The aetiology of rickets-like lower limb deformities in Malawian children

Summary: Debilitating rickets-like lower limb deformities are common in children throughout the world, particularly in Malawi, Africa where the causes are unknown. We have identified that Blount disease and calcium deficiency rickets are the likely causes of these deformities and propose calcium supplementation as a potential treatment of Malawian rickets. Introduction: Surgical correction of rickets-like lower limb deformities is the most common paediatric operation performed at Beit Cure Orthopaedic Hospital, Malawi. The aim of this study was to investigate the aetiology of these deformities. Methods: Children with a tibio-femoral angle of deformity >20° were enrolled (n = 42, 3.0–15.0 years). Anthropometric and early life and well-being data were collected. Early morning serum and urine samples were collected on the morning of the operation for markers of calcium and phosphate homeostasis. Knee radiographs were obtained, and the children were diagnosed with either Blount (BD, n = 22) or evidence of rickets disease (RD, n = 20). As BD is a mechanical rather than metabolic disease, BD were assumed to be biochemically representative of the local population and thus used as a local reference for RD. Results: There were no differences in anthropometry or early life experiences between BD and RD. Parathyroid hormone (PTH), 1,25-dihydroxyvitamin D, total alkaline phosphatase and urinary phosphate were significantly higher and serum phosphate, 25-hydroxyvitamin D (25OHD) and tubular maximal reabsorption of phosphate significantly lower in RD than BD. There was no difference in serum calcium, fibroblast growth factor 23 or markers of iron status between groups. All children had 25OHD > 25 nmol/L. Conclusions: Vitamin D deficiency is not implicated in the aetiology of RD or BD in Malawian children. The cause of RD in Malawi is likely to be dietary calcium deficiency leading to elevated PTH resulting in increased losses of phosphate from the bone and glomerular filtrate. The causes of BD remain unclear; there was no evidence in support of previously suggested risk factors such as being overweight or starting to walk early. Prior to surgical intervention, supplementation with calcium should be considered for children with RD

Genital tract abnormalities among female sex workers who douche with Lemon/Lime juice in Nigeria

Vaginal douche products have been associated with cervical cancer. We examined female sex workers (FSWs) in Nigeria who douche with lemon or lime juice and compared the findings with that of nonusers. We obtained Pap smears and performed colposcopy of the vulva, vagina and cervix. A total of 374 FSWs comprising 81 Lemon users (LUs) and 293 non lemon users (NLUs) were examined. Their mean age was 27.8 ± 6.7 (range 16-63) years. At colposcopy, 17(4.5%) had genital warts [LUs 5(6.2%); NLUs 12(4.1%); p=0.43], 61(16.3%) had suspectedsquamous intraepithelial lesions (SILs) [LUs 17(21.0%); NLUs 44(15.0%); p=0.20] and 65(17.4%) had other findings. Pap smear cytology showed that 87(24.6%) had SILs [LUs 26(33.3%); NLUs 61(22.1%); p=0.03]. Lemon/lime use was associated with cervical dysplasia after controlling for HIV status (Adjusted OR=1.8; 95% CI,1.0-3.0). Our data suggests an association between the practice of douching with citrus juice and cervical dysplasia (Afr J Reprod Health 2009; 13[1]:37-45)

Universal Heat Conduction in YBa_2Cu_3O_6.9

The thermal conductivity of YBa_2Cu_3O_6.9 was measured at low temperatures in untwinned single crystals with concentrations of Zn impurities from 0 to 3% of Cu. A linear term kappa_0/T = 0.19 mW/K^2.cm is clearly resolved as T -> 0, and found to be virtually independent of Zn concentration. The existence of this residual normal fluid strongly validates the basic theory of transport in unconventional superconductors. Moreover, the observed universal behavior is in quantitative agreement with calculations for a gap function of d-wave symmetry.Comment: Latex file, 4 pages, 3 EPS figures, to appear in Physical Review Letter

Thermal conductivity of Mg-doped CuGeO_3 at very low temperatures: Heat conduction by antiferromagnetic magnons

Thermal conductivity \kappa is measured at very low temperatures down to 0.28 K for pure and Mg-doped CuGeO_3 single crystals. The doped samples carry larger amount of heat than the pure sample at the lowest temperature. This is because antiferromagnetic magnons appear in the doped samples and are responsible for the additional heat conductivity, while \kappa of the pure sample represents phonon conductivity at such low temperatures. The maximum energy of the magnon is estimated to be much lower than the spin-Peierls-gap energy. The result presents the first example that \kappa at very low temperatures probes the magnon transport in disorder-induced antiferromagnetic phase of spin-gap systems

Low-temperature electronic heat transport in La_{2-x}Sr_{x}CuO_{4} single crystals: Unusual low-energy physics in the normal and superconducting states

The thermal conductivity \kappa is measured in a series of La_{2-x}Sr_{x}CuO_{4} (x = 0 - 0.22) single crystals down to 90 mK to elucidate the evolution of the residual electronic thermal conductivity \kappa_{res}, which probes the extended quasiparticle states in the d-wave gap. We found that \kappa_{res}/T grows smoothly, except for a 1/8 anomaly, above x = 0.05 and shows no discontinuity at optimum doping, indicating that the behavior of \kappa_{res}/T is not governed by the metal-insulator crossover in the normal state; as a result, \kappa_{res}/T is much larger than what the normal-state resistivity would suggest in the underdoped region, which highlights the peculiarities in the low-energy physics in the cuprates.Comment: 5 pages, 3 figures, final version published in PRL. Discussions have been modified and an analysis of the phonon term has been adde

Absence of residual quasiparticle conductivity in the underdoped cuprate YBa2Cu4O8

We report here measurements of the in-plane thermal conductivity K(T) of the underdoped cuprate YBa2Cu4O8 (Y124) below 1K. K(T) is shown to follow a simple, phononic T^3 dependence at the lowest temperatures for both current directions, with a negligible linear, quasiparticle contribution. This observation is in marked contrast with behavior reported in optimally doped cuprates, and implies that extended zero-energy (or low energy) low-energy quasiparticles are absent in YBa2Cu4O8 at low temperatures.Comment: RevTex, 4 pages, 2 figures, Revised versio

The Local Role in Homeland Security

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73848/1/j.1540-5893.2005.00236.x.pd

Breakdown of Fermi-liquid theory in a cuprate superconductor

The behaviour of electrons in solids is remarkably well described by Landau's Fermi-liquid theory, which says that even though electrons in a metal interact they can still be treated as well-defined fermions, called ``quasiparticles''. At low temperature, the ability of quasiparticles to transport heat is strictly given by their ability to transport charge, via a universal relation known as the Wiedemann-Franz law, which no material in nature has been known to violate. High-temperature superconductors have long been thought to fall outside the realm of Fermi-liquid theory, as suggested by several anomalous properties, but this has yet to be shown conclusively. Here we report on the first experimental test of the Wiedemann-Franz law in a cuprate superconductor, (Pr,Ce)$_2$CuO$_4$. Our study reveals a clear departure from the universal law and provides compelling evidence for the breakdown of Fermi-liquid theory in high-temperature superconductors.Comment: 7 pages, 3 figure

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries.

Vitamin D is an essential nutrient for bone health and may influence the risks of respiratory illness, adverse pregnancy outcomes, and chronic diseases of adulthood. Because many countries have a relatively low supply of foods rich in vitamin D and inadequate exposure to natural ultraviolet B (UVB) radiation from sunlight, an important proportion of the global population is at risk of vitamin D deficiency. There is general agreement that the minimum serum/plasma 25-hydroxyvitamin D concentration (25(OH)D) that protects against vitamin D deficiency-related bone disease is approximately 30 nmol/L; therefore, this threshold is suitable to define vitamin D deficiency in population surveys. However, efforts to assess the vitamin D status of populations in low- and middle-income countries have been hampered by limited availability of population-representative 25(OH)D data, particularly among population subgroups most vulnerable to the skeletal and potential extraskeletal consequences of low vitamin D status, namely exclusively breastfed infants, children, adolescents, pregnant and lactating women, and the elderly. In the absence of 25(OH)D data, identification of communities that would benefit from public health interventions to improve vitamin D status may require proxy indicators of the population risk of vitamin D deficiency, such as the prevalence of rickets or metrics of usual UVB exposure. If a high prevalence of vitamin D deficiency is identified (>20% prevalence of 25(OH)D 1%), food fortification and/or targeted vitamin D supplementation policies can be implemented to reduce the burden of vitamin D deficiency-related conditions in vulnerable populations