Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Putting the world in mind: The case of mental representation of quantity

A reoccurring question in cognitive science concerns the way the world is represented. Cognitive scientists quantify the contribution of a physical attribute to a sensation and try to characterize the underlying mechanism. In numerical cognition, the contribution of physical properties to quantity perception in comparison tasks was widely demonstrated albeit leaving the underlying mechanism unclear. Furthermore, it is unclear whether this contribution is related solely to comparison tasks or to a core, general ability. Here we demonstrate that the shape of the convex hull, the smallest convex polygon containing all objects in an array, plays a role in the transfer function between quantity and its mental representation. We used geometric probability to demonstrate that the shape of the convex hull is correlated with quantity in a way that resembles the behavioral enumeration curve of subitizing and estimation. Then, in two behavioral experiments we manipulated the shape of the convex hull and demonstrated its effect on enumeration. Accordingly, we suggest that humans learn the correlation between convex hull shape and numerosity and use it to enumerate.</p

Isotropic measures and maximizing ellipsoids : Between John and Loewner

We define a one-parametric family of positions of a centrally symmetric convex body K which interpolates between the John position and the Loewner position: for r>0, we say that K is in maximal intersection position of radius r if Vol n (K ∩ rB n 2 ) ≥ Vol n (K ∩ rTB n 2 ) for all T ∈ SL n . We show that under mild conditions on K, each such position induces a corresponding isotropic measure on the sphere, which is simply the normalized Lebesgue measure on r −1 K ∩ S n−1 . Inparticular, for r M satisfying r n M κ n =Vol n (K), the maximal intersection position of radius r M is an M-position, so we get an M-position with an associated isotropic measure. Lastly, we give an interpretation of John’s theorem on contact points as a limit case of the measures induced from the maximal intersection positions. </p

Data from: Energy savings in greenhouses by transition from high-pressure sodium to LED lighting

These simulations describe the dynamic changes (5 minute intervals) of the indoor climate (temperature, humidity, CO2 concentration) and energy consumption (lighting and heating) of a simulated greenhouse season in a typical meteorological year (350 days starting September 27). A modern, Venlo type, 4 hectare greenhouse with a tomato crop is simulated, with either HPS or LED lamps. 15 different weather scenarios from around the world are included, as well as various settings for design and climate control. The GreenLight model, https://github.com/davkat1/GreenLight, was used for this purpose

Energy savings in greenhouses by transition from high-pressure sodium to LED lighting

Greenhouses in high latitudes consume vast amounts of energy for heating and supplemental lighting. Light emitting diodes (LEDs) have been suggested as having great potential for reducing greenhouse energy use, as they are extremely efficient at converting electricity to light. However, LEDs emit very little heat, which must be compensated by the greenhouse heating system. Thus, it is unclear how much energy can be saved by LEDs when the need for extra heating is taken into account. This study presents a first analysis of the energy demands for greenhouses transitioning from high-pressure sodium (HPS) to LED lighting, providing a quantification of the total energy savings achieved by LEDs. Model simulations using GreenLight, an open source greenhouse model, were used to examine a wide range of climates, from subtropical China to arctic Sweden, and multiple settings for indoor temperature, lamp intensity, lighting duration, and insulation. In most cases, the total energy saving by transition to LEDs was 10–25%. This value was linearly correlated with the fraction of energy used for lighting before the transition, which was 40–80%. In all scenarios, LEDs reduced the energy demand for lighting but increased the demand for heating. Since energy for lighting and heating is often derived from different origins, the benefits of a transition to LEDs depend on the environmental and financial costs of the available energy sources. The framework provided here can be used to select lighting installations that make optimal use of available energy resources in the most efficient and sustainable manner

Process-based greenhouse climate models : Genealogy, current status, and future directions

CONTEXT: Process-based greenhouse climate models are valuable tools for the analysis and design of greenhouse systems. A growing number of greenhouse models are published in recent years, making it difficult to identify which components are shared across models, which are new developments, and what are the objectives, strengths and weaknesses of each model. OBJECTIVE: We present an overview of the current state of greenhouse modelling by analyzing studies published between 2018 and 2020. This analysis helps identify the key processes considered in process-based greenhouse models, and the common approaches used to model them. Moreover, we outline how greenhouse models differ in terms of their objectives, complexity, accuracy, and transparency. METHODS: We describe a general structure of process-based greenhouse climate models, including a range of common approaches for describing the various model components. We analyze recently published models with respect to this structure, as well as their intended purposes, greenhouse systems they represent, equipment included, and crops considered. We present a model inheritance chart, outlining the origins of contemporary models, and showing which were built on previous works. We compare model validation studies and show the various types of datasets and metrics used for validation. RESULTS AND CONCLUSIONS: The analysis highlights the range of objectives and approaches prevalent in greenhouse modelling, and shows that despite the large variation in model design and complexity, considerable overlap exists. Some possible reasons for the abundance of models include a lack of transparency and code availability; a belief that model development is in itself a valuable research goal; a preference for simple models in control-oriented studies; and a difference in the time scales considered. Approaches to model validation vary considerably, making it difficult to compare models or assess if they serve their intended purposes. We suggest that increased transparency and availability of source code will promote model reuse and extension, and that shared datasets and evaluation benchmarks will facilitate model evaluation and comparison. SIGNIFICANCE: This study highlights several issues that should be considered in greenhouse model selection and development. Developers of new models can use the decomposition provided in order to present their models and facilitate extension and reuse. Developers are encouraged to reflect on and explicitly state their model's range of suitability, complexity, validity, and transparency. Lastly, we highlight several steps that could be taken by the greenhouse modelling community in order to advance the field as a whole