All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study

BACKGROUND: Because individuals with osteoarthritis (OA) avoid physical activities that exacerbate symptoms, potentially increasing risk for cardiovascular disease (CVD) and death, we assessed the relationship between OA disability and these outcomes. METHODS: In a population cohort aged 55+ years with at least moderately severe symptomatic hip and/or knee OA, OA disability (Western Ontario McMaster Universities (WOMAC) OA scores; Health Assessment Questionnaire (HAQ) walking score; use of walking aids) and other covariates were assessed by questionnaire. Survey data were linked to health administrative data to determine the relationship between baseline OA symptom severity to all-cause mortality and occurrence of a composite CVD outcome (acute myocardial infarction, coronary revascularization, heart failure, stroke or transient ischemic attack) over a median follow-up of 13.2 and 9.2 years, respectively. RESULTS: Of 2156 participants, 1,236 (57.3%) died and 822 (38.1%) experienced a CVD outcome during follow-up. Higher (worse) baseline WOMAC function scores and walking disability were independently associated with a higher all-cause mortality (adjusted hazard ratio, aHR, per 10-point increase in WOMAC function score 1.04, 95% confidence interval, CI 1.01–1.07, p = 0.004; aHR per unit increase in HAQ walking score 1.30, 95% CI 1.22–1.39, p<0.001; and aHR for those using versus not using a walking aid 1.51, 95% CI 1.34–1.70, p<0.001). In survival analysis, censoring on death, risk of our composite CVD outcome was also significantly and independently associated with greater baseline walking disability ((aHR for use of a walking aid  = 1.27, 95% CI 1.10–1.47, p = 0.001; aHR per unit increase in HAQ walking score  = 1.17, 95% CI 1.08–1.27, p<0.001). CONCLUSIONS: Among individuals with hip and/or knee OA, severity of OA disability was associated with a significant increase in all-cause mortality and serious CVD events after controlling for multiple confounders. Research is needed to elucidate modifiable mechanisms

The Partonic Nature of Instantons

In both Yang-Mills theories and sigma models, instantons are endowed with degrees of freedom associated to their scale size and orientation. It has long been conjectured that these degrees of freedom have a dual interpretation as the positions of partonic constituents of the instanton. These conjectures are usually framed in d=3+1 and d=1+1 dimensions respectively where the partons are supposed to be responsible for confinement and other strong coupling phenomena. We revisit this partonic interpretation of instantons in the context of d=4+1 and d=2+1 dimensions. Here the instantons are particle-like solitons and the theories are non-renormalizable. We present an explicit and calculable model in d=2+1 dimensions where the single soliton in the CP^N sigma-model can be shown to be a multi-particle state whose partons are identified with the ultra-violet degrees of freedom which render the theory well-defined at high energies. We introduce a number of methods which reveal the partons inside the soliton, including deforming the sigma model and a dual version of the Bogomolnyi equations. We conjecture that partons inside Yang-Mills instantons hold the key to understanding the ultra-violet completion of five-dimensional gauge theories.Comment: 28 pages. v3: extra references and comments. Mathematica notebooks for the figures can be downloaded from http://www.damtp.cam.ac.uk/user/dt281/parton.htm

On noncommutative vacua and noncommutative solitons

We consider noncommutative theory of a compact scalar field. The recently discovered projector solitons are interpreted as classical vacua in the model considered. Localized solutions to the projector equation are pointed out and their brane interpretation is discussed. An example of the noncommutative soliton interpolating between such vacua is given. No strong noncommutativity limit is assumed.Comment: 9 pages, latex, references adde

Maternal pregnancy vitamin D supplementation increases offspring bone formation in response to mechanical loading : findings from a MAVIDOS trial sub-study

The Maternal Vitamin D Osteoporosis (MAVIDOS) trial reported higher total body bone mineral content in winter-born infants of mothers receiving vitamin D supplementation [1000 IU/day cholecalciferol] compared with placebo from 14 weeks gestation until delivery. This sub-study aimed to determine whether antenatal vitamin D supplementation altered postnatal bone formation in response to mechanical stimulation. Thirty-one children born to MAVIDOS participants randomised to either placebo (n=19) or cholecalciferol (n=12) were recruited at age 4-5 years. Children received whole body vibration (WBV) for 10 minutes on 5 consecutive days. Fasting blood samples for bone homeostasis, 25 hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and bone turnover markers (Pro-collagen Type 1 N-terminal propeptide, P1NP; Cross-linked C-telopeptide of Type I Collagen, CTX) were collected pre-WBV and on day 8 (D8). Mean changes (D) in P1NP (ng/ml) between baseline and D8 in the vitamin-D intervention and placebo groups were 40.6 and -92.6 respectively and mean changes (Δ) in CTX (ng/ml) were 0.034 (intervention) and -0.084 (placebo) respectively. Between-group DP1NP difference was 133.2ng/ml [95% CI 0.4, 266.0; p=0.049] and ΔCTX 0.05ng/ml (95% CI -0.159, 0.26ng/mL; p=0.62). Antenatal vitamin-D supplementation resulted in increased P1NP in response to WBV, suggesting early life vitamin D supplementation increases the anabolic response of bone to mechanical loading in children

Creating the cultures of the future: cultural strategy, policy and institutions in Gramsci. Part three: Is there a theory of cultural policy in Gramsci’s prison notebooks?

In this article, I argue that Gramsci’s prison notes on questions of cultural strategy, policy and institutions, which have so far been largely overlooked by scholars, provide further analytical insights to those offered by his more general concepts. Together they enrich the theoretical underpinnings for critical frameworks of analysis as well as for radical practices of cultural strategy, cultural policy-making and cultural organisation. On the basis of a detailed analysis of these notes, I then answer the question of whether they amount to a theory of cultural policy

Neutrino Oscillations v.s. Leptogenesis in SO(10) Models

We study the link between neutrino oscillations and leptogenesis in the minimal framework assuming an SO(10) see-saw mechanism with 3 families. Dirac neutrino masses being fixed, the solar and atmospheric data then generically induce a large mass-hierarchy and a small mixing between the lightest right-handed neutrinos, which fails to produce sufficient lepton asymmetry by 5 orders of magnitudes at least. This failure can be attenuated for a very specific value of the mixing sin^2(2\theta_{e3})=0.1, which interestingly lies at the boundary of the CHOOZ exclusion region, but will be accessible to future long baseline experiments.Comment: 23 pages, 8 eps figures, JHEP3 format; more accurate effect of dilution reduces previous results, inclusion of all phases, added reference

Triggering an eruptive flare by emerging flux in a solar active-region complex

A flare and fast coronal mass ejection originated between solar active regions NOAA 11514 and 11515 on July 1, 2012 in response to flux emergence in front of the leading sunspot of the trailing region 11515. Analyzing the evolution of the photospheric magnetic flux and the coronal structure, we find that the flux emergence triggered the eruption by interaction with overlying flux in a non-standard way. The new flux neither had the opposite orientation nor a location near the polarity inversion line, which are favorable for strong reconnection with the arcade flux under which it emerged. Moreover, its flux content remained significantly smaller than that of the arcade (approximately 40 %). However, a loop system rooted in the trailing active region ran in part under the arcade between the active regions, passing over the site of flux emergence. The reconnection with the emerging flux, leading to a series of jet emissions into the loop system, caused a strong but confined rise of the loop system. This lifted the arcade between the two active regions, weakening its downward tension force and thus destabilizing the considerably sheared flux under the arcade. The complex event was also associated with supporting precursor activity in an enhanced network near the active regions, acting on the large-scale overlying flux, and with two simultaneous confined flares within the active regions.Comment: Accepted for publication in Topical Issue of Solar Physics: Solar and Stellar Flares. 25 pages, 12 figure