Patients achieving sustained deep remission, deep remission or sustained remission of rheumatoid arthritis are more likely than other responders to maintain remission or low disease activity after dose reduction or withdrawal of etanercept

Background Biologic disease-modifying antirheumatic drugs (bDMARDs) are important options for managing rheumatoid arthritis (RA). Once patients achieve disease control, clinicians may consider dose reduction or withdrawal of the bDMARD. Results from published studies indicate that some patients will maintain remission; however, others will flare. We analyzed data from three etanercept down-titration studies in patients with RA to determine what extent of remission provides the greatest predictability of maintaining remission following dose reduction or discontinuation. Methods Patients with moderate to severe RA from the PRESERVE, PRIZE, and Treat-to-Target (T2T) randomized controlled trials were included. We determined the proportion of patients achieving remission with etanercept at the last time point in the induction period, and sustained remission (last two time points), according to the Disease Activity Score 28-joints (DAS28), the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean criteria, and the clinical disease activity index (CDAI). We also calculated the proportion achieving DAS28 deep remission (DAS28 ≤ 1.98), sustained deep remission (last two time points), and low disease activity (LDA), and LDA according to the CDAI. Then, we evaluated whether they maintained remission or LDA following etanercept dose reduction or withdrawal. Results Patients achieving sustained and/or deep remission were more likely than patients achieving remission or LDA to maintain remission/LDA after etanercept dose reduction or withdrawal. In PRESERVE, the proportions of patients with DAS28 sustained deep remission, deep remission, sustained remission, remission, and LDA who maintained remission following etanercept dose reduction were 81%, 67%, 58%, 56%, and 36%, respectively, P < 0.001 for trend. In PRESERVE, this trend was significant when etanercept was discontinued and when ACR/EULAR Boolean and CDAI remission criteria were used. Although some sample sizes were small, the PRIZE and T2T studies also demonstrated response trends according to ACR/EULAR Boolean and CDAI remission criteria, and T2T demonstrated response trends according to DAS28. Conclusions These results suggest that patients achieving disease control according to a stringent definition, such as sustained ACR/EULAR Boolean or CDAI remission, or a new definition of sustained deep remission by DAS28, have a higher probability of remaining in remission or LDA following etanercept dose reduction or withdrawal

Clinical application of a rapid microbiological test based on capillary zone electrophoresis to assess local skin infection

<p>Abstract</p> <p>Background</p> <p>The basic clinical problem associated with infection treatment is the fact that classic, commonly and routinely used isolation and identification methods are based on long-term processes of a phenotypic analysis of microorganisms. Consequently sometimes, especially in small centres, rapid implementation of antibacterial treatment becomes delayed.</p> <p>The work presents the initial results of rapid microbiological identification based on an original method of capillary zone electrophoresis (CZE). The study involved the analysis of 78 biological samples from post-operative wounds and trophic ulcers.</p> <p>Results</p> <p>The attempt was made to identify individual bacterial species based on characteristic features of electropherograms achieved. Finally, G(+) cocci type bacteria and different G(-) rods were identified with sensitivity of 88.1% and specificity of 100%.</p> <p>Conclusions</p> <p>Based on the clinical trials using an electrophoretic technique in the field of microbiological diagnostics of infected exudate from a post-operative wound it can be concluded that it is a rapid and relatively sensitive method for initial identification of infectious pathogens.</p

Supramolecular recognition of estrogens via molecularly imprinted polymers

The isolation and preconcentration of estrogens from new types of biological samples (acellular and protein-free simulated body fluid) by molecularly imprinted solid-phase extraction has been described. In this technique, supramolecular receptors, namely molecularly imprinted polymers (MIPs) are used as a sorbent material. The recognition sites of MIPs were prepared by non-covalent multiple interactions and formed with the target 17β-estradiol as a template molecule. High-performance liquid chromatography with spectroscopic UV, selective, and a sensitive electrochemical CoulArray detector was used for the determination of 17β-estradiol, estrone, and estriol in simulated body fluid which mimicked human plasma

Single-Molecule Electrochemical Transistor Utilizing a Nickel-Pyridyl Spinterface

Using a scanning tunnelling microscope break-junction technique, we produce 4,4′-bipyridine (44BP) single-molecule junctions with Ni and Au contacts. Electrochemical control is used to prevent Ni oxidation and to modulate the conductance of the devices via nonredox gatingthe first time this has been shown using non-Au contacts. Remarkably the conductance and gain of the resulting Ni-44BP-Ni electrochemical transistors is significantly higher than analogous Au-based devices. Ab-initio calculations reveal that this behavior arises because charge transport is mediated by spin-polarized Ni <i>d</i>-electrons, which hybridize strongly with molecular orbitals to form a “spinterface”. Our results highlight the important role of the contact material for single-molecule devices and show that it can be varied to provide control of charge and spin transport

Factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended-release clinical trials

BACKGROUND: Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.METHODS: Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.RESULTS: Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.CONCLUSIONS: Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.<br/

Zarys koncepcji aerodynamicznej UAV w układzie konstrukcyjnym gyrodyny

The article presents an aerodynamic concept of UAV in the gyrodyne configuration, as a more efficient one than the currently used UAV airframe configuration applied for monitoring tasks of power lines and railway infrastructure. A sample task which is realised by conceptual gyrodyne based on monitoring aerial power lines was characterised and described . The assumed idea of UAV was shown in comparison to the currently used aircraft configuration presented in the introduction. Referring to momentum theory, hover efficiency of the multicopter and the helicopter was evaluated. In relation to the helicopter, an initial draft of the airframe conception accompanied by a description of advantages of the gyrodyne configuration was exposed. Problems related to the gyrodyne configuration were emphasised in the summary.Artykuł przedstawia zarys koncepcji aerodynamicznej UAV w układzie gyrodyny, jako układu konstrukcyjnego sprawniejszego energetycznie spośród obecnie stosowanych układów UAV w zastosowaniu do zadań monitorowania infrastruktury energetycznej i kolejowej. Scharakteryzowano i opisano przykładowe zadanie realizowane przez koncepcyjną gyrodynę polegające na monitoringu napowietrznej linii energetycznej. Prezentowaną koncepcję UAV przedstawiono w zestawieniu z opisanymi we wstępie aktualnie stosowanymi układami UAV oraz oceniono na podstawie teorii strumieniowej sprawność zawisu dla przykładowego UAV w układzie multikoptera i śmigłowca. Następnie pokazano szkic koncepcji wraz z opisem spodziewanych zalet układu gyrodyny w stosunku do układu śmigłowca z jednoczesnym podkreśleniem w podsumowaniu możliwych problemów wynikających z przyjętego układu

Optimization of the position of the local distribution centre of the regional post logistics network

The phenomenon of the present postal services is the fact that, customers expect the lowest price while maintaining the availability, security and on time delivery of mail items. We can find that, the costs associated with transport of the postal substrate is one of the most important factors affecting the total cost of the postal services. These transport costs depend on various factors such as the investment in vehicles purchase, operational costs of the postal vehicles (costs of maintenance, repairs, fuel costs of the vehicle, etc.) labour costs of the drivers and so on. For this reason, it is important to find such an operational - organizational solutions that can reduce the costs associated with the transportation of postal shipments, resulting in reducing the total cost of postal services. One option to do this is to minimize the length of postal transportation routes. This article presents the approach based on the application of graph theory to optimize existing connections of postal logistics network. Published results is oriented to revaluate existing position of local centre and find a location for the new local distribution centre potentially. New location of local distribution centre can to optimize (minimize) the total transport costs of the local postal transportation network in area of the Lublin Province