Methotrexate therapy in rheumatoid arthritis: a life table review of 587 patients treated in community practice

To determine whether methotrexate (MTX) maintains its effectiveness in rheumatoid arthritis (RA) in the setting of community based private rheumatology practice we used life table analysis to review the combined experience of a group of these practices. Of 587 patients with RA who started to take MTX, total termination rate at 70 months was 24.4% with most terminations prompted by drug toxicity. Older age (greater than 65 years) was associated with higher rates of toxicity. Treatment termination rates varied substantially between rheumatologists. We conclude that MTX therapy for RA is well tolerated and maintains effectiveness for at least 70 months.     

Intermodality, retrospective image registration in the thorax

The purpose of this study was to develop an accurate, retrospectively applicable procedure for registering thoracic studies from different modalities in a short amount of time and with minimal operator intervention. METHODS: CT and PET studies were acquired from six patients. The pleural surfaces in both image sets were determined by segmenting based on 50% of the maximum soft-tissue value in the study. These surfaces were converted into three-dimensional volumes and used to register the CT and PET studies in three dimensions using a sum of least squares fitting approach. The registered PET study was then displayed in a hot metal scale overlayed on top of the gray scale CT study. The accuracy of the fit was evaluated through a phantom study and preliminary clinical evaluation. RESULTS: A phantom study was performed to determine the limits of this technique. The accuracy was determined to be less than 2.3 mm in the x and y direction and 3 mm in the z direction. Preliminary clinical evaluation was also performed with encouraging results. CONCLUSION: This technique accurately registers PET and CT images of the thorax, retrospectively, without the need for external fiducial markers or other a priori action.     

A study of void formation in fast neutron-irradiated metals

Experimental observations on the temperature dependence of void formation in Type 304 stainless steel are presented. The average void size is seen to increase while the void number density decreases with increasing irradiation temperature. The total void volume reaches a maximum at an intermediate temperature (～500°C). A thermodynamically based model for void formation has been developed in an effort to understand these and other experimental observations. The model is a quasi-steady-state approach that attempts to describe the void and dislocation loop nucleation and growth rates as a function of temperature, neutron flux, and type and density of point-defect sinks. The model was written in the form of a computer routine which iterates over small time steps and fitted to experimental observations of void formation in irradiated austenitic stainless steel by adjustment of material constants within reasonable limits. Good agreement was obtained for a wide range of experimental results. Development of the model has emphasized that some kind of preferential attraction between one type of sink and one type of point defect is necessary in order for void growth to occur. The preferential attraction suggested is that between the stress field of a dislocation and the misfit strain of an interstitial. The model also pointed out the necessity of separating the neutron flux and time of irradiation when reporting information on void formation. It is expected that quite different dependences of void size and number density on the total neutron dose would be obtained depending on whether the experimental information was obtained under constant flux or under constant time conditions. It was also concluded that the magnitude and temperature dependence of dislocation loop formation would have a marked effect on void formation.     

"Recurrence in major depression: A conceptual analysis": Correction to Monroe and Harkness (2011).

Reports an error in "Recurrence in major depression: A conceptual analysis" by Scott M. Monroe and Kate L. Harkness (Psychological Review, Advanced Online Publication, Sep 5, 2011, np). An incorrect version of Figure 2 was published, and Figure 3 was published in color instead of Figure 4. Also, in Table 1, the acronym “(FLED)” should not have been included in the Recurrence section, under Confusion to avoid, following “Not to be confused with a first lifetime recurrence.” All versions of this article have been corrected. (The following abstract of the original article appeared in record 2011-20042-001.) Theory and research on major depression have increasingly assumed a recurrent and chronic disease model. Yet not all people who become depressed suffer recurrences, suggesting that depression is also an acute, time-limited condition. However, few if any risk indicators are available to forecast which of the initially depressed will or will not recur. This prognostic impasse may be a result of problems in conceptualizing the nature of recurrence in depression. In the current paper we first provide a conceptual analysis of the assumptions and theoretical systems that presently structure thinking on recurrence. This analysis reveals key concerns that have distorted views about the long-term course of depression. Second, as a consequence of these theoretical problems we suggest that investigative attention has been biased toward recurrent forms of depression and away from acute, time-limited conditions. Third, an analysis of how these theoretical problems have influenced research practices reveals that an essential comparison group has been omitted from research on recurrence: people with a single lifetime episode of depression. We suggest that this startling omission may explain why so few predictors of recurrence have as yet been found. Finally, we examine the reasons for this oversight, document the validity of depression as an acute, time-limited disorder, and provide suggestions for future research with the goal of discovering early risk indicators for recurrent depression. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Does interpersonal psychotherapy protect women from depression in the face of stressful life events?

The present study compared the role of life events in predicting time to index episode onset under conditions of no or variable treatment versus the role of life events in predicting time to recurrence during maintenance interpersonal psychotherapy (IPT). Eighty-three women with recurrent major depression participated in acute IPT treatment followed by 2 years of maintenance IPT. Life events were assessed using contextual interview and rating methods. Cox regression survival analyses indicated that, although severe life events were significantly associated with time to index episode onset, there was little evidence of an association between events experienced during maintenance treatment and time to recurrence. These results provide evidence that IPT may decrease the potency of life events in provoking recurrence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Architecture for integrated telecommunication management platforms

Telecommunication management network (TMN) systems represent diverse telecommunication domains with wide-ranging functionality which frequently employ different technologies and produce isolated solutions. Yet as telecommunications become more sophisticated, there is a growing need for telecommunication management integration and interoperability. The authors present a general TMN computing-platform architecture which is flexible and powerful enough to support contrasting TMN management applications while facilitating integration. To validate the architecture, three diverse management applications were profiled based on components of the TMN platform architecture. Core infrastructure components, required by a broad range of TMN applications, are identified and examined and TMN-specific technology is highlighted