Growth characteristics in individuals with osteogenesis imperfecta in North America: results from a multicenter study.

PurposeOsteogenesis imperfecta (OI) predisposes people to recurrent fractures, bone deformities, and short stature. There is a lack of large-scale systematic studies that have investigated growth parameters in OI.MethodsUsing data from the Linked Clinical Research Centers, we compared height, growth velocity, weight, and body mass index (BMI) in 552 individuals with OI. Height, weight, and BMI were plotted on Centers for Disease Control and Prevention normative curves.ResultsIn children, the median z-scores for height in OI types I, III, and IV were -0.66, -6.91, and -2.79, respectively. Growth velocity was diminished in OI types III and IV. The median z-score for weight in children with OI type III was -4.55. The median z-scores for BMI in children with OI types I, III, and IV were 0.10, 0.91, and 0.67, respectively. Generalized linear model analyses demonstrated that the height z-score was positively correlated with the severity of the OI subtype (P < 0.001), age, bisphosphonate use, and rodding (P < 0.05).ConclusionFrom the largest cohort of individuals with OI, we provide median values for height, weight, and BMI z-scores that can aid the evaluation of overall growth in the clinic setting. This study is an important first step in the generation of OI-specific growth curves

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Salinity Contributions from Geothermal Waters to the Rio Grande and Shallow Aquifer System in the Transboundary Mesilla (United States)/Conejos-Médanos (Mexico) Basin

Freshwater scarcity has raised concerns about the long-term availability of the water supplies within the transboundary Mesilla (United States)/Conejos-Médanos (Mexico) Basin in Texas, New Mexico, and Chihuahua. Analysis of legacy temperature data and groundwater flux estimates indicates that the region’s known geothermal systems may contribute more than 45,000 tons of dissolved solids per year to the shallow aquifer system, with around 8500 tons of dissolved solids being delivered from localized groundwater upflow zones within those geothermal systems. If this salinity flux is steady and eventually flows into the Rio Grande, it could account for 22% of the typical average annual cumulative Rio Grande salinity that leaves the basin each year—this salinity proportion could be much greater in times of low streamflow. Regional water level mapping indicates upwelling brackish waters flow towards the Rio Grande and the southern part of the Mesilla portion of the basin with some water intercepted by wells in Las Cruces and northern Chihuahua. Upwelling waters ascend from depths greater than 1 km with focused flow along fault zones, uplifted bedrock, and/or fractured igneous intrusions. Overall, this work demonstrates the utility of using heat as a groundwater tracer to identify salinity sources and further informs stakeholders on the presence of several brackish upflow zones that could notably degrade the quality of international water supplies in this developed drought-stricken region

Salinity Contributions from Geothermal Waters to the Rio Grande and Shallow Aquifer System in the Transboundary Mesilla (United States)/Conejos-Médanos (Mexico) Basin

Freshwater scarcity has raised concerns about the long-term availability of the water supplies within the transboundary Mesilla (United States)/Conejos-Médanos (Mexico) Basin in Texas, New Mexico, and Chihuahua. Analysis of legacy temperature data and groundwater flux estimates indicates that the region’s known geothermal systems may contribute more than 45,000 tons of dissolved solids per year to the shallow aquifer system, with around 8500 tons of dissolved solids being delivered from localized groundwater upflow zones within those geothermal systems. If this salinity flux is steady and eventually flows into the Rio Grande, it could account for 22% of the typical average annual cumulative Rio Grande salinity that leaves the basin each year—this salinity proportion could be much greater in times of low streamflow. Regional water level mapping indicates upwelling brackish waters flow towards the Rio Grande and the southern part of the Mesilla portion of the basin with some water intercepted by wells in Las Cruces and northern Chihuahua. Upwelling waters ascend from depths greater than 1 km with focused flow along fault zones, uplifted bedrock, and/or fractured igneous intrusions. Overall, this work demonstrates the utility of using heat as a groundwater tracer to identify salinity sources and further informs stakeholders on the presence of several brackish upflow zones that could notably degrade the quality of international water supplies in this developed drought-stricken region

Adherence in children using positive airway pressure therapy: a big-data analysis.

BackgroundPositive airway pressure (PAP) has become a prominent treatment for children with sleep-disordered breathing. However, there are no large-scale studies to clarify whether PAP is well tolerated in children, and which factors are associated with better adherence to PAP therapy. In this study, we aimed to clarify adherence patterns of PAP therapy in a large paediatric population.MethodsWe did a cross-sectional big-data analysis in children from Oct 1, 2014, to Aug 1, 2018, using existing data derived from PAP devices uploaded nightly in the AirView cloud database. The AirView database is a usage tracking system available to all patients who are assigned PAP therapy, which requires consent from the patient or parent or guardian. All patients older than 4 years and younger than 18 years who used continuous or automated PAP devices were evaluated. Only patients living in the USA and enrolled with a single insurance company were included. If patients were participating in an engagement programme, programme onset must have been within 7 days of therapy onset. Our primary outcome was the proportion of patients who used PAP continuously over 90 days. The primary outcome was assessed in all patients who met the age inclusion criterion and had reliable age data available. Data on missing PAP use were imputed as zero, but data on other metrics were not imputed and excluded from analysis.FindingsWe used data recorded from Oct 1, 2014, to Aug 1, 2018. Of 40 140 children screened, 36 058 (89·8%) were US residents and 20 553 (90·1%) of them met the eligibility criteria and had accessible data (mean age 13·0 years [SD 3·7]). On the basis of 90 days of monitoring data, 12 699 (61·8%) patients continuously used PAP. Factors significantly associated with adherence included age group, residual apnoea-hypopnoea index, use and onset of patient engagement programmes, PAP pressure, and nightly median PAP mask leak, all over the 90-day study period.InterpretationTo our knowledge, our study represents the largest analysis of children using PAP therapy to date. The findings suggest that adherence to PAP therapy is lower than in previous reports from adults. However, numerous actionable factors were associated with improvements in adherence and should be used strategically in clinical decision making to improve PAP adherence in children.FundingResMed

Adherence in children using positive airway pressure therapy: a big-data analysis.

BackgroundPositive airway pressure (PAP) has become a prominent treatment for children with sleep-disordered breathing. However, there are no large-scale studies to clarify whether PAP is well tolerated in children, and which factors are associated with better adherence to PAP therapy. In this study, we aimed to clarify adherence patterns of PAP therapy in a large paediatric population.MethodsWe did a cross-sectional big-data analysis in children from Oct 1, 2014, to Aug 1, 2018, using existing data derived from PAP devices uploaded nightly in the AirView cloud database. The AirView database is a usage tracking system available to all patients who are assigned PAP therapy, which requires consent from the patient or parent or guardian. All patients older than 4 years and younger than 18 years who used continuous or automated PAP devices were evaluated. Only patients living in the USA and enrolled with a single insurance company were included. If patients were participating in an engagement programme, programme onset must have been within 7 days of therapy onset. Our primary outcome was the proportion of patients who used PAP continuously over 90 days. The primary outcome was assessed in all patients who met the age inclusion criterion and had reliable age data available. Data on missing PAP use were imputed as zero, but data on other metrics were not imputed and excluded from analysis.FindingsWe used data recorded from Oct 1, 2014, to Aug 1, 2018. Of 40 140 children screened, 36 058 (89·8%) were US residents and 20 553 (90·1%) of them met the eligibility criteria and had accessible data (mean age 13·0 years [SD 3·7]). On the basis of 90 days of monitoring data, 12 699 (61·8%) patients continuously used PAP. Factors significantly associated with adherence included age group, residual apnoea-hypopnoea index, use and onset of patient engagement programmes, PAP pressure, and nightly median PAP mask leak, all over the 90-day study period.InterpretationTo our knowledge, our study represents the largest analysis of children using PAP therapy to date. The findings suggest that adherence to PAP therapy is lower than in previous reports from adults. However, numerous actionable factors were associated with improvements in adherence and should be used strategically in clinical decision making to improve PAP adherence in children.FundingResMed

Exploring the Potential Linkages Between Oil-Field Brine Reinjection, Crystalline Basement Permeability, and Triggered Seismicity for the Dagger Draw Oil Field, Southeastern New Mexico, USA, Using Hydrologic Modeling

We used hydrologic models to explore the potential linkages between oil-field brine reinjection and increases in earthquake frequency (up to Md 3.26) in southeastern New Mexico and to assess different injection management scenarios aimed at reducing the risk of triggered seismicity. Our analysis focuses on saline water reinjection into the basal Ellenburger Group beneath the Dagger Draw Oil field, Permian Basin. Increased seismic frequency (\u3eMd 2) began in 2001, 5 years after peak injection, at an average depth of 11 km within the basement 15 km to the west of the reinjection wells. We considered several scenarios including assigning an effective or bulk permeability value to the crystalline basement, including a conductive fault zone surrounded by tighter crystalline basement rocks, and allowing permeability to decay with depth. We initially adopted a 7 m (0.07 MPa) head increase as the threshold for triggered seismicity. Only two scenarios produced excess heads of 7m five years after peak injection. In the first, a hydraulic diffusivity of 0.1 m2s-1 was assigned to the crystalline basement. In the second, a hydraulic diffusivity of 0.3 m2s-1 was assigned to a conductive fault zone. If we had considered a wider range of threshold excess heads to be between 1 and 60m, then the range of acceptable hydraulic diffusivities would have increased (between 0.1-0.01 m2s-1 and 1-0.1 m2s-1 for the bulk and fault zone scenarios, respectively). A permeability–depth decay model would have also satisfied the 5-year time lag criterion. We also tested several injection management scenarios including redistributing injection volumes between various wells and lowering the total volume of injected fluids. Scenarios that reduced computed excess heads by over 50% within the crystalline basement resulted from reducing the total volume of reinjected fluids by a factor of 2 or more

Mesilla/Conejos-Médanos Basin: U.S.-Mexico Transboundary Water Resources

Synthesizing binational data to characterize shared water resources is critical to informing binational management. This work uses binational hydrogeology and water resource data in the Mesilla/Conejos-Médanos Basin (Basin) to describe the hydrologic conceptual model and identify potential research that could help inform sustainable management. The Basin aquifer is primarily composed of continuous basin-fill Santa Fe Group sediments, allowing for transboundary through flow. Groundwater flow, however, may be partially or fully restricted by intrabasin uplifts and limited recharg

Growth characteristics in individuals with osteogenesis imperfecta in North America: results from a multicenter study

© 2018, American College of Medical Genetics and Genomics. Purpose: Osteogenesis imperfecta (OI) predisposes people to recurrent fractures, bone deformities, and short stature. There is a lack of large-scale systematic studies that have investigated growth parameters in OI. Methods: Using data from the Linked Clinical Research Centers, we compared height, growth velocity, weight, and body mass index (BMI) in 552 individuals with OI. Height, weight, and BMI were plotted on Centers for Disease Control and Prevention normative curves. Results: In children, the median z-scores for height in OI types I, III, and IV were −0.66, −6.91, and −2.79, respectively. Growth velocity was diminished in OI types III and IV. The median z-score for weight in children with OI type III was −4.55. The median z-scores for BMI in children with OI types I, III, and IV were 0.10, 0.91, and 0.67, respectively. Generalized linear model analyses demonstrated that the height z-score was positively correlated with the severity of the OI subtype (P \u3c 0.001), age, bisphosphonate use, and rodding (P \u3c 0.05). Conclusion: From the largest cohort of individuals with OI, we provide median values for height, weight, and BMI z-scores that can aid the evaluation of overall growth in the clinic setting. This study is an important first step in the generation of OI-specific growth curves