, following implementation of the 2012 European Society of Cardiology (ESC) STEMI guidelines have improved, is yet unclear. METHODS AND RESULTS The study was based on a prospective detailed registry of 2004 consecutive patients with STEMI treated with primary percutaneous coronary intervention (pPCI). We compared trends during two different time periods (2006-2012 vs. 2012-2018). Endpoints included mortality and major adverse cardiac events (MACE: death, repeat myocardial infarction, target vessel revascularization and coronary artery bypass surgery) at 1 month, 1 and 2 years. Rates of transradial interventions have risen significantly (67.3 vs. 42.0%; P

The aetiology of amyotrophic lateral sclerosis (ALS), a rare and extremely severe neurodegenerative disease, has been associated with magnetic fields exposure. However, evidence for such a relation in the general population is weak, although the previous null results might also be due to exposure misclassification, or a relationship might exist only for selected subgroups. To test such a hypothesis we carried out a population-based case-control study in two Northern and Southern Italy regions, including 703 ALS cases newly diagnosed from 1998 to 2011 and 2737 controls randomly selected from the residents in the study provinces. Overall, we found that a residence near high-voltage power lines, within the corridors yielding a magnetic fields of ≥0.1 μT, was not associated with an excess disease risk, nor did we identify a dose-response relationship after splitting the exposed corridor according to the 0.1, 0.2 and 0.4 μT cut-points of exposure. These results were confirmed taking into account age at onset, period of diagnosis, sex, geographical area, and length of exposure. Overall, despite the residual possibility of unmeasured confounding or small susceptible subgroups not identified in our study, these results appear to confirm that the exposure to magnetic fields from power lines occurring in the general population is not associated with increased ALS risk.

Introduction The aim of our study was to evaluate whether a biopsy from the tumor base after transurethral resection of bladder tumor (TURBT) has an impact on subsequent management of patients with bladder tumors. While tumor base biopsy at the completion of TURBT is a common practice, there is no definition of its role within the major international professional guidelines. Material and methods We retrospectively reviewed the records of consecutive patients undergoing TURBT between 2015 and 2019 at our institution. We recorded demographic and tumor characteristics of initial TURBT, tumor base biopsy and restaging TURBT pathology outcomes. The pathologic outcomes were correlated to assess the additional value of a separate tumor base biopsy. Results A total of 532 patients underwent TURBT. A separate tumor base biopsy after completion of TURBT was performed in 154 patients. The mean patient's age was 72.8 ±11.7 years (range 48-94) and 119 (77.2%) were men. In 40 patients (25.9%) muscle was absent in the pathological specimen of the tumor resection. Muscle was present in all but 6 (3.9%) tumor base biopsies. Of the 33 patients who underwent repeated transurethral resection for pT1 tumors, 2 had residual low-grade pTa, 1 had residual high-grade pT1, and 3 patients were upstaged to pT2. Conclusions Although tumor base biopsy at the completion of TURBT is a common practice, our analysis fails to demonstrate any tangible benefit in the staging of bladder tumors. In our experience tumor base biopsy did not change the management in patients with superficial or muscle invasive disease.

Results from studies evaluating potential effects of prenatal exposure to radio-frequency electromagnetic fields from cell phones on birth outcomes have been inconsistent. Using data on 55,507 pregnant women and their children from Denmark (1996-2002), the Netherlands (2003-2004), Spain (2003-2008), and South Korea (2006-2011), we explored whether maternal cell-phone use was associated with pregnancy duration and fetal growth. On the basis of self-reported number of cell-phone calls per day, exposure was grouped as none, low (referent), intermediate, or high. We examined pregnancy duration (gestational age at birth, preterm/postterm birth), fetal growth (birth weight ratio, small/large size for gestational age), and birth weight variables (birth weight, low/high birth weight) and meta-analyzed cohort-specific estimates. The intermediate exposure group had a higher risk of giving birth at a lower gestational age (hazard ratio = 1.04, 95% confidence interval: 1.01, 1.07), and exposure-response relationships were found for shorter pregnancy duration (P < 0.001) and preterm birth (P = 0.003). We observed no association with fetal growth or birth weight. Maternal cell-phone use during pregnancy may be associated with shorter pregnancy duration and increased risk of preterm birth, but these results should be interpreted with caution, since they may reflect stress during pregnancy or other residual confounding rather than a direct effect of cell-phone exposure. The Generalized EMF Research Using Novel Methods (GERoNiMO) Project was supported by the European Union (grant 603794). The Amsterdam Born Children and Their Development Study (ABCD) was supported by the Netherlands Organization for Health Research and Development (grant 2100.0076) and the Electromagnetic Fields and Health Research program (grants 85600004 and 85800001). The Danish National Birth Cohort Study (DNBC) was supported by the Danish Epidemiology Science Centre, the Lundbeck Foundation (grant 195/04), the Egmont Foundation, the March of Dimes Birth Defect Foundation, the Augustinus Foundation, and the Medical Research Council (grant SSVF 0646). The Spanish Environment and Childhood Project (INMA) was supported by the European Union (grants FP7-ENV-2011, 282957, and HEALTH.2010.2.4.5-1); Instituto de Salud Carlos III (grants G03/176, CB06/02/0041, FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314, 09/02647, 11/01007, 11/02591, CP11/00178, FIS-PI06/0867, FIS-PS09/00090, FIS-PI041436, FIS-PI081151, FIS-PI042018, FIS-PI09/02311, FISPI13/1944, FIS-PI13/2429, FIS-PI14/0981, FIS-PI13/141687, CP13/00054 (including FEDER funds), and MS13/00054); the Conselleria de Sanitat Generalitat Valenciana; the Generalitat de Catalunya (grants CIRIT1999SGR and 00241); Obra Social Cajastur; the Universidad de Oviedo; the Department of Health of the Basque Government (grants 2005111093 and 2009111069); and the Provincial Government of Gipuzkoa (grants DFG06/004 and DFG08/001). The Korean Mothers and Children’s Environment Health Study (MOCEH) was supported by the National Institute of Environmental Research, the Ministry of the Environment, and the Information and Communication Technology (ICT) research and development program of the Ministry of Science and ICT (grants 2017-0-00961 and 2019-0-00102), South Korea.

Cortical layer 1 (L1) interneurons have been proposed as a hub for attentional modulation of underlying cortex, but the transformations that this circuit implements are not known. We combined genetically targeted voltage imaging with optogenetic activation and silencing to study the mechanisms underlying sensory processing in mouse barrel cortex L1. Whisker stimuli evoked precisely timed single spikes in L1 interneurons, followed by strong lateral inhibition. A mild aversive stimulus activated cholinergic inputs and evoked a bimodal distribution of spiking responses in L1. A simple conductance-based model that only contained lateral inhibition within L1 recapitulated the sensory responses and the winner-takes-all cholinergic responses, and the model correctly predicted that the network would function as a spatial and temporal high-pass filter for excitatory inputs. Our results demonstrate that all-optical electrophysiology can reveal basic principles of neural circuit function in vivo and suggest an intuitive picture for how L1 transforms sensory and modulatory inputs. Video Abstract: [Figure presented] By simultaneously combining genetically targeted voltage imaging with optogenetic modulation of neuronal activity, Fan et al. demonstrate that all-optical electrophysiology in awake animals can be a powerful tool for revealing hidden principles of neural circuit function.

Background: There have been few studies of children's cognitive development in relation to mothers' cell phone use, and most were limited to outcomes at age 3 years or younger. We examined the relationship between maternal cell phone use during pregnancy and cognitive performance in 5-year old children. Methods: This study included data from 3 birth cohorts: the Danish National Birth Cohort (DNBC) (n = 1209), Spanish Environment and Childhood Project (INMA) (n = 1383), and Korean Mothers and Children's Environment Health Study (MOCEH) (n = 497). All cohorts collected information about maternal cell phone use during pregnancy and cognitive performance in children at age 5. We performed linear regression to compute mean differences (MD) and 95% confidence intervals (CI) in children's general, verbal, and non-verbal cognition scores comparing frequency of maternal prenatal cell phone use with adjustments for numerous potential confounding factors. Models were computed separately for each cohort and using pooled data in meta-analysis. Results: No associations were detected between frequency of prenatal cell phone use and children's cognition scores. Scores tended to be lower in the highest frequency of use category; MD (95% CI) in general cognition scores were 0.78 (−0.76, 2.33) for none, 0.11 (−0.81, 1.03) for medium, and −0.41 (−1.54, 0.73) for high compared to low frequency of use. This pattern was seen across all cognitive dimensions, but the results were imprecise overall. Conclusion: We observed patterns of lower mean cognition scores among children in relation to high frequency maternal prenatal cell phone use. The causal nature and mechanism of this relationship remain unknown. Keywords: Cell phones, Children, Cognition, Pooled analysis, Meta-analysis, Intelligence

Background Pesticides are a potential risk factor for childhood leukemia. Studies evaluating the role of prenatal and/or early life exposure to pesticides in the development of childhood leukemia have produced a range of results. In addition to indoor use of pesticides, higher risks have been reported for children born near agricultural crops. No studies have looked at pesticide exposure based on proximity of birth residence to commercial plant nurseries, even though nurseries are located much closer to residences than agricultural crops and can potentially result in chronic year-round pesticide exposure. Objectives To evaluate whether risk of childhood leukemia is associated with pesticide use as determined by distance of residence at birth to commercial, outdoor plant nurseries. Methods We conducted a large statewide, record-based case-control study of childhood leukemia in California, which included 5788 childhood leukemia cases and an equal number of controls. Pesticide exposure was based on a spatial proximity model, which combined geographic information system data with aerial satellite imagery. Results Overall, the results supported an increased childhood leukemia risk only for birth residences very close to nurseries. For birth residences less than 75 m from plant nurseries, we found an increased risk of childhood leukemia (odds ratio (OR) 2.40, 95% confidence interval (CI) 0.99-5.82) that was stronger for acute lymphocytic leukemia (OR 3.09, 95% CI 1.14-8.34). Discussion The association was robust to choices of reference group, cut points and data quality. Our findings suggest that close proximity to plant nurseries may be a risk factor for childhood leukemia and that this relationship should be further evaluated.

Age is the primary risk factor for the vast majority of disorders, including neurodegenerative diseases impacting brain function. Whether the consequences of aging at the biological level can be reversed, or age-related changes prevented, to change the trajectory of such disorders is thus of extreme interest and value. Studies using young plasma, the acellular component of blood, have demonstrated that aging is malleable, with the ability to restore functions in old animals. Fascinatingly, this functional improvement is even observed in the brain, despite the blood-brain barrier, indicating that peripheral sources can effectively impact central sites leading to clinically relevant changes such as enhancement of cognitive function. A plasma-based approach is also attractive as aging is inherently complex, with an array of mechanisms dysregulated in diverse cells and organs throughout the body leading to disturbed function. Plasma, containing a natural mixture of components, has the ability to act multimodally, modulating diverse mechanisms that can converge to change the trajectory of age-related diseases. Here we review the evidence that plasma modulates aging processes in the brain and consider the therapeutic applications that derive from these observations. Plasma and plasma-derived therapeutics are an attractive translation of this concept, requiring critical consideration of benefits, risks, and ethics. Ultimately, knowledge derived from this science will drive a comprehensive molecular understanding to deliver optimized therapeutics. The potential of highly differentiated, multimodal therapeutics for treatment of age-related brain disorders provides an exciting new clinical approach to address the complex etiology of aging. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13311-019-00746-z) contains supplementary material, which is available to authorized users.

The stability of neural dynamics arises through a tight coupling of excitatory (E) and inhibitory (I) signals. Genetically encoded voltage indicators (GEVIs) can report both spikes and subthreshold dynamics in vivo, but voltage only reveals the combined effects of E and I synaptic inputs, not their separate contributions individually. Here we combine optical recording of membrane voltage with simultaneous optogenetic manipulation to probe E and I individually in barrel cortex Layer 1 (L1) neurons in awake mice. Our studies reveal how the L1 microcircuit integrates thalamocortical excitation, lateral inhibition and top-down neuromodulatory inputs. We develop a simple computational model of the L1 microcircuit which captures the main features of our data. Together, these results suggest a model for computation in L1 interneurons consistent with their hypothesized role in attentional gating of the underlying cortex. Our results demonstrate that all-optical electrophysiology can reveal basic principles of neural circuit function in vivo.One Sentence SummaryAll-optical electrophysiology revealed the function in awake mice of an inhibitory microcircuit in barrel cortex Layer 1.

There have been many studies from 1979 to the present reporting raised risks for childhood leukaemia with exposure to power-frequency magnetic fields. There are also suggestions that the reported risk has been decreasing. We examine trends in the risk over time from all available studies. For 41 studies, we combine reported risks using inverse-variance weighting, drawing risk estimates from previous pooled analyses where possible for greater consistency. We examine the cumulative risk for studies published up to each successive calendar year for all studies and for various subsets, and test for a trend over the period. The cumulative relative risk has indeed declined, for our most rigorous analysis from a maximum 2.44 in 1997 to 1.58 in 2017, but not statistically significantly when tested as a linear trend. We find suggestions of higher risks in studies looking at higher exposures and in studies with better quality exposure assessment. We conclude that there is a decline in reported risk from the mid 1990s to now, which is unlikely to be solely explained by improving study quality but may be due to chance, and an elevated risk remains.

Background: Studies have reported an increased risk of childhood leukaemia associated with living near high-voltage electric power transmission lines that extend to distances at which magnetic fields from lines are negligible. We conducted a large records-based case-control study of childhood leukaemia risk in the population living near power lines in California. Methods: The study included 5788 childhood leukaemia and 3308 central nervous system (CNS) cancer cases (for comparison) born in and diagnosed in California (1986–2008), and matched to population-based controls by age and sex. We geocoded birth address and estimated the distance from residence to transmission lines using geographic information systems, aerial imagery, and, for some residences, site visits. Results: For leukaemia, there was a slight excess of cases within 50 m of a transmission line over 200 kV (odds ratio 1.4, 95% confidence interval 0.7–2.7). There was no evidence of increased risk for distances beyond 50 m, for lower-voltage lines, or for CNS cancers. Conclusions: Our findings did not clearly support an increased childhood leukaemia risk associated with close proximity (

BACKGROUND: We previously reported associations between cellphone exposure and emotional and behavioural difficulties in children in the Danish National Birth Cohort using cross-sectional data. To overcome the limitations of cross-sectional analysis, we re-examined these associations with prospectively collected data.METHODS: Based on maternal reports, prenatal and postnatal cellphone exposures were assessed at age 7 years, and emotional and behavioural difficulties were assessed at 7 and 11 years with the Strengths and Difficulties Questionnaire. We used multivariable-adjusted logistic regression models to estimate ORs and 95% CIs relating prenatal exposure and age-7 cellphone use to emotional and behavioural difficulties at age 11 years.RESULTS: Children without emotional and behavioural difficulties at age 7 years, but who had cellphone exposures, had increased odds of emotional and behavioural difficulties at age 11 years, with an OR of 1.58 (95% CI 1.34 to 1.86) for children with both prenatal and age-7 cellphone exposures, 1.41 (95% CI 1.20 to 1.66) for prenatal exposure only, and 1.36 (95% CI 1.14 to 1.63) for age-7 use only. These results did not materially change when early adopters were excluded, or when children with emotional and behavioural difficulties at age 7 years were included in the analysis.CONCLUSIONS: Our findings are consistent with patterns seen in earlier studies, and suggest that both prenatal and postnatal exposures may be associated with increased risks of emotional and behavioural difficulties in children.

Numerous studies have reported a protective association between asthma and acute lymphoblastic leukemia (ALL), but the causal structure of this association remains unclear. We present a hybrid simulation to examine the compatibility of this association with uncontrolled confounding by infection or another unmeasured factor. We generated a synthetic cohort using inputs on the interrelations of asthma, ALL, infections, and other suggested risk factors from the literature and the Danish National Birth Cohort. We computed odds ratios (ORs) between asthma and ALL in the synthetic cohort with and without adjustment for infections and other (including unmeasured) confounders. Only if infection was an extremely strong risk factor for asthma (OR of 10) and an extremely strong protective factor against ALL (OR of 0.1) was the asthma-ALL association compatible with the literature (OR of 0.78). Similarly, strong uncontrolled confounding by an unmeasured factor could downwardly bias the asthma-ALL association, but not enough to replicate findings in the literature. This investigation illustrates that the reported protective association between asthma and ALL is unlikely to be entirely due to uncontrolled confounding by infections or an unmeasured confounder alone. Simulation can be used to advance our understanding of risk factors for rare outcomes as demonstrated by this study.

Exposure assessment for electric fields is particularly difficult. Power lines may carry no current at all and thus produce no magnetic fields, but they still may be energized and produce similar electric field as when fully loaded. Given the ubiquitous nature of extremely low frequency electromagnetic fields (EMF), there is concern regarding their potential to adversely affect human health. Calculation of electric fields in the presence of trees or buildings is difficult, thus it is better to measure the electric field than to rely on calculations. Unlike studies of residential magnetic-field exposure and childhood leukemia, epidemiological studies of residential electric fields have been predominately negative. Studies on occupational exposure to EMF and adult leukemia have mostly linked job titles with cancer incidence or mortality. Breast cancer is the most commonly occurring malignancy in women in the United States and the second most worldwide.

Background: While studies have consistently found an association between childhood leukemia risk and magnetic fields, the associations between childhood leukemia and distance to overhead power lines have been inconsistent. We pooled data from multiple studies to assess the association with distance and evaluate whether it is due to magnetic fields or other factors associated with distance from lines. Methods: We present a pooled analysis combining individual-level data (29,049 cases and 68,231 controls) from 11 record-based studies. Results: There was no material association between childhood leukemia and distance to nearest overhead power line of any voltage. Among children living In this first comprehensive pooled analysis of childhood leukemia and distance to power lines, we found a small and imprecise risk for residences

The process of aging is multifactorial and therefore single interventions may be unlikely to attenuate the myriad pathologies. Plasma contains many beneficial factors which have been shown in animal models to ameliorate multiple age-related deficits across varied organ systems, including the brain. We demonstrated that human plasma from young 18-22-year-old donors reverses age-related cognitive decline and enhances hippocampal neurogenesis and cell survival in aged immunocompromised mice, while plasma from aged individuals (62-68 years old) has detrimental effects in young mice. Utilizing cell-based assays we identified a human plasma fraction (PF) which enhanced neuronal outgrowth and synaptic connectivity. We demonstrate that PF administration provides benefits beyond those observed with whole plasma treatment, resulting in decreased brain inflammation, increased synaptic density and neuronal activation. We evaluated longitudinal treatment of PF and observed no depletion in stem cell populations while maintaining an enhanced level of neurogenesis. We examined PF in an α-synuclein mouse model of Parkinson’s disease, where treatment significantly reversed functional, inflammatory, and neuronal deficits. To further our understanding of interplay between multiple mechanisms inducing neurogenesis, we examined the effect of exercise on PF treated mice and observed a synergistic increase in neurogenesis. Proteomic analysis of mouse plasma following PF treatment demonstrates differential protein levels compared to running or the combination of running and PF, suggesting that PF is mechanistically different from the effect of running. In summary, we demonstrate that PF is a multifactorial and multimodal, clinically-relevant, intervention for the treatment of global changes induced by aging.

BACKGROUND: Amyotrophic lateral sclerosis (ALS) has been consistently related to "electric occupations," but associations with magnetic field levels were generally weaker than those with electrical occupations. Exposure to electric shock has been suggested as a possible explanation. Furthermore, studies were generally based on mortality or prevalence of ALS, and studies often had limited statistical power. METHODS: Using two electric shock and three magnetic field job-exposure matrices, we evaluated the relationship of occupational magnetic fields, electric shocks, electric occupations, and incident ALS in a large population-based nested case-control study in Sweden. Subanalyses, specified a priori, were performed for subjects by gender and by age (less than and more than 65 years). RESULTS: Overall, we did not observe any associations between occupational magnetic field or electric shock exposure and ALS. For individuals less than 65 years old, high electric shock exposure was associated with an odds ratio (OR) of 1.22 (95% confidence interval [CI] = 1.03, 1.43). The corresponding result for the age group 65 years or older was OR = 0.92 (95% CI = 0.81, 1.05). Results were similar regardless which job exposure matrices, exposure definitions, or cutpoints were used. For electric occupations, ORs were close to unity, regardless of age. For welders, no association was observed overall, although for welders

We conducted a large registry-based study in California to investigate the association between race/ethnicity and childhood leukaemia focusing on two subtypes: acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML).We obtained information on 5788 cases and 5788 controls by linking California cancer and birth registries. We evaluated relative risk of childhood leukaemia by race and ethnicity of the child and their parents using conditional logistic regression, with adjustment for potential confounders.Compared with Whites, Black children had lower risk of ALL (OR=0.54, 95% CI 0.45 to 0.66) as well as children of Black/Asian parents (OR=0.31, 95% CI 0.10 to 0.94). Asian race was associated with increased risk of AML with OR=1.643, 95% CI 1.10 to 2.46 for Asian vs Whites; and OR=1.67, 95% CI 1.04 to 2.70 for Asian/Asian vs White/White. Hispanic ethnicity was associated with increased risk of ALL (OR=1.37, 95% CI 1.22 to 1.52). A gradient in risk of ALL was observed while comparing Hispanic children with both parents Hispanic, one parent Hispanic and non-Hispanic children (p Value for trend0.0001). The highest risk of ALL was observed for children with a combination of Hispanic ethnicity and White race compared with non-Hispanic whites (OR=1.27, 95% CI 1.12 to 1.44). The lowest risk was observed for non-Hispanic blacks (OR=0.46, 95% CI 0.36 to 0.60). Associations for total childhood leukaemia were similar to ALL.Our results confirm that there are ethnic and racial differences in the incidence of childhood leukaemia. These differences indicate that some genetic and/or environmental/cultural factors are involved in aetiology of childhood leukaemia.

Background: Exposure to radiofrequency electromagnetic fields (RF-EMF) from mobile communication technologies is changing rapidly. To characterize sources and associated variability, we studied the differences and correlations in exposure patterns between children aged 8 to 18 and their parents, over the course of the day, by age, by activity pattern, and for different metrics of exposure. Methods: Using portable RF-EMF measurement devices, we collected simultaneous real-time personal measurements of RF-EMF over 24 to 72 h in 294 parent-child pairs from Denmark, the Netherlands, Slovenia, Switzerland, and Spain. The devices measured the power flux density (mW/m(2)) in 16 different frequency bands every 4 s, and activity diary Apps kept by the participants were used to collect time-activity information in realtime. We analyzed their exposures by activity, for the different source constituents of exposure: downlink (radiation emitted from mobile phone base stations), uplink (transmission from phone to base station), broadcast, DECT (digital enhanced cordless telecommunications) and Wi-Fi. We looked at the correlations between parents and children overall, during day (06:00-22.00) and night (22:00-06:00) and while spending time at home. Results: The mean of time-weighted average personal exposures was 0.16 mW/m(2) for children and 0.15 mW/m(2) for parents, on average predominantly originating from downlink sources (47% for children and 45% for parents), followed by uplink (18% and 27% respectively) and broadcast (25% and 19%). On average, exposure for downlink and uplink were highest during the day, and for Wi-Fi and DECT during the evening. Exposure during activities where most of the time is spent (home, school and work) was relatively low whereas exposure during travel and outside activities was higher. Exposure to uplink increased with age among young people, while DECT decreased slightly. Exposure to downlink, broadcast, and Wi-Fi showed no obvious trend with age. We found that exposure to total RF-EMF is correlated among children and their parents (R-speannan = 0.45), especially while at home (0.62) and during the night (0.60). Correlations were higher for environmental sources such as downlink (0.57) and broadcast (0.62) than for usage-related exposures such as uplink (0.29). Conclusion: The generation gap between children and their parents is mostly evident in uplink exposure, due to more and longer uplink and cordless phone calls among parents, and their tendency to spend slightly more time in activities with higher environmental RF-EMF exposure, such as travel. Despite these differences in personal behavior, exposure to RF-EMF is moderately correlated between children and their parents, especially exposures resulting from environmental RF-EMF sources., GERoNiMO project: This work was supported by funding from the European Commission Seventh Framework Programme under grant agreement number FP7 603794.r HERMES project: This work is supported by the Swiss National Science Foundation (project number 138190). This research is also supported by the Swiss Research Foundation for Electricity and Mobile Communication (reference number 41).r ABCD, The Netherlands: This work is supported by the Netherlands Organisation for Health Research and Development (grant 2100.0076) and within the programme Electromagnetic Fields and Health Research (grants 85600004 and 85800001).r DNBC, Denmark: This work is supported by the Danish Epidemiology Science Centre; The Lundbeck Foundation; Egmont Foundation; March of Dimes Birth Defect Foundation; Augustinus Foundation; and the Medical Research Council.r ZuMe, Switzerland: This work is supported by the AWEL (Office for Waste, Water, Energy and Air) in Zurich.r INMA, Spain: This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds; PI12/01890 incl. FEDER funds; CP13/00054 incl. FEDER funds; MS13/00054), CIBERESP, Generalitat de Catalunya-CIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR (2009 SGR 501, 2014 SGR 822), Fundacio La marato de TV3 (090430), Spanish Ministry of Economy and Competitiveness (SAF2012-32991 incl. FEDER funds), Agence Nationale de Securite Sanitaire de l'Alimentation de l'Environnement et du Travail (1262C0010), European Commission (261357, 308333 and 603794). ISGlobal is a member of the CERCA Program, Generalitat de Catalunya.

AIMS: Studies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the effect of mobility. METHODS: We analyzed data from a population-based case-control study of childhood leukemia using cases who were born in California and diagnosed between 1988 and 2008 and birth certificate controls. We used stratified logistic regression, case-only analysis, and propensity-score adjustments to assess predictors of residential mobility between birth and diagnosis, and account for potential confounding due to residential mobility. RESULTS: Children who moved tended to be older, lived in housing other than single-family homes, had younger mothers and fewer siblings, and were of lower socioeconomic status. Odds ratios for leukemia among non-movers living < 50 meters (m) from a 200 + kilovolt line (OR: 1.62; 95% CI: 0.72–3.65) and for calculated fields ≥ 0.4 microTesla (OR: 1.71; 95% CI: 0.65–4.52) were slightly higher than previously reported overall results. Adjustments for propensity scores based on all variables predictive of mobility, including dwelling type, increased odds ratios for leukemia to 2.61 (95% CI: 1.76–3.86) for living < 50 m from a 200 + kilovolt line and to 1.98 (1.11–3.52) for calculated fields. Individual or propensity-score adjustments for all variables, except dwelling type, did not materially change the estimates of power line exposures on childhood leukemia. CONCLUSION: The residential mobility of childhood leukemia cases varied by several sociodemographic characteristics, but not by the distance to the nearest power line or calculated magnetic fields. Mobility appears to be an unlikely explanation for the associations observed between power lines exposure and childhood leukemia.

Introduction: Previous studies have reported associations between prenatal cell phone use and child behavioral problems, but findings have been inconsistent and based on retrospective assessment of cell phone use. This study aimed to assess this association in a multi-national analysis, using data from three cohorts with prospective data on prenatal cell phone use, together with previously published data from two cohorts with retrospectively collected cell phone use data. Methods: We used individual participant data from 83,884 mother-child pairs in the five cohorts from Denmark (1996–2002), Korea (2006–2011), the Netherlands (2003–2004), Norway (2004–2008), and Spain (2003–2008). We categorized cell phone use into none, low, medium, and high, based on frequency of calls during pregnancy reported by the mothers. Child behavioral problems (reported by mothers using the Strengths and Difficulties Questionnaire or Child Behavior Checklist) were classified in the borderline/clinical and clinical ranges using validated cut-offs in children aged 5–7 years. Cohort specific risk estimates were meta-analyzed. Results: Overall, 38.8% of mothers, mostly from the Danish cohort, reported no cell phone use during pregnancy and these mothers were less likely to have a child with overall behavioral, hyperactivity/inattention or emotional problems. Evidence for a trend of increasing risk of child behavioral problems through the maternal cell phone use categories was observed for hyperactivity/inattention problems (OR for problems in the clinical range: 1.11, 95%CI 1.01, 1.22; 1.28, 95%CI 1.12, 1.48, among children of medium and high users, respectively). This association was fairly consistent across cohorts and between cohorts with retrospectively and prospectively collected cell phone use data. Conclusions: Maternal cell phone use during pregnancy may be associated with an increased risk for behavioral problems, particularly hyperactivity/inattention problems, in the offspring. The interpretation of these results is unclear as uncontrolled confounding may influence both maternal cell phone use and child behavioral problems. Keywords: Attention deficit disorder with hyperactivity, Cell phones, Child behavior, Child health, Electromagnetic radiation, Pregnancy

In this paper we compare the findings of epidemiologic studies of childhood leukemia that examined at least two of ELF magnetic fields and/or distance to power lines, and exposure to radon and gamma radiation or distance to nuclear plants. Many of the methodologic aspects are common to studies of non-ionising (i.e. ELF-MF) and ionising radiation. A systematic search and review of studies with more than one exposure under study identified 33 key and 35 supplementary papers from ten countries that have been included in this review. Examining studies that have looked at several radiation exposures, and comparing similarities and differences for the different types of radiation, through the use of directed acyclic graphs, we evaluate to what extent bias, confounding and other methodological issues might be operating in these studies. We found some indication of bias, although results are not clear cut. There is little evidence that confounding has had a substantial influence on results. Influence of the residential mobility on the study conduct and interpretation is complex and can manifest as a selection bias, confounding, increased measurement error or could also be a potential risk factor. Other factors associated with distance to power lines and to nuclear power plants should be investigated. A more complete and consistent reporting of results in the future studies will allow for a more informative comparison across studies and integration of results.

Objectives The aim of this exposure assessment study was to gain information about the exposure levels of adolescents in Israel to power frequency (50 Hz) magnetic fields (MF) through personal monitoring, and to provide reliable data for national policy development. Methods 84 adolescents, 6–10th grade students, carried an EMDEX II meter attached to their body for 24 h. The meter recorded the MF every 1.5 s. The students documented their activities and microenvironments, such as apartment (awake or asleep), school, transportation, open public areas and other indoor environments. Results The geometric mean (GM) of the daily time weighted average (TWA) of all the participants was 0.059 μT (STD = 1.83). This result is similar to those of personal exposure surveys conducted in the UK (GM 0.042–0.054 μT), but lower than levels found in the US (GM 0.089 − 0.134 μT). The arithmetic mean was 0.073 μT, 23% higher than the GM. Fields were lowest at school (GM 0.033 μT), and average outdoor exposures were higher than indoor ones. 3.6% of the participants were exposed to daily TWA above 0.2 μT. The typical time spent above 0.2 μT ranged from few minutes to few hours. The time spent above 0.4 μT and 1 μT were much shorter, around 1–15 min and from few seconds to 2 min, respectively. Momentary peaks ever recorded were in the range of 0.35–23.6 μT Conclusions Exposure of adolescents in Israel is similar to data reported in other countries, being below 0.1 μT for the vast majority, with very few average exposures above 0.2 μT. Analysis of the different microenvironments allows for a cost-effective and equitable policy development.

Studies have reported an increased risk of childhood leukemia associated with exposure to magnetic fields. We conducted a large records-based case–control study of childhood leukemia risk and exposure to magnetic fields from power lines in California. The study included 5,788 childhood leukemia cases (born in and diagnosed in California 1986–2008) matched to population-based controls on age and sex. We calculated magnetic fields at birth addresses using geographic information systems, aerial imagery, historical information on load and phasing, and site visits. Based on unconditional logistic regression controlling for age, sex, race/ethnicity, and socioeconomic status using subjects geocoded to a basic standard of accuracy, we report a slight risk deficit in two intermediate exposure groups and a small excess risk in the highest exposure group (odds ratio of 1.50 (95% confidence interval [0.70, 3.23])). Subgroup and sensitivity analyses as well as matched analyses gave similar results. All estimates had wide confidence intervals. Our large, statewide, record-based case–control study of childhood leukemia in California does not in itself provide clear evidence of risk associated with greater exposure to magnetic fields from power lines, but could be viewed as consistent with previous findings of increased risk.

Objective: to monitor the efficacy of transurethral resection (TUR) of a urinary bladder tumor, which has performed under the standard conditions and by using fluorescence cystoscopy (FCS), to diagnose early bladder cancer (BC), and to determine tumor aggression and prognosis of the disease.Subjects and methods. 174 BC patients, who had undergone 4-6 weeks postoperatively re-endoscopy comprising routine cystoscopy (CS), FCS, and TUR biopsy of a postoperative scar area and fluorescent portions, were examined. Group 1 included 95 patients who had under- gone routine TUR; Group 2 consisted of 79 patients in whom TUR had performed under fluorescence guidance. Results. Re-endoscopy revealed fluorescence portions in 56 (58.9%) patients in Group 1 and in 28 (35.4%) in Group 2. Endothelial tumors were found in 45 (47.4%) patients from Group 1 and in 19 (24.1%) from Group 2. In the latter, residual tumors were less frequently observed than those in Group 1 (24.1 and 47.4%, respectively; p < 0.005). Control endoscopic study of Tis identified in 15 (15.8%) of the 95 examinees in Group 1 and only in 4 (5.1%) of 79 in Group 2 (p < 0.001). There was a significant difference in the frequency of residual tumors (Ta stage) in Groups 1 and 2 patients (16.8 and 8.9%; p < 0.005). The differences in the frequency of residual papillary tumors at T1 stage were also significant in the analyzed groups (10.5 and 6.3%, respectively; p < 0.05). At the same time, the difference was insignificant in the incidence of a recurrence at T2 stage. Amongst 27 Group 1 patients with multiple urinary bladder involvement, residual tumors were identified in 14 (51.9%); these were present only in 4 (18.2%) of 22 patients from Group 2 (p < 0.001). Conclusion. Early repeated CS and biopsy under fluorescence guidance should be recommended to patients with BC at stages Tis and Ta— T1 for the timely detection and removal of residual tumors and for the prevention of recurrences.

Background. The advantage of our proposed therapy technique is to transit from the photodynamic diagnosis stage to effective therapeutic exposure (photodynamic therapy (PDT)) during one intervention.Objective: to evaluate the efficiency and safety of the novel treatment option for superficial bladder carcinoma (BC).Subjects and methods. The study enrolled 18 patients aged 66 ± 5 years (range 60−75 years) with superficial BC. A photosensitizer (photoditazine, Veta-Grand, Russia) was intravesically injected in a dose of 10 mg in 20 ml of saline solution 2 hours before intervention. Endoscopy was carried out on Storz PDT equipment with a monochrome light source at a wavelength of 402 nm, which corresponded to the maximum absorption spectrum for the molecule of photoditazine. The procedure was started with the PDT stage during which damaged bladder mucosal areas were found. Then there was transurethral resection of detected papillary masses and fluorescent areas with well-defined outlines. The fluorescent areas with ill-defined outlines underwent targeted light exposure at a wavelength of 402 nm for 5–10 min. The total light exposure of the bladder mucosa during the entire procedure was at least 30 min. The above procedure was performed in the patients at their inclusion into the study, then 1, 4, 7, 10, and 13 months later. The rates of complete tumor regression and adverse events were estimated during the study.Results. Multifocal bladder mucosa lesion with invasion grades Ta, T1, Tis was detectable in all the patients at their inclusion into the study. Complete tumor regression was noted in 13 (72 %), 15 (83 %), and 17 (94 %) patients 1, 4, and 7 months after initiation of treatment, respectively. Following 10 and 13 months, no tumor tissue was found in the biopsy specimens from any patients. There were no evident local and systemic toxic reactions, including skin photosensitization.Conclusions. The proposed technique versus the traditional treatments for superficial BC is advantageous in its high antitumor selectivity and the absence of obvious local and systemic toxic reactions (so in the possibility of multiple repetitions of a treatment procedure), and a complementary combination of photodynamic diagnosis and therapeutic exposure (PDT) during one procedure. Our proposed technique is a promising treatment for superficial BC, including carcinoma in situ.

Background. How to derive urine is stemmed from removal of the bladder and from the necessity of its disengaging from the process of urination. Most surgeons prefer to do incontinent urine derivation in elderly and senile patients.Subjects and methods. In 2007 to 2009, the Leningrad Regional Oncology Dispensary treated 103 patients with diseases requiring the bladder be removed. All these patients underwent cystectomy as an independent operation or one of the surgical stages, followed by incontinent urine derivation described by Bricker. The patients were divided into 2 groups: 1) Bricker-type end-to-side ureteroileal anastomosis; 2) Wallace-type one. Group 1 comprised 50 patients: 37 (74 %) women and 13 (26 %) men; Group 2 included 53 patients: 48 (90.6 %) women and 5 (9.6 %) men. These were elderly and senile patients aged 60 to 79 years (mean age 65 ± 3.71).Results. In Group 1, 36 (72 %) patients were preoperatively diagnosed as having hydroureteronephrosis (HUN). Of them, 23 (64%) patients underwent preoperative percutaneous puncture nephrostomy (PPN). In Group 2, HUN was diagnosed in 43 (81 %) patients; of them 27 (63 %) had PPN. Complications and resurgeries were more common in Group 1 (p < 0.001). In Group 2, there were a larger number of cases of incompetence of the ureteroileal anastomosis. This complication required no surgical correction, but a longer drainage standing.Conclusion. The Bricker operation is the safest urine derivation in elderly and senile patients after surgery involving cystectomy. Wallacetype ureteroileal anastomosis during the Bricker operation is accompanied by a considerable reduction in the number of early and late postoperative complications and resurgeries. Wallace-type ureteroileal anastomosis is considered the method of choice in cancer patients.

It was recently reported that residential altitude is inversely associated with all-cause mortality among incident dialysis patients; however, no adjustment was made for key case-mix and laboratory variables. We re-examined this question in a contemporary patient database with comprehensive clinical and laboratory data. In a contemporary 8-year cohort of 144,892 maintenance dialysis patients from a large dialysis organization, we examined the relationship between residential altitude and all-cause mortality. Using data from the US Geological Survey, the average residential altitudes per approximately 43,000 US zip codes were compiled and linked to the residential zip codes of each patient. Mortality risks for these patients were estimated by Cox proportional hazard ratios. The study population's mean ± standard deviation age was 61 ± 15 years. Forty-five percent of patients were women, and 57% of patients had diabetes. In fully adjusted analysis, those residing in the highest altitude strata (≥ 6000 ft) had a lower all-cause mortality risk in fully adjusted analyses: death hazard ratio: 0.92 (95% confidence interval, 0.86-0.99), as compared with patients in the reference group (

Low serum albumin concentration and low dietary protein intake are associated with protein-energy wasting (PEW) and higher mortality in maintenance hemodialysis patients. The role of these nutritional markers is less clear in clinical outcomes of the first several months of dialysis therapy, where mortality is exceptionally high. In a cohort of 17,445 incident hemodialysis patients, we examined variation in serum albumin and the normalized protein catabolic rate (nPCR), a surrogate of dietary intake, and quarterly mortality in the first 2 years of dialysis therapy. Cox proportional hazard models were fitted to estimate the association between mortality and combined albumin/nPCR categories for eight quarters. We investigated the associations between mortality and baseline and subsequent serum albumin levels per cohort quarter as well as changes in albumin and nPCR over time. Patients were 64 +/- A 15 years old (mean +/- A SD) and included 45 % women, 24 % African Americans and 58 % diabetics. Correlations between quarterly serum albumin and nPCR varied from 0.18 to 0.25. Serum albumin +0.2 g/kg/day) showed reverse effect on mortality from the 2nd to the last quarter. Low serum albumin and nPCR are associated with mortality. A rapid rise in nPCR by the end of the second year may indicate pre-existing PEW

Cell phone use has increased rapidly in recent years, with over 5.2 billion cell phone subscribers at the end of 2010.1–4 This has led to concern about the potential health effects of exposure to radio frequency (RF) radiation from cell phones used at close proximity to the head. Today’s children are exposed to cell phones beginning at a very early age and continuing throughout life. They will have a higher and much longer lifetime exposure than today’s adults. Children may be more susceptible to potential effects of RF due to their developing organ and tissue systems, and differences in size, shape, water content, and tissue distribution of the head.5,6 Should RF exposure from cell phones have a harmful effect on human health, children may be at the highest risk and should be given high priority in research.7 The International Agency for Research on Cancer (IARC) recently classified RF radiation as possibly carcinogenic.8 Laboratory and provocation studies have reported a range of findings across various non-cancer outcomes as well, including changes in glucose metabolism and electrical activity in the brain, effects on visual and somatosensory evoked-potentials, and reports of subjective symptoms such as fatigue and skin sensations in relation to RF exposure.9,10 Epidemiologic studies have investigated changes in behavior and cognition11–13 and headaches14 with some observing positive associations, and numerous relevant outcomes are still to be examined. While no mechanism for an effect of RF exposure from cell phones on human health has been established, these findings along with widespread exposure call for further research into potential health effects of cell phone use, particularly among young children. As cell phones are typically positioned close to the head during use, particularly the ear, their effect on the occurrence of auditory function is of interest. While several causes of hearing loss have been identified, including genetics, otitis media, certain prenatal and early-life infections, injuries, and prolonged exposure to loud noises, a recent review suggests that, for approximately 56% of hearing impaired children in the United States, the cause is unknown.15 To date, experimental and non-experimental studies have not provided solid evidence of effects of cell phones on auditory function.16–24 The only prospective study completed on this subject was of adults and found that cell phone users had a significant increase in average auditory threshold (evidence of hearing damage) at the end of three years of follow-up compared to non-users.24 While this study may have encountered problems of bias due to loss-to-follow-up, the results point to the need for additional research in this area. In the present study we investigated the associations between mothers’ reports of cell phone use by children and hearing loss at age seven years using data from a large birth cohort. We also examined whether hearing loss at age 18 months affects cell phone use at age seven.