3,134 research outputs found
Effects of rituximab-based B-cell depletion therapy on skin manifestations of lupus erythematosus--report of 17 cases and review of the literature
Cutaneous manifestations occur frequently in systemic lupus erythematosus (SLE) and are pathognomonic in subacute-cutaneous lupus erythematosus (SCLE) and chronic cutaneous lupus erythematosus (CCLE). Although B-cell depletion therapy (BCDT) has demonstrated efficacy in SLE with visceral involvement, its usefulness for patients with predominant skin manifestations has not been fully established. In this single-centre, retrospective study 14 consecutive SLE, one CCLE and two SCLE patients with recalcitrant skin involvement were treated with 2 × rituximab 1 g, and 1 × cyclophosphamide 750 mg. Six months after BCDT, nine of 17 (53%) patients were in complete (CR) or partial remission (PR). Relapses occurred in 12 patients (71%) at a mean time of 10 ± 1.8 months after BCDT. A second cycle of BCDT achieved a more sustained remission in seven of nine patients (78%) lasting for a mean time of 18.4 ± 2.7 months. Minor adverse events were experienced by three patients. Mean follow-up was 30 months. Our own results and the literature review demonstrate that BCDT based on rituximab is well tolerated and may be effective for cutaneous lesions of lupus erythematosus. Randomized controlled trials are necessary to further evaluate the value of BCDT for this group of patients
Mid-Infrared diagnostics of metal-rich HII regions from VLT and Spitzer Spectroscopy of Young Massive Stars in W31
We present near-IR VLT/ISAAC and mid-IR Spitzer/IRS spectroscopy of the young
massive cluster in the W31 star-forming region. H-band spectroscopy provides
refined classifications for four cluster members O stars with respect to Blum
et al. In addition, photospheric features are detected in the massive Young
Stellar Object (mYSO) #26. Spectroscopy permits estimates of stellar
temperatures and masses, from which a cluster age of ~0.6 Myr and distance of
3.3 kpc are obtained, in excellent agreement with Blum et al. IRS spectroscopy
reveals mid-infrared fine structure line fluxes of [Ne II-III] and [S III-IV]
for four O stars and five mYSOs. In common with previous studies, stellar
temperatures of individual stars are severely underestimated from the observed
ratios of fine-structure lines, despite the use of contemporary stellar
atmosphere and photoionization models. We construct empirical temperature
calibrations based upon the W31 cluster stars of known spectral type,
supplemented by two inner Milky Way ultracompact (UC) HII regions whose
ionizing star properties are established. Calibrations involving [NeIII]
15.5um/[NeII] 12.8um, [SIV] 10.5um/[NeII] 12.8um or [ArIII] 9.0um/[NeII] 12.8um
have application in deducing the spectral types of early- to mid- O stars for
other inner Milky Way compact and UCHII regions. Finally, evolutionary phases
and timescales for the massive stellar content in W31 are discussed, due to the
presence of numerous young massive stars at different formation phases in a
`coeval' cluster.Comment: 16 pages, 13 figures, accepted for MNRA
First Reported Fatalities Associated with the 'Research Chemical' 2-Methoxydiphenidine
2-Methoxydiphenidine, i.e. 1-[1-(2-methoxyphenyl)-2-phenylethyl]piperidine, also known as 'MXP' or '2-MeO-diphenidine' (or 2-MXP), has been available as a 'research chemical' since 2013 as a purported alternative to the 'dissociative anesthetics' methoxetamine and ketamine. Three deaths which involved the detection of 2-MXP in post-mortem blood and urine were encountered in forensic casework. The 2-, 3- and 4-methoxyphenyl positional isomers were synthesized to confirm the identity and concentration of 2-MXP. The 2-MXP femoral blood concentrations in the cases were found to be 24.0, 2.0 and 1.36 mg/L (the latter with an alternative cause of death). Some additional prescription drugs were encountered at therapeutic concentrations in all three cases. Analysis of the biofluids allowed the detection and characterization of various metabolites, including the suggested presence of hydroxy-2-MXP as the main metabolite with the hydroxyl group located on the piperidine rather than the phenyl or benzyl moiety. Additional metabolites included O-desmethyl-2-MXP and hydroxylated O-desmethyl-2-MXP. Diphenidine and hydroxy-diphenidine, also showing the presence of the hydroxyl group on the piperidine ring, were also detected. It was not possible to identify whether these arose from 2-MXP biotransformation or whether they represented the presence of diphenidine as a separate substance. These are the first published fatalities involving 2-MXP and presents analytical data to assist analytical toxicologists with future casework
A study of the BrO and BrO₂ radicals with vacuum ultraviolet photoelectron spectroscopy
Author name used in this publication: J. M. DykeAuthor name used in this publication: E. P. F. LeeAuthor name used in this publication: D. K. W. MokAuthor name used in this publication: F. T. ChauVersion of RecordPublishe
Analysis of multicenter clinical trials with very low event rates
INTRODUCTION: In a five-arm randomized clinical trial (RCT) with stratified randomization across 54 sites, we encountered low primary outcome event proportions, resulting in multiple sites with zero events either overall or in one or more study arms. In this paper, we systematically evaluated different statistical methods of accounting for center in settings with low outcome event proportions. METHODS: We conducted a simulation study and a reanalysis of a completed RCT to compare five popular methods of estimating an odds ratio for multicenter trials with stratified randomization by center: (i) no center adjustment, (ii) random intercept model, (iii) Mantel-Haenszel model, (iv) generalized estimating equation (GEE) with an exchangeable correlation structure, and (v) GEE with small sample correction (GEE-small sample correction). We varied the number of total participants (200, 500, 1000, 5000), number of centers (5, 50, 100), control group outcome percentage (2%, 5%, 10%), true odds ratio (1, > 1), intra-class correlation coefficient (ICC) (0.025, 0.075), and distribution of participants across the centers (balanced, skewed). RESULTS: Mantel-Haenszel methods generally performed poorly in terms of power and bias and led to the exclusion of participants from the analysis because some centers had no events. Failure to account for center in the analysis generally led to lower power and type I error rates than other methods, particularly with ICC = 0.075. GEE had an inflated type I error rate except in some settings with a large number of centers. GEE-small sample correction maintained the type I error rate at the nominal level but suffered from reduced power and convergence issues in some settings when the number of centers was small. Random intercept models generally performed well in most scenarios, except with a low event rate (i.e., 2% scenario) and small total sample size (n ≤ 500), when all methods had issues. DISCUSSION: Random intercept models generally performed best across most scenarios. GEE-small sample correction performed well when the number of centers was large. We do not recommend the use of Mantel-Haenszel, GEE, or models that do not account for center. When the expected event rate is low, we suggest that the statistical analysis plan specify an alternative method in the case of non-convergence of the primary method
Report of a Joint Cancer Research UK/Medical Research Council workshop on cancer cachexia research at the Royal College of Physicians, Tuesday, 2 December 2003
A joint workshop held by Cancer Research UK and the Medical Research Council aimed to stimulate interest in further research into the area of cancer cachexia. The workshop was divided into four sessions: an overview of cancer cachexia, potential mechanisms involved and methodologies that might be used to understand cachexia, and also the experience of cachexia from other disease areas. The workshop identified a need to develop a multimodal therapeutic approach to cancer cachexia and a need to undertake more multidisciplinary research
Black Holes in Modified Gravity (MOG)
The field equations for Scalar-Tensor-Vector-Gravity (STVG) or modified
gravity (MOG) have a static, spherically symmetric black hole solution
determined by the mass with two horizons. The strength of the gravitational
constant is where is a parameter. A regular
singularity-free MOG solution is derived using a nonlinear field dynamics for
the repulsive gravitational field component and a reasonable physical
energy-momentum tensor. The Kruskal-Szekeres completion of the MOG black hole
solution is obtained. The Kerr-MOG black hole solution is determined by the
mass , the parameter and the spin angular momentum . The
equations of motion and the stability condition of a test particle orbiting the
MOG black hole are derived, and the radius of the black hole photosphere and
the shadows cast by the Schwarzschild-MOG and Kerr-MOG black holes are
calculated. A traversable wormhole solution is constructed with a throat
stabilized by the repulsive component of the gravitational field.Comment: 14 pages, 3 figures. Upgraded version of paper to match published
version in European Physics Journal
Emotions in context: examining pervasive affective sensing systems, applications, and analyses
Pervasive sensing has opened up new opportunities for measuring our feelings and understanding our behavior by monitoring our affective states while mobile. This review paper surveys pervasive affect sensing by examining and considering three major elements of affective pervasive systems, namely; “sensing”, “analysis”, and “application”. Sensing investigates the different sensing modalities that are used in existing real-time affective applications, Analysis explores different approaches to emotion recognition and visualization based on different types of collected data, and Application investigates different leading areas of affective applications. For each of the three aspects, the paper includes an extensive survey of the literature and finally outlines some of challenges and future research opportunities of affective sensing in the context of pervasive computing
- …