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At least 667 records · Page 37

Irisin attenuates lipopolysaccharide-induced acute lung injury by downregulating inflammatory cytokine expression through miR-199a-mediated Rad23b overexpression

Highlights: • Acute lung injury (ALI) is a leading cause of mortality and therapies for ALI are yet to be thoroughly investigated. • Recent evidence has shown that irisin attenuates lipopolysaccharide-induced acute lung injury. • Irisin can alleviate ALI by inhibiting miR-199a and upregulating Rad23b expression. Acute lung injury (ALI) is a leading cause of mortality as a result of inflammatory cytokine overexpression and increased rates of apoptosis. Therapies for ALI are yet to be thoroughly investigated. Recent evidence has shown that irisin exerts protective effects against many types of pathologies. The present study aimed to determine the function of irisin in an ALI mouse model induced by lipopolysaccharide (LPS) and the corresponding underlying mechanisms at the tissue, cellular, and molecular levels.

60 APPLIED LIFE SCIENCES↗

NFATc1 promotes epithelial-mesenchymal transition and facilitates colorectal cancer metastasis by targeting SNAI1

Highlights: • Metastasis remains a major cause of colorectal cancer (CRC) mortality. • In this study, we examined the role of nuclear factor of activated T cells 1 (NFATc1), which showed increased expression in metastatic CRC tissues and positively correlated with CRC clinical stages. • Mechanistically, SNAI1 was transcriptionally activated by NFATc1 and interacted with SLUG to promote EMT and CRC metastasis. • Calcineurin-NFAT inhibitor FK506 could reverse these effects, offering novel therapeutic strategies for metastatic CRC. Metastatic recurrence remains a major cause of colorectal cancer (CRC) mortality. In this study, we investigated the mechanistic role of nuclear factor of activated T cells 1 (NFATc1) in CRC metastasis. First, we explored the potential role of NFATc1 in CRC using bioinformatics and hypothesized that NFATc1 might play different roles at different stages of CRC development. Then, we examined the relative expression of NFATc1 in 25 CRC tissues and adjacent normal tissues, and further analyzed the correlation between NFATc1 expression levels and clinical stages in 120 CRC patients. The role of NFATc1 in CRC metastasis and the molecular mechanisms were investigated in both in vitro and in vivo models. Our results showed that the expression of NFATc1 was increased in metastatic CRC tissues and positively associated with clinical stages (stage I vs. stage II, III or IV) of CRC. Overexpression of NFATc1 promoted CRC cell migration, invasion, and epithelial-mesenchymal transition (EMT). Moreover, SNAI1 was verified as the direct transcriptional target of NFATc1 and interacted with SLUG to promote EMT. Remarkably, our lung and liver metastasis mouse model demonstrated that NFATc1 overexpression accelerated CRC metastasis, and treatment with FK506, a calcineurin-NFAT pathway inhibitor, could suppress CRC metastasis in vivo. Taken together, our findings suggest that NFATc1 could transcriptionally activate SNAI1, which in turn interacts with SLUG to mediate EMT to promote CRC metastasis. Thus, making NFATc1 a promising therapeutic target in the treatment of metastatic CRC.

60 APPLIED LIFE SCIENCES↗

The effect of leaf biopesticide (Mirabilis jalapa) and entomopathogenic fungi (Beauveria bassiana) combinations to some physiological characters and histology of Crocidolomia pavonana (Lepidoptera: Pyralidae) larvae

Crocidolomia pavonana is one of the most prominent pest that cause damage to vegetables especially Brassicaceae such us cabbage, broccoli, mustard greens and turnips, these vegetable have been widely consumed and cultivated in Indonesia. The invation of this pest might created high risk of cultivated failure. Enviromentally pest control efforts by utilizing biological control agents such us biopesticides of plants and entomopathogenic fungi have been carried out, but the work was relatively long and strongly influenced by environmental factors. The purpose of this study was to combine biopesticide of Mirabilis jalapa and entomopathogenic fungi Beauveria bassiana to look at mortality of C. pavonana larvae observing by histological incision and scanning electron microscope. Concentration treatments of extracts M. jalapa was (control; 0,1; 0,2; 0,4 and 0,8 gr/ml) and the result showed that the effective concentration was 0,8 g/ml which affect significantly (P<0,05) in reduce pupa weight, improve pupasi time, lowering percentage of emergence imago and improve the long phase of pupa which differ significantly with control. The combination of biopesticides proved to accelerate the mortality of larvae. Histological incision observed at hour 24, 48, 72 and 96, where the biggest damage occurred at hour 96. Observation by scanning electron microscope showed fungus spores that attach to the body surface of larvae subsequently penetrate into the body. Thus the combination use of biopesticides M. jalapa and fungi B. bassiana, can be used as an alternative pest control C. pavonana.

60 APPLIED LIFE SCIENCES↗

Simulated population responses of common carp to commercial exploitation

Common carp Cyprinus carpio is a widespread invasive species that can become highly abundant and impose deleterious ecosystem effects. Thus, aquatic resource managers are interested in controlling common carp populations. Control of invasive common carp populations is difficult, due in part to the inherent uncertainty of how populations respond to exploitation. To understand how common carp populations respond to exploitation, we evaluated common carp population dynamics (recruitment, growth, and mortality) in three natural lakes in eastern South Dakota. Common carp exhibited similar population dynamics across these three systems that were characterized by consistent recruitment (ages 3 to 15 years present), fast growth (K = 0.37 to 0.59), and low mortality (A = 1 to 7%). We then modeled the effects of commercial exploitation on size structure, abundance, and egg production to determine its utility as a management tool to control populations. All three populations responded similarly to exploitation simulations with a 575-mm length restriction, representing commercial gear selectivity. Simulated common carp size structure modestly declined (9 to 37%) in all simulations. Abundance of common carp declined dramatically (28 to 56%) at low levels of exploitation (0 to 20%) but exploitation >40% had little additive effect and populations were only reduced by 49 to 79% despite high exploitation (>90%). Maximum lifetime egg production was reduced from 77 to 89% at a moderate level of exploitation (40%), indicating the potential for recruitment overfishing. Exploitation further reduced common carp size structure, abundance, and egg production when simulations were not size selective. Our results provide insights to how common carp populations may respond to exploitation. Although commercial exploitation may be able to partially control populations, an integrated removal approach that removes all sizes of common carp has a greater chance of controlling population abundance and reducing perturbations induced by this invasive species.

54 ENVIRONMENTAL SCIENCES↗

Causes of Death and Characteristics of Decedents With Viral Hepatitis, United States, 2010

Previous research indicates that the mortality burden from viral hepatitis is growing, particularly among middle-aged persons. To monitor progress toward prevention goals, it is important to continue to document characteristics and comortalities of these deaths. This study sought to examine demographic characteristics and the most frequent causes of death among decedents with a viral hepatitis–related death. A cross-sectional study was performed on approximately 2.4 million death records from 2010. We calculated mortality rates for decedents with and without hepatitis A, B, and C virus (HAV, HBV, and HCV) and relative risks for the most frequently cited conditions in decedents with and without HBV and HCV. In 2010, there were 18 473 (0.7%) deaths with HAV, HBV, and HCV listed among causes of death, disproportionately in those aged 45–64 years. Among the 10 frequent causes of death, decedents listing HBV or HCV died, on average, 22–23 years earlier than decedents not listing these infections. HBV- and HCV-infected decedents aged 45–64 years had an increased risk of having the following conditions reported than decedents without these infections: cancer of liver and intrahepatic bile duct; fibrosis, cirrhosis, and other liver diseases; alcohol-related liver disease; gastrointestinal hemorrhage; human immunodeficiency infection; acute and unspecified renal failure; and septicemia (HCV only). Decedents with other causes of death that include HBV or HCV died 22–23 years earlier than decedents not listing these infections. These data suggest and support the need for prevention, early identification, and treatment of HBV and HCV.

60 APPLIED LIFE SCIENCES↗

Constrained tree growth and gas-exchange of seawater-exposed forests in the Pacific Northwest, USA

1. Rising sea levels under climate change may have significant impacts on coastal vegetation dynamics, yet the response of coastal forest growth, gas-exchange, and survival to seawater intrusion remains poorly documented. 2. We conducted a dendroecology study across six sites in western Washington, USA, to examine how tree growth, gas exchange (indexed by basal area increment, BAI, and wood d13C, respectively), and survival varies with seawater exposure through two approaches. First, tree core samples were collected at a site where seawater exposure started only four years prior to sampling, which allowed a cause-and-effect test of the impacts of seawater exposure on trees, and second, samples were collected at five additional sites where we compared downstream to upstream trees under current sea-level conditions. 3. At the seawater intrusion site, BAI and carbon isotope discrimination (?) decreased significantly (p < 0.01) in the year of intrusion (2014) and stayed unchanged thereafter. Four years later (2018), the percentage of recently standing dead trees in the forest was 73.0% basal area. Across the regional assessment, percentage of standing dead trees was significantly greater in downstream than upstream forests at five of the six sites (averaged 37.7±11.0% and 4.3±2.1% basal area for downstream and upstream, respectively). Growth was significantly lower (p < 0.01) at the downstream than upstream for five sites, and ? was lower for all needle-leaf trees (three sites) on the downstream compared to the upstream, but no difference was observed between downstream and upstream for broad-leaf trees (three sites). 4. Synthesis Combined, both the cause-and-effect manipulative study and the regional assessment demonstrate that seawater exposure drives reductions in growth, decreased ? of needle-leaf trees, increased mortality, and greater climate sensitivity, regardless of whether the seawater exposure is recent or long-term.

Costal forests, tree growth, tree-ring, tree morta↗

High fluid shear strain causes injury in silver shark: Preliminary implications for Mekong hydropower turbine design

Fluid shear arises when two bodies of water, travelling at different velocities, intersect. Fish entrained at the interface of these two water masses will experience shear stress; which can be harmful. The stress magnitude is dependent on waterbody mass and velocity; with the fish impact largely related to body size. Elevated shear stress occurs where rapidly flowing water passes near spillways, across screens, within turbine draft tubes or other passage routes. A flume was used to determine critical tolerances of silver shark (Balantiocheilos melanopterus) to different shear stress rates generated by a high velocity jet. Fish experienced higher levels of injury and mortality as shear stress was increased. Excessive shear forces had damaging impacts on fish. Mortality occurred at shear levels higher that 600/s. It is important that developers should attempt to model potential shear profiles expected during turbine passage in selected designs. These data will be critical to determine potential impacts on fish. If the likelihood of adverse impact is high, then alternative designs which have lower shear stress could be explored.

hydro power plants↗

Local carbon reserves are insufficient for phloem terpene induction during drought in Pinus edulis in response to bark beetle–associated fungi

Stomatal closure during drought inhibits carbon uptake and may reduce a tree's defensive capacity. Limited carbon availability during drought may increase a tree's mortality risk, particularly if drought constrains trees' capacity to rapidly produce defenses during biotic attack. We parameterized a new model of conifer defense using physiological data on carbon reserves and chemical defenses before and after a simulated bark beetle attack in mature Pinus edulis under experimental drought. Attack was simulated using inoculations with a consistent bluestain fungus (Ophiostoma sp.) of Ips confusus, the main bark beetle colonizing this tree, to induce a defensive response. Trees with more carbon reserves produced more defenses but measured phloem carbon reserves only accounted for c. 23% of the induced defensive response. Our model predicted universal mortality if local reserves alone supported defense production, suggesting substantial remobilization and transport of stored resin or carbon reserves to the inoculation site. Our results show that de novo terpene synthesis represents only a fraction of the total measured phloem terpenes in P. edulis following fungal inoculation. Without direct attribution of phloem terpene concentrations to available carbon, many studies may be overestimating the scale and importance of de novo terpene synthesis in a tree's induced defense response.

59 BASIC BIOLOGICAL SCIENCES↗

Demography, dynamics and data: building confidence for simulating changes in the world's forests

Vegetation demographic models (VDMs) are advanced tools for simulating forest responses to climate and land-use changes, and are essential for projecting carbon cycling and large-scale forest management strategies. Despite their increasing incorporation into Earth System Models, VDMs differ in their demographic assumptions, with no prior quantitative comparison of their performance. We benchmarked nine VDMs against observational data from boreal, temperate and tropical sites, assessing their accuracy in predicting tree growth, carbon turnover, biomass stocks and size distributions. Models were simulated under consistent climate conditions with postdisturbance recovery monitored for at least 420 yr. Postdisturbance carbon recovery trajectories showed significant variability while remaining within observational ranges. Initial regrowth rates varied substantially (0.03-0.60, 0.18-0.70 and 0.35-1.10 kgCm-2 yr-1 for boreal, temperate and tropical sites, respectively), influenced by each model's initial forest state. Models captured mature forest carbon content but showed compensating effects between overestimated growth and underestimated mortality rates. This first multi-model benchmarking identifies growth and mortality rates as critical calibration targets and highlights the need to refine postdisturbance establishment conditions for model development. We outline specific benchmarking variables needed to improve predictions of forest responses to environmental change.

demographic vegetation model benchmarking↗

Overstory and understory relationships in longleaf pine plantations 14 years after thinning and woody control.

To develop silvicultural strategies for restoring longleaf pine (Pinus palustris Mill.) savannas, mortality and growth of overstory pines and midstory hardwoods and abundance and species richness of herbs were studied for 14 years after pine thinning and nonpine woody control. Pine cover in thinned stands was about half of that in nonthinned stands through year 5, but it lagged by only 8% and 3% in years 9 and 14, respectively, because of vigorous crown responses. Despite a cumulative mortality of 64% of hardwood stems from prescribed fires in years 0, 4, and 9, hardwood basal area in thinned stands (2.1 m2/ha) was three times that in nonthinned stands (0.7 m2/ha) in year 14. Thinning was associated with 13%-22% more cover and six to eight more species of herbs in years 3-8 but only 6% more cover and two more species in year 14 because of accelerated growth of pine cover and hardwood basal area. However, similar increases in cover and richness of herb species in the woody control treatment were retained through year 14 because it had sustained reductions in hardwood and shrub abundance. Silvicultural strategies that substantially delay encroachment by pines, hardwoods, and shrubs will be those most effective at retaining herb species in longleaf pine savannas, including planting pines at wide spacing, periodic thinning and woody control, and frequent burning.

60 APPLIED LIFE SCIENCES↗

Comparative Study of Barotrauma Risk during Fish Passage through Kaplan Turbines

Rapid pressure changes in hydroelectric turbine flows can cause barotrauma that can be hazardous to the passage of fish, in particular migratory juvenile salmonids. Although numerous laboratory tests have evaluated the effect of rapid decompression in fish species of relevance, numerical modeling studies offer the advantage of predicting, for new turbine designs, the potential risks of mortality and injury from rapid pressure change during turbine passage. However, rapid pressure change is only one of several hydraulic risks encountered by fish during turbine passage in addition to blade strike, shear, and turbulence. To better understand the role of rapid pressure changes, the present work focuses on the application of a computational fluid dynamics based method for evaluating the risk of pressure-related mortality to fish passing through an early 1960s era original hydroelectric Kaplan turbine at Wanapum Dam (Columbia River, Washington), and a modern advanced Kaplan turbine installed in 2005. The results show that the modeling approach acceptably reproduced the nadir pressure distributions compared to field data previously collected at the site using an autonomous sensor. Our findings show that the new advanced-design unit performs better, in terms of reduced barotrauma risk to fish from exposure to low pressures, than the original turbine unit. The outcomes allow for comparative analyses of turbine designs and operations prior to installation, an advantage that can potentially be integrated in the process of designing new turbine units to achieve superior environmental performance. Overall, the results show that modern turbine designs can achieve the multiple objectives of increasing power generation, lowering cavitation potential, and reducing barotrauma risks to passing fish.

13 HYDRO ENERGY↗

Lab Collaboration Project (LCP) for Marine Energy: Quantifying Collision Risk for Fish and Turbines Final Technical Report (Task 10)

A persistent environmental concern for the widespread deployment of tidal turbines is the potential for fish and marine mammals to collide with rotating blades (Copping et al. 2016, Copping and Hemery 2020). This is a consequence of well-documented bird and bat mortalities around wind turbines (Smallwood 2007, Thompson et al. 2017), as well as fish mortality at conventional hydropower dams (Pracheil et al. 2016) and tidal barrages (Dadswell and Rulifson 1994). However, unlike hydropower dams or barrages, tidal turbines do not involve structures that channel all flow through the turbines. Similarly, while functionally similar to wind turbines, tidal turbines often operate at lower relative velocities and, depending on the end-use application, may be significantly smaller than utility-scale wind turbines. Both of these factors reduce the likelihood and severity of collision, but the knowledge base on this topic remains limited.

13 HYDRO ENERGY↗

Carbon stored in live ponderosa pines in the Sierra Nevada will not return to pre-drought (2012) levels during the 21st century due to bark beetle outbreaks

Outbreaks of several bark beetle species can develop rapidly in response to drought and may result in large transfers of carbon (C) stored in live trees to C stored in dead trees (10s of Tg C yr -1 in the western U.S. alone), which over time will be released back to the atmosphere. The western pine beetle (WPB) outbreak incited by the 2012–2015 mega-drought in the Sierra Nevada, California, U.S., could portend more frequent and/or severe bark beetle outbreaks as the temperature warms and drought frequency and intensity increase in the future. However, changes in the frequency and/or severity (resultant levels of host tree mortality) of beetle outbreaks are difficult to predict as outbreaks are complex with non-linear and eruptive processes primarily driven by interactions among beetle populations, the demography of hosts and other tree species, and climate and weather. Using an insect phenology and tree defense model, we projected the future likelihood of WPB outbreaks in the Sierra Nevada with climate drivers from different Earth System Models. Our goal was to understand how host (ponderosa pine, PIPO) recovery and future warming and drought affect the frequency and severity of WPB outbreaks and their C consequences. Our projections suggested that by 2100 the C stored in live PIPO (mean: 1.98 kg C m -2 , 95% CI: 1.74–2.21 kg C m -2 ) will not return to levels that occurred before the 2012–2015 drought (2012: ~2.30 kg C m –2 ) due to future WPB outbreaks. However, differences in climate models indicate a wide range of possible WPB outbreak frequencies and severities. Our results suggest that total plot basal area is the most significant factor in the mortality rate of PIPO by WPB in any given year, followed by drought severity and temperature. High levels of host basal area, higher temperature, and extreme drought all contribute to the frequency and severity of future WPB outbreaks. While PIPO basal area may decline under increased drought and warming, limiting high-stand basal area (>60 m 2 ha -1 ) may reduce the severity of future WPB outbreaks in the Sierra Nevada.

54 ENVIRONMENTAL SCIENCES↗

Does Age, Residency, or Feeding Guild Coupled with a Drought Index Predict Avian Health during Fall Migration?

Birds are good indicators of environmental change and are often studied for responses to climate. Many studies focus on breeding birds, while fewer look at the migration period, which is a critical time for many birds. Birds are more susceptible to unusual climatic events during their migration due to the metabolic stress of long-distance movements. In the fall of 2020, an unusual cold weather event coupled with drought and wildfire smoke led to a large avian mortality event in New Mexico. Later analysis pointed to the mortality being largely due to starvation. This was the impetus for our research. We used 11 years of fall bird banding data from two locations, along with local drought indices, to determine what predicts avian health during the migration period. We used fat score data from over 15,000 individual birds to assess whether drought indices, age, diet, or residency influenced avian health using multiple logistic regression. We found that the probability of positive fat scores decreased as drought severity increased for younger, insectivorous, migratory birds. Insectivores had a higher probability of receiving a fat score greater than zero relative to local drought conditions, which is important, since many North American insectivores are in steep decline. Migratory birds showed a greater response than year-round residents, and older birds showed a lower but significant response compared to hatch-year birds. Our results suggest that migratory insectivores in the southwestern United States may be less resilient to drought-related climate change.

59 BASIC BIOLOGICAL SCIENCES↗

Water Velocity Measurements on a Vertical Barrier Screen at the Bonneville Dam Second Powerhouse

Fish screens at hydroelectric dams help to protect rearing and migrating fish by preventing them from passing through the turbines and directing them towards the bypass channels by providing a sweeping flow parallel to the screen. However, fish screens may actually be harmful to fish if they become impinged on the surface of the screen or become disoriented due to poor flow conditions near the screen. Recent modifications to the vertical barrier screens (VBS) at the Bonneville Dam second powerhouse (B2) intended to increase the guidance of juvenile salmonids into the juvenile bypass system (JBS) have resulted in high mortality and descaling rates of hatchery subyearling Chinook salmon during the 2008 juvenile salmonid passage season. To investigate the potential cause of the high mortality and descaling rates, an in situ water velocity measurement study was conducted using acoustic Doppler velocimeters (ADV) in the gatewell slot at Units 12A and 14A of B2. From the measurements collected the average approach velocity, sweep velocity, and the root mean square (RMS) value of the velocity fluctuations were calculated. The approach velocities measured across the face of the VBS varied but were mostly less than 0.3 m/s. The sweep velocities also showed large variances across the face of the VBS with most measurements being less than 1.5 m/s. This study revealed that the approach velocities exceeded criteria recommended by NOAA Fisheries and Washington State Department of Fish and Wildlife intended to improve fish passage conditions.

13 HYDRO ENERGY↗

Recovery of Forest Structure Following Large-Scale Windthrows in the Northwestern Amazon

The dynamics of forest recovery after windthrows (i.e., broken or uprooted trees by wind) are poorly understood in tropical forests. The Northwestern Amazon (NWA) is characterized by a higher occurrence of windthrows, greater rainfall, and higher annual tree mortality rates (~2%) than the Central Amazon (CA). We combined forest inventory data from three sites in the Iquitos region of Peru, with recovery periods spanning 2, 12, and 22 years following windthrow events. Study sites and sampling areas were selected by assessing the windthrow severity using remote sensing. At each site, we recorded all trees with a diameter at breast height (DBH) ≥ 10 cm along transects, capturing the range of windthrow severity from old-growth to highly disturbed (mortality > 60%) forest. Across all damage classes, tree density and basal area recovered to >90% of the old-growth values after 20 years. Aboveground biomass (AGB) in old-growth forest was 380 (±156) Mg ha -1 . In extremely disturbed areas, AGB was still reduced to 163 (±68) Mg ha -1 after 2 years and 323 (± 139) Mg ha -1 after 12 years. This recovery rate is ~50% faster than that reported for Central Amazon forests. The faster recovery of forest structure in our study region may be a function of its higher productivity and adaptability to more frequent and severe windthrows. These varying rates of recovery highlight the importance of extreme wind and rainfall on shaping gradients of forest structure in the Amazon, and the different vulnerabilities of these forests to natural disturbances whose severity and frequency are being altered by climate change.

54 ENVIRONMENTAL SCIENCES↗

Tree Growth Enhancement Drives a Persistent Biomass Gain in Unmanaged Temperate Forests

While enhanced tree growth over the last decades has been reported in forests across the globe, it remains unclear whether it drives persistent biomass increases of forest stands, particularly in mature forests. Enhanced tree growth and stand-level biomass are often linked with a simultaneous increase in density-driven mortality and a reduction in tree longevity. Identifying empirical evidence regarding the balance between these processes is challenging due to the confounding effects of stand history, management, and environmental changes. Here, we investigate the link between growth and biomass via the negative relationship between average tree size and stand density (tree number per area). We find increasing stand density for a given mean tree size in unmanaged closed-canopy forests in Switzerland over the past six decades and a positive relationship between tree growth and stand density across forest plots—qualitatively consistent with our simulations using a mechanistic, cohort-resolving ecosystem model (BiomeE). Model simulations show that, in the absence of other disturbances, enhanced tree growth persistently increases biomass stocks despite simultaneous decreases in carbon residence time and tree longevity. However, the magnitude of simulated biomass changes for a given growth enhancement critically depends on the shape of the mortality functions. Our analyses reconcile reports of growth-induced reductions of tree longevity with model predictions of persistent biomass increases, and with our finding of trends toward denser forests in response to growth—also in mature stands.

biomass stocks↗

Dose‐response relationships between internally‐deposited uranium and select health outcomes in gaseous diffusion plant workers, 1948‐2011

Objective To examine dose‐response relationships between internal uranium exposures and select outcomes among a cohort of uranium enrichment workers. Methods Cox regression was conducted to examine associations between selected health outcomes and cumulative internal uranium with consideration for external ionizing radiation, work‐related medical X‐rays and contaminant radionuclides technetium ( 99 Tc) and plutonium ( 239 Pu) as potential confounders. Results Elevated and monotonically increasing mortality risks were observed for kidney cancer, chronic renal diseases, and multiple myeloma, and the association with internal uranium absorbed organ dose was statistically significant for multiple myeloma. Adjustment for potential confounders had minimal impact on the risk estimates. Conclusion Kidney cancer, chronic renal disease, and multiple myeloma mortality risks were elevated with increasing internal uranium absorbed organ dose. The findings add to evidence of an association between internal exposure to uranium and cancer. Future investigation includes a study of cancer incidence in this cohort.

Yiin, James H.↗