Patient reported frequency of lupus flare: associations with foundation makeup and sunscreen use

Objective: To test the hypothesis that usage of foundation makeup (FM) and sunscreen lotion (SS), used individually or in combination, is associated with significant changes in the likelihood of lupus symptom exacerbation. Methods: Self-reported flare days (SRF) and use of FM and SS products, were retrospectively examined in 80 Caucasian Australian women with ACR classified SLE for a year. Negative binomial regression modelled SRF days (outcome) against independent FMSS variable and covariates: age; diagnosis years; outdoor hours; BMI; stress; immune therapy medication (ITM) use. Results: Statistically significant inverse associations between SRF days and FMSS use were found. Protective effects were statistically significant (p < 0.05) for combined FMSS exposure days (OR 0.998, CI 0.997 - 1.0) and FM alone (OR 0.603, CI 0.363 - 1.0). Significant associations consistent with increased SRF risk were seen in sub-analysis models for participants taking ITM: univariate model (OR 1.968, p = 0.03); multivariate model for FMSS (OR 2.11, CI 1.161 - 3.835); FM days (OR 1.855, CI 1.023 - 3.364). Results show SRF day reduction of 0.15% for each day of product exposure. Conclusion: Study results highlight protective effects of wearing FM with or without SS. This reduction in flare days ultimately has potential to improve quality of life in SLE patients

Analysis of Centelloside of Pegagan (Centella Asiatica)

Centella asiatica is still categorized as a wild plant that has not undergone domestication. Sustainability of medicinal and aromatic plants for sustainable harvesting of medicinal plants so that it is not only in nature but also the harvest of cultivated so obtained uniform quality. Chemical constituents arealready known: contain some saponin compounds, including asiaticoside, madeccasoside and asiatic acid. This study aims to determine the bioactive content; asiaticoside, madeccasoside and asiatic acid on the top(leaves and petiol) and bottom (roots and tendrils) with HPLC method. The experiment was conducted in growth chamber Department of Biological Sciences and School of Pharmacy Auburn University, USA. This study conducted in September-December 2011. The materials used are Centella asiatica of Deli Serdang accession, Kabanjahe accession, Berastagi accession and Samosir accession. Equipment needed to support the growth chamber study were digital scales, plastic pots, HPLC system types waters alliance 2695 autosampler, 996 photodiode array detector, coulomb adsorbosphere C18 5μ, size 250 x 4.60 mm, UV absorbance, wavelength of 210 nm, flow rate 1.8 ml / min, injection volume of 20 mL, Empower Pro software, and others. The results that the pattern of centelloside (asiaticoside, madecassoside and asiatic acid), when the content of one of the high content of bioactive, the others bioactive will be lower or biosynthetic pattern toward a compound needed. Centelloside plant age affects the content of Centella asiatica. Centelloside pattern is influenced by the condition of the planting medium, very high levels of phosphorus, biosynthesis of centelloside more toward to asiaticoside

Madagascar’s extraordinary biodiversity: Threats and opportunities

Madagascar's unique biota is heavily affected by human activity and is under intense threat. Here, we review the current state of knowledge on the conservation status of Madagascar's terrestrial and freshwater biodiversity by presenting data and analyses on documented and predicted species-level conservation statuses, the most prevalent and relevant threats, ex situ collections and programs, and the coverage and comprehensiveness of protected areas. The existing terrestrial protected area network in Madagascar covers 10.4% of its land area and includes at least part of the range of the majority of described native species of vertebrates with known distributions (97.1% of freshwater fishes, amphibians, reptiles, birds, and mammals combined) and plants (67.7%). The overall figures are higher for threatened species (97.7% of threatened vertebrates and 79.6% of threatened plants occurring within at least one protected area). International Union for Conservation of Nature (IUCN) Red List assessments and Bayesian neural network analyses for plants identify overexploitation of biological resources and unsustainable agriculture as themost prominent threats to biodiversity. We highlight five opportunities for action at multiple levels to ensure that conservation and ecological restoration objectives, programs, and activities take account of complex underlying and interacting factors and produce tangible benefits for the biodiversity and people of Madagascar

Madagascar’s extraordinary biodiversity: Evolution, distribution, and use

Madagascar's biota is hyperdiverse and includes exceptional levels of endemicity. We review the current state of knowledge on Madagascar's past and current terrestrial and freshwater biodiversity by compiling and presenting comprehensive data on species diversity, endemism, and rates of species description and human uses, in addition to presenting an updated and simplified map of vegetation types. We report a substantial increase of records and species new to science in recent years; however, the diversity and evolution of many groups remain practically unknown (e.g., fungi and most invertebrates). Digitization efforts are increasing the resolution of species richness patterns and we highlight the crucial role of field- and collections-based research for advancing biodiversity knowledge and identifying gaps in our understanding, particularly as species richness corresponds closely to collection effort. Phylogenetic diversity patterns mirror that of species richness and endemism in most of the analyzed groups. We highlight humid forests as centers of diversity and endemism because of their role as refugia and centers of recent and rapid radiations. However, the distinct endemism of other areas, such as the grassland-woodland mosaic of the Central Highlands and the spiny forest of the southwest, is also biologically important despite lower species richness. The documented uses of Malagasy biodiversity are manifold, with much potential for the uncovering of new useful traits for food, medicine, and climate mitigation. The data presented here showcase Madagascar as a unique living laboratory for our understanding of evolution and the complex interactions between people and nature. The gathering and analysis of biodiversity data must continue and accelerate if we are to fully understand and safeguard this unique subset of Earth's biodiversity

Vitamin D levels are associated with expression of SLE, but not flare frequency

This study explores links between vitamin D deficiency (25(OH)D = 50 nmol/L) and serological autoimmunity (ANA > 1:80) and frequency of self-reported flares (SRF) in participants with clinical autoimmunity (SLE). 25(OH)D levels of 121 females were quantified and compared. The cohort consisted of 80 ACR defined SLE patients and 41 age and sex matched controls. Association analysis of log2 (25(OH)D) levels and ANA 80 positivity was undertaken via two-sample t-tests and regression models. Significant differences were found for 25(OH)D levels (mean: control 74nmol/L (29.5ng/ml); SLE 58nmol/L (23.1ng/ml), P = 0.04), 25(OH)D deficiency (P = 0.02). Regression models indicate that, for a twofold rise in 25(OH)D level, the odds ratio (OR) for ANA-positivity drops to 36% of the baseline OR. No link was found between SRF-days and 25(OH)D levels. Our results support links between vitamin D deficiency and expression of serological autoimmunity and clinical autoimmunity (SLE). However, no demonstrable association between 25(OH)D and SRF was confirmed, suggesting independent influences of other flare-inducing factors. Results indicate that SLE patients have high risk of 25(OH)D deficiency and therefore supplementation with regular monitoring should be considered as part of patient management

Visual narratives performing and transforming people living with autoimmune illness: a pilot case study

Identity perspectives underpin an arts health intervention research project titled 'Artmaking, Visual Narrative and Wellbeing'. This article considers the adaptability benefits of working with artmaking narratives to support the long-term emotional and physical wellbeing of people living with chronic autoimmune illness. The article describes the methods and background to the pilot transdisciplinary case study of twelve participants, the intervention, data sources and qualitative strategies that were intersected with quantitative, medical, physical and functionality indicators. It identified that time and memory work, using montage methods in visual narratives, supported a renewed confidence in the participants' life journey. Notions of pain and time temporarily retreated when strong affective responses emerged from new storied possibilities. These findings demonstrate how visual narrative methods work as a sense-making experience for the collision between past narratives and present specific medical and/or socio-cultural contexts. The findings are discussed in the context of their potential contribution to the wider arts and health debat

Self-reported Lupus flare: Association with everyday home and personal product exposure

Background: The number of chemicals in household products has driven concern about potential adverse health through their use. Most research concentrates on product chemicals with reproductive and carcinogenic consequences, however some evidence exists that immune effects can lead to exacerbation of autoimmune illnesses such as lupus (SLE). Objectives: This paper examines household and personal product exposure patterns in a pilot case/control study of female Australians. We also examined associations between common product exposure and SLE symptom exacerbation over a year period. Methods: We enrolled 41 control and 80 SLE participants aged 18–80 years. Qualitative techniques of structured interview and thematic analysis retrospectively explored patterns of product use, and flare history data of SLE participants. Negative binomial regression models explored associations between self-reported flare (SRF) days and exposure to 34 common home product groups. Results: Mean product counts did not differ between participant groups (mean 33.1: SD 11.8), or flare groups (flare mean 32.6:SD 12, no-flare 31.8:SD 6.6). Products used for personal hygiene and general house cleaning were most frequently used.Significant association with increased SRF day relative risk (IRR) was seen for bath oil use (IRR 1.008, CI 1.00–1.02). Paradoxical “protective” effects, (reduced SRF days) were found for cleansing beauty (IRR 0.999, CI 0.998–0.999), make-up (IRR 0.998, CI 0.997–0.999); adhesives (IRR 0.994, CI 0.991–0.997) and paint (IRR 0.99, CI 0.986–0.995). Conclusions: Everyday product exposures can impact on symptom exacerbation in SLE. Some offering protection and others increased health risk. Identifying environmental associations offer the possibility of life-style interventions to reduce illness impact

Exploring lifetime occupational exposure and SLE flare: a patient-focussed pilot study

Introduction: Environmental effectors, such as ultraviolet radiation exposure, infection and stress, have been established as having a role in exacerbating lupus symptoms. However, unpredictable patterns of flare events still remain a mystery. Occupational effectors have also been suggested as having a contributing role; however, they are not widely researched. In this paper we report a pilot study designed to generate focus areas for future research regarding occupational exposures and systemic lupus erythematosus (SLE). Methods: The study explored potential links between exposures and the occurrence of patient-reported flare events in 80 Australian women with SLE (American College of Rheumatology (ACR) criteria classified). Specifically, the study assessed the hypothesis that occupational exposure is associated with significant changes in the likelihood of lupus flares. Lifetime employment history was analysed with the Finnish Job Exposure Matrix (FINJEM), 40 different semiquantified exposure class estimates for a wide number of occupations based on probability of exposure (p≥5%=exposed) were analysed with the construction of negative binomial regression models to test relationships between occupational agents and flare days. A backward stepwise elimination was used to generate a parsimonious model. Results: Significant associations were noted for exposure classes of manual handling burden, (p=0.02, incidence rate ratio (IRR) 1.01), Iron (p=0.00, IRR 1.37), wood dust (p=0.00, IRR 3.34) and asbestos (p=0.03, IRR 2.48). Conclusion: Exposure assessment results indicated that occupations, such as nursing, with a high manual handling burden, posed increased risk to patients with SLE, however, the greatest risk was associated with wood dust and iron exposure with teachers and specialist labourers

Non-invasive detection of microvascular changes in a paediatric and adolescent population with type 1 diabetes: a pilot cross-sectional study

Background: The detection of microvascular damage in type 1 diabetes is difficult and traditional investigations do not detect changes until they are well established. The purpose of this study was to investigate the combined ability of nailfold capillaroscopy, laser Doppler flowmetry, retinal vessel analysis and 24-hr ambulatory blood pressure monitoring to detect early microvascular changes in a paediatric and adolescent population with type 1 diabetes. Methods: Patients aged between 8–18 years with type I diabetes and no other autoimmune conditions were studied. The participants underwent the above cardiac and vascular investigations in a single three-hour session. Standard parameters including HbA1c were also investigated. Associations between all parameters were described by correlation analysis. Fisher’s exact and t-tests determined the association with clinical findings. Results: 26 participants were recruited. The mean HbA1c was 8.1% (SD ± 1.1) with a mean duration of type 1 diabetes of 7.9 years (SD ± 3.4). Three participants had microalbuminuria and one had early signs of retinopathy. Participants with microvascular complications had more avascular areas on nailfold capillaroscopy (p = 0.03). Recent HbA1c was positively associated with the number of nailfold microhaemorrhages (p = 0.03) Decreased baseline perfusion by laser Doppler flowmetry was associated with increased capillary density (p = 0.001) and an increased number of microaneurysms (p = 0.04) on nailfold capillaroscopy. Conclusions: This pilot study has shown that in children and adolescents with established type 1 diabetes, abnormal microvasculature can be detected by these investigations. These markers were also positively associated with evidence of suboptimal diabetes control as assessed by HbA1c. Further research will be necessary to determine the practical role of these investigations in the management and progress of the complications of type 1 diabetes

Checklist of the Bryophytes of Madagascar

International audienceThis updated checklist of the bryophytes of Madagascar was compiled from the literature, herbarium and recent collections. A total of 1144 species and infraspecific taxa are recorded for Madagascar composed of 751 mosses, 390 liverworts and 3 hornworts. 28.67% of the species reported for the Island are endemics. Twenty-four taxa are newly recorded for Madagascar and two of them, Fissidens cyathaeicola Brugg.Nann. and Taxithelium nepalense (Schwägr.) Broth. are reported for the first time for the Sub-Saharan Africa region