Anti-TNF treatment in juvenile idiopathic arthritis and associated uveitis : Clinical perspectives on growth, uveitis, and drug survival

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of childhood chronic arthritides, associated with chronic uveitis in 20% of cases. For JIA patients responding inadequately to conventional disease-modifying anti-rheumatic drugs (DMARDs), biologic therapies, anti-tumor necrosis factor (anti-TNF) agents are available. In this retrospective multicenter study, 258 JIA-patients refractory to DMARDs and receiving biologic agents during 1999-2007 were included. Prior to initiation of anti-TNFs, growth velocity of 71 patients was delayed in 75% and normal in 25%. Those with delayed growth demonstrated a significant increase in growth velocity after initiation of anti-TNFs. Increase in growth rate was unrelated to pubertal growth spurt. No change was observed in skeletal maturation before and after anti-TNFs. The strongest predictor of change in growth velocity was growth rate prior to anti-TNFs. Change in inflammatory activity remained a significant predictor even after decrease in glucocorticoids was taken into account. In JIA-associated uveitis, impact of two first-line biologic agents, etanercept and infliximab, and second-line or third-line anti-TNF agent, adalimumab, was evaluated. In 108 refractory JIA patients receiving etanercept or infliximab, uveitis occurred in 45 (42%). Uveitis improved in 14 (31%), no change was observed in 14 (31%), and in 17 (38%) uveitis worsened. Uveitis improved more frequently (p=0.047) and frequency of annual uveitis flares was lower (p=0.015) in those on infliximab than in those on etanercept. In 20 patients taking adalimumab, 19 (95%) had previously failed etanercept and/or infliximab. In 7 patients (35%) uveitis improved, in one (5%) worsened, and in 12 (60%) no change occurred. Those with improved uveitis were younger and had shorter disease duration. Serious adverse events (AEs) or side-effects were not observed. Adalimumab was effective also in arthritis. Long-term drug survival (i.e. continuation rate on drug) with etanercept (n=105) vs. infliximab (n=104) was at 24 months 68% vs. 68%, and at 48 months 61% vs. 48% (p=0.194 in log-rank analysis). First-line anti-TNF agent was discontinued either due to inefficacy (etanercept 28% vs. infliximab 20%, p=0.445), AEs (7% vs. 22%, p=0.002), or inactive disease (10% vs. 16%, p=0.068). Females, patients with systemic JIA (sJIA), and those taking infliximab as the first therapy were at higher risk for treatment discontinuation. One-third switched to the second anti-TNF agent, which was discontinued less often than the first. In conclusion, in refractory JIA anti-TNFs induced enhanced growth velocity. Four-year treatment survival was comparable between etanercept and infliximab, and switching from first-line to second-line agent a reasonable therapeutic option. During anti-TNF treatment, one-third with JIA-associated anterior uveitis improved.

Long-lived giant number fluctuations in a swarming granular nematic

Coherently moving flocks of birds, beasts, or bacteria are examples of living matter with spontaneous orientational order. How do these systems differ from thermal equilibrium systems with such liquid crystalline order? Working with a fluidized monolayer of macroscopic rods in the nematic liquid crystalline phase, we find giant number fluctuations consistent with a standard deviation growing linearly with the mean, in contrast to any situation where the central limit theorem applies. These fluctuations are long-lived, decaying only as a logarithmic function of time. This shows that flocking, coherent motion, and large-scale inhomogeneity can appear in a system in which particles do not communicate except by contact.

Kinetics of Pressureless Infiltration of Al-Mg Melts into Porous Alumina Preforms

Effective “hydrodynamic” radii governing infiltration kinetics of reactive Al-Mg melts into alumina preforms were found to be three orders of magnitude smaller than the average pore size of the packed bed and also smaller compared with the kinetics for a nonreactive system. A sinusoidal capillary model was developed to predict flow kinetics within the packed bed. For the reactive system, two factors were ascribed for additional melt retardation: (1) different intrinsic wettabilities of the two liquids on alumina, thereby leading to significantly different “effective” local contact angles; and (2) local solute depletion from the meniscus, which was incorporated as a time-dependent contact angle.

The Exeter Contemporary flanged cemented acetabular component in primary total hip arthroplasty

Aims: We report on the outcome of the Exeter Contemporary flanged cemented all-polyethylene acetabular component with a mean follow-up of 12 years (10 to 13.9). This study reviewed 203 hips in 194 patients. 129 hips in 122 patients are still in situ; 66 hips in 64 patients were in patients who died before ten years, and eight hips (eight patients) were revised. Clinical outcome scores were available for 108 hips (104 patients) and radiographs for 103 hips (100 patients). Patients and Methods: A retrospective review was undertaken of a consecutive series of 203 routine primary cemented total hip arthroplasties (THA) in 194 patients. Results: There were no acetabular component revisions for aseptic loosening. Acetabular revision was undertaken in eight hips. In four hips revision was necessitated by periprosthetic femoral fractures, in two hips by recurrent dislocation, in one hip for infection and in one hip for unexplained ongoing pain. Oxford and Harris hip scores demonstrated significant clinical improvement (all p < 0.001). Radiolucent lines were present in 37 (36%) of the 103 acetabular components available for radiological evaluation. In 27 of these, the line was confined to zone 1. No component had migrated. Conclusion: Kaplan–Meier survivorship, with revision for aseptic loosening as the endpoint, was 100% at 12.5 years and for all causes was 97.8% (95% confidence interval 95.6 to 100) when 40 components remained at risk. The Exeter Contemporary flanged cemented acetabular component demonstrates excellent survivorship at 12.5 years. Take home message: The Exeter Contemporary flanged cemented acetabular component has excellent clinical outcomes and survivorship when used with the Exeter stem in total hip arthroplasty.

Scattering polarization in the presence of magnetic and electric fields

The polarization of radiation by scattering on an atom embedded in combined external quadrupole electric and uniform magnetic fields is studied theoretically. Limiting cases of scattering under Zeeman effect, and Hanle effect in weak magnetic fields are discussed. The theory is general enough to handle scattering in intermediate magnetic fields (Hanle-Zeeman effect) and for arbitrary orientation of magnetic field. The quadrupolar electric field produces asymmetric line shifts, and causes interesting level-crossing phenomena either in the absence of an ambient magnetic field, or in its presence. It is shown that the quadrupolar electric field produces an additional depolarization in the Q/I profiles and rotation of the plane of polarization in the U/I profile over and above that arising from magnetic field itself. This characteristic may have a diagnostic potential to detect steady-state and time-varying electric fields that surround radiating atoms in solar atmospheric layers. (c) 2007 Elsevier Ltd. All rights reserved.

Peptide mimics for structural features in proteins. Crystal structures of three heptapeptide helices with a C-terminal 6-->1 hydrogen bond.

The crystal structure determination of three heptapeptides containing alpha-aminoisobutyryl (Aib) residues as a means of helix stabilization provides a high-resolution characterization of 6-->1 hydrogen-bonded conformations, reminiscent of helix-terminating structural features in proteins. The crystal parameters for the three peptides, Boc-Val-Aib-X-Aib-Ala-Aib-Y-OMe, where X and Y are Phe, Leu (I), Leu, Phe (II) and Leu, Leu (III) are: (I) space group P1, Z = 1, a = 9.903 A, b = 10.709 A, c = 11.969 A, alpha = 102.94 degrees, beta = 103.41 degrees, gamma = 92.72 degrees, R = 4.55%; (II) space group P21, Z = 2, a = 10.052 A, b = 17.653 A, c = 13.510 A, beta = 108.45 degrees, R = 4.49%; (III) space group P1, Z = 2 (two independent molecules IIIa and IIIb in the asymmetric unit), a = 10.833 A, b = 13.850 A, c = 16.928 A, alpha = 99.77 degrees, beta = 105.90 degrees, gamma = 90.64 degrees, R = 8.54%. In all cases the helices form 3(10)/alpha-helical (or 3(10)helical) structures, with helical columns formed by head-to-tail hydrogen bonding. The helices assemble in an all-parallel motif in crystals I and III and in an antiparallel motif in II. In the four crystallographically characterized molecules, I, II, IIIa and IIIb, Aib(6) adopts a left-handed helical (hL) conformation with positive phi, psi values, resulting in 6-->1 hydrogen-bond formation between Aib(2) CO and Leu(7)/Phe(7) NH groups. In addition a 4-->1 hydrogen bond is seen between Aib(3) CO and Aib(6) NH groups. This pattern of hydrogen bonding is often observed at the C-terminus of helices proteins, with the terminal pi-type turn being formed by four residues adopting the hRhRhRhL conformation.

GMRT observations of the group Holmberg 124: Evolution by tidal forces and ram pressure?

We report new radio continuum and 21 cm HI observations using the Giant Metrewave Radio Telescope (GMRT) of the group Holmberg 124 ( Ho 124) comprising four late-type galaxies, namely NGC 2820, Mrk 108, NGC 2814 and NGC 2805. The three galaxies, NGC 2820, Mrk 108 and NGC 2814 which are closely located in the sky plane have clearly undergone tidal interactions as seen from the various morphological tidal signatures and debris. Moreover we note various features in the group members which we believe might be due to ram pressure. In this paper, we describe four interesting results emerging from our observations: a) detection of the tidal radio continuum bridge at 330 MHz connecting the galaxies NGC 2820+ Mrk 108 with NGC 2814. The radio bridge was discovered at 1465 MHz by van der Hulst & Hummel ( 1985, A& A, 150, 17). We find that the bridge has a fairly steep spectrum with a spectral index alpha(S proportional to nu(alpha)) of - 1.8(-0.2)(+0.3) which is much steeper than the - 0.8 quoted by van der Hulst & Hummel ( 1985); b) detection of other tidal features like the tilted HI and radio continuum disk of NGC 2814, a HI streamer and a radio continuum tail arising from the south of NGC 2814. We also report the detection of a possible tidal dwarf galaxy in HI; c) sharp truncation in the HI distribution in the south of NGC 2820 and in the HI and radio continuum distribution in the north of NGC 2814. The optical disks in both the cases look undisturbed. As pointed out by Davis et al. ( 1997, AJ, 114, 613), ram pressure affects different components of the interstellar medium to varying degrees. Simple estimates of pressure in different components of the interstellar medium ( radio continuum, Ha and HI) in NGC 2820 indicate that ram pressure will significantly influence HI; d) detection of a large one-sided HI loop to the north of NGC 2820. No radio continuum emission or Ha emission is associated with the HI loop. We discuss various scenarios for the origin of this loop including a central starburst, ram pressure stripping and tidal interaction. We do not support the central starburst scenario since the loop is not detected in ionized gas. Using the upper limit on X-ray luminosity of Ho 124 (Mulchaey et al. 2003, ApJS, 145, 39), we estimate an upper limit on the intragroup medium (IGrM) density of 8.8 x 10(-4) cm(-3). For half this electron density, we estimate the ram pressure force of the IGrM to be comparable to the gravitational pull of the disk of NGC 2820. Since tidal interaction has obviously influenced the group, we suggest that the loop could have formed by ram pressure stripping if tidal effects had reduced the surface density of HI in NGC 2820. From the complex observational picture of Ho 124 and the numerical estimates, we suggest that the evolution of the Ho 124 group may be governed by both tidal forces due to the interaction and the ram pressure due to motion of the member galaxies in the IGrM and that the IGrM densities should not be too low (i.e. >= 4 x 10(-4)). However this needs to be verified by further observations.

Diffraction and Total Cross-Section at the Tevatron and the LHC

At the Tevatron, the total p_bar-p cross-section has been measured by CDF at 546 GeV and 1.8 TeV, and by E710/E811 at 1.8 TeV. The two results at 1.8 TeV disagree by 2.6 standard deviations, introducing big uncertainties into extrapolations to higher energies. At the LHC, the TOTEM collaboration is preparing to resolve the ambiguity by measuring the total p-p cross-section with a precision of about 1 %. Like at the Tevatron experiments, the luminosity-independent method based on the Optical Theorem will be used. The Tevatron experiments have also performed a vast range of studies about soft and hard diffractive events, partly with antiproton tagging by Roman Pots, partly with rapidity gap tagging. At the LHC, the combined CMS/TOTEM experiments will carry out their diffractive programme with an unprecedented rapidity coverage and Roman Pot spectrometers on both sides of the interaction point. The physics menu comprises detailed studies of soft diffractive differential cross-sections, diffractive structure functions, rapidity gap survival and exclusive central production by Double Pomeron Exchange.

Wave propagation in a micropolar fluid contained in a visco-elastic membrane

The aim of the paper is to investigate the propagation of a pulse in a micropolar fluid contained in a visco-elastic membrane. It was undertaken with a view to study how closely we can approximate the flow of blood in arteries by the above model. We find that for large Reynolds number, the effect of micropolarity is hardly perceptible, whereas for small Reynolds numbers it is of considerable importance.

The Raman spectrum of boric acid

The Raman spectrum of crystalline boric acid is recorded using mercuryλ2537 excitation. Fifteen Raman lines, three of them belonging to the lattice spectrum, are reported. Satisfactory assignments of all the observed Raman frequencies are made using the available X-ray crystal structure data. From the presence of a new high frequency Raman band at about 3420 cm.−1 it is suggested that there might be a small number of long, weak O-H....O hydrogen bonds in the crystal, in addition to the hydrogen bonds of moderate strength reported from X-ray diffraction data.

Role of entropy in the stability of cobalt titanates

The standard molar Gibbs free energy of formation of Co2TiO4, CoTiO3,and CoTi2O5 as a function of temperature over an extended range (900 to 1675) K was measured using solid-state electrochemical cells incorporating yttria-stabilized zirconia as the electrolyte, with CoO as reference electrode and appropriate working electrodes. For the formation of the three compounds from their component oxides CoO with rock-salt and TiO2 with rutile structure, the Gibbs free energy changes are given by:Delta(f)G degrees((ox))(Co2TiO4) +/- 104/(J . mol(-1)) = -18865 - 4.108 (T/K)Delta(f)G degrees((ox))(CoTiO3) +/- 56/(J . mol(-1)) = -19627 + 2.542 (T/K) Delta(f)G degrees((ox))(CoTi2O5) +/- 52/(J . mol(-1)) = -6223 - 6.933 (T/K) Accurate values for enthalpy and entropy of formation were derived. The compounds Co2TiO4 with spinel structure and CoTi2O5 with pseudo-brookite structure were found to be entropy stabilized. The relatively high entropy of these compounds arises from the mixing of cations on specific crystallographic sites. The stoichiometry of CoTiO3 was confirmed by inert gas fusion analysis for oxygen. Because of partial oxidation of cobalt in air, the composition corresponding to the compound Co2TiO4 falls inside a two-phase field containing the spinet solid solution Co2TiO4-Co3O4 and CoTiO3. The spinel solid solution becomes progressively enriched in Co3O4 with decreasing temperature. (c) 2010 Elsevier Ltd. All rights reserved.