Five-year impact of repeated praziquantel treatment on subclinical morbidity due to Schistosoma japonicum in China

We report the 5-year impact (1996-2001) of repeated praziquantel chemotherapy on subclinical morbidity related to Schistosoma japonicum infection. We repeated stool examinations and hepatosplenic ultrasonography in a cohort of 120 individuals living on an island with endemic infection in Dongting Lake, China. Prevalence of schistosome infection fell by 43% and intensity (geometric mean eggs per gram) declined by 80% over the 5 years. However, transmission persisted at a dangerously high rate of 13% per year for re-infection or new infection in the cohort. The prevalence of left-lobe enlargement and dilated portal vein fell significantly (P 0.05). However, endpoint infection was even more strongly associated with left-lobe enlargement (57% versus 15%, P < 0.01). The proportions of subjects with improved parenchymal and periportal fibrosis were much higher than the proportions of subjects that progressed (P < 0.05). Reduction of prevalence and intensity of infection, and improvement of subclinical morbidity, were benefits of repeated treatments. Further research is needed to understand why some patients developed fibrosis despite substantial reductions in egg counts and to evaluate the functional importance of residual subclinical morbidity after chemotherapy-based control in the lake and marshland area of Chin

Richard S. Smith v. Rocky Mountain Helicopters : Brief of Respondent

BRIEF OF RESPONDENT AND CROSS APPELLANT Appeal from the Fourth Judicial District Court Of Utah County Honorable Boyd L. Park, District Judg

Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country

ABSTRACT: Background: It is plausible that optimal cardiovascular disease (CVD) risk management differs in patients with rheumatoid arthritis (RA) from low or middle income compared to high income populations. This study aimed at producing evidence-based points to consider for CVD prevention in South African RA patients. Methods: Five rheumatologists, one cardiologist and one epidemiologist with experience in CVD risk management in RA patients, as well as two patient representatives, two health professionals and one radiologist, one rheumatology fellow and 11 rheumatologists that treat RA patients regularly contributed. Systematic literature searches were performed and the level of evidence was determined according to standard guidelines. Results: Eighteen points to consider were formulated. These were grouped into 6 categories that comprised overall CVD risk assessment and management (n=4), and specific interventions aimed at reducing CVD risk including RA control with disease modifying anti-rheumatic drugs, glucocorticoids and non-steroidal anti-inflammatory drugs (n=3), lipid lowering agents (n=8), antihypertensive drugs (n=1), low dose aspirin (n=1) and lifestyle modification (n=1). Each point to consider differs partially or completely from recommendations previously reported for CVD risk management in RA patients from high income populations. Currently recommended CVD risk calculators do not reliably identify South African black RA patients with very high-risk atherosclerosis as represented by carotid artery plaque presence on ultrasound. Conclusions: Our findings indicate that optimal cardiovascular risk management likely differs substantially in RA patients from low or middle income compared to high income populations. There is an urgent need for future multicentre longitudinal studies on CVD risk in black African patients with RA.The first meeting held amongst local Rheumatologists was funded by the South African Arthritis and Rheumatology Association. The studies by Professor González-Gay have been supported by grants from “Fondo de Investigaciones Sanitarias” PI06/0024, PS09/00748, PI12/00060, PI15/00525, PI18/00043, and RD12/0009/0013 and RD16/0012 (RIER) from “Instituto de Salud Carlos III” (ISCIII) (Spain), co-funded by FEDER funds

There and back again: molecular phylogenetics of the Brazilian endemic Psyllocarpus (Rubiaceae: Spermacoceae) supports a circumscription of the genus based on its original concept

The Spermacoce clade (tribe Spermacoceae) is one of the most taxonomically complex groups in Rubiaceae due to the unclear delimitation of Borreria and Spermacoce, in which several smaller genera are phylogenetically intermingled. One of these genera is the Brazilian endemic Psyllocarpus, whose circumscription was broadened, thereby including two sections. Psyllocarpus sect. Psyllocarpus, being based on the original genus delineation, includes nine species, distributed in the Cerrado and campo rupestre of eastern Brazil, whereas P. sect. Amazonica comprises three species, occurring in the Amazonian campinas. Furthermore, P. intermedius was not classified in any of these sections when it was later described. In order to test the monophyly of Psyllocarpus and assess its relationships to other genera, we conducted phylogenetic analyses, sampling across the whole Spermacoce clade, including nearly all Psyllocarpus species. A combined nuclear ribosomal (ETS and ITS) and plastid (rps16 and trnLtrnF) dataset was generated, representing 124 species (ca 25% of the species in the clade) in 15 genera (ca 65%). Various methodologies were applied to investigate the degree of incongruence among markers and address the lack of resolution and low support values for some branches. Our results revealed that Psyllocarpus is not monophyletic. Psyllocarpus campinorum (from P . sect. Amazonica) and P intermedius are situated as distinct lineages in the Spermacoce clade, yet do not belong to Psyllocarpus. Members of section Psyllocarpus form a strongly supported clade sister to Staelia and was recovered with high to maximum support across different datasets and inference methods. Therefore, Psyllocarpus has to be circumscribed based on its original concept, excluding P. sect. Amazonica and P. intermedius. This establishes the genus as a monophyletic and easily diagnosable taxon, characterized by terete leaves, homostylous flowers, a bilobate calyx, included stamens and style, and compressed, septifragally dehiscent capsules with a persistent septum

Expression of osteoprotegerin and its ligands, RANKL and TRAIL, in rheumatoid arthritis

Osteoprotegerin (OPG), receptor activator of nuclear factor-?B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been involved in rheumatoid arthritis (RA) pathophysiology. In this study, we assessed messenger RNA (mRNA) expression of these molecules by qPCR in peripheral blood from 26 patients with RA (12 of them with ischemic heart disease -IHD) and 10 healthy controls. Correlation coefficients between OPG, RANKL and TRAIL expression levels in RA patients and their clinical and demographic characteristics were also evaluated. Whereas OPG and OPG/TRAIL ratio expression were significantly increased in RA patients compared to controls (fold change?=?1.79, p?=?0.013 and 2.07, p?=?0.030, respectively), RANKL/OPG ratio was significantly decreased (fold change?=?0.50, p?=?0.020). No significant differences were found between patients and controls in RANKL and TRAIL expression. Interestingly, TRAIL expression was significantly higher in RA patients with IHD compared to those without IHD (fold change?=?1.46, p?=?0.033). Moreover, biologic disease-modifying antirheumatic drugs (DMARDs) significantly decreased RANKL expression in RA patients (p?=?0.016). Our study supports an important role of OPG and TRAIL in RA. Furthermore, it highlights an effect of biologic DMARDs in the modulation of RANKL

Survival or Sustainability? Contributions of Innovatively-Managed News Ventures to the Future of Egyptian Journalism

In the repressive political climate prevailing in Egypt in 2013-15, news ventures aspiring to high standards of reporting were forced to innovate. This paper analyses three Egyptian start-ups that experimented with novel revenue streams and news services during that period, to gain insights into their approaches to managing journalism. In the process it compares different criteria for assessing sustainability and concludes that, in adverse political environments, narrow economic measures of profitability and survival may give a misleading picture as to the sustainability of the kind of journalism conducive to democratic practice. Operating collaboratively, transparently and ethically may slow productivity and profitability in the short term while laying stronger foundations for durable relations among media teams, as well as with readers and advertisers, in the long run

Carotid artery plaque in women with rheumatoid arthritis and low estimated cardiovascular disease risk: a cross-sectional study

INTRODUCTION: We previously reported that most patients with rheumatoid arthritis (RA) and moderate cardiovascular disease (CVD) risk according to the Systematic COronary Evaluation score (SCORE) experience carotid artery plaque. In this study, we aimed to identify patient characteristics that can potentially predict carotid plaque presence in women with RA and a concurrent low CVD risk according to the SCORE. METHODS: A cohort of 144 women with an evaluated low risk of CVD (SCORE value of zero) was assembled amongst 550 consecutive patients with RA that underwent CVD risk factor recording and carotid artery ultrasound. Participants had no established CVD, moderate or severe chronic kidney disease, or diabetes. We assessed carotid plaque(s) presence and its associated patient characteristics. RESULTS: Carotid artery plaque was present in 35 (24.3%) of women with RA. Age, the number of synthetic disease-modifying agents (DMARDs) and total cholesterol concentrations were independently associated with plaque in multivariable stepwise backward regression analysis (odds ratio (95% confidence interval)=1.15 (1.07 to 1.24), P49.5 years or/and total cholesterol concentration of >5.4 mmol/l, respectively, compared to only 7.8% in those (n=64; 44.4%) with age≤49.5 years or/and total cholesterol concentration of ≤5.4 mmol/l, respectively. CONCLUSIONS: Approximately one-third of women with RA who experience a low SCORE value and are aged >49.5 years or/and have a total cholesterol concentration of >5.4 mmol/l, experience high-risk atherosclerosis, which requires intensive CVD risk management

A Shift-Invariant Latent Variable Model for Automatic Music Transcription

In this work, a probabilistic model for multiple-instrument automatic music transcription is proposed. The model extends the shift-invariant probabilistic latent component analysis method, which is used for spectrogram factorization. Proposed extensions support the use of multiple spectral templates per pitch and per instrument source, as well as a time-varying pitch contribution for each source. Thus, this method can effectively be used for multiple-instrument automatic transcription. In addition, the shift-invariant aspect of the method can be exploited for detecting tuning changes and frequency modulations, as well as for visualizing pitch content. For note tracking and smoothing, pitch-wise hidden Markov models are used. For training, pitch templates from eight orchestral instruments were extracted, covering their complete note range. The transcription system was tested on multiple-instrument polyphonic recordings from the RWC database, a Disklavier data set, and the MIREX 2007 multi-F0 data set. Results demonstrate that the proposed method outperforms leading approaches from the transcription literature, using several error metrics

Kidney function, endothelial activation and atherosclerosis in black and white Africans with rheumatoid arthritis

OBJECTIVE: To determine whether kidney function independently relates to endothelial activation and ultrasound determined carotid atherosclerosis in black and white Africans with rheumatoid arthritis (RA). METHODS: We calculated the Jelliffe, 5 Cockcroft-Gault equations, Salazar-Corcoran, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (EGFR) equations in 233 (112 black) RA patients. RESULTS: The CKD-EPI eGFR was 0.1 for comparisons of AUC (SE)) for the other 8 equations. Based on optimal eGFR cutoff values with sensitivities and specificities ranging from 42 to 60% and 70 to 91% respectively, as determined in ROC curve analysis, a low eGFR increased the odds ratio for plaque 2.2 to 4.0 fold. CONCLUSION: Reduced kidney function is independently associated with atherosclerosis and endothelial activation in black and white Africans with RA, respectively. CKD is highly prevalent in black Africans with RA. Apart from the MDRD, eGFR equations are useful in predicting carotid plaque presence, a coronary heart disease equivalent, amongst black African RA patients