Sensitivity to Change of the Ultrasound synovitis SONAR Score in RA Patients: Results of the Scqm Cohort

Background/Purpose: Since the end of 2009, an ultrasound scoring call SONAR has been implemented for RA patients as a routine tool in the SCQM registry (Swiss Clinical Quality Management registry for rheumatic diseases). A cross-sectional evaluation of patients with active disease and clinical remission according to the DAS28ESR and the novel ACR/EULAR remission criteria from 2010 clearly indicated a good correlational external validity of synovial pathologies with clinical disease activity in RA (2012 EULAR meeting. Objective: of this study was to evaluate the sensitivity to change of B-mode and Power-Doppler scores in a longitudinal perspective along with the changes in DAS28ESR in two consecutive visits among the patients included in the SCQM registry Methods: All patients who had at least two SONAR scores and simultaneous DAS28ESR evaluations between December 2009 and June 2012 were included in this study. The data came from 20 different operators working mostly in hospitals but also in private practices, who had received a previous teaching over 3 days in a reference center. The SONAR score includes a semi-quantitative B mode and Power-Doppler evaluation of 22 joints from 0 to 3, maximum 66 points for each score. The selection of these 22 joints was done in analogy to a 28 joint count and further restricted to joint regions with published standard ultrasound images. Both elbows and wrist joints were dynamically scanned from the dorsal and the knee joints from a longitudinal suprapatellar view in flexion and in joint extension. The bilateral evaluation of the second to fifth metacarpophalangeal and proximal interphalangeal joints was done from a palmar view in full extension, and the Power-Doppler scoring from a dorsal view with hand and finger position in best relaxation. Results: From the 657 RA patients with at least one score performed, 128 RA patients with 2 or more consultations of DAS28ESR, and a complete SONAR data set could be included. The mean (SD) time between the two evaluations was 9.6 months (54). The mean (SD) DAS28ESR was: 3.5 (1.3) at the first visit and was significantly lower (mean 3.0, SD.2.0, p:_0.0001) at the second visit. The mean (SD) of the total B mode was 12 (9.5) at baseline and 9.6 (7.6) at follow-up (p_0.0004). The Power-Doppler score at entry was 2.9 (5.7) and 1.9 (3.6), at the second visit, p _0.0001. The Pearson r correlation between change in DAS28ESR and the B mode was 0.44 (95% CI: 0.29, 0.57, p_ 0.0001),and 0.35 (95% CI: 0.16, 0.50, p _ 0.0002) for the Power-Doppler score,. Clinical relevant change in DAS (_1.1) was associated with a change of total B mode score _3 in 23/32 patients and a change a Doppler score _0.5 in 19/26. Conclusion: This study confirms that the SONAR score is sensitive to change and provides a complementary method of assessing RA disease activity to the DAS that could be very useful in daily practice.

Dispensació d'antibiòtics sense recepta a les oficines de farmàcia

Introducció: L’ús indiscriminat d’antibiòtics, l’augment de les resistències i la mancança d’investigació en nous antibiòtics fa que ens trobem en un moment de crisi antibiòtica on cal prendre mesures. Objectiu: Quantificar el percentatge de farmàcies que venen antibiòtics sense recepta mèdica oficial per un dels tres casos següents: infecció d’orina, mal de coll o bronquitis aguda. Metodologia: Estudi prospectiu realitzat en el període gener-maig 2013 a la Regió Sanitària del Camp de Tarragona. Resultats: Es van visitar un total de 45 farmàcies. Es va vendre antibiòtic en 12 (80%) farmàcies on es va simular infecció d’orina, en 10 (66,7%) on es va simular mal de coll i en 5 (33,3%) on es va simular bronquitis aguda (p<0,05). Només en un 22,2% dels casos en què es va vendre un antibiòtic es va preguntar per les al·lèrgies de la pacient i també en un 22,2% l’argument per no dispensar l’antibiòtic va ser de tipus raonat. Conclusió: Aquests resultats mostren que tot i les campanyes que s’han fet per conscienciar la població sobre l’ús racional dels antibiòtics i el fet que vendre antibiòtics sense recepta és il·legal, se segueixen dispensant antibiòtics sense recepta.

A topological view of the replicon.

The replication of circular DNA faces topological obstacles that need to be overcome to allow the complete duplication and separation of newly replicated molecules. Small bacterial plasmids provide a perfect model system to study the interplay between DNA helicases, polymerases, topoisomerases and the overall architecture of partially replicated molecules. Recent studies have shown that partially replicated circular molecules have an amazing ability to form various types of structures (supercoils, precatenanes, knots and catenanes) that help to accommodate the dynamic interplay between duplex unwinding at the replication fork and DNA unlinking by topoisomerases.

Eficiência bioeconômica de cordeiros F1 Dorper x Santa Inês para produção de carne

O objetivo deste trabalho foi avaliar a eficiência bioeconômica de cordeiros F1 Dorper x Santa Inês para produção de carne. Analisou-se o desempenho de ovinos ½ sangue Dorper x ½ sangue Santa Inês, nas fases de cria e de acabamento. A fase de produção das crias foi realizada em caatinga nativa e a fase de acabamento em confinamento. As matrizes foram suplementadas nos últimos 50 dias de prenhez e nos primeiros 30 dias de lactação. As crias foram desmamadas aos 70 dias de idade, divididas em três lotes e confinadas, alimentadas com capim-elefante (Pennisetum purpureum) ad libitum e concentrado na proporção de 1,5%, 2,5% e 3,5% do peso vivo, respectivamente. O sexo não exerceu influência sobre os pesos no nascimento, no desmame, nem sobre o ganho em peso até o desmame. Não foi observada influência do sexo sobre os pesos e os ganhos em peso aos 30 e 50 dias de confinamento. Nas fases de produção e acabamento em confinamento, os animais de nascimento simples foram superiores aos de nascimento duplo quanto a essas variáveis. Houve efeito linear significativo para peso e ganho em peso aos 30 e 50 dias de confinamento. Os três níveis de uso de concentrado foram economicamente viáveis. As margens brutas de peso vivo, por kg de cordeiro produzido, foram de R$ 0,26 kg-1, R$ 0,30 kg-1 e R$ 0,36 kg-1 para concentrados a 1,5%, 2,5% e 3,5% do peso vivo, respectivamente. Os melhores resultados econômicos foram obtidos quando o nível de concentrado foi de 3,5% do peso vivo.

Characterization of OsMIK in a rice mutant with reduced phytate content reveals an insertion of a rearranged retrotransposon.

The rice low phytic acid (lpa) mutant Os-lpa-XS110-1(XS-lpa) has ~45 % reduction in seed phytic acid (PA) compared with the wild-type cultivar Xiushui 110. Previously, a single recessive gene mutation was shown to be responsible for the lpa phenotype and was mapped to a region of chromosome 3 near OsMIK (LOC_Os03g52760) and OsIPK1 (LOC_Os03g51610), two genes involved in PA biosynthesis. Here, we report the identification of a large insert in the intron of OsMIK in the XS-lpa mutant. Sequencing of fragments amplified through TAIL-PCRs revealed that the insert was a derivative of the LINE retrotransposon gene LOC_Os03g56910. Further analyses revealed the following characteristics of the insert and its impacts: (1) the inserted sequence of LOC_Os03g56910 was split at its third exon and rejoined inversely, with its 5' and 3' flanking sequences inward and the split third exon segments outward; (2) the LOC_Os03g56910 remained in its original locus in XS-lpa, and the insertion probably resulted from homologous recombination repair of a DNA double strand break; (3) while the OsMIK transcripts of XS-lpa and Xiushui 110 were identical, substantial reductions of the transcript abundance (~87 %) and the protein level (~60 %) were observed in XS-lpa, probably due to increased methylation in its promoter region. The above findings are discussed in the context of plant mutagenesis, epigenetics and lpa breeding.

Respostas da fotossíntese de três espécies de citros a fatores ambientais

Foram avaliadas as respostas das trocas gasosas à irradiância, à temperatura, ao déficit de pressão de vapor e à concentração interna de CO2 em plantas jovens de laranjeira 'Valência', tangor 'Murcote' e lima ácida 'Tahiti', sob condições controladas. As taxas máximas de assimilação de CO2 foram de 9,8, 12,8 e 13,0 µmol m-2 s-1 em 'Valência', 'Murcote' e 'Tahiti', respectivamente. Diferenças na taxa de assimilação de CO2 foram relacionadas com a condutância estomática e com a eficiência instantânea de carboxilação. A saturação da fotossíntese pela luz foi em torno de 750 µmol m-2 s-1 em 'Valência'. Em 'Murcote' e 'Tahiti', não houve um ponto evidente de saturação lumínica, pois houve pequenos aumentos da assimilação de CO2 acima de 1.000 µmol m-2 s-1. Os pontos de compensação de CO2 foram 4,8, 5,8 e 5,4 Pa em 'Valência', 'Murcote' e 'Tahiti', respectivamente. Temperaturas das folhas entre 25ºC e 30ºC corresponderam à faixa ótima para a fotossíntese em 'Valência' e ao redor de 30ºC em 'Murcote' e 'Tahiti'. Quedas das taxas de assimilação de CO2 em temperaturas acima ou abaixo da ideal ocorreram em razão de quedas parciais na condutância estomática e na eficiência instantânea de carboxilação. A taxa de assimilação de CO2 também decresceu com o aumento do déficit de pressão de vapor de 1,5 para 3,5 kPa. Este efeito foi mais acentuado quando a temperatura aumentou de 28ºC para 35ºC.

Fontes de lipídio e monensina sódica na fermentação, cinética e degradabilidade ruminal de bovinos

O objetivo deste trabalho foi avaliar a degradabilidade, a fermentação e a cinética ruminal de dietas com caroço de algodão ou sal de cálcio de ácidos graxos, como fontes de gordura, acrescidos de monensina sódica, e verificar o efeito da última em dietas com caroço de algodão. Quatro novilhos Nelore, canulados no rúmen, foram submetidos a um experimento em delineamento quadrado latino 4x4. Os tratamentos consistiram de três dietas com monensina (sal de cálcio graxo, caroço de algodão e controle) e uma dieta com caroço de algodão sem monensina. Os períodos de incubação foram de 0, 3, 6, 12, 24, 48, 72 e 96 horas, e o líquido ruminal foi colhido nos horários 0, 1,5, 2, 3, 4, 6, 8, 12 e 24 horas depois da alimentação. As dietas com caroço de algodão apresentaram maior degradabilidade da fibra em detergente neutro e maior teor de proteína bruta. A dieta com caroço de algodão e monensina apresentou maior taxa de passagem líquida e turnover ruminal. Não houve diferença entre as dietas quanto ao pH, amônia ruminal e ácidos graxos voláteis. As fontes de gordura, sal de cálcio de ácidos graxos e caroço de algodão não apresentaram efeito deletério no rúmen. A utilização de monensina afeta a degradabilidade, a cinética e a fermentação ruminal, quando se utiliza caroço de algodão na dieta.

Influence of substrates and in vitro preconditioning treatments on ex vitro acclimatization of Arachis retusa

The objective of this work was to evaluate the influence of substrate and preconditioning treatments on the acclimatization of in vitro plants of Arachis retusa. Plants were transferred to Plantmax or sand, and fertilized with Hoagland's nutrient solution. Plants maintained in sand, with or without fertilizer, showed the highest survival rates. In order to evaluate the influence of in vitro preconditioning treatments, stem segments were cultured on MS medium supplemented with different sucrose concentrations. The highest survival and developmental rates were observed in plants from two accessions cultured on MS supplemented with 1.5% and 3% sucrose. Flowering and fruit production were observed after five months.

Viral suppression rates in salvage treatment with raltegravir improved with the administration of genotypic partially active or inactive nucleoside/tide reverse transcriptase inhibitors.

BACKGROUND: Nucleoside reverse transcriptase inhibitors (NRTIs) are often administered in salvage therapy even if genotypic resistance tests (GRTs) indicate high-level resistance, but little is known about the benefit of these additional NRTIs. METHODS: The effect of <2 compared with 2 NRTIs on viral suppression (HIV-1 RNA < 50 copies/mL) at week 24 was studied in salvage patients receiving raltegravir. Intent-to-treat and per-protocol analyses were performed; last observation carried forward imputation was used to deal with missing information. Logistic regressions were weighted to create a pseudopopulation in which the probability of receiving <2 and 2 NRTIs was unrelated to baseline factors predicting treatment response. RESULTS: One-hundred thirty patients were included, of whom 58.5% (n = 76) received <2 NRTIs. NRTIs were often replaced by other drug classes. Patients with 2 NRTIs received less additional drug classes compared with patients with <2 NRTIs [median (IQR): 1 (1-2) compared with 2 (1-2), P Wilcoxon < 0.001]. The activity of non-NRTI treatment components was lower in the 2 NRTIs group compared with the <2 NRTIs group [median (IQR) genotypic sensitivity score: 2 (1.5-2.5) compared with 2.5 (2-3), P Wilcoxon < 0.001]. The administration of <2 NRTIs was associated with a worse viral suppression rate at week 24. The odds ratios were 0.34 (95% confidence interval: 0.13 to 0.89, P = 0.027) and 0.19 (95% confidence interval: 0.05 to 0.79, P = 0.023) when performing the last observation carried forward and the per-protocol approach, respectively. CONCLUSIONS: Our findings showed that partially active or inactive NRTIs contribute to treatment response, and thus the use of 2 NRTIs in salvage regimens that include raltegravir seems warranted.

Early EEG correlates of neuronal injury after brain anoxia.

OBJECTIVES: EEG and serum neuron-specific enolase (NSE) are used for outcome prognostication in patients with postanoxic coma; however, it is unclear if EEG abnormalities reflect transient neuronal dysfunction or neuronal death. To assess this question, EEG abnormalities were correlated with NSE. Moreover, NSE cutoff values and hypothermic EEG features related with poor outcome were explored.¦METHODS: In a prospective cohort of 61 adults treated with therapeutic hypothermia (TH) after cardiac arrest (CA), multichannel EEG recorded during TH was assessed for background reactivity and continuity, presence of epileptiform transients, and correlated with serum NSE collected at 24-48 hours after CA. Demographic, clinical, and functional outcome data (at 3 months) were collected and integrated in the analyses.¦RESULTS: In-hospital mortality was 41%, and 82% of survivors had good neurologic outcome at 3 months. Serum NSE and EEG findings were strongly correlated (Spearman rho = 0.45; p < 0.001). Median NSE peak values were higher in patients with unreactive EEG background (p < 0.001) and discontinuous patterns (p = 0.001). While all subjects with nonreactive EEG died, 5 survivors (3 with good outcome) had NSE levels >33 μg/L.¦CONCLUSION: The correlation between EEG during TH and serum NSE levels supports the hypothesis that early EEG alterations reflect permanent neuronal damage. Furthermore, this study confirms that absent EEG background reactivity and presence of epileptiform transients are robust predictors of poor outcome after CA, and that survival with good neurologic recovery is possible despite serum NSE levels> 33 μg/L. This underscores the importance of multimodal assessments in this setting.

Curva crítica de diluição de nitrogênio da cultivar Asterix de batata

O objetivo deste trabalho foi ajustar a curva crítica de diluição do nitrogênio (N) da batata 'Asterix' e avaliar o seu emprego no manejo da adubação nitrogenada. Tubérculos dessa cultivar foram plantados em sacolas de polietileno com 5 dm³ de substrato orgânico, na densidade de 4,4 sacolas m-2. Os tratamentos consistiram de cinco soluções nutritivas, com concentrações de N de 5, 8,3, 11,3, 14,3 e 16,3 mmol L-1. Os demais nutrientes foram fornecidos nas concentrações: 8,3 de K+, 1,75 de Ca2+, 1,2 de H2PO4-, 0,7 de Mg2+ e 0,7 mmol L-1 de SO4(2-), complementados por micronutrientes. Em intervalos de sete dias, entre os 43 e 99 dias após o plantio, foram determinados: a massa de matéria seca (MS) e o teor de N nas folhas, hastes e tubérculos. Foi ajustada a curva crítica de diluição [N (g kg-1) = 36MS-0.37] para a produção total de MS da planta. Essa curva pode ser usada, como referencial, na interpretação dos resultados de análise foliar e na estimativa das quantidades de N extraídas pelas plantas da batata 'Asterix', no decorrer do ciclo de crescimento e desenvolvimento.

Prevalence, awareness and treatment of type 2 diabetes mellitus in Switzerland: the CoLaus study.

ABSTRACT: Aims To assess the prevalence, awareness and treatment levels of Type 2 diabetes in a Swiss city. Methods Population-based cross-sectional study of 6181 subjects (3246 women) aged 35-75 years living in Lausanne, Switzerland. Type 2 diabetes was defined as fasting plasma glucose >/= 7 mmol/l and/or oral hypoglycaemic treatment and/or insulin. Results Total prevalence of Type 2 diabetes was 6.3% (95% confidence interval: 5.7-7.0%), higher in men (9.1%) than in women (3.8%, P < 0.001) and increased with age. Two-thirds (65.3%; 60.4-70.0%) of participants with Type 2 diabetes were aware of their status and among those aware 86.0% (81.5-90.3%) were treated. Treatment was more frequent in men (91.3%) than in women (75.9%, P < 0.001). Two-thirds of those treated for Type 2 diabetes were on monotherapy. Biguanides were prescribed in 65.0% of Type 2 diabetes patients and represented 48% of all antidiabetic drugs. Multivariable analysis showed male gender, increasing age, waist or BMI to be positively associated with prevalence of Type 2 diabetes, while leisure-time physical activity and alcohol consumption were negatively associated. Among participants presenting with Type 2 diabetes, increasing age was positively associated with awareness of Type 2 diabetes. Among subjects diagnosed with Type 2 diabetes, male gender and increasing age were positively associated with treatment. Conclusion Prevalence of Type 2 diabetes in Switzerland is estimated to be between 5.7% and 7.0%. Two-thirds of patients with Type 2 diabetes are aware of their status, and over three quarters of those aware are treated.

Thermoset Composite Concrete Reinforcement, HR-325, Part 2, 1992

This is the second part of the final report submitted to the Iowa Department of Transportation. Part 1 contained a comparison of unaged fiber composite and steel dowels and derivation of the appropriate theoretical model for analyzing the results. Part 2 of this final report covers the theoretical and experimental models for accelerated aging of fiber composite reinforcing bars and dowels cast in a concrete environment. Part 2 contains results from testing of unaged and aged fiber composite dowels and steel dowels, in addition to unaged and aged fiber composite reinforcing bars. Additional tests have been performed on unaged dowels (both steel and fibercomposite) to verify results from Part 1 and to keep the testing program consistent. Slight modifications have been made to the dowel specimens presented in Part 1. These modifications are noted in the Section 3.4 of this report. The flexural modulus of elasticity for the FC dowel bar given in Part 1 of the final report (Table 3. 2) was for the incorrect structural shape (non-circular cross section). The value is corrected and given in Part 2 of the final report (Table 3.4 for the.modulus of elasticity supplied by the manufacturer, and Tables 3. 5 and 3. 6 for experimentally determined modulus of elasticities) • The value in Part 1 was not used for any analysis of the FC dowel bars.