Role of peripheral quantitative computed tomography in identifying disuse osteoporosis in paraplegia

Objective: Disuse osteoporosis is a major long-term health consequence of spinal cord injury (SCI) that still needs to be addressed. Its management in SCI should begin with accurate diagnosis, followed by targeted treatments in the most vulnerable subgroups. We present data quantifying disuse osteoporosis in a cross-section of the Scottish paraplegic population to identify subgroups with lowest bone mineral density (BMD). Materials and Methods: Forty-seven people with chronic SCI at levels T2-L2 were scanned using peripheral Quantitative Computed Tomography (pQCT) at four tibial sites and two femoral sites, at the Queen Elizabeth National Spinal Injuries Unit, Glasgow (U.K.). At the distal epiphyses, trabecular BMD (BMDtrab), total BMD, total bone cross-sectional area (CSA), and bone mineral content (BMC) were determined. In the diaphyses, cortical BMD, total bone CSA, cortical CSA, and BMC were calculated. Bone, muscle and fat CSAs were estimated in the lower leg and thigh. Results: BMDtrab decreased exponentially with time since injury, at different rates in the tibia and femur. At most sites, female paraplegics had significantly lower BMC, total bone CSA and muscle CSA than male paraplegics. Subjects with lumbar SCI tended to have lower bone values and smaller muscle CSAs than in thoracic SCI. Conclusion: At the distal epiphyses of the tibia and femur, there is generally a rapid and extensive reduction in BMDtrab after SCI. Female subjects, and those with lumbar SCI, tend to have lower bone values than males or those with thoracic SCI, respectively. Keywords: Bone loss, osteoporosis, paraplegia, peripheral Quantitative Computed Tomography, spinal cord injur

The Size of the Narrow-Line Emitting Region in the Seyfert 1 Galaxy NGC 5548 from Emission-Line Variability

The narrow [O III] 4959, 5007 emission-line fluxes in the spectrum of the well-studied Seyfert 1 galaxy NGC 5548 are shown to vary with time. From this we show that the narrow line-emitting region has a radius of only 1-3 pc and is denser (n ~ 10^5 cm^{-3}) than previously supposed. The [O III] line width is consistent with virial motions at this radius given previous determinations of the black hole mass.Since the [O III] emission-line flux is usually assumed to be constant and is therefore used to calibrate spectroscopic monitoring data, the variability has ramifications for the long-term secular variations of continuum and emission-line fluxes, though it has no effect on shorter-term reverberation studies. We present corrected optical continuum and broad Hbeta emission-line light curves for the period 1988 to 2008.Comment: 11 pages, 5 figures, 6 tables. Accepted for publication in Ap

POEMMA: Probe Of Extreme Multi-Messenger Astrophysics

The Probe Of Extreme Multi-Messenger Astrophysics (POEMMA) mission is being designed to establish charged-particle astronomy with ultra-high energy cosmic rays (UHECRs) and to observe cosmogenic tau neutrinos (CTNs). The study of UHECRs and CTNs from space will yield orders-of-magnitude increase in statistics of observed UHECRs at the highest energies, and the observation of the cosmogenic flux of neutrinos for a range of UHECR models. These observations should solve the long-standing puzzle of the origin of the highest energy particles ever observed, providing a new window onto the most energetic environments and events in the Universe, while studying particle interactions well beyond accelerator energies. The discovery of CTNs will help solve the puzzle of the origin of UHECRs and begin a new field of Astroparticle Physics with the study of neutrino properties at ultra-high energies.Comment: 8 pages, in the Proceedings of the 35th International Cosmic Ray Conference, ICRC217, Busan, Kore

Household air pollution in low- and middle-income countries: health risks and research priorities

Household air pollution (HAP), which results from incomplete combustion of the solid fuels traditionally used for cooking and heating, affects the homes of nearly 3 billion people. It is the leading environmental cause of death and disability worldwide, with highest risks for women and children due to their domestic roles. The high levels of pollutants found in HAP cause a range of diseases, in addition to burns and scalds and injuries or violence experienced during fuel collection. Additionally, household solid fuel use can pose substantive environmental risks, including degradation from fuel gathering as well as climate change from release of both CO2 and short-lived climate forcers, such as black carbon, during combustion. Despite the broad support to find solutions, only a few solid fuel interventions have shown that they might improve health over the long term, especially when implemented at the scale required (Box 1)

Thoracic and Lumbar Vertebral Bone Mineral Density Changes in a Natural Occurring Dog Model of Diffuse Idiopathic Skeletal Hyperostosis

Ankylosing spinal disorders can be associated with alterations in vertebral bone mineral density (BMD). There is however controversy about vertebral BMD in patients wuse idiopathic skeletal hyperostosis (DISH). DISH in Boxer dogs has been considered a natural occurring disease model for DISH in people. The purpose of this study was to compare vertebral BMD between Boxers with and without DISH. Fifty-nine Boxers with (n=30) or without (n=29) DISH that underwent computed tomography were included. Vertebral BMD was calculated for each thoracic and lumbar vertebra by using an earlier reported and validated protocol. For each vertebral body, a region of interest was drawn on the axial computed tomographic images at three separate locations: immediately inferior to the superior end plate, in the middle of the vertebral body, and superior to the inferior end plate. Values from the three axial slices were averaged to give a mean Hounsfield Unit value for each vertebral body. Univariate statistical analysis was performed to identify factors to be included in a multivariate model. The multivariate model including all dogs demonstrated that vertebral DISH status (Coefficient 24.63; 95% CI 16.07 to 33.19; p <0.001), lumbar vertebrae (Coefficient -17.25; 95% CI -23.42 to -11.09; p < 0.01), and to a lesser extent higher age (Coefficient -0.56; 95% CI -1.07 to -0.05; p = 0.03) were significant predictors for vertebral BMD. When the multivariate model was repeated using only dogs with DISH, vertebral DISH status (Coefficient 20.67; 95% CI, 10.98 to 30.37; p < 0.001) and lumbar anatomical region (Coefficient -38.24; 95% CI, -47.75 to -28.73; p < 0.001) were again predictors for vertebral BMD but age was not. The results of this study indicate that DISH can be associated with decreased vertebral BMD. Further studies are necessary to evaluate the clinical importance and pathophysiology of this finding

GenTAC registry report: Gender differences among individuals with genetically triggered thoracic aortic aneurysm and dissection

Previous data suggest women are at increased risk of death from aortic dissection. Therefore, we analyzed data from the GenTAC registry, the NIH‐sponsored program that collects information about individuals with genetically triggered thoracic aortic aneurysms and cardiovascular conditions. We performed cross‐sectional analyses in adults with Marfan syndrome (MFS), familial thoracic aortic aneurysm or dissection (FTAAD), bicuspid aortic valve (BAV) with thoracic aortic aneurysm or dissection, and subjects under 50 years of age with thoracic aortic aneurysm or dissection (TAAD <50 years). Women comprised 32% of 1,449 subjects and were 21% of subjects with BAV, 34% with FTAAD, 22% with TAAD <50 years, and 47% with MFS. Thoracic aortic dissections occurred with equal gender frequency yet women with BAV had more extensive dissections. Aortic size was smaller in women but was similar after controlling for BSA. Age at operation for aortic valve dysfunction, aneurysm or dissection did not differ by gender. Multivariate analysis (adjusting for age, BSA, hypertension, study site, diabetes, and subgroup diagnoses) showed that women had fewer total aortic surgeries (OR = 0.65, P  < 0.01) and were less likely to receive angiotensin converting enzyme inhibitors (ACEi; OR = 0.68, P  < 0.05). As in BAV, other genetically triggered aortic diseases such as FTAAD and TAAD <50 are more common in males. In women, decreased prevalence of aortic operations and less treatment with ACEi may be due to their smaller absolute aortic diameters. Longitudinal studies are needed to determine if women are at higher risk for adverse events. © 2013 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97193/1/35836_ftp.pd

Pan-European landscape of research into neurodevelopmental copy number variants: a survey by the MINDDS consortium

Background Several rare copy number variants have been identified to confer risk for neurodevelopmental disorders (NDD-CNVs), and increasingly NDD-CNVs are being identified in patients. There is a clinical need to understand the phenotypes of NDD-CNVs. However due to rarity of NDD-CNVs in the population, within individual countries there is a limited number of NDD-CNV carriers who can participate in research. The pan-european MINDDS (Maximizing Impact of Research in Neurodevelopmental Disorders) consortium was established in part to address this issue. Methodology A survey was developed to scope out the current landscape of NDD-CNV research across member countries of the MINDDS consortium, and to identify clinical cohorts with potential for future research. Results 36 centres from across 16 countries completed the survey. We provide a list of centres who can be contacted for future collaborations. 3844 NDD-CNV carriers were identified across clinical and research centres spanning a range of medical specialties, including psychiatry, paediatrics, medical genetics. A broad range of phenotypic data was available; including medical history, developmental history, family history and anthropometric data. In 12/16 countries, over 75% of NDD-CNV carriers could be recontacted for future studies. Conclusion This survey has highlighted the potential within Europe for large multi-centre studies of NDD-CNV carriers, to improve knowledge of the complex relationship between NDD-CNV and clinical phenotype. The MINNDS consortium is in a position to facilitate collaboration, data-sharing and knowledge exchange on NDD-CNV phenotypes across Europe

The POEMMA (Probe of Extreme Multi-Messenger Astrophysics) mission

The Probe Of Extreme Multi-Messenger Astrophysics (POEMMA) is designed to observe cosmic neutrinos (CNs) above 20 PeV and ultra-high energy cosmic rays (UHECRs) above 20 EeV over the full sky. The POEMMA mission calls for two identical satellites flying in loose formation, each comprised of a 4-meter wide field-of-view (45 degrees) Schmidt photometer. The hybrid focal surface includes a fast (1 ${\mu}$s) ultraviolet camera for fluorescence observations and an ultrafast (10 ns) optical camera for Cherenkov observations. POEMMA will provide new multi-messenger windows onto the most energetic events in the universe, enabling the study of new astrophysics and particle physics at these otherwise inaccessible energies.Comment: 8 pages, 6 figures, presented in 36th International Cosmic Ray Conference (Madison). arXiv admin note: substantial text overlap with arXiv:1907.0621

Characterization of Changes in Serum Anti-Glycan Antibodies in Crohn's Disease – a Longitudinal Analysis

INTRODUCTION: Anti-glycan antibodies are a promising tool for differential diagnosis and disease stratification of patients with Crohn's disease (CD). We longitudinally assessed level and status changes of anti-glycan antibodies over time in individual CD patients as well as determinants of this phenomenon. METHODS: 859 serum samples derived from a cohort of 253 inflammatory bowel disease (IBD) patients (207 CD, 46 ulcerative colitis (UC)) were tested for the presence of anti-laminarin (Anti-L), anti-chitin (Anti-C), anti-chitobioside (ACCA), anti-laminaribioside (ALCA), anti-mannobioside (AMCA) and anti-Saccharomyces cerevisiae (gASCA) antibodies by ELISA. All patients had at least two and up to eleven serum samples taken during the disease course. RESULTS: Median follow-up time for CD was 17.4 months (Interquartile range (IQR) 8.0, 31.6 months) and for UC 10.9 months (IQR 4.9, 21.0 months). In a subgroup of CD subjects marked changes in the overall immune response (quartile sum score) and levels of individual markers were observed over time. The marker status (positive versus negative) remained widely stable. Neither clinical phenotype nor NOD2 genotype was associated with the observed fluctuations. In a longitudinal analysis neither changes in disease activity nor CD behavior led to alterations in the levels of the glycan markers. The ability of the panel to discriminate CD from UC or its association with CD phenotypes remained stable during follow-up. In the serum of UC patients neither significant level nor status changes were observed. CONCLUSIONS: While the levels of anti-glycan antibodies fluctuate in a subgroup of CD patients the antibody status is widely stable over time