Cross-ethnic meta-analysis identifies association of the GPX3-TNIP1 locus with amyotrophic lateral sclerosis.

Cross-ethnic genetic studies can leverage power from differences in disease epidemiology and population-specific genetic architecture. In particular, the differences in linkage disequilibrium and allele frequency patterns across ethnic groups may increase gene-mapping resolution. Here we use cross-ethnic genetic data in sporadic amyotrophic lateral sclerosis (ALS), an adult-onset, rapidly progressing neurodegenerative disease. We report analyses of novel genome-wide association study data of 1,234 ALS cases and 2,850 controls. We find a significant association of rs10463311 spanning GPX3-TNIP1 with ALS (p = 1.3 × 10-8), with replication support from two independent Australian samples (combined 576 cases and 683 controls, p = 1.7 × 10-3). Both GPX3 and TNIP1 interact with other known ALS genes (SOD1 and OPTN, respectively). In addition, GGNBP2 was identified using gene-based analysis and summary statistics-based Mendelian randomization analysis, although further replication is needed to confirm this result. Our results increase our understanding of genetic aetiology of ALS.Amyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disease. Here, Wray and colleagues identify association of the GPX3-TNIP1 locus with ALS using cross-ethnic meta-analyses.

Evaluating adhesion reduction efficacy of type I/III collagen membrane and collagen-GAG resorbable matrix in primary flexor tendon repair in a chicken model.

BACKGROUND: Reduction of peritendinous adhesions after injury and repair has been the subject of extensive prior investigation. The application of a circumferential barrier at the repair site may limit the quantity of peritendinous adhesions while preserving the tendon's innate ability to heal. The authors compare the effectiveness of a type I/III collagen membrane and a collagen-glycosaminoglycan (GAG) resorbable matrix in reducing tendon adhesions in an experimental chicken model of a "zone II" tendon laceration and repair. METHODS: In Leghorn chickens, flexor tendons were sharply divided using a scalpel and underwent repair in a standard fashion (54 total repairs). The sites were treated with a type I/III collagen membrane, collagen-GAG resorbable matrix, or saline in a randomized fashion. After 3 weeks, qualitative and semiquantitative histological analysis was performed to evaluate the "extent of peritendinous adhesions" and "nature of tendon healing." The data was evaluated with chi-square analysis and unpaired Student's t test. RESULTS: For both collagen materials, there was a statistically significant improvement in the degree of both extent of peritendinous adhesions and nature of tendon healing relative to the control group. There was no significant difference seen between the two materials. There was one tendon rupture observed in each treatment group. Surgical handling characteristics were subjectively favored for type I/III collagen membrane over the collagen-GAG resorbable matrix. CONCLUSION: The ideal method of reducing clinically significant tendon adhesions after injury remains elusive. Both materials in this study demonstrate promise in reducing tendon adhesions after flexor tendon repair without impeding tendon healing in this model.

Levothyroxine treatment of subclinical hypothyroidism, fatal and nonfatal cardiovascular events, and mortality.

BACKGROUND Subclinical hypothyroidism (SCH) has been associated with ischemic heart disease (IHD); however, it is unknown whether treatment of SCH with levothyroxine sodium will reduce the risk of IHD. The aim of this study was to investigate the association between levothyroxine treatment of SCH with IHD morbidity and mortality. METHODS We used the United Kingdom General Practitioner Research Database to identify individuals with new SCH (serum thyrotropin levels of 5.01-10.0 mIU/L and normal free thyroxine levels) recorded during 2001 with outcomes analyzed until March 2009. All analyses were performed separately for younger (40-70 years) and older (>70 years) individuals. Hazard ratios (HRs) for IHD events (fatal and nonfatal) were calculated after adjustment for conventional IHD risk factors, baseline serum thyrotropin levels, and initiation of levothyroxine treatment as a time-dependent covariate. RESULTS Subclinical hypothyroidism was identified in 3093 younger and 1642 older individuals. For a median follow-up period of 7.6 years, 52.8% and 49.9% of younger and older patients with SCH were treated with levothyroxine, respectively. There were 68 incident IHD events in 1634 younger patients treated with levothyroxine (4.2%) vs 97 IHD events in 1459 untreated individuals (6.6%) (multivariate-adjusted HR, 0.61; 95% CI, 0.39-0.95). In contrast, in the older group there were 104 events in 819 treated patients (12.7%) vs 88 events in 823 untreated individuals (10.7%) (HR, 0.99; 95% CI, 0.59-1.33). CONCLUSIONS Treatment of SCH with levothyroxine was associated with fewer IHD events in younger individuals, but this was not evident in older people. An appropriately powered randomized controlled trial of levothyroxine in SCH examining vascular outcomes is now warranted.

Optical-feedback cavity ring-down spectroscopy measurements of extinction by aerosol particles.

Optical feedback cavity ring-down spectroscopy (OF-CRDS) using a continuous wave distributed feedback diode laser at 1650 nm has been used to measure extinction of light by samples of monodisperse spherical aerosol particles <1 mum in diameter. The OF-CRDS method allows measurements of low levels of extinction of incident light to be made at repetition rates of 1 kHz or greater. A statistical model is proposed to describe the linear relationship between the extinction coefficient (alpha) and its variance (Var(alpha)). Application of this model to experimental measurements of Var(alpha) for a range of alpha values typically below approximately 1 x 10(-6) cm(-1) allows extinction cross-sections for the aerosol particles to be obtained without need for knowledge of the particle number density. Samples of polystyrene spheres with diameters of 400, 500, 600, and 700 nm were used to test the model by comparing extinction cross-sections determined from the experiment with the predictions of Mie theory calculations. Fitting of ring-down decay traces exhibiting amplitude noise to extract cavity ring-down times introduces additional quadratic and higher order polynomial dependencies of the variance that become significant for larger particle number densities and thus extinction coefficients (typically for alpha > 1 x 10(-6) cm(-1) under our experimental conditions). Aggregation of particles at larger number densities is suggested as a further source of variance in the measurements. Extinction cross-sections are severely underestimated if the measurements are made too rapidly to sample uncorrelated distributions of particle numbers and positions.

Cavity ring-down spectroscopy measurements of single aerosol particle extinction. I. The effect of position of a particle within the laser beam on extinction.

A continuous wave distributed feedback diode laser operating in the near infrared at wavelengths close to 1650 nm has been used to measure the extinction of light by single aerosol particles. The technique of optical feedback cavity ring-down spectroscopy (CRDS) was used for measurement of CRDS events at a repetition rate of 1.25 kHz. This very high repetition rate enabled multiple measurements of the extinction of light by single aerosol particles for the first time and demonstrated the dependence of light scattering on the position of a particle within the laser beam. A model is proposed to explain quantitatively this phenomenon. The minimum detectable dimensionless extinction coefficient epsilonmin was determined to be 3x10(-6). Extinction values obtained for single spherical polymer beads from a monodisperse sample of particles of diameter of 4 microm are in near-quantitative agreement with the values calculated by the Mie scattering theory. The deviations from the Mie theory expected for measurement of extinction by CRDS using a continuous wave laser are discussed in the companion paper.

Effect of repetitive exercise testing on breathlessness in humans.

There are conflicting reports on the reproducibility of the visual analogue scale (VAS) and the modified Borg scale for the estimation of breathlessness during exercise. In an attempt to clarify the situation, two groups of healthy subjects undertook a progressive exercise test either daily (Group A) or weekly (Group B) on 10 separate occasions. Breathlessness was estimated every 1 min using the VAS. After 10 occasions, both Group A (P <0.05) and Group B ( P <0.01) showed a significant increase in the mean intercept of the breathlessness/ventilation (VAS/ V (I)) relationship. The increase was not progressive; using change point regression, reproducible values were found to occur after approximately the fifth occasion in both subject groups. As the slope of the VAS/ V (I) relationship was highly reproducible and did not change with repeat testing, it would appear that at least two mechanisms are involved in the generation of the sensation of breathlessness. A decrease in the exercise heart rate over the same time period was significantly correlated with changes in the VAS/ V (I) intercept in both groups (P <0.01 and P <0.005 respectively). The relationship is unlikely to be causal, but may be indicative of a common underlying mechanism. It is suggested that breathlessness scores are likely to decrease as a direct result of repetitive testing over, on average, the first five periods of assessment. On the basis of this study, it may be inferred that a physiological mechanism contributes to the modulation of breathlessness during repetitive exercise testing.