Reducing anaemia in low income countries: control of infection is essential.

In settings with high infection burdens, iron interventions for anaemia may be neither safe nor effective. Strategies to tackle the global burden of anaemia must take this into account, argue Sant-Rayn Pasricha and colleagues

Enhanced Eddy Activity in the Beaufort Gyre in Response to Sea Ice Loss

The Beaufort Gyre freshwater content has increased since the 1990s, potentially stabilizing in recent years. The mechanisms proposed to explain the stabilization involve either mesoscale eddy activity that opposes Ekman pumping or the reduction of Ekman pumping due to reduced sea ice?ocean surface stress. However, the relative importance of these mechanisms is unclear. Here, we present observational estimates of the Beaufort Gyre mechanical energy budget and show that energy dissipation and freshwater content stabilization by eddies increased in the late-2000s. The loss of sea ice and acceleration of ocean currents after 2007 resulted in enhanced mechanical energy input but without corresponding increases in potential energy storage. To balance the energy surplus, eddy dissipation and its role in gyre stabilization must have increased after 2007. Our results imply that declining Arctic sea ice will lead to an increasingly energetic Beaufort Gyre with eddies playing a greater role in its stabilization

Serum Hepcidin Concentrations Decline during Pregnancy and May Identify Iron Deficiency: Analysis of a Longitudinal Pregnancy Cohort in The Gambia.

Background: Antenatal anemia is a risk factor for adverse maternal and fetal outcomes and is prevalent in sub-Saharan Africa. Less than half of antenatal anemia is considered responsive to iron; identifying women in need of iron may help target interventions. Iron absorption is governed by the iron-regulatory hormone hepcidin.Objective: We sought to characterize changes in hepcidin and its associations with indexes of iron stores, erythropoiesis, and inflammation at weeks 14, 20, and 30 of gestation and to assess hepcidin's diagnostic potential as an index of iron deficiency.Methods: We measured hemoglobin and serum hepcidin, ferritin, soluble transferrin receptor (sTfR), and C-reactive protein (CRP) at 14, 20, and 30 wk of gestation in a cohort of 395 Gambian women recruited to a randomized controlled trial. Associations with hepcidin were measured by using linear regression, and hepcidin's diagnostic test accuracy [area under the receiver operating characteristic curve (AUCROC), sensitivity, specificity, cutoffs] for iron deficiency at each time point was analyzed.Results: The prevalence of anemia increased from 34.6% at 14 wk of gestation to 50.0% at 20 wk. Hepcidin concentrations declined between study enrollment and 20 wk, whereas ferritin declined between 20 and 30 wk of gestation. The variations in hepcidin explained by ferritin, sTfR, and CRP declined over pregnancy. The AUCROC values for hepcidin to detect iron deficiency (defined as ferritin <15 μg/L) were 0.86, 0.83, and 0.84 at 14, 20, and 30 wk, respectively. Hepcidin was superior to hemoglobin and sTfR as an indicator of iron deficiency.Conclusions: In Gambian pregnant women, hepcidin appears to be a useful diagnostic test for iron deficiency and may enable the identification of cases for whom iron would be beneficial. Hepcidin suppression in the second trimester suggests a window for optimal timing for antenatal iron interventions. Hemoglobin does not effectively identify iron deficiency in pregnancy. This trial was registered at www.isrctn.com as ISRCTN49285450

Enhanced eddy activity in the Beaufort Gyre in response to sea ice loss

The Beaufort Gyre freshwater content has increased since the 1990s, potentially stabilizing in recent years. The mechanisms proposed to explain the stabilization involve either mesoscale eddy activity that opposes Ekman pumping or the reduction of Ekman pumping due to reduced sea ice–ocean surface stress. However, the relative importance of these mechanisms is unclear. Here, we present observational estimates of the Beaufort Gyre mechanical energy budget and show that energy dissipation and freshwater content stabilization by eddies increased in the late-2000s. The loss of sea ice and acceleration of ocean currents after 2007 resulted in enhanced mechanical energy input but without corresponding increases in potential energy storage. To balance the energy surplus, eddy dissipation and its role in gyre stabilization must have increased after 2007. Our results imply that declining Arctic sea ice will lead to an increasingly energetic Beaufort Gyre with eddies playing a greater role in its stabilization

Enhanced eddy activity in the Beaufort Gyre in response to sea ice loss

The Beaufort Gyre freshwater content has increased since the 1990s, potentially stabilizing in recent years. The mechanisms proposed to explain the stabilization involve either mesoscale eddy activity that opposes Ekman pumping or the reduction of Ekman pumping due to reduced sea ice–ocean surface stress. However, the relative importance of these mechanisms is unclear. Here, we present observational estimates of the Beaufort Gyre mechanical energy budget and show that energy dissipation and freshwater content stabilization by eddies increased in the late-2000s. The loss of sea ice and acceleration of ocean currents after 2007 resulted in enhanced mechanical energy input but without corresponding increases in potential energy storage. To balance the energy surplus, eddy dissipation and its role in gyre stabilization must have increased after 2007. Our results imply that declining Arctic sea ice will lead to an increasingly energetic Beaufort Gyre with eddies playing a greater role in its stabilization

Photometric Accretion Signatures Near the Substellar Boundary

Multi-epoch imaging of the Orion equatorial region by the Sloan Digital Sky Survey has revealed that significant variability in the blue continuum persists into the late-M spectral types, indicating that magnetospheric accretion processes occur below the substellar boundary in the Orion OB1 association. We investigate the strength of the accretion-related continuum veiling by comparing the reddening-invariant colors of the most highly variable stars against those of main sequence M dwarfs and evolutionary models. A gradual decrease in the g band veiling is seen for the cooler and less massive members, as expected for a declining accretion rate with decreasing mass. We also see evidence that the temperature of the accretion shock decreases in the very low mass regime, reflecting a reduction in the energy flux carried by the accretion columns. We find that the near-IR excess attributed to circumstellar disk thermal emission drops rapidly for spectral types later than M4. This is likely due to the decrease in color contrast between the disk and the cooler stellar photosphere. Since accretion, which requires a substantial stellar magnetic field and the presence of a circumstellar disk, is inferred for masses down to 0.05 Msol we surmise that brown dwarfs and low mass stars share a common mode of formation.Comment: 37 pages, 14 figures, accepted by A

Efficacy of autologous mesenchymal stromal cell treatment for chronic degenerative musculoskeletal conditions in dogs: a retrospective study

Introduction: The objective of this study was to retrospectively analyze clinical data from a referral regenerative medicine practice, to investigate the efficacy of autologous mesenchymal stromal cells (MSC) in 245 dogs deemed unresponsive to conventional treatment by their referring vet. Methods: Diagnostic imaging [radiology and musculoskeletal ultrasound (MSK-US)] identified musculoskeletal pathology holistically. MSCs, produced according to current guidelines, were initially administered with PRP by targeted injection to joints and/or tendons, with a second MSC monotherapy administered 12 weeks later to dogs with severe pathology and/or previous elbow arthroscopic interventions. Dogs with lumbosacral disease received epidural MSCs with additional intravenous MSCs administered to dogs with spondylosis of the cervical, thoracic and lumbar spine. All dogs received laser therapy at 10 J/cm2 at the time of treatment and for 5 sessions thereafter. Objective outcome measures (stance analysis, range of joint motion, pressure algometry) and validated subjective outcome measures (owner reported VetMetrica HRQL™ and veterinary pain and quality of life impact scores) were used to investigate short and long-term (6–104 weeks) efficacy. Outcome data were collected at predetermined time windows (0–6, 7–12, 13–18, 19–24, 25–48, 49–78, 79–104) weeks after initial treatment. Results: There were statistically significant improvements in post compared with pre-treatment measures at all time windows in stance analysis, shoulder and hip range of motion, lumbosacral pressure algometry, and to 49–78 weeks in carpus and elbow range of motion. Improvements in 4 domains of quality of life as measured by VetMetricaTM were statistically significant, as were scores in vet-assessed pain and quality of life impact. In dogs receiving one initial treatment the mean time before a second treatment was required to maintain improvements in objective measures was 451 days. Diagnostic imaging confirmed the regenerative effects of MSCs in tendinopathies by demonstrating resolution of abnormal mineralization and restoration of normal fiber patterns. Discussion: This represents the first study using “real-world” data to show that cell-based therapies, injected into multiple areas of musculoskeletal pathology in a targeted holistic approach, resulted in rapid and profound positive effects on the patient's pain state and quality of life which was maintained with repeat treatment for up to 2 years

Decreased Hepcidin Levels Are Associated with Low Steady-state Hemoglobin in Children With Sickle Cell Disease in Tanzania.

BACKGROUND: The contribution of hepcidin as a regulator of iron metabolism & erythropoiesis on the severity of anemia in sickle cell disease (SCD) remains poorly characterized, especially in Sub-Saharan African populations. The aims of the study were to determine if hepcidin is associated with severity of steady-state anemia in SCD and to investigate factors associated with hepcidin and anemia in SCD. METHODS: Archived samples from 199 Tanzanian children, 56% boys aged 3-18 with laboratory-confirmed SCD were analysed based on recorded averaged steady-state hemoglobin (ASSH) quartiles (lowest vs. highest). Univariable and multivariable logistic regression was used to assess associations with ASSH quartiles. FINDINGS: In univariable analysis, hepcidin <5·5 ng/mL was associated with increased odds of being in the lowest ASSH quartile (OR 2·20; 95%CI 1·2-3·93) but which was limited to girls (OR 4·85, 95%CI 1·79-13·09, p = .046 for interaction). In multivariable analyses including either reticulocyte percentage or erythropoietin, lower hepcidin remained significantly associated with lowest ASSH quartile, although the hepcidin-sex interaction no longer reached statistical significance. No associations with ASSH quartile were observed for markers of inflammation, hemolysis or potential iron markers except for microcytosis, associated with higher ASSH, but which was confounded by reticulocyte percentage and alpha-thalassaemia status. INTERPRETATION: Hepcidin is lower in more severely anaemic children with SCD independent of inflammation or markers of erythropoiesis. FUNDING: Funding sources include The Wellcome Trust (080025, 095009, 094780 & 070114), MRC-UK (MC-A760-5QX00), NIHR Oxford Biomedical Research Centre, and the Bill and Melinda Gates Foundation ("Hepcidin and Iron in Global Health", OPP1055865)