Objective
In current management paradigms of rheumatoid arthritis (RA), patient global assessment (PGA) is crucial to decide whether a patient has attained remission (target) or needs reinforced ...therapy. We investigated whether the clinical and psychological determinants of PGA are appropriate to support this important role.
Methods
This was a cross‐sectional, single‐center study including consecutive ambulatory RA patients. Data collection comprised swollen 28‐joint count (SJC28), tender 28‐joint count (TJC28), C‐reactive protein (CRP) level, PGA, pain, fatigue, function, anxiety, depression, happiness, personality traits, and comorbidities. Remission was categorized using American College of Rheumatology/European League Against Rheumatism Boolean‐based criteria: remission, near‐remission (only PGA >1), and nonremission. A binary definition without PGA (3v‐remission) was also studied. Univariable and multivariable analyses were used to identify explanatory variables of PGA in each remission state.
Results
A total of 309 patients were included (remission 9.4%, near‐remission 37.2%, and nonremission 53.4%). Patients in near‐remission were indistinguishable from remission regarding disease activity, but described a disease impact similar to those in nonremission. In multivariable analyses, PGA in near‐remission was explained (R2adjusted = 0.50) by fatigue, pain, anxiety, and function. Fatigue and pain had no relationship with disease activity measures.
Conclusion
In RA, a consensually acceptable level of disease activity (SJC28, TJC28, and CRP level ≤1) does not equate to low disease impact: a large proportion of these patients are considered in nonremission solely due to PGA. PGA mainly reflects fatigue, pain, function, and psychological domains, which are inadequate to define the target for immunosuppressive therapy. This consideration suggests that clinical practice should be guided by 2 separate remission targets: inflammation (3v‐remission) and disease impact.
BACKGROUND There is evidence that intrauterine growth restriction, resulting in newborn girls that are small for gestational age (SGA), may be related to the onset of polycystic ovary syndrome ...(PCOS). Thus, we studied whether women born SGA have a higher prevalence of PCOS than women born appropriate for gestational age (AGA). METHODS This was a prospective birth cohort study of 384 women born at term between June 1, 1978, and May 31, 1979, in Ribeirão Preto, Brazil. After exclusion, 165 women effectively participated in this study, of whom 43 were SGA and 122 were AGA. The prevalence of PCOS was analysed. At a mean age of 29 years, the women agreed to follow the study protocol, which included: anamnesis, physical examination, serum tests follicle stimulating hormone, luteinizing hormone, total and free testosterone, dehydroepiandrostenedione sulphate, 17-OH-progesterone, fasting insulin, sex steroid-binding globulin (SHBG) and fasting glucose and pelvic ultrasound. Data regarding gestational age, birthweight, age at menarche and maternal data were obtained from the files of the cohort. The adjusted relative risk (RR) values of the SGA, insulin resistance, body mass index, maternal smoking and parity variables were analysed using Poisson regression with robust adjustment of variance for the prediction of PCOS. RESULTS The prevalence of PCOS was higher in the SGA group than in the AGA group adjusted RR = 2.44, 95% CI (1.39–4.28). Hyperandrogenism was more prevalent in the SGA women than in the AGA women (P = 0.011). Circulating SHBG was lower in the SGA women than in the AGA women (P = 0.041), but fasting insulinemia was similar in both groups. CONCLUSIONS The prevalence of PCOS in SGA women was twice as high as in AGA women in our study population.
In this work we report the preparation of fucan-coated magnetite (Fe3O4) nanoparticles by the co-precipitation method. These nanoparticles were characterized by scanning electron microscopy, ...transmission electron microscopy, X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, Mössbauer spectroscopy and magnetic measurements. The nanoparticles showed quasi-spherical morphology with mean sizes around 10nm. XRD and FT-IR confirmed the functionalization of the Fe3O4 nanoparticles with the fucan polysaccharide. Room temperature magnetization measurements and Mössbauer spectroscopy showed that the nanoparticles exhibited superparamagnetic behavior at 300K and the magnetic properties of the Fe3O4 are partly screened by the coating preventing aggregation.
•Syntheses of fucan-coated Fe3O4 nanoparticles were made by co-precipitation method.•The efficiency of polysaccharide coated was analyzed by XRD and FT-IR.•The magnetic nanoparticles mean size was 10–20nm.•The fucan-coated magnetite nanoparticles showed superparamagnetic behavior.
Sugarcane cultivation stands out in Brazilian agribusiness, covering more than eight million hectares for the production of sugar, ethanol, and by-products. Fertilization is one of the limiting ...factors in sugarcane yield, for which filter cake is a viable solution to meet plant nutritional needs. This study aimed to assess the effect of enriched filter cake on gas exchange and yield in RB041443 sugarcane, cultivated in soils of the coastal tablelands of Paraíba, Brazil. The experiment was conducted in the Monte Alegre S/A sugarcane mill, in the municipality of Mamanguape, using a randomized blocks experimental design, with 12 treatments (T1- cake, T2- cake + MAP, T3- cake + gypsum, T4 - cake + phosphate, T5- cake + bagasse, T6- cake + MAP + gypsum, T7- cake + MAP + phosphate, T8- cake + MAP + bagasse, T9- cake + gypsum + phosphate, T10- cake + gypsum + bagasse, T11- cake + phosphate + bagasse, and T12- control (only MAP)), and 4 replications, totaling 48 plots. A significant effect (5% probability) was also observed for the variables number of leaves and tons of stem per hectare (TSH). T1- cake, T4- cake + phosphate, T6- cake + MAP + gypsum and T10- cake + gypsum + bagasse, had the best results for TSH, with yields greater than 140 t ha-1. Regarding stomatal conductance, the highest values were obtained in T6 and T8, which, together with T11, had the highest gs values. Concerning the internal carbon concentration, T1, T2, T6, and T8 stood out. T6 also had a significant effect on transpiration. From this study, it was concluded that the use of enriched filter cake as a base fertilizer in sugarcane culture contributes to increasing the yield of the RB041443 variety, generating positive responses for plant gas exchange, being T1 and T10 indicated to increase the production in the sugar-energy sector.
The microscopic environment inside a metazoan organism is highly crowded. Whether individual cells can tailor their behavior to the limited space remains unclear. In this study, we found that cells ...measure the degree of spatial confinement by using their largest and stiffest organelle, the nucleus. Cell confinement below a resting nucleus size deforms the nucleus, which expands and stretches its envelope. This activates signaling to the actomyosin cortex via nuclear envelope stretch-sensitive proteins, up-regulating cell contractility. We established that the tailored contractile response constitutes a nuclear ruler-based signaling pathway involved in migratory cell behaviors. Cells rely on the nuclear ruler to modulate the motive force that enables their passage through restrictive pores in complex three-dimensional environments, a process relevant to cancer cell invasion, immune responses, and embryonic development.
The objective of this work was to evaluate the effectiveness of antimicrobial edible coatings to wrap cheeses, throughout 60d of storage, as an alternative to commercial nonedible coatings. Coatings ...were prepared using whey protein isolate, glycerol, guar gum, sunflower oil, and Tween 20 as a base matrix, together with several combinations of antimicrobial compounds—natamycin and lactic acid, natamycin and chitooligosaccharides (COS), and natamycin, lactic acid, and COS. Application of coating on cheese decreased water loss (~10%, wt/wt), hardness, and color change; however, salt and fat contents were not significantly affected. Moreover, the antimicrobial edible coatings did not permit growth of pathogenic or contaminant microorganisms, while allowing regular growth of lactic acid bacteria throughout storage. Commercial nonedible coatings inhibited only yeasts and molds. The antimicrobial edible coating containing natamycin and lactic acid was the best in sensory terms. Because these antimicrobial coatings are manufactured from food-grade materials, they can be consumed as an integral part of cheese, which represents a competitive advantage over nonedible coatings.
Abstract
Investigations of the origin and evolution of the Milky Way disc have long relied on chemical and kinematic identifications of its components to reconstruct our Galactic past. Difficulties ...in determining precise stellar ages have restricted most studies to small samples, normally confined to the solar neighbourhood. Here, we break this impasse with the help of asteroseismic inference and perform a chronology of the evolution of the disc throughout the age of the Galaxy. We chemically dissect the Milky Way disc population using a sample of red giant stars spanning out to 2 kpc in the solar annulus observed by the Kepler satellite, with the added dimension of asteroseismic ages. Our results reveal a clear difference in age between the low- and high-α populations, which also show distinct velocity dispersions in the V and W components. We find no tight correlation between age and metallicity nor α/Fe for the high-α disc stars. Our results indicate that this component formed over a period of more than 2 Gyr with a wide range of M/H and α/Fe independent of time. Our findings show that the kinematic properties of young α-rich stars are consistent with the rest of the high-α population and different from the low-α stars of similar age, rendering support to their origin being old stars that went through a mass transfer or stellar merger event, making them appear younger, instead of migration of truly young stars formed close to the Galactic bar.
Recent advances have improved our understanding of the renin‐angiotensin system (RAS). These have included the recognition that angiotensin (Ang)‐(1‐7) is a biologically active product of the RAS ...cascade. The identification of the ACE homologue ACE2, which forms Ang‐(1‐7) from Ang II, and the GPCR Mas as an Ang‐(1‐7) receptor have provided the necessary biochemical and molecular background and tools to study the biological significance of Ang‐(1‐7). Most available evidence supports a counter‐regulatory role for Ang‐(1‐7) by opposing many actions of Ang II on AT1 receptors, especially vasoconstriction and proliferation. Many studies have now shown that Ang‐(1‐7) by acting via Mas receptor exerts inhibitory effects on inflammation and on vascular and cellular growth mechanisms. Ang‐(1‐7) has also been shown to reduce key signalling pathways and molecules thought to be relevant for fibrogenesis. Here, we review recent findings related to the function of the ACE2/Ang‐(1‐7)/Mas axis and focus on the role of this axis in modifying processes associated with acute and chronic inflammation, including leukocyte influx, fibrogenesis and proliferation of certain cell types. More attention will be given to the involvement of the ACE2/Ang‐(1‐7)/Mas axis in the context of renal disease because of the known relevance of the RAS for the function of this organ and for the regulation of kidney inflammation and fibrosis. Taken together, this knowledge may help in paving the way for the development of novel treatments for chronic inflammatory and renal diseases.
Biomass burning in the Brazilian Amazon is modulated by climate factors, such as droughts, and by human factors, such as deforestation, and land management activities. The increase in forest fires ...during drought years has led to the hypothesis that fire activity decoupled from deforestation during the twenty-first century. However, assessment of the hypothesis relied on an incorrect active fire dataset, which led to an underestimation of the decreasing trend in fire activity and to an inflated rank for year 2015 in terms of active fire counts. The recent correction of that database warrants a reassessment of the relationships between deforestation and fire. Contrasting with earlier findings, we show that the exacerbating effect of drought on fire season severity did not increase from 2003 to 2015 and that the record-breaking dry conditions of 2015 had the least impact on fire season of all twenty-first century severe droughts. Overall, our results for the same period used in the study that originated the fire-deforestation decoupling hypothesis (2003-2015) show that decoupling was clearly weaker than initially proposed. Extension of the study period up to 2019, and novel analysis of trends in fire types and fire intensity strengthened this conclusion. Therefore, the role of deforestation as a driver of fire activity in the region should not be underestimated and must be taken into account when implementing measures to protect the Amazon forest.
Background: Although the survival rate has considerably improved, many patients with systemic lupus erythematosus (SLE) develop irreversible organ damage. Objectives: The objectives of this paper are ...to characterize cumulative damage in SLE patients and identify variables associated with its presence and severity. Methods: A cross-sectional analysis of SLE patients from the Portuguese Lupus register Reuma.pt/SLE in whom damage assessment using the SLICC/ACR-Disability Index (SDI) was available was performed. Predictor factors for damage, defined as SDI ≥ 1, were determined by logistic regression analyses. A sub-analysis of patients with severe damage (SDI ≥ 3) was also performed. Results: In total, 976 patients were included. SDI was ≥1 in 365 patients, of whom 89 had severe damage. Musculoskeletal (24.4%), neuropsychiatric (24.1%) and ocular (17.2%) domains were the most commonly affected. Older age, longer disease duration, renal involvement, presence of antiphospholipid antibodies and current therapy with steroids were independently associated with SDI ≥ 1. The subpopulation with severe damage had, in addition, a greater interval between the first manifestation attributable to SLE and the clinical diagnosis as well as and more frequently early retirement due to SLE. Conclusions: This large lupus cohort confirmed that demographic and clinical characteristics as well as medication are independently associated with damage. Additionally, premature retirement occurs more often in patients with SDI ≥ 3. Diagnosis delay might contribute to damage accrual.
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