2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients'and clinicians'values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR

Pharmacodynamic monitoring of immunosuppression in kidney transplantation

Advances in immunosuppressive therapies have improved kidney transplant outcomes. However, immunosuppressant drug-induced toxicities continue to reduce tolerability and impact patient and graft survival. A major ongoing challenge in kidney transplantation is to establish ways of tailoring immunosuppressant therapy so as to maintain efficacy while minimizing toxicity. Pharmacodynamic monitoring by direct measurement of immune cell function has the potential to personalize immunosuppression. The purpose of this review is to provide the clinician with an overview of the methodology and use of immune function monitoring in the field of kidney transplantation. © 2010 The Authors Journal compilation © 2010 Asian Pacific Society of Nephrolog

Four fundamental dimensions underlie the perception of human actions

We evaluate the actions of other individuals based upon a variety of movements that reveal critical information to guide decision making and behavioural responses. These signals convey a range of information about the actor, including their goals, intentions and internal mental states. Although progress has been made to identify cortical regions involved in action processing, the organising principles underlying our representation of actions still remains unclear. In this paper we investigated the conceptual space that underlies action perception by assessing which qualities are fundamental to the perception of human actions. We recorded 240 different actions using motion-capture and used these data to animate a volumetric avatar that performed the different actions. 230 participants then viewed these actions and rated the extent to which each action demonstrated 23 different action characteristics (e.g., avoiding-approaching, pulling-pushing, weak-powerful). We analysed these data using Exploratory Factor Analysis to examine the latent factors underlying visual action perception. The best fitting model was a four-dimensional model with oblique rotation. We named the factors: friendly-unfriendly, formidable-feeble, planned-unplanned, and abduction-adduction. The first two factors of friendliness and formidableness explained approximately 22% of the variance each, compared to planned and abduction, which explained approximately 7–8% of the variance each; as such we interpret this representation of action space as having 2 + 2 dimensions. A closer examination of the first two factors suggests a similarity to the principal factors underlying our evaluation of facial traits and emotions, whilst the last two factors of planning and abduction appear unique to actions