The thorny issue of choosing outcome measures for aphasia therapy trials: A comparison of discourse and aphasia battery outcomes following Multi-modality and Constraint Induced aphasia therapy

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The Structures of Distant Galaxies V: The Evolution of Galaxy Structure in Stellar Mass at z < 1

Galaxy structure and morphology is nearly always studied using the light originating from stars, however ideally one is interested in measuring structure using the stellar mass distribution. Not only does stellar mass trace out the underlying distribution of matter, it also minimises the effects of star formation and dust on the appearance and structure of a galaxy. We present in this paper a study of the stellar mass distributions and structures of galaxies at z<1 as found within the GOODS fields. We use pixel by pixel K-corrections to construct stellar mass and mass-to-light ratio maps of 560 galaxies of known morphology at magnitudes z_{850}<24. We measure structural and size parameters using these stellar mass maps, as well as on ACS BViz band imaging. This includes investigating the structural CAS-Gini-M_{20} parameters and half-light radius for each galaxy. We compare structural parameters and half-light radii in the ACS z_{850}-band and stellar mass maps, finding no systematic bias introduced by measuring galaxy sizes in z_{850}. We furthermore investigate relations between structural parameters in the ACS BViz bands and stellar mass maps, and compare our result to previous morphological studies. Combinations of various parameters in stellar mass generally reveal clear separations between early and late type morphologies, but cannot easily distinguish between star formation and dynamically disturbed systems. We also show that while ellipticals and early-type spirals have fairly constant CAS values at z<1 we find a tendency for late-type spiral and peculiar morphological types to have a higher A(M_{*}) at higher redshift. We argue that this, and the large fraction of peculiars that appear spiral-like in stellar mass maps, are possible evidence for either an active bulge formation in some late-type disks at z<1 or the presence of minor merger events.Comment: 27 pages, MNRAS in pres

Structure Through Colour: A Pixel Approach Towards Understanding Galaxies

We present a study of pixel Colour Magnitude Diagrams (pCMDs) for a sample of 69 nearby galaxies chosen to span a wide range of Hubble types. Our goal is to determine how useful a pixel approach is for studying galaxies according to their stellar light distributions and content. The galaxy images were analysed on a pixel-by-pixel basis to reveal the structure of the individual pCMDs. We find that the average surface brightness (or projected mass density) in each pixel varies according to galaxy type. Early-type galaxies exihibit a clear ``prime sequence'' and some pCMDs of face-on spirals reveal ``inverse-L'' structures. We find that the colour dispersion at a given magnitude is found to be approximately constant in early-type galaxies but this quantity varies in the mid and late-types. We investigate individual galaxies and find that the pCMDs can be used to pick out morphological features. We discuss the discovery of ``Red Hooks'' in the pCMDs of six early-type galaxies and two spirals and postulate their origins. We develop quantitative methods to characterise the pCMDs, including measures of the blue-to-red light ratio and colour distributions of each galaxy and we organise these by morphological type. We compare the colours of the pixels in each galaxy with the stellar population models of Bruzual & Charlot (2003) to calculate star formation histories for each galaxy type and compare these to the stellar mass within each pixel. Maps of pixel stellar mass and mass-to-light ratio are compared to galaxy images. We apply the pCMD technique to three galaxies in the Hubble Ultra Deep Field to test the usefulness of the analysis at high redshift. We propose that these results can be used as part of a new system of automated classification of galaxies that can be applied at high redshift.Comment: 16 pages, 20 figures, MNRAS, accepted. For high resolution figures see: http://www.nottingham.ac.uk/~ppxmml/lcm_2007.pd

The Tumultuous Formation of the Hubble Sequence at z > 1 Examined with HST/WFC3 Observations of the Hubble Ultra Deep Field

We examine in this paper a stellar mass selected sample of galaxies at 1 < z < 3 within the Hubble Ultra Deep Field, utilising WFC3 imaging to study the rest-frame optical morphological distribution of galaxies at this epoch. We measure how apparent morphologies (disk, elliptical, peculiar) correlate with physical properties, such as quantitative structure and spectral-types. One primary result is that apparent morphology does not correlate strongly with stellar populations, nor with galaxy structure at this epoch, suggesting a chaotic formation history for Hubble types at z > 1. By using a locally defined definition of disk and elliptical galaxies based on structure and spectral-type, we find no true ellipticals at z > 2, and a fraction of 3.2+/-2.3% at 1.5 < z < 2. Local counterparts of disk galaxies are at a similar level of 7-10%, much lower than the 75% fraction at lower redshifts. We further compare WFC3 images with the rest-frame UV view of galaxies from ACS imaging, showing that galaxies imaged with ACS that appear peculiar often contain an `elliptical' like morphology in WFC3. We show through several simulations that this larger fraction of elliptical-like galaxies is partially due to the courser PSF of WFC3, and that the `elliptical' class very likely includes early-type disks. We also measure the merger history for our sample using CAS parameters, finding a redshift evolution increasing with redshift, and a peak merger fraction of ~30% at z~2 for the most massive galaxies with M_*> 10^{10} M_sol, consistent with previous results from ACS and NICMOS. We compare our results to semi-analytical model results and find a relatively good agreement between our morphological break-down and the predictions. Finally, we argue that the peculiars, ellipticals and peculiar ellipticals have similar properties, suggesting similar formation modes, likely driven by major mergers.Comment: 21 pages, submitted to MNRA

Clinical Utility of Random Anti–Tumor Necrosis Factor Drug–Level Testing and Measurement of Antidrug Antibodies on the Long-Term Treatment Response in Rheumatoid Arthritis

Objective: To investigate whether antidrug antibodies and/or drug non-trough levels predict the long-term treatment response in a large cohort of patients with rheumatoid arthritis (RA) treated with adalimumab or etanercept and to identify factors influencing antidrug antibody and drug levels to optimize future treatment decisions.  Methods: A total of 331 patients from an observational prospective cohort were selected (160 patients treated with adalimumab and 171 treated with etanercept). Antidrug antibody levels were measured by radioimmunoassay, and drug levels were measured by enzyme-linked immunosorbent assay in 835 serial serum samples obtained 3, 6, and 12 months after initiation of therapy. The association between antidrug antibodies and drug non-trough levels and the treatment response (change in the Disease Activity Score in 28 joints) was evaluated.  Results: Among patients who completed 12 months of followup, antidrug antibodies were detected in 24.8% of those receiving adalimumab (31 of 125) and in none of those receiving etanercept. At 3 months, antidrug antibody formation and low adalimumab levels were significant predictors of no response according to the European League Against Rheumatism (EULAR) criteria at 12 months (area under the receiver operating characteristic curve 0.71 [95% confidence interval (95% CI) 0.57, 0.85]). Antidrug antibody–positive patients received lower median dosages of methotrexate compared with antidrug antibody–negative patients (15 mg/week versus 20 mg/week; P = 0.01) and had a longer disease duration (14.0 versus 7.7 years; P = 0.03). The adalimumab level was the best predictor of change in the DAS28 at 12 months, after adjustment for confounders (regression coefficient 0.060 [95% CI 0.015, 0.10], P = 0.009). Etanercept levels were associated with the EULAR response at 12 months (regression coefficient 0.088 [95% CI 0.019, 0.16], P = 0.012); however, this difference was not significant after adjustment. A body mass index of ≥30 kg/m2 and poor adherence were associated with lower drug levels.  Conclusion: Pharmacologic testing in anti–tumor necrosis factor–treated patients is clinically useful even in the absence of trough levels. At 3 months, antidrug antibodies and low adalimumab levels are significant predictors of no response according to the EULAR criteria at 12 months

Oral abstracts 3: RA Treatment and outcomesO13. Validation of jadas in all subtypes of juvenile idiopathic arthritis in a clinical setting

Background: Juvenile Arthritis Disease Activity Score (JADAS) is a 4 variable composite disease activity (DA) score for JIA (including active 10, 27 or 71 joint count (AJC), physician global (PGA), parent/child global (PGE) and ESR). The validity of JADAS for all ILAR subtypes in the routine clinical setting is unknown. We investigated the construct validity of JADAS in the clinical setting in all subtypes of JIA through application to a prospective inception cohort of UK children presenting with new onset inflammatory arthritis. Methods: JADAS 10, 27 and 71 were determined for all children in the Childhood Arthritis Prospective Study (CAPS) with complete data available at baseline. Correlation of JADAS 10, 27 and 71 with single DA markers was determined for all subtypes. All correlations were calculated using Spearman's rank statistic. Results: 262/1238 visits had sufficient data for calculation of JADAS (1028 (83%) AJC, 744 (60%) PGA, 843 (68%) PGE and 459 (37%) ESR). Median age at disease onset was 6.0 years (IQR 2.6-10.4) and 64% were female. Correlation between JADAS 10, 27 and 71 approached 1 for all subtypes. Median JADAS 71 was 5.3 (IQR 2.2-10.1) with a significant difference between median JADAS scores between subtypes (p < 0.01). Correlation of JADAS 71 with each single marker of DA was moderate to high in the total cohort (see Table 1). Overall, correlation with AJC, PGA and PGE was moderate to high and correlation with ESR, limited JC, parental pain and CHAQ was low to moderate in the individual subtypes. Correlation coefficients in the extended oligoarticular, rheumatoid factor negative and enthesitis related subtypes were interpreted with caution in view of low numbers. Conclusions: This study adds to the body of evidence supporting the construct validity of JADAS. JADAS correlates with other measures of DA in all ILAR subtypes in the routine clinical setting. Given the high frequency of missing ESR data, it would be useful to assess the validity of JADAS without inclusion of the ESR. Disclosure statement: All authors have declared no conflicts of interest. Table 1Spearman's correlation between JADAS 71 and single markers DA by ILAR subtype ILAR Subtype Systemic onset JIA Persistent oligo JIA Extended oligo JIA Rheumatoid factor neg JIA Rheumatoid factor pos JIA Enthesitis related JIA Psoriatic JIA Undifferentiated JIA Unknown subtype Total cohort Number of children 23 111 12 57 7 9 19 7 17 262 AJC 0.54 0.67 0.53 0.75 0.53 0.34 0.59 0.81 0.37 0.59 PGA 0.63 0.69 0.25 0.73 0.14 0.05 0.50 0.83 0.56 0.64 PGE 0.51 0.68 0.83 0.61 0.41 0.69 0.71 0.9 0.48 0.61 ESR 0.28 0.31 0.35 0.4 0.6 0.85 0.43 0.7 0.5 0.53 Limited 71 JC 0.29 0.51 0.23 0.37 0.14 -0.12 0.4 0.81 0.45 0.41 Parental pain 0.23 0.62 0.03 0.57 0.41 0.69 0.7 0.79 0.42 0.53 Childhood health assessment questionnaire 0.25 0.57 -0.07 0.36 -0.47 0.84 0.37 0.8 0.66 0.4

Socioeconomic deprivation is associated with reduced response and lower treatment persistence with TNF inhibitors in rheumatoid arthritis

Objective To investigate the association between socioeconomic deprivation and outcomes following TNF inhibitor (TNFi) treatment. Methods Individuals commencing their first TNFi in the British Society for Rheumatology Biologics Register for RA (BSRBR-RA) and Biologics in RA Genetics and Genomics Study Syndicate (BRAGGSS) cohort were included. Socioeconomic deprivation was proxied using the Index of Multiple Deprivation and categorized as 20% most deprived, middle 40% or 40% least deprived. DAS28-derived outcomes at 6 months (BSRBR-RA) and 3 months (BRAGGSS) were compared using regression models with the least deprived as referent. Risks of all-cause and cause-specific drug discontinuation were compared using Cox models in the BSRBR-RA. Additional analyses adjusted for lifestyle factors (e.g. smoking, BMI) as potential mediators. Results 16 085 individuals in the BSRBR-RA were included (mean age 56 years, 76% female), of whom 18%, 41% and 41% were in the most, middle and least deprived groups, respectively. Of 3459 included in BRAGGSS (mean age 57, 77% female), proportions were 22%, 36% and 41%, respectively. The most deprived group had 0.3-unit higher 6-month DAS28 (95% CI 0.22, 0.37) and were less likely to achieve low disease activity (odds ratio [OR] 0.76; 95% CI 0.68, 0.84) in unadjusted models. Results were similar for 3-month DAS28 (β = 0.23; 95% CI 0.11, 0.36) and low disease activity (OR 0.77; 95% CI 0.63, 0.94). The most deprived were more likely to discontinue treatment (hazard ratio 1.18; 95% CI 1.12, 1.25), driven by ineffectiveness rather than adverse events. Adjusted estimates were generally attenuated. Conclusion Socioeconomic deprivation is associated with reduced response to TNFi. Improvements in determinants of health other than lifestyle factors are needed to address socioeconomic inequities

Gesture production patterns in aphasic discourse: in-depth description and preliminary predictions

Background: Gesture frequently accompanies speech in healthy speakers. For many individuals with aphasia, gestures are a target of speech-language pathology intervention, either as an alternative form of communication or as a facilitative device for language restoration. The patterns of gesture production for people with aphasia and the participant variables that predict these patterns remain unclear.Aims: We aimed to examine gesture production during conversational discourse in a large sample of individuals with aphasia. We used a detailed gesture coding system to determine patterns of gesture production associated with specific aphasia types and severities.Methods & Procedures: We analysed conversation samples from AphasiaBank, gathered from 46 people with post-stroke aphasia and 10 healthy matched controls all of whom had gestured at least once during a story re-tell task. Twelve gesture types were coded. Descriptive statistics were used to describe the patterns of gesture production. Possible significant differences in production patterns according to aphasia type and severity were examined with a series of analyses of variance (ANOVA) statistics, and multiple regression analysis was used to examine these potential predictors of gesture production patterns.Outcomes & Results: Individuals with aphasia gestured significantly more frequently than healthy controls. Aphasia type and severity impacted significantly on gesture type in specific identified patterns detailed here, especially on the production of meaning-laden gestures.Conclusions: These patterns suggest the opportunity for gestures as targets of aphasia therapy. Aphasia fluency accounted for a greater degree of data variability than aphasia severity or naming skills. More work is required to delineate predictive factors