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Introduction: Brain metastases (BM) in soft-tissue sarcomas (STS) is associated with poor prognosis. This large population analysis presents (1) demographic and clinical variables of these patients, (2) potential risk factors, (3) impact of BM on overall survival, and (4) treatment strategies. Methods: Patients with STS and BM were identified from the Surveillance, Epidemiology, and End Results database. Demographic and clinical variables, as well as treatment modalities, were analyzed. Overall 5-year survival was calculated using the Kaplan-Meier method, and the survival difference was assessed using the log-rank test. A multivariate analysis was performed using the Cox proportional hazard regression to determine the risk factors. Results: Twenty-two patients (22/8,433) with STS presented BM at diagnosis. A multivariate analysis showed that women and American Indians/Alaska Natives had a greater risk of presenting BM. The most common histological subtype to metastasize to the brain was alveolar soft part sarcoma (4/22). In 54.5% of patients with BM, the tumor had also metastasized to the lung, although having synchronous bone, liver, and lung metastases showed the greatest increase in risk for presenting BM (odd ratio [OR] = 1,857.7, confidence interval [CI] 95%, 88.4 to 3,9046.6, P < 0.0001). Individually, bone metastasis increased the risk of presenting BM the most (OR = 205.0, CI 95%, 30.5 to 1,379.6, P < 0.0001). The mean survival of patients with BM was 10.22 months. The standard treatment approach included surgery, radiation therapy, and chemotherapy. Conclusion: BM in patients with STS represents an infrequent but lethal event. Women and American Indians/Alaska Natives are at a higher risk of presenting BM, as well as patients with synchronous metastases. Patients are mainly managed with systemic therapy.

Aims The objective of this study is to analyze how the impact of Diabetes Mellitus [DM] in patients with COVID-19 varies according to altitudinal gradient. Methods We obtained 1,280,806 records from adult patients with COVID-19 and DM to analyze the probability of COVID-19, development of COVID-19 pneumonia, hospitalization, intubation, admission to the Intensive Care Unit [ICU] and case-fatality rates [CFR]. Variables were controlled by age, sex and altitude of residence to calculate adjusted prevalence and prevalence ratios. Results Patients with DM had a 21.8% higher prevalence of COVID-19 and an additional 120.2% higher prevalence of COVID-19 pneumonia. The adjusted prevalence was also higher for these outcomes as well as for hospitalization, intubation and ICU admission. COVID-19 and pneumonia patients with DM had a 97.0% and 19.4% higher CFR, respectively. With increasing altitudes, the probability of being a confirmed COVID-19 case and the development of pneumonia decreased along CFR for patients with and without DM. However, COVID-19 patients with DM were more likely to require intubation when residing at high altitude. Conclusions The study suggests that patients with DM have a higher probability of being a confirmed COVID-19 case and developing pneumonia. Higher altitude had a protective relationship against SARS-CoV-2 infection; however, it may be associated with more severe cases in patients with and without DM. High altitude decreases CFR for all COVID-19 patients. Our work also shows that women are less affected than men regardless of altitude.

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We present two cases of severe COVID-19 that were rejected by medical institutions. The management of the disease was done at home with methylprednisolone (MP) pulse therapy for three days. This resulted in a favorable evolution and resolution of most symptoms. COVID-19 infection presents as asymptomatic disease, non-severe symptomatic disease, and severe respiratory inflammatory disease. The first two forms are dependent on viral response and a “cytokine storm” is responsible for the progression into severe disease. Glucocorticoids (GC) reduce inflammation by different mechanism depending of their concentration. Pulses lead to overall apoptosis of immune cells. Studies using pulse MP as treatment for SARS-CoV-1 showed clinical improvement and decreased incidence of ARDS compared with patients who received low dose steroid treatment. Inhibition of excessive inflammation through timely administration of GC in the early stage of inflammatory cytokine storm effectively prevents the occurrence of ARDS.

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In light of global environmental crises and the need for sustainable development, the fields of public health and environmental sciences have become increasingly interrelated. Both fields require interdisciplinary thinking and global solutions, which is largely directed by scientific progress documented in peer-reviewed journals. Journal editors play a critical role in coordinating and shaping what is accepted as scientific knowledge. Previous research has demonstrated a lack of diversity in the gender and geographic representation of editors across scientific disciplines. This study aimed to explore the diversity of journal editorial boards publishing in environmental science and public health. The Clarivate Journal Citation Reports database was used to identify journals classified as Public, Environmental, and Occupational (PEO) Health, Environmental Studies, or Environmental Sciences. Current EB members were identified from each journal’s publicly available website between 1 March and 31 May 2021. Individuals’ names, editorial board roles, institutional affiliations, geographic locations (city, country), and inferred gender were collected. Binomial 95% confidence intervals were calculated for the proportions of interest. Pearson correlations with false discovery rate adjustment were used to assess the correlation between journal-based indicators and editorial board characteristics. Linear regression and logistic regression models were fitted to further assess the relationship between gender presence, low- and middle-income country (LMIC) presence and several journal and editor-based indicators. After identifying 628 unique journals and excluding discontinued or unavailable journals, 615 journal editorial boards were included. In-depth analysis was conducted on 591 journals with complete gender and geographic data for their 27,772 editors. Overall, the majority of editors were men (65.9%), followed by women (32.9%) and non-binary/other gender minorities (0.05%). 75.5% journal editorial boards (n = 446) were composed of a majority of men (>55% men), whilst only 13.2% (n = 78) demonstrated gender parity (between 45–55% women/gender minorities). Journals categorized as PEO Health had the most gender diversity. Furthermore, 84% of editors (n = 23,280) were based in high-income countries and only 2.5% of journals (n = 15) demonstrated economic parity in their editorial boards (between 45–55% editors from LMICs). Geographically, the majority of editors’ institutions were based in the United Nations (UN) Western Europe and Other region (76.9%), with 35.2% of editors (n = 9,761) coming solely from the United States and 8.6% (n = 2,373) solely from the United Kingdom. None of the editors-in-chief and only 27 editors in total were women based in low-income countries. Through the examination of journal editorial boards, this study exposes the glaring lack of diversity in editorial boards in environmental science and public health, explores the power dynamics affecting the creation and dissemination of knowledge, and proposes concrete actions to remedy these structural inequities in order to inform more equitable, just and impactful knowledge creation.

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