Summary
Background
Conflicting results have been recently reported for the accuracy of the Endoscopic Reference Score (EREFS), an standardised endoscopic classification, to predict the histological ...activity of eosinophilic oesophagitis (EoE).
Aim
To evaluate the accuracy of the EREFS to predict either histological or clinical activity of EoE.
Methods
Prospective multicentre study conducted in eight Spanish centres evaluating adult EoE patients, either naïve or after treatment. Symptoms were evaluated before upper endoscopy through the Dysphagia Symptom Score, whereas researchers scored the EREFS immediately after the endoscopic procedure, unaware of the histological outcome.
Results
One hundred and forty‐five EoE patients undergoing 240 consecutive endoscopic procedures were included. Exudates (P = 0.03), furrows (P = 0.03) and a composite score of inflammatory signs (exudates, furrows and oedema) (P < 0.001) accurately predicted histological activity. Exudates were the only endoscopic sign showing a good correlation with histological outcome after therapy. Furrows and oedema persisted in 50% and 70% of patients despite histological remission. No endoscopic feature exceeded 70% accuracy to predict histological activity. Likewise, no endoscopic finding could adequately predict dysphagia severity. Crepe paper mucosa, diffuse exudates and severe rings correlated with higher symptom scores.
Conclusions
Endoscopic findings assessed by the Endoscopic Reference Score did not correlate with histological or clinical disease activity in adult EoE patients. Only exudates correlated with peak eosinophil count and histological outcome, whereas furrows and oedema persisted in over half of patients despite histological remission.
Summary
Tuberculosis (TB), a chronic disease caused by infection with the Mycobacterium tuberculosis complex, is endemic in wild boar (Sus scrofa) and red deer (Cervus elaphus) in south‐central ...Spain. Understanding the temporal dynamics of this chronic infection requires long time series data collection over large areas. The aim of this paper was to identify the determinants of TB prevalence and severity in both species in Ciudad Real province, Spain, from 2000 to 2012. Study variables included management, population dynamics, and a range of geographical and climatological factors. The prevalence of TB in wild boar increased from 50% to 63% since the study commenced. This may be due to an increased hunting bag (a proxy for population abundance), which was correlated with TB infection rates. Low rainfall (a stochastic factor) was associated with higher individual risk of TB presence and progression, resulting in an increased proportion of severe cases of wild boar TB in dry years. This was probably a result of increased food restriction leading to a higher susceptibility to TB. In contrast, red deer TB showed an apparent stable trend, which may be a consequence of the species’ higher and stable population size. Hunting management, characterized by fencing, was associated with a higher risk of TB in both wild boar and red deer, suggesting that intensive hunting management may have contributed to exacerbated TB figures. This difference was more marked in red deer than in wild boar, probably because fencing imposes less restriction on movement, population mixing and TB spread to wild boar than to deer. Our findings on TB dynamics are fundamental for assessing the impact of future disease‐control actions (e.g. field vaccination). Moreover, such control plans must operate in the long term and cover large areas.
We use nine years of γ-ray data provided by the Fermi Large Area Telescope (LAT) to systematically study the light curves (LCs) of more than 2000 active galactic nuclei (AGN) included in recent ...Fermi-LAT catalogs. Ten different techniques are used, which are organized in an automatic periodicity-search pipeline, in order to search for evidence of periodic emission in γ rays. Understanding the processes behind this puzzling phenomenon will provide a better view about the astrophysical nature of these extragalactic sources. However, the observation of temporal patterns in γ-ray LCs of AGN is still challenging. Despite the fact that there have been efforts to characterize the temporal emission of some individual sources, a systematic search for periodicities by means of a full likelihood analysis applied to large samples of sources was missing. Our analysis finds 11 AGN, of which 9 are identified for the first time, showing periodicity at more than 4 in at least four algorithms. These findings will help in solving questions related to the astrophysical origin of this periodic behavior.
Saccharomyces cerevisiae is an important unicellular yeast species within the biotechnological and the food and beverage industries. A significant application of this species is the production of ...ethanol, where concentrations are limited by cellular toxicity, often at the level of the cell membrane. Here, we characterize 61 S. cerevisiae strains for ethanol tolerance and further analyze five representatives with various ethanol tolerances. The most tolerant strain, AJ4, was dominant in coculture at 0 and 10% ethanol. Unexpectedly, although it does not have the highest noninhibitory concentration or MIC, MY29 was the dominant strain in coculture at 6% ethanol, which may be linked to differences in its basal lipidome. Although relatively few lipidomic differences were observed between strains, a significantly higher phosphatidylethanolamine concentration was observed in the least tolerant strain, MY26, at 0 and 6% ethanol compared to the other strains that became more similar at 10%, indicating potential involvement of this lipid with ethanol sensitivity. Our findings reveal that AJ4 is best able to adapt its membrane to become more fluid in the presence of ethanol and that lipid extracts from AJ4 also form the most permeable membranes. Furthermore, MY26 is least able to modulate fluidity in response to ethanol, and membranes formed from extracted lipids are least leaky at physiological ethanol concentrations. Overall, these results reveal a potential mechanism of ethanol tolerance and suggest a limited set of membrane compositions that diverse yeast species use to achieve this.
Many microbial processes are not implemented at the industrial level because the product yield is poorer and more expensive than can be achieved by chemical synthesis. It is well established that microbes show stress responses during bioprocessing, and one reason for poor product output from cell factories is production conditions that are ultimately toxic to the cells. During fermentative processes, yeast cells encounter culture media with a high sugar content, which is later transformed into high ethanol concentrations. Thus, ethanol toxicity is one of the major stresses in traditional and more recent biotechnological processes. We have performed a multilayer phenotypic and lipidomic characterization of a large number of industrial and environmental strains of
to identify key resistant and nonresistant isolates for future applications.
Alveolar recruitment manoeuvres (ARM) performed during general anaesthesia improve oxygenation; however cardiovascular depression may be observed. The aim of the study was to compare the effects of ...sustained inflation (SI) and stepwise ARMs on cardiac output (CO), mean arterial blood pressure and arterial oxygen tension (PaO2) in ten mechanically ventilated goats anaesthetised with isoflurane.
In the SI ARM, peak inspiratory presure (PIP) was increased to 30 cmH2O and sustained for 20 s. In the stepwise ARM, the PIP was increased by 5 cmH2O each minute for three minutes from 10 to 25 cmH2O. Both ARMs were followed by positive end-expiratory pressure of 5 cmH2O. Paired lithium dilution CO measurements and arterial blood samples were obtained before and after each ARM. The order of the ARM was randomised and each goat was subjected to both techniques. Data was reported as median and interquartile range (IQR). Significance was set at 0.05.
The median change in CO (measured by subtracting values after and before ARM) was −0.15 L min−1 (IQR -0.51; 0.03) and − 0.90 L min−1 (IQR -1.69; −0.58) for SI and stepwise ARM respectively (p = 0.04). The median change in PaO2 was 3 kPa (IQR -2.7; 7.6) and 0.4 kPa (IQR -3.4; 5.5) for SI and stepwise ARM respectively (p = 0.03).
In conclusion, SI ARM causes less impact on CO and provides a better improvement in PaO2 compared to stepwise ARM in goats.
•Sustained inflation and stepwise ARMs improve oxygenation but cause haemodynamic instability.•No previous reports compare these alveolar recruitment manoeuvres in healthy lungs.•Sustained inflation had less impact on cardiac output in goats.•Sustained inflation also caused greater increase in arterial oxygen tension in normoxaemic goats, however without clinical significance.
Background
Little has been published on the real‐world effectiveness and safety of apremilast in psoriasis.
Objectives
To evaluate the effectiveness, safety and drug survival of apremilast at ...52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice.
Methods
Retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis or palmoplantar psoriasis treated with apremilast from March 2016 to March 2018.
Results
We studied 292 patients with plaque psoriasis and 85 patients with palmoplantar psoriasis. The mean (SD) Psoriasis Area and Severity Index (PASI) score was 10.7 (7.0) at baseline and 3.0 (4.2) at 52 weeks. After 12 months of treatment, 73.6% of patients had a PASI score of 3 or less. In terms of relative improvement by week 52, 49.7% of patients achieved PASI‐75 (≥75% reduction in PASI score) and 26.5% achieved PASI‐90. The mean physician global assessment score for palmoplantar psoriasis fell from 4.2 (5.2) at baseline to 1.3 (1.3) at week 52. Overall drug survival after 1 year of treatment with apremilast was 54.9 %. The main reasons for treatment discontinuation were loss of efficacy (23.9%) and adverse events (15.9%). Almost half of the patients in our series (47%) experienced at least one adverse event. The most common events were gastrointestinal problems.
Conclusions
Apremilast may be a suitable alternative for the treatment of moderate to severe psoriasis and palmoplantar psoriasis. Although the drug has a good safety profile, adverse gastrointestinal effects are common.
Today, communication is a key factor of destination competitiveness. The aim of the present study is to examine the effect of message consistency between different online communication tools on the ...formation of consumer-based destination brand equity (CBDBE), within two distinct brand positioning strategies (single-destination brand vs. multiple-destination brands). An experimental design is applied to manipulate message consistency (high vs. low) and the type of brand positioning strategy implemented by the destination (single vs. multiple brands). The results demonstrate that when the messages received by the tourist are highly consistent across different channels, branding strategy type exerts no differential effect on CBDBE. By contrast, when the messages present low consistency, a single destination branding strategy generates higher CBDBE than a multiple destination branding strategy. The study makes an original contribution to the literature, showing the interaction between destination branding strategy type and degree of consistency in the messages received by the tourist.
PDF
