Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

Objective. SLE has a relapsing-remitting course with disease activity flares over time. This study aims to identify clinical predictors of SLE flares.Methods. This prospective cohort study over 24 months included all SLE patients on follow-up at one academic lupus clinic. Flare was defined as an increase in SLEDAI-2K score ≥4 points. Baseline clinical and demographic parameters were compared using survival analysis for time-to-flare outcome with univariate log-rank tests. Variables with significant differences were further evaluated as predictors with multivariate Cox regression models adjusting for potential confounding or contributing factors and hazard ratio (HR) calculation.Results. A total of 202 SLE patients were included. Over the follow-up period, 1083 visits were documented and 16.8% of patients presented with flares. In multivariate analysis, the following parameters emerged as flare predictors: SLE diagnosis up to 25 years of age (HR = 2.14, P = 0.03), lupus nephritis previous to baseline visit (HR = 4.78, P < 0.0001) and immunosuppressor treatment for severe SLE (HR = 3.22, P < 0.001). Baseline disease activity, disease duration and treatment with prednisone or HCQ were not predictive factors.Conclusion. Patients with an SLE diagnosis before age 25 years, lupus nephritis or immunosuppressor treatment for severe SLE present greater HRs for flares, suggesting the need for tighter clinical monitoring. Current immunosuppressive strategies seem to be inefficient in providing flare prevention

Successful management of bilateral orbital metastases from invasive lobular breast cancer with abemaciclib and letrozole: a case report and literature review

Breast cancer is a significant global health concern, contributing to substantial morbidity and mortality among women. Hormone receptor-positive (HR+)/HER2- negative (HER2-) breast cancer constitutes a considerable proportion of cases, and significant advancements have been made in its management. CDK4/6 inhibitors (CDK4/6is) are a new targeted therapy that has demonstrated efficacy in adjuvant, advanced and metastatic settings. The propensity of lobular breast carcinomas for estrogen-rich sites, such as periocular tissues and orbital fat, may explain their tendency for orbital metastases. Current treatment strategies for these cases are predominantly palliative, and the prognosis remains poor. This article presents a unique case of a 51-year-old female with progressive right periorbital edema, pain, and limited ocular motility. An imaging work-up showed bilateral intra and extraconal orbital infiltration, which was biopsied. The histopathologic analysis disclosed mild chronic inflammatory infiltrate with thickened fibrous tissue and moderately differentiated lobular carcinoma cells, positive for GATA3 and CK7 markers, with 100% of tumor nuclei expressing estrogen receptors (ER+). A systemic evaluation showed a multicentric nodular formation in both breasts. Further diagnostic assessments unveiled an HR+/HER2- bilateral lobular breast carcinoma with synchronous bilateral orbital metastases. Systemic treatment was initiated with abemaciclib 150mg twice daily and letrozole 2.5mg once a day. However, this regimen was interrupted due to toxicity. After two weeks, treatment was resumed with a reduced abemaciclib dose (100mg twice daily) alongside letrozole, with a reasonable tolerance. Nearly two years after the initial diagnosis of inoperable metastatic cancer, the patient remains on the same systemic treatment regimen with no signs of invasive disease. This case report is the first of a patientpresenting with bilateral orbital metastases from bilateral lobular breast cancer, showing an impressive and sustained response to a first-line treatment regimen combining abemaciclib and letrozole. A literature review on bilateral orbital metastases from breast cancer is also presented.info:eu-repo/semantics/publishedVersio

Acoustic monitoring of black-tufted marmosets in a tropical forest disturbed by mining noise

Simple Summary: Communication is one way that animals use to obtain and defend resources, escape predators and attract sexual partners. However, this process can be disrupted by anthropogenic noise, which often differs from natural sounds in frequency, duration and intensity. This study aimed to understand whether, and how, calls emitted by black-tufted marmosets (Callithrix penicillata) are affected by mining noise. We compared ambient noise and the acoustic parameters of the contact calls of these animals in two study areas, one near and one far from the Brucutu Mine, Minas Gerais, Brazil. We found background noise to be higher in the area near the mine, and marmoset vocalizations more frequent, compared to the far area. Calls emitted in the near area also differed in spectral parameters from the far area, which suggests an effort by the animals to adapt their vocal activity to a noisier environment. Our results indicate that mining noise may affect the acoustic communication of black-tufted marmosets. These results may be taken as a starting point for establishing public policies to promote preventive and/or mitigative measures to protect wildlife around sites of mining activity. Moreover, measures to regulate any noisy activities in relation to wild animals are pressing since these are lacking in Brazil. Abstract: All habitats have noise, but anthropogenic sounds often differ from natural sounds in terms of frequency, duration and intensity, and therefore may disrupt animal vocal communication. This study aimed to investigate whether vocalizations emitted by black-tufted marmosets (Callithrix penicillata) were affected by the noise produced by mining activity. Through passive acoustic monitoring, we compared the noise levels and acoustic parameters of the contact calls of marmosets living in two study areas (with two sampling points within each area)—one near and one far from an opencast mine in Brazil. The near area had higher anthropogenic background noise levels and the marmosets showed greater calling activity compared to the far area. Calls in the near area had significantly lower minimum, maximum and peak frequencies and higher average power density and bandwidth than those in the far area. Our results indicate that the mining noise affected marmoset vocal communication and may be causing the animals to adjust their acoustic communication patterns to increase the efficiency of signal propagation. Given that vocalizations are an important part of social interactions in this species, concerns arise about the potential negative impact of mining noise on marmosets exposed to this human activity

Digestibility in selected rainbow trout families and modelling of growth from the specific intake of digestible protein

The experiments aimed to clarify variations in digestibility of dietary nutrients in rainbow trout. Furthermore, the objective was to study how differences in digestibility might be related to growth and feed utilisation at various growth rates. When comparing the results from the experiments it appeared that particularly protein digestibility was closely related to specific growth rate and feed conversion ratio at high growth rates. As a tool to visualise the relationship between protein digestibility and growth of rainbow trout a growth model was developed based on the specific intake of digestible protein, and general assumptions on protein content and protein retention efficiency in rainbow trout. The model indicated that increased protein digestibility only partly explained growth increase and that additional factors were important for growth increment

Dissecting the Molecular Mechanism of Nucleotide-Dependent Activation of the KtrAB K+ Transporter

KtrAB belongs to the Trk/Ktr/HKT superfamily of monovalent cation (K+ and Na+) transport proteins that closely resemble K+ channels. These proteins underlie a plethora of cellular functions that are crucial for environmental adaptation in plants, fungi, archaea, and bacteria. The activation mechanism of the Trk/Ktr/HKT proteins remains unknown. It has been shown that ATP stimulates the activity of KtrAB while ADP does not. Here, we present X-ray structural information on the KtrAB complex with bound ADP. A comparison with the KtrAB-ATP structure reveals conformational changes in the ring and in the membrane protein. In combination with a biochemical and functional analysis, we uncover how ligand- dependent changes in the KtrA ring are propagated to the KtrB membrane protein and conclude that, despite their structural similarity, the activation mechanism of KtrAB is markedly different from the activation mechanism of K+ channels

Determining temporal sampling schemes for passive acoustic studies in different tropical ecosystems

Among different approaches to exploring and describing the ecological complexity of natural environments, soundscape analyses have recently provided useful proxies for understanding and interpreting dynamic patterns and processes in a landscape. Nevertheless, the study of soundscapes remains a new field with no internationally accepted protocols. This work provides the first guidelines for monitoring soundscapes in three different tropical areas, specifically located in the Atlantic Forest, Rupestrian fields, and the Cerrado (Brazil). Each area was investigated using three autonomous devices recording for six entire days during a period of 15 days in both the wet and dry seasons. The recordings were processed via a specific acoustic index and successively subsampled in different ways to determine the degree of information loss when reducing the number of minutes of recording used in the analyses. We describe for the first time the temporal and spectral soundscape features of three tropical environments. We test diverse programming routines to describe the costs and the benefits of different sampling designs, considering the pressing issue of storing and analyzing extensive data sets generated by passive acoustic monitoring. Schedule 5 (recording one minute of every five) appeared to retain most of the information contained in the continuous recordings from all the study areas. Less dense recording schedules produced a similar level of information only in specific portions of the day. Substantial sampling protocols such as those presented here will be useful to researchers and wildlife managers, as they will reduce time- and resource-consuming analyses, whilst still achieving reliable results

The role of the freshwater shrimp atyaephyra desmarestii in leaf litter breakdown in streams

This version does not correspond to the published one. To access the final version go to: http://www.springerlink.com/content/a31518u452m03286/In aquatic ecosystems, microorganisms and invertebrates provide critical links between plant detritus and higher trophic levels. Atyaephyra desmarestii is an omnivorous decapod that inhabits freshwaters and exhibits high tolerance to temperature oscillations and high ability to colonize new habitats. Although A. desmarestii is able to ingest a variety of foods, few studies have been conducted to elucidate the role of this freshwater shrimp on detritus breakdown in streams. In this study, A. desmarestii was allowed to feed on conditioned or unconditioned alder and eucalyptus leaves in microcosms with or without access to its fecal pellets. At the end of the experiment, total body length of the animals was measured, and the remaining leaves and fecal pellets were used for dry mass quantification and assessment of bacterial and fungal diversity by denaturing gradient gel electrophoresis (DGGE). Cluster analyses of DGGE fingerprints indicated that the major differences in microbial communities on leaves were between leaf types, while on fecal pellets were between conditioned and unconditioned leaves. However, the consumption rate by the shrimp did not differ between leaf types, and was significantly higher on leaves conditioned by microorganisms and in treatments without access to feces. In treatments without access to feces, the production of feces and fine particulate organic matter was also significantly higher for conditioned leaves. Overall, our results support the feeding plasticity of A. desmarestii and its potential role in plant litter breakdown in streams. This might have implications for maintaining stream ecosystem functioning, particularly if more vulnerable shredders decline.The Portuguese Foundation for the Science and Technology supported S. Duarte (SFRH/BPD/47574/2008