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1. The Golden Meteorite Fall: Fireball Trajectory, Orbit and Meteorite Characterization

Author

Brown, P. G., McCausland, P. J. A., Hildebrand, A. R, Hanton, L. T. J., Eckart, L. M., Busemann, H., Krietsch, D., Maden, C., Welten, K., Caffee, M. W., Laubenstein, M., Vida, D., Ciceri, F., Silber, E., Herd, C. D. K., Hill, P., Devillepoix, H., Sansom, Eleanor K., Cupák, Martin, Anderson, Seamus, Flemming, R. L., Nelson, A. J., Mazur, M., Moser, D. E., Cooke, W. J., Hladiuk, D., Malečić, Barbara, Prtenjak, Maja Telišman, and Nowell, R.

Subjects
Astrophysics - Earth and Planetary Astrophysics, Physics - Geophysics
Abstract

The Golden (British Columbia, Canada) meteorite fall occurred on Oct 4, 2021 at 0534 UT with the first recovered fragment (1.3 kg) landing on an occupied bed. The meteorite is an unbrecciated, low-shock (S2) ordinary chondrite of intermediate composition, typed as an L/LL5. From noble gas measurements the cosmic ray exposure age is 25 Ma while gas retention ages are all >2 Ga. Short-lived radionuclides and noble gas measurements of the pre-atmospheric size overlap with estimates from infrasound and lightcurve modelling producing a preferred pre-atmospheric mass of 70-200 kg. The orbit of Golden has a high inclination (23.5 degs) and is consistent with delivery from the inner main belt. The highest probability (60%) of an origin is from the Hungaria group. We propose that Golden may originate among the background S-type asteroids found interspersed in the Hungaria region. The current collection of 18 L and LL chondrite orbits shows a strong preference for origins in the inner main belt, suggesting multiple parent bodies may be required to explain the diversity in CRE ages and shock states., Comment: 92 Pages, 20 Tables, 21 Figures, plus 3 appendices, accepted in Meteoritics and Planetary Science Oct 26 2023

Published
2023

2. The threat of Centaurs for terrestrial planets and their orbital evolution as impactors

Author

Galiazzo, M. A., Silber, E. A., and Dvorak, R.

Subjects
Astrophysics - Earth and Planetary Astrophysics
Abstract

Centaurs are solar system objects with orbits situated among the orbits of Jupiter and Neptune. Centaurs represent one of the sources of Near-Earth Objects. Thus, it is crucial to understand their orbital evolution which in some cases might end in collision with terrestrial planets and produce catastrophic events. We study the orbital evolution of the Centaurs toward the inner solar system, and estimate the number of close encounters and impacts with the terrestrial planets after the Late Heavy Bombardment assuming a steady state population of Centaurs. We also estimate the possible crater sizes. We compute the approximate amount of water released: on the Earth, which is about 0.00001 the total water present now. We also found sub-regions of the Centaurs where the possible impactors originate from. While crater sizes could extend up to hundreds of kilometers in diameter given the presently known population of Centaurs the majority of the craters would be less than about 10 km. For all the planets and an average impactor size of 12 km in diameter, the average impact frequency since the Late Heavy Bombardment is one every 1.9 Gyr for the Earth and 2.1 Gyr for Venus. For smaller bodies (e.g. > 1 km), the impact frequency is one every 14.4 Myr for the Earth, 13.1 Myr for Venus and, 46.3 for Mars, in the recent solar system. Only 53% of the Centaurs can enter into the terrestrial planet region and 7% can interact with terrestrial planets., Comment: 15 pages, 8 figures, Monthly Notices of the Royal Astronomical Society, 2018

Published
2018
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3. V-type Near-Earth asteroids: dynamics, close encounters and impacts with terrestrial planets

Author

Galiazzo, M. A., Silber, E. A., and Bancelin, D.

Subjects
Astrophysics - Earth and Planetary Astrophysics
Abstract

Asteroids colliding with planets vary in composition and taxonomical type. Among Near-Earth Asteroids (NEAs) are the V-types, basaltic asteroids that are classified via spectroscopic observations. In this work, we study the probability of V-type NEAs colliding with Earth, Mars and Venus, as well as the Moon. We perform a correlational analysis of possible craters produced by V-type NEAs. To achieve this, we performed numerical simulations and statistical analysis of close encounters and impacts between V-type NEAs and the terrestrial planets over the next 10 Myr. We find that V-type NEAs can indeed have impacts with all the planets, the Earth in particular, at an average rate of once per 12 Myr. There are four candidate craters on Earth that were likely caused by V-type NEAs., Comment: The article has been accepted by "Astronomical Notes / Astronomische Nachrichten" 2017

Published
2016
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5. The spectrum of psychosis in multiple sclerosis: a clinical case series

Author

Gilberthorpe TG, O'Connell KE, Carolan A, Silber E, Brex PA, Sibtain NA, and David AS

Subjects
Psychosis, multiple sclerosis, neuropsychiatric, cognitive, schizophrenia-like, demyelination, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

Thomas G Gilberthorpe,1 Kara E O’Connell,2,3 Alison Carolan,1 Eli Silber,4 Peter A Brex,4 Naomi A Sibtain,4 Anthony S David3 1Department of Liaison Psychiatry, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK; 2Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland; 3Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, 4Department of Neurology, Kings College Hospital, London, UK Abstract: Psychosis in the context of multiple sclerosis (MS) has previously been reported as a rare occurrence. However, recent epidemiological studies have found prevalence rates of psychosis in MS that are two to three times higher than those in the general population. Untreated psychosis in patients with MS can adversely impact on adherence to MS medication, levels of disability, and quality of life. This retrospective case series describes the spectrum of psychotic disorders occurring in association with MS using demographic, clinical, and neuroimaging data. In the discussion, we highlight the particular diagnostic and treatment challenges that such disorders can pose for clinicians and through our case vignettes provide examples of potential interventions for this complex patient population. Keywords: psychosis, multiple sclerosis, neuropsychiatric, cognitive, schizophrenia-like, demyelination

Published
2017

6. The Golden meteorite fall: Fireball trajectory, orbit, and meteorite characterization

Author

Brown, P.G., McCausland, P.J.A., Hildebrand, A.R., Hanton, L.T.J., Eckart, L.M., Busemann, H., Krietsch, D., Maden, C., Welten, K., Caffee, M.W., Laubenstein, M., Vida, D., Ciceri, F., Silber, E., Herd, C.D.K., Hill, P., Devillepoix, Hadrien, Sansom, Ellie, Cupak, Martin, Anderson, S., Flemming, R.L., Nelson, A.J., Mazur, M., Moser, D.E., Cooke, W.J., Hladiuk, D., Malečić, B., Prtenjak, M.T., Nowell, R., Brown, P.G., McCausland, P.J.A., Hildebrand, A.R., Hanton, L.T.J., Eckart, L.M., Busemann, H., Krietsch, D., Maden, C., Welten, K., Caffee, M.W., Laubenstein, M., Vida, D., Ciceri, F., Silber, E., Herd, C.D.K., Hill, P., Devillepoix, Hadrien, Sansom, Ellie, Cupak, Martin, Anderson, S., Flemming, R.L., Nelson, A.J., Mazur, M., Moser, D.E., Cooke, W.J., Hladiuk, D., Malečić, B., Prtenjak, M.T., and Nowell, R.

Abstract

The Golden (British Columbia, Canada) meteorite fall occurred on October 4, 2021 at 0534 UT with the first recovered fragment (1.3 kg) landing on an occupied bed. The associated fireball was recorded by numerous cameras permitting reconstruction of its trajectory and orbit. The fireball entered the atmosphere at a 54° angle from the horizontal at a speed of 18 km s−1. The fireball reached a peak brightness of −14, having first become luminous at a height of >84 km and ending at 18 km altitude. Analysis of the infrasonic record of the bolide produced an estimated mass of (Formula presented.) kg while modeling of the fireball light curve suggests an initial mass near 70 kg. The fireball experienced a major flare near 31 km altitude where more than half its mass was lost in the form of dust and gram-sized fragments under a dynamic pressure of 3.3 MPa. The strength and fragmentation behavior of the fireball were similar to those reported for other meteorite-producing fireballs (Borovička et al., 2020). Seven days after the fireball occurred, an additional 0.9 kg fragment was recovered during the second day of dedicated searching guided by initial trajectory and dark flight calculations. Additional searching in the fall and spring of 2021–2022 located no additional fragments. The meteorite is an unbrecciated, low-shock (S2) ordinary chondrite of intermediate composition, typed as an L/LL5 with a grain density of ~3530 k gm−3, an average bulk density of 3150 kg m−3 and calculated porosity of ~10%. From noble gas measurements, the cosmic ray exposure age is 25 ± 4 Ma while gas retention ages are all >2 Ga. Short-lived radionuclides and noble gas measurements of the pre-atmospheric size overlap with estimates from infrasound and light curve modeling producing a preferred pre-atmospheric mass of 70–200 kg. The orbit of Golden has a high inclination (23.5°) and is consistent with delivery from the inner main belt. The highest probability (60%) of an origin is from the Hungari

Published
2023

8. Evolution of the dust trail of comet 17P/Holmes

Author

Gritsevich, M., Nissinen, M., Oksanen, A., Suomela, J., Silber, E. A., Gritsevich, M., Nissinen, M., Oksanen, A., Suomela, J., and Silber, E. A.

Abstract

The massive outburst of the comet 17P/Holmes in 2007 October is the largest known outburst by a comet thus far. We present a new comprehensive model describing the evolution of the dust trail produced in this phenomenon. The model comprises of multiparticle Monte Carlo simulation including the solar radiation pressure effects, gravitational disturbance caused by Venus, Earth and Moon, Mars, Jupiter and Saturn, and gravitational interaction of the dust particles with the parent comet itself. Good accuracy of computations is achieved by its implementation in Orekit, which executes Dormad-Prince numerical integration methods with higher precision. We demonstrate performance of the model by simulating particle populations with sizes from 0.001 to 1 mm with corresponding spherically symmetric ejection speed distribution, and towards the Sun outburst modelling. The model is supplemented with and validated against the observations of the dust trail in common nodes for 0.5 and 1 revolutions. In all cases, the predicted trail position showed a good match to the observations. Additionally, the hourglass pattern of the trail was observed for the first time within this work. By using variations of the outburst model in our simulations, we determine that the assumption of the spherical symmetry of the ejected particles leads to the scenario compatible with the observed hourglass pattern. Using these data, we make predictions for the two-revolution dust trail behaviour near the outburst point that should be detectable by using ground-based telescopes in 2022. © 2022 The Author(s).

Published
2022

9. 40Ar/39 AND ZIRCON U-Pb ANALYSES DATE THE HIAWATHA IMPACT STRUCTURE, NORTHWEST GREENLAND, TO THE LATE PALEOCENE

Author

Kenny, G. G., Hyde, W. R., Storey, M., Garde, A. A., Whitehouse, M. J., Beck, P., Johansson, L., Søndergaard, A. S., Bjørk, A. A., MacGregor, J. A., Khan, S. A., Mouginot, J., Johnson, B. C., Silber, E. A., Wielandt, D. K. P., Kjaer, K. H., Larsen, N. K., Kenny, G. G., Hyde, W. R., Storey, M., Garde, A. A., Whitehouse, M. J., Beck, P., Johansson, L., Søndergaard, A. S., Bjørk, A. A., MacGregor, J. A., Khan, S. A., Mouginot, J., Johnson, B. C., Silber, E. A., Wielandt, D. K. P., Kjaer, K. H., and Larsen, N. K.

Published
2022

12. A 500-kiloton airburst over Chelyabinsk and an enhanced hazard from small impactors

Author

Brown, P.G., Assink, J.D., Astiz, L., Blaauw, R., Boslough, M.B., Borovicka, J., Brachet, N., Brown, D., Campbell-Brown, M., Ceranna, L., Cooke, W., de Groot-Hedlin, C., Drob, D.P., Edwards, W., Evers, L.G., Garces, M., Gill, J., Hedlin, M., Kingery, A., Laske, G., Le Pichon, A., Mialle, P., Moser, D.E., Saffer, A., Silber, E., Smets, P., Spalding, R.E., Spurny, P., Tagliaferri, E., Uren, D., Weryk, R.J., Whitaker, R., and Krzeminski, Z.

Subjects
Observations, Methods, Environmental aspects, Asteroids -- Observations -- Environmental aspects, Environmental impact analysis -- Methods
Abstract

(24,25) (26) (10) The Chelyabinsk airburst (10) was observed globally by multiple instruments--including infrasound, seismic, US government sensors and more than 400 video cameras--at ranges up to 700 km away. [...], Most large (over a kilometre in diameter) near-Earth asteroids are now known, but recognition that airbursts (or fireballs resulting from nuclear-weapon-sized detonations of meteoroids in the atmosphere) have the potential to do greater damage (1) than previously thought has shifted an increasing portion of the residual impact risk (the risk of impact from an unknown object) to smaller objects (2). Above the threshold size of impactor at which the atmosphere absorbs sufficient energy to prevent a ground impact, most of the damage is thought to be caused by the airburst shock wave (3), but owing to lack of observations this is uncertain (4,5). Here we report an analysis of the damage from the airburst of an asteroid about 19 metres (17 to 20 metres) in diameter southeast of Chelyabinsk, Russia, on 15 February 2013, estimated to have an energy equivalent of approximately 500 (± 100) kilotons of trinitrotoluene (TNT, where 1 kiloton of TNT = 4.185 x [10.sup.12] joules). We show that a widely referenced technique (4-6) of estimating airburst damage does not reproduce the observations, and that the mathematical relations (7) based on the effects of nuclear weapons--almost always used with this technique--overestimate blast damage. This suggests that earlier damage estimates (5,6) near the threshold impactor size are too high. We performed a global survey of airbursts of a kiloton or more (including Chelyabinsk), and find that the number of impactors with diameters of tens of metres may be an order of magnitude higher than estimates based on other techniques (8,9). This suggests a non-equilibrium (if the population were in a long-term collisional steady state the size-frequency distribution would either follow a single power law or there must be a size-dependent bias in other surveys) in the near-Earth asteroid population for objects 10 to 50 metres in diameter, and shifts more of the residual impact risk to these sizes.

Published
2013

13. A numerical approach to study ablation of large bolides: Application to Chelyabinsk

Author

Trigo-Rodríguez, J. M., Dergham, J., Gritsevich, M., Lyytinen, E., Silber, E. A., Williams, I. P., Trigo-Rodríguez, J. M., Dergham, J., Gritsevich, M., Lyytinen, E., Silber, E. A., and Williams, I. P.

Abstract

In this study, we investigate the ablation properties of bolides capable of producing meteorites. The casual dashcam recordings from many locations of the Chelyabinsk superbolide associated with the atmospheric entry of an 18 m in diameter near-Earth object (NEO) have provided an excellent opportunity to reconstruct its atmospheric trajectory, deceleration, and heliocentric orbit. In this study, we focus on the study of the ablation properties of the Chelyabinsk bolide on the basis of its deceleration and fragmentation. We explore whether meteoroids exhibiting abrupt fragmentation can be studied by analyzing segments of the trajectory that do not include a disruption episode. We apply that approach to the lower part of the trajectory of the Chelyabinsk bolide to demonstrate that the obtained parameters are consistent. To do that, we implemented a numerical (Runge–Kutta) method appropriate for deriving the ablation properties of bolides based on observations. The method was successfully tested with the cases previously published in the literature. Our model yields fits that agree with observations reasonably well. It also produces a good fit to the main observed characteristics of Chelyabinsk superbolide and provides its averaged ablation coefficient σ = 0.034 s2 km-2. Our study also explores the main implications for impact hazard, concluding that tens of meters in diameter NEOs encountering the Earth in grazing trajectories and exhibiting low geocentric velocities are penetrating deeper into the atmosphere than previously thought and, as such, are capable of producing meteorites and even damage on the ground. Copyright © 2021 Josep M. Trigo-Rodríguez et al.

Published
2021

15. Infrasonic Detection of a Large Bolide over South Sulawesi, Indonesia on October 8, 2009: Preliminary Results

Author

Silber, E. A, Brown, P. G, and Le Pinchon, A

Subjects
Space Sciences (General)
Abstract

In the morning hours of October 8, 2009, a bright object entered Earth's atmosphere over South Sulawesi, Indonesia. This bolide disintegrated above the ground, generating stratospheric infrasound returns that were detected by infrasonic stations of the global International Monitoring System (IMS) Network of the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) at distances up to 17 500 km. Here we present instrumental recordings and preliminary results of this extraordinary event. Using the infrasonic period-yield relations, originally derived for atmospheric nuclear detonations, we find the most probable source energy for this bolide to be 70+/-20 kt TNT equivalent explosive yield. A unique aspect of this event is the fact that it was apparently detected by infrasound only. Global events of such magnitude are expected only once per decade and can be utilized to calibrate infrasonic location and propagation tools on a global scale, and to evaluate energy yield formula, and event timing.

Published
2011

16. Physically based alternative to the PE criterion for meteoroids

Author

Moreno-Ibáñez, M., Gritsevich, M., Trigo-Rodríguez, J. M., Silber, E. A., Moreno-Ibáñez, M., Gritsevich, M., Trigo-Rodríguez, J. M., and Silber, E. A.

Abstract

Meteoroids impacting the Earth atmosphere are commonly classified using the PE criterion. This criterion was introduced to support the identification of the fireball type by empirically linking its orbital origin and composition characteristics. Additionally, it is used as an indicator of the meteoroid tensile strength and its ability to penetrate the atmosphere. However, the level of classification accuracy of the PE criterion depends on the ability to constrain the value of the input data, retrieved from the fireball observation, required to derive the PE value. To overcome these uncertainties and achieve a greater classification detail, we propose a new formulation using scaling laws and dimensionless variables that groups all the input variables into two parameters that are directly obtained from the fireball observations. These two parameters, α and β, represent the drag and the mass-loss rates along the luminous part of the trajectory, respectively, and are linked to the shape, strength, ablation efficiency, mineralogical nature of the projectile, and duration of the fireball. Thus, the new formulation relies on a physical basis. This work shows the mathematical equivalence between the PE criterion and the logarithm of 2αβ under the same PE criterion assumptions. We demonstrate that log(2αβ) offers a more general formulation that does not require any preliminary constraint on the meteor flight scenario and discuss the suitability of the new formulation for expanding the classification beyond fully disintegrating fireballs to larger impactors including meteorite-dropping fireballs. The reliability of the new formulation is validated using the Prairie Network meteor observations. © 2020 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society

Published
2020

17. EAN guideline on palliative care of people with severe, progressive multiple sclerosis

Author

Solari, A., Giordano, A., Sastre-Garriga, J., Kopke, S., Rahn, A. C., Kleiter, I, Aleksovska, K., Battaglia, M. A., Bay, J., Copetti, M., Drulovic, J., Kooij, L., Mens, J., Meza Murillo, E. R., Milanov, I, Milo, R., Pekmezovic, T., Vosburgh, J., Silber, E., Veronese, S., Patti, F., Voltz, R., Oliver, D., Solari, A., Giordano, A., Sastre-Garriga, J., Kopke, S., Rahn, A. C., Kleiter, I, Aleksovska, K., Battaglia, M. A., Bay, J., Copetti, M., Drulovic, J., Kooij, L., Mens, J., Meza Murillo, E. R., Milanov, I, Milo, R., Pekmezovic, T., Vosburgh, J., Silber, E., Veronese, S., Patti, F., Voltz, R., and Oliver, D.

Abstract

Background and purpose Patients with severe, progressive multiple sclerosis (MS) have complex physical and psychosocial needs, typically over several years. Few treatment options are available to prevent or delay further clinical worsening in this population. The objective was to develop an evidence-based clinical practice guideline for the palliative care of patients with severe, progressive MS. Methods This guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Formulation of the clinical questions was performed in the Patients-Intervention-Comparator-Outcome format, involving patients, carers and healthcare professionals (HPs). No uniform definition of severe MS exists: in this guideline, constant bilateral support required to walk 20 m without resting (Expanded Disability Status Scale score > 6.0) or higher disability is referred to. When evidence was lacking for this population, recommendations were formulated using indirect evidence or good practice statements were devised. Results Ten clinical questions were formulated. They encompassed general and specialist palliative care, advance care planning, discussing with HPs the patient's wish to hasten death, symptom management, multidisciplinary rehabilitation, interventions for caregivers and interventions for HPs. A total of 34 recommendations (33 weak, 1 strong) and seven good practice statements were devised. Conclusions The provision of home-based palliative care (either general or specialist) is recommended with weak strength for patients with severe, progressive MS. Further research on the integration of palliative care and MS care is needed. Areas that currently lack evidence of efficacy in this population include advance care planning, the management of symptoms such as fatigue and mood problems, and interventions for caregivers and HPs.

Published
2020

18. EAN guideline on palliative care of people with severe, progressive multiple sclerosis

Author

Solari, Alessandra, Giordano, Andrea, Sastre‐Garriga, J., Köpke, Sascha, Rahn, Anne Christin, Kleiter, I., Aleksovska, K., Battaglia, M. A., Bay, J., Copetti, M., Drulovic, J., Kooij, L., Mens, J., Meza Murillo, E. R., Milanov, I., Milo, R., Pekmezovic, T., Vosburgh, J., Silber, E., Veronese, Simone, Patti, Francesco, Voltz, Raymond, Oliver, David, Solari, Alessandra, Giordano, Andrea, Sastre‐Garriga, J., Köpke, Sascha, Rahn, Anne Christin, Kleiter, I., Aleksovska, K., Battaglia, M. A., Bay, J., Copetti, M., Drulovic, J., Kooij, L., Mens, J., Meza Murillo, E. R., Milanov, I., Milo, R., Pekmezovic, T., Vosburgh, J., Silber, E., Veronese, Simone, Patti, Francesco, Voltz, Raymond, and Oliver, David

Published
2020

22. Physics of meteor generated shock waves in the Earth's atmosphere – A review

Author

Silber, E. A., Boslough, M., Hocking, W. K., Gritsevich, M., and Whitaker, R. W.

Subjects
METEOR RADAR, CYLINDRICAL SHOCK WAVES, METEOR, METEOROID, GAS DYNAMICS, CYLINDRICAL SHOCK WAVE, SHOCK PHYSICS, SHOCK WAVES, RADAR, METEOR RADARS, SHOCK WAVE, EARTH ATMOSPHERE
Abstract

Shock waves and the associated phenomena generated by strongly ablating meteoroids with sizes greater than a few millimeters in the lower transitional flow regime of the Earth's atmosphere are the least explored aspect of meteor science. In this paper, we present a comprehensive review of literature covering meteor generated shock wave phenomena, from the aspect of both meteor science and hypersonic gas dynamics. The primary emphasis of this review is placed on the mechanisms and dynamics of the meteor shock waves. We discuss key aspects of both shock generation and propagation, including the great importance of the hydrodynamic shielding that develops around the meteoroid. In addition to this in-depth review, the discussion is extended to an overview of meteoroid fragmentation, followed by airburst type events associated with large, deep penetrating meteoroids. This class of objects has a significant potential to cause extensive material damage and even human casualties on the ground, and as such is of great interest to the planetary defense community. To date, no comprehensive model exists that accurately describes the flow field and shock wave formation of a strongly ablating meteoroid in the non-continuum flow regime. Thus, we briefly present the current state of numerical models that describe the comparatively slower flow of air over non-ablating bodies in the rarefied regime. In respect to the elusive nature of meteor generated shock wave detection, we also discuss relevant aspects and applications of meteor radar and infrasound studies as tools that can be utilized to study meteor shock waves and related phenomena. In particular, infrasound data can provide energy release estimates of meteoroids entering the Earth's atmosphere. We conclude with a summary of unresolved questions in the domain of meteor generated shock waves; topics which should be a focus of future investigations in the field. © 2018 COSPAR

Published
2018
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23. Emigration of doctors, military and alternative service service Some proposals based on a survey of medical students

Author

Michelow, I., Silber, E., and Price, M.R.

Abstract

In the face of a critical shortage of skilled medical personnel, especially in the rural areas of South Africa, and high rates of emigration of doctors, a survey was conducted in 1989 of white male medical stl!dents at the University of the Witwatersrand to assess their intentions to emigrate, their reasons for emigrating and their attitudes to alternative civilian service. Ninety-five per cent of respondents still had military service obligations; 39% said they were considering emigrating. Military service was ranked as the first or second most important reason by 59% of those intending to emigrate and 47% said they would remain in South Africa if alternative service were available. The majority of those willing to do alternative service were also willing to do this in rural areas. The introduction of the option of alternative service would reduce emigration, increase the provision of medical care in rural areas, and acknowledge the right of individuals to serve the country in a non-militar: capacity.

Published
2017

25. Consumer involvement in formulation of the questions to be answered: findings from the EAN Guideline on Palliative Care of People with severe Multiple Sclerosis

Author

Koepke, S., Giordano, A., Veronese, S., Rahn, A. C., Kleiter, I., Basedow-Rajwich, B., Fornari, A., Battaglia, M., Drulovic, J., Kooij, L., Koops, J., Mens, J., Meza Murillo, E. R., Milanov, I., Milo, R., Patti, F., Pekmezovic, T., Sastre-Garriga, J., Silber, E., Vosburgh, J., Voltz, R., Bay, J., Oliver, D., Solari, A., Koepke, S., Giordano, A., Veronese, S., Rahn, A. C., Kleiter, I., Basedow-Rajwich, B., Fornari, A., Battaglia, M., Drulovic, J., Kooij, L., Koops, J., Mens, J., Meza Murillo, E. R., Milanov, I., Milo, R., Patti, F., Pekmezovic, T., Sastre-Garriga, J., Silber, E., Vosburgh, J., Voltz, R., Bay, J., Oliver, D., and Solari, A.

Published
2018

26. Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomised, double-blind, placebo-controlled trial

Author

Lublin, F, Miller, D, Freedman, M, Cree, B, Wolinsky, J, Weiner, H, Lubetzki, C, Hartung, H, Montalban, X, Uitdehaag, B, Kappos, L, Easton, J, Kesselring, J, Weinshenker, B, Laupacis, A, Zarbin, M, Calandra, T, Temkin, N, Dimarco, J, Polman, C, Yousry, T, Hodgkinson, S, Barnett, M, King, J, Butzkueven, H, Macdonell, R, Taylor, B, D'Hooghe, M, Dubois, B, Seeldrayers, P, Mulleners, E, Willekens, B, Delvaux, V, Antel, J, Bhan, V, Devonshire, V, Grandmaison, F, O'Connor, P, Vorobeychik, G, Patry, D, Veloso, F, Duquette, P, Blevins, G, Jacques, F, Lee, L, Berger, J, Havrdova, E, Ticha, V, Kanovsky, P, Rektor, I, Minks, E, Pazdera, L, Vachova, M, Hradilek, P, Frederiksen, J, Petersen, T, Stenager, E, Kallela, M, Eralinna, J, Elovaara, I, Brochet, B, Pelletier, J, Camu, W, Wierstlewski, S, Edan, G, Vermersch, P, de Seze, J, Buttmann, M, Haas, J, Linker, R, Hohlfeld, R, Kieseier, B, Rauer, S, Baum, K, Faiss, J, Tiel Wilck, K, Ziemssen, T, Berthele, A, Maschke, M, Meuth, S, Sailer, M, Kastrup, O, Kleiter, I, Stangel, M, Jakab, G, Csiba, L, Csanyi, A, Imre, P, Rozsa, A, Sándor, P, Valikovics, A, Comi, G, Trojano, M, Lugaresi, A, Colle, A, Ghezzi, A, Mancardi, G, Capra, R, Perini, P, Scarpini, E, Centonze, D, Pozzilli, C, Patti, F, Grimaldi, L, Bertolotto, A, van Oosten, B, de Jong, B, Hupperts, R, van Dijl, R, Frequin, S, Hengstman, G, Selmaj, K, Czlonkowska, A, Kaminska, A, Stelmasiak, Z, Ramo, C, Ramio, L, Izquierdo, G, Arroyo, R, Casanova, B, Garcia Merino, J, Rodriguez Antigüedad, A, Brieva, L, Martinez Yelamos, S, Diaz Tejedor, E, Saiz Hinarejos, A, Olsson, T, Lycke, J, Linnebank, M, Schluep, M, Kamm, C, Gobbi, C, Bebek, N, Dokuz, E, Zorlu, Y, Karabudak, R, Terzi, M, Duddy, M, Lee, M, Nicholas, R, Silber, E, Sharrack, B, Chataway, J, Cottrell, D, Rog, D, Schmierer, K, Mitchell, G, Nelson, F, Saidha, S, Houtchens, M, Graves, D, Miller, A, Agius, M, Bowen, J, Rae Grant, A, Lynch, S, Reder, A, Cascione, M, Cohen, B, Coyle, P, Brook, S, Luzzio, C, Goldman, M, Conway, J, Khan, O, Parks, B, Steingo, B, Weinstock Guttman, B, Lathi, E, Bandari, D, Corboy, J, English, J, Picone, M, Goodman, A, Applebee, A, Gazda, S, Kisanuki, Y, Skeen, M, Wray, S, Moses, H, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Clinical sciences, Neuroprotection & Neuromodulation, Neurology, Amsterdam Neuroscience - Neuroinfection & -inflammation, Willekens, Barbara, and INFORMS study investigators

Subjects
0301 basic medicine, Male, Clinical Trial, Phase III, administration & dosage, Placebo-controlled study, Aucun, Administration, Oral, chemistry.chemical_compound, 0302 clinical medicine, 10. No inequality, Medicine(all), education.field_of_study, Research Support, Non-U.S. Gov't, Orvostudományok, General Medicine, Middle Aged, Multiple Sclerosis, Chronic Progressive, Fingolimod, 3. Good health, drug therapy, Multicenter Study, Treatment Outcome, Randomized Controlled Trial, Disease Progression, Female, Settore MED/26 - Neurologia, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Population, Klinikai orvostudományok, Placebo, 03 medical and health sciences, Young Adult, Double-Blind Method, Internal medicine, Fingolimod Hydrochloride, Journal Article, medicine, Humans, education, Aged, Expanded Disability Status Scale, Dose-Response Relationship, Drug, business.industry, Multiple sclerosis, medicine.disease, Surgery, 030104 developmental biology, Siponimod, chemistry, Human medicine, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

BACKGROUND: No treatments have been approved for primary progressive multiple sclerosis. Fingolimod, an oral sphingosine 1-phosphate receptor modulator, is effective in relapse-onset multiple sclerosis, but has not been assessed in primary progressive multiple sclerosis. We assessed the safety and efficacy of fingolimod in patients with primary progressive multiple sclerosis. METHODS: In INFORMS, a multicentre, double-blind, placebo-controlled parallel-group study, patients with primary progressive multiple sclerosis recruited across 148 centres in 18 countries were randomly allocated (1:1) with computer-generated blocks to receive oral fingolimod or placebo for at least 36 months and a maximum of 5 years. Patients were initially assigned to fingolimod 1·25 mg per day or placebo (cohort 1); however, after a protocol amendment on Nov 19, 2009, patients were switched in a masked manner to fingolimod 0·5 mg, whereas those on placebo continued on matching placebo. From then onwards, patients were assigned to receive fingolimod 0·5 mg/day or placebo (cohort 2). Key inclusion criteria were age 25-65 years, clinical diagnosis of primary progressive multiple sclerosis, 1 year or more of disease progression, and two of the following criteria: positive brain MRI; positive spinal cord MRI; or positive cerebrospinal fluid. Additional eligibility criteria included disease duration of 2-10 years and objective evidence of disability progression in the previous 2 years. Patients and study investigators were masked to group assignment. We used a novel primary composite endpoint based on change from baseline in Expanded Disability Status Scale (EDSS), 25' Timed-Walk Test, or Nine-Hole Peg Test to assess time to 3-month confirmed disability progression in study participants treated for at least 3 years. All randomised patients took at least one dose of study drug. The primary efficacy analysis included all patients in cohort 2 and those assigned to placebo in cohort 1. The safety analysis included all patients in cohorts 1 and 2. This study is registered with ClinicalTrials.gov, number NCT00731692. The study is now closed. FINDINGS: 970 patients were randomly assigned between Sept 3, 2008, and Aug 30, 2011 (147 to fingolimod 1·25 mg and 133 to placebo in cohort 1; 336 to fingolimod 0·5 mg and 354 to placebo in cohort 2). The efficacy analysis set (n=823) consisted of 336 patients randomly allocated to fingolimod 0·5 mg and 487 to placebo. Baseline characteristics were similar across groups and representative of a primary progressive multiple sclerosis population (48% women, mean age 48·5 years [SD 8·4], mean EDSS 4·67 [SD 1·03], 87% free of gadolinium-enhancing lesions). By end of study, 3-month confirmed disability progression had occurred in 232 and 338 patients in the fingolimod and placebo groups, respectively, resulting in Kaplan-Meier estimates of 77·2% (95% CI 71·87-82·51) of patients in the fingolimod group versus 80·3% (73·31-87·25) of patients in the placebo group (risk reduction 5·05%; hazard ratio 0·95, 95% CI 0·80-1·12; p=0·544). Safety results were generally consistent with those of studies of fingolimod in patients with relapse-onset multiple sclerosis. Lymphopenia occurred in 19 (6%) patients in the fingolimod group versus none in the placebo group, bradycardia in five (1%) versus one (

Published
2016
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27. Phase III Dose-Comparison Study of Glatiramer Acetate for Multiple Sclerosis

Author

Comi, G, Cohen, Ja, Arnold, Dl, Wynn, D, Filippi, M, FORTE Study Group, Rocc, Ma, Perego, E, Absinta, M, Mesaros, S, Vuotto, R, Misci, P, Petrolini, M, Coyle, P, Wolinsky, J, Antel, J, Zamvil, S, Feigin, P, Carra, Aj, Bettinelli, Rj, Luetic, Gg, Vrech, Ca, Dubois, Bd, Metz, L, Bar Or, A, Bhan, V, Myles, M, Havrdova, E, Ehler, E, Kanovsky, P, Talab, R, Zapletalova, O, Gross Paju, K, Taba, P, Elovaara, I, Erälinna, Jp, Kinnunen, E, Koivisto, K, Reunanen, M, Brochet, B, Camu, W, Damier, P, Defer, G, Tumani, H, Becker, E, Buettner, T, Diener, Hc, Franz, P, Haas, J, Heesen, C, Heidenreich, F, Koelmel, Hw, Reifschneider, G, Retzlaff, K, Thoemke, F, Ziemssen, T, Rozsa, C, Bartos, L, Csanyi, A, Deme, I, Komoly, S, Panczel, G, Simo, M, Achiron, A, Milo, R, Bergamaschi, R, Bertolotto, A, Capra, R, Caputo, D, Cavalla, P, Centonze, D, Cottone, S, DE STEFANO, Nicola, Gasperini, C, Mancardi, G, Provinciali, L, Ruggieri, S, Scarpini, E, Zaffaroni, M, Metra, M, Kizlaitiene, R, Vaitkus, A, Zwanikken, Cp, Hupperts, Rm, Jongen, Pj, Szczudlik, A, Fryze, W, Kazibutowska, Z, Pierzchaa, K, Pniewski, J, Podemski, R, Stepień, A, Bajenaru, O, Campeanu, A, Marginean, I, Popescu, Cd, Toldisan, I, Boiko, A, Gustov, A, Malkova, N, Perfilyev, S, Poverennova, I, Saykhunov, M, Shutov, A, Skoromets, A, Spirin, N, Stolyarov, I, Volkova, L, Rodriguez Antigüedad, A, Arbizu, T, Arroyo, R, Barcena, J, Casanova, B, Fernández, O, Montalban, X, Ramió, L, Saiz Hinarejos, A, Sharrack, B, Silber, E, Young, C, Agius, M, Birnbaum, G, Campagnolo, D, Chaudhary, K, Cohen, J, Ford, C, Fox, E, Goodman, A, Green, B, Gupta, A, Hughes, B, Javed, A, Jeffery, D, Kasper, L, Kaufman, M, Khan, O, Kresa Reahl, K, Leist, T, Lynch, S, Markowitz, C, Mattson, D, Moses, H, Parks, B, Parry, G, Phillips, T, Picone, M, Rammohan, K, Rizvi, S, Royal, W, Scarberry, S, Sheppard, C, Simnad, V, Thrower, B, Whitham, R, Wynn, D., Comi, G, Cohen, Ja, Arnold, Dl, Wynn, D, Filippi, M, FORTE Study, Group, Diener, Hans Christoph (Beitragende*r), Klinische Neurowetenschappen, and RS: MHeNs School for Mental Health and Neuroscience

Subjects
Male, Medizin, MULTICENTER, Relapsing-Remitting, Gastroenterology, law.invention, DOUBLE-BLIND, Randomized controlled trial, law, Recurrence, Drug Toxicity, Clinical endpoint, Secondary Prevention, administration /&/ dosage/adverse effects/therapeutic use, Middle Aged, drug therapy, Intention to Treat Analysis, Treatment Outcome, Neurology, Tolerability, Disease Progression, RELAPSE RATE, TRIAL, Female, Settore MED/26 - Neurologia, Drug, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Multiple Sclerosis, Drug-Related Side Effects and Adverse Reactions, Adolescent, Endpoint Determination, DOUBLE-BLIND, RELAPSE RATE, FOLLOW-UP, DISABILITY, TRIAL, MULTICENTER, MS, Dose-Response Relationship, Multiple Sclerosis, Relapsing-Remitting, Adolescent, Adult, Disease Progression, Dose-Response Relationship, Drug, Drug Toxicity, Endpoint Determination, Female, Humans, Immunosuppressive Agents, administration /&/ dosage/adverse effects/therapeutic use, Intention to Treat Analysis, Male, Middle Aged, Multiple Sclerosis, drug therapy, Multiple Sclerosis, drug therapy, Peptides, administration /&/ dosage/adverse effects/therapeutic use, Recurrence, prevention /&/ control, Treatment Outcome, Internal medicine, medicine, Humans, Glatiramer acetate, Expanded Disability Status Scale, Intention-to-treat analysis, Peptides, Dose-Response Relationship, Drug, business.industry, DISABILITY, MS, Glatiramer Acetate, Confidence interval, Surgery, Relative risk, prevention /&/ control, Neurology (clinical), FOLLOW-UP, business
Abstract

Objective: To evaluate the safety, tolerability, and efficacy of glatiramer acetate (GA) 40mg compared to a 20mg dose. Methods: Patients with multiple sclerosis (MS) with ≥1 documented relapse in 12 months prior to screening, or ≥2 documented relapses in 24 months prior to screening, and Expanded Disability Status Scale (EDSS) score 0 to 5.5 were enrolled. Patients were evaluated at screening, baseline, and at months 1, 2, 3, 6, 9, and 12. Primary endpoint was rate of confirmed relapses observed during 12-month study. Analysis was by intent-to-treat. Results: A total of 1,155 patients randomized to GA 20mg (n = 586) or 40mg (n = 569). The groups were well-matched at baseline on demographic, clinical, and magnetic resonance imaging (MRI) characteristics. The primary endpoint was similar in both groups (relative risk [RR] = 1.07; 95% confidence interval [CI], 0.88–1.31; p = 0.486) with mean annualized relapse rates (ARRs) of 0.33 for the 20mg group, 0.35 for the 40mg group, and 0.27 for patients from both groups who completed the entire 1-year treatment. A total of 77% of patients remained relapse-free in both groups. Both groups showed a reduction in mean number of gadolinium-enhancing and new T2 lesions over time with trend for faster reduction in the first trimester with the 40mg dose compared with 20mg dose. Both doses were well-tolerated with a safety profile similar to that observed in previous studies of 20mg GA. Interpretation: In relapsing-remitting MS patients, both the currently-approved GA 20mg and 40mg doses were safe and well-tolerated, with no gain in efficacy for the higher dose. Ann Neurol 2011;69:75–82.

Published
2011
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28. On shock waves and the role of hyperthermal chemistry in the early diffusion of overdense meteor trains

Author

Silber, E. A., Hocking, W. K., Niculescu, M. L., Gritsevich, M., Silber, R. E., Silber, E. A., Hocking, W. K., Niculescu, M. L., Gritsevich, M., and Silber, R. E.

Abstract

Studies of meteor trails have until now been limited to relatively simple models, with the trail often being treated as a conducting cylinder, and the head (if considered at all) treated as a ball of ionized gas. In this article, we bring the experience gleaned from other fields to the domain of meteor studies, and adapt this prior knowledge to give a much clearer view of the microscale physics and chemistry involved in meteor-trail formation, with particular emphasis on the first 100 or so milliseconds of the trail formation.We discuss and examine the combined physicochemical effects of meteor-generated and ablationally amplified cylindrical shock waves that appear in the ambient atmosphere immediately surrounding the meteor train, as well as the associated hyperthermal chemistry on the boundaries of the high temperature post-adiabatically expanding meteor train. We demonstrate that the cylindrical shock waves produced by overdense meteors are sufficiently strong to dissociate molecules in the ambient atmosphere when it is heated to temperatures in the vicinity of 6000 K, which substantially alters the considerations of the chemical processes in and around the meteor train.We demonstrate that some ambient O2, along with O2 that comes from the shock dissociation of O3, survives the passage of the cylindrical shock wave, and these constituents react thermally with meteor metal ions, thereby subsequently removing electrons from the overdense meteor train boundary through fast, temperature-independent, dissociative recombination governed by the second Damköhler number. Possible implications for trail diffusion and lifetimes are discussed. © 2017 The Authors.

Published
2017

31. The threat of Centaurs for terrestrial planets and their orbital evolution as impactors.

Author

Galiazzo, M A, Silber, E A, and Dvorak, R

Subjects
INNER planets, CASCADE impactors (Meteorological instruments), TRANS-Neptunian objects, CELESTIAL mechanics, STELLAR evolution
Abstract

Centaurs are solar system objects with orbits situated among those of the giant planets. Originating mainly from the Trans-Neptunian objects, Centaurs represent one of the sources of Near-Earth Objects. Thus, it is crucial to understand their orbital evolution which in some cases might end in collision with terrestrial planets and produce catastrophic events. We study the orbital evolution of the Centaurs toward the inner solar system and estimate the number of close encounters and impacts with the terrestrial planets after the Late Heavy Bombardment, assuming a steady-state population of Centaurs. We also estimate the possible crater sizes. We compute the approximate amount of water released on the Earth, which is about 10−5 of the total water present now. We also found subregions of the Centaurs where the possible impactors originate from. While crater sizes could extend up to hundreds of kilometres in diameter, given the presently known population of Centaurs the majority of the craters would be less than ∼10 km in all the planets. For an average impactor size of ∼12 km in diameter, the average impact frequency since the Late Heavy Bombardment is one every ∼1.9 Gyr for the Earth and 2.1 Gyr for Venus. For smaller bodies (e.g. >1 km), the impact frequency is one every 14.4 Myr for the Earth, 13.1 Myr for Venus, and 46.3 for Mars in the recent solar system. Only 53 per cent of the Centaurs can enter into the terrestrial planet region and ∼7 per cent can interact with terrestrial planets. [ABSTRACT FROM AUTHOR]

Published
2019
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32. The Chelyabinsk airburst: Implications for the Impact Hazard

Author

Brown, P.G., Assink, J.D., Astiz, L., Blaauw, R., Boslough, M.B., Borovicka, J., Brachet, N., Brown, D., Campbell-Brown, M., Ceranna, L., Cooke, W., de Groot-Hedin, C., Drob, D.P., Edwards, W., Evers, L.G., Garces, M., Gill, J., Hedlin, M., Kingery, A., Laske, G., le Pichon, A., Mialle, P., Moser, D.E., Saffer, A., Silber, E., Smets, P.S.M., Spalding, R.E., Spurny, P., Tagliaferri, E., Uren, D., Weryk, J., Whitaker, R., and Krzeminski, Z.

Subjects
asteroids, comets and Kuiper belt, meteoritics
Published
2013

40. Health-related quality of life in multiple sclerosis: Effects of natalizumab

Author

Rudick, R. A., Miller, D., Hass, S., Hutchinson, M, Calabresi, P. A., Confavreux, C., Galetta, S. L., Giovannoni, G., Havrdova, E., Kappos, L., Lublin, F. D., Miller, D. H., O'Connor, P. W., Phillips, J. T., Polman, C. H., Radue, Ew, Stuart, W. H., Wajgt, A., Weinstock Guttman, B., Wynn, D. R., Lynn, F., Panzara, M. A., Affirm, Macdonell, SENTINEL Investigators including: R., Hughes, A., Taylor, I., Lee, Y. C., Ma, H., King, J., Kilpatrick, T., Butzkueven, H., Marriott, M., Pollard, J., Spring, P., Spies, J., Barnett, M., Dehaene, I., Vanopdenbosch, L., D’Hooghe, M., Van Zandijcke, M., Derijck, O., Seeldrayers, P., Jacquy, J., Piette, T., De Cock, C., Medaer, R., Soors, P., Vanroose, E., Vanderhoven, L., Nagels, G., Dubois, B., Deville, M. C., D’Haene, R., Jacques, F., Hallé, D., Gagnon, S., Likavcan, E., Murray, T. J., Bhan, V., Mackelvey, R., Maxner, C. E., Christie, S., Giaccone, R., Guzman, D. A., Melanson, M., Esfahani, F., Gomori, A. J., Nagaria, M. H., Grand’Maison, F., Berger, L., Nasreddine, Z., Duplessis, M., Brunet, D., Jackson, A., Pari, G., O’Connor, P., Gray, T., Hohol, M., Marchetti, P., Lee, L., Murray, B., Sahlas, J., Perry, J., Devonshire, V., Hooge, J., Hashimoto, S., Oger, J., Smyth, P., Rice, G., Kremenchutzky, M., Stourac, P., Kadanka, Z., Benesova, Y., Niedermayerova, I., Meluzinova, E., Marusic, P., M, Bojar, Zarubova, K., Houzvicková, E., Piková, J., Talab, R., Faculty, Hospital Olomouc, Olomouc, B. Muchova, Urbánek, K, Kettnerova, Z., Mares, J., Otruba, P., Zapletalová, O., Hradilek, P., Ddolezil, D. Dolezil, Woznicova, I., Höfer, R., Ambler J. Fiedler, Z. Ambler J. Fiedler, Sucha, J., Matousek, V., Rektor, I., Dufek, M., Mikulik, R., Mastik, J., Tyrlikova, I., General, Teaching Hospital, Prague, E. Havrdová, Horakova, D., Kalistová, H., Týblová, M., Ehler, E., Novotná, A., Geier, P., Soelberg Sorensen, P., Ravnborg, M., Petersen, B., Blinkenberg, M., Färkkilä, M., Harno, H., Kallela, M., Häppölä, O., Elovaara, I., Kuusisto, H., Ukkonen, M., Peltola, J., Palmio, J., Pelletier, J., Feuillet, L., Suchet, L., Dalecky, A., Tammam, D., Edan, G., Le Page, E., Mérienne, M., Yaouanq, J., Clanet, M., Mekies, C., Azais Vuillemin, C., Senard, A., Lau, G., Steinmetz, G., Warter V. Wolff, J. Warter V. Wolff, Fleury, M., Tranchant, C., Stark, E., Buckpesch Heberer, U., Henn, K. H., Skoberne, T., Schimrigk, S., Hellwig, K., Brune, N., Weiller, C., Gbadamosi, J., Röther, J., Heesen, C., Buhmann, C., Karageorgiou, C., Korakaki, D., Giannoulis, D. r., Tsiara, S., Thomaides, T., Thomopoulos, I., Papageorgiou, H., Armakola, F., Komoly, S., Rózsa, C., Matolcsi, J., Szabó, G. y., Molnár, B., Lovas, G., Dioszeghy, P., Szulics, P., Magyar, Z., Incze, J., Farkas, J., Clemens, B., Kánya, J., Valicskó, Z. s., Bense, E., Nagy, Z. s., Geréby, G., Perényi, J., Simon, Z. s., Szapper, M., Gedeon, L., Csanyi, A., Rum, G., Lipóth, S., Szegedi, A., Jávor, L., Nagy, I., Adám, I., Szirmai, I., Simó, M., Ertsey, C., I, Amrein, Kamondi, A., Harcos, P., Dobos, E., Szabó, B., Balas, V., Guseo, A., Fodor, E., Jófejü, E., Eizler, K., Csiba, L., Csépány, T., Pallagi, E., Bereczki, D., Jakab, G., Juhász, M., Bszabó, B. Szabó I. Mayer, Katona, G., Hutchinson, M., O’Dwyer, J., O’Rourke, K., Sanders, E. A. C. M., Rijk van Andel, J. F., Bomhof, M. A. M., van Erven, P., Hintzen I. Hoppenbrouwers, R. Q. Hintzen I. Hoppenbrouwers, Neuteboom, R. F., Zemel, D., van Doorn, P. A., Jacobs, B. C., Munster, E. T. h. L. Van, ter Bruggen, J. P., Bernsen, R., Jongen, P. J. H., de Smet, E. A. A., Tacken, H. F. H., Polman, C., Zwemmer, J., Nielsen, J., Kalkers, N., Kragt, J., Jasperse, B., Willoughby, E., Anderson, N. E., Barber, A., Anderson, T., Parkin, P. J., Fink, J., Avery, S., Mason, D., Kwiecinski, H., Zakrzewska Pniewska, B., Kaminska, A., Podlecka, A., Nojszewska, M., Czlonkowska, A., Zaborski, J., Wicha, W., Kruszewska Ozimowska, J., Darda Ledzion, L., Selmaj, K., Mochecka Thoelke, A., Pentela Nowicka, J., Walczak, A., Stasiolek, M., Stelmasiak, Z., Bartosik Psujek, H., Mitosek Szewczyk, K., Belniak, E., Chyrchel, U., Maciejowski, M., Strzyzewska Lubos, L., Lubos, L., Matusik, E., Maciejek, Z., Niezgodzinska Maciejek, A., Sobczynska, D., Slotala, T., Wawrzyniak, S., Kochanowicz K. Kuczynski, J. Kochanowicz K. Kuczynski, Zimnoch, R., Pryszmont, M., Drozdowski, W., Baniukiewicz, E., Kulakowska, A., Borowik, H., Lewonowska, M., Szczudlik, A., Róg, T., Gryz Kurek, E., Pankiewicz, J., Furgal, J., Kimkowicz, A., Fryze, W., Wierbicki, T., Michalak, L., Kowalewska, J., Swiatkiewicz, J., Hillert, J., Åkesson, E, Fredrikson, S., Diener, P, Olsson, T., Wallström, E., Fpiehl, F. Piehl L. Hopia, Brundin, L., Marta, M., Andersson, M., Lycke, J., Runmarker, B., Malmeström, C., Vaghfeldt, P., Skoog, B., Schluep, M., Bogousslavskyr, J., Du Pasquier, R., Achtnichts, L., Kuhle, J., Buitrago Telez, C., Schläger, R., Naegelin, Y., Eraksoy, M., Bebek, N., Akman Demir, G., Topcuoglu, B., Kurtuncu, M., Istanbul, University, Istanbul:, A. Siva, Saip, S., Altintas, A., Kiyat, A., Sharief, M., Kasti, M., Lim, E. T., Rashid, W., Silber, E., Saldanha, G., Hawkins, C., Mamutse, G., Woolmore, J., Hawkes, C., Findley, L., Dasilva, R., Gunasekara, H., Palace, J., Cader, Z., Littleton, E., Burke, G., Sharrack O. Suliman, B. Sharrack O. Suliman, Klaffke, S., Swash, M., Dhillon, H., Bates, D., Westwood, M., Nichol, P., Barnes, D., Wren, D., Stoy, N., Robertson, N., Pickersgill, T., Pearson, O., Lawthom, C., Young, C., Mills, R., Lecky, B., Ford, C., Katzman, J., Rosenberg, G., Cooper, J., Wrubel, B., Richardson, B., Lynch, S., Ridings, L., Mcvey, A., Nowack, W., Rae Grant, A., Mackin, G. A., Castaldo, J. E., Spikol, L. J., Carter, J., Wingerchuk, D., Caselli, R., Dodick, D., Scarberry, S., Bailly, R., Garnaas, K., Haake, B., Rossman, H., Belkin, M., Boudouris, W. D., Pierce, R. P., Mass, M., Yadav, V., Bourdette, D., Whitham, R. H., Heitzman, D., Martin, A., Greenfield, C. F., Agius, M., Richman, D. P., Vijayan, N., Wheelock, V. L., Reder, A., Arnason, B., Noronha, A., Balabanov, R., Ray, A., Sheremata, W., Delgado, S., Shebert, B., Maldonado, J., Bowen, J., Garden, G. A., Distad, B. J., Carrithers, M., Rizzo, M., Vollmer, T., Reiningerova, J., Guarnaccia, J., Lo, A., Richardson, G. 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Subjects
Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Visual analogue scale, Health Status, Population, Pain, Comorbidity, Placebo, Antibodies, law.invention, Natalizumab, Randomized controlled trial, Quality of life, Double-Blind Method, law, Internal medicine, Surveys and Questionnaires, Monoclonal, medicine, Prevalence, Humans, Longitudinal Studies, education, Humanized, education.field_of_study, Expanded Disability Status Scale, Neuroscience (all), business.industry, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Female, Patient Satisfaction, Treatment Outcome, United States, Quality of Life, Multiple sclerosis, medicine.disease, Neurology, Physical therapy, Neurology (clinical), business, medicine.drug
Abstract

Objective To report the relationship between disease activity and health-related quality of life (HRQoL) in relapsing multiple sclerosis, and the impact of natalizumab. Methods HRQoL data were available from 2,113 multiple sclerosis patients in natalizumab clinical studies. In the Natalizumab Safety and Efficacy in Relapsing Remitting Multiple Sclerosis (AFFIRM) study, patients received natalizumab 300mg (n = 627) or placebo (n = 315); in the Safety and Efficacy of Natalizumab in Combination with Interferon Beta-1a in Patients with Relapsing Remitting Multiple Sclerosis (SENTINEL) study, patients received interferon beta-1a (IFN-β-1a) plus natalizumab 300mg (n = 589), or IFN-β-1a plus placebo (n = 582). The Short Form-36 (SF-36) and a subject global assessment visual analog scale were administered at baseline and weeks 24, 52, and 104. Prespecified analyses included changes from baseline to week 104 in SF-36 and visual analog scale scores. Odds ratios for clinically meaningful improvement or worsening on the SF-36 Physical Component Summary (PCS) and Mental Component Summary were calculated. Results Mean baseline SF-36 scores were significantly less than the general US population and correlated with Expanded Disability Status Scale scores, sustained disability progression, relapse number, and increased volume of brain magnetic resonance imaging lesions. Natalizumab significantly improved SF-36 PCS and Mental Component Summary scores at week 104 in AFFIRM. PCS changes were significantly improved by week 24 and at all subsequent time points. Natalizumab-treated patients in both studies were more likely to experience clinically important improvement and less likely to experience clinically important deterioration on the SF-36 PCS. The visual analog scale also showed significantly improved HRQoL with natalizumab. Interpretation HRQoL was impaired in relapsing multiple sclerosis patients, correlated with severity of disease as measured by neurological ratings or magnetic resonance imaging, and improved significantly with natalizumab. Ann Neurol 2007

Published
2007

41. The Chelyabinsk airburst: Implications for the Impact Hazard

Author

Brown, P.G. (author), Assink, J.D. (author), Astiz, L. (author), Blaauw, R. (author), Boslough, M.B. (author), Borovicka, J. (author), Brachet, N. (author), Brown, D. (author), Campbell-Brown, M. (author), Ceranna, L. (author), Cooke, W. (author), de Groot-Hedin, C. (author), Drob, D.P. (author), Edwards, W. (author), Evers, L.G. (author), Garces, M. (author), Gill, J. (author), Hedlin, M. (author), Kingery, A. (author), Laske, G. (author), le Pichon, A. (author), Mialle, P. (author), Moser, D.E. (author), Saffer, A. (author), Silber, E. (author), Smets, P.S.M. (author), Spalding, R.E. (author), Spurny, P. (author), Tagliaferri, E. (author), Uren, D. (author), Weryk, J. (author), Whitaker, R. (author), Krzeminski, Z. (author), Brown, P.G. (author), Assink, J.D. (author), Astiz, L. (author), Blaauw, R. (author), Boslough, M.B. (author), Borovicka, J. (author), Brachet, N. (author), Brown, D. (author), Campbell-Brown, M. (author), Ceranna, L. (author), Cooke, W. (author), de Groot-Hedin, C. (author), Drob, D.P. (author), Edwards, W. (author), Evers, L.G. (author), Garces, M. (author), Gill, J. (author), Hedlin, M. (author), Kingery, A. (author), Laske, G. (author), le Pichon, A. (author), Mialle, P. (author), Moser, D.E. (author), Saffer, A. (author), Silber, E. (author), Smets, P.S.M. (author), Spalding, R.E. (author), Spurny, P. (author), Tagliaferri, E. (author), Uren, D. (author), Weryk, J. (author), Whitaker, R. (author), and Krzeminski, Z. (author)

Abstract

Geoscience & Engineering, Civil Engineering and Geosciences

Published
2013

43. Neurosarcoidosis presenting as ghost lesions in the CNS: a diagnostic dilemma

Author

Wijesekera L, Crocker M, Silber E, deSouza Rm, Chandler C, and Hampton T

Subjects
medicine.medical_specialty, Stereotactic biopsy, Sarcoidosis, Fourth ventricle, Dizziness, Diagnosis, Differential, Central Nervous System Diseases, medicine, Humans, Past medical history, medicine.diagnostic_test, business.industry, Headache, Neurosarcoidosis, Magnetic resonance imaging, General Medicine, Middle Aged, medicine.disease, Pronator drift, Magnetic Resonance Imaging, Gait Ataxia, Female, Radiology, Headaches, medicine.symptom, business
Abstract

A 50-year-old woman presented with a short history of headaches and dizziness. One week earlier she noticed impaired right leg coordination and had fallen twice. She had no significant past medical history. Examination showed impaired right arm and leg coordination, mild pronator drift and gait ataxia with no other neurological deficits. A magnetic resonance imaging scan of the brain showed an intra-axial mass lesion centred on the right middle cerebellar peduncle with partial effacement of the fourth ventricle and an unusual, slightly nodular pattern of enhancement (Figure 1). A computed tomography scan of the chest demonstrated bilateral nodular hilar masses felt consistent with reactive lymphadenopathy. No single large mass was present. Brain magnetic resonance imaging was consistent with either a primary lesion or atypical metastasis. She commenced dexamethasone 4 mg four times per day and stereotactic biopsy was scheduled. The planning magnetic resonance imaging, 2 weeks later, demonstrated marked reduction in the lesion's size raising the possibility of CNS lymphoma. Surgery was cancelled. Lumbar puncture showed no abnormalities. The steroid dose was reduced as a result of cushingoid sequelae and to establish if the lesion would re-expand. Interval scans showed progressive reduction in mass size despite decreasing steroid doses. Partial signal normalization within the cerebellum with resolution of mass effect and enhancement was observed (Figure 2). Repeat computed tomography of the chest (Figure 3) showed new, small, peripheral, left and right upper lobe pulmonary lesions. Histology following open biopsy of the left-sided lesion showed noncoalescent non-necrotizing granulomata consistent with sarcoidosis. Six months later the patient remains symptom free on prednisolone 2.5 mg once per day.

Published
2008
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46. Upper limb motor function at 5000 metres: determinants of performance and residual sequelae.

Author

Silber E and Silber, E

Abstract

Little is known about the effects of age and symptoms of acute mountain sickness and the potential benefit of short term acclimatisation on fine motor performance at altitude. There is uncertainty about whether time spent at altitude results in permanent neurological sequelae. Nine hole pegboard tests were performed on a group of trekkers at sea level (n=61), after ascending to Kanchenjunga base camp (5100 m; n=46), and 20 weeks after return to sea level (n=43). Comparison of baseline and altitude times showed a mean slowing from 36.2 to 39.0 seconds, a 7. 8% deterioration in performance (p<0.0001), which was greatest in subjects aged 50 years or older (5.04 v 1.93 seconds, p=0.017), those tested within 24 hours of arrival at 5100 m (4.75 seconds, 13. 3% v 0.48 seconds, 1.3% p<0.001), and persons experiencing symptoms of acute mountain sickness (p=0.012), each of which were independent determinants of deterioration. Repeat pegboard testing at sea level after 20 weeks showed no significant change compared with baseline (p=0.68). This confirms the deleterious effects of altitude on fine motor function, emphasises the benefit of acclimatisation, and suggests that older persons and those with symptoms of acute mountain sickness are particularly susceptible. The risk of long term motor dysfunction after exposure to these relatively moderate altitudes seems to be small. [ABSTRACT FROM AUTHOR]

Published
2000

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