Clinically aggressive central giant cell granulomas in two patients with neurofibromatosis 1

Background Neurofibromatosis 1 (NF1) is an autosomal dominantly inherited disorder caused by a spectrum of mutations affecting the Nf1 gene. Affected patients develop benign and malignant tumors at an increased frequency. Clinical findings include multiple cutaneous café-au-lait pigmentations, neurofibromas, axillary freckling, optic gliomas, benign iris hamartomas (Lisch nodules), scoliosis, and poorly defined soft tissue lesions of the skeleton. Kerl first reported an association of NF1 with multiple central giant cell granulomas (CGCGs) of the jaws. There have since been 4 additional published cases of NF1 patients with CGCGs of the jaws. Clinical cases We report on 2 patients who presented with NF1 and aggressive CGCGs of the jaws. In both cases, the clinical course was characterized by numerous recurrences despite mechanical curettage and surgical resection. Conclusions We review proposed mechanisms to explain the apparent association between NF1 and an increased incidence of CGCGs of the jaws. While the presence of CGCGs of the jaws in patients with NF1 could represent either a coincidental association or a true genetic linkage, we propose that this phenomenon is most likely related to NF1-mediated osseous dysplasia. Compared to normal bone, the Nf1-haploinsufficient bone in a patient with NF1 may be less able to remodel in response to as of yet unidentified stimuli (e.g. excessive mechanical stress and/or vascular fragility), and consequently may be more susceptible to developing CGCG-like lesions. Alternatively, the CGCG in NF1 patients could represent a true neoplasm, resulting from additional, as of yet unidentified, genetic alterations to Nf1-haploinsufficient bone

Lightcone reference for total gravitational energy

We give an explicit expression for gravitational energy, written solely in terms of physical spacetime geometry, which in suitable limits agrees with the total Arnowitt-Deser-Misner and Trautman-Bondi-Sachs energies for asymptotically flat spacetimes and with the Abbot-Deser energy for asymptotically anti-de Sitter spacetimes. Our expression is a boundary value of the standard gravitational Hamiltonian. Moreover, although it stands alone as such, we derive the expression by picking the zero-point of energy via a ``lightcone reference.''Comment: latex, 7 pages, no figures. Uses an amstex symbo

Energy of Isolated Systems at Retarded Times as the Null Limit of Quasilocal Energy

We define the energy of a perfectly isolated system at a given retarded time as the suitable null limit of the quasilocal energy $E$. The result coincides with the Bondi-Sachs mass. Our $E$ is the lapse-unity shift-zero boundary value of the gravitational Hamiltonian appropriate for the partial system $\Sigma$ contained within a finite topologically spherical boundary $B = \partial \Sigma$. Moreover, we show that with an arbitrary lapse and zero shift the same null limit of the Hamiltonian defines a physically meaningful element in the space dual to supertranslations. This result is specialized to yield an expression for the full Bondi-Sachs four-momentum in terms of Hamiltonian values.Comment: REVTEX, 16 pages, 1 figur

A correlation of the cosmic microwave sky with large scale structure

We cross correlate the large-scale cosmic microwave background (CMB) sky measured by WMAP with two probes of large-scale structure at z ~ 1. The hard X-ray background, measured by the HEAO-1 satellite, is positively correlated with the WMAP data at the 2.5-3.0 sigma level. The number counts of radio galaxies in the NVSS survey are also correlated at a slightly weaker level (2.-2.5 sigma). These correlations appear to arise from both hemispheres on the sky and are resilient to changes in the levels of masking of the Galaxy and point sources, suggesting that foregrounds are not responsible for the signal. The implication is that some of the observed CMB fluctuations arise at low redshifts. The level of the correlations is consistent with that expected for the cosmological constant (Omega_Lambda = 0.72) concordance model resulting from the integrated Sachs-Wolfe effect. Thus, we may be observing dark energy's effect on the growth of structure.Comment: 8 pages, 3 postscript figure

Mosquito Abundance, Bed net Coverage and Other Factors Associated with Variations in Sporozoite Infectivity Rates in Four Villages of Rural Tanzania.

Entomological surveys are of great importance in decision-making processes regarding malaria control strategies because they help to identify associations between vector abundance both species-specific ecology and disease intervention factors associated with malaria transmission. Sporozoite infectivity rates, mosquito host blood meal source, bed net coverage and mosquito abundance were assessed in this study. A longitudinal survey was conducted in four villages in two regions of Tanzania. Malaria vectors were sampled using the CDC light trap and pyrethrum spray catch methods. In each village, ten paired houses were selected for mosquitoes sampling. Sampling was done in fortnight case and study was undertaken for six months in both Kilimanjaro (Northern Tanzania) and Dodoma (Central Tanzania) regions. A total of 6,883 mosquitoes were collected including: 5,628 (81.8%) Anopheles arabiensis, 1,100 (15.9%) Culex quinquefasciatus, 89 (1.4%) Anopheles funestus, and 66 (0.9%) Anopheles gambiae s.s. Of the total mosquitoes collected 3,861 were captured by CDC light trap and 3,022 by the pyrethrum spray catch method. The overall light trap: spray catch ratio was 1.3:1. Mosquito densities per room were 96.5 and 75.5 for light trap and pyrethrum spray catch respectively. Mosquito infectivity rates between villages that have high proportion of bed net owners and those without bed nets was significant (P < 0.001) and there was a significant difference in sporozoite rates between households with and without bed nets in these four villages (P < 0.001). Malaria remains a major problem in the study areas characterized as low transmission sites. Further studies are required to establish the annual entomological inoculation rates and to observe the annual parasitaemia dynamics in these communities. Outdoor mosquitoes collection should also be considered

Prospects for Advancing Tuberculosis Control Efforts through Novel Therapies

BACKGROUND: Development of new, effective, and affordable tuberculosis (TB) therapies has been identified as a critical priority for global TB control. As new candidates emerge from the global TB drug pipeline, the potential impacts of novel, shorter regimens on TB incidence and mortality have not yet been examined. METHODS AND FINDINGS: We used a mathematical model of TB to evaluate the expected benefits of shortening the duration of effective chemotherapy for active pulmonary TB. First, we considered general relationships between treatment duration and TB dynamics. Next, as a specific example, we calibrated the model to reflect the current situation in the South-East Asia region. We found that even with continued and rapid progress in scaling up the World Health Organization's DOTS strategy of directly observed, short-course chemotherapy, the benefits of reducing treatment duration would be substantial. Compared to a baseline of continuing DOTS coverage at current levels, and with currently available tools, a 2-mo regimen introduced by 2012 could prevent around 20% (range 13%–28%) of new cases and 25% (range 19%–29%) of TB deaths in South-East Asia between 2012 and 2030. If effective treatment with existing drugs expands rapidly, overall incremental benefits of shorter regimens would be lower, but would remain considerable (13% [range 8%–19%] and 19% [range 15%–23%] reductions in incidence and mortality, respectively, between 2012 and 2030). A ten-year delay in the introduction of new drugs would erase nearly three-fourths of the total expected benefits in this region through 2030. CONCLUSIONS: The introduction of new, shorter treatment regimens could dramatically accelerate the reductions in TB incidence and mortality that are expected under current regimens—with up to 2- or 3-fold increases in rates of decline if shorter regimens are accompanied by enhanced case detection. Continued progress in reducing the global TB burden will require a balanced approach to pursuing new technologies while promoting wider implementation of proven strategies

Outer-Sphere Contributions to the Electronic Structure of Type Zero Copper Proteins

Bioinorganic canon states that active-site thiolate coordination promotes rapid electron transfer (ET) to and from type 1 copper proteins. In recent work, we have found that copper ET sites in proteins also can be constructed without thiolate ligation (called “type zero” sites). Here we report multifrequency electron paramagnetic resonance (EPR), magnetic circular dichroism (MCD), and nuclear magnetic resonance (NMR) spectroscopic data together with density functional theory (DFT) and spectroscopy-oriented configuration interaction (SORCI) calculations for type zero Pseudomonas aeruginosa azurin variants. Wild-type (type 1) and type zero copper centers experience virtually identical ligand fields. Moreover, O-donor covalency is enhanced in type zero centers relative that in the C112D (type 2) protein. At the same time, N-donor covalency is reduced in a similar fashion to type 1 centers. QM/MM and SORCI calculations show that the electronic structures of type zero and type 2 are intimately linked to the orientation and coordination mode of the carboxylate ligand, which in turn is influenced by outer-sphere hydrogen bonding

Markets and marketing research on poverty and its alleviation: Summarizing an evolving logic toward human capabilities, well-being goals and transformation

Marketing practitioners and business scholars now view some of the world’s poorest communities as profitable growth markets. Hence a market-based approach to poverty alleviation has gathered momentum. This article traces the evolution of such a market-based approach over four decades and highlights a gradual trend away from a deficit-reduction approach (focused on constraints and justice) towards an opportunity-expansion approach (focused on capabilities and well-being). This trend is summarized in an analytical framework of human capabilities, well-being goals and transformative impact evolved from the literature. The framework is then used to analyse the practice of sanitation marketing, which has emerged as a key method in one of the highest priority domains in international development discourse – sanitation. The article concludes with a discussion of how contemporary work can further take forward the key tenets of the framework and guide the development of ‘good markets’ for the poor