Epidemiology of traumatic spinal cord injury in Galicia, Spain: trends over a 20-year period

[Abstract] Study design: Observational study with prospective and retrospective monitoring. Objective: To describe the epidemiological and demographic characteristics of traumatic spinal cord injury (TSCI), and to analyze its epidemiological changes. Setting: Unidad de Lesionados Medulares, Complejo Hospitalario Universitario A Coruña, in Galicia (Spain). Methods: The study included patients with TSCI who had been hospitalized between January 1995 and December 2014. Relevant data were extracted from the admissions registry and electronic health record. Results: A total of 1195 patients with TSCI were admitted over the specified period of time; 76.4% male and 23.6% female. Mean patient age at injury was 50.20 years. Causes of injury were falls (54.2%), traffic accidents (37%), sports/leisure-related accidents (3.5%) and other traumatic causes (5.3%). Mean patient age increased significantly over time (from 46.40 to 56.54 years), and the number of cases of TSCI related to traffic accidents decreased (from 44.5% to 23.7%), whereas those linked to falls increased (from 46.9% to 65.6%). The most commonly affected neurological level was the cervical level (54.9%), increasing in the case of levels C1–C4 over time, and the most frequent ASIA (American Spinal Injury Association) grade was A (44.3%). The crude annual incidence rate was 2.17/100 000 inhabitants, decreasing significantly over time at an annual percentage rate change of −1.4%. Conclusions: The incidence rate of TSCI tends to decline progressively. Mean patient age has increased over time and cervical levels C1–C4 are currently the most commonly affected ones. These epidemiological changes will eventually result in adjustments in the standard model of care for TSCI

Tuberculosis is associated with expansion of a motile, permissive and immunomodulatory CD16(+) monocyte population via the IL-10/STAT3 axis

The human CD14+ monocyte compartment is composed by two subsets based on CD16 expression. We previously reported that this compartment is perturbed in tuberculosis (TB) patients, as reflected by the expansion of CD16+ monocytes along with disease severity. Whether this unbalance is beneficial or detrimental to host defense remains to be elucidated. Here in the context of active TB, we demonstrate that human monocytes are predisposed to differentiate towards an anti-inflammatory (M2-like) macrophage activation program characterized by theCD16+CD163+MerTK+pSTAT3+ phenotype and functional properties such as enhanced protease-dependent motility, pathogen permissivity and immunomodulation. This process is dependent on STAT3 activation, and loss-of-function experiments point towards a detrimental role in host defense against TB. Importantly, we provide a critical correlation between the abundance of the CD16+CD163+MerTK+pSTAT3+ cells and the progression of the disease either at the local level in a non-human primate tuberculous granuloma context, or at the systemic level through the detection of the soluble form of CD163 in human sera. Collectively, this study argues for the pathogenic role of the CD16+CD163+MerTK+pSTAT3+ monocyte-to-macrophage differentiation program and its potential as a target for TB therapy,and promotes the detection of circulating CD163 as a potential biomarker for disease progression and monitoringof treatment efficacy.Fil: Lastrucci, Claire. Centre National de la Recherche Scientifique; FranciaFil: Bénard, Alan. Centre National de la Recherche Scientifique; FranciaFil: Balboa, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Pingris, Karine. Centre National de la Recherche Scientifique; FranciaFil: Souriant, Shanti. Centre National de la Recherche Scientifique; FranciaFil: Poincloux, Renaud. Centre National de la Recherche Scientifique; FranciaFil: Al Saati, Talal. Inserm; FranciaFil: Rasolofo, Voahangy. Pasteur Institute in Antananarivo; MadagascarFil: González Montaner, Pablo. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas ; ArgentinaFil: Inwentarz, Sandra. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas ; ArgentinaFil: Moraña, Eduardo José. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas ; ArgentinaFil: Kondova, Ivanela. Biomedical Primate Research Centre; Países BajosFil: Verreck, Franck A. W.. Biomedical Primate Research Centre; Países BajosFil: Sasiain, María del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Neyrolles, Olivier. Centre National de la Recherche Scientifique; FranciaFil: Maridonneau Parini, Isabel. Centre National de la Recherche Scientifique; FranciaFil: Lugo Villarino, Geanncarlo. Centre National de la Recherche Scientifique; FranciaFil: Cougoule, Celine. Centre National de la Recherche Scientifique; Franci

Managing Carbon

Storing carbon (C) and offsetting carbon dioxide (CO2) emissions with the use of wood for energy, both of which slow emissions of CO2 into the atmosphere, present significant challenges for forest management (IPCC 2001). In the United States, there has been a net increase in C in forests and in harvested wood products stocks (Tables 7.1 and 7.2), a result of historical and recent ecological conditions, management practices, and use of forest products (Birdsey et al. 2006). However, recent projections for the forest sector suggest that annual C storage could begin to decline, and U.S. forests could become a net C emitter of tens to hundreds of Tg C year ¹ within a few decades (USDA FS 2012a). It is therefore urgent to identify effective C management strategies, given the complexity of factors that drive the forest C cycle and the multiple objectives for which forests are managed. An ideal C management activity contributes benefits beyond increasing C storage by achieving other management objectives and providing ecosystem services in a sustainable manner. Strategies for effectively managing forest C stocks and offsetting C emissions requires a thorough understanding of biophysical and social influences on the forest C cycle (Birdsey et al. 1993). Successful policies and incentives may be chosen to support strategies if sufficient knowledge of social processes (e.g., landowner or wood-user response to incentives and markets) is available. For example, if C stocks are expected to decrease owing to decreasing forest land area caused by exurban development, policies or incentives to avoid deforestation in those areas may be effective. If C stocks are expected to decrease owing to the effects of a warmer climate, reducing stand densities may retain C over the long term by increasing resilience to drought and other stressors and by reducing crown fire hazard (Jackson et al. 2005; Reinhardt et al. 2008). Protecting old forests and other forests that have high C stocks may be more effective than seeking C offsets associated with wood use, especially if those forests would recover C more slowly in an altered climate. If climate change increases productivity in a given area over a long period of time, increasing forest C stocks through intensive management and forest products, including biomass energy, may be especially effective. It is equally important to know which strategies might make some management practices unacceptable (e.g., reducing biodiversity). However, no standard evaluation framework exists to aid decision making on alternative management strategies for maximizing C storage while minimizing risks and tradeoffs. Here we discuss (1) where forest C is stored in the United States, (2) how to measure forest C through space and time, (3) effectiveness of various management strategies in reducing atmospheric greenhouse gases (GHG), and (4) effectiveness of incentives, regulations, and institutional arrangements for implementing C management. Understanding of biophysical and social influences on the forest C cycle (Birdsey et al. 1993). Successful policies and incentives may be chosen to support strategies if sufficient knowledge of social processes (e.g., landowner or wood-user response to incentives and markets) is available. For example, if C stocks are expected to decrease owing to decreasing forest land area caused by exurban development, policies or incentives to avoid deforestation in those areas may be effective. If C stocks are expected to decrease owing to the effects of a warmer climate, reducing stand densities may retain C over the long term by increasing resilience to drought and other stressors and by reducing crown fire hazard (Jackson et al. 2005; Reinhardt et al. 2008). Protecting old forests and other forests that have high C stocks may be more effective than seeking C offsets associated with wood use, especially if those forests would recover C more slowly in an altered climate. If climate change increases productivity in a given area over a long period of time, increasing forest C stocks through intensive management and forest products, including biomass energy, may be especially effective. It is equally important to know which strategies might make some management practices unacceptable (e.g., reducing biodiversity). However, no standard evaluation framework exists to aid decision making on alternative management strategies for maximizing C storage while minimizing risks and tradeoffs. Here we discuss (1) where forest C is stored in the United States, (2) how to measure forest C through space and time, (3) effectiveness of various management strategies in reducing atmospheric greenhouse gases (GHG), and (4) effectiveness of incentives, regulations, and institutional arrangements for implementing C management