Avalanche defences for Flateyri, Iceland. From hazard evaluation to construction of defences.

The village of Flateyri was hit by two major avalanches in 1995, with the latter one killing 20 of the 45 people caught in it. These, together with the catastrophic avalanche in the nearby Súôavík in January the same year, initiated a complete review of all government actions and regulations regarding avalanche risk and avalanche defences in Iceland. The government set a long term goal for the acceptable risk to people living in avalanche prone areas and increased funding for the construction of avalanche defences. The avalanche situation in Flateyri is quite serious and the risk the inhabitants live with is very high. The town is threatened by avalanches from two gullies, Innra-Bæjargil in the north-west and Skollahvilft in the north-east, with several records of avalanches reaching well into the present residential area. To fulfil the safety requirements, an appraisal study was carried out and a proposal made for avalanche defences for the community, consisting of two earthfill deflecting dams and an earthfill catching dam. The proposal was accepted by the local authorities and the Icelandic government in the spring of 1996, design work was carried out in that summer and construction work started in September 1996. The construction of the dams is now close to completion, two years after the accident

The avalanche situation in Neskaupstadur, Iceland : A preliminary defensive plan

The avalanche situation in the town of Neskaupstaôur is rather unique and in many respects more difficult than in any other place in Iceland. The avalanche risk is high in a large portion of the 2,7 km long residential area, with similar snow accumulation conditions throughout the entire area. Additionally, conditions for the construction of avalanche defences are rather difficult. The avalanche starting zones are extensive and many of these have difficult geological conditions. The uppermost houses are located close to the mountain, with limited space to construct avalanche defences above them, especially in the western part of the town. After the avalanche accidents in Súàavík and Flateyri in 1995 the Icelandic government has set a long term goal for the acceptable risk to people living in avalanche prone areas. To fulfil this goal, a risk analysis has to be made in connection with avalanche defence planning. The risk analysis for Neskaupstaôur indicates that the risk level is far above the acceptable limits in certain parts of the town. To improve the situation, a preliminary protection plan has been set up for the whole town. The plan is based on a combination of supporting structures, deflecting dams, catching dams and breaking mounds

Inclusion of fish or fish oil in weight-loss diets for young adults: effects on blood lipids.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOBJECTIVE: To assess the effects of fish (lean or oily) and fish oil consumption on blood lipid concentration during weight loss. DESIGN: Randomized, controlled 8-week trial of energy-restricted diet varying in fish and fish oil content. Subjects, 324 men and women, aged 20-40 years, body mass index 27.5-32.5 kg m(-2), from Iceland, Spain and Ireland, were randomized to one of four groups: (1) control (sunflower oil capsules, no seafood), (2) cod diet (3 x 150 g week(-1)), (3) salmon diet (3 x 150 g week(-1)), (4) fish oil (DHA/EPA capsules, no seafood). The macronutrient composition of the diets was similar between the groups and the capsule groups were single-blinded. MEASUREMENTS: Total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein cholesterol, triacylglycerol (TG) and anthropometrics were measured at baseline and end point. RESULTS: The difference in logTG lowering between the control group and the cod diet, salmon diet and fish oil from baseline to end point was -0.036 (95% CI -0.079 to 0.006), -0.060 (-0.101 to -0.018) and -0.037 (-0.079 to 0.006), respectively. Reduction in TC was about 0.2 mmol l(-1) greater in the fish groups (cod and salmon) than in the control group, but only of borderline significance when adjusting for weight loss. HDL tended to decrease less in the diet groups consuming a significant amount of n-3 fatty acids (salmon and fish oil). CONCLUSION: Weight-loss diet including oily fish resulted in greater TG reduction than did a diet without fish or fish oil. Controlled trials using whole fish as a test meal are encouraged to be able to elucidate the role of different constituents of fish for human health

The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

Jonas G Halldorsson1, Kjell M Flekkoy2, Gudmundur B Arnkelsson3, Kristinn Tomasson4, Kristinn R Gudmundsson5, Eirikur Orn Arnarson1,61Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; 2Department of Psychology, University of Oslo, and Department of Geriatric Medicine, Ulleval University Hospital, Oslo, Norway; 3Department of Psychology, University of Iceland, Reykjavik, Iceland; 4Administration of Occupational Safety and Health, Reykjavik, Iceland; 5Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; 6Faculty of Medicine, University of Iceland, Reykjavik, IcelandAims: To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later.Methods: Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent.Results: Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms.Conclusions: Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity.Keywords: follow-up, pediatric, symptoms, traumatic head injur

Karahnjukar dam spillway: Comparison of operational data and results from hydraulic modelling

The Karahnjukar dam spillway is the spillway for the Halslon reservoir, the main reservoir for the 690 MW Karahnjukar Hydroelectric Project in East Iceland. The spillway consist of a 140 m long overflowing weir with a capacity of 2250 m3/s which discharges into a side channel, followed by a 450 m long chute. The chute terminates at a canyon edge where the jet drops some 100 m into a narrow gorge downstream of the Karahnjukar dam. During the design phase of the project, the flow conditions in the spillway were modelled in the hydraulic model tests in 1:45 scale model at the Laboratory for Hydraulics, Hydrology and Glaciology (VAW) of ETH Zurich. The power plant went into operation in 2008 and since then considerable experience has been obtained from operation of the spillway. In particular, flow depths and air discharge measurements have been obtained during spilling periods. In this paper, these measurements are presented and compared with results from the hydraulic model tests. In particular, flow depths are discussed as well as aeration effectiveness

How Do Bone Marrow Lesions Cause Osteoarthritis Pain? a Structural and Functional Tissue-Based Study

Background/Purpose: Susceptibility to ankylosing spondylitis (AS) is primarily genetic; thus far 113 susceptibility variants for AS have been identified. However, most of the AS associated SNPs do not directly affect protein-coding genes. Studies of disease- and trait-associated SNPs suggest they may act by affecting gene regulatory regions in specific cell types or tissues. Therefore, identifying the AS relevant cell types is crucial for further mechanistic studies. Methods: We applied several bioinformatics methods to utilize epigenetic, gene and protein expression information to identify the primary relevant cell types through which genetic variants associated with AS operate. In total, there are 113 AS associated loci; 39 of them show genome-wide significance in AS-only analyses, whereas the remainder are genome-wide significant in analyses leveraging pleiotrophy with other related diseases (Crohn’s disease (CD), psoriasis, primary sclerosing cholangitis (PSC) and ulcerative colitis (UC))1. Results: AS-associated SNPs are disproportionately found in regions bearing epigenetic marks indicating transcriptional activity found in immune cell types including monocytes, CD4+ and CD8+ T cells, NK cells, regulatory T cells, and B cells. Gene expression studies showed enrichment of AS associated loci in genes specifically expressed in monocytes and NK cells while protein expression study shows protein products of AS associated loci were significantly enriched in CD8+ T cells. Epigenetic analyses also showed evidence that AS-associated signals operate in gut cell types including in mucosa from the small intestine, sigmoid colon and rectum. These findings particularly relate to pleiotropic loci also associated with IBD, psoriasis, and PSC. Conclusion: These findings highlight the role of key immune cell types in the mechanism by which genetic associations with AS drive the disease, as well as providing further evidence for the involvement of the gut in the pathogenesis of AS. 1Ellinghaus D. at al, Nature Genetics 201

Concurrent acute myeloid leukemia and T lymphoblastic lymphoma in a patient with rearranged PDGFRB genes

Concurrent hematologic malignancies are relatively rare. We encountered a case of concurrent acute myeloid leukemia (AML) and T lymphoblastic lymphoma. The bone marrow chromosome analysis showed the karyotype 46, XY, t(5;12)(q33;p13), which indicated presence of PDGFRB gene translocations. Therefore, this disease belongs to the new WHO category of myeloid and lymphoid neoplasms with abnormalities in PDGFRA, PDGFRB and FGFR1 genes. Although such genetic mutations are prone to multi-lineage differentiation, the present case is in fact the first report of concurrent AML and T lymphoblastic lymphoma involving PDGFRB mutations. The patient was treated with cytarabine and daunomycin in combination with high dose dexamethasone. Allogeneic stem cell transplantation was performed after successful remission induction for both entities. The patient eventually died of chronic graft-versus-host-disease related infection. Based on such an experience, we suggest the decision of stem cell transplantation should be weighed carefully against the risks, especially when tyrosine kinase inhibitors are safe and potentially effective in dealing with such entities

Serum Biomarkers of Disease Activity in Longitudinal Assessment of Patients with ANCA-Associated Vasculitis

OBJECTIVE: Improved biomarkers of current disease activity and prediction of relapse are needed in antineutrophil cytoplasmic antibody–associated vasculitis (AAV). For clinical relevance, biomarkers must perform well longitudinally in patients on treatment and in patients with nonsevere flares. METHODS: Twenty‐two proteins were measured in 347 serum samples from 74 patients with AAV enrolled in a clinical trial. Samples were collected at Month 6 after remission induction, then every 3 months until Month 18, or at the time of flare. Associations of protein concentrations with concurrent disease activity and with future flare were analyzed using mixed‐effects models, Cox proportional hazards models, and conditional logistic regression. RESULTS: Forty‐two patients had flares during the 12‐month follow‐up period, and 32 remained in remission. Twenty‐two patients had severe flares. Six experimental markers (CXCL13, IL‐6, IL‐8, IL‐15, IL‐18BP, and matrix metalloproteinase‐3 [MMP‐3]) and ESR were associated with disease activity using all three methods (P < 0.05, with P < 0.01 in at least one method). A rise in IL‐8, IL‐15, or IL‐18BP was associated temporally with flare. Combining C‐reactive protein (CRP), IL‐18BP, neutrophil gelatinase‐associated lipocalin (NGAL), and sIL‐2Rα improved association with active AAV. CXCL13 and MMP‐3 were increased during treatment with prednisone, independent of disease activity. Marker concentrations during remission were not predictive of future flare. CONCLUSION: Serum biomarkers of inflammation and tissue damage and repair have been previously shown to be strongly associated with severe active AAV were less strongly associated with active AAV in a longitudinal study that included mild flares and varying treatment. Markers rising contemporaneously with flare or with an improved association in combination merit further study

Circulating Angiopoietin-2 as a Biomarker in ANCA-Associated Vasculitis

The endothelial-specific Angiopoietin-Tie2 ligand-receptor system is an important regulator of endothelial activation. Binding of angiopoietin-2 (Ang-2) to Tie2 receptor renders the endothelial barrier responsive to pro-inflammatory cytokines. We previously showed that circulating Ang-2 correlated with disease severity in a small cohort of critically ill patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis. The current study reassessed Ang-2 as a biomarker of disease activity and relapse in AAV. Circulating Ang-2 was measured in 162 patients with severe AAV (BVAS/WG≥3, with or without glomerulonephritis) in a clinical trial. Ang-2 levels during active AAV were compared to levels in the same patients during remission (BVAS/WG = 0). Levels in clinical subsets of AAV were compared, and association with future disease course was assessed. Ang-2 levels were elevated in severe disease (median 3.0 ng/ml, interquartile range 1.9–4.4) compared to healthy controls (1.2, 0.9–1.5). However, they did not reliably decline with successful treatment (median 2.6 ng/ml, interquartile range 1.9–3.8, median change −0.1). Ang-2 correlated weakly with BVAS/WG score (r = 0.17), moderately with markers of systemic inflammation (r = 0.25–0.41), and inversely with renal function (r = −0.36). Levels were higher in patients with glomerulonephritis, but levels adjusted for renal dysfunction were no different in patients with or without glomerulonephritis. Levels were higher in patients with newly diagnosed AAV and lower in patients in whom treatment had recently been started. Ang-2 levels during active disease did not predict response to treatment, and Ang-2 levels in remission did not predict time to flare. Thus, Ang-2 appears to have limited practical value in AAV as a biomarker of disease activity at time of measurement or for predicting future activity