Predictors of survival in a cohort of patients with polymyositis and dermatomyositis: effect of corticosteroids, methotrexate and azathioprine

Introduction: The idiopathic inflammatory myopathies are rare diseases for which data regarding the natural history, response to therapies and factors affecting mortality are needed. We performed this study to examine the effects of treatment and clinical features on survival in polymyositis and dermatomyositis patients. Methods: A total of 160 consecutive patients (77 with polymyositis and 83 with dermatomyositis) seen at the University of Michigan from 1997 to 2003 were included. Medical records were abstracted for clinical, laboratory and therapeutic data, including initial steroid regimen and immunosuppressive use. State vital records were utilized to derive mortality and cause of death data. Survival was modeled by left-truncated Kaplan-Meier estimation and Cox regression. Results: The 5- and 10-year survival estimates were 77% (95% CI = 66 to 85), and 62% (95% CI = 48 to 73), respectively, and the rates were similar for polymyositis and dermatomyositis. Survival between the sexes was similar through 5 years and significantly lower thereafter for males (10-year survival: 18% male, 73% female; P = 0.002 for 5- to 10-year interval). The sex disparity was restricted to the polymyositis group. Increased age at diagnosis and non-Caucasian race were associated with lower survival. Intravenous versus oral corticosteroid use was associated with a higher risk of death among Caucasians (HR = 10.6, 95% CI = 2.1 to 52.8). Early survival between patients treated with methotrexate versus azathioprine was similar, but survival at 10 years was higher for the methotrexate-treated group (76% vs 52%, P = 0.046 for 5- to 10-year interval). Conclusions: Patients treated initially with intravenous corticosteroids had higher mortality, which was likely related to disease severity. Both methotrexate and azathioprine showed similar early survival benefits as first-line immunosuppressive drugs. Survival was higher between 5 and 10 years in the methotrexate-treated group, but could not be confirmed in multivariable modeling for the full follow-up period. Other important predictors of longterm survival included younger age, female sex and Caucasian race.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90025/1/IIM_ART2012.pdf1611

Evolution of red wines I. Ambient influences on colour composition during early maturation

Observations of changing colour composition and phenolic content of two new red wines were made during the 12-month -period after vintage. Spectral data were plotted with reference to two storage temperatures (3 and 25 °C), storage under nitrogen and under air headspace, pasteurised and non-pasteurised wines, cold-stabilised and non cold-stabilised wines. Progressive formation of polymeric pigments occurred under nitrogen headspace with much faster reaction rates at 25 °C. The presence of oxygen increased rate of change in colour composition, but data points were erratic. Pasteurisation had no influence on phenolic ageing reactions, nor did prior cold-stabilisation. Two types of phenolic condensation reactions during normal wine ageing are indicated. Interpretations suggest the feasibility of accelerating red wine maturation, while at the same time directing phenolic ageing reactions along controlled lines

Apollo to Artemis: Mining 50-Year Old Records to Inform Future Human Lunar Landing Systems

Under the Artemis lunar exploration program, NASA is committed to landing American astronauts on the moon by 2024. While NASAs new Space Launch System rocket and Orion capsule will carry astronauts from Earth to the Gateway, the human lunar landing system has not yet been fully defined. As in the Apollo program, there are concerns for vehicle weight and internal volume such that seats may not be desirable, and standing during lunar descent and ascent may be a preferred engineering solution. With such a design, astronauts will experience +GZ (head-to-foot) accelerations during capsule accelerations, and it is unclear whether spaceflight deconditioned astronauts can tolerate these. Apollo astronauts stood during lunar descent and ascent, and the data contained in the early program records for those missions represent a unique resource that may provide insights to the cardiovascular stress associated with this human landing system design

Red wine quality and style: Diversities of composition and adverse influences from free SO2

Relationships between wine colour composition and the overall quality rating were investigated by analyses of 404 young red wines in two varietal classes from three successive vintages. The wines, of Shiraz and Cabernet Sauvignon from 20 viticultural regions of Australia, had been presented for comparative assessment at the Adelaide Wine Shows of 1974-75-76. There was a large variability in all aspects of phenolic content, in wine colour density and tint, in pH, and in levels of total SO2 and free SO2. The latter was the major influence on pigment equilibria, in which there was up to 10-fold variation in the degree of ionisation of anthocyanins (a). Positive quality factors were wine colour density, the parameter a, coloured anthocyanins, total pigments and total phenolics. Negative factors included colour tint, free SO2 and total SO2. There was no correlation with wine pH. Wide variation in winemaking practice concerning the amount and timing of SO2 additions is considered to have been responsible for much of the range in quality within these groups of wines.Qualität und Nuance von Rotwein: Schwankungen der Zusammensetzung sowie nachteiliger Einfluß von freiem SO2 Anhand der Analysen von 404 jungen Rotweinen - zwei Sorten aus drei aufeinanderfolgenden Jahrgängen - wurden die Beziehungen zwischen den Komponenten der Weinfärbung und der Gesamtnote der sensorischen Qualitätsprüfung untersucht. Die Weine, Shiraz und Cabernet Sauvignon, waren bei den Adelaide Wine Shows 1974/75/76 zur vergleichenden Beurteilung angestellt worden. Sämtliche Parameter des Phenolgehaltes, die Farbintensität und -tönung, der pH-Wert sowie der Gehalt an Gesamt-SO2 und freiem SO2 zeigten eine beträchtliche Variabilität. Das freie SO2 beeinflußte das Pigmentgleichgewicht am stärksten, wobei der Ionisationsgrad der Anthocyane (a) bis zu 10fach schwanken konnte. Positive Qualitätsfaktoren waren: Farbintensität, der Parameter a, gefärbte Anthocyane, Gesamtpigmente sowie Gesamtphenole. Zu den negativen Faktoren gehörten Farbtönung, freies SO2 und Gesamt-SO2. Keinerlei Korrelation bestand zum Wein-pH. Die unterschiedlichen Qualitätsnoten der geprüften Rotweine dürften zum Gutteil kellertechnisch, durch die beträchtlichen Schwankungen der zugesetzten SO2 -Mengen und des Behandlungszeitpunktes, bedingt sein

The Detection of a 3.5-h Period in the Classical Nova Velorum 1999 (V382 Vel) and the Long Term Behavior of the Nova Light Curve

We present CCD photometry, light curve and time series analysis of the classical nova V382 Vel (N Vel 1999). The source was observed for 2 nights in 2000, 21 nights in 2001 and 7 nights in 2002 using clear filters. We report the detection of a distinct period in the light curve of the nova P=0.146126(18) d (3.5 h). The period is evident in all data sets, and we interpret it as the binary period of the system. We also measured an increase in the amplitude modulation of the optical light (in magnitude) by more than 55% from 2000 to 2001 and about 64% from 2001 to 2002. The pulse profiles in 2001 show deviations from a pure sinusoidal shape which progressively become more sinusoidal by 2002. The main cause of the variations in 2001 and 2002 can be explained with the occultation of the accretion disk by the secondary star. We interpret the observed deviations from a pure sinusoidal shape as additional flux resulting from the aspect variations of the irradiated face of the secondary star.Comment: 16 pages and 4 figures, accepted as it stands to be published in the Astronomical Journal (AJ

Assessing the Effect of Spaceflight on the Propensity for Astronauts to Develop Disk Herniation

BACKGROUND: A previous study [1] reported that the instantaneous risk of developing a Herniated Nucleus Pulposus (HNP) was higher in astronauts who had flown at least one mission, as compared with those in the corps who had not yet flown. However, the study only analyzed time to HNP after the first mission (if any) and did not account for the possible effects of multiple missions. While many HNP's occurred well into astronauts' careers or in some cases years after retirement, the higher incidence of HNPs relatively soon after completion of space missions appears to indicate that spaceflight may lead to an increased risk of HNP. The purpose of this study was to support the Human System Risk Board assessment of back pain, evaluate the risk of injury due to dynamic loads, and update the previous dataset which contained events up to December 31, 2006. METHODS: Data was queried from the electronic medical record and provided by the Lifetime Surveillance of Astronaut Health. The data included all 330 United States astronauts from 1959 through February 2014. Cases were confirmed by Magnetic Resonance Imaging, Computerized Tomography, Myelography, operative findings, or through clinical confirmation with a neurologist or neurosurgeon. In this analysis, astronauts who had an HNP at selection into the corps or had an HNP diagnosis prior to their first flight were excluded. The statistical challenges in using the available data to separate effects of spaceflight from those associated with general astronaut training and lifestyle on propensity to develop HNPs are many. The primary outcome is reported date of first HNP (if any), which at best is only an approximation to the actual time of occurrence. To properly analyze this data with a survival analysis model, one must also know the "exposure" time - i.e. how long each astronaut has been at risk for developing an HNP. If an HNP is reported soon after a mission, is it mission caused or general? If the former, exposure time should be counted from the time of landing (assuming the risk of HNP occurring during a mission is zero). If the latter, exposure time should be counted from the time of selection; however we can't directly know which one to use. In our analysis we take both of these possibilities into account with a competing risks model, wherein two distinct stochastic processes are going on: TG = time to HNP (general) and TS = time to HNP (spaceflight). Under this type of model, whichever of these occurs first is what we observe; in other words we don't observe TG or TS, only min(TG, TS). Here, we parameterized the model in terms of separate Weibull hazard functions for each process and estimated all parameters using maximum likelihood. In addition, we allowed for a "cured fraction" - i.e. the possibility that some astronauts may never develop an HNP. RESULTS: Results will include a depiction of the competing hazard functions as well as a probability curve for the relative likelihood that an HNP reported at a given time after a mission is actually mission caused. Other factors, such as dwell time in microgravity and vehicle landing environment will be explored. An overall assessment as to whether spaceflight truly exacerbates HNP risk will be made

Coherent response of lakes in Ontario, Canada to reductions in sulphur deposition: the effects of climate on sulphate concentrations

International audienceSulphate deposition in south-central Ontario declined between 1976 and 2000 by more than 50%, whereas lake sulphate (SO42?) concentrations decreased by, on average, only half as much. To investigate the factors that controlled this slower than expected response, the temporal patterns in lake SO42? concentrations were compared with patterns in both deposition and climate, since climate has a major influence on the hydrological cycle in this part of the continent. To do this, the temporal coherence in SO42? concentrations between 9 lake basins was estimated using the intraclass correlation from a repeated-measures analysis of variance and two subsets of lakes were found (six in one group, four in the other), each with lakes having synchronous patterns. One subset (4 lakes) included the 3 with the longest water replenishment times (>3.4 yr) which are expected to respond to decreases in SO42? deposition more slowly. However, the average pattern reflecting the temporal changes of each of the two subsets was very similar. The response of both subsets of lakes to the decreasing SO42? deposition over two decades was independent of the degree of acidification or sensitivity to acidification of the lakes. In a determination of which factors best predicted each of those two subsets' SO42? time series, good predictive models were produced by regional/global-scale climate indices, specifically the Southern Oscillation Index (SOI) describing the El Niño Southern Oscillation (ENSO) and the North Atlantic Oscillation Index (NAOI), as well as by SO42? deposition indices. When the predictor variables were combined, models which described the long-term changes in lake SO42? concentration best included the SOI, the NAOI and SO42? deposition. Thus, large-scale climate factors play a major role in determining the response of aquatic systems to changes in SO42? deposition, perhaps through their influence on lake and/or catchment processes that effectively delay recovery. Keywords: Atmospheric deposition, lake recovery, temporal trends, climate, temporal coherenc

Response to “Absence of Conclusive Evidence for the Safety and Efficacy of Gonadotropin‐Releasing Hormone Analogue Treatment in Protecting Against Chemotherapy‐Induced Gonadal Injury”

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139979/1/onco0613.pd