A Comparative Analysis of Cognitive Deficits in Rheumatoid Arthritis and Fibromyalgia: Impact of Symptoms Severity and Its Clinical Implications

Carmen M Galvez-Sánchez,1,* Stefan Duschek,2,* Gustavo A Reyes del Paso3,* 1Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain; 2Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria; 3Department of Psychology, University of Jaén, Jaén, Spain*These authors contributed equally to this workCorrespondence: Carmen M Galvez-Sánchez, Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Building 31, Murcia, 30100, Spain, Tel +34 868 88 868 88 7328, Email [email protected]: Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated.Patients and Methods: A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons.Results: Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients.Conclusion: The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.Plain Language Summary: The investigation substantiated noteworthy impairments in attention, memory, and executive functions among individuals diagnosed with Fibromyalgia Syndrome (FMS) and Rheumatoid Arthritis (RA).The heightened cognitive deficits observed in FMS patients compared to those with RA could be attributed in part to the heightened severity of pain and secondary symptoms characteristic of FMS.Semantic clustering, by leveraging cognitive resources optimally, may serve as a compensatory mechanism for memory deficits and thus warrants inclusion in interventions aimed at assisting patients in coping with cognitive impairments.Incorporating cognitive deficit screenings into routine diagnostic protocols for FMS and RA is recommended, as it may facilitate the development of personalized treatment strategies aimed at enhancing the overall quality of life for affected individuals.Keywords: fibromyalgia syndrome, rheumatoid arthritis, cognitive impairments, depression, anxiety, fatigue, insomni

Permeation of Herbicidal Dichlobenil From a Casoron Formulation Through Nitrile Gloves

The aim of this study was to measure permeation of the herbicide dichlobenil in Casoron 4G through disposable and chemically protective nitrile gloves using an American Society for Testing and Materials-type permeation cell and a closed-loop system employing two different solvents (hexane and water) and two different challenge situations (aqueous emulsion and solid formulation). Capillary gas chromatography–mass spectrometry was used for quantification purposes. The chemically protective glove did not allow any permeation up to 8 h for the solid-formulation and water-collection challenges, but permeation was detected in all other challenges. The disposable glove allowed the most permeation, and the solid-formulation challenge with water collection necessitated that a dichlobenil equivalent be calculated because of the presence of its hydrolysis degradation product 2,6-dichlorobenzamide. Permeation from the solid formulation was detectable by hexane collection for both the disposable and chemically protective gloves and by water collection for the disposable glove. It was concluded that hexane-solvent collection was not valid for the disposable glove at 4 and 8 h of permeation in the solid Casoron challenge or for the aqueous emulsion challenge at 8 h relative to the water-collection solvent data. The hexane-solvent collection for the chemically protective glove was valid for the 8-h solid-formulation challenge but not for the 8-h aqueous-solution challenge. All water-solvent collections were valid; however, dichlobenil usually permeated the gloves

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder characterized by (i) pruritus with onset in the second or third trimester of pregnancy, (ii) elevated serum aminotransferases and bile acid levels, and (iii) spontaneous relief of signs and symptoms within two to three weeks after delivery. ICP is observed in 0.4–1% of pregnancies in most areas of Central and Western Europe and North America, while in Chile and Bolivia as well as Scandinavia and the Baltic states roughly 5–15% and 1–2%, respectively, of pregnancies are associated with ICP. Genetic and hormonal factors, but also environmental factors may contribute to the pathogenesis of ICP. Intrahepatic cholestasis of pregnancy increases the risk of preterm delivery (19–60%), meconium staining of amniotic fluid (27%), fetal bradycardia (14%), fetal distress (22–41%), and fetal loss (0.4–4.1%), particularly when associated with fasting serum bile acid levels > 40 μmol/L. The hydrophilic bile acid ursodeoxycholic acid (10–20 mg/kg/d) is today regarded as the first line treatment for intrahepatic cholestasis of pregnancy. Delivery has been recommended in the 38th week when lung maturity has been established

The age of the opening of the Ice-Free Corridor and implications for the peopling of the Americas

The Clovis-first model for the peopling of the Americas by ∼13.4 ka has long invoked the Ice-Free Corridor (IFC) between the retreating margins of the Cordilleran and Laurentide ice sheets as the migration route from Alaska and the Yukon down to the Great Plains. Evidence from archaeology and ancient genomics, however, now suggests that pre-Clovis migrations occurred by at least ∼15.5 to 16.0 ka or earlier than most recent assessments of the age of IFC opening at ∼14 to 15 ka, lending support to the use of a Pacific coast migration route instead. Uncertainties in ages from the IFC used in these assessments, however, allow for an earlier IFC opening which would be consistent with the availability of the IFC as a migration route by ∼15.5 to 16.0 ka. Here, we use 64 cosmogenic (10Be) exposure ages to closely date the age of the full opening of the IFC at 13.8 ± 0.5 ka. Our results thus clearly establish that the IFC was not available for the first peopling of the Americas after the Last Glacial Maximum, whereas extensive geochronological data from the Pacific coast support its earlier availability as a coastal migration route

An empirical model for probabilistic decadal prediction: global attribution and regional hindcasts

Empirical models, designed to predict surface variables over seasons to decades ahead, provide useful benchmarks for comparison against the performance of dynamical forecast systems; they may also be employable as predictive tools for use by climate services in their own right. A new global empirical decadal prediction system is presented, based on a multiple linear regression approach designed to produce probabilistic output for comparison against dynamical models. A global attribution is performed initially to identify the important forcing and predictor components of the model . Ensemble hindcasts of surface air temperature anomaly fields are then generated, based on the forcings and predictors identified as important, under a series of different prediction ‘modes’ and their performance is evaluated. The modes include a real-time setting, a scenario in which future volcanic forcings are prescribed during the hindcasts, and an approach which exploits knowledge of the forced trend. A two-tier prediction system, which uses knowledge of future sea surface temperatures in the Pacific and Atlantic Oceans, is also tested, but within a perfect knowledge framework. Each mode is designed to identify sources of predictability and uncertainty, as well as investigate different approaches to the design of decadal prediction systems for operational use. It is found that the empirical model shows skill above that of persistence hindcasts for annual means at lead times of up to 10 years ahead in all of the prediction modes investigated. It is suggested that hindcasts which exploit full knowledge of the forced trend due to increasing greenhouse gases throughout the hindcast period can provide more robust estimates of model bias for the calibration of the empirical model in an operational setting. The two-tier system shows potential for improved real-time prediction, given the assumption that skilful predictions of large-scale modes of variability are available. The empirical model framework has been designed with enough flexibility to facilitate further developments, including the prediction of other surface variables and the ability to incorporate additional predictors within the model that are shown to contribute significantly to variability at the local scale. It is also semi-operational in the sense that forecasts have been produced for the coming decade and can be updated when additional data becomes available

The prevalence and functional impact of musculoskeletal conditions amongst clients of a primary health care facility in an under-resourced area of Cape Town

BACKGROUND:The extent of disease burden of musculoskeletal conditions (MSC) not due to injury has not been well determined in sub-Saharan Africa. The 1999 Global Burden of Disease study estimated the prevalence of osteoarthritis and rheumatoid arthritis to be 150/100,000 compared to 1,500/100,000 in Europe. The objective of the study was to determine the prevalence of MSC and the functional implications in a sample of people attending community health centres in Cape Town, South Africa. METHODS: A cross-sectional, descriptive study was conducted in clinics in two resource poor communities. Phase I consisted of screening and those who screened positive for peripheral or spinal joint pain went on to complete Phase II, which included the Stanford Health Assessment Questionnaire. RESULTS: 1005 people were screened in Phase I. Of these, 362 (36%) reported MSC not due to injury in the past three months. Those with MSC had higher rates of co-morbidities in every category than those without. The mean Disability Index for those with MSC was mild to moderate and moderate to severe in those over 55 years. CONCLUSIONS: Although the sample may not be representative of the general community, the prevalence is considerably greater than those reported elsewhere even when the population of the catchment area is used as a denominator, (367/100 000). The common presentation of MSC with co-morbid diabetes and hypertension requires holistic management by appropriately trained health care practitioners. Any new determination of burden of disease due to MSC should recognise that these disorders may be more prevalent in developing countries than previously estimated

Taxonomic variations in the gut microbiome of gout patients with and without tophi might have a functional impact on urate metabolism

Objective: To evaluate the taxonomic composition of the gut microbiome in gout patients with and without tophi formation, and predict bacterial functions that might have an impact on urate metabolism. Methods: Hypervariable V3–V4 regions of the bacterial 16S rRNA gene from fecal samples of gout patients with and without tophi (n=33 and n=25, respectively) were sequenced and compared to fecal samples from 53 healthy controls. We explored predictive functional profles using bioinformatics in order to identify diferences in taxonomy and metabolic pathways. Results: We identifed a microbiome characterized by the lowest richness and a higher abundance of Phascolarctobacterium, Bacteroides, Akkermansia, and Ruminococcus_gnavus_group genera in patients with gout without tophi when compared to controls. The Proteobacteria phylum and the Escherichia-Shigella genus were more abundant in patients with tophaceous gout than in controls. Fold change analysis detected nine genera enriched in healthy controls compared to gout groups (Bifdobacterium, Butyricicoccus, Oscillobacter, Ruminococcaceae_UCG_010, Lachnospiraceae_ND2007_group, Haemophilus, Ruminococcus_1, Clostridium_sensu_stricto_1, and Ruminococcaceae_ UGC_013). We found that the core microbiota of both gout groups shared Bacteroides caccae, Bacteroides stercoris ATCC 43183, and Bacteroides coprocola DSM 17136. These bacteria might perform functions linked to one-carbon metabo‑ lism, nucleotide binding, amino acid biosynthesis, and purine biosynthesis. Finally, we observed diferences in key bacterial enzymes involved in urate synthesis, degradation, and elimination. Conclusion: Our fndings revealed that taxonomic variations in the gut microbiome of gout patients with and with‑ out tophi might have a functional impact on urate metabolism. Keywords: Gout, Gut microbiota, Uric acid metabolis

The STF2p Hydrophilin from Saccharomyces cerevisiae Is Required for Dehydration Stress Tolerance

The yeast Saccharomyces cerevisiae is able to overcome cell dehydration; cell metabolic activity is arrested during this period but restarts after rehydration. The yeast genes encoding hydrophilin proteins were characterised to determine their roles in the dehydration-resistant phenotype, and STF2p was found to be a hydrophilin that is essential for survival after the desiccation-rehydration process. Deletion of STF2 promotes the production of reactive oxygen species and apoptotic cell death during stress conditions, whereas the overexpression of STF2, whose gene product localises to the cytoplasm, results in a reduction in ROS production upon oxidative stress as the result of the antioxidant capacity of the STF2p protein

A change in the optical polarization associated with a gamma-ray flare in the blazar 3C 279

It is widely accepted that strong and variable radiation detected over all accessible energy bands in a number of active galaxies arises from a relativistic, Doppler-boosted jet pointing close to our line of sight. The size of the emitting zone and the location of this region relative to the central supermassive black hole are, however, poorly known, with estimates ranging from light-hours to a light-year or more. Here we report the coincidence of a gamma-ray flare with a dramatic change of optical polarization angle. This provides evidence for co-spatiality of optical and gamma-ray emission regions and indicates a highly ordered jet magnetic field. The results also require a non-axisymmetric structure of the emission zone, implying a curved trajectory for the emitting material within the jet, with the dissipation region located at a considerable distance from the black hole, at about 10^5 gravitational radii.Comment: Published in Nature issued on 18 February 2010. Corresponding authors: Masaaki Hayashida and Greg Madejsk