Calcinosis in juvenile dermatomyositis: Updates on pathogenesis and treatment

Calcinosis, or the deposition of insoluble calcium salts in the skin, subcutaneous tissue, fascia, tendons, and muscles, is a feared complication of juvenile dermatomyositis. Calcinosis is estimated to affect up to 40% of patients with juvenile dermatomyositis and contributes to significant disease morbidity. Calcinosis can be challenging to treat, and the most effective treatment remains unknown because of a lack of comparative studies. We aim to review the literature published in the last 5 years to summarize updates on the pathogenesis and treatment of calcinosis in juvenile dermatomyositis and describe future areas for research

Application of semantic control to a class of pursuer-evader problems

AbstractIn this article, we describe our work in developing a comprehensive software system for tactical decision aiding for an evader faced with multiple pursuers. The objective is to provide the evader with defensive maneuver decisions that maximize its chances of survival.We have developed a hierarchical semantic controller consisting of a System Identifier, a Goal Selector and an Adapter. This system is implemented on a 386DX personal computer via object-oriented programming, knowledge-based systems, Analytical Hierarchy Process, optimal control, and differential game methodologies.The viability of our Semantic Control approach to the evasive action selection problem has been shown and its operation has been tested against pursuers which follow either pure pursuit or proportional guidance strategies. The user is included in the decision process via approval of setpoints. Displays of the engagement and effect of coverage by countermeasures provide a visual reinforcement of the recommendation made. Use of semantic controllers as TDA support systems for man-in-the-loop, pursuer-evader problems on a PC with current software and hardware technology is feasible. The ability to deploy the system on a portable PC permits the use of the technology in a wide variety of applications

Intra-articular delivery of AAV vectors encoding PD-L1 attenuates joint inflammation and tissue damage in a mouse model of rheumatoid arthritis

Objective: Rheumatoid arthritis (RA) is the most common form of autoimmune inflammatory arthritis. Intra-articular gene delivery to block proinflammatory cytokines has been studied in pre-clinical models and human clinical trials. It has been demonstrated that the level of programmed death-ligand 1 (PD-L1) is associated with rheumatoid arthritis (RA). This study examined the therapeutic role of PD-L1 by intra-articular delivery via adeno-associated virus (AAV) vectors in the mouse collagen-induced arthritis (CIA) model. Methods: Mice were intra-articularly injected with AAV5 vectors encoding human PD-L1 on day 0 and immunized with bovine type II collagen to induce CIA simultaneously. On day 49 post AAV administration, joints were collected for histo-pathological and cytokine analysis. Additionally, the systemic impacts of intra-articular injection of AAV5/PD-L1 vectors were also studied. To study the therapeutic effect of PD-L1, AAV5/PD-L1 vectors were administered into the joints of RA mice on day 21. Results: After administration of AAV5/PD-L1 vectors, strong PD-L1 expression was detected in AAV transduced joints. Joints treated with PD-L1 at the time of arthritis induction exhibited significantly less swelling and improved histopathological scores when compared to untreated joints. Additionally, the infiltration of T cells and macrophages was decreased in joints of CIA mice that received AAV5/PD-L1 vectors (P<0.05). The levels of pro-inflammatory cytokines, including IL-1, IL-6, IL-17 and TNFα, were lower in AAV5/PD-L1 treated than untreated joints (P<0.05). Furthermore, the administration of AAV5/PD-L1 vectors into the joints of CIA mice did not impact serum cytokine levels and the antibody titers to type II collagen. Biodistribution of AAV vectors after intra-articular injection showed undetectable AAV genomes in other tissues except for a low level in the liver. Similar to the results of AAV5/PD-L1 vector administration on day 0, decreased joint swelling and lower histopathological damage were observed in joints treated with AAV5/PD-L1 vectors on day 21. Conclusion: The results from this study demonstrate that local AAV mediated PD-L1 gene delivery into the joints is able to prevent the development and block the progression of arthritis in CIA mice without impacting systemic immune responses. This study provides a novel strategy to effectively treat inflammatory joint diseases using local AAV gene therapy by interference with immune checkpoint pathways

A Deep Learning Framework for the Detection and Quantification of Reticular Pseudodrusen and Drusen on Optical Coherence Tomography

PURPOSE: The purpose of this study was to develop and validate a deep learning (DL) framework for the detection and quantification of reticular pseudodrusen (RPD) and drusen on optical coherence tomography (OCT) scans. METHODS: A DL framework was developed consisting of a classification model and an out-of-distribution (OOD) detection model for the identification of ungradable scans; a classification model to identify scans with drusen or RPD; and an image segmentation model to independently segment lesions as RPD or drusen. Data were obtained from 1284 participants in the UK Biobank (UKBB) with a self-reported diagnosis of age-related macular degeneration (AMD) and 250 UKBB controls. Drusen and RPD were manually delineated by five retina specialists. The main outcome measures were sensitivity, specificity, area under the receiver operating characteristic (ROC) curve (AUC), kappa, accuracy, intraclass correlation coefficient (ICC), and free-response receiver operating characteristic (FROC) curves. RESULTS: The classification models performed strongly at their respective tasks (0.95, 0.93, and 0.99 AUC, respectively, for the ungradable scans classifier, the OOD model, and the drusen and RPD classification models). The mean ICC for the drusen and RPD area versus graders was 0.74 and 0.61, respectively, compared with 0.69 and 0.68 for intergrader agreement. FROC curves showed that the model's sensitivity was close to human performance. CONCLUSIONS: The models achieved high classification and segmentation performance, similar to human performance. TRANSLATIONAL RELEVANCE: Application of this robust framework will further our understanding of RPD as a separate entity from drusen in both research and clinical settings

Recognition of the Phanerozoic “Young Granite Gneiss” in the central Yeongnam Massif

Up to now, all the high-grade gneisses of the Korean peninsula have been regarded as Precambrian basement rocks and presence of the Phanerozoic high-grade metamorphic rocks have remained unknown. However, such granite gneiss is discovered through this study from the central Yeongnam massif near Gimcheon. SHRIMP zircon U-Pb age determinations on the granite gneiss, having well-developed gneissic foliations and migmatitic textures, reveal concordant age of ca. 250 Ma indicating the Early Triassic emplacement of this pluton, which is in contradict to the previous belief that it is a Precambrian product. Even though the granite gneiss reveals well-developed gneissic foliations and some zircons show rather low Th/U ratios, the metamorphic age has not been determined successfully. However, the age of metamorphism can be constrained as middle Triassic considering the absence of any evidences of metamorphism from the nearby granitic plutons having emplacement ages of ca. 225 Ma. Early Triassic emplacement and subsequent Middle Triassic metamorphism of the granite gneiss from the Yeongnam massif bear a remarkable resemblance to the case of South China block. We suggest the possibility that Early to Middle Triassic metamorphism of the Korean peninsula might be products of the intracontinental collisional events not directly related with the Early Triassic continental collision event

The performance of the jet trigger for the ATLAS detector during 2011 data taking

The performance of the jet trigger for the ATLAS detector at the LHC during the 2011 data taking period is described. During 2011 the LHC provided proton–proton collisions with a centre-of-mass energy of 7 TeV and heavy ion collisions with a 2.76 TeV per nucleon–nucleon collision energy. The ATLAS trigger is a three level system designed to reduce the rate of events from the 40 MHz nominal maximum bunch crossing rate to the approximate 400 Hz which can be written to offline storage. The ATLAS jet trigger is the primary means for the online selection of events containing jets. Events are accepted by the trigger if they contain one or more jets above some transverse energy threshold. During 2011 data taking the jet trigger was fully efficient for jets with transverse energy above 25 GeV for triggers seeded randomly at Level 1. For triggers which require a jet to be identified at each of the three trigger levels, full efficiency is reached for offline jets with transverse energy above 60 GeV. Jets reconstructed in the final trigger level and corresponding to offline jets with transverse energy greater than 60 GeV, are reconstructed with a resolution in transverse energy with respect to offline jets, of better than 4 % in the central region and better than 2.5 % in the forward direction