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5 studies you may have missed

CNN Health

Scientists have uncovered how cells that lie under the surface of your skin allow you to perceive details and textures. These cells are called Merkel cells. “These experiments are the first direct proof that Merkel cells can encode touch into neural signals that transmit information to the brain about the objects in the world around us,” researcher Ellen Lumpkin said in a statement.

Even Mindy Kaling Can’t Win the Body-Image Wars

TIME

“In the same way that we don’t know what contributes to disordered thoughts about body image, we don’t know what confers a healthier message,” says Dr. Evelyn Attia, the director at Columbia Center for Eating Disorders. “But it’s nice to have a period of time where people are trying on these messages, where celebs are getting the word out that there are lots of healthy bodies, lots of healthy definitions of beauty,” Attia says. “It’s a bit of a refreshing chapter.”

Molecular, Cellular Secrets of Soft Touch Revealed

GEN News

In an article entitled “Epidermal Merkel cells are mechanosensory cells that tune mammalian touch receptors,” a research team led by Ellen Lumpkin, Ph.D., associate professor of somatosensory biology at Columbia University Medical Center, showed that Merkel cells actively participate in touch reception in mice. In particular, the researchers showed that Merkel cells display fast, touch-evoked mechanotransduction currents.

Insomnia May Be A 24-Hour Condition, Research Shows

CBS New York

“What this research suggests is that even during the day, people with insomnia, their brains are in a hyper-arousal state,” said Dr. Carl Bazil, director of the sleep center at NewYork-Presbyterian/Columbia University Medical Center. “They’re on edge more than other people. “They may need more in terms of things like exercise, meditation, to train your brain to calm down when you need to,” Bazil said.

Vitamin D has no effect on depression

CNN

Dr. Jonathan A. Shaffer, PhD, MS, licensed clinical psychologist, clinical researcher, and assistant professor of medical sciences at Columbia University Medical Center and colleagues reviewed the effects of vitamin D supplementation on depressive symptoms in randomized controlled trials.

New Health Law Is Sending Many Back to School

New York Times

The new law is affecting the very nature of the quandaries that arise, said Robert Klitzman, director of the masters of bioethics program at Columbia University, run through the School of Continuing Education. He has had to alter the program as a result. Questions his program now addresses include: Does the government have the right to demand that people buy health insurance, and should they be penalized if they don’t?

Probiotic Eases Ills in Children

New York Times

“What’s notable here is that they used a specific probiotic in a good design and they also did follow-up,” said Stephen S. Morse, an infectious disease specialist at Columbia University who was not involved in the study. “This strengthens the evidence for the value of probiotics, but we still have a lot to learn.”

The Science of Older and Wiser

New York Times

Since ancient times, the elusive concept of wisdom has figured prominently in philosophical and religious texts. …True personal wisdom involves five elements, said Professor [Ursula] Staudinger, now a life span psychologist and professor at Columbia University.

Improve Your Decision-Making Skills By Doing This

TIME

It’s all about giving our attention enough time to sort out the relevant information from the distractors, says one of the study’s co-authors, Vincent Ferrera, an associate professor of neuroscience at Columbia University Medical Center. “The little extra time to sort out the irrelevant information makes the decision-making more efficient,” he says.

Nurse numbers, education linked to patient death rate

Reuters

Researchers found the proportion of staff nurses with a bachelor’s degree and the number of patients each nurse had to care for could add up to a difference of 30 percent or more in mortality rates for inpatients. …”Nursing is the largest workforce in a hospital, and is therefore the most expensive,” said Pat Stone, director of the Columbia University School of Nursing’s Center for Health Policy in New York.

Camels Linked to Spread of MERS Virus in People

New York Times

“It would be very difficult to know if they were ill, since these are creatures that slobber a great deal,” said Dr. W. Ian Lipkin, the senior author of the study and a virus expert at Columbia University’s Mailman School of Public Health in New York. The results, by researchers from Saudi Arabia and the United States, were published on Tuesday in mBio, an online journal.

Fear suppressing neurons found

BBC News

Attila Losonczy, from Columbia University in New York and colleagues, were interested in how the hippocampus stores memories of a particular context and then separates this memory from a fearful event. When looking at individual neurons in the brains of mice, they found inhibitory cells – called interneurons – were crucial for fear memory formation to travel to the correct part of the brain.

Science refreshes its view of aging

Chicago Tribune

Scientists also addressed the need to stay mentally active. Symptoms of cognitive decline appear later in people with more “cognitive reserve,” said Yaakov Stern. A Columbia University professor of clinical neuropsychology, Stern was Skyped in to talk at the conference after being stuck home in the East Coast snowstorm.

More talking to babies helps their brains

Associated Press

Brain scans support the link, said Dr. Kimberly Noble of Columbia University Medical Center. Early experiences shape the connections that children’s brains form, and kids from higher socio-economic backgrounds devote more “neural real estate” to brain regions involved in language development, she found.

Inmates in Solitary More Likely to Hurt Themselves

Associated Press

A first-of-its-kind study found that New York City jail inmates sent to solitary confinement are nearly seven times more likely to try to hurt or kill themselves than those never assigned to it. …Dr. Ernest Drucker, a Columbia University epidemiologist who was one of the peer reviewers, called the study the “largest, most comprehensive” look at the use of solitary that he was aware of.

Ethics Questions Arise as Genetic Testing of Embryos Increases

New York Times

Preimplantation diagnosis often goes unmentioned by doctors. In a recent national survey, Dr. Robert Klitzman, a professor of clinical psychiatry and bioethicist at Columbia University, found that most internists were unsure about whether they would suggest the method to couples with genes for diseases like cystic fibrosis or breast cancer. Only about 6 percent had ever mentioned it to patients and only 7 percent said they felt qualified to answer patients’ questions about it.

Ground Zero in Alzheimer’s Disease

Nature Neuroscience
In a technical tour de force, Khan et al. report an elegant set of imaging and histology experiments in several mouse models, as well as human patients, that provide convergent evidence that the LEC [lateral entorhinal cortex] is specifically targeted by Alzheimer’s disease pathology.

Taking a Restful Position

New York Times

Q. Is it best to sleep on your back, side or stomach?

A. “This mainly matters if you have sleep apnea, which is often worse on your back,” said Dr. Carl W. Bazil, director of the division of epilepsy and sleep at NewYork-Presbyterian/Columbia University Medical Center. “Snoring is often worse as well, as many bed partners can attest.”

Agonizing Choices for Lives Saved by Miracle Drugs

Wall Street Journal

In the operating room, an alarm suddenly blared: Megan’s nerve signals had flatlined, suggesting paralysis. “Megan, wiggle your toes!” her surgeon, David Roye, recalls yelling, waking her from anesthesia. …In the summer of 2012, Megan’s parents took her to Dr. Roye, a specialist in straightening children’s spines at Columbia University Medical Center. He told Megan he thought he could achieve “about a 50% correction,” he says.

Giving Vaccines Together Increases Fever Risk

New York Times

These findings are not a reason to avoid the vaccines, according to the lead author, Dr. Melissa S. Stockwell, an assistant professor of pediatrics at Columbia University Medical Center. Getting the vaccines at the same visit increases the time of protection, and eliminates the problem of failing to return for the second shot.

The Cruelest Pregnancy

New York Times

In late November, Marlise [Munoz], 33, was found unconscious on the kitchen floor by her husband, Erick. She had apparently suffered a pulmonary embolism. …“It’s extremely risky for fetal development,” said Mary D’Alton, the head of obstetrics and gynecology at Columbia University Medical Center and NewYork-Presbyterian Hospital. But, she added, “If the family is willing and it’s something they want, it’s something I would attempt — and have attempted.” She said that she was involved in two such pregnancies. In one, the fetus died in utero at 27 weeks. In the other, a child was born, but with problems.

A Mental Alarm Clock

New York Times

Q. Why do I wake up at exactly the same time every night, without any stimulus? It has happened all my life, and it doesn’t even matter what time I went to bed.

A. What you are experiencing is probably a normal period of relative alertness that happens in the middle of the night, said Dr. Carl W. Bazil, director of the division of epilepsy and sleep at NewYork-Presbyterian/Columbia University Medical Center.

Should medical school be shortened to three years?

Washington Post

NYU launched its program in September with Hill and 15 other students chosen from a pool of 50 applicants — nearly a third of the medical school’s 160-member class. Texas Tech University Health Sciences Center in Lubbock graduated its first three-year class in 2013; its nine students are training in family medicine. Fifteen more students started this fall. In September, Columbia University’s College of Physicians and Surgeons launched a “fast track MD” for candidates who already hold doctorates in biology; there were 40 applicants for four slots.

Coldest Air In Decades Bearing Down On Tri-State Area

CBS New York

The sidewalks wet with melted snow refrozen into ice could also turn dangerous. Experts advise being careful going up and down stairs. And while it is obviously best not to fall at all, doctors said there are ways to prevent serious injuries. “One of the most common injuries we see during icy weather like this is broken wrists, so if you can catch yourself by falling on your side or avoid falling on an outstretched hand, that might save you a broken bone,” said Dr. Chris Tedeschi of NewYork Presbyterian-Columbia University Medical Center.

Study: Vitamin E may help Alzheimer’s patients

CNN Health

There is no cure for Alzheimer’s, nor is there an effective method of reversing symptoms such as memory loss, disorientation and difficulties in organizing thoughts. But a new study in the Journal of the American Medical Association suggests there may be some hope for improvement in these patients, in the form of vitamin E. The study authors say that this is the first demonstration of vitamin E benefiting Alzheimer’s patients with mild to moderate disease. However, they caution that it doesn’t prove that the vitamin is always effective and therefore should not be universally recommended. …Activities of daily living are rarely shown to improve in clinical trials, so that is a strength of the study, said Dr. Scott Small, director of the Alzheimer’s Disease Research Center at Columbia University Medical Center, who was not involved in this study.

Vitamin E Slows Decline of Some Alzheimer’s Patients in Study

New York Times

Now a study suggests that vitamin E supplements may be good for some Alzheimer’s patients after all. The benefit was not huge, but for a devastating disease that has proved almost impervious to treatment, it was notable. The study, published in Wednesday’s issue of JAMA, The Journal of the American Medical Association, found that over a little more than two years, high-dose vitamin E slowed the decline of people with mild to moderate Alzheimer’s by about six months on average. …“Is it really going to dramatically alter the lives of Alzheimer’s patients? That’s unclear,” said Dr. Scott Small, director of Columbia University’s Alzheimer’s Disease Research Center, who was not involved in the study. “But it might improve patients’ ability to bathe themselves and dress themselves.”

Lab Mice Rejoice Over Pending Budget Vote

WNYC Radio

The Senate is poised to pass a budget deal this week that could restore funding for medical research trimmed as a result of automatic budget cuts known as the sequester. Researchers in New York City are cautiously optimistic that they will have access to grants from the National Institutes of Health that they rely on to conduct their work.

Why do big donors give away millions?

NPR Marketplace

Across the country, the campuses of colleges and universities are dotted with buildings bearing the names of big donors. …The sheer proliferation of buildings named for wealthy individuals and families might suggest that one of the motives behind generosity is the credit that one receives for a gift.

Dr. Roy Vagelos and his wife Diana donated $50 million to the construction of a new graduate and medical education building for Columbia University Medical Center, that will bear their names. Asked whether that was part of the motive for his gift, he sounded exasperated.

“Names don’t mean a hell of a lot to me,” Dr. Vagelos said. “The fact that students at Columbia will have the best facilities, probably in the world, for their education, is important to me.” Vagelos, the son of Greek immigrants who owned a restaurant in New Jersey, graduated from Columbia’s medical school on scholarship, sixty years ago.

“I was born in October of 1929, which was the month of the stock market crash, the big crash,” Vagelos said. “Our little restaurant specialized in ice cream and homemade candies. That went down the tubes at the time of the stock market crash.” After graduating from medical school, Vagelos embarked on a high-profile career. He rose to become the CEO of Merck Pharmaceuticals.

The Case for Tolerating E-Cigarettes

The New York Times

Debate over e-cigarettes — battery-powered cigarette look-alikes that heat liquid nicotine but emit a harmless vapor — is raging. New York City and Chicago are considering adding e-cigarettes to their bans on smoking in bars, restaurants and parks, and Los Angeles is moving to restrict e-cigarette sales, even though e-cigarettes don’t generate smoke and, while not proved to be entirely safe for users, are undoubtedly less hazardous than tobacco cigarettes.

By Amy L. Fairchild, PhD, a professor, and James Colgrove, PhD, an associate professor, of sociomedical sciences at the Mailman School of Public Health at Columbia.————

Letters in response to the essay by Drs. Fairchild and Colgrove: Thomas Farley, MD, MPH, commissioner of the New York City Department of Health and Mental Hygiene; Joseph A. Califano Jr., former chairman of The National Center on Addiction and Substance Abuse at Columbia University (CASAColumbia); and Daniel Seidman, PhD, director of Smoking Cessation Services at Columbia University Medical Center, submitted letters in response to the essay by Drs. Fairchild and Colgrove. These were published in the Dec. 14, 2013 issue of The New York Times, and can also be seen here.

See e-cigs clearly through the vapor

New York Daily News

Last week, the City Council held hearings on whether e-cigarette users should be allowed to “vape” in indoor public spaces. Rather than wait for the U.S. Food and Drug Administration to rule one way or the other on the possible dangers of e-cigarette vapor, the Council is mulling whether it should be included with cigarette smoke as a potential hazard. If so, these products will be included in the city’s 2002 Smoke-Free Air Act, which banned smoking in restaurants and bars. After looking carefully at the research, I say, good. Regulations on e-cigs, which deliver heated nicotine directly into the lungs, cannot come soon enough.

By Daniel Seidman, PhD, director of Smoking Cessation Services at Columbia University Medical Center and author of the book “Smoke-Free in 30 Days.”

PTSD Patients Likely to Skip Blood Pressure Meds

MedPage Today

Hypertensive patients with post-traumatic stress disorder missed significantly more doses of their blood pressure drugs than patients without PTSD, researchers found. In a small study, 68% of hypertensive patients with positive screening results for PTSD on a primary care-oriented symptom assessment were judged to be nonadherent to their medications, versus 26% of hypertensive patients with no PTSD symptoms (P=0.001), according to Ian Kronish, MD, MPH, of Columbia University in New York City, and colleagues. The study also showed a possible trend toward increasing nonadherence with more severe PTSD, the researchers reported online in JAMA Internal Medicine.

How future doctors learn from their patients

CBS News

Medical school means long hours, hard work and a lot of stress — but third-year medical student Loren Galler Rabinowitz is used to the pressure. Before she enrolled at Columbia University College of Physicians and Surgeons in New York City, she was a world-class competitive skater, won the Miss Massachusetts pageant, competed for Miss America in 2011 and somehow found the time to graduate from Harvard. Learning to be a good doctor presents a whole new set of challenges. Rabinowitz sat down recently with CBS News chief medical correspondent Dr. Jon LaPook to discuss her experiences as a doctor-in-training.

Video games may help fend off senior moments

Chicago Tribune

At age 70, Allan S. is not a gamer, but when his time comes to play Space Fortress for a Columbia study on the aging brain, he eagerly takes his seat in front of a computer monitor, grabs the joystick and starts shooting missiles at the enemy fortress on the screen. …”It’s a frustrating and complex game,” says the cognitive neuroscientist running the study, Yaakov Stern, Ph.D., professor of clinical neuropsychology at Columbia University College of Physicians and Surgeons. …Allan is in his fifth session with the game and he doesn’t have total control over his ship. “I know what I have to do, but getting that information down into my arm to move the spaceship is slow,” he says. Still, it’s fun, and Allan travels to Columbia’s Taub Institute for Research on Alzheimer’s Disease and the Aging Brain three days a week to play the game for 45 minutes at a time.

Morning-after pill may be less effective for heavier women

NBC News

Some morning-after pills may not be a reliable way to prevent pregnancy in heavier women. The European manufacturer of an emergency contraceptive pill, Norlevo, will caution women in new labeling that the product is “not effective” for women over 176 pounds and doesn’t work as well in women who weigh 165 pounds or more. …“The FDA is currently reviewing the available and related scientific information on this issue, including the publication upon which the Norlevo labeling change was based,” said Erica Jefferson, deputy director for the FDA office of media affairs. …Dr. Carolyn Westhoff doesn’t want to see women become overly alarmed by the study. “This is just a single result and we don’t have any way to replicate it,” said Westhoff, a professor of obstetrics and gynecology at New York-Presbyterian Hospital/Columbia University Medical Center.

Diabetes: Mouse Studies Point to Kinase as Treatment Target

MedPage Today

Targeting a pathway that plays a major role in both hepatic glucose production and insulin sensitivity may eventually help treat type 2 diabetes, researchers reported. In a series of experiments in mice, researchers found that inhibition of the kinase CaMKII — or even some of its downstream components — lowered blood glucose and insulin levels, Ira Tabas, MD, PhD, of Columbia University Medical Center in New York City, and colleagues reported online in Cell Metabolism. The pathway is activated by glucagon signaling in the liver, and appears to have roles in both insulin resistance as well as hepatic glucose production in the liver.

Dr. Max Gomez: Once-Conjoined Twins Make Medical History

CBS New York

A story of two miracles, two decades in the making, began with the birth of conjoined twin sisters who were later separated by surgery. CBS 2′s Dr. Max Gomez was in the operating room when the pair were separated and recently brought CBS 2 a joyful follow-up. The separation of Rosa and Carmen Taveras was unusual, but an event that took place earlier this month was nearly unheard of in medical history. …Rosa is only the fourth conjoined twin ever known to have given birth after separation. And, after the extensive pelvic reconstruction that was performed on the twins, Rosa didn’t believe that she would be able to give birth. …Beyond the historical aspects of the birth, the moment was a real payoff for Dr. Steven Stylianos, one of the lead surgeons in the twins’ separation. “When you see a child with those challenges first walk, when you learn that they hit their teenage years and they were just the same as every other girl in school, and now that they’re young women and they’ve had their reproductive capabilities put to the test with a very successful, beautiful, little boy being born — those are really moments to treasure,” Stylianos said.

Fred Kavli dies at 86; promoted scientific research worldwide

Los Angeles Times

Fred Kavli, a Southern California philanthropist, physicist, entrepreneur, and founder and chairman of the Kavli Foundation, which promotes scientific research worldwide, died Thursday. He was 86. …The Southern California-based foundation, which awards $1-million cash prizes to spark cutting-edge research, was created by Kavli in 2000 to promote science for the benefit of humanity. The foundation includes research institutes on three continents that specialize in the study of astrophysics, nanoscience, neuroscience and theoretical physics. …The foundation has endowed research institutes at universities worldwide, including Columbia University, Yale University, the University of Cambridge, Peking University, and the Norwegian University of Science and Technology.

Merck brings maternity program for poor nations to U.S.

Reuters

Merck & Co on Tuesday said it is expanding its “Merck for Mothers” program, which aims to reduce pregnancy-related deaths from impoverished countries such as Senegal and Zambia, to the United States – a stark reminder of how far the country lags other wealthy nations on key measures of health. “As Americans, we simply should not accept that 46 countries have lower rates” of reported maternal mortality, said Merck Chief Executive Ken Frazier. …The leading maternal killers include cardiovascular disease, venous thromboembolism, hemorrhage, hypertension and sepsis, said Dr Mary D’Alton of Columbia University Medical Center in New York City, a specialist in high-risk maternal and fetal medicine. …The program will also work through the American Congress of Obstetricians and Gynecologists to develop standardized protocols for treating the leading causes of maternal death, said Columbia’s D’Alton.

Hypochondria: Vetting symptoms to diagnose disease

CBS News

In this digital age of medicine, it’s hard not to look up your symptoms online — and fear the worst. But hypochondriasis, or hypochondria, can be a serious issue for some who are obsessed with the idea that they may have a life-threatening medical condition. …Medical school students often seem to develop hypochondria as they go through the process of learning about everything that can go wrong with the human body. Loren Galler Rabinowitz, a third-year medical student at Columbia University College of Physicians and Surgeons, says she’s seen first-hand how med students tend to think they suffer from the exotic diseases they’re studying. She gives the example of a young man in her class who thought his headaches might be caused by a rare disorder they’d just learned about — even though the condition is normally seen only in elderly women.

New method predicts Alzheimer’s timetables

Metro New York

Pinpointing the stages and progression of Alzheimer’s is getting more precise. A research team from Columbia University Medical Center has validated a new algorithm for predicting the length of time until full-time care, nursing home residency, and death for Alzheimer’s patients. Led by Dr. Yaakov Stern, professor of neuropsychology at CUMC, researchers followed two sets of Alzheimer’s patients for 10 years. Together, they developed a Longitudinal Grade of Membership (L-GoM) model, which looks at 16 variables in patients. “The benefit of the L-GoM model is that it takes into account the complexity of Alzheimer’s disease,” Stern said. “Patients don’t typically fall neatly into mild, moderate, or severe disease categories. Our method is flexible enough to handle missing data.”

Endocrine Society announces 2014 Laureate Award winners

Phys.org

The Endocrine Society today announced it has selected 15 accomplished endocrinologists as winners of the organization’s prestigious 2014 Laureate Awards. …

  • John P. Bilezikian, MD – Distinguished Educator Award. This annual award recognizes exceptional achievement as an educator in the discipline of endocrinology and metabolism. Bilezikian is a mentor to a generation of trainees, a major innovator of new educational programs, both nationally and internationally, and a tireless advocate for the recruitment of physicians and physician-scientists in endocrinology. He is Chair of the Endocrine Fellows Foundation, a not-for-profit organization that has, for the past 20 years, provided competitive research grants to endocrinology fellows. Bilezikian is the Dorothy L. and Daniel H. Silberberg Professor of Medicine and Professor of Pharmacology at Columbia University Medical Center in New York City.
  • Domenico Accili, MD – Edwin B. Astwood Award Lecture. This annual award recognizes outstanding contributions to research in endocrinology. Accili’s new landmark findings in beta-cell differentiation are revolutionizing the understanding of the pathophysiology of diabetes and reshaping the programs for therapy of both type 2 and type 1 diabetes. Accili is the Russell Berrie Foundation Professor of Diabetes (in Medicine) at Columbia University Medical Center and Director of the Columbia University Diabetes and Endocrinology Research Center in New York City.

Do Our Bones Influence Our Minds?

The New Yorker

In the mid-nineteen-nineties, a young French geneticist and physician named Gerard Karsenty became curious about a mysterious protein, called osteocalcin, that is found at high concentrations in the skeleton. He worked with mice that had been engineered to lack the substance, expecting to find problems with their bones. But their skeletons appeared essentially normal, he says, a result that left him “deeply depressed.” The mice did have issues, though. Their abdomens were fatty, they had trouble breeding, and they were “stupid,” meaning “they never rebelled or tried to bite or escape,” said Karsenty, now fifty-nine years old and the chair of the department of genetics and development at Columbia University Medical Center. He has studied osteocalcin for almost two decades.

Bassett medical school’s popularity soars

Observer-Dispatch

Cooperstown has proven an unexpectedly popular place for medical students. When the Bassett Healthcare Network and the Columbia University College of Physicians and Surgeons joined forces to start a new 10-student medical school program in the fall of 2010, officials predicted great things. But no one foresaw the program’s popularity with medical school applicants. So far, it has drawn between 698 and 971 applications a year for just 10 slots, said Senior Associate Dean Dr. Walter Franck. That compares to 5,100 to 5,800 applications for 155 spots in Columbia’s regular medical school and MD/PhD programs, he said.

The silent killer

Manhattan Times

When Dr. Carlos López-Jiménez sees a patient with a blood pressure reading of 225/80, he suggests they go straight to the emergency room. But most of they time they don’t. High blood pressure, or hypertension, is a silent killer. In the U.S., one out of every three adults has it—but not everyone knows it. There are no symptoms. Left untreated, high blood pressure could result in eye disease, kidney failure, heart damage, stroke, vascular dementia and more. “It can wreck everything if not properly diagnosed and treated,” said Dr. J. Thomas Bigger. At a community forum hosted by Columbia University Medical Center this past Wed., Oct. 23rd, doctors talked about how to minimize the risks.

Superfund Status Sought for Queens Industrial Site

New York Times

City, state and federal agencies have long known that an industrial site in Ridgewood, Queens, contained radioactive material. The location, currently home to an auto repair shop, a construction firm, a warehouse and a deli, was once used by the Wolff-Alport Chemical Company, which sold thorium to the federal government for research on atomic bombs. …The latest comprehensive federal study, released in February 2012, found [contamination] levels significant enough to conclude that “workers at the auto body shop and pedestrians who frequently use the sidewalks at this location may have an elevated risk of cancer.” …Dr. David Brenner, director of the Center for Radiological Research at Columbia University Medical Center, compares the auto repair shop workers’ annual exposure to a medical CT scan or about 200 chest X-rays. “You wouldn’t voluntarily have a CT scan each year,” Dr. Brenner said. “No one working there should change jobs, but we don’t want anyone to have more radiation than they have to, so it should be cleaned up.”