Ukraine conflict: Putin likens sanctions on Russia to declaration of war, World News | wionews.com https://www.wionews.com/world/ukraine-conflict-putin-likens-sanctions-on-russia-to-declaration-of-war-459428?utm_medium=Social&utm_source=Facebook&utm_campaign=FB-M&theme=mobile
Day: 03/05/2022
NASA Just Saw Something Come Out Of A Black Hole For The First Time Ever
NASA Just Saw Something Come Out Of A Black Hole For The First Time Ever https://www.physics-astronomy.com/2022/03/nasa-just-saw-something-come-out-of.html?m=1
Learning Radiology – Spine Sign
Learning Radiology – Spine Sign http://www.learningradiology.com/notes/chestnotes/spinesign.htm
The dignity of peace
Published on 4 March 2022
As the Russian invasion of Ukraine has entered its second week, the often gruesome images we see now are a stark reminder that we are not dealing with a “special military operation”, as President Putin calls it. This is an all-out war of aggression, an unprovoked attack started by one nation against its peaceful neighbour.
I’ve left no doubt of my position on this. I firmly support Ukraine’s sovereignty as an independent nation, its people’s right to choose their own destiny, free from outside interference. And so I’ve come out in favour of the strongest possible sanctions against Russia, its leaders and its economy. The free world must do what it can to force Putin and his cronies to change course and end this war. The bloodshed must stop now. The war crimes must stop. Russian troops must retreat.
For that to happen, Russia must feel the full force of economic and social isolation. I am old enough to remember how international sanctions and consistent boycott finally brought the South African Apartheid regime to its knees. The challenge before us is one of much greater scale, but it can be done if we all, collectively and individually, make informed choices about products we consume and services we use.
Putin’s war on Ukraine, explained
As I watch the global community respond to this call for consequences in every area of civic life, from sports to culture, from academia to business, I want to be clear that my support for effective, hard-hitting sanctions does not diminish my empathy for the Russian people, the many millions who have not asked for this confrontation, and who now see their day-to-day lives uprooted and changed, possibly for a very long time to come.
Of course, Russians don’t live in fear of cluster bombs tearing them apart in the street. No missiles will be hitting their homes as they sit down for dinner with their loved ones. That’s the everyday terror Ukrainians have to live with at this very moment. It’s the kind of terror that will traumatise so many for years to come.
But I look at the boyish faces of captured Russian soldiers tearfully calling their mothers, and I look at the thousands defying the oppressor and demonstrating for peace in St. Petersburg and Moscow, and what I don’t see anywhere is enthusiasm for Putin’s war. All I see is fear, anxiety and the frustration of a people taken on a self-destructive journey even some of Putin’s most consistent cheerleaders never signed up for.
Global Dignity Day 2011 Finland – Archbishop Desmond Tutu
Ukrainian friends understandably ask me where those anxious Russians were in the years since 2014, when Putin’s true intentions became obvious to everyone. But his war has always also been a war against his own people, against the voices that warned of his ambitions and called for a more peaceful course. Over two decades, Putin has created a system of control, intimidation, oppression, and disinformation that has all but silenced, if not killed, his critics and put all of Russia in a chokehold that is now threatening to suffocate the last remnants of civil society and a free press. It’s plain to see: as Ukrainians are robbed of their dignity by the everyday horrors of war, ordinary Russians had theirs stripped away slowly but continuously as the country slipped into totalitarianism.
Global Dignity Day 2011 Finland – President Martti Ahtisaari
In moments like these, I am reminded of the words of two giant peacemakers who I admire greatly. The late Archbishop Desmond Tutu, a dear friend who devoted his life to the causes of reconciliation and forgiveness, once said:
“If you want peace, make sure everyone’s dignity is intact.”
And Finland’s former President Martti Ahtisaari, himself no stranger to conflict with Russia, has always stressed that lasting peace and dignity for all are two sides of the same coin. Ukrainians deserve the dignity of sovereignty and peace. The people of Russia deserve the dignity of freedom and liberty. As the world looks for ways to end this conflict for good and keep the peace, we must find ways to achieve both.
I’m proud we’re supporting the people of Ukraine, including through Virgin Unite donations to The Red Cross and Tabletochki, and urge everyone to do what they can to support https://www.withukraine.org/en.
Primary Hyperoxaluria
A 40-year-old man with end-stage kidney disease and calcium oxalate nephrolithiasis presented to the emergency department with a 7-year history of joint pain. He also reported blurry vision, painful skin lesions, and tooth loss, all of which had developed over the past several years. Physical examination was notable for the absence of incisors and the presence of synovitis of the elbows, knees, and ankles; deformities of the finger joints; and tender subcutaneous nodules on the back and the legs. Corneal calcium deposits were seen on slit-lamp examination (Panel A). Computed tomography of the abdomen showed nephrocalcinosis in both kidneys (Panel B), and radiography of the hands showed dense metaphyseal bands and calcium deposits in the soft tissues (Panel C). A biopsy specimen of a subcutaneous nodule showed calcium oxalate deposition with birefringence on polarized microscopy (Panel D). Two AGXT variants were observed on genetic testing, and a diagnosis of primary hyperoxaluria type 1 was made. Primary hyperoxaluria is a rare autosomal recessive disorder involving the overproduction of oxalate by the liver that may go undiagnosed for years. Early symptoms include nephrocalcinosis and nephrolithiasis. As kidney function worsens, systemic oxalate deposition may occur, including in the joints, bones, eyes, and skin. The patient had been undergoing hemodialysis, and his joint pain abated when the frequency of treatment was increased. He is undergoing evaluation for liver and kidney transplantation.
Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults
Abstract
BACKGROUND
Whether the use of balanced multielectrolyte solution (BMES) in preference to 0.9% sodium chloride solution (saline) in critically ill patients reduces the risk of acute kidney injury or death is uncertain.
METHODS
In a double-blind, randomized, controlled trial, we assigned critically ill patients to receive BMES (Plasma-Lyte 148) or saline as fluid therapy in the intensive care unit (ICU) for 90 days. The primary outcome was death from any cause within 90 days after randomization. Secondary outcomes were receipt of new renal-replacement therapy and the maximum increase in the creatinine level during ICU stay.
RESULTS
A total of 5037 patients were recruited from 53 ICUs in Australia and New Zealand — 2515 patients were assigned to the BMES group and 2522 to the saline group. Death within 90 days after randomization occurred in 530 of 2433 patients (21.8%) in the BMES group and in 530 of 2413 patients (22.0%) in the saline group, for a difference of −0.15 percentage points (95% confidence interval [CI], −3.60 to 3.30; P=0.90). New renal-replacement therapy was initiated in 306 of 2403 patients (12.7%) in the BMES group and in 310 of 2394 patients (12.9%) in the saline group, for a difference of −0.20 percentage points (95% CI, −2.96 to 2.56). The mean (±SD) maximum increase in serum creatinine level was 0.41±1.06 mg per deciliter (36.6±94.0 μmol per liter) in the BMES group and 0.41±1.02 mg per deciliter (36.1±90.0 μmol per liter) in the saline group, for a difference of 0.01 mg per deciliter (95% CI, −0.05 to 0.06) (0.5 μmol per liter [95% CI, −4.7 to 5.7]). The number of adverse and serious adverse events did not differ meaningfully between the groups.
CONCLUSIONS
We found no evidence that the risk of death or acute kidney injury among critically ill adults in the ICU was lower with the use of BMES than with saline. (Funded by the National Health and Medical Research Council of Australia and the Health Research Council of New Zealand; PLUS ClinicalTrials.gov number, NCT02721654. opens in new tab.)
Primary Hypertrophic Osteoarthropathy
A 31-year-old man presented to the internal medicine clinic with 10 years of progressive enlargement of his fingertips and toes and intermittent aches in his distal forearms and lower legs. He had no clinically significant medical history or family history of similar symptoms. Finger and toe clubbing, with a supranormal angle of 210 degrees between the nail bed and the proximal nail fold, was observed on examination. Hyperpigmentation of the proximal nail folds; tenderness to palpation of the distal forearms and lower legs, fingertips, and toes; and widening of the distal forearms and lower legs (Panels A and B, respectively) were also observed. There was no skin thickening or hyperhidrosis. Radiographs of the fingers showed bony proliferation at the tips of the phalanges (Panel C), and radiographs of the ankles showed increased periosteal bone formation at the distal tibia and fibula (Panel D). Serum laboratory tests (including thyroid-function studies), an echocardiogram, and whole-body positron-emission tomography–computed tomography were normal. The patient received a diagnosis of primary hypertrophic osteoarthropathy, a hereditary syndrome characterized by clubbing, periosteal bone proliferation, and (not seen in this case) facial skin thickening and hyperhidrosis, in the absence of systemic conditions. The patient was initially treated with nonsteroidal antiinflammatory drugs for 3 months. Given persistent symptoms, zoledronic acid was administered, and his pain had abated at follow-up 2 months later.
Naveen Yadav, M.D.
Uday Yanamandra, M.D., D.M.
Armed Forces Medical College, Pune, India
naveeny7000@gmail.com
Vitamin D-calcium supplement effect on tibia similar to that of placebo
U.S. Army recruits taking a daily calcium and vitamin D supplement during basic training had no change in tibial microarchitecture compared with placebo, according to study data published in Bone.
“A calcium and vitamin D fortified food product prevented increases in biochemical markers of bone resorption, but there were no significant changes in tibial density or microarchitecture in men and women after military training,” Erin Gaffney-Stomberg, PhD, RD, division chief of the combat feeding division at the U.S. Army Research Institute of Environmental Medicine in Natick, Massachusetts, and colleagues wrote. “In addition, markers of bone formation increased, and parathyroid hormone decreased equally in both groups over the course of training.”
Researchers conducted a randomized controlled trial of 50 male and 50 female U.S. Army recruits aged 17 to 42 years in basic training at Fort Jackson in South Carolina between April and June 2015. Participants had not been pregnant or breastfeeding in the 6 months before the study and had no self-reported history of endocrine or bone-modifying disorders, kidney disease, renal calculi or glucocorticoid prescription within 2 years. Participants were randomly assigned to an intervention group receiving a snack bar fortified with 1,000 mg of calcium and 1,000 IU of vitamin D daily, or a control group receiving a placebo snack bar. A background questionnaire was conducted at baseline to obtain demographic information. Anthropometric measurements and fasting blood samples were collected at baseline and at an 8-week follow-up. High-resolution peripheral quantitative CT was conducted at baseline and follow-up to measure density, microarchitecture and strength at the distal metaphyseal and diaphyseal regions of the tibia.
There were 93 recruits who completed the study, including 45 in the supplement group and 47 in the placebo group. At 8 weeks, increases in total volumetric bone mineral density, trabecular volumetric BMD, trabecular number, trabecular thickness, and trabecular bone volume/total volume, and a decrease in trabecular separation were observed for all participants. Women had changes in all bone parameters, and men had a change in all parameters except for trabecular number and separation.
All participants experienced increases in stiffness and failure load at the distal metaphyseal site, with no significant difference between the supplement and placebo groups. Stiffness and failure load did not change among women, but men had increases in stiffness of 1.3% and failure load of 3.4% at 8 weeks compared with baseline. (P < .05).
Increases in cortical perimeter and cortical volumetric BMD were observed in both groups at 8 weeks compared with baseline, but there were no other parameter changes at the diaphyseal site. Women experienced a decrease in cortical porosity and cortical volumetric BMD at 8 weeks, but there was no difference between the supplement and placebo groups. Men in both groups had an increase in cortical perimeter and decrease in cortical volumetric BMD at 8 weeks. Small increases in stiffness and failure load at the diaphyseal site were observed in women for both groups, but not in men.
“These results indicate that bone density and microarchitecture were not impacted by calcium and vitamin D supplementation at the doses tested,” the researchers wrote. “However, post hoc power analysis indicated that the current study achieved 35.8% power to detect a difference by group, and 106 volunteers per group would be required to detect a statistically significant difference if one exists. Thus, underpowering cannot be excluded as a possibility.”
The researchers said studies powered to examine stress fracture outcomes along with bone density and microarchitecture changes at varying doses of calcium and vitamin D are needed to better understand the effects of supplementation. They said future studies should also involve diverse groups of participants and take place during different times of the year.
Personalized cell therapy shows promise in metastatic breast cancer
Three of six women with metastatic breast cancer who received investigational tumor-infiltrating lymphocytes plus pembrolizumab demonstrated tumor reductions greater than 50%, according to phase 2 study results.
One patient achieved a complete response and did not require further treatment or surgical intervention, findings from the ongoing NCI-led study showed.
Background
The study is designed to evaluate use of tumor-infiltrating lymphocytes (TILs) for patients with metastatic epithelial cancers, including breast cancer.
“Nearly all who develop metastatic breast cancer will ultimately die [of] their disease,” researcher Steven A. Rosenberg, MD, PhD, chief of the surgery branch and head of the tumor immunology section of NCI’s Center for Cancer Research, told Healio. “We can prolong survival [for] these patients, but the best of surgery, radiation and chemotherapy cannot cure them.”
Chimeric antigen receptor T-cell therapy targets a unique antigen found on the surface of certain cancers. TILs have been effective where other cell therapies have failed because the highly personalized treatment is based on the neoantigens specific to a patient’s tumor, Rosenberg said.
Every patient in the NCI study had a unique set of cancer mutations, Rosenberg said.
“Regardless of whether it is found in the breast, colon or elsewhere, solid cancer antigens tend to be unique, and they are unique because each of the antigens are the product of mutations that occur within the cancer itself,” he told Healio. “Ironically, it is those very cancer mutations that represent the possible Achilles’ heel of solid cancers when it comes to use of immunotherapy.”
Methodology
The study included 42 patients (median age, 49 years; range, 35-67) with hormone receptor-positive metastatic breast cancer.
More than two-thirds of patients had TILs generated from resected tumors that recognized at least one neoantigen. Researchers identified eight patients clinically eligible for the investigational therapy.
Six patients subsequently received a TIL infusion followed by up to four doses of the anti-PD-1 therapy pembrolizumab (Keytruda, Merck).
Key findings
Three of the six patients achieved an objective response to TIL therapy plus pembrolizumab. One patient who achieved a complete response remained cancer free more than 5.5 years after her infusion.
Another patient had an objective response that lasted 10 months and resulted in 69% tumor regression. The patient had one remaining tumor resected and had no evidence of disease or further metastases at data cutoff.
A third patient had an objective partial response that lasted 6 months and resulted in a 52% reduction in tumors. The patient developed disease in an axillary node but continued experiencing breast tumor regression at 9 months after infusion, at which time she had all remaining tumors surgically resected. She remained disease free 31 months after TIL infusion.
Clinical implications
Despite the small patient population, Rosenberg said the findings demonstrate patients with metastatic breast cancer can achieve considerable reductions in tumor volume despite disease progression while receiving standard-of-care treatments.
“This study shows that certain breast cancers can be susceptible to immunotherapy,” he added.
The NIH expects its new cell manufacturing facility to be fully operational soon, Rosenberg said. This will allow his group to enroll and treat more patients with TILs as part of the phase 2 study.
His group is enrolling patients with metastatic breast cancer, and he encouraged clinicians or patients interested in being evaluated for the study to email their nurse referral system at irc@nih.gov.
“I expect there to be a substantial increase in the number of patients we will be treating over the next several months,” Rosenberg said.
Resistance exercise superior to aerobic exercise for sleep
A yearlong resistance exercise program for inactive adults with hypertension improved sleep quality and duration compared with aerobic exercise, combined aerobic and resistance exercises and no exercise, researchers reported.
Angelique Brellenthin
Poor sleep quality is associated with high BP and elevated cholesterol; regular short sleep, defined as less than 7 hours per night, can increase risk for CV events, Angelique Brellenthin, PhD, assistant professor of kinesiology at Iowa State University in Ames, Iowa, and colleagues wrote in an abstract. The American Heart Association recommends aerobic physical activity to improve sleep; however, there are limited data on the effects of other popular types of physical activity, such as resistance exercise, on sleep.
“While resistance exercise is not often considered a front-line lifestyle intervention to improve CV health — as opposed to aerobic or ‘cardio’ exercise — resistance exercise may have substantial indirect effects on CV health, nonetheless, by improving the duration and quality of sleep,” Brellenthin told Healio.
Brellenthin and colleagues analyzed data from 406 inactive adults aged 35 to 70 years (53% women) with overweight or obesity and stage 1 hypertension at high risk for CVD. Researchers randomly assigned participants to one of four exercise groups: aerobic exercise only (n = 101), resistance exercise only (n = 102), combined aerobic and resistance exercises (n = 101) and a no-exercise control group (n = 102) for 1 year. All exercise participants performed time-matched supervised exercise three times per week for 60 minutes per session; the combined exercise group performed 30 minutes each of aerobic and resistance exercises at 50% to 80% of their maximum intensity. Participants completed the Pittsburgh Sleep Quality Index (PSQI) at baseline and 12 months; only participants with complete baseline data on all PSQI subscales were included (n = 386).
Primary outcomes were the PSQI total sleep quality score, sleep duration in hours, sleep efficiency (defined as time asleep/time in bed), sleep latency (time to fall asleep) and sleep disturbances (a combination of the number and frequency of disturbances).
Within the cohort, 94% of participants completed the intervention with an 83% exercise adherence rate.
For all groups, including controls, PSQI total scores and sleep disturbances decreased significantly. Among participants who reported getting less than 7 hours of sleep at baseline, sleep duration increased by a mean of 40 minutes for participants in the resistance exercise group, by a mean of 23 minutes in the aerobic exercise group, a mean of 17 minutes in the combined exercise group and a mean of 16 minutes in the control group.
Within groups, sleep efficiency increased in the resistance exercise (P = .0005) and combined exercise groups (P = .03), but not in the aerobic exercise (P = .97) or control groups (P = .86; P = .04 for between-within groups interaction).
Sleep latency also decreased by a mean of 3 minutes for participants in the resistance exercise group (P = .003), although the overall between-within groups interaction effect was not significant.
Brellenthin said more research is needed regarding the ideal amount of resistance exercise for clinical improvements and the potential mechanisms linking resistance exercise with improved sleep, particularly those that might differ from traditional aerobic exercise mechanisms.
ARYAN'S BLOG 