Microvascular function is impaired in ankylosing spondylitis and improves after tumour necrosis factor a blockade

Objectives: Ankylosing spondylitis (AS) is associated with increased cardiovascular morbidity and mortality. Microvascular function has been linked to several risk factors for cardiovascular disease. Inflammation in AS may cause microvascular dysfunction. To test this, we assessed microvascular function in (a) patients with AS compared to healthy controls and (b) patients with AS before and after 1 month of anti-tumour necrosis factor (TNF)alpha treatment with etanercept. Methods: A total of 15 consecutive patients with AS, who were scheduled for etanercept treatment according to the Assessment in Ankylosing Spondylitis (ASAS) group guidelines, and 12 healthy controls matched for age and sex, were recruited. Endothelium-dependent and independent vasodilatation in skin were evaluated with laser Doppler fluxmetry after iontophoresis of acetylcholine and sodium nitroprusside, respectively. Videomicroscopy was used to measure recruitment of skin capillaries after arterial occlusion. Results: Compared to healthy controls, patients with AS had impaired endothelium-dependent vasodilatation and capillary recruitment. Following anti-TNF alpha treatment, microvascular function improved significantly for endothelium-dependent vasodilatation (p = 0.03) and capillary recruitment (p = 0.006). A significant correlation was observed between changes in endothelium-dependent vasodilatation and changes in erythrocyte sedimentation rate (ESR) (r = -0.56; p = 0.03). Conclusion: Microvascular dysfunction is present in patients with AS with active disease, but improves as inflammation regresses after TNF alpha blockad

A muon-track reconstruction exploiting stochastic losses for large-scale Cherenkov detectors

IceCube is a cubic-kilometer Cherenkov telescope operating at the South Pole. The main goal of IceCube is the detection of astrophysical neutrinos and the identification of their sources. High-energy muon neutrinos are observed via the secondary muons produced in charge current interactions with nuclei in the ice. Currently, the best performing muon track directional reconstruction is based on a maximum likelihood method using the arrival time distribution of Cherenkov photons registered by the experiment\u27s photomultipliers. A known systematic shortcoming of the prevailing method is to assume a continuous energy loss along the muon track. However at energies >1 TeV the light yield from muons is dominated by stochastic showers. This paper discusses a generalized ansatz where the expected arrival time distribution is parametrized by a stochastic muon energy loss pattern. This more realistic parametrization of the loss profile leads to an improvement of the muon angular resolution of up to 20% for through-going tracks and up to a factor 2 for starting tracks over existing algorithms. Additionally, the procedure to estimate the directional reconstruction uncertainty has been improved to be more robust against numerical errors

Rest and activity enrichment use by slower-growing broilers : a pilot study

In the Netherlands, the production of broiler chickens experienced a significant change between 2014 and 2016 due to alternative production concepts being introduced, i.e. the slower-growing concept. Currently, around 35-40% of broiler chickens is produced in the Netherlands according to this slower-growing concept. However, because the slower growing breeds have only recently been introduced, we lack knowledge with regard to the environmental enrichments that are needed to meet their behavioural needs. This pilot study was performed within the PPP Slower growing broiler chickens (SloGro/SloBro) and aimed to identify the preference of slower-growing broilers for different types of rest (round metal perch, mushroom plastic perch, flat-shape plastic perch, round wooden perch and platform) and activity enrichment (firmly pressed straw bale (control, current standard), loosely pressed straw bale and lucerne bale). The number of birds sitting on the platforms was 8 times higher as compared to the perch types combined. When looking at the number of birds sitting under the different types of rest enrichments, birds seemed to have a slight preference to sit under the round metal perch, while the round wooden perch was least preferred. The number of birds sitting on the loosely pressed straw bales was higher compared to the number of birds on the firmly pressed straw and lucerne bales. This might be related to less birds sitting around the loosely pressed straw bales and therefore less disturbance compared to the firmly pressed straw and lucerne bales. To conclude, slower-growing broilers preferred platforms over perches. With regard to activity enrichments, slower-growing broilers seemed to prefer to sit on loosely pressed straw bales, while they seemed to prefer to sit around firmly pressed straw and lucerne bales

Erythrocyte Sedimentation Rate, C-Reactive Protein Level, and Serum Amyloid A Protein for Patient Selection and Monitoring of Anti-Tumor Necrosis Factor Treatment in Ankylosing Spondylitis

Objective. To study the usefulness of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum amyloid A (SAA) for response prediction and monitoring of anti-tumor necrosis factor (anti-TNF) treatment in ankylosing spondylitis (AS) patients. Methods. Patients were included consecutively before starting etanercept or infliximab treatment. ASsessment in Ankylosing Spondylitis (ASAS) response, defined as a 50% improvement or an absolute improvement of 2 points of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 0-10 scale), was assessed at 3 months. Inflammatory markers and the BASDAI were collected at baseline and 1 and 3 months. Longitudinal data analysis was performed to compare associations between inflammatory markers and the BASDAI over time by calculating standardized betas. Predictive values of baseline levels of inflammatory markers for ASAS response were calculated. Results. In total, 155 patients were included, of whom, after 3 months of treatment, 70% in the etanercept cohort and 71% in the infliximab cohort responded. All markers, notably SAA, decreased significantly (P <0.0001). Standardized betas were 0.49 for ESR, 0.43 for CRP, and 0.39 for SAA. Normal baseline levels of CRP and SAA were significantly associated with nonresponse. A combination of elevated CRP and SAA levels at baseline revealed the highest predictive value (81%) for ASAS response. Conclusion. ESR, CRP, and SAA were significantly associated with the BASDAI over 3 months, and the association with ESR was the strongest. Elevated baseline CRP and SAA levels revealed the highest predictive value for response. Together, this study demonstrates that inflammatory markers, and notably CRP and SAA, may facilitate patient selection and monitoring of efficacy of anti-TNF treatment in AS, and could he added to response criteri