ABSTRACT We present results of a stellar occultation by the Jupiter Trojan asteroid Patroclus and its nearly equal size moon, Menoetius. The geocentric mid-time of the event was 2013 October 21 ...06:43:02 UT. Eleven sites out of 36 successfully recorded an occultation. Seven chords across Patroclus yielded an elliptical limb fit of 124.6 by 98.2 km. There were six chords across Menoetius that yielded an elliptical limb fit of 117.2 by 93.0 km. There were three sites that got chords on both objects. At the time of the occultation we measured a separation of 664.6 km (0.247 arcsec) and a position angle for Menoetius of 265 7 measured eastward from J2000 north. Combining this occultation data with previous light curve data, the axial ratios of both objects are 1.3 : 1.21 : 1, indicative of a mostly oblate ellipsoid with a slight asymmetry in its equatorial projection. The oblate shape is not an equilibrium shape for the current rotation period, but would be if it were rotating with an ∼8 h period. This faster period is consistent with a pre-evolved state of the system with an orbital separation that is 50% smaller. Our best estimate of the system density is 0.88 g cm−3.
Antibody-secreting cells are generated in regional lymphoid tissues and traffic as plasmablasts (PBs) via lymph and blood to target sites for local immunity. We used multiparameter flow cytometry to ...define PB trafficking programs (TPs, combinations of adhesion molecules and chemoattractant receptors) and their imprinting in patients in response to localized infection or immune insults. TPs enriched after infection or autoimmune inflammation of mucosae correlate with sites of immune response or symptoms, with different TPs imprinted during small intestinal, colon, throat, and upper respiratory immune challenge. PBs induced after intramuscular or intradermal influenza vaccination, including flu-specific antibody-secreting cells, display TPs characterized by the lack of mucosal homing receptors. PBs of healthy donors display diverse mucosa-associated TPs, consistent with homeostatic immune activity. Identification of TP signatures of PBs may facilitate noninvasive monitoring of organ-specific immune responses.
We present the hitherto largest sample of gas-phase metallicity radial gradients measured at sub-kpc resolution in star-forming galaxies in the redshift range of z 1.2, 2.3. These measurements are ...enabled by the synergy of slitless spectroscopy from the Hubble Space Telescope near-infrared channels and the lensing magnification from foreground galaxy clusters. Our sample consists of 76 galaxies with stellar mass ranging from 107 to 1010 , an instantaneous star formation rate in the range of 1, 100 yr−1, and global metallicity of solar. At a 2 confidence level, 15/76 galaxies in our sample show negative radial gradients, whereas 7/76 show inverted gradients. Combining ours and all other metallicity gradients obtained at a similar resolution currently available in the literature, we measure a negative mass dependence of Δlog(O/H)/ = (−0.020 0.007) + (−0.016 0.008) , with the intrinsic scatter being = 0.060 0.006 over 4 orders of magnitude in stellar mass. Our result is consistent with strong feedback, not secular processes, being the primary governor of the chemostructural evolution of star-forming galaxies during the disk mass assembly at cosmic noon. We also find that the intrinsic scatter of metallicity gradients increases with decreasing stellar mass and increasing specific star formation rate. This increase in the intrinsic scatter is likely caused by the combined effect of cold-mode gas accretion and merger-induced starbursts, with the latter more predominant in the dwarf mass regime of .
Ibrutinib has been approved by the Food and Drug Administration for the treatment of patients with untreated chronic lymphocytic leukemia (CLL) since 2016 but has not been compared with ...chemoimmunotherapy. We conducted a phase 3 trial to evaluate the efficacy of ibrutinib, either alone or in combination with rituximab, relative to chemoimmunotherapy.
Patients 65 years of age or older who had untreated CLL were randomly assigned to receive bendamustine plus rituximab, ibrutinib, or ibrutinib plus rituximab. The primary end point was progression-free survival. The Alliance Data and Safety Monitoring Board made the decision to release the data after the protocol-specified efficacy threshold had been met.
A total of 183 patients were assigned to receive bendamustine plus rituximab, 182 to receive ibrutinib, and 182 to receive ibrutinib plus rituximab. Median progression-free survival was reached only with bendamustine plus rituximab. The estimated percentage of patients with progression-free survival at 2 years was 74% with bendamustine plus rituximab and was higher with ibrutinib alone (87%; hazard ratio for disease progression or death, 0.39; 95% confidence interval CI, 0.26 to 0.58; P<0.001) and with ibrutinib plus rituximab (88%; hazard ratio, 0.38; 95% CI, 0.25 to 0.59; P<0.001). There was no significant difference between the ibrutinib-plus-rituximab group and the ibrutinib group with regard to progression-free survival (hazard ratio, 1.00; 95% CI, 0.62 to 1.62; P=0.49). With a median follow-up of 38 months, there was no significant difference among the three treatment groups with regard to overall survival. The rate of grade 3, 4, or 5 hematologic adverse events was higher with bendamustine plus rituximab (61%) than with ibrutinib or ibrutinib plus rituximab (41% and 39%, respectively), whereas the rate of grade 3, 4, or 5 nonhematologic adverse events was lower with bendamustine plus rituximab (63%) than with the ibrutinib-containing regimens (74% with each regimen).
Among older patients with untreated CLL, treatment with ibrutinib was superior to treatment with bendamustine plus rituximab with regard to progression-free survival. There was no significant difference between ibrutinib and ibrutinib plus rituximab with regard to progression-free survival. (Funded by the National Cancer Institute and Pharmacyclics; ClinicalTrials.gov number, NCT01886872 .).
Objective
To use consensus methods and the considerable expertise contained within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) organization to extend the 3 previously developed ...treatment plans for moderate juvenile dermatomyositis (DM) to span the full course of treatment.
Methods
A consensus meeting was held in Chicago on April 23–24, 2010, involving 30 pediatric rheumatologists and 4 lay participants. Nominal group technique was used to achieve consensus on treatment plans that represented typical management of moderate juvenile DM. A preconference survey of CARRA, completed by 151 (56%) of 272 members, was used to provide additional guidance to the discussion.
Results
Consensus was reached on timing and rate of steroid tapering, duration of steroid therapy, and actions to be taken if patients were unchanged, worsening, or experiencing medication side effects or disease complications. Of particular importance, a single consensus steroid taper was developed.
Conclusion
We were able to develop consensus treatment plans that describe therapy for moderate juvenile DM throughout the treatment course. These treatment plans can now be used clinically, and data collected prospectively regarding treatment effectiveness and toxicity. This will allow comparison of these treatment plans and facilitate the development of evidence‐based treatment recommendations for moderate juvenile DM.
Questions remain about the long-term health impacts of the 1991 Gulf War on its veterans.
To measure psychological disorders in Australian Gulf War veterans and a military comparison group and to ...explore any association with exposure to Gulf War-related psychological stressors.
Prevalences of DSM-IV psychological disorders were measured using the Composite International Diagnostic Interview. Gulf War-related psychological stressors were measured using a service experience questionnaire.
A total of 31% of male Gulf War veterans and 21% of the comparison group met criteria for a DSM-IV disorder first present in the post-Gulf War period. The veterans were at greater risk of developing post-Gulf War anxiety disorders including post-traumatic stress disorder, affective disorders and substance use disorders. The prevalence of such disorders remained elevated a decade after deployment. The findings can be explained partly as a 'war-deployment effect'. There was a strong dose-response relationship between psychological disorders and number of reported Gulf War-related psychological stressors.
Service in the 1991 Gulf War is associated with increased risk of psychological disorders and these are related to stressful experiences.
Objective
To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (IIMs).
Methods
Univariable and multivariable multinomial logistic ...regression analyses were performed in a large juvenile IIM registry (n = 365) and included demographic characteristics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms.
Results
Multivariable associations with chronic or polycyclic courses compared to a monocyclic course included myositis‐specific autoantibodies (multinomial odds ratio OR 4.2 and 2.8, respectively), myositis‐associated autoantibodies (multinomial OR 4.8 and 3.5), and a documented infection within 6 months of illness onset (multinomial OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to a polycyclic course. Furthermore, severe illness onset was associated with a chronic course compared to monocyclic or polycyclic courses (multinomial OR 2.1 and 2.6, respectively), while anti‐p155/140 autoantibodies were associated with chronic or polycyclic courses compared to a monocyclic course (multinomial OR 3.9 and 2.3, respectively). Additional univariable associations of a chronic course compared to a monocyclic course included photosensitivity, V‐sign or shawl sign rashes, and cuticular overgrowth (OR 2.2–3.2). The mean ultraviolet index and highest ultraviolet index in the month before diagnosis were associated with a chronic course compared to a polycyclic course in boys (OR 1.5 and 1.3), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2).
Conclusion
Our findings indicate that myositis autoantibodies, in particular anti‐p155/140, and a number of early clinical features and environmental exposures are associated with a chronic course in patients with juvenile IIM. These findings suggest that early factors, which are associated with poorer outcomes in juvenile IIM, can be identified.
We present hitherto the largest sample of gas-phase metallicity radial gradients measured at sub-kiloparsec resolution in star-forming galaxies in the redshift range of \(z\in1.2, 2.3\). These ...measurements are enabled by the synergy of slitless spectroscopy from the Hubble Space Telescope near-infrared channels and the lensing magnification from foreground galaxy clusters. Our sample consists of 76 galaxies with stellar mass ranging from 10\(^7\) to 10\(^{10}\) \(M_\odot\), instantaneous star-formation rate in the range of 1, 100 \(M_\odot\)/yr, and global metallicity \(\frac{1}{12}\), 2 solar. At 2-\(\sigma\) confidence level, 15/76 galaxies in our sample show negative radial gradients, whereas 7/76 show inverted gradients. Combining ours and all other metallicity gradients obtained at similar resolution currently available in the literature, we measure a negative mass dependence of \(\Delta\log({\rm O/H})/\Delta r~ \mathrm{dex~kpc^{-1}} = \left(-0.020\pm0.007\right) + \left(-0.016\pm0.008\right) \log(M_\ast/10^{9.4} M_\odot)\) with the intrinsic scatter being \(\sigma=0.060\pm0.006\) over four orders of magnitude in stellar mass. Our result is consistent with strong feedback, not secular processes, being the primary governor of the chemo-structural evolution of star-forming galaxies during the disk mass assembly at cosmic noon. We also find that the intrinsic scatter of metallicity gradients increases with decreasing stellar mass and increasing specific star-formation rate. This increase in the intrinsic scatter is likely caused by the combined effect of cold-mode gas accretion and merger-induced starbursts, with the latter more predominant in the dwarf mass regime of \(M_\ast\lesssim10^9 M_\odot\).
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