Predictors of disease worsening defined by progression of organ damage in diffuse systemic sclerosis: a European Scleroderma Trials and Research (EUSTAR) analysis.

Objectives Mortality and worsening of organ function are desirable endpoints for clinical trials in systemic sclerosis (SSc). The aim of this study was to identify factors that allow enrichment of patients with these endpoints, in a population of patients from the European Scleroderma Trials and Research group database. Methods Inclusion criteria were diagnosis of diffuse SSc and follow-up over 12\ub13 months. Disease worsening/organ progression was fulfilled if any of the following events occurred: new renal crisis; decrease of lung or heart function; new echocardiography-suspected pulmonary hypertension or death. In total, 42 clinical parameters were chosen as predictors for the analysis by using (1) imputation of missing data on the basis of multivariate imputation and (2) least absolute shrinkage and selection operator regression. Results Of 1451 patients meeting the inclusion criteria, 706 had complete data on outcome parameters and were included in the analysis. Of the 42 outcome predictors, eight remained in the final regression model. There was substantial evidence for a strong association between disease progression and age, active digital ulcer (DU), lung fibrosis, muscle weakness and elevated C-reactive protein (CRP) level. Active DU, CRP elevation, lung fibrosis and muscle weakness were also associated with a significantly shorter time to disease progression. A bootstrap validation step with 10 000 repetitions successfully validated the model. Conclusions The use of the predictive factors presented here could enable cohort enrichment with patients at risk for overall disease worsening in SSc clinical trial

Argan [Argania spinosa (L.) Skeels] oil

Argan oil is extracted from the kernels of Argania spinosa (L.) Skeels, a tree that almost exclusively grows endemically in southern Morocco. If argan oil was initia11y only known around its traditional production area, major efforts combining chemical, agronomic and human sciences have led to its international recognition and marketing. In addition, to ensure the sustainable production of a sufficient quantity of argan kernels, a vast and unprecedented program that led to the reforestation of large areas of drylands has been developed in Morocco. Therefore, argan oil production is considered as an economic and ecologic success. Edible argan oil is prepared by cold-pressing roasted argan kernels. Unroasted kernels afford an oil of cosmetic grade, showing a bitter taste. Both oils, which are not refined and are virgin oils, share a similar fatty acid content that includes oleic and linoleic acids as major components. Additiona11y, argan oil is rich in antioxidants. Together, these components likely contribute to the oil pharmacological properties that, in humans, traditionally included cardiovascular disease and skin protection. Recent scientific studies have greatly expanded the scope of these pharmacological activities. Argan oil is now rewarded with a "Geographic Indication" that certifies its exclusive and authentic Moroccan origin and the compliance with strict production rules. In addition, the quality of argan oil can nowadays be ascertained by using an array of physicochemica1 methods. By-products, generated in large quantity during argan oil production, are also finding promising development routes