Treatment with tumor necrosis factor inhibitors in axial spondyloarthritis: comparison between private rheumatology practices and academic centers in a large observational cohort

OBJECTIVE To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. METHODS We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort. RESULTS All patients had been treated with ≥ 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (± SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 ± 1.0 vs 3.4 ± 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0). CONCLUSION With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.

Characterization of the Axial Jet Separator with a CO2/Helium Mixture: Toward GC-AMS Hyphenation

Development of interfaces for sample introduction from high pressures is important for real-time online hyphenation of chromatographic and other separation devices with mass spectrometry (MS) or accelerator mass spectrometry (AMS). Momentum separators can reduce unwanted low-density gases and introduce the analyte into the vacuum. In this work, the axial jet separator, a new momentum interface, is characterized by theory and empirical optimization. The mathematical model describes the different axial penetration of the components of a jetgas mixture and explains the empirical results for injections of CO2 in helium into MS and AMS instruments. We show that the performance of the new interface is sensitive to the nozzle size, showing good qualitative agreement with the mathematical model. Smaller nozzle sizes are more preferable due to their higher inflow capacity. The CO2 transmission efficiency of the interface into a MS instrument is ~14% (CO2/helium separation factor of 2.7). The interface receives and delivers flows of ~17.5 mL/min and ~0.9 mL/min, respectively. For the interfaced AMS instrument, the ionization and overall efficiencies are 0.7-3% and 0.1-0.4%, respectively, for CO2 amounts of 4-0.6 µg C, which is only slightly lower compared to conventional systems using intermediate trapping. The ionization efficiency depends on to the carbon mass flow in the injected pulse and is suppressed at high CO2 flows. Relative to a conventional jet separator, the transmission efficiency of the axial jet separator is lower, but its performance is less sensitive to misalignments.

Animal Guts as Nonideal Chemical Reactors: Partial Mixing and Axial Variation in Absorption Kinetics

Animal guts have been idealized as axially uniform plug-flow reactors (PFRs) without significant axial mixing or as combinations in series of such PFRs with other reactor types. To relax these often unrealistic assumptions and to provide a means for relaxing others, I approximated an animal gut as a series of n continuously stirred tank reactors (CSTRs) and examined its performance as a Function of n. For the digestion problem of hydrolysis and absorption in series, I suggest as a first approximation that a tubular gut of length L and diameter D comprises n=L/D tanks in series. For n greater than or equal to 10, there is little difference between performance of the nCSTR model and an ideal PFR in the coupled tasks of hydrolysis and absorption. Relatively thinner and longer guts, characteristic of animals feeding on poorer forage, prove more efficient in both conversion and absorption by restricting axial mixing, in the same total volume, they also give a higher rate of absorption. I then asked how a fixed number of absorptive sites should be distributed among the n compartments. Absorption rate generally is maximized when absorbers are concentrated in the hindmost few compartments, but high food quality or suboptimal ingestion rates decrease the advantage of highly concentrated absorbers. This modeling approach connects gut function and structure at multiple scales and can be extended to include other nonideal reactor behaviors observed in real animals.

Discharge data derived from five water level gauges and discharge measurements in the Aguima and Niaou catchment, Benin, West Africa

This paper analyzes the hydrological processes and the impact of soil properties and land use on these processes in tropical headwater catchment in the sub-humid part of Benin (West-Africa), the Aguima catchment. The presented study is integrated in the GLOWA IMPETUS project, which investigates the effects of global change on the water cycle and water availability on a regional scale in Morocco and Benin. The lack of field investigations concerning soil and surface hydrology in the Benin research area necessitates detailed field measurements including measurements of discharge, soil water dynamics, soil physical properties etc. on the local scale in order to understand the dominant runoff generation processes and its influencing factors. This is a pre-requisite to be able to forecast the effects which global change has on hydrological processes and water availability in the region. The paper gives an overview over the hydrologic measuring concept of the IMPETUS-Benin project focusing on measurements concerning the soil saturated conductivity ksat and discharge behaviour of two different sub-catchment of the Aguima catchment. The results of ksat measurements revealed that interflow is the dominant runoff process on the hillslopes of the investigated catchment. Concerning the impact of land use on the hydrological processes infiltration experiments showed that infiltration rates were reduced on cultivated land compared to natural land cover. This results in significant differences in runoff behaviour and runoff ratios while comparing natural and agricultural used catchments.

Chemical composition and accumulation rates of chemical elements in metalliferous sediments from axial zones of the East Pacific Rise and the Mid-Atlantic Ridge

In the monograph metalliferous sediments of the East Pacific Rise near 21°S are under consideration. Distribution trends of chemical, mineral and grain size compositions of metalliferous sediments accumulated near the axis of this ultrafast spreading segment of the EPR are shown. On the basis of lithological and geochemical investigations spatial and temporal variations of hydrothermal activity are estimated. Migration rates of hydrothermal fields along the spreading axis are calculated. The model of cyclic hydrothermal process is suggested as a result of tectono-magmatic development of the spreding centre.

Concentrations of heavy and precious metals in animals from hydrothermal vents of the Axial Seamount (Juan de Fuca Ridge) and Guaymas Basin (Gulf of California)

A series of samples of inhabitants of hydrothermal vents were collected during the 12-th cruise of R/V Akademik Mstislav Keldysh in Guaymas Basin (the Gulf of California) and the Axial Seamount area (Juan de Fuca Ridge). Concentrations of trace and heavy metals in the tissues of Ridgeia piscesae, Riftia pachyptila, and Paralvinella palmiformis were analyzed. Neutron-activation analysis revealed significantly higher concentrations of uranium in tissues of Paralvinella palmiformis as compared to ambient seawater. Possible reasons for such phenomenon are discussed. The data obtained by neutron-activation method are compared with those obtained by atomic-absorption method for the same tissues analyzed.

Geochemical and isotopic composition of basalts from the axial Mid-Atlantic Ridge, South Atlantic

One of the essential problems of oceanic tectonics is estimation of the influence of plumes of the deep hot mantle on processes in the axial spreading zone. Areas of two giant (St. Helena and Tristan da Cunha) plumes in the Mid-Atlantic Ridge (MAR) rift zone (South Atlantic) are characterized by the effusion of basalts that differ from typical depleted riftogenic tholeiites by anomalously high contents of lithophile components and specific isotopic compositions. Moreover, the rift valley floor with basalt effusion is significantly uplifted above the adjacent sectors of the rift. The formation of the St. Helena Seamount located 400 km east of the MAR axis is related to magmatism that is active to this day. St. Helena Island is a member of the structural ensemble of large volcanic seamounts (Bonaparte, Bagration, and Kutuzov). Like St. Helena Island, each seamount incorporates a series of smaller rises of different morphologies and dimensions. Thus, a system of subparallel series of NE-trending (~45°) rises extend from the seamount ensemble to the African continent. According to the plate tectonics concept, the seamount series represent hotspots related to a deep mantle plume that can be projected onto the present-day St. Helena Island area (St. Helena plume). At the same time, the inferred topographic map based on satellite altimetry data shows that the seamount series also extend along the opposite southwestern direction (~225°) toward the axial MAR and even intersect the latter structure. This fact cannot be explained by the hotspot hypothesis, which suggests stationary positions of plumes relative to the mobile oceanic plate. In the course of Cruise 10 of the R/V Akademik Ioffe (2002), detailed geological and geophysical investigations were carried out at the junction of one structural series with the MAR rift zone located near the Martin Vaz Fracture Zone (Martin Vaz test area, 19°-20° S). The present communication is devoted to the study of lithology, geochemistry, and isotopy of basalts dredged at the test area.