The Future of Rheumatoid Arthritis and Hand Surgery - Combining Evolutionary Pharmacology and Surgical Technique

Rheumatoid arthritis is a systemic autoimmune disease of uncertain aetiology, which is characterized primarily by synovial inflammation with secondary skeletal destructions

Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand

<p>Abstract</p> <p>Background</p> <p>Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand.</p> <p>Methods</p> <p>A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria.</p> <p>Results</p> <p>The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner.</p> <p>Conclusion</p> <p>We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.</p

Introduction: Human ecology in the Himalaya

Knowledge of human adaptation in the Himalayas has developed more slowly than that for other world mountain systems. At the same time, the opening of the region to research has focused attention toward description in a “natural history” mode until quite recently. Where these studies have addressed issues of adaptation they have tended to do so more as a heuristic tool rather than in terms of contributing to the development of adaptive perspectives from a uniquely Himalayan vantage point. The contributions to this special issue suggest some of Himalayan cultural ecology's new themes as it more directly assumes a truly processual approach that incorporates the individual and domestic dimensions of adaptation within historical and social contexts .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44482/1/10745_2004_Article_BF00889710.pd

Fibronectin is a stress responsive gene regulated by HSF1 in response to geldanamycin

Fibronectin is an extracellular matrix glycoprotein with key roles in cell adhesion and migration. Hsp90 binds directly to fibronectin and Hsp90 depletion regulates fibronectin matrix stability. Where inhibition of Hsp90 with a C-terminal inhibitor, novobiocin, reduced the fibronectin matrix, treatment with an N-terminal inhibitor, geldanamycin, increased fibronectin levels. Geldanamycin treatment induced a stress response and a strong dose and time dependent increase in fibronectin mRNA via activation of the fibronectin promoter. Three putative heat shock elements (HSEs) were identified in the fibronectin promoter. Loss of two of these HSEs reduced both basal and geldanamycin-induced promoter activity, as did inhibition of the stress-responsive transcription factor HSF1. Binding of HSF1 to one of the putative HSE was confirmed by ChIP under basal conditions, and occupancy shown to increase with geldanamycin treatment. These data support the hypothesis that fibronectin is stress-responsive and a functional HSF1 target gene. COLA42 and LAMB3 mRNA levels were also increased with geldanamycin indicating that regulation of extracellular matrix (ECM) genes by HSF1 may be a wider phenomenon. Taken together, these data have implications for our understanding of ECM dynamics in stress-related diseases in which HSF1 is activated, and where the clinical application of N-terminal Hsp90 inhibitors is intended

Strategy selection for sustainable manufacturing with integrated AHP-VIKOR method under interval-valued fuzzy environment

Selection of an appropriate sustainability strategy is a multi-criteria decision making (MCDM) problem for manufacturing organizations due to incommensurate and conflicting evaluation criteria. In addition, incomplete information and different opinions of decision makers lead to uncertainties such as interval data and fuzziness. This study proposes a hierarchal MCDM method by combining Analytical Hierarchal Process (AHP) and VlseKriterijuska Optimizacija I Komoromisno Resenje (VIKOR) methods under interval-valued fuzzy environment to deal with ranking of sustainable manufacturing strategies. Linguistic variables were used to assess the ratings of strategies and weights for selection criteria. These linguistic variables were expressed in the triangular interval-valued fuzzy sets. Using a case study of manufacturing small and medium enterprise, the final ranking of the strategies was elicited in accordance with this procedure. Subsequently, a sensitivity analysis was performed to validate the stability of the proposed final ranking. This method can be used as a decision making tool for alternative or strategy selection in other areas where uncertainties are inherent

Dynamic anaerobic membrane bioreactor DAnMBR) with phase separation for food processing wastewater treatment at mesophilic temperature: characterization of cake layer

The treatment of high-strength wastewater using an anaerobic digester coupled with a dynamic membrane has gained significant interest of late due to its small footprint and low cost of supporting material for the membrane. Dynamic membrane fundamentally performs similarly to the conventional membranes by the cake layer deposited onto the supporting material with eventual fouling stage. The filtration performance is proportionally related to the cake layer development. Thus, the objective of this study is to characterize the cake layer affecting the filtration performance. A two-phase anaerobic digester with submerged 20-µm woven filter cloth as the supporting membrane (DAnMBR) was used in this study to treat food-processing wastewater. The organic loading rate of 5.0 g COD/L.day was fed into the DAnMBR, and the cake layer samples were taken at 14 days intervals until fouling occurred. The performance of the wastewater treatment and characteristics of the cake layer and bulk sludge were analyzed. It took a total of 35 days for the dynamic membrane to foul with a final flux of 2.5 L/m2·h and transmembrane pressure of 0.7 bar. The protein ratio to polysaccharide (PN/PS) of the extracellular polymeric substances increased significantly compared to soluble microbial product PN/PS ratio; thus, it is the main contributor to the membrane fouling. The thickness of the cake layer increased slightly from day 14 to 28 but sharply at the fouled stage (day 35), agreeing with the treatment performance. The concentrations of COD, BOD5, ammoniacal nitrogen, oil and grease, total suspended solids, and turbidity followed closely the inverse proportional trend of cake layer development. The size of the foulants that made up the cake layer resulted in micropore size dynamic membrane emanating the treatment performance of the DAnMBR is comparable to the conventional microfiltration AnMBR

Dynamic anaerobic membrane bioreactor (DAnMBR) with phase separation for food processing wastewater treatment at mesophilic temperature: Characterization of cake layer

The treatment of high-strength wastewater using an anaerobic digester coupled with a dynamic membrane has gained significant interest of late due to its small footprint and low cost of supporting material for the membrane. Dynamic membrane fundamentally performs similarly to the conventional membranes by the cake layer deposited onto the supporting material with eventual fouling stage. The filtration performance is proportionally related to the cake layer development. Thus, the objective of this study is to characterize the cake layer affecting the filtration performance. A two-phase anaerobic digester with submerged 20-µm woven filter cloth as the supporting membrane (DAnMBR) was used in this study to treat food-processing wastewater. The organic loading rate of 5.0 g COD/L.day was fed into the DAnMBR, and the cake layer samples were taken at 14 days intervals until fouling occurred. The performance of the wastewater treatment and characteristics of the cake layer and bulk sludge were analyzed. It took a total of 35 days for the dynamic membrane to foul with a final flux of 2.5 L/m2·h and transmembrane pressure of 0.7 bar. The protein ratio to polysaccharide (PN/PS) of the extracellular polymeric substances increased significantly compared to soluble microbial product PN/PS ratio; thus, it is the main contributor to the membrane fouling. The thickness of the cake layer increased slightly from day 14 to 28 but sharply at the fouled stage (day 35), agreeing with the treatment performance. The concentrations of COD, BOD5, ammoniacal nitrogen, oil and grease, total suspended solids, and turbidity followed closely the inverse proportional trend of cake layer development. The size of the foulants that made up the cake layer resulted in micropore size dynamic membrane emanating the treatment performance of the DAnMBR is comparable to the conventional microfiltration AnMBR