Bioconcentration of pharmaceuticals by aquatic flora in an Australian river system.

Pharmaceuticals are emerging contaminants in the environment and are a ubiquitous presence in rivers downstream of wastewater treatment plant outfalls. Questions remain about the persistence of pharmaceuticals in rivers, and the uptake and bioconcentration of pharmaceuticals by aquatic plants. Our study took place in the Yarrowee/Leigh/Barwon River system in southeastern Australia. We quantified the concentrations of five pharmaceuticals (carbamazepine, primidone, propranolol, tramadol, and venlafaxine) in surface water at five sites along a 144-km stretch of river, downstream of the presumed primary point source (a wastewater treatment plant outfall). We quantified pharmaceuticals in the leaves of two aquatic plant species (Phragmites australis and Vallisneria australis) sampled at each site, and calculated bioconcentration factors. All five pharmaceuticals were detected in surface waters, and the highest detected concentration exceeded 500 ng.L-1 (tramadol). Four of the pharmaceuticals (all except tramadol) were detected and quantified at all sites, including the furthest site from the outfall (144 km). Carbamazepine showed less attenuation with distance from the outfall than the other pharmaceuticals. Carbamazepine and venlafaxine were quantified in the leaves of both aquatic plant species (range: 10-31 ng.g-1), and there was evidence that bioconcentration factors increased with decreasing surface water concentrations. The study demonstrates the potential long-distance persistence of pharmaceuticals in river systems, and the bioconcentration of pharmaceuticals by aquatic plants in natural ecosystems. These phenomena deserve greater attention as aquatic plants are a potential point of transfer of pharmaceuticals from aquatic ecosystems to terrestrial food webs.

A review of multi-disciplinary decomposition research and key drivers of variation in decay.

The decomposition of animal remains is a multifaceted process, involving ecological, biological, and chemical interactions. While the complexity is acknowledged through concepts like the necrobiome, it's unclear if this complexity is reflected in research. Appreciation of the complexity of decomposition is crucial for identifying sources of variation in estimations of time since death in medico-legal science, as well as building broader ecological knowledge of the decomposition process. To gain insights into the extent of multidisciplinary research in the field of decomposition science, we conducted an examination of peer-reviewed literature on four key drivers of variation: volatile organic compounds, microbes, drugs/toxins, and insects. Among 650 articles, we identified their scientific discipline, driver/s of variation investigated, and year of publication. We found that 19% explored relationships between two drivers, while only 4% investigated interactions between three. None considered all four drivers. Over the past three decades, there has been a steady increase in decomposition research publications, signifying its growing importance. Most research (79%) was linked to forensic science, highlighting opportunities for interdisciplinary collaboration in decomposition science. Overall, our review underscores the need to incorporate multidisciplinary approaches and theory into contemporary decomposition research.

DIGITAL NIST: An examination of the obstacles and opportunities in the digital transformation of NIST's reference materials.

Early in 2022, NIST embarked on a pilot project to produce digital calibration reports and digital certificates of analysis for reference materials. The goal is to produce examples of digital reports and certificates to assess the scope and challenges of digital transformation in those particular measurement services. This paper focuses on the Reference Material Certificate effort of the pilot project. Our aims for this part of the pilot project are: to generate a digital Reference Material Certificate from certification data; descriptive information about the material, and other data and metadata as needed; to generate a human-readable report from the digital Reference Material Certificate; and to hold a workshop to gather stakeholder feedback. The challenges for NIST include the diverse and complex information presently contained in NIST certificates, converting values to non-SI units to match the needs of stakeholders, and format updates to NIST Reference Material Certificates necessary to allow for machine generation. Other practical challenges include the wide variety of Reference Materials offered by NIST, as well as the needs of internal and external stakeholders. This presentation will report on the progress of the NIST effort and discuss some of the challenges and solutions to producing Digital Reference Material Certificates.

Lost to follow-up: Post-operative polysomnography in at-risk, pediatric obstructive sleep apnea.

OBJECTIVE: Analyze adherence to AASM recommendations for post-operative polysomnography in eligible pediatric patients. STUDY DESIGN: Retrospective Cohort. SETTING: Tertiary, Outpatient Sleep Lab. METHODS: We conducted a retrospective analysis of pediatric patients, ages 1-17, previously diagnosed with moderate-severe obstructive sleep apnea that completed a surgical intervention. Chart review included demographic data, a co-morbidity of interest, the presence of an otolaryngology, primary care, or sleep medicine encounter, time to follow-up, the presence of a post-operative polysomnography, time to post-operative polysomnography, and the presence of an annual follow-up with any provider. RESULTS: Of the 373 patients, 67 patients met inclusion criteria. Fifty-nine followed-up with any provider, with 21 completing post-operative polysomnography. Patients with residual or recurrent symptoms (p < 0.01) and all patients with severe obstructive sleep apnea (p = 0.04) were more likely to complete post-operative polysomnography (PSG). Sub-analysis across at-risk categories (isolated moderate, isolated severe, moderate & a co-morbidity, and severe & a co-morbidity) revealed patients with severe obstructive sleep apnea & a co-morbidity completed a follow-up PSG more often than isolated moderate obstructive sleep apnea (p = 0.01). There was a difference in follow-up with sleep medicine across at-risk categories (p < 0.01). CONCLUSION: Recurrent symptoms and increasing disease severity were associated with obtaining post-operative polysomnography. However, variability existed for which patients completed post-operative polysomnography. We speculate an inconsistent standard across disciplines, inadequate post-operative obstructive sleep apnea management education, and uncoordinated systemic processes contribute to this discrepancy. Our findings support a standardized, multi-disciplinary care pathway for the management of at-risk, pediatric obstructive sleep apnea.

Self-Assembled Peptide Habitats to Model Tumor Metastasis.

Metastatic tumours are complex ecosystems; a community of multiple cell types, including cancerous cells, fibroblasts, and immune cells that exist within a supportive and specific microenvironment. The interplay of these cells, together with tissue specific chemical, structural and temporal signals within a three-dimensional (3D) habitat, direct tumour cell behavior, a subtlety that can be easily lost in 2D tissue culture. Here, we investigate a significantly improved tool, consisting of a novel matrix of functionally programmed peptide sequences, self-assembled into a scaffold to enable the growth and the migration of multicellular lung tumour spheroids, as proof-of-concept. This 3D functional model aims to mimic the biological, chemical, and contextual cues of an in vivo tumor more closely than a typically used, unstructured hydrogel, allowing spatial and temporal activity modelling. This approach shows promise as a cancer model, enhancing current understandings of how tumours progress and spread over time within their microenvironment.

Implementing a Registry Federation for Materials Science Data Discovery.

As a result of a number of national initiatives, we are seeing rapid growth in the data important to materials science that are available over the web. Consequently, it is becoming increasingly difficult for researchers to learn what data are available and how to access them. To address this problem, the Research Data Alliance (RDA) Working Group for International Materials Science Registries (IMRR) was established to bring together materials science and information technology experts to develop an international federation of registries that can be used for global discovery of data resources for materials science. A resource registry collects high-level metadata descriptions of resources such as data repositories, archives, websites, and services that are useful for data-driven research. By making the collection searchable, it aids scientists in industry, universities, and government laboratories to discover data relevant to their research and work interests. We present the results of our successful piloting of a registry federation for materials science data discovery. In particular, we out a blueprint for creating such a federation that is capable of amassing a global view of all available materials science data, and we enumerate the requirements for the standards that make the registries interoperable within the federation. These standards include a protocol for exchanging resource descriptions and a standard metadata schema for encoding those descriptions. We summarize how we leveraged an existing standard (OAI-PMH) for metadata exchange. Finally, we review the registry software developed to realize the federation and describe the user experience.

Tuneable Hybrid Hydrogels via Complementary Self-Assembly of a Bioactive Peptide with a Robust Polysaccharide.

Synthetic materials designed for improved biomimicry of the extracellular matrix must contain fibrous, bioactive, and mechanical cues. Self-assembly of low molecular weight gelator (LMWG) peptides Fmoc-DIKVAV (Fmoc-aspartic acid-isoleucine-lysine-valine-alanine-valine) and Fmoc-FRGDF (Fmoc-phenylalanine-arginine-glycine-aspartic acid-phenylalanine) creates fibrous and bioactive hydrogels. Polysaccharides such as agarose are biocompatible, degradable, and non-toxic. Agarose and these Fmoc-peptides have both demonstrated efficacy in vitro and in vivo. These materials have complementary properties; agarose has known mechanics in the physiological range but is inert and would benefit from bioactive and topographical cues found in the fibrous, protein-rich extracellular matrix. Fmoc-DIKVAV and Fmoc-FRGDF are synthetic self-assembling peptides that present bioactive cues "IKVAV" and "RGD" designed from the ECM proteins laminin and fibronectin. The work presented here demonstrates that the addition of agarose to Fmoc-DIKVAV and Fmoc-FRGDF results in physical characteristics that are dependent on agarose concentration. The networks are peptide-dominated at low agarose concentrations, and agarose-dominated at high agarose concentrations, resulting in distinct changes in structural morphology. Interestingly, at mid-range agarose concentration, a hybrid network is formed with structural similarities to both peptide and agarose systems, demonstrating reinforced mechanical properties. Bioactive-LMWG polysaccharide hydrogels demonstrate controllable microenvironmental properties, providing the ability for tissue-specific biomaterial design for tissue engineering and 3D cell culture.

Murine Typhus Presenting With Mucosal Involvement.

Lipschutz ulcers (LU) present as painful genital ulcers in nonsexually active females. Associated infections include Epstein Barr virus, Mycoplasma pneumoniae, Cytomegalovirus, and influenza. To our knowledge, this is the first report of LU occurring with murine typhus. Murine typhus is caused by Rickettsia typhi, a Gram-negative, obligate intracellular organism. Rat fleas (Xenopsylla cheopis) are the classic vector, although cat fleas (Ctenocephalides felis) found on cats, dogs, and opossums have been implicated in maintaining the life cycle of R. typhi in suburban areas. Murine typhus can have a nonspecific presentation making a strong index of suspicion crucial to its diagnosis. The most common presenting signs include fever, poor appetite, malaise, and headache. Laboratory abnormalities may include elevated C-reactive protein, elevated erythrocyte sedimentation rate, hypoalbuminemia, elevated transaminases, elevated neutrophil band count, and thrombocytopenia. The treatment of choice for R. typhi is doxycycline.

BET 2: Is there an association between iodine, shellfish and contrast agent allergies?

A shortcut review was carried out to establish whether having a shellfish or iodine allergy changed the risk of allergic reaction in patients receiving radiocontrast medium more than other concomitant allergies. One relevant paper (a systematic review) was identified for inclusion using the reported search strategy. The author, date and country of publication; group studied; study type; relevant outcomes; results and study weaknesses of this paper are tabulated. It is concluded that there is no evidence that allergy to shellfish or iodine alters the risk of reaction to intravenous contrast more than any other allergies.

Colour tuning and enhancement of gel-based electrochemiluminescence devices utilising Ru(ii) and Ir(iii) complexes.

Combining luminophores in ratios that compensate for energy transfer provides a readily selectable range of new emission colours for gel-based electrochemiluminescence devices (ECLDs). A novel blue ECLD luminophore is also introduced and shown to enhance the intensity of the conventional green emitter through a mixed annihilation ECL mechanism. Peak-to-peak voltages were minimised using asymmetric potential pulse sequences, which increased the longevity of the ECLD emission.

Nephrogenic diabetes insipidus in a 15-year-old Hispanic female with a novel AQP2 mutation.

Nephrogenic diabetes insipidus (NDI) is a rare inherited disorder most often caused by mutations in the arginine-vasopressin receptors or aquaporin channels, which subsequently impairs the water reabsorption in the kidney. This case report describes a 15-year-old female diagnosed with NDI after an acute gastroenteritis and multiple fluid boluses leading to intractable emesis. Gene testing reveals our patient is compound heterozygous for novel AQP2 gene mutations with a cytosine-to-thymine substitution at nucleotide position 277 and adenine-to-cytosine substitution at nucleotide position 659. Therefore, we report a novel AQP2 gene mutation in an adolescent patient which is outside the common age for diagnosis.

Creation of a Flight Nurse Critical Care Ultrasound Program.

OBJECTIVE: Our objectives were 2-fold: to describe the creation of a flight nurse (FN) ultrasound (US) program and to evaluate whether critical care US performed by nonphysician providers in the prehospital setting can clarify patient assessment. METHODS: Twenty FNs completed a didactic and hands-on US curriculum focusing on critical care modalities. FNs displayed competency by successful completion of an objective-structured clinical examination. Portable US devices were used during patient transports when deemed clinically indicated by the FN. If US was subsequently performed, the FN was asked if US use prompted a change in assessment. Associations were evaluated with chi-square and bivariate logistic regression analyses. RESULTS: FNs reported US use during 102 (12.3%) patient transports, of which intensive care unit (ICU) to ICU (58.8%) constituted the majority of cases followed by emergency department (ED) to ED (28.4%), ED to ICU (4.9%), and scene to ED (2.9%). FNs agreed or strongly agreed that US use clarified the cause of patient symptoms in 67.4% of transports. CONCLUSION: FNs were more likely to perform US when they expressed lower confidence in their initial patient assessment. FNs reported that US helped to clarify patient assessments.

Influence of soil moisture regimes on growth, photosynthetic capacity, leaf biochemistry and reproductive capabilities of the invasive agronomic weed; Lactuca serriola.

Global temperatures are predicted to increase by 1.5-5.9°C during this century, and this change is likely to impact average rainfall, with predictions that water deficit will perhaps be the most severe threat to sustainable agriculture. In this respect, invasive weeds, which have traits better adapted to drought stress than crops, add to concerns regarding crop sustainability. Lactuca serriola, an aggressive agronomic weed is thought to be a successful weed because of its ability to maintain high water use efficiency under drought conditions. In this study, experiments were conducted to examine the influence of different soil moisture regimes (100%, 75%, 50% and 25% water holding capacity (WHC)) on growth, photosynthetic capacity, leaf biochemistry and reproduction of this species. Soil moisture significantly affected plant's height, stem diameter, number of leaves and biomass. The highest plant height (115.14 cm ± 11.64), shoot diameter (9.4 mm ± 0.18), leaf area (1206.5 mm2 ± 73.29), plant fresh weight (83.1 ± 3.98) and dry weight (22.38 ± 1.24) were recorded at 75% soil moisture content. A fundamental adaptation to drought was observed as plants in the 25% WHC treatment had the highest root: shoot ratio. Soluble sugars and total phenolic content were highest in the 25% WHC treatment and significantly different to 100% WHC which was a response to soil moisture stress to ameliorate the damaging effects of reactive oxygen species produced under stress conditions. Results also indicate that L. serriola can survive and produce seeds under water stress as more than 6000 seeds were produced per plant in all WHC treatments. In this study, there was no significant difference in the seed weight, number of seeds produced and their germination ability. This can have a huge impact on agricultural systems as the species can survive both under low and high soil moisture conditions. We therefore suggest that the demonstrated ability of L. serriola to complete its life cycle and produce biomass and seeds under water stressed conditions leads to the introduction of strategies that minimize weed survival while maximizing irrigation efficiency for the crop. A clear understanding of the ecological and biological characteristics of this weed will help land managers take appropriate control measures to mitigate the effect of this species on economic crop productivity.

Secondary Self-Assembly of Supramolecular Nanotubes into Tubisomes and Their Activity on Cells.

The properties and structures of viruses are directly related to the three-dimensional structure of their capsid proteins, which arises from a combination of hydrophobic and supramolecular interactions, such as hydrogen bonds. The design of synthetic materials demonstrating similar synergistic interactions still remains a challenge. Herein, we report the synthesis of a polymer/cyclic peptide conjugate that combines the capability to form supramolecular nanotubes via hydrogen bonds with the properties of an amphiphilic block copolymer. The analysis of aqueous solutions by scattering and imaging techniques revealed a barrel-shaped alignment of single peptide nanotubes into a large tubisome (length: 260 nm (from SANS)) with a hydrophobic core (diameter: 16 nm) and a hydrophilic shell. These systems, which have a structure that is similar to those of viruses, were tested in vitro to elucidate their activity on cells. Remarkably, the rigid tubisomes are able to perforate the lysosomal membrane in cells and release a small molecule into the cytosol.

Water-fat magnetic resonance imaging quantifies relative proportions of brown and white adipose tissues: ex-vivo experiments.

Quantifying the amount of brown adipose tissue (BAT) within white adipose tissue (WAT) in human depots may serve as a target to combat obesity. We aimed to quantify proton density fat fraction (PDFF) of BAT and WAT in relatively pure and in mixed preparation using water-fat imaging. Three ex-vivo experiments were performed at 3 T using excised interscapular BAT and inguinal/subcutaneous WAT from mice. The first two experiments consisted of BAT and WAT in separate tubes, and the third used mixed preparation with graded quantities of BAT and WAT. To investigate the influence of partial volume on PDFF metrics, low ( 2.66 mm3 ) and high spatial resolution ( 0.55 mm3 acquired voxels) in two orthogonal three-dimensional sections were compared. The low-resolution acquisitions are corrected for T2* and multipeak lipid spectrum, thus considered "quantitative," whereas the high-resolution acquisitions are not corrected but were performed to better spatially segment BAT from WAT zones. As potential BAT metrics, we quantified the average PDFF and the volume of tissue having PDFF ≤50% ( VOLPDFF≤50% ) based on the PDFF histogram. In the first experiment, the average PDFF of BAT was 23±6% and 21±7.6% and the average PDFF of WAT was 76±7% and 87±7% using high- and low-resolution techniques, respectively. A similar trend with excellent reproducibility in average PDFF of BAT and WAT was observed in the second experiment. In the third experiment over the four acquisitions, the BAT-dominant tube demonstrated lower PDFF (mean ± SD) of 55±2% than WAT-dominant (69±4%) and WAT-only tubes (88±4%) . Estimating VOLPDFF≤50% , the BAT-dominant tube demonstrated higher volume of 0.26 cm3 than WAT-dominant ( 0.16 cm3 ) and WAT-only tubes ( 0.01 cm3 ). The presence of BAT exhibits a lower PDFF relative to WAT, thus allowing segmentation of low PDFF tissue for quantification of volume representative of BAT. Future studies will determine the clinical relevance of BAT volume within human depots.

Scaffolds Formed via the Non-Equilibrium Supramolecular Assembly of the Synergistic ECM Peptides RGD and PHSRN Demonstrate Improved Cell Attachment in 3D.

Self-assembling peptides (SAPs) are a relatively new class of low molecular weight gelators which immobilize their solvent through the spontaneous formation of (fibrillar) nanoarchitectures. As peptides are derived from proteins, these hydrogels are ideal for use as biocompatible scaffolds for regenerative medicine. Importantly, due to the propensity of peptide sequences to act as signals in nature, they are easily functionalized to be cell instructive via the inclusion of bioactive epitopes. In nature, the fibronectin peptide sequence, arginine-glycine-aspartic acid (RGD) synergistically promotes the integrin α5ß1 mediated cell adhesion with another epitope, proline-histidine-serine-arginine-asparagine (PHSRN); however most functionalization strategies focus on RGD alone. Here, for the first time, we discuss the biomimetic inclusion of both these sequences within a self-assembled minimalistic peptide hydrogel. Here, based on our work with Fmoc-FRGDF (N-flourenylmethyloxycarbonyl phenylalanine-arginine-glycine-aspartic acid-phenylalanine), we show it is possible to present two epitopes simultaneously via the assembly of the epitopes by the coassembly of two SAPs, and compare this to the effectiveness of the signals in a single peptide; Fmoc-FRGDF: Fmoc-PHSRN (N-flourenylmethyloxycarbonyl-proline-histidine-serine-arginine-asparagine) and Fmoc-FRGDFPHSRN (N-flourenylmethyloxycarbonyl-phenylalanine-arginine-glycine-asparticacid-phenylalanine-proline-histidine-serine-arginine-asparagine). We show both produced self-supporting hydrogel underpinned by entangled nanofibrils, however, the stiffness of coassembled hydrogel was over two orders of magnitude higher than either Fmoc-FRGDF or Fmoc-FRGDFPHSRN alone. In-vitro three-dimensional cell culture of human mammary fibroblasts on the hydrogel mixed peptide showed dramatically improved adhesion, spreading and proliferation over Fmoc-FRGDF. However, the long peptide did not provide effective cell attachment. The results demonstrated the selective synergy effect of PHSRN with RGD is an effective way to augment the robustness and functionality of self-assembled bioscaffolds.

Validity and reliability of smartphone orientation measurement to quantify dynamic balance function.

OBJECTIVE: Postural control is frequently compromised after sub-concussive and concussive head trauma, and balance testing is an integral part of neuromotor assessment and management. The main objective of this paper is to develop a novel smartphone-based neuromotor assessment protocol for screening of dynamic balance decrements stemming from head trauma. APPROACH: Experiments 1 and 2 compared Android smartphone orientation detection algorithms to a biomechanics laboratory motion capture system using a pendulum (i.e. non-biological movement) and a human stepping task (i.e. biological movement). Experiment 3 examined the test-retest reliability of a stepping-in-place protocol in three different sensory conditions (eyes open, no-vision, head shake) using temporal and spatial variability metrics extracted from thigh orientation signal in a sample of healthy young adults. MAIN RESULTS: Smartphone sensors provided valid measurements of movement timing and amplitude variables. However, sensor firmware version and Android OS version significantly affected quality of measurement. High test-retest reliability was shown for the temporal and spatial variables of interest during the stepping-in-place task. SIGNIFICANCE: Collectively, these experiments show that our smartphone application is a valid and reliable way to measure leg movement characteristics (mean stride time and its variability (CV), Peak Thigh SD, Thigh ROM, and Peak Return Velocity) during dynamic balance activity, which could provide an objective way to assess neuromotor function after head trauma and in other populations with balance dysfunction.

Incidental Anatomic Finding of Celiacomesenteric Trunk Associated with 'Nutcracker Phenomenon,' or Compression of the Left Renal Vein.

BACKGROUND Celiacomesenteric trunk (CMT) is a very rare anatomic finding in which the celiac artery and the superior mesenteric artery (SMA) originate from the abdominal aorta through a common trunk. Clinical associations with CMT include arterial aneurysm, thrombosis, and celiac artery compression. However, an association between CMT and abdominal venous congestion caused by left renal vein compression, or 'nutcracker phenomenon,' has not been previously reported. CASE REPORT A 91-year-old woman, who died from a cerebrovascular accident (CVA), underwent a cadaveric examination at our medical school. On examination of the abdomen, there was an incidental finding of CMT. The arterial and venous diameters were measured, and vascular histopathology was undertaken. The vascular anatomy was consistent with CMT type 1-b. Nutcracker phenomenon (NCP) (left renal vein compression) was seen anatomically as dilatation and engorgement of the left renal vein, relative to the right renal vein (10.77±0.13 mm vs. 4.49±0.56 mm, respectively), and dilatation and engorgement of the left ovarian vein, relative to the right ovarian vein (4.37±0.15 mm vs. 1.06±0.09 mm, respectively) with left ovarian varicocele. The aortoceliac angle (ACA) and the aortomesenteric angle (AMA) approached zero degrees. CONCLUSIONS We have described a rare anatomic finding of CMT that created an acute AMA and NCP. Awareness of this rare association between CMT and NCP by clinicians, vascular surgeons, and radiologists may be of value in the future evaluation and surgical management of patients who present clinically with 'nutcracker syndrome.'

Increased Epicardial Fat Volume Is Independently Associated with the Presence and Severity of Systemic Sclerosis.

RATIONALE AND OBJECTIVES: The study aimed to determine if intrathoracic fat volumes are associated with the presence and severity of systemic sclerosis (SSc), defined by the presence of pulmonary arterial hypertension (PAH). MATERIALS AND METHODS: A total of 265 patients were included in the study, 202 of whom had SSc (134 had SSc with no PAH and 68 had SSc-associated PAH) and who underwent high-resolution computed tomography, and 63 controls who underwent coronary computed tomography angiography with calcium scoring. Intrathoracic and epicardial (EFV) fat volumes were quantified by manual tracing of the mediastinum and the pericardium, the difference of which represents the extrapericardial fat volume. Associations between these three fat volumes and the presence and severity of SSc, adjusted for cardiovascular risk factors and interstitial lung disease, were evaluated by logistic regression analysis. RESULTS: Of the 202 patients with SSc, the mean age was 55 years (ranged from 20 to 86), and 79% (159 of 202) were women. Adjusted EFV (odds ratio [OR]: 1.065; 95% confidence interval [CI]: 1.046-1.084, P = < 0.0001), extrapericardial fat volume (OR: 1.028, 95% CI: 1.017-1.038, P = < 0.0001), and intrathoracic fat volume (OR: 1.033, 95% CI: 1.023-1.043, P = 0.001) were associated with the presence of SSc. Only EFV was associated with SSc severity (adjusted OR: 1.010, 95% CI: 1.003-1.018, P = 0.007). CONCLUSION: Increased epicardial fat volume is associated with the presence and severity of SSc, independent of cardiovascular risk factors and interstitial lung disease.