Role of ultrasonography in diagnosing early rheumatoid arthritis and remission of rheumatoid arthritis - a systematic review of the literature

Introduction

Ultrasonography (US) might have an added value to clinical examination in diagnosing early rheumatoid arthritis (RA) and assessing remission of RA. We aimed to clarify the added value of US in RA in these situations performing a systematic review.

Methods

A systematic literature search was performed for RA, US, diagnosis and remission. Methodological quality was assessed; the wide variability in the design of studies prohibited pooling of results.

Results

Six papers on the added value of US diagnosing early RA were found, in which at least bilateral metacarpophalangeal (MCP), wrists and metatarsophalangeal (MTP) joints were scanned. Compared to clinical examination, US was superior with regard to detecting synovitis and predicting progression to persistent arthritis or RA. Eleven papers on assessing remission were identified, in which at least the wrist and the MCP joints of the dominant hand were scanned. Often US detected inflammation in patients clinically in remission, irrespective of the remission criteria used. Power Doppler signs of synovitis predicted X-ray progression and future flare in patients clinically in remission.

Conclusions

US appears to have added value to clinical examination for diagnosing of RA when scanning at least MCP, wrist and MTP joints, and, when evaluating remission of RA, scanning at least wrist and MCP joints of the dominant hand. For both purposes primarily power Doppler US might be used since its results are less equivocal than those of greyscale US.     

The Synthesis,Fluorescence and Antiviral Studies of 3′-Amino-2′,3′-Dideoxythymidine/substituted 10-Cyano-9-isothiocyanatoanthracene Adducts

Abstract

Adducts of 3′-amino-2′,3′-dideoxythymidine and various methoxy-substituted 10-cyano-9-isothiocyanatoanthracenes were prepared for use as fluorescent-tagged molecular probes. The thymidine/anthracene adducts were subjected to antiviral assays to determine if the adducts possessed antiviral activity.     

1H-Nuclear magnetic resonance pattern recognition studies with N-phenylanthranilic acid in the rat: time- and dose-related metabolic effects

N-Phenylanthranilic acid (NPAA) causes renal papillary necrosis (RPN) in the rat following repeated oral dosing. Non-invasive early detection of RPN is difficult, but a number of potential biomarkers have been investigated, including phospholipid and uronic acid excretion. This study used ¹H-nuclear magnetic resonance (NMR) spectroscopic analysis of urine to investigate urinary metabolic perturbations occurring in the rat following exposure to NPAA. Male Alderley Park rats received NPAA (300, 500 or 700?mg?kg^?1?day^?1 orally) for 7?days, and urine was collected on days 7–8, 14–15, 21–22 and 28–29. In a separate study, urine was collected on days 1–2, 3–4, 5–6 and 7–8 from rats receiving 500?mg?kg^?1?day^?1. Samples were analysed by ¹H NMR spectroscopy combined with multivariate data analysis and clinical chemistry. Histopathology and clinical chemistry analysis of terminal blood samples was carried out following termination on days 4, 6, 8 and 29 (4?week time course) and days 2, 4, 6 and 8 (8?day study). Urine analysis revealed a marked, though variable, excretion of β-hydroxybutyrate, acetoacetate and acetone (ketone bodies) seen on days 3–4, 5–6 and 7–8 of the study. It is postulated that the ketonuria might be secondary to an alteration in fatty acid metabolism due to inhibition of prostaglandin synthesis. In addition, an elevation in urinary ascorbate was observed during the first 8?days of the study. Ascorbate is considered to be a biomarker of hepatic response, probably reflecting an increased hepatic activity due to glucuronidation of NPAA.     

Evaluating the effectiveness of conservation site networks under climate change: accounting for uncertainty

We forecasted potential impacts of climate change on the ability of a network of key sites for bird conservation (Important Bird Areas; IBAs) to provide suitable climate for 370 bird species of current conservation concern in two Asian biodiversity hotspots: the Eastern Himalaya and Lower Mekong. Comparable studies have largely not accounted for uncertainty, which may lead to inappropriate conclusions. We quantified the contribution of four sources of variation (choice of general circulation models, emission scenarios and species distribution modelling methods and variation in species distribution data) to uncertainty in forecasts and tested if our projections were robust to these uncertainties. Declines in the availability of suitable climate within the IBA network by 2100 were forecast as ‘extremely likely’ for 45% of species, whereas increases were projected for only 2%. Thus, we predict almost 24 times as many ‘losers’ as ‘winners’. However, for no species was suitable climate ‘extremely likely’ to be completely lost from the network. Considerable turnover (median = 43%, 95% CI = 35–69%) in species compositions of most IBAs were projected by 2100. Climatic conditions in 47% of IBAs were projected as ‘extremely likely’ to become suitable for fewer priority species. However, no IBA was forecast to become suitable for more species. Variation among General Circulation Models and Species Distribution Models contributed most to uncertainty among forecasts. This uncertainty precluded firm conclusions for 53% of species and IBAs because 95% confidence intervals included projections of no change. Considering this uncertainty, however, allows robust recommendations concerning the remaining species and IBAs. Overall, while the IBA network will continue to sustain bird conservation, climate change will modify which species each site will be suitable for. Thus, adaptive management of the network, including modified site conservation strategies and facilitating species' movement among sites, is critical to ensure effective future conservation.     

Introduction

Abstrat

In this paper we discuss genetic discourses and practices in stem cell science. We report on how biomedical scientists, in both the UK and the USA, view the scientific literature and their own experimental research in the emerging field of human embryonic stem (hES) cells. We focus on the genetic manipulation of stem cells to make specialized (beta) cells as a potential cure for diabetes. We draw on Gieryn's notion of boundary work as an analytical motif, and suggest this is a productive way to theorize boundary crossings in the shifting landscapes of expectations in the field of new medical technologies. We argue that initial expectations of a revolution in regenerative medicine have been damped down by the difficulties of making insulin producing pancreatic beta cells from stem cells. We contend the consequent shifts in expectations have led to the emergence of other more radical experimental strategies (such as using oncogenes) in the search for potential cures for Type 1 diabetes. In conclusion, we argue that regenerative medicine is a fruitful example of the shaping of contested biomedical landscapes and we contend that embryonic stem cells are a productive case study of the interactions between genetics, science and society.     

Anammox bacterial populations in deep marine hypersaline gradient systems

To extend the knowledge of anaerobic ammonium oxidation (anammox) habitats, bacterial communities were examined in two hypersaline sulphidic basins in Eastern Mediterranean Sea. The 2 m thick seawater–brine haloclines of the deep anoxic hypersaline basins Bannock and L’Atalante were sampled in intervals of 10 cm with increasing salinity. ¹⁵N isotope pairing incubation experiments showed the production of ²⁹N₂ and ³⁰N₂ gases in the chemoclines, ranging from 6.0 to 9.2 % salinity of the L’Atalante basin. Potential anammox rates ranged from 2.52 to 49.65 nmol N₂ L^?1 day^?1 while denitrification was a major N₂ production pathway, accounting for more than 85.5 % of total N₂ production. Anammox-related 16S rRNA genes were detected along the L’Atalante and Bannock haloclines up to 24 % salinity, and the amplification of the hydrazine synthase genes (hzsA) further confirmed the presence of anammox bacteria in Bannock. Fluorescence in situ hybridisation and sequence analysis of 16S rRNA genes identified representatives of the marine anammox genus ‘Candidatus Scalindua’ and putatively new operational taxonomic units closely affiliated to sequences retrieved in marine environments that have documented anammox activity. ‘Scalindua brodae’ like sequences constituted up to 84.4 % of the sequences retrieved from Bannock. The anammox community in L’Atalante was different than in Bannock and was stratified according to salinity increase. This study putatively extends anammox bacterial habitats to extremely saline sulphidic ecosystems.     

Mischaracterising density dependence biases estimated effects of coloured covariates on population dynamics

Environmental effects on population growth are often quantified by coupling environmental covariates with population time series, using statistical models that make particular assumptions about the shape of density dependence. We hypothesized that faulty assumptions about the shape of density dependence can bias estimated effect sizes of temporally autocorrelated covariates. We investigated the presence of bias using Monte Carlo simulations based on three common per capita growth functions with distinct density dependent forms (θ-Ricker, Ricker and Gompertz), autocorrelated (coloured) ‘known’ environmental covariates and uncorrelated (white) ‘unknown’ noise. Faulty assumptions about the shape of density dependence, combined with overcompensatory intrinsic population dynamics, can lead to strongly biased estimated effects of coloured covariates, associated with lower confidence interval coverage. Effects of negatively autocorrelated (blue) environmental covariates are overestimated, while those of positively autocorrelated (red) covariates can be underestimated, generally to a lesser extent. Prewhitening the focal environmental covariate effectively reduces the bias, at the expense of the estimate precision. Fitting models with flexible shapes of density dependence can also reduce bias, but increases model complexity and potentially introduces other problems of parameter identifiability. Model selection is a good option if an appropriate model is included in the set of candidate models. Under the specific and identifiable circumstances with high risk of bias, we recommend prewhitening or careful modelling of the shape of density dependence.     

Restoration of indigenous dominance in exotic grassland by the establishment of juvenile Microlaena stipoides plants

Two experiments were conducted to determine the establishment success of reintroducing Microlaena stipoides (pātītī, weeping rice grass) into existing high‐fertility grassland on the volcanic cones of the Auckland Isthmus. The first experiment monitored the survival and development of juveniles planted in a factorial design including two planting densities, two slope classes and two aspects across three cones. Plant survival during establishment was consistently over 90%. Maximum M. stipoides cover after 2 years (>80%) was achieved on north‐facing steep slopes (>25°) at the greater planting density (40 plants/m²). However, results were particularly idiosyncratic to specific cone/topographical combinations. The second experiment, on a flat site on one cone, monitored the survival and development of juveniles planted across four post‐planting treatments designed to suppress resident vegetation recovery. Plant survival after 6 months was relatively low (50%), and none of the treatments achieved greater than 5% cover of M. stipoides after 1 year. The chosen post‐planting treatments were unable to suppress vigorous recovery of competitive exotic grasses on a moist fertile site. Overall, juvenile planting was shown to be a potentially successful method of Microlaena establishment and could restore indigenous dominance to exotic grassland in this environment, but individual site factors and the high cost of establishment must be considered.     

When genes go wild: highly variable internal transcibed spacer1 and conserved mitochondrial DNA haplotypes used to examine the genetic diversity and dispersal pathways of invasive Hylotrupes bajulus in Western Australia

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Commensal bacteria‐dependent select expression of CXCL2 contributes to periodontal tissue homeostasis

The oral and intestinal host tissues both carry a heavy microbial burden. Although commensal bacteria contribute to healthy intestinal tissue structure and function, their contribution to oral health is poorly understood. A crucial component of periodontal health is the recruitment of neutrophils to periodontal tissue. To elucidate this process, gingival tissues of specific‐pathogen‐free and germ‐free wild‐type mice and CXCR2KO and MyD88KO mice were examined for quantitative analysis of neutrophils and CXCR2 chemoattractants (CXCL1, CXCL2). We show that the recruitment ofneutrophils to the gingival tissue does not require commensal bacterial colonization but is entirely dependent on CXCR2 expression. Strikingly, however, commensal bacteria selectively upregulate the expression of CXCL2, but not CXCL1, in a MyD88‐dependent way that correlates with increased neutrophil recruitment as compared with germ‐free conditions. This is the first evidence that the selective use of chemokine receptor ligands contributes to neutrophil homing to healthy periodontal tissue.