On the Significance of Absorption Features in HST/COS Data

We present empirical scaling relations for the significance of absorption features detected in medium resolution, far-UV spectra obtained with the Cosmic Origins Spectrograph (COS). These relations properly account for both the extended wings of the COS line spread function and the non-Poissonian noise properties of the data, which we characterize for the first time, and predict limiting equivalent widths that deviate from the empirical behavior by \leq 5% when the wavelength and Doppler parameter are in the ranges \lambda = 1150-1750 A and b > 10 km/s. We have tested a number of coaddition algorithms and find the noise properties of individual exposures to be closer to the Poissonian ideal than coadded data in all cases. For unresolved absorption lines, limiting equivalent widths for coadded data are 6% larger than limiting equivalent widths derived from individual exposures with the same signal-to-noise. This ratio scales with b-value for resolved absorption lines, with coadded data having a limiting equivalent width that is 25% larger than individual exposures when b \approx 150 km/s.Comment: 25 pages, 3 tables, 7 figures, accepted for publication in PAS

Return to Play after Cervical Spine Injuries: A Consensus of Opinion

Study Design: Survey. Objective: Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods: Ten common clinical scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice. We evaluated responses to questions about patient RTP, level of contact, imaging required for a clinical decision, and time to return for each scenario. The chi-square test was used for statistical analysis, with p \u3c 0.05 considered significant. Results: Evaluation of the surgeons’ responses to these cases showed significant consensus regarding return to high-contact sports in cases of cervical cord neurapraxia without symptoms or stenosis, surgically repaired herniated disks, and nonoperatively healed C1 ring or C2 hangman’s fractures. Greater variability was found in recommendations for patients showing persistent clinical symptomatology. Conclusion: This survey suggests a consensus among surgeons for allowing patients with relatively normal imaging and resolution of symptoms to return to high-contact activities; however, patients with cervical stenosis or clinical symptoms continue to be a challenge for management. This survey may serve as a basis for future clinical trials and consensus guidelines

Nicotine Increases Osteoblast Activity of Induced Bone Marrow Stromal Cells in a Dose-Dependent Manner: An in Vitro Cell Structure Experiment

Previous studies by our group showed that nicotine delivered via a transdermal nicotine patch significantly enhanced posterior spinal fusion rates in rabbits. Nicotine transdermal patches provide a steady serum level; there may be a dose-dependent effect of nicotine on posterior spinal fusion. In an in vitro cell culture model of rabbit bone marrow–derived osteoblast-like cells, cells were exposed to different concentrations of nicotine (0, 20, 40, 80 ng/mL and 10, 100, 250 μg/mL). Wells were stained with an alkaline phosphatase (ALP) staining kit to determine ALP enzyme activity. Cells were stained with Von Kossa for mineralization. A two-way analysis of variance (ANOVA) using dose and time as variables showed significant differences among groups; post hoc analysis showed that the 100-μg/mL dose of nicotine significantly enhanced ALP activity over controls. A one-way ANOVA using dose as the variable showed that the 100- and 250-μg/mL doses had significantly greater mineralization than controls. Dose-response analysis revealed a statistically significant effect of nicotine dose on ALP activity and Von Kossa activity. The effects of nicotine on spinal fusion may be dose-dependent and due to stimulation of osteoblastic activity. Nicotine may not be responsible for the inhibited bone healing observed in smokers

Searching for Far-Ultraviolet Auroral/Dayglow Emission from HD209458b

We present recent observations from the HST-Cosmic Origins Spectrograph aimed at characterizing the auroral emission from the extrasolar planet HD209458b. We obtained medium-resolution (R~18-20,000) far-ultraviolet (1150-1700A) spectra at both the Phase 0.25 and Phase 0.75 quadrature positions as well as a stellar baseline measurement at secondary eclipse. This analysis includes a catalog of stellar emission lines and a star-subtracted spectrum of the planet. We present an emission model for planetary H2 emission, and compare this model to the planetary spectrum. No unambiguously identifiable atomic or molecular features are detected, and upper limits are presented for auroral/dayglow line strengths. An orbital velocity cross-correlation analysis finds a statistically significant (3.8 sigma) feature at +15 (+/- 20) km/s in the rest frame of the planet, at 1582 A. This feature is consistent with emission from H2 B-X (2-9) P(4) (lambda_{rest} = 1581.11 A), however the physical mechanism required to excite this transition is unclear. We compare limits on relative line strengths seen in the exoplanet spectrum with models of ultraviolet fluorescence to constrain the atmospheric column density of neutral hydrogen between the star and the planetary surface. These results support models of short period extrasolar giant planets with weak magnetic fields and extended atomic atmospheres.Comment: Accepted to ApJ. 12 pages, 5 figures, 4 table

Observations of Mass Loss from the Transiting Exoplanet HD 209458b

Using the new Cosmic Origins Spectrograph (COS) on the {\it Hubble Space Telescope (HST)}, we obtained moderate-resolution, high signal/noise ultraviolet spectra of HD 209458 and its exoplanet HD 209458b during transit, both orbital quadratures, and secondary eclipse. We compare transit spectra with spectra obtained at non-transit phases to identify spectral features due to the exoplanet's expanding atmosphere. We find that the mean flux decreased by $7.8\pm 1.3$% for the C II 1334.5323\AA\ and 1335.6854\AA\ lines and by $8.2\pm 1.4$% for the Si III 1206.500\AA\ line during transit compared to non-transit times in the velocity interval --50 to +50 km s$^{-1}$. Comparison of the C II and Si III line depths and transit/non-transit line ratios shows deeper absorption features near --10 and +15 km s$^{-1}$ and less certain features near --40 and +30--70 km s$^{-1}$, but future observations are needed to verify this first detection of velocity structure in the expanding atmosphere of an exoplanet. Our results for the C II lines and the non-detection of Si IV 1394.76\AA\ absorption are in agreement with \citet{Vidal-Madjar2004}, but we find absorption during transit in the Si III line contrary to the earlier result. The $8\pm 1$% obscuration of the star during transit is far larger than the 1.5% obscuration by the exoplanet's disk. Absorption during transit at velocities between --50 and +50 km s$^{-1}$ in the C II and Si III lines requires high-velocity ion absorbers, but models that assume that the absorbers are high-temperature thermal ions are inconsistent with the COS spectra. Assuming hydrodynamic model values for the gas temperature and outflow velocity at the limb of the outflow as seen in the C II lines, we find mass-loss rates in the range (8--40)$\times 10^{10}$ g s$^{-1}$.Comment: 25 pages, 4 figures, Astrophysical Journal in pres

Evaluation of the impact of immediate versus WHO recommendations-guided antiretroviral therapy initiation on HIV incidence: the ANRS 12249 TasP (Treatment as Prevention) trial in Hlabisa sub-district, KwaZulu-Natal, South Africa: study protocol for a cluster randomised controlled trial

Background: Antiretroviral therapy (ART) suppresses HIV viral load in all body compartments and so limits the risk of HIV transmission. It has been suggested that ART not only contributes to preventing transmission at individual but potentially also at population level. This trial aims to evaluate the effect of ART initiated immediately after identification/diagnosis of HIV-infected individuals, regardless of CD4 count, on HIV incidence in the surrounding population. The primary outcome of the overall trial will be HIV incidence over two years. Secondary outcomes will include i) socio-behavioural outcomes (acceptability of repeat HIV counselling and testing, treatment acceptance and linkage to care, sexual partnerships and quality of life); ii) clinical outcomes (mortality and morbidity, retention into care, adherence to ART, virologic failure and acquired HIV drug resistance), iii) cost-effectiveness of the intervention. The first phase will specifically focus on the trial's secondary outcomes.Methods/design: A cluster-randomised trial in 34 (2 × 17) clusters within a rural area of northern KwaZulu-Natal (South Africa), covering a total population of 34,000 inhabitants aged 16 years and above, of whom an estimated 27,200 would be HIV-uninfected at start of the trial. The first phase of the trial will include ten (2 × 5) clusters. Consecutive rounds of home-based HIV testing will be carried out. HIV-infected participants will be followed in dedicated trial clinics: in intervention clusters, they will be offered immediate ART initiation regardless of CD4 count and clinical stage; in control clusters they will be offered ART according to national treatment eligibility guidelines (CD4 <350 cells/μL, World Health Organisation stage 3 or 4 disease or multidrug-resistant/extensively drug-resistant tuberculosis). Following proof of acceptability and feasibility from the first phase, the trial will be rolled out to further clusters.Discussion: We aim to provide proof-of-principle evidence regarding the effectiveness of Treatment-as-Prevention in reducing HIV incidence at the population level. Data collected from the participants at home and in the clinics will inform understanding of socio-behavioural, economic and clinical impacts of the intervention as well as feasibility and generalizability. © 2013 Iwuji et al.; licensee BioMed Central Ltd

Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques

Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. Results One hundred one patients were included in the study. Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p \u3e 0.0001). Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes