Lumbar Bone Mineral Density Phantomless Computed Tomography Measurements and Correlation with Age and Fracture Incidence

Objective: Low bone quality is a contributing factor to motor vehicle crash (MVC) injury. Quantification of occupant bone mineral density (BMD) is important from an injury causation standpoint. The first aim of this study was to validate a technique for measuring lumbar volumetric BMD (vBMD) from phantomless computed tomography (CT) scans. The second aim was to apply the validated phantomless technique to quantify lumbar vBMD in Crash Injury Research and Engineering Network (CIREN) occupants for correlation with age, fracture incidence, and osteopenia/osteoporosis diagnoses.

Methods: Quantitative CT (qCT) and dual-energy X-ray absorptiometry (DXA) were collected prospectively for 50 subjects and used to validate a technique to measure vBMD from 281 phantomless CT scans of CIREN occupants. Hounsfield unit (HU) measurements were collected from the L1–L5 vertebrae, right psoas major muscle, and anterior subcutaneous fat for all subjects and from 3 phantom ports with known mg/cc calcium hydroxyapatite values for the validation group. qCT calibration was accomplished using regressions between the phantom HU and mg/cc values to convert L1–L5 HU values to mg/cc. A phantomless calibration technique was developed where the fat and muscle HU values were linearly regressed against fat (?69 mg/cc) and muscle (77 mg/cc) to establish a conversion for L1–L5 HU measurements to mg/cc. vBMD calculated from qCT versus the phantomless method was compared for the 50 subjects to assess agreement and a mg/cc osteopenia threshold was established using DXA T-scores. CIREN HU measurements were converted to mg/cc using the phantomless technique and the mg/cc osteopenia threshold was used to compare vBMD to age, fracture incidence, and osteopenia comorbidity classifications in CIREN.

Results: Linear regression of lumbar vBMD derived from the qCT versus phantomless calibrations showed excellent agreement (R² = 0.87, P <.0001). A 145 mg/cc threshold for osteopenia was established (sensitivity = 1, specificity = 0.57) and 44 CIREN occupants had vBMD below this threshold. Of these 44 occupants, 64% were not classified as osteopenic in CIREN, but vBMD suggested undiagnosed osteopenia. Age was negatively correlated with vBMD in both sexes (P <.0001) and CIREN occupants with less than 145 mg/cc vBMD sustained an average 1.7 additional rib/sternum fractures (P =.036).

Conclusions: Because lumbar vBMD was estimated from phantomless CT scans with accuracy similar to qCT, the phantomless technique can be broadly applied to both prospectively and retrospectively assess patient bone quality for research and clinical studies related to MVCs, falls, and aging.     

Circumpolar terrestrial arthropod monitoring: A review of ongoing activities,opportunities and challenges,with a focus on spiders

The terrestrial chapter of the Circumpolar Biodiversity Monitoring Programme (CBMP) has the potential to bring international multi-taxon, long-term monitoring together, but detailed fundamental species information for Arctic arthropods lags far behind that for vertebrates and plants. In this paper, we demonstrate this major challenge to the CBMP by focussing on spiders (Order: Araneae) as an example group. We collate available circumpolar data on the distribution of spiders and highlight the current monitoring opportunities and identify the key knowledge gaps to address before monitoring can become efficient. We found spider data to be more complete than data for other taxa, but still variable in quality and availability between Arctic regions, highlighting the need for greater international co-operation for baseline studies and data sharing. There is also a dearth of long-term datasets for spiders and other arthropod groups from which to assess status and trends of biodiversity. Therefore, baseline studies should be conducted at all monitoring stations and we make recommendations for the development of the CBMP in relation to terrestrial arthropods more generally.     

Leaders of the Pack: An analysis of the Canadian 'Sustainable Communities' 2000 municipal competition

The first annual Sustainable Community competition, co-sponsored by the Federation of Canadian Municipalities (FCM) and CH2M Hill in 2000, received 52 submissions from municipalities across Canada. These submissions were systematically analysed to identify common characteristics shared by competition entrants, including what differentiates competition participants from other Canadian municipalities, what kinds of sustainability projecs municipalities have been most likely to undertake and what motivating and success factors are most commonly cited. Urban municipalities were more likely than rural municipalities to undertake sustainability projects. Stakeholder involvement was found to be the most important factor in determining the success of a project. Many projects in the competition had not identified clear holistic visions and benchmarks, and these were noted as areas where improvement could be made. The impact of higher levels of government in setting benchmarks and providing support was also noteworthy.     

Growth of the Decision Tree: Advances in Bottom‐Up Climate Change Risk Management

There has recently been a return in climate change risk management practice to bottom‐up, robustness‐based planning paradigms introduced 40 years ago. The World Bank's decision tree framework (DTF) for “confronting climate uncertainty” is one incarnation of those paradigms. In order to better represent the state of the art in climate change risk assessment and evaluation techniques, this paper proposes: (1) an update to the DTF, replacing its “climate change stress test” with a multidimensional stress test; and (2) the addition of a Bayesian network framework that represents joint probabilistic behavior of uncertain parameters as sensitivity factors to aid in the weighting of scenarios of concern (the combination of conditions under which a water system fails to meet its performance targets). Using the updated DTF, water system planners and project managers would be better able to understand the relative magnitudes of the varied risks they face, and target investments in adaptation measures to best reduce their vulnerabilities to change. Next steps for the DTF include enhancements in: modeling of extreme event risks; coupling of human‐hydrologic systems; integration of surface water and groundwater systems; the generation of tradeoffs between economic, social, and ecological factors; incorporation of water quality considerations; and interactive data visualization.