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  • Radiation Bridging in CAR T: Where Are We Now?

    Radiation Bridging in CAR T: Where Are We Now?

    While the use of radiation bridging therapy (BT) in chimeric antigen receptor (CAR) T-cell therapy for blood cancer is expanding, plenty of unanswered questions remain on topics such as ideal timing and doses, a radiologist cautioned hematologist colleagues.

    The lack of guidelines has immediate clinical implications, said John P. Plastaras, MD, PhD, professor of radiation oncology at the Hospital of the University of Pennsylvania, Philadelphia, in a presentation at 18th International Conference on Malignant Lymphoma (ICML) 2025 in Lugano, Switzerland.

    “This actually just came up the other day when one of our medical colleagues said, ‘I’m really worried about this patient. They’re ready for CAR T cell, but I think you need to radiate this area. Can you do it a week after [therapy]?’ The answer is, ‘We don’t know.’”

    On the other hand, clinicians now have clarity about safety and interaction with CAR T-cell therapy, he noted, and data is coming in rapidly.

    Here are some questions and answers about radiation BT:

    What is BT in CAR T-cell therapy?

    BT refers to treatment that provides a “bridge” for patients between the components of CAR T-cell therapy.

    As a 2024 report about BT in hematologic cancer explained, the treatment “is delivered after leukapheresis for CAR T-cells” — the process in which white cells are removed from a patient’s blood, which is then returned to the body — “has been completed and before lymphodepleting chemotherapy and CAR T-cell infusion.”

    The report said “patients who receive BT are predominantly those with a higher disease burden and rapidly progressive disease. These patients tend to have worse overall outcomes, likely related to their aggressive underlying disease.”

    Where does radiation fit into BT?

    According to the 2024 report, “combination chemoimmunotherapy has typically been the form of BT that is used most often.” Targeted therapy is another option, the report said, although data is from “very small sample sizes.”

    And then there’s radiation, which the report said is useful “particularly in patients with limited sites of disease or patients who are at risk for structural complications such as airway compromise or renal dysfunction.”

    What do we know about radiation’s efficacy?

    The first oral report on bridging radiation in CAR T-cell therapy only appeared in 2018, Plastaras said, followed by the first published report in 2019. Despite this fairly short time period, “we are certainly seeing a lot of new data,” Plastaras said.

    He highlighted the newly released International Lymphoma Radiation Oncology Group (ILROG) study of radiation BT in conjunction with CAR T-cell therapy for relapsed/refractory B-cell lymphomas. The retrospective study of 172 patients at 10 institutions treated from 2018 to 2020 showed that 1- and 2-year progression-free survival (PFS) rate was 43% (95% CI, 36-51) and overall survival rate was 38% (95% CI, 30-45).

    In a multivariable model, comprehensive radiation BT was linked to superior PFS than focal therapy (hazard ratio, 0.38; 95% CI, 0.22-0.63; P < .001).

    “Comprehensive radiation was a very strong predictor for improved PFS, but we did not see was a huge dose effect,” said Plastaras, who coauthored the study.

    What about toxicity?

    Questions about other clinical matters were resolved prior to 2022, he said, when CAR T-cell therapy was used primarily in third line and later settings.

    “Does radiation cause excess toxicities?” he asked. “A lot of the single-institution studies answered that, and I think most medical oncologists and hematologists are okay with this idea that radiation isn’t causing a lot of excess toxicities.”

    As for whether radiation interferes with the effectiveness of CAR T-cell therapy, “the data to this point have demonstrated that probably not,” he said. “We’ve probably put that one to bed.”

    What do we know about treatment timing?

    “The timing question is still quite open,” Plastaras said. “How much time should there be between radiation and lympho-depleting chemotherapy? Is it better to put the radiation very close to the CAR T-cell [therapy] so this priming effect might happen, or can that happen weeks in advance? We don’t know the answers to those.”

    According to Plastaras, researchers are still trying to understand the role radiation the consolidation period after CAR T-cell therapy. “If we wait for day-30 PET [scan], is that OK? Do we need to wait longer? Are we going to mess up the lymph nodes that have CAR T-cells floating around in them?”

    What about doses and imaging?

    There’s also a lack of insight into technical questions about radiation dose and fractionation. “The [radiation] volume question is one of key importance. Do we just do gross disease? Do we treat all the other small spots out there, and importantly, do we treat regional nodes or not? We get these questions all the time.”

    The role of imaging is also unclear, he said, in terms of timing during and after bridging radiation therapy and after CAR T-cell therapy.

    What do we need to learn about now?

    Looking forward, Plastaras outlined what he called “version 2.0” questions for the evolving field: Can radiation rebulking decrease CAR-T cell toxicities? Will very low dose “priming” radiation affect outcomes? 

    He highlighted other questions: Can radiation be part of a combined modality approach in limited stage relapsed/refractory disease? Should central nervous system lymphoma be treated differently? 

    When will we get new guidelines?

    According to Plastaras, Memorial Sloan Kettering Cancer Center Radiology Oncologist Brandon Imber,MD, MA, in New York City, is leading a new ILROG guideline project with the intention of publishing details in the journal Blood. “This is a work in progress,” Plastaras said. “Our target is 2025 to at least get something submitted.”

    Plastaras had no disclosures.

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  • Astronomers spot first visual proof of rare double-detonation supernova – The Jerusalem Post

    1. Astronomers spot first visual proof of rare double-detonation supernova  The Jerusalem Post
    2. Calcium in a supernova remnant as a fingerprint of a sub-Chandrasekhar-mass explosion  Nature
    3. New evidence that some supernovae may be a “double detonation”  Ars Technica
    4. ‘It is beautiful’: Scientists photograph rare death of a star  TRT Global
    5. Astronomers get first visual of a sun dying by detonating twice  MSN

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  • Mysterious seismic wave speed-up deep within Earth’s mantle explained at last – Physics World

    Mysterious seismic wave speed-up deep within Earth’s mantle explained at last – Physics World






    Mysterious seismic wave speed-up deep within Earth’s mantle explained at last – Physics World


















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  • ‘Forgotten’ designer of art nouveau Métro entrances to get Paris museum | France

    ‘Forgotten’ designer of art nouveau Métro entrances to get Paris museum | France

    The “forgotten” designer of Paris’s most iconic Métro station entrances and art nouveau buildings is to be given his rightful place in the city’s history with a museum dedicated to his work.

    Hector Guimard left a distinctive mark across the French capital in the early 1900s, creating elaborate and monumental Métro entrances whose fans of iron and glass resembling unfurled insect wings were nicknamed dragonflies.

    The remaining station surrounds of sinuous cast iron, with lamps resembling lily-of-the-valley flowers and topped with the stylised Métropolitain sign that Guimard also designed, feature in postcards, tourist photos and style books. When installed in the early 1900s, however, many Parisiens were scandalised.

    One critic declared the green paint “un-French” and another said the ornate signs were “confusing to children trying to learn their letters … and stupefying to foreigners”.

    Art nouveau went out of fashion, and by 1913 the transport authorities had dropped Guimard’s designs. By 1942, when Guimard died aged 75 in New York, where he and his American Jewish wife had sought refuge from the Nazis, he had already been forgotten and much of his work consigned to the scrap heap.

    “It may be surprising to foreign visitors but the French have never really liked art nouveau,” said Fabien Choné, a Guimard collector and head of Hector Guimard Diffusion, a company involved in establishing the new museum. “There was great opposition to Guimard’s Métro entrances. While visitors saw them as marvellous symbols of the belle époque Métro, Parisians criticised it as what they called spaghetti style and couldn’t understand why tourists liked them.”

    A Métro station entrance on the boulevard Pasteur by Hector Guimard, circa 1900. Photograph: Roger Viollet/Getty Images

    On returning to Paris in 1948, his widow, Adeline, an artist whose work had been displayed at the 1899 Beaux-Arts salon, worked tirelessly to preserve and promote her husband’s legacy, which included about 50 residential buildings.

    She donated his drawings and smaller creations, including furniture, to museums, many of them in the US, and offered to bequeath the couple’s art nouveau home, the Hôtel Guimard, and its contents to the state and then to the city. Both turned down the offer and the building was converted into flats with the furnishings scattered.

    In the wave of modernism that swept post-war Europe the style was sober and many Guimard creations were declared without historic or artistic value and destroyed. Of the 167 Métro entrances that he designed – described by Salvador Dalí, who painted Tribute to Guimard in 1970, as divine – only 88 remain.

    Choné said: “After the war, each time the city did any work on the streets, they got rid of Guimard’s designs. Even up until the 1960s to 70s the logic was one of destruction rather than preservation.”

    Abbesses station in Montmartre, Paris. Photograph: UlyssePixel/Alamy

    The museum will be established at the Hôtel Mezzara, a four-storey building in Paris’s 16th arrondissement designed by Guimard in 1910 and which features much of his signature ironwork, including a spectacular glass skylight and chandeliers.

    The building, originally commissioned by Guimard’s friend Paul Mezzara, a rich textile manufacturer from Venice and later acquired by the education ministry and used as student accommodation until a decade ago, will undergo a €6m (£5.2m), two-year renovation before opening around the end of 2027.

    Once open it will display known Guimard creations including art nouveau furniture and decorations as well as an archive of his designs and documents.

    “It is absurd that there is recognition of Guimard at museums around the world, especially in the US, and nothing in Paris when he created some of the most important symbols of the city,” Choné said.

    Nicolas Horiot, an architect and the president of Le Cercle Guimard, an association created 23 years ago to save Guimard’s designs and documents, said it had been a decade-long battle to get the state and Paris authorities to recognise the designer’s work. He said the museum would right a historic wrong.

    “After the second world war, Guimard was completely forgotten. Art nouveau no longer interested people in the urban design of the 1960s and many of his pieces were destroyed,” he said. “The revival started in 1970 with an exhibition in New York, but it was a step-by-step process. We see this museum as repairing an injustice done to Guimard.”

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  • Hypereosinophilic Syndrome in a Patient With Cystic Fibrosis: A Rare Case of Cardiac Involvement and Response to Mepolizumab

    Hypereosinophilic Syndrome in a Patient With Cystic Fibrosis: A Rare Case of Cardiac Involvement and Response to Mepolizumab


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  • Rare Lung Cells Mitigate Smoke & Virus Damage

    Rare Lung Cells Mitigate Smoke & Virus Damage

    A rare cell in the lining of lungs is fundamental to the organwide response necessary to repair damage from toxins like those in wildfire smoke or respiratory viruses, Stanford Medicine researchers and their colleagues have found. A similar process occurs in the pancreas, where the cells, called neuroendocrine cells, initiate a biological cascade that protects insulin-producing pancreatic islet cells from damage.

    Treating the airways of mice with an experimental drug that activates the repair pathway protected their airways from damage after infection with influenza or the virus that causes COVID-19. Conversely, animals in which the pathway was blocked experienced much more severe damage to their airways.

    Activating the signaling pathway initiated by airway or pancreatic neuroendocrine cells in a similar way in humans might enhance the ability of firefighters and those with respiratory illnesses to avoid permanent lung damage, the researchers believe. They also suspect it could help prevent people with metabolic syndrome from progressing to diabetes.

    “This whole signaling cascade both protects and regenerates vulnerable cells in the airway and the pancreas,” said Philip Beachy, PhD, professor of urology and of developmental biology. “If this circuit is disrupted, the damage is much worse — specialized airway cells are lost, and the stem cells can’t divide to repair the damage. We think it’s likely to be important in many other tissues in the body.”

    Although the study was conducted in mice, there are tantalizing clues of a similar pathway in humans: People treated with a cancer drug that blocks the pathway are twice as likely as their peers to develop diabetes after their treatment.

    “The association is highly significant and gives us early hints that activating this pathway might be protective for people with metabolic syndrome who are beginning to lose beta cell function,” Beachy said.

    Beachy, who is the Ernest and Amelia Gallo Professor and a member of the Stanford Stem Cell Institute, is the senior author of the research, which was published online June 9 in Cell. Research scientist William Kong, PhD, is the study’s first author.

    Neuroendocrine cells are less than 1% of the total number of cells in the cells that line the airway, which is made up of a type of tissue called epithelium. Some of them cluster together in what are called neuroepithelial bodies and play an important role in sensing oxygen levels and modulating immune responses in the lungs. But others, especially those in the tracheal airway, are solitary, nestled alone among other types of epithelial cells. It’s not been clear until now exactly what function these solitary neuroendocrine cells perform.

    The hedgehog family

    Beachy’s laboratory has focused on the function of a protein family called Hedgehog proteins since Beachy identified the first member in fruit flies in 1992. Members of the family are best known for their critical function in embryo patterning in early development, but they also aid in the rejuvenation of many types of tissue. Desert hedgehog is one of the least studied of the three family members (the others are Sonic hedgehog and Indian hedgehog).

    Previous work in Beachy’s lab showed that stem cells in the epithelial lining of the bladder respond to a signal cascade initiated by Sonic hedgehog to regenerate the bladder lining after bacterial infection. They wondered if hedgehog proteins were involved in the repair of damage in other epithelial tissues like the airway.

    When Kong used a technique called bulk RNA sequencing to search for genetic messages encoding any of the hedgehog family members in the cells of the trachea, they detected a faint signal for the Desert hedgehog protein, but not for the other two family members. When they engineered mice in a way that caused cells expressing the Desert hedgehog protein to become fluorescent, they saw that the solitary neuroendocrine cells were making the Desert hedgehog protein.

    Further research showed that the Desert hedgehog protein leaves the epithelium and travels into the layer of tissue beneath the epithelium, called the mesenchyme. There, it triggers cells to begin producing another protein called Gli1. When the airway cells sense damage, Gli1 induces the expression of a protein called IL-6 that triggers stem cells in the epithelium called basal cells to begin dividing and specializing to repair the damage.

    This crosstalk between tissue layers, which the researchers call epithelial-mesenchymal feedback, protects and regenerates specialized cells in the lung epithelium, including multi-ciliated cells that use their feathery arms to sweep particles and viruses out of the lungs and secretory cells that make mucus to trap unwanted invaders. In the absence of these cells, viruses and toxins can penetrate much more deeply into the lungs

    Protective process

    The entire process happens within hours of toxin exposure in a coordinated cascade that eventually includes even non-Gli1-expressing cells of the airway.

    “At each stage, the signal is amplified until the entire trachea is impacted,” Beachy said. “This rapid response not only protects the epithelial cells from dying but it also activates a regenerative response.”

    The consequences of impeding this protective message are severe.

    “If this signal cascade is disrupted, the damage is much worse. Ciliated and secretory cells are lost, and the basal cells don’t divide. In fact, it’s all they can do to stretch out and try to cover the injured area,” Kong said.

    Both Desert hedgehog and Gli1 are critical to the repair process. Mice unable to produce Desert hedgehog or Gli1 were much more sensitive to exposure to sulfur dioxide gas, which is an environmental pollutant and mimics the damage inflicted by other inhaled toxins. While control mice lost 85% of ciliated cells and 41% of secretory cells within 24 hours, mice lacking the protein lost 96% of ciliated cells and 88% of secretory cells during the same time.

    Activating the hedgehog signaling pathway with a small molecule dramatically increased cell survival after sulfur dioxide exposure: 66% of ciliated cells and 82% of secretory cells survived in treated animals, versus 9.7% of ciliated cells and 43% of secretory cells in control animals.

    Kong next tested the effect of the Desert hedgehog pathway activation on mice infected with influenza and the virus that causes COVID-19. Although no mice unable to make Gli survived more than five days after infection with influenza, all mice treated with the small molecule activator survived at least eight days after infection. Mice infected with the virus that causes COVID-19 that were unable to activate the Desert hedgehog pathway suffered extensive loss of ciliated cells in the airway.

    Finally, the researchers turned their attention to the pancreas, which has a similar tissue organization as the airway. They found that the insulin-producing beta cells, which are a type of neuroendocrine cell, also make Desert hedgehog and that the organ exhibits the same epithelial-mesenchymal feedback loop with IL-6 to protect the vulnerable cells.

    The researchers are now exploring whether and how the hedgehog pathway could be activated in humans to prevent lung damage in people exposed to airborne toxins or who are at risk for diabetes.

    “We have reasons to think it might not be a good idea to activate the hedgehog pathway long term,” Beachy said. “We are considering how to stimulate the pathway in a targeted way, either delivering it to the airway with an aerosol or targeting it to the pancreas. And we have early hints it might be possible.”

    Reference: Kong W, Lu WJ, Dubey M, et al. Neuroendocrine cells orchestrate regeneration through Desert hedgehog signaling. Cell. 2025;0(0). doi:10.1016/j.cell.2025.05.012

    This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source. Our press release publishing policy can be accessed here.

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  • Sport agent Jonathan Barnett accused of rape in US lawsuit

    Sport agent Jonathan Barnett accused of rape in US lawsuit

    Adam Fradgley - AMA/West Bromwich Albion FC via Getty Images Barnett with thinning white hair, wearing darkened glasses, a dark overcoat, white shirt and blue tie, stands in front of a microphone in 2018. Adam Fradgley – AMA/West Bromwich Albion FC via Getty Images

    Barnett denies the woman’s allegations that he kept her as a “sex slave”

    High-profile British sports agent Jonathan Barnett has been accused of raping a woman more than 39 times, in a US lawsuit.

    In a civil complaint lodged at a US district court in Los Angeles, the unnamed woman, referred to as “Jane Doe”, says Mr Barnett “trafficked” her from Australia to the UK in 2017, “tortured” and kept her as a “sex slave” over a six year period.

    She says Mr Barnett made “repeated threats to her life and the lives of her minor children”.

    The 75-year-old known for representing leading footballers including Gareth Bale and Jack Grealish, says the charges “have no basis in reality and are untrue”.

    “We will vigorously defend this lawsuit through the appropriate legal process. I am looking forward to being entirely vindicated and exonerated,” a statement from his lawyers said.

    Mr Barnett was ranked as the world’s most powerful sports agent in 2019 by Forbes magazine.

    The civil case was filed on Wednesday.

    According to court documents, the pair first met in the 1990s through a professional athlete in London and reconnected online and then in person in 2017.

    Within a matter of weeks she relocated to the UK with her teenage children – with sports agency CAA Stellar, headed by Mr Barnett, covering moving expenses.

    The filing says that upon her arrival, he told her he “owned” her and raped her in a hotel room.

    Mr Barnett went on to impose strict rules to obey him at all times, referring to him as “My Master” and to “never say it hurts”, according to the lawsuit.

    The complaint goes on to describe alleged degrading acts that included drinking urine or ingesting faeces.

    The alleged torture also included the woman “tied up overnight without food or water”.

    She says she was “trafficked, threatened, tortured, and held” in bondage in different locations throughout the world, including Los Angeles, from 2017 to 2023.

    “Realising she was powerless against a dangerous predator, Ms Doe submitted to Barnett in order to avoid being severely beaten or even killed,” the lawsuit said.

    “Jane Doe” is also suing Hollywood talent firm Creative Artists Agency and sports agency CAA Stellar, where Mr Barnett was executive chairman until his retirement last year.

    The court documents state the CAA Stellar’s parent companies, talent agencies ICM and CAA, “failed to find and/or willfully or recklessly disregarded” that substantial payments were made between 2017 and 2023, despite the woman not being an athlete or agent.

    It is claimed Barnett referred to her as “slave” in emails sent from his work account.

    Court documents say Mr Barnett used his “money and power to maintain coercive control” over the woman who was “in fear of her life and the lives of her children”.

    Lawyers for “Jane Doe” state the case is about “institutional abuse at the highest level”.

    They are seeking compensation on her behalf.

    According to LA Times, CAA said it first heard of the woman’s allegations last year when her lawyers made settlement demands – and the press inquired.

    “While the complaint attempts to connect these allegations to CAA’s business, Ms Doe has never been an employee, consultant, or contractor of CAA, ICM, or Stellar, nor has she ever had any business connection to CAA, ICM, or Stellar,” CAA said in its statement.

    “CAA takes any allegations of this nature seriously, and through counsel, promptly urged Ms Doe to contact law enforcement in the United Kingdom.”

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  • Radio stations will remain available outside UK

    Radio stations will remain available outside UK

    BBC Hands with pink nail polish hold an iPhone with the BBC Sounds app on the screen. BBC

    The BBC has said its radio stations will continue to be available for people outside the UK to listen to live after BBC Sounds access is restricted for international listeners.

    BBC Sounds will close for listeners outside the UK on 21 July 2025.

    International listeners will be able to listen to the BBC’s radio stations through links on the station directory online, the BBC said.

    This includes the BBC’s national stations – BBC Radio 1, Radio 2, and Radio 3, 6Music, 1Xtra and Asian Network, Radio 4Xtra and 5Live – all the stations in Scotland, Northern Ireland and Wales and every local radio station in England.

    The BBC announced in April that it had delayed blocking BBC Sounds app for audiences outside the UK.

    That delay came after a decision made by the corporation meant listeners outside the UK would only be able to access Radio 4 and the World Service via a new audio section on the BBC website.

    Questions had been asked about what this would mean for listeners in the Republic of Ireland who would be unable to use the internet to access Northern Ireland-based stations BBC Radio Ulster and Radio Foyle.

    The BBC said listening to BBC audio programming on non-BBC platforms would not be affected by the change.

    It also said a range of English, Welsh and Gaelic language podcasts were available on BBC.com/audio and third-party podcast services.

    What is BBC Sounds?

    BBC Sounds is the online home of BBC radio.

    People can listen to live radio streams, on demand programmes, podcasts, audiobooks and music mixes.

    It can be accessed via the Sounds website or its dedicated app.

    People can also listen on many smart speakers and internet radio devices.

    The BBC said UK users who went on holiday outside the UK for a short time would still be able to use the BBC Sounds app.

    A BBC spokesperson said: “BBC Sounds will now be available on the same basis as BBC iPlayer.

    “Both services are restricted to a UK domestic audience, reflecting rights and associated considerations.

    “BBC Radio Ulster/Foyle will remain more widely available via bbc.com.”

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  • Indian Army’s deputy chief exposes ‘one border-three enemies’ nexus – Firstpost

    Indian Army’s deputy chief exposes ‘one border-three enemies’ nexus – Firstpost

    China has turned Pakistan into a laboratory to test its weapon systems, according to Lieutenant General Rahul R Singh, the Deputy Chief of Army Staff. He further said that China provided real-time intelligence to Pakistan during Operation Sindoor and became India’s backdoor adversary.

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    The alliance between the two countries is such that China has now become India’s “backdoor adversary” and has turned Pakistan into a live laboratory to test its weapons and military systems, according to Lieutenant General Rahul R Singh, the deputy chief of the Indian Army.

    As Turkey also stood with Pakistan in the conflict with India in May, India now essentially faces not one but three adversaries on its Western border, said Singh.

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    In the India-Pakistan conflict in May, Pakistan relied heavily on Chinese and Turkish weapons and military systems. Pakistan used China’s PL-15 missiles, J-10 and JF-17 fighter planes, and HQ-9 air defence systems, and Turkey’s drones against India.

    “We had one border and two adversaries — actually three. Pakistan was in the front. China was providing all possible support — 81 per cent of the military hardware with Pakistan is Chinese&mldr;China is able to test its weapons against other weapons, so it’s like a live lab available to them. Turkey also played an important role in providing the type of support it did,” said Singh at the ‘New Age Military Technologies: Industry Capabilities & Way Forward’ conference on Friday.

    India launched Operation Sindoor on the intervening night of May 6-7 in response to the Pahalgam terrorist attack in which 26 people were killed. After India struck nine terrorist sites in Pakistan and Pakistan Occupied Jammu and Kashmir (POJK), Pakistan attacked military and civilian sites across northwestern India. In the four-day conflict, India responded by battering several Pakistani military sites, including airbases, radar sites, and air defence systems.

    ‘China is acting as backdoor adversary’

    With such an axis that Pakistan has forged, India now essentially faces three adversaries on its Western border in the form of Pakistan, China, and Turkey, according to Singh.

    As for the role of China, Singh said that it provided real-time support intelligence to Pakistan and this continued even at the negotiations were going on at the level of the directors general of military operations (DGMOs).

    “Pakistan was the front face. We had China providing all possible support and it’s no surprise because if you were to look at statistics in the last five years, 81 per cent of the military hardware that Pakistan is getting is all Chinese. And China of course has the good old dictum ‘killed by a borrowed knife’ — the 36 stratagems that China talks about. So, they would rather use the neighbour to cause pain then getting involved in the mudslinging a match on the northern border,” said Singh.

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    Even though major population centres were not attacked in the conflict in May, India should be prepared for it for future rounds of conflict.

    Outside of Jammu and Kashmir, where civilian sites, including houses and religious places, were struck, attacks on civilian sites were not widely reported. India had said that Pakistan had launched missiles and drones at Amritsar, the holiest city for Sikhs, but those attacks were foiled.

    Notably, Singh said that an Israeli Iron Dome-like system cannot work in India because of the size of the country.

    “We do not have the luxury like we have been seeing the way Israel has with the Iron Dome and number of other air defense features that they have. We do not have a luxury because our country is vast so and such things cost a lot of money,” said Singh.

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  • Timing of Surgery and Medical Optimization in Multisystem Trauma: A Systematic Review of Outcomes Based on Internal Medicine Co-management With Orthopedic, Neurosurgical, Vascular, Thoracic, and General Surgical Emergencies

    Timing of Surgery and Medical Optimization in Multisystem Trauma: A Systematic Review of Outcomes Based on Internal Medicine Co-management With Orthopedic, Neurosurgical, Vascular, Thoracic, and General Surgical Emergencies


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