An Exploratory Graphical Method for Identifying Associations in r x c Contingency Tables

On finding a significant association between rows and columns of an r x c contingency table, the next step is to study the nature of the association in more detail. The use of a scree plot to visualize the largest contributions to Χ2 among all cells in the table in order to determine the nature of the association in more detail is proposed

Early efficacy trial of anakinra in corticosteroid-resistant autoimmune inner ear disease

BACKGROUND. Autoimmune inner ear disease (AIED) is a rare disease that results in progressive sensorineural hearing loss. Patients with AIED initially respond to corticosteroids; however, many patients become unresponsive to this treatment over time, and there is no effective alternative therapy for these individuals. METHODS. We performed a phase I/II open-label, single-arm clinical trial of the IL-1 receptor antagonist anakinra in corticosteroid-resistant AIED patients. Given that the etiology of corticosteroid resistance is likely heterogeneous, we used a Simon 2-stage design to distinguish between an unacceptable (= 30%) response rate to anakinra therapy. Subjects received 100 mg anakinra by subcutaneous injection for 84 days, followed by a 180-day observational period. RESULTS. Based on patient responses, the Simon 2-stage rule permitted premature termination of the trial after 10 subjects completed the 84-day drug period, as the target efficacy for the entire trial had been achieved. Of these 10 patients, 7 demonstrated audiometric improvement, as assessed by pure tone average (PTA) and word recognition score (WRS). In these 7 responders, reduced IL-1 beta plasma levels correlated with clinical response. Upon discontinuation of treatment, 3 subjects relapsed, which correlated with increased IL-1 beta plasma levels. CONCLUSION. We demonstrated that IL-1 beta inhibition in corticosteroid-resistant AIED patients was effective in a small cohort of patients and that IL-1 beta plasma levels associated with both clinical hearing response and disease relapse. These results suggest that a larger phase II randomized clinical trial of IL-1 beta inhibition is warranted

Prevalence, Clinical Profile, and Significance of Left Ventricular Remodeling in the End-Stage Phase of Hypertrophic Cardiomyopathy

Background— End stage (ES) is a recognized part of the hypertrophic cardiomyopathy (HCM) disease spectrum. Frequency, clinical profile and course, and treatment strategies in these patients remain incompletely defined. Methods and Results— Three HCM cohorts comprised 1259 patients, including 44 (3.5%) characterized as ES with systolic dysfunction (ejection fraction <50% at rest; range 15% to 49%). ES developed at a wide age range (14 to 74 years), with 45% of patients ≤40 years old. Although 29 patients (66%) died of progressive heart failure, had sudden death events, or underwent heart transplantation, 15 (34%) survived with medical management over 3±3 years. Duration from onset of HCM symptoms to ES identification was considerable (14±10 years), but ES onset to death/transplantation was brief (2.7±2 years). ES occurred with similar frequency in patients with or without prior myectomy ( P =0.84). Appropriate defibrillator interventions were 10% per year in patients awaiting donor hearts. Most ES patients (n=23; 52%) showed substantial left ventricular (LV) remodeling with cavity dilatation. Less complete remodeling occurred in 21 patients (48%), including 5 with persistence of a nondilated and markedly hypertrophied LV. Pathology and magnetic resonance imaging showed extensive (transmural) fibrosis in 9 of 11 ES patients. At initial evaluation, patients who developed ES were younger with more severe symptoms, had a larger LV cavity, and more frequently had a family history of ES than other HCM patients. Conclusions— ES of nonobstructive HCM has an expanded and more diverse clinical expression than previously appreciated, including occurrence in young patients, heterogeneous patterns of remodeling, frequent association with atrial fibrillation, and impaired LV contractility that precedes cavity dilatation, wall thinning, and heart failure symptoms. ES is an unfavorable complication (mortality rate 11% per year) and a sudden death risk factor; it requires vigilance to permit timely recognition and the necessity for defibrillator implantation and heart transplantation

Contemporary Natural History and Management of Nonobstructive Hypertrophic Cardiomyopathy

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Androgen stimulated chemotherapy in the dunning R-3327 prostatic adenocarcinoma

This study was undertaken to determine whether hormonal stimulation followed by chemotherapy with a cell-cycle specific agent would improve the effectiveness of the chemotherapy in a prostatic adenocarcinoma model.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46680/1/240_2004_Article_BF00256893.pd

Large format heterodyne arrays for observing far-infrared lines with SOFIA

In the wavelength regime between 60 and 300 microns there are a number of atomic and molecular emission lines that are key diagnostic probes of the interstellar medium. These include transitions of [CII], [NII], [OI], HD, H_2D^+, OH, CO, and H_2O, some of which are among the brightest global and local far-infrared lines in the Galaxy. In Giant Molecular Clouds (GMCs), evolved star envelopes, and planetary nebulae, these emission lines can be extended over many arc minutes and possess complicated, often self absorbed, line profiles. High spectral resolution (R > 10^5) observations of these lines at sub-arcminute angular resolution are crucial to understanding the complicated interplay between the interstellar medium and the stars that form from it. This feedback is central to all theories of galactic evolution. Large format heterodyne array receivers can provide the spectral resolution and spatial coverage to probe these lines over extended regions. The advent of large format (~100 pixel) spectroscopic imaging cameras in the far-infrared (FIR) will fundamentally change the way astronomy is performed in this important wavelength regime. While the possibility of such instruments has been discussed for more than two decades, only recently have advances in mixer and local oscillator technology, device fabrication, micromachining, and digital signal processing made the construction of such instruments tractable. These technologies can be implemented to construct a sensitive, flexible, heterodyne array facility instrument for SOFIA. The instrument concept for StratoSTAR: Stratospheric Submm/THz Array Receiver includes a common user mounting, control system, IF processor, spectrometer, and cryogenic system. The cryogenic system will be designed to accept a frontend insert. The frontend insert and associated local oscillator system/relay optics would be provided by individual user groups and reflect their scientific interests. Rapid technology development in this field makes SOFIA the ideal platform to operate such a modular, continuously evolving instrument