Management of Neuropsychiatric Systemic Lupus Erythematosus: Current Approaches and Future Perspectives

Neuropsychiatric systemic lupus erythematosus (NPSLE) is a generic definition referring to a series of neurological and psychiatric symptoms directly related to systemic lupus erythematosus (SLE). NPSLE includes heterogeneous and rare neuropsychiatric (NP) manifestations involving both the central and peripheral nervous system. Due to the lack of a gold standard, the attribution of NP symptoms to SLE represents a clinical challenge that obligates the strict exclusion of any other potential cause. In the acute setting, management of these patients does not differ from other non-SLE subjects presenting with the same NP manifestation. Afterwards, an individualized therapeutic strategy, depending on the presenting manifestation and severity of symptoms, must be started. Clinical trials in NPSLE are scarce and most of the data are extracted from case series and case reports. High-dose glucocorticoids and intravenous cyclophosphamide remain the cornerstone for patients with severe symptoms that are thought to reflect inflammation or an underlying autoimmune process. Rituximab, intravenous immunoglobulins, or plasmapheresis may be used if response is not achieved. When patients present with mild to moderate NP manifestations, or when maintenance therapy is warranted, azathioprine and mycophenolate may be considered. When symptoms are thought to reflect a thrombotic underlying process, anticoagulation and antiplatelet agents are the mainstay of therapy, especially if antiphospholipid antibodies or antiphospholipid syndrome are present. Recent trials on SLE using new biologicals, based on newly understood SLE mechanisms, have shown promising results. Based on what we currently know about its pathogenesis, it is tempting to speculate how these new therapies may affect the management of NPSLE patients. This article provides a comprehensive and critical review of the literature on

Laboratory and Neuroimaging Biomarkers in Neuropsychiatric Systemic Lupus Erythematosus: Where Do We Stand, Where To Go?

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multi-systemic involvement. Nervous system involvement in SLE leads to a series of uncommon and heterogeneous neuropsychiatric (NP) manifestations. Current knowledge on the underlying pathogenic processes and their subsequent pathophysiological changes leading to NP-SLE manifestations is incomplete. Several putative laboratory biomarkers have been proposed as contributors to the genesis of SLE-related nervous system damage. Alongside the laboratory biomarkers, several neuroimaging tools have shown to reflect the nature of tissue microstructural damage associated with SLE, and thus were suggested to contribute to the understanding of the pathophysiological changes and subsequently help in clinical decision making. However, the number of useful biomarkers in NP-SLE in clinical practice is disconcertingly modest. In some cases it is not clear whether the biomarker is truly involved in pathogenesis, or the result of non-specific pathophysiological changes in the nervous system (e.g., neuroinflammation) or whether it is the consequence of a concomitant underlying abnormality related to SLE activity. In order to improve the diagnosis of NP-SLE and provide a better targeted care to these patients, there is still a need to develop and validate a range of biomarkers that reliably capture the different aspects of disease heterogeneity. This article critically reviews the current state of knowledge on laboratory and neuroimaging biomarkers in NP-SLE, discusses the factors that need to be addressed to make these biomarkers suitable for clinical application, and suggests potential future research paths to address important unmet needs in the NP-SLE field

GENDER INEQUALITY IN ACCOUNTING PROFESSION FROM THE PERSPECTIVE OF THE GLASS CEILING

Among the studies developed on gender differences in occupations, the theoretical glass ceiling approach has been used internationally to explain the occurrence of barriers that hinder and even prevent the professional growth of women and generate wage inequalities between men and women in the performance of similar functions. Given the above, the study aims to identify gender differences in the accounting profession analyzed from the perspective of the glass ceiling. The research methodology is descriptive, documentary and the approach is quantitative. Data were extracted from the Annual Social Information (RAIS), base year 2013. The investigated population are employees who work in accounting in companies located in southern Brazil. The results indicate that the professions of accounting auditor and accountant are performed, most often by male professionals. It was found that men have higher pay and a predominance of men in the accounting department of larger companies. We conclude that glass ceiling is present in the accounting profession, creating an invisible barrier to women's access to positions of greater evidence of the accounting profession. Keywords: Glass Ceiling. Gender. Accounting Professional. Inequality

Association of 25-hydroxyvitamin D with Metabolic Syndrome in Patients with Psoriasis: A Case-control Study

Vitamin D deficiency is associated with higher cardiovascular risk and metabolic syndrome (MeS) criteria. The main objective of this study was to analyse the association of 25-hydroxyvitamin D (25-OHD) serum levels with MeS (National Cholesterol Education Program Adult Treatment Panel-III criteria) in 46 Spanish patients with psoriasis, but without arthritis and systemic treatment, and 46 control subjects, matched by sex and age. The patients with psoriasis showed significantly lower level of 25-OHD than controls (30.5 vs. 38.3 ng/ml; p =0.0001). Patients with MeS had significantly lower serum levels of 25-OHD than those without MeS (24.1 +/- 7.5 vs. 32.8 +/- 8.9,p =0.007), and a negative correlation was found between 25-OHD and waist circumference, diastolic blood pressure, fasting glucose, and triglyceridaemia. In the control group no significant correlation between 25-OHD and MeS was found. Although the sample was small, our results suggest a potential protective role for 25-OHD in the metabolic profile of patients with psoriasis without arthritis

CROTALÁRIA E TREMOÇO: LEGUMINOSAS PARA UMA AGRICULTURA MAIS SUSTENTÁVEL

Na região sul do Brasil existe predomínio de monocultivos, predominando soja no verão e aveia/azevém no inverno. No alto Uruguai Catarinense, em grande parte das propriedades, destaca-se o cultivo de gramíneas no verão (milho) e no inverno (aveia, azevém e trigo). A adubação verde é uma prática agrícola que consiste no plantio de espécies vegetais em rotação ou em consórcio com culturas de interesse econômico. Essas espécies apresentam ciclo anual ou perene, cobrindo o terreno por determinado período ou durante todo o ano. Civilizações milenares, como a chinesa, grega e romana, já adotavam a adubação verde para melhorar o desempenho da agricultura. Atualmente, as transformações promovidas pela modernização da agricultura acabaram por substituir os resíduos vegetais e outros materiais de origem orgânica por fertilizantes minerais. Embora sejam cultivadas espécies de várias famílias botânicas, como adubo verde, as da família Leguminosae destacam-se por proporcionarem o aporte de elevadas quantidades de massa vegetal ao solo e formarem associação simbiótica com bactérias fixadoras de nitrogênio, conhecidas genericamente como rizóbios. Como resultado dessa simbiose, essas plantas são capazes de fornecer N (nitrogênio) para culturas de interesse econômico. As crotalárias (Crotalaria spp.) são leguminosas de rápido crescimento, tolerantes à seca e doenças; são herbáceas eretas, cultivadas no verão, estando vinculadas à cobertura de solo e ao combate de nematoides. O tremoço branco (Lupinus albus) tem capacidade para ser uma planta de cobertura, pertencendo, assim como as crotalárias, também à família das leguminosas, porém sendo uma cultura de inverno. Essas plantas apresentam bom potencial de expansão para cultivo, especialmente como cobertura, fornecendo nitrogênio e auxiliando no controle de nematoides. Com isso, objetiva-se apresentar potenciais vantagens das leguminosas de verão, como as crotalárias, e de inverno, como o tremoço, e encaixes destas plantas com culturas sucessoras. Para isso será utilizado um banner com imagens, informações relacionadas ao melhor encaixe com as culturas sucessoras e quantidades de N fornecido paras as culturas em sucessão. Além disso, serão apresentadas plantas e colunas de solo visando a observação do sistema radicular destas plantas como plantas com potencial descompactador de solo. Espera-se conscientizar os ouvintes da importância destas plantas leguminosas para uma agricultura mais eficiente e com menor demanda de insumos externos a propriedade

Implication of type 4 NADPH oxidase (NOX4) in tauopathy.

Aggregates of the microtubule-associated protein tau are a common marker of neurodegenerative diseases collectively termed as tauopathies, such as Alzheimer’s disease (AD) and frontotemporal dementia. Therapeutic strategies based on tau have failed in late stage clinical trials, suggesting that tauopathy may be the consequence of upstream causal mechanisms. As increasing levels of reactive oxygen species (ROS) may trigger protein aggregation or modulate protein degradation and, we had previously shown that the ROS producing enzyme NADPH oxidase 4 (NOX4) is a major contributor to cellular autotoxicity, this study was designed to evaluate if NOX4 is implicated in tauopathy. Our results show that NOX4 is upregulated in patients with frontotemporal lobar degeneration and AD patients and, in a humanized mouse model of tauopathy induced by AVV-TauP301L brain delivery. Both, global knockout and neuronal knockdown of the Nox4 gene in mice, diminished the accumulation of pathological tau and positively modified established tauopathy by a mechanism that implicates modulation of the autophagy-lysosomal pathway (ALP) and, consequently, improving the macroautophagy flux. Moreover, neuronal-targeted NOX4 knockdown was sufficient to reduce neurotoxicity and prevent cognitive decline, even after induction of tauopathy, suggesting a direct and causal role for neuronal NOX4 in tauopathy. Thus, NOX4 is a previously unrecognized causative, mechanism-based target in tauopathies and blood-brain barrier permeable specific NOX4 inhibitors could have therapeutic potential even in established disease.post-print5895 K

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ