Treatment and outcomes in necrotising autoimmune myopathy: an australian perspective

Necrotising Autoimmune Myopathy (NAM) presents as a subacute proximal myopathy with high creatine kinase levels. It is associated with statin exposure, 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody, connective tissue diseases, signal recognition particle (SRP) antibody and malignancy. This case series presents our Western Australian NAM patient cohort: comparing the subgroup presentations, biopsy appearance and treatment outcomes. We retrospectively collected data on patients diagnosed with NAM at the Western Australian Neuroscience Research Institute between the years 2000 and 2015. We identified 20 patients with Necrotising Autoimmune Myopathy: 14 with anti-HMGCR antibodies; two with anti-SRP antibodies; three with connective tissue disease; two as yet unspecified. Median creatine kinase level was 6047units/L (range 1000–17000). The statin naïve patients with HMGCR antibodies and patients with SRP antibodies were the most severely affected subgroups, with higher creatine kinase levels, and were more resistant to immunotherapy. Two or more immunotherapy agents were required in 90%; eight patients required IVIG and rituximab. Steroid weaning commonly precipitated relapses. Four patients had complete remission, and the remaining patients still require immunotherapy. Necrotising Autoimmune Myopathy is a potentially treatable myopathy, which can be precipitated by statin therapy and requires early, aggressive immunotherapy, usually requiring multiple steroid sparing agents for successful steroid weaning

British research in accounting and finance (2001–2007): the 2008 research assessment exercise

No abstract available

Species-habitat associations in a Sri Lankan dipterocarp forest

Forest structure and species distribution patterns were examined among eight topographically defined habitats for the 205 species with stems ≥ 1 cm dbh inhabiting a 25-ha plot in the Sinharaja rain forest, Sri Lanka. The habitats were steep spurs, less-steep spurs, steep gullies and less-steep gullies, all at either lower or upper elevations. Mean stem density was significantly greater on the upper spurs than in the lower, less-steep gullies. Stem density was also higher on spurs than in gullies within each elevation category and in each upper-elevation habitat than in its corresponding lower-elevation habitat. Basal area varied less among habitats, but followed similar trends to stem density. Species richness and Fisher\u27s alpha were lower in the upper-elevation habitats than in the lower-elevation habitats. These differences appeared to be related to the abundances of the dominant species. Of the 125 species subjected to torus-translation tests, 99 species (abundant and less abundant and those in different strata) showed at least one positive or negative association to one or more of the habitats. Species associations were relatively more frequent with the lower-elevation gullies. These and the previous findings on seedling ecophysiology, morphology and anatomy of some of the habitat specialists suggest that edaphic and hydrological variation related to topography, accompanied by canopy disturbances of varying intensity, type and extent along the catenal landscape, plays a major role in habitat partitioning in this forest. Copyright © 2006 Cambridge University Press

Multistability of free spontaneously-curved anisotropic strips

Multistable structures are objects with more than one stable conformation, exemplified by the simple switch. Continuum versions are often elastic composite plates or shells, such as the common measuring tape or the slap bracelet, both of which exhibit two stable configurations: rolled and unrolled. Here we consider the energy landscape of a general class of multistable anisotropic strips with spontaneous Gaussian curvature. We show that while strips with non-zero Gaussian curvature can be bistable, strips with positive spontaneous curvature are always bistable, independent of the elastic moduli, strips of spontaneous negative curvature are bistable only in the presence of spontaneous twist and when certain conditions on the relative stiffness of the strip in tension and shear are satisfied. Furthermore, anisotropic strips can become tristable when their bending rigidity is small. Our study complements and extends the theory of multistability in anisotropic shells and suggests new design criteria for these structures.Comment: 20 pages, 10 figure

Fast Simulation of Facilitated Spin Models

We show how to apply the absorbing Markov chain Monte Carlo algorithm of Novotny to simulate kinetically constrained models of glasses. We consider in detail one-spin facilitated models, such as the East model and its generalizations to arbitrary dimensions. We investigate how to maximise the efficiency of the algorithms, and show that simulation times can be improved on standard continuous time Monte Carlo by several orders of magnitude. We illustrate the method with equilibrium and aging results. These include a study of relaxation times in the East model for dimensions d=1 to d=13, which provides further evidence that the hierarchical relaxation in this model is present in all dimensions. We discuss how the method can be applied to other kinetically constrained models.Comment: 8 pages, 4 figure

German Lexical Personality Factors: Relations with the HEXACO Model

We correlated the scales of the HEXACO Personality Inventory (HEXACO-PI) with adjective scale markers of factors previously obtained in indigenous lexical studies of personality structure in the German language. Self-ratings obtained from a sample of 323 German participants showed a pattern of strong convergent and weak discriminant correlations, supporting the content-based interpretation of the German lexical factors in terms of the HEXACO dimensions. Notably, convergent correlations were strong for both the broader and the narrower variants of the Honesty-Humility factor as observed in German lexical studies. Also, convergent correlations for HEXACO Openness to Experience were, as expected, stronger for German adjectives describing a creative and intellectual orientation than for German adjectives describing intellectual ability. Copyright © 2006 John Wiley & Sons, Ltd

A comparison of the effect of age on levator ani and obturator internus muscle cross‐sectional areas and volumes in nulliparous women

Aims Functional tests have demonstrated minimal loss of vaginal closure force with age. So we tested the null hypotheses that age neither affects the maximum cross‐sectional area (CSA) nor the volume of the levator muscle. Corresponding hypotheses were also tested in the adjacent obturator internus muscle, which served as a control for the effect of age on appendicular muscle in these women. Methods Magnetic resonance images of 15 healthy younger (aged 21–25 years) and 12 healthy older nulliparous women (aged >63 years) were selected to avoid the confounding effect of childbirth. Models were created from tracing outlines of the levator ani muscle in the coronal plane, and obturator internus in the axial plane using 3D Slicer v. 3.4. Muscle volumes were calculated using Slicer, while CSA was measured using Imageware™ at nine locations. The hypotheses were tested using repeated measures analysis of variance with P  < 0.05 being considered significant. Results The effect of age did not reach statistical significance for the decrease in levator ani muscle maximum CSA or the decrease in volume (4.3%, P  = 0.62 and 10.9%, 0.12, respectively). However, age did significantly adversely decrease obturator internus muscle maximum CSA and volume (24.5% and 28.2%, P  < 0.001, respectively). Significant local age‐related changes were observed dorsally in both muscles. Conclusions Unlike the adjacent appendicular muscle, obturator internus, the levator ani muscle in healthy nullipara does not show evidence of significant age‐related atrophy. Neurourol. Urodynam. 31:481–486, 2012. © 2012 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91125/1/21208_ftp.pd

A comparison of the effect of age on levator ani and obturator internus muscle cross‐sectional areas and volumes in nulliparous women

Aims Functional tests have demonstrated minimal loss of vaginal closure force with age. So we tested the null hypotheses that age neither affects the maximum cross‐sectional area (CSA) nor the volume of the levator muscle. Corresponding hypotheses were also tested in the adjacent obturator internus muscle, which served as a control for the effect of age on appendicular muscle in these women. Methods Magnetic resonance images of 15 healthy younger (aged 21–25 years) and 12 healthy older nulliparous women (aged >63 years) were selected to avoid the confounding effect of childbirth. Models were created from tracing outlines of the levator ani muscle in the coronal plane, and obturator internus in the axial plane using 3D Slicer v. 3.4. Muscle volumes were calculated using Slicer, while CSA was measured using Imageware™ at nine locations. The hypotheses were tested using repeated measures analysis of variance with P  < 0.05 being considered significant. Results The effect of age did not reach statistical significance for the decrease in levator ani muscle maximum CSA or the decrease in volume (4.3%, P  = 0.62 and 10.9%, 0.12, respectively). However, age did significantly adversely decrease obturator internus muscle maximum CSA and volume (24.5% and 28.2%, P  < 0.001, respectively). Significant local age‐related changes were observed dorsally in both muscles. Conclusions Unlike the adjacent appendicular muscle, obturator internus, the levator ani muscle in healthy nullipara does not show evidence of significant age‐related atrophy. Neurourol. Urodynam. 31:481–486, 2012. © 2012 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91125/1/21208_ftp.pd