Influence of the different “patient global assessment” formulations on disease activity score by different indices in rheumatoid arthritis

© 2018, International League of Associations for Rheumatology (ILAR). Patient global assessment (PGA) is included in almost all rheumatoid arthritis (RA) composite disease activity indices and definitions of remission. However, different PGA formulations exist and are used interchangeably in research and clinical practice. We investigated how five different PGA formulations used in four disease indices affect the remission rates. This was an ancillary analysis of data from a cross-sectional study in patients with RA. The data comprised the following: 28-joint counts, C-reactive protein, and five PGA formulations. Remission rate variation was assessed using five PGA formulations in each index (ACR/EULAR Boolean, CDAI, SDAI, and DAS28-CRP). PGA agreement was assessed by the following: Pearson’s correlation; Bland-Altman plots; paired samples t test; and establishing the proportion of patients who scored (i) all formulations within an interval of 20mm and (ii) each formulation ≤ 10mm. This analysis included 191 patients. PGA formulations presented good correlations (≥ 0.65), but Bland-Altman plots showed clinically significant differences, which were statistically confirmed by comparison of means. Just over a half (51.8%) of patients scored all PGA formulations within a 20-mm interval. The proportion of those scoring ≤ 10mm varied from 11.5 to 16.2%. When different formulations of PGA were used in each index, remission differences of up to 4.7, 4.7, 6.3, and 5.2% were observed. When formulations were used in their respective indices, as validated, the remission rates were similar (13.1, 13.6, 14.1, and 18.3%). Using PGA formulations interchangeably may have implications in the assessment of disease activity and in the attainment of remission, and this can impact upon management decisions

The role of ornamentals in human life

The integration of flowers in daily human life has a long history and substantiates our appreciation for their delicacy and wide variation in possible shapes and colours. Since the very early civilizations flowers were used for medical purposes and above all have been part of important cultural and religious customs. Records of their use have been preserved over centuries in different parts of the world and in most if not all major religions flowers have a featuring role. Whereas in the past flower production for floral design was local and probably limited and restricted to wealthy and powerful people that could afford gardens for pleasure, nowadays floral production has become a knowledge and infrastructural intensive, highly specialised industry with trading networks on a global scale and floricultural exhibitions being organised all over the world. As with all intensive industry, concerns on environmental aspects including carbon footprints as well as the well-being of labourers have been raised and have led to certification programs that resulted in impressive reductions in energy and resources as well as environmental impact. It can be expected that given the global environmental and economic issues, ornamental production will have to even intensify these efforts substantially to provide flowers at low environmental costs for people to enjoy in and around their homes.</p

Lilium

The genus Lilium consists of approximately 100 species that are distributed throughout the cold and temperate parts of the Northern Hemisphere. It is subdivided into seven sections: Martagon, Pseudolirium, Lilium, Archelirion, Sinomartagon, Leucolirion, and Oxypetalum. The main species are described with their characteristics. The role of these species in the breeding of lilies is presented in an updated crossing polygon. Lily is a model crop for interspecific hybridization studies resulting in a range of techniques such as pollination methods to overcome inhibition of pollen tubes in the style, embryo rescue methods to prevent embryo abortion, and polyploidization methods to overcome F1 sterility. The use of meiotic and mitotic polyploidization for obtaining polyploids and the application of genomic in situ hybridization (GISH) proved the importance of intergenomic recombination for introgression of characters. Molecular breeding has not been implemented in actual breeding yet. Progress is made in the development of markers for breeding of Lilium. Especially the development of massive parallel sequencing methods known as NGS sequencing and the availability of high-throughput marker systems resulted in new genetic maps of lily with markers closely linked to resistance genes (LMoV and Fusarium). During the last 50 years, lily has become worldwide one of the most important flower bulbs and cut flowers. They are mainly cultivated in the Netherlands with bulb production acreage of more than 5000 ha. The assortment of lilies consists of thousands of polyploid cultivars which can be classified in different established hybrid groups (Asiatic, LA, OT, OA, LO, Longiflorum, and Oriental). Recently the double-flowered lilies are a new development