Microscopic calculations of medium effects for 200-MeV (p,p') reactions

We examine the quality of a G-matrix calculation of the effective nucleon-nucleon (NN) interaction for the prediction of the cross section and analyzing power for 200-MeV (p,p') reactions that populate natural parity states in $^{16}$O, $^{28}$Si, and $^{40}$Ca. This calculation is based on a one-boson-exchange model of the free NN force that reproduces NN observables well. The G-matrix includes the effects of Pauli blocking, nuclear binding, and strong relativistic mean-field potentials. The implications of adjustments to the effective mass ansatz to improve the quality of the approximation at momenta above the Fermi level will be discussed, along with the general quality of agreement to a variety of (p,p') transitions.Comment: 36 pages, TeX, 18 figure

Nuclear Transparency to Intermediate-Energy Protons

Nuclear transparency in the (e,e'p) reaction for 135 < Tp < 800 MeV is investigated using the distorted wave approximation. Calculations using density-dependent effective interactions are compared with phenomenological optical potentials. Nuclear transparency is well correlated with proton absorption and neutron total cross sections. For Tp < 300 MeV there is considerable sensitivity to the choice of optical model, with the empirical effective interaction providing the best agreement with transparency data. For Tp > 300 MeV there is much less difference between optical models, but the calculations substantially underpredict transparency data and the discrepancy increases with A. The differences between Glauber and optical model calculations are related to their respective definitions of the semi-inclusive cross section. By using a more inclusive summation over final states the Glauber model emphasizes nucleon-nucleon inelasticity, whereas with a more restrictive summation the optical model emphasizes nucleon-nucleus inelasticity; experimental definitions of the semi-inclusive cross section lie between these extremes.Comment: uuencoded gz-compressed tar file containing revtex and bbl files and 5 postscript figures, totalling 31 pages. Uses psfi

Quasielastic Electron Scattering from Nuclei: Random-Phase vs. Ring Approximations

We investigate the extent to which the nuclear transverse response to electron scattering in the quasielastic region, evaluated in the random-phase approximation can be described by ring approximation calculations. Different effective interactions based on a standard model of the type g'+V_pi+V_rho are employed. For each momentum transfer, we have obtained the value of g'_0 permitting the ring response to match the position of the peak and/or the non-energy weighted sum rule provided by the random-phase approach has been obtained. It is found that, in general, it is not possible to reproduce both magnitudes simultaneously for a given g'_0 value.Comment: 7 pages, 4 Postscript figures, to appear in Physical Review

Functional approach to the electromagnetic response function: the Longitudinal Channel

In this paper we address the (charge) longitudinal electromagnetic response for a homogeneous system of nucleons interacting via meson exchanges in the functional framework. This approach warrants consistency if the calculation is carried on order-by-order in the mesonic loop expansion with RPA-dressed mesonic propagators. At the 1-loop order and considering pion, rho and omega exchanges we obtain a quenching of the response, in line with the experimental results.Comment: RevTeX, 18 figures available upon request - to be published in Physical Review

Long-term adherence to IFN beta-1a treatment when using rebismart1device in patients with relapsing-remitting multiple sclerosis

The effectiveness of disease-modifying drugs in the treatment of multiple sclerosis is associated with adherence. RebiSmart® electronic device provides useful information about adherence to the treatment with subcutaneous (sc) interferon (IFN) ß-1a (Rebif®). The aim of the study was to determine long-term adherence to this treatment in patients with relapsing- remitting multiple sclerosis (RRMS). This retrospective multicentre observational study analysed 258 patients with RRMS who were receiving sc IFN ß-1a (Rebif®) treatment by using RebiSmart® until replacement (36 months maximum lifetime) or treatment discontinuation. Adherence was calculated with data (injection dosage, time, and date) automatically recorded by RebiSmart®. Patients in the study had a mean age of 41 years with a female proportion of 68%. Mean EDSS score at start of treatment was 1.8 (95% CI, 1.6-1.9). Overall adherence was 92.6%(95% CI, 90.6-94.5%). A total of 30.2% of patients achieved an adherence rate of 100%, 80.6% at least 90%, and only 13.2% of patients showed a suboptimal adherence (<80%). A total of 59.9% of subjects were relapse-free after treatment initiation. Among 106 subjects (41.1%) who experienced, on average, 1.4 relapses, the majority were mild (40.6%) or moderate (47.2%). Having experienced relapses from the beginning of the treatment was the only variable significantly related to achieving an adherence of at least 80% (OR = 3.06, 1.28-7.31). Results of this study indicate that sc IFN ß-1a administration facilitated by RebiSmart® could lead to high rates of adherence to a prescribed dose regimen over 36 months

Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia is a prevalent and disabling disorder characterized by widespread pain and other symptoms such as insomnia, fatigue or depression. Catastrophization is considered a key clinical symptom in fibromyalgia; however, there are no studies on the pharmacological or psychological treatment of catastrophizing. The general aim of this study is to assess the effectiveness of cognitive-behaviour therapy and recommended pharmacological treatment for fibromyalgia (pregabalin, with duloxetine added where there is a comorbid depression), compared with usual treatment at primary care level.</p> <p>Method/design</p> <p><it>Design</it>: A multi-centre, randomized controlled trial involving three groups: the control group, consisting of usual treatment at primary care level, and two intervention groups, one consisting of cognitive-behaviour therapy, and the other consisting of the recommended pharmacological treatment for fibromyalgia.</p> <p><it>Setting</it>: 29 primary care health centres in the city of Zaragoza, Spain.</p> <p><it>Sample</it>: 180 patients, aged 18–65 years, able to understand and read Spanish, who fulfil criteria for primary fibromyalgia, with no previous psychological treatment, and no pharmacological treatment or their acceptance to discontinue it two weeks before the onset of the study.</p> <p><it>Intervention</it>: Psychological treatment is based on the manualized protocol developed by Prof. Escobar et al, from the University of New Jersey, for the treatment of somatoform disorders, which has been adapted by our group for the treatment of fibromyalgia. It includes 10 weekly sessions of cognitive-behaviour therapy. Pharmacological therapy consists of the recommended pharmacological treatment for fibromyalgia: pregabalin (300–600 mg/day), with duloxetine (60–120 mg/day) added where there is a comorbid depression).</p> <p><it>Measurements</it>: The following socio-demographic data will be collected: sex, age, marital status, education, occupation and social class. The diagnosis of psychiatric disorders will be made with the Structured Polyvalent Psychiatric Interview. Other instruments to be administered are the Pain Catastrophizing Scale, the Hamilton tests for Anxiety and for Depression, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQuol-5 domains (EQ-5D), and the use of health and social services (CSRI). Assessments will be carried out at baseline, 1, 3, and 6 months.</p> <p><it>Main variable</it>: Pain catastrophizing.</p> <p><it>Analysis</it>: The analysis will be per intent to treat. We will use the general linear models of the SPSS version 15 statistical package, to analyse the effect of the treatment on the result variable (pain catastrophizing).</p> <p>Discussion</p> <p>It is necessary to assess the effectiveness of pharmacological and psychological treatments for pain catastrophizing in fibromyalgia. This randomized clinical trial will determine whether both treatments are effective for this important prognostic variable in patients with fibromyalgia.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN10804772</p

Primate TNF Promoters Reveal Markers of Phylogeny and Evolution of Innate Immunity

Background. Tumor necrosis factor (TNF) is a critical cytokine in the immune response whose transcriptional activation is controlled by a proximal promoter region that is highly conserved in mammals and, in particular, primates. Specific single nucleotide polymorphisms (SNPs) upstream of the proximal human TNF promoter have been identified, which are markers of human ancestry. Methodology/Principal findings. Using a comparative genomics approach we show that certain fixed genetic differences in the TNF promoter serve as markers of primate speciation. We also demonstrate that distinct alleles of most human TNF promoter SNPs are identical to fixed nucleotides in primate TNF promoters. Furthermore, we identify fixed genetic differences within the proximal TNF promoters of Asian apes that do not occur in African ape or human TNF promoters. Strikingly, protein-DNA binding assays and gene reporter assays comparing these Asian ape TNF promoters to African ape and human TNF promoters demonstrate that, unlike the fixed differences that we define that are associated with primate phylogeny, these Asian ape-specific fixed differences impair transcription factor binding at an Sp1 site and decrease TNF transcription induced by bacterial stimulation of macrophages. Conclusions/significance. Here, we have presented the broadest interspecies comparison of a regulatory region of an innate immune response gene to date. We have characterized nucleotide positions in Asian ape TNF promoters that underlie functional changes in cell type- and stimulus-specific activation of the TNF gene. We have also identified ancestral TNF promoter nucleotide states in the primate lineage that correspond to human SNP alleles. These findings may reflect evolution of Asian and African apes under a distinct set of infectious disease pressures involving the innate immune response and TNF