Beliefs and preferences regarding biological treatments for severe asthma

Background: Severe asthma is a serious condition with a significant burden on patients' morbidity, mortality, and quality of life. Some biological therapies targeting the IgE and interleukin-5 (IL5) mediated pathways are now available. Due to the lack of direct comparison studies, the choice of which medication to use varies. We aimed to explore the beliefs and practices in the use of biological therapies in severe asthma, hypothesizing that differences will occur depending on the prescribers’ specialty and experience. Methods: We conducted an online survey composed of 35 questions in English. The survey was circulated via the INterasma Scientific Network (INESNET) platform as well as through social media. Responses from allergists and pulmonologists, both those with experience of prescribing omalizumab with (OMA/IL5) and without (OMA) experience with anti-IL5 drugs, were compared. Results: Two hundred eighty-five (285) valid questionnaires from 37 countries were analyzed. Seventy-on percent (71%) of respondents prescribed biologics instead of oral glucocorticoids and believed that their side effects are inferior to those of Prednisone 5 mg daily. Agreement with ATS/ERS guidelines for identifying severe asthma patients was less than 50%. Specifically, significant differences were found comparing responses between allergists and pulmonologists (Chi-square test, p < 0.05) and between OMA/IL5 and OMA groups (p < 0.05). Conclusions: Uncertainties and inconsistencies regarding the use of biological medications have been shown. The accuracy of prescribers to correctly identify asthma severity, according to guidelines criteria, is quite poor. Although a substantial majority of prescribers believe that biological drugs are safer than low dose long-term treatment with oral steroids, and that they must be used instead of oral steroids, every effort should be made to further increase awareness. Efficacy as disease modifiers, biomarkers for selecting responsive patients, timing for outcomes evaluation, and checks need to be addressed by further research. Practices and beliefs regarding the use of asthma biologics differ between the prescriber's specialty and experience; however, the latter seems more significant in determining beliefs and behavior. Tailored educational measures are needed to ensure research results are better integrated in daily practice

Leveraging knowledge as a competitive asset? The intensity, performance and structure of universities’ entrepreneurial knowledge exchange activities at a regional level

© 2016, The Author(s). Universities are no longer considered to be isolated islands of knowledge, but as institutions increasingly engaged with a range of external partners through entrepreneurial activities. This paper examines the associations between the intensity and performance of knowledge exchange activities undertaken in UK universities with non-academic actors. Drawing on data concerning the structural factors of interactions of universities in the UK with external partners, the paper sheds further light on the nature of these activities through a prism of competitive and uncompetitive regions in order to better understand how universities may be able to leverage both their knowledge and partnerships more effectively as competitive assets. On the one hand, it is found that academics in uncompetitive regions are more intensively engaged in entrepreneurial activities but generate less income from them than their counterparts in competitive regions, suggesting that there are differences in the income-generating capacity of academics across regions. On the other hand, academic knowledge is found to be more strongly bounded within a certain distance in uncompetitive regions whilst geographical distance seems less of a hindrance to academics in competitive regions

Content of heavy metals, uranium, radium and radon in drinking water from underground water sources in proximity to old mines

Regional Inspectorate of Protection and Control of Public Health - Haskovo In the Haskovo Province polymetal deposit fields have operated for many years. Some of them are the lead-zinc deposits near the villages of Sarnitza, Boyan Botevo, and Spahievo. Besides these, uranium deposits were mined in the past: The Fountain Plot is part of the Haskovo uranium-ore deposit and is situated 6 km to the west of the Bolyarovo district. Taking into consideration that in the past, a number of mines operated on the territory of the city of Haskovo and the Mineral bath Municipality, and also the absence of research into possible contamination of subterranean waters from them, we set a goal to investigate whether there is a Pb, Cd, As, Cu, Zn, U-234, U-235, U-238, Ra-226 and Rn-222 contamination of drinking water from the central water sources located in close proximity to the old mines in the Haskovo and Mineral bath Municipalities. In the month of November 2007 we collected 6 water samples from the above-mentioned water sources to investigate presence of Pb, Cd, Zn, Cu and As and to determining of the radiological indicators and taking and test of drinking water from 9 pumping stations for establishing the level of Rn-222. Content of heavy metals in drinking water from the studied pumping stations are: Pb: of 0 to < 0.004 mg/dm3, Cd: of 0 to < 0.004 mg/dm3, Zn: of <0.013 to 0.402 ±0.005 mg/dm3, Cu: of 0 to <0.018 mg/dm3, As: of 0.00095 ±0.00002 mg/dm3 to 0.0130 ±0.0002 mg/dm3. Content of uranium, radium-226 and total β-activity in drinking water from studied 6 pumping station are: U-238: of 0.0025±20% to <0.0250 mg/l, Ra-226: of 0.0481±25%Bq/l to 0.1315±25%Bq/l and Rn-222 in 9 central water source in the Haskovo town and Mineral bath Municipality are: of 3.5±0.6Bq/l to 185.5 ±10.4Bq/l. The total β -activity vary of 0.11 ±10%Bq/l to 1.12 ±10%Bq/l .ConclusionThe content of heavy metals in the studied water sources is within the per missible hygiene standard levels.The studied drinking water is not hazardous to the health of the consumers. The radiation analysis shows that the overall indicative dose is below 0.10mSv/year), which corresponds to the ordinance documents.The established levels of radon in the studied drinking water are probably due to contamination from the exploited uranium fields in the past.Scripta Scientifica Medica 2009; 41(1): 75-80

Neuroendocrine Tumour Arising in a Retrorectal Dermoid Cyst

Retrorectal dermoid cysts are rare congenital lesions but those with malignant degeneration are extremely unusual. The purpose of the poster is to allow doctors to share information about the investigation and treatment of this uncommon and difficult for surgery condition and to stress the attention on the probability of malignancy in retrorectal cysts in adults. To establish the diagnosis and to prevent complication, a total radical resection is recommended. Here, we are reporting, for the first time, the clinicopathological features and treatment of a neuroendocine cell tumour that arose in a retrorectal dermoid cyst.Case Report: A 45-year-old woman was hospitalized at our surgical department with confirmed retrorectal presacral multilocular cystic mass by CT and MRI. She complained of rectal pain and fullness, change in stool calibre and urinary frequency. There was not a history of rectal bleeding.CT and MRI scans of the abdomen and pelvic region revealed a cystic multilocular mass, with a size of 125/83mm in the rectrorectal presacral space, pressing but not invading the rectal walls. There were no signs of any secondary lesions in the lungs and the liver. Rectal US was not preformed. The patient underwent a laparotomy. Total cyst excision was performed with adnexectomy and hysterectomy. Because of great technical difficulties during the extirpation of the tumor, an iatrogenic lesion of the rectal wall was done. It was sutured with interrupted absorbable stitches. The operation was accomplished with a virtual colostomy. The pathological conclusion of the specimen was a dermoid cyst, sized 150mm/90mm, lined by stratified squamous epithelium with dermal appendages, chronically inflamed fibrous tissue and a solid component, where neuroendocrine neoplasm NET-G2 was identified. The immunohistochemical tests revealed a diffuse positive immunoexpression to Chromogranin, Synaptophysin, Vimentin, EMA, focal positive expression to HMW/CK and negative reaction to S100, GFAP, Desmin; proliferating index Ki67 - 13.1%.The patient had an uneventful hospital course and the virtual colostomy was not used. The woman was discharged 10 days later, on May 18, 2016. The oncological committee did not recommend neither radiotherapy nor chemotherapy. The follow-up visits will reveal if there are any recurrences in the future

As in Saccharomyces cerevisiae, aspartate transcarbamoylase is assembled on a multifunctional protein including a dihydroorotase-like cryptic domain in Schizosaccharomyces pombe.

The organisation of the URA1 gene of Schizosaccharomyces pombe was determined from the entire cDNA cloned by the transformation of an ATCase-deficient strain of Saccharomyces cerevisiae. The URA1 gene encodes the bifunctional protein GLNase/CPSase-ATCase which catalyses the first two steps of the pyrimidine biosynthesis pathway. The complete nucleotide sequence of the URA1 cDNA was elucidated and the deduced amino-acid sequence was used to define four domains in the protein; three functional domains, corresponding to GLNase (glutamine amidotransferase), CPSase (carbamoylphosphate synthetase) and ATCase (aspartate transcarbamoylase) activities, and one cryptic DHOase (dihydroorotase) domain. Genetic investigations confirmed that both GLNase/CPSase and ATCase activities are carried out by the same polypeptide. They are also both feedback-inhibited by UTP (uridine triphosphate). Its organization and regulation indicate that the S. pombe URA1 gene product appears very similar to the S. cerevisiae URA2 gene product.journal articleresearch support, non-u.s. gov't1995 Julimporte