Autoimmune blistering diseases treated with glucocorticoids: An international study of steroid-induced myopathy.

BACKGROUND: Patients with autoimmune blistering diseases (AIBDs) are often exposed to chronic glucocorticoid (GC) treatment with many side effects. Glucocorticoid-induced myopathy (GIM) is a well-established side effect, which particularly affects the proximal muscles. The Glucocorticoid Toxicity Index (GTI) is a validated global assessment tool which quantifies GC toxicity over time. OBJECTIVES: This study marks the first study which analyses GIM in patients with AIBDs. The objectives of this study were to utilize the GTI to investigate the nature and prevalence of GIM in AIBD patients and explore potential risk factors. METHODS: This international cohort study was conducted in blistering disease clinics across Australia, China, Greece, Iran, Japan, the Philippines, Turkey and the United States of America between February 2019 and July 2023. The GTI tool was completed by a medical practitioner at each patient visit. Data related to glucocorticoid toxicity were entered into the Steritas GTI 2.0 to generate an aggregate improvement and cumulative worsening score at each visit. RESULTS: The study included 139 patients. There were 132 episodes of myopathy, and 47.5% of patients developed muscle weakness at some point during the study period. Cumulative GC dose correlated positively with myopathy risk, while average dose and treatment duration were not significant. Older age, male gender and obesity more than doubled the likelihood of developing GIM. CONCLUSIONS: GIM is a common side effect experienced by AIBD patients on GC treatment. Muscle weakness is less likely to occur if cumulative GC dose is less than 0.75 mg/kg/day. Studies of exercise programs to mitigate myopathy and newer alternative treatments to reduce cumulative GC dose should be considered.

Effects of temperature and light intensity on flowering of barley (Hordeum vulgare L.).

In order to analyse the effects of temperature (9-22 degreesC) and light intensity (170-576 micromol m(-2) s(-1)) on plant development two barley varieties with contrasting seasonal growth habits were included in a series of experiments consisting of controlled environment tests. The effect of constant (18 degrees C) and daily fluctuating (18/16 degrees C) temperature with a long photoperiod was also examined in a set of barley varieties including winter, facultative and spring barleys. Dicktoo with facultative growth habit was more sensitive to unfavourable conditions than Kompolti korai with winter growth habit; the flowering of Dicktoo was significantly delayed by sub- and supra-optimal temperatures and low light intensity accompanied by higher or fluctuating temperatures. The optimal temperature at flowering was also significantly lower for Dicktoo than for Kompolti korai (16.0 degrees C vs. 21.0 degrees C, respectively). Plant development was the fastest when there was no fluctuating environmental factor in the growing conditions and was significantly delayed with application of photo cycle. The addition of thermo cycle to photo cycle had an even stronger delaying effect. Facultative barleys were the most sensitive, followed by winter barleys, while spring barleys the least sensitive to the introduction of thermo cycle.

Effects of photo and thermo cycles on flowering time in barley: a genetical phenomics approach.

The effects of synchronous photo (16 h daylength) and thermo (2 degrees C daily fluctuation) cycles on flowering time were compared with constant light and temperature treatments using two barley mapping populations derived from the facultative cultivar 'Dicktoo'. The 'Dicktoo'x'Morex' (spring) population (DM) segregates for functional differences in alleles of candidate genes for VRN-H1, VRN-H3, PPD-H1, and PPD-H2. The first two loci are associated with the vernalization response and the latter two with photoperiod sensitivity. The 'Dicktoo'x'Kompolti korai' (winter) population (DK) has a known functional polymorphism only at VRN-H2, a locus associated with vernalization sensitivity. Flowering time in both populations was accelerated when there was no fluctuating factor in the environment and was delayed to the greatest extent with the application of synchronous photo and thermo cycles. Alleles at VRN-H1, VRN-H2, PPD-H1, and PPD-H2--and their interactions--were found to be significant determinants of the increase/decrease in days to flower. Under synchronous photo and thermo cycles, plants with the Dicktoo (recessive) VRN-H1 allele flowered significantly later than those with the Kompolti korai (recessive) or Morex (dominant) VRN-H1 alleles. The Dicktoo VRN-H1 allele, together with the late-flowering allele at PPD-H1 and PPD-H2, led to the greatest delay. The application of synchronous photo and thermo cycles changed the epistatic interaction between VRN-H2 and VRN-H1: plants with Dicktoo type VRN-H1 flowered late, regardless of the allele phase at VRN-H2. Our results are novel in demonstrating the large effects of minor variations in environmental signals on flowering time: for example, a 2 degrees C thermo cycle caused a delay in flowering time of 70 d as compared to a constant temperature.

An evaluation of a network for professional development in child and adolescent mental health in rural and remote communities.

In 1998 a telemedicine network was established in South Australia and the Northern Territory to deliver educational material to professionals working in child and adolescent mental health in remote areas. The network involved a wide range of health professions, from psychiatrists to psychologists and social workers. The first 12 months of network activity were evaluated by quantitative and qualitative techniques. Four sources of data were used: an activity log, questionnaires, interviews and action research. A total of 36 telemedicine sessions were held, ranging in duration from 45 to 90 min (average 56 min) and involving a total of 45 different professionals, who participated an average of four times each (range 1-15). The most common types of session were case discussions (47%), followed by specialist seminars (36%) and administrative and introductory sessions (17%). The benefits of the network included: networking and peer support; improved efficiency and reduced travel costs; and improved efficiency of health services. The problems included: costs; lack of access to technical support; and the need for staff induction and training.

Molecular cytogenetic analysis of Aegilops cylindrica host.

The genomic constitution of Aegilops cylindrica Host (2n = 4x = 28, DcDcCcCc) was analyzed by C-banding, genomic in situ hybridization (GISH), and fluorescence in situ hybridization (FISH) using the DNA clones pSc119, pAs1, pTa71, and pTA794. The C-banding patterns of the Dc- and Cc-genome chromosomes of Ae. cylindrica are similar to those of D-and C-genome chromosomes of the diploid progenitor species Ae. tauschii Coss. and Ae. caudata L., respectively. These similarities permitted the genome allocation and identification of the homoeologous relationships of the Ae. cylindrica chromosomes. FISH analysis detected one major 18S-5.8S-25S rDNA locus in the short arm of chromosome 1Cc. Minor 18S-5.8S-25S rDNA loci were mapped in the short arms of 5Dc and 5Cc. 5S rDNA loci were identified in the short arm of chromosomes 1Cc, 5Dc, 5Cc, and 1Dc. GISH analysis detected intergenomic translocation in three of the five Ae. cylindrica accessions. The breakpoints in all translocations were non-centromeric with similar-sized segment exchanges.