An interdisciplinary approach to the care of 155 WG patients resulted in a median survival of >21 years. Kidney or lung involvement at diagnosis was predictive of a >3-fold higher mortality. Although CYC remains essential in the treatment of WG, it was administered as briefly as possible and under close surveillance to avoid permanent CYC-related morbidity, which can lead to serious therapeutic problems in chronic relapsing WG.

Small, physiologic changes in the water content of patellar cartilage and the concomitant change in proteoglycan and collagen density following exercise can be detected using MRI. The proposed T(2)-mapping method, together with other non-invasive MR cartilage imaging techniques, could aid in the early diagnosis of OA.

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SummaryDietary behavioral choices have a strong effect on the environmental impact associated with the food system. Here, we consider the greenhouse gas (GHG) emissions associated with production of food that is lost at the retail and consumer level, as well as the potential effects on GHG emissions of a shift to dietary recommendations. Calculations are based on the U.S. Department of Agriculture's (USDA) food availability data set and literature metaanalysis of emission factors for various food types. Food losses contribute 1.4 kilograms (kg) carbon dioxide equivalents (CO 2 -eq) capita −1 day −1 (28%) to the overall carbon footprint of the average U.S. diet; in total, this is equivalent to the emissions of 33 million average passenger vehicles annually. Whereas beef accounts for only 4% of the retail food supply by weight, it represents 36% of the diet-related GHG emissions. An iso-caloric shift from the current average U.S. diet to USDA dietary recommendations could result in a 12% increase in diet-related GHG emissions, whereas a shift that includes a decrease in caloric intake, based on the needs of the population (assuming moderate activity), results in a small (1%) decrease in diet-related GHG emissions. These findings emphasize the need to consider environmental costs of food production in formulating recommended food patterns.

Supplying adequate human nutrition within ecosystem carrying capacities is a key element in the global environmental sustainability challenge. Life cycle assessment (LCA) has been used effectively to evaluate the environmental impacts of food production value chains and to identify opportunities for targeted improvement strategies. Dietary choices and resulting consumption patterns are the drivers of production, however, and a consumption-oriented life cycle perspective is useful in understanding the environmental implications of diet choices. This review identifies 32 studies that use an LCA framework to evaluate the environmental impact of diets or meals. It highlights the state of the art, emerging methodological trends and current challenges and limitations to such diet-level LCA studies. A wide range of bases for analysis and comparison (i.e., functional units) have been employed in LCAs of foods and diet; we conceptually map appropriate functional unit choices to research aims and scope and argue for a need to move in the direction of a more sophisticated and comprehensive nutritional basis in order to link nutritional health and environmental objectives. Nutritional quality indices are reviewed as potential approaches, but refinement through ongoing collaborative research between environmental and nutritional sciences is necessary. Additional research needs include development of regionally specific life cycle inventory databases for food and agriculture and expansion of the scope of assessments beyond the current focus on greenhouse gas emissions.