Long-term mortality in treated-to-target RA and UA: results of the BeSt and IMPROVED cohort

Objectives To study long-term (up to 20-year) mortality of two treat-to-target trial cohorts in undifferentiated arthritis (UA) and early rheumatoid arthritis (RA).Methods The BeSt (BehandelStrategieen) study (n=508, early RA) was performed between 2000 and 2012. For 10 years, patients were treated-to-target disease activity score (DAS)10 years since treatment start, with smoking as an important risk factor.Pathophysiology and treatment of rheumatic diseasesPublic Health and primary carePrevention, Population and Disease management (PrePoD

The miR-644a/CTBP1/p53 axis suppresses drug resistance by simultaneous inhibition of cell survival and epithelialmesenchymal transition in breast cancer

Tumor cells develop drug resistance which leads to recurrence and distant metastasis. MicroRNAs are key regulators of tumor pathogenesis; however, little is known whether they can sensitize cells and block metastasis simultaneously. Here, we report miR-644a as a novel inhibitor of both cell survival and EMT whereby acting as pleiotropic therapy-sensitizer in breast cancer. We showed that both miR-644a expression and its gene signature are associated with tumor progression and distant metastasis-free survival. Mechanistically, miR-644a directly targets the transcriptional co-repressor C-Terminal Binding Protein 1 (CTBP1) whose knock-outs by the CRISPRCas9 system inhibit tumor growth, metastasis, and drug resistance, mimicking the phenotypes induced by miR-644a. Furthermore, downregulation of CTBP1 by miR-644a upregulates wild type- or mutant-p53 which acts as a 'molecular switch' between G1-arrest and apoptosis by inducing cyclin-dependent kinase inhibitor 1 (p21, CDKN1A, CIP1) or pro-apoptotic phorbol-12-myristate-13-acetate-induced protein 1 (Noxa, PMAIP1), respectively. Interestingly, an increase in mutant-p53 by either overexpression of miR-644a or downregulation of CTBP1 was enough to shift this balance in favor of apoptosis through upregulation of Noxa. Notably, p53- mutant patients, but not p53-wild type ones, with high CTBP1 have a shorter survival suggesting that CTBP1 could be a potential prognostic factor for breast cancer patients with p53 mutations. Overall, re-activation of the miR-644a/CTBP1/p53 axis may represent a new strategy for overcoming both therapy resistance and metastasis

Mycobiota and occurrence of Fumonisin B1 in wheat harvested in Southern Brazil

Although fumonisin B1 (FB1) is a mycotoxin poorly studied in wheat, the Fusarium genus fungi have been frequently detected in this cereal, especially in subtropical regions such as southern Brazil, thus studies on their occurrence are required. This study evaluated the mycobiota, water activity and the presence of FB1 in 11 wheat cultivars grown in the northeastern and northwestern of Rio Grande do Sul. The mycobiota was identified by morphological and molecular techniques and FB1 was determined by liquid chromatography with fluorescence detection (HPLC-FL). Microbial counts lower than 103CFU were found in the samples, and the fungi genera Phoma, Cladosporium and Fusarium were the most frequent. Despite this, 54% of the samples were contaminated with FB1 at levels ranging from 958 to 4,906µg FB1 kg-1

The effects of the levels of burnout midwives working in a?ri{dotless} on the job satisfaction and empathic tendencies of them [A?ri{dotless} ilinde çali{dotless}şan ebelerin tükenmişlik düzeylerinin iş doyumlari{dotless} ve empatik e?ilimleri üzerine etkisi]

Gulhane Military Medical AcademyAIM:The this study was carried out descriptively for the purpose of determining the effect level of burnout has on the job satisfaction and empathic tendencies of midwives. METHOD: The findings of the study were obtained using a questionnaire directed at the socio-demographic and occupational characteristics of midwives, the Maslach Burnout Inventory, the Minnesota Job Satisfaction Scale, and the Empathic Tendency Scale.100 midwives working at A?ri{dotless} Maternity and Pediatrics Hospital, A?ri{dotless} State Hospital, Health Care Centers 1, 2, 3, 4, and 6, Center for Maternal and Infant Health, and Family Planning center established the population of the study. 74 midwives willing to participate in the study constituted the sample group. The data obtained was evaluated using a SPSS 14.0 (Statistical Package for Social Science) software program. Numbers and percentages, a significance test for the difference of two means, the Man Whitney U Test, the Kruskal-Wallis Test, and correlation analysis were used to evaluate the data. RESULTS: The majority of the midwives participating in the study are aged 30 and under, and are medical vocational high school graduates. A third of the married midwives, approximately half of the midwives participating in the study, have children. Just over a half of the midwives are at second base and work full-time during the day, most of them are contract employees, and have been working for 1-5 years. Over half of the midwives participating in the study chose their profession willingly and the majority of them expressed that their profession was satisfying economically. It was determined that the age, education level, and working position of the midwives, together with the economical satisfaction of the job, and obtaining a certificate of merit did not affect burnout, whereas, marital status, having children, the organization they worked for, their years of service, and working hours did affect burnout. A significant inverse relationship was determined between the levels of burnout with job satisfaction and the score means of empathic tendencies. CONCLUSİON: As midwives burnout level increases,studies determines that their job satisfaction and empathic tendencies decrease.Şahin, S. A.; Atatürk ÜniversitesiTurkey; email: [email protected]

Crashworthiness Sensitivity Analysis of Axisymmetric Rectangular Crash Absorbers with Diaphragms

12th International Science-Technical Conference AUTOMOTIVE SAFETY, AUTOMOTIVE SAFETY (2020 : Kielce; Poland)The main goal of this study is to analyze the effects of the wall and diaphragm thicknesses of a rectangular crash absorber on its crashworthiness performance. The crash absorber has three equally distanced diaphragms inside. A five variable problem is considered where the long and short edge thicknesses along with the thicknesses of the three diaphragms are accounted as design variables. The crashworthiness sensitivity analyses are performed on the initial peak force (IPCF) and specific energy absorption (SEA). 100 training points and 30 test points are created within the design domain using Latin hypercube sampling, and surrogate models are constructed. For each response, the most accurate surrogate model is determined and these models are further used in the sensitivity analysis. The effect of long and short edge thicknesses is found to be higher than the effect of diaphragms in both responses, with the effect of long edge thickness higher than the effect of short edge thickness. © 2020 IEEE

The emerging role of national academies in surgical training: An inspiring environment for increasing the quality of health care in breast cancer management

Medical education, both graduate and postgraduate, is given at medical schools and affiliated teaching hospitals. The training at these institutions is necessary and valuable. In each field of the medical profession, the relevant science is being developed and changed constantly. Training of medical staff and auxilliary professionals must be adaptable to changes in the field. Also, the development of standards for the diagnosis and treatment of diseases is important. Independent institutions, called academies, serve an extremely useful task in the continuing further training that needs to be adjusted according to individual needs. Academies are independent and free from bureaucracies. Standardized records are uniform and comparable at these institutions. Both patients and medical staff receive training from these institutions. In this way, a high standard is provided in medicine, error rates are decreased and patient satisfaction is increased. Breast cancer, the most common tumor in women, is a serious cause of morbidity and mortality. The European Institute of Oncology (EIO) in Milan, Italy and the European Academy of Senology in Duesseldorf, Germany play important roles in establishing the standards of breast care. They provide substantial training for physicians to achieve high quality in breast cancer management. SENATURK (Senoloji Akademisi, Turkish Academy of Senology) was established in 2010 in Istanbul, Turkey. Both national and international scientists and physicians including eminent senologists are currently faculty members of this young organization. SENATURK collaborates with other institutions in Europe. Its missions include developing training programs for each level of the profession, as well as developing data recording systems and electronic learning tools for breast cancer prevention, diagnosis, treatment, rehabilitation and palliation. Briefly, SENATURK plays a significant role as the opinion leader on every aspect of health care related to conditions and diseases of the breast