Update of EULAR recommendations for the treatment of systemic sclerosis

The aim was to update the 2009 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc), with attention to new therapeutic questions. Update of the previous treatment recommendations was performed according to EULAR standard operating procedures. The task force consisted of 32 SSc clinical experts from Europe and the USA, 2 patients nominated by the pan-European patient association for SSc (Federation of European Scleroderma Associations (FESCA)), a clinical epidemiologist and 2 research fellows. All centres from the EULAR Scleroderma Trials and Research group were invited to submit and select clinical questions concerning SSc treatment using a Delphi approach. Accordingly, 46 clinical questions addressing 26 different interventions were selected for systematic literature review. The new recommendations were based on the available evidence and developed in a consensus meeting with clinical experts and patients. The procedure resulted in 16 recommendations being developed (instead of 14 in 2009) that address treatment of several SSc-related organ complications: Raynaud's phenomenon (RP), digital ulcers (DUs), pulmonary arterial hypertension (PAH), skin and lung disease, scleroderma renal crisis and gastrointestinal involvement. Compared with the 2009 recommendations, the 2016 recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for the treatment of SSc-related RP and DUs, riociguat, new aspects for endothelin receptor antagonists, prostacyclin analogues and PDE-5 inhibitors for SSc-related PAH. New recommendations regarding the use of fluoxetine for SSc-related RP and haematopoietic stem cell transplantation for selected patients with rapidly progressive SSc were also added. In addition, several comments regarding other treatments addressed in clinical questions and suggestions for the SSc research agenda were formulated. These updated data-derived and consensus-derived recommendations will help rheumatologists to manage patients with SSc in an evidence-based way. These recommendations also give directions for future clinical research in SSc

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Bacteria and their distribution under red-tide conditions

Survey of the density of red-tide organisms and bacterioplankton as well as simultaneous determinations of temperature, salinity, pH, secchi disc and dissolved oxygen were carried out at four stations in the Kaštela Bay (middle Adriatic Sea) on a weekly basis between June 15 and September 20, 1989. A close connection between bacterioplankton and Gonyaulax polyedra was observed during the bloom manifested by high coefficients of correlation between them in the surface layers. No correlation was established in the bottom layers since vertical gradients of bacterioplankton density were considerably weaker than in phytoplankton. These differences were also shown in strong vertical gradient of pH and 02-saturation

RFID-based Efficient Method for Parking Slot Car Detection

Enabling a sustainable urban mobility is one of primary goals of the so-called Smart Cities vision, and the deployment of smart parking systems represents a key aspect. The proper operation of these systems heavily depends on their ability to automatically detect the presence of vehicles in the parking spaces. To date, this problem is solved by expensive wireless/wired systems. As the car presence is only one bit of information, with importance of knowing the ID of a slot, in this paper we consider the possibility of using Battery Assisted Passive (BAP) tags for those purposes. Specifically, the considered system uses a BAP tag, with the battery replaced by a solar cell. Once the light level is below some thresholds (ensured by car on top of it), the tag stops transmitting the data, and the system recognizes the slot as occupied. The feasibility of the proposed solution is experimentally verified, and first results are reported

Eutrophication influence on phytoplankton community composition in three bays on the Eastern Adriatic coast

SummaryThis study shows the influence of eutrophication pressure on the phytoplankton community structure, abundance and biodiversity in the investigated bays with different hydromorphological features. Šibenik Bay is a highly stratified estuary of the karstic river Krka; Kaštela Bay is a semi-enclosed coastal bay, which is influenced by the relatively small river Jadro; and Mali Ston Bay is located at the Neretva River estuary, the largest river on the eastern part of the Adriatic Sea. All of the areas are affected by urban pressure, which is reflected in the trophic status of the waters. The greatest anthropogenic influence was found in Kaštela Bay while the lowest influence was found in Mali Ston Bay. In this study, the highest biomass concentration and maximum abundance of phytoplankton were recorded at the stations under the strongest anthropogenic influence. Those stations show a dominance of abundance compared to the biomass and a dominance of opportunistic species, which is reflected in the lower biodiversity of phytoplankton community. Diatoms were the most represented group of the phytoplankton community in all three bays, followed by the dinoflagellates. Diatoms that were highlighted as significant for the difference between the bays were Skeletonema marinoi in Šibenik Bay, Leptocylindrus minimus in Kaštela Bay and the genus Chaetoceros spp. in Mali Ston Bay. Dinoflagellates were more abundant at the stations under the strongest anthropogenic influence, and most significant were Prorocentrum triestinum in Kaštela Bay and Gymnodinium spp. in Šibenik Bay and Mali Ston Bay

Allele frequencies of six highly polymorphic DNA loci in the Croatian population

The allele frequency distributions in a series of Croats were analyzed for six unlinked polymorphic DNA loci: THO1, FESFPS, VWA01, APOB, D1S80, and D17S5. The allele frequencies were determined for 100 unrelated genomic DNA samples. The observed heterozygote frequencies of the loci ranged from 0.63 to 0.76; however, the the expected heterozygosity ranged from 0.68 to 0.82, with only D17S5 having a significant excess of homozygous phenotypes (p < 0.001). The excess homozygosity seen in the D17S5 system may be due to allelic drop-out and warrants further technical analysis of that system, given the uniform lack of significant deviation in the other five systems. The forensic usefulness of these systems can be measured using two different statistics: the power of discrimination and the likelihood of a coincidental match. The power of discrimination ranged from 0.85 to 0.94 for the 6 systems with the combined likelihood of a coincidental match based on these 6 systems of 1 in 3.6 million, or slightly less than the population of Croatia. A second, more conservative estimator of the likelihood of a match is based on the most common phenotype for each system. If someone had the most common phenotype for each of the 6 systems, the chance of a coincidental match would be approximately 1 in 64,000. For paternity testing the usefulness of a system is measured by the average power of exclusion or (1-power of exclusion), the random man not excluded. The average power of exclusion, based on observed heterozygosity, ranged from 0.33 to 0.53, and the average power of exclusion based on the expected heterozygosity ranged from 0.39 to 0.64. The combined average power of exclusion was 99.2% for these 6 systems, using the expected heterozygosity. Based on the results of testing these six systems, there is no significant substructuring within the southern Croatian populations, and these systems provide a useful tool for forensic, paternity, and anthropological applications

Killed Mycobacterium vaccae suspension in children with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled trial

Background The hygiene hypothesis is often proposed to explain the high prevalence of atopy in the western world. Dysregulation of the immune system may result from inadequate exposure to micro-organisms such as mycobacteria. A small trial suggested that a killed extract of Mycobacterium vaccae ameliorates atopic dermatitis (AD).Objectives To confirm in a large clinical trial whether killed M. vaccae ameliorates AD in 5-16-year-old children.Methods This was a randomized, placebo-controlled, double-blind, multi-centre study of the effect of intradermal injection of killed M. vaccae (0.1 or 1 mg) on patients, aged 5-16, with moderate-to-severe AD. Patients were followed up for 24 weeks. The primary end point was the change in severity of AD at 12 weeks, assessed using the six area, six-sign, atopic dermatitis (SASSAD) score. Secondary end points included changes in disease extent, patient's global assessment and children's dermatology life quality index.Results There were 166 patients randomized. The mean SASSAD score fell to a similar degree at week 12 in all treatment arms: from 33 to 24, (26%) in the high-dose group, from 30 to 23 (25%) in the low-dose group and from 36 to 27 (24%) in the placebo group (P > 0.05). Secondary end points followed the same trend. Adverse events were generally those expected to occur in this population. Injection site reactions occurred in 32 patients at week 4.Conclusions M. vaccae was no more effective than the placebo in ameliorating the severity of AD