Search

Background:Placebo and nocebo responses have important consequences for the development of pharmaceutical drugs and the design of randomized controlled trials (RCTs). They can lead to the incorrect measurement of treatment-related efficacy and adverse effects (AEs).Objectives:The goal of this study was to evaluate the frequency and magnitude of placebo and nocebo responses in placebo-controlled RCTs of non-tumor necrosis factor (TNF) biologics and Janus kinase (JAK) inhibitors in patients with rheumatoid arthritis (RA) showing an insufficient response to TNF inhibitors.Methods:We performed a meta-analysis on the rates of placebo response, AEs, severe AEs (SAEs), and withdrawal owing to AEs in placebo-controlled randomized clinical trials (RCTs) of non-TNF biologics and JAK inhibitors in patients with RA showing an insufficient response to TNF inhibitors.Results:Nine RCTs contained a total of 3,442 patients (1,840 experimental subjects and 1,602 controls). The pooled incidence of an ACR20 response rate in placebo-treated patients was 22.1% (95% CI 16.4–29.1%) and 27.9% (95% CI 24.5–31.6%) in RCTs of non-TNF inhibitors and JAK inhibitors, respectively. A strong negative correlation was observed between drug efficacies (ACR20 response) and AE rates in the placebo arm, indicating that the greater the placebo response, the weaker the nocebo response (r = -0.762, P = 0.017). A strong positive correlation was observed between drug efficacies (ACR20 response) in the placebo and active comparator, indicating that the greater the placebo response, the greater the treatment response (r = 0.737, P = 0.003). The pooled estimate in placebo-treated patients with at least one AE was 71.8% (95% CI 57.4–82.7%) and 58.7% (95% CI 52.8–64.3%) in RCTs of non-TNF inhibitors and JAK inhibitors, respectively. The pooled estimate in placebo-treated patients who withdrew from treatment owing to an AE was 3.8% (95% CI 2.7–5.3%) and 4.0% (95% CI 2.7–6.0%) in RCTs of non-TNF inhibitors and JAK inhibitors, respectively. A strong positive correlation was observed between AE rates in the placebo and active arms, indicating that the greater the nocebo response, the stronger the AE rate in the active arm (r = 0.855, P = 0.003).Conclusion:The frequency of the placebo and nocebo responses was 22.1% vs. 27.9% and 71.8% vs. 58.7% in placebo-controlled RCTs of non-TNF inhibitors and JAK inhibitors for RA, respectively, and the greater the placebo response, the weaker the nocebo response and the greater the efficacy.References:[1]Mitsikostas DD, Chalarakis NG, Mantonakis LI, Delicha EM, Sfikakis PP. Nocebo in fibromyalgia: meta-analysis of placebo-controlled clinical trials and implications for practice. Eur J Neurol 2012;19:672-80.[2]Kravvariti E, Kitas GD, Mitsikostas DD, Sfikakis PP. Nocebos in rheumatology: emerging concepts and their implications for clinical practice. Nat Rev Rheumatol 2018;14:727-40.[3]Colloca L, Barsky AJ. Placebo and Nocebo Effects. N Engl J Med 2020;382:554-61.Disclosure of Interests:None declared

Objective This study aimed to evaluate the relationship between circulating prolactin level and systemic lupus erythematosus (SLE), and to establish a correlation between plasma/serum prolactin levels and SLE activity. Methods We performed a meta-analysis comparing the plasma/serum prolactin levels in patients with SLE to controls, and examined correlation coefficients between circulating prolactin level and SLE disease activity. Results Twenty-five studies with a total of 1056 SLE patients and 426 controls were included. Prolactin levels were significantly higher overall in the SLE group than in the control group (standardized mean difference (SMD) = 0.987, 95% CI = 0.512–1.463, p = 4.7 × 10−5). Stratification by ethnicity showed significantly elevated prolactin levels in the SLE group in Asian, Latin American, and mixed populations (SMD = 0.813, 95% CI = 0.137–1.490, p = 0.018; SMD = 0.981, 95% CI = 0.307–1.655, p = 0.004; SMD = 1.469, 95% CI = 0.443–2.495, p = 0.005, respectively), but not in the European population. Subgroup analysis by sample size showed significantly higher prolactin levels in the SLE group by small ( n 30). Meta-analysis of correlation coefficients showed a significantly positive correlation between circulating prolactin level and SLE activity (correlation coefficient = 0.379, 95% CI = 0.026–0.487, p = 4.0 × 10−9). Circulating prolactin levels were positively associated with SLE activity in European, Asian, and mixed populations (SMD = 0.532, 95% CI = 0.443–0.609 p −8; SMD = 0.427, 95% CI = 0.240–0.583, p = 2.4 × 10−5; SMD = 0.433, 95% CI = 0.212–0.591, p = 2.7 × 10−5, respectively). Conclusions Our meta-analysis demonstrated that circulating prolactin levels are higher in patients with SLE, and that a significantly positive correlation exists between prolactin levels and SLE activity.

Although left ventricular diastolic dysfunction (LVDD) is a pronounced feature of adult cirrhotic cardiomyopathy and a major predictor of poor outcomes following liver transplantation (LT), little is known about if pretransplant cardiac dysfunction affects perioperative outcomes in pediatric LT.We retrospectively evaluated pretransplant clinical and Doppler echocardiographic data for 45 consecutive pediatric LT recipients who were treated between 2007 and 2013 (median age = 15 months; interquartile range = 9 to 78 months). LVDD was defined according to the cirrhotic cardiomyopathy criteria, and the myocardial performance index (MPI) was measured using tissue Doppler imaging. Intraoperative data and hospitalization days following LT were compared.LVDD and MPI ≥0.5 (defined as a z score ≥2) were observed in 13% and 27% of patients, respectively. Patients with an MPI ≥0.5 demonstrated the increased accumulation of lactate at the end of their LT operation (mean = 2.48 vs 0.82; P = .026) compared with patients with an MPI 0.5. The hospital stay was longer in patients with LVDD (median = 46 days vs 30 days; P = .041) and patients with an MPI ≥0.5 (median = 38 days vs 29 days; P = .014) compared with patients without LVDD and MPI 0.5, respectively.LVDD might be less prevalent (13%) in pediatric patients compared with adults. However, pretransplant cardiac dysfunction in patients with LVDD and an MPI ≥0.5 adversely affects perioperative outcomes, necessitating that such pediatric LT recipients be cautiously observed perioperatively.

Hasan, M. Shahnaz/0000-0002-7493-7416; Abouqal, Redouane/0000-0002-6117-4341; Altindis, Mustafa/0000-0003-0411-9669; Masjedi, Mansoor/0000-0001-6175-9289; Popescu, Roxana/0000-0002-9387-1141; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; Meco, Basak Ceyda/0000-0003-2951-9634; Kumar, Perikala Vijayananda/0000-0001-8315-7000; Zand, Farid/0000-0003-3489-3372; Maghsoudi, Behzad/0000-0002-1279-8799; KAMARUL ZAMAN, MAZUIN/0000-0002-7920-6399; Gan, Chin Seng/0000-0002-6758-4798; Horoz, Ozden Ozgur/0000-0001-7590-650X; Medeiros, Eduardo A/0000-0002-6205-259X; Sabetian, Golnar/0000-0001-8764-2150; UNAL, SERHAT/0000-0003-1184-4711; Gan, Chin Seng/0000-0002-6758-4798; Delia, Muntean/0000-0001-9100-4530; Yalcin, Ata Nevzat/0000-0002-7243-7354; Leblebicioglu, Hakan/0000-0002-6033-8543; Horhat, Florin George/0000-0001-6133-0204; Yousef, Reham H. A./0000-0003-4004-3008; Delgado Aguirre, Hector Alberto/0000-0001-5448-7975; El Kholy, Amani/0000-0002-0645-7664; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Sanaei Dashti, Anahita/0000-0002-2827-3575; KARABAY, OGUZ/0000-0003-1514-1685; Barahona G., Nayide/0000-0003-3559-6900; Stagnaro, Juan Pablo/0000-0003-3836-9957; Alexandru Florin, Rogobete/0000-0003-1286-4431; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Duszynska, Wieslawa/0000-0002-5880-4904; Ngo, Quy Chau/0000-0002-6787-2757; Elmanakhly, Arwa/0000-0001-8557-0536; yildizdas, dincer/0000-0003-0739-5108; Kanj, Souha/0000-0001-6413-3396; Gupta, Umesh/0000-0001-7717-1404 WOS: 000392626300014 PubMed: 27742143 Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DAHAI), we collected prospective data from861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central lineassociated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheterassociated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. VDR; Foundation to Fight against Nosocomial Infections The funding for design, development, maintenance, technical support, data validation, and report generation of the Surveillance Online System, and the activities carried out at International Nosocomial Infection Control Consortium headquarters, were provided by VDR and the Foundation to Fight against Nosocomial Infections.

The surfaces of nanoparticles of SiO2, TiO2 and Al2O3 have been modified by γ-(2,3-epoxypropoxy)propyltrimethoxysilane (KH-560) in order to achieve proper dispersion of nanoparticles and possible chemical interactions between nanoparticles and polymeric coatings, and then the homogeneous fluoropolymer coatings containing nanoparticles of SiO2, TiO2 and Al2O3 have been successfully prepared on mild steel substrates. The surface morphologies of the coatings were characterised by field emission scanning electron microscopy. The effects of incorporating various nanoparticles on the corrosion resistance of fluoropolymer-coated steel were investigated by potentiodynamic polarisation curve, electrochemical impedance spectroscopy and salt spray tests. The results showed that KH560-modified nanoparticles can decrease agglomeration effectively, and the nanoparticles play a beneficial role in improving the corrosion resistance of the coated steel significantly. In addition, SiO2 nanoparticles are of the best effect ...

We aimed to evaluate the relationship between circulating blood adipokine levels and systemic sclerosis (SSc). We conducted a meta-analysis on serum/plasma adiponectin, leptin, or resistin levels in patients with SSc and controls, and performed a subgroup analysis based on ethnicity and/or disease type. Eleven studies (511 patients with SSc and 341 controls) were included in the meta-analysis. Meta-analysis revealed that adiponectin levels were significantly lower in patients with SSc than in controls (standardized mean differences [SMD] = −0.638; 95 % confidence intervals [CI] = −1.154, −0.122; P = 0.015). Stratification by ethnicity showed a low adiponectin level associated with SSc in Caucasians (SMD = −0.439; 95 % CI = −1.092, −0.213; P = 0.187) and Asians (SMD = −1.006; 95 % CI = −2.031, −0.019; P = 0.055), although this result was not statistically significant. Stratification by disease type revealed that the adiponectin level was significantly lower in the diffuse SSc, but not limited SSc, group than in the control (diffuse: SMD = −1.445; 95 % CI = −2.276, −0.614; P = 0.001; limited: SMD = 0.188; 95 % CI = −0.064, 0.439; P = 0.144). Meta-analysis showed no association between leptin levels and SSc (SMD = −0.029; 95 % CI = −1.362, 1.304; P = 0.966), and no association between resistin levels and SSc (SMD = 0.202; 95 % CI = −0.091, 0.496; P = 0.177). Our meta-analysis revealed a significantly lower circulating adiponectin level in patients with SSc than in controls. This difference was apparent in the diffuse type of SSc, but not in the limited type. However, circulating leptin and resistin levels were not different between patients with SSc and healthy controls.

A combination of finite element method and neural network methods was used for rapid prediction of the roll force during skin pass rolling of 980DP and 1180CP high strength steels. The FE based commercial package DEFOEM-2D was used to develop a mathematical model of the skin pass rolling operation. Numerical experiments were designed with different process parameters to produce training data for a neural network algorithm. The friction coefficient was considered as an input parameter in the neural network but it was optimised using an iterative method employing an equation that relates the friction coefficient to the rolling force. The load prediction method described in this paper is sufficiently rapid that it can be used in real-time as an adjustment tool for skin pass rolling mills with error within 10% (based on plant data from POSCO).

Objective This study aimed to systemically review the evidence regarding the relationship between circulating blood osteopontin (OPN) level and systemic lupus erythematosus (SLE), correlation between serum OPN levels and SLE activity, and association between OPN polymorphisms and SLE susceptibility. Methods We conducted a meta-analysis on the serum/plasma OPN levels in SLE patients and healthy controls, correlation coefficients between the circulating OPN level and SLE Disease Activity Index (SLEDAI) in SLE patients, and the association between OPN polymorphisms and SLE risk. Results Nine studies with 1938 SLE patients and 3037 controls were included. Meta-analysis revealed that, compared with the control group, the OPN level was significantly higher in the SLE group (SMD = 0.965, 95% CI = 0.337–1.393, p = 0.001) and in the SLE group with renal disease (SMD = 2.219, 95% CI = 0.681–3.757, p = 0.005). Meta-analysis of correlation coefficients showed a trend of positive correlation between the circulating OPN level and SLEDAI (correlation coefficient = 0.590, 95% CI = −0.025 to 0.881, p = 0.059). While no association was found between SLE and the OPN 707 T/C and 1083 G/A polymorphisms, a significant association was identified between the OPN 1239 C allele and SLE (OR = 1.192, 95% CI = 1.008–1.410, p = 0.040), and between the OPN 9250 C allele and SLE in Asians (OR = 2.070, 95% CI = 1.570–2.730, p = 2.5 × 10−7). Conclusions Our meta-analysis revealed a significantly higher circulating OPN level in SLE patients, a trend of positive correlation between OPN levels and SLE activity, and a significant association between OPN 1239 C/A and 9250 C/T polymorphisms, and SLE development.

Plasma electrolytic oxidation (PEO) coatings were produced on AZ31 magnesium alloy in a phosphate-based electrolyte with current density varying from 5 to 20 A dm−2. The influences of the current density on the PEO process and resulting coating characteristics were discussed. The coating morphology and phase composition were studied by scanning electron microscopy and X-ray diffraction technique, respectively. The corrosion performance of the coatings was evaluated in 3.5 wt-% NaCl solution using potentiodynamic polarisation scans. The electrochemical corrosion results proved that the coating produced at current density of 10 A dm−2 shows the best corrosion resistance. The tribological test suggested that the ceramic coating produced at 10 A dm−2 exhibited the most superior wear resistance.

Since the WTO accession in 2001, China’s outward foreign direct investment (OFDI) and foreign trade have been leaping forward, especially reflected as the “One Belt & One Road” initiative (BRI), proposed in 2013, which has been its largest public product for international community thus far. On that basis, this study focuses on the third-country effects of carbon dioxide (CO2) emissions in BRI related countries, and delves into its spatial interaction from rising impacts of China’s global economic cooperation activities, with the economic & political distance from China as institutional factors, using spatial econometric method in a panel data of 60 BRI countries from 2007 to 2016. Accordingly, the empirical results first significantly reveal the existence of spatial autocorrelation for CO2 emissions per capita in BRI countries by Moran’s I test. Furthermore, according to the main estimated results of the spatial Durbin model with spatial fixed effects, China’s OFDI and imports to BRI countries exert third-country effects or spatial spillover effects; from the perspective of sustainability and emission reduction during BRI, China is required to launch more economic cooperation in emerging and low carbon industries with limited political claims. In response, BRI countries are supposed to develop its high tech and low carbon complementary industries with surrounding countries, so as to keep the CO2 emissions at a low level.

Gypsophila capituliflora Rupr. (purplehead baby’s breath), a perennial herb, is native to the desert region of northwestern China and Central Asia. It is valuable for ornamental use and preventing land erosion (Mao 1996). In August 2017, during a survey of diseases of desert plants, severe outbreaks of powdery mildew infections with approximately 90% disease incidence on G. capituliflora were observed in the desert region of Alashankoy City, Xinjiang, China. Symptoms first appeared as thin white patches on needle-like leaves, which subsequently turned yellow and necrotic, and resulted in permanent death of plants. Three representative voucher specimens were deposited in the Mycological Herbarium of Tarim University (HMUT6449.1 to 6449.3). Appressoria were well-developed, multilobed or slightly lobed, solitary or opposite in pairs. Conidiophores arose from the top of the mother cell and produced single conidia. Foot cells were cylindrical, straight, or slightly flexuous at the base, 27 to 58 × 5 to 12 μm (n = 30), and were followed by one to three mostly short cells. Conidia were cylindrical to oblong-ellipsoid, 35 to 56 × 12.5 to 18 μm (n = 50), without fibrosin bodies, and showed angular/rectangular wrinkling of outer walls. Germ tubes were produced on the terminal or subterminal position of conidia with lobed appressoria. Chasmothecia were gregarious or scattered, dark brown, and 85 to 195 μm in diameter (n = 30). Appendages were septate, usually irregularly branched, arising from the lower half of the chasmothecia, 35 to 210 μm in length (n = 30). Asci were sessile or short-stalked in shape, 45 to 87 × 23 to 48 μm, and mostly contained two to six colorless ascospores, ellipsoid-ovoid to subglobose, with dimensions of 15 to 30 × 9 to 21 μm (n = 30). The specific measurements and morphological characteristics were consistent with those of Erysiphe buhrii U. Braun (Braun and Cook 2012; Choi et al. 2016). To confirm the identification, the internal transcribed spacer (ITS) and 28S rRNA gene of the three deposited isolates (HMUT6449.1 to 6449.3) were amplified and sequenced following the method of Meeboon and Takamatsu (2015) and deposited in GenBank (accession nos. MH256036 to MH256038). An NCBI-BLAST search indicated that these sequences showed 100% identity of the ITS (559/559 nucleotides) and LSU (805/805 nucleotides) with E. buhrii on G. paniculata (LC009959) and 99.3% identity of the ITS (558/562 nucleotides) with E. buhrii on G. oldhamiana (KU945278). Based on phylogenetic trees generated from maximum likelihood and Bayesian analysis of the combined alignment of ITS and 28S rRNA, the three strains clustered with E. buhrii (MUMH 0787) in an independent clade with 100% bootstrap support value and posterior probability of 1. The pathogenicity test was confirmed by Koch’s postulates. Leaves of six healthy potted plants were gently pressed against diseased leaves for inoculation. Three noninoculated plants served as controls. Each plant was kept in a separate plastic humid chamber in a greenhouse at 25 to 30°C for 7 days. Typical symptoms of powdery mildew, morphologically identical to the original observations on diseased plants, developed on the inoculated plants. No symptoms were observed on the control plants. E. buhrii has been reported on Gypsophila spp. in Hungary, Romania, Ukraine, Turkey, USSR, Argentina, Korea, and Mongolia (Farr and Rossman 2020). To our knowledge, this is the first record of E. buhrii on G. capituliflora. Considering G. capituliflora is one of the major plant species in the local ecosystem, the occurrence of the powdery mildew disease poses a serious threat to the fragile ecological systems of the desert area, and it may continue to accelerate the process of desertification in Xinjiang, China.

Several radiolabeled folic acid conjugates have been developed for targeted imaging and therapy. However, the therapeutic concept with radiolabeled folate conjugates has not yet been applied to clinical applications owing to the high renal absorbed dose. The effectiveness of targeted radionuclide therapy (TRT) depends primarily on the absorbed dose rate and on the total absorbed dose delivered to the tumor and to normal tissue. Owing to various limitations associated with organ level dosimetry, voxel-based dosimetry has become essential for the assessment of a more accurate absorbed dose during TRT. In this study, we synthesized iron oxide nanoparticle (IONP)-conjugated radiolabeled folate (

Background:Obesity can be a factor that affects response to tumor necrosis factor inhibitors (TNFi). Few studies have investigated the impact of obesity on the response to TNFi in patients with ankylosing spondylitis (AS).Objectives:The aim of our study was to investigate the impact of different body mass index (BMI) categories on TNFi response in patients with AS.Methods:Patients with AS from the Korean College of Rheumatology Biologics (KOBIO) registry were included in the current study. Patients who started a first TNFi after recruitment, and had available BMI data as well as a baseline and follow-up visit at 1 year (±6 months) were included. Patients with a BMI 30). We evaluated the proportion of patients achieving the 40% improvement in ASAS criteria (ASAS40), as well as Ankylosing Spondylitis Disease Activity Score (ASDAS) improvement status at 1 year.Results:A total of 1003 AS patients starting a first TNFi were considered in the current study (696 patients of normal weight, 267 patients with overweight, and 40 obese patients). After at 1 year follow-up visit, obese individuals were significantly higher ASDAS-CRP levels but were not significantly lower ASDAS major improvement in comparison to patients of normal weight.Conclusion:Obesity is associated with significantly higher ASDAS-CRP at follow-up visit in patients with AS.Disclosure of Interests:None declared

Background:Methotrexate (MTX), an effective disease-modifying antirheumatic drug (DMARD) [2], is the most widely used DMARD for the treatment of rheumatoid arthritis (RA). However, not all patients are responsive to the drug; 30% of the patients discontinue therapy within 1 year of commencing the treatment, usually because of the lack of efficacy or undesirable adverse effects Small-molecule Janus kinase inhibitors are clinically developed for the treatment of RA.Objectives:The aim of this study is to investigate the relative efficacy and safety of tofacitinib, baricitinib, upadacitinib, and filgotinib in comparison with adalimumab in patients with active RA and having inadequate responses to MTX.Methods:We performed a Bayesian network meta-analysis to combine direct and indirect evidence from randomized controlled trials (RCTs) to examine the efficacy and safety of tofacitinib, baricitinib, upadacitinib, filgotinib, and adalimumab in RA patients having inadequate responses to MTX.Results:Four RCTs, comprising 5,451 patients, met the inclusion criteria. The baricitinib 4mg+MTX and upadacitinib 15mg+MTX group showed a significantly higher American College of Rheumatology 20% (ACR20) response rate than the adalimumab 40mg+MTX group. The ranking probability based on the surface under the cumulative ranking curve (SUCRA) indicated that baricitinib 4mg+MTX had the highest probability of being the best treatment for achieving the ACR20 response rate, followed by upadacitinib 15mg+MTX, tofacitinib 5mg+MTX, filgotinib 200mg+MTX, filgotinib 100mg+MTX, adalimumab 40mg+MTX, and placebo+MTX. The upadacitinib 15mg+MTX and baricitinib 4mg+MTX groups showed significantly higher ACR50 and ACR70 response rates than adalimumab 40mg+MTX. In terms of Herpes zoster infection, the ranking probability based on the SUCRA indicated that placebo+MTX were likely to be the safest treatments, followed by filgotinib 200mg+MTX, filgotinib 100mg+MTX, adalimumab 40mg+MTX, tofacitinib 5mg+MTX, upadacitinib 15mg+MTX, and baricitinib 4mg+MTX. Regarding safety analysis, no statistically significant differences were found between the respective intervention groups.Conclusion:In RA patients with an inadequate response to MTX, baricitinib 4mg+MTX and upadacitinib 15mg+MTX showed the highest ACR response rates, suggesting a difference in efficacy among the different JAK inhibitors.References:[1]Fleischmann R, Mysler E, Hall S, Kivitz AJ, Moots RJ, Luo Z, DeMasi R, Soma K, Zhang R, Takiya LJTL (2017) Efficacy and safety of tofacitinib monotherapy, tofacitinib with methotrexate, and adalimumab with methotrexate in patients with rheumatoid arthritis (ORAL Strategy): a phase 3b/4, double-blind, head-to-head, randomised controlled trial. 390:457-468[2]Taylor PC, Keystone EC, van der Heijde D et al (2017) Baricitinib versus Placebo or Adalimumab in Rheumatoid Arthritis. N Engl J Med 376:652-662[3]Fleischmann R, Pangan AL, Mysler E, Bessette L, Peterfy C, Durez P, Ostor A, Li Y, Zhou Y, Othman AA (2018) A phase 3, randomized, double-blind study comparing upadacitinib to placebo and to adalimumab, in patients with active rheumatoid arthritis with inadequate response to methotrexate. ARTHRITIS & RHEUMATOLOGY. WILEY 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, pp[4]Combe B, Kivitz A, Tanaka Y, van der Heijde D, Matzkies F, Bartok B, Ye L, Guo Y, Tasset C, Sundy J (2019) LB0001 EFFICACY AND SAFETY OF FILGOTINIB FOR PATIENTS WITH RHEUMATOID ARTHRITIS WITH INADEQUATE RESPONSE TO METHOTREXATE: FINCH1 PRIMARY OUTCOME RESULTS. BMJ Publishing Group Ltd, ppDisclosure of Interests:None declared

Background:Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune inflammatory disease with increased risk for mortality and cancers possibly because of the effects of systemic inflammation and immunodeficiency due to disease itself and/or cytotoxic agents for SLE management. Although there has been improvement in the prognosis of SLE over decades with the treatment advance including standardized treatment strategy for lupus nephritis and less cytotoxic agents, the improvement also is fixed nowadays.Objectives:In this study, we we are to investigate the mortality and cancer of SLE patients in a longitudinal SLE cohort and compare the morality ratio and incidence of cancer with general population over time.Methods:This study was conducted in Hanyang BAE lupus cohort during the period of 1998 to 2015. Mortality data and malignancy data were derived in connection with data from the Korean National Statistics Office and the Korea Central Incidence Database, respectively. The Standardized Mortality Ratio (SMR) and Standardized Incidence Ratio (SIR) was estimated yearly by dividing the observed number deaths/cancers by the expected number of deaths/cancers of age- and sex- matched general population from matched year.Results:Mortality data were available in 1284 patients and total 71 deaths were observed. The most common cause of death was SLE itself (52.1%) followed by infection (18.3%), cerebrovascular disease (8.5%) and suicide (7.0%). The total age and sex adjusted SMR was 3.4 [95% CI (Confidential Interval) 2.6-4.1]. When we conduct subgroup analysis by age, the sex-adjusted SMR was significantly increased in young and middle aged adult patients: the SMR in patients younger than 20 was 12.2, but it was not significant due to the small number of young patients (observed death 3, expected death 0.3, 95% CI 0-26.0). The adjusted SMR in patients aged 20-39, aged 40-59 and aged over 60 were 9.8 (observed death 35, expected death 4.8, 95% CI 6.5-13.0), 3.7 (observed death 24, expected death 11.5, 95% CI 2.2-5.2), and 1.0 (observed death 9, expected death 10.3, 95% CI 0.3-1.6), respectively. Compared with alive patients, died patients had more serositis and more neurologic disorder according to American College of Rheumatology classification criteria for SLE despite the shorter observational period (5.6 years vs. 9.4 years).Malignancy data were available in 1,020 patients and 56 primary cancers were diagnosed. Solid tumor was developed in 51 patient and hematologic malignancy was developed in 5 patients (3 non-Hodgkin’s lymphoma, 1 solitary plasmacytoma and 1 acute lymphoblastic leukemia). Thyroid cancer was the most common solid cancer (24 patients) followed by colorectal (5 patients), breast (4 patients), cervical cancer (4 patients) and hepatocellular carcinoma (3 patients). The total age and sex adjusted SIR was 1.1 (95% CI 0.8-1.4).Conclusion:Patients with SLE had higher risk of mortality than general population and the younger patients had the higher risk of mortality. The leading cause of death was SLE itself followed by infection and cerebrovascular disease. The risk for cancer in patient with SLE was similar with that of general population.Disclosure of Interests:None declared

Background:Cyclophosphamide (CYC) is effective for induction of remission of AAV, resulting in complete remission rates of around 70%. Thus, CYC has been the standard remission induction therapy for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV); however, it is toxic and causes infections, malignancies, and infertility. Therefore, other agents that are less toxic but that have similar efficacy were explored. Since the disease course of AAV usually requires long-term immunosuppression, mycophenolate mofetil (MMF), a less toxic agent compared to CYC, has been explored as an alternative to CYC.Objectives:The aim of this study is to assess the efficacy and safety of MMF versus cyclophosphamide CYC in patients with active AAV.Methods:We performed a meta-analysis of four randomized clinical trials (RCTs) (300 patients) to examine the relative efficacy and safety of MMF compared to CYC in patients with active AAV.Results:There was no significant difference in remission at 6 months between MMF and CYC (OR 1.311, 95% confidence interval [CI] 0.570 – 3.017,P= 0.524). Additionally, the relapse rate did not differ between the MMF group and CYC group (OR 1.331, 95% CI 0.497 – 3.568,P= 0.570). There was no significant difference in serious adverse event (SAE) (OR 1.232, 95% CI 0.754 – 2.014,P= 0.404) and infection rate (OR 0.958, 95% CI 0.561 – 1.634,P= 0.873) between the MMF and CYC groups. Some heterogeneity was found in the meta-analysis of remission and relapse rate (I2= 57.4%, 63.4%), but no between-study heterogeneity was found during the meta-analysis of the SAE and infection rate. Egger’s regression test showed no evidence of publication bias (Egger’s regression testP-values > 0.1).Conclusion:MMF was an equally effective alternative treatment to CYC, and MMF was comparable to CYC in patients with active AAV in terms of safety, suggesting that MMF can be used as an alternative to CYC for remission induction in AAV.References:[1]Han F, Liu G, Zhang X, Li X, He Q, He X, Li Q, Wang S, Wang H, Chen J (2011) Effects of mycophenolate mofetil combined with corticosteroids for induction therapy of microscopic polyangiitis. Am J Nephrol 33:185-192[2]Jones RB, Hiemstra TF, Ballarin J et al (2019) Mycophenolate mofetil versus cyclophosphamide for remission induction in ANCA-associated vasculitis: a randomised, non-inferiority trial. Ann Rheum Dis 78:399-405[3]Tuin J, Stassen PM, Bogdan DI, Broekroelofs J, van Paassen P, Cohen Tervaert JW, Sanders JS, Stegeman CA (2019) Mycophenolate Mofetil Versus Cyclophosphamide for the Induction of Remission in Nonlife-Threatening Relapses of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Randomized, Controlled Trial. Clin J Am Soc Nephrol 14:1021-1028[4]Hu W, Liu C, Xie H, Chen H, Liu Z, Li L (2008) Mycophenolate mofetil versus cyclophosphamide for inducing remission of ANCA vasculitis with moderate renal involvement. Nephrol Dial Transplant 23:1307-1312Disclosure of Interests:None declared

Capparis spinosa subsp. himalayensis (Capparaceae) as a wild plant grows widely in Xinjiang and Tibet of China, as well as northern India and Pakistan (Fici 2015; Zhang and Tucker 2008). Its root, barks, leaves, and fruits are used for the treatment of rheumatism in traditional medicine. Since 2010, C. spinosa subsp. himalayensis has been affected by a powdery mildew with nearly 80% disease incidence in the northwest of Taklimakan desert, Xinjiang, China. Symptoms of powdery mildew first appear as circular to irregular white colonies, which subsequently develop into an abundant growth on the upper and lower surface of the leaves. As the disease progresses, the infection spreads to whole leaves, resulting in leaf death and decreased medicinal value. Two representative specimens were deposited in the Mycological Herbarium of Tarim University (HMUT0911551 and HMUT0911552). Mycelium was abundantly hypophyllous, sometimes amphigenous, forming thin white patches or covering entire leaves. Conidiophores emerged through leaf stomata, singly or branched, and formed dimorphic conidia. Primary conidia were lanceolate with distinct apical points measuring 44 to 63 × 12 to 22 μm. Secondary conidia were ellipsoid to cylindrical measuring 41 to 59 × 12 to 20 μm. Both conidia were hyaline with angular/rectangular wrinkling of the outer walls. The chasmothecia were nearly gregarious and globe-shaped, 98 to 249 μm in diameter, often immersed in dense mycelial tomentum with numerous asci. Numerous and well-developed appendages on the lower half of the chasmothecia were irregularly branched. Asci were stalked, long or wide ellipsoidal in shape, and 84 to 136 × 25.4 to 56.8 μm. The asci usually contained two ellipsoidal, colorless ascospores measuring 22.8 to 46.7 × 15.4 to 28.7 μm. The specific measurements and morphological features were consistent with those of Leveillula taurica (Lev.) Arnaud (Braun and Cook 2012). To confirm the identification, the internal transcribed spacer (ITS) and 28S rDNA of isolates HMUT0911551 and HMUT0911552 were amplified and sequenced as described by Song et al. (2016). NCBI BLAST search indicated that the ITS sequences (GenBank accession nos. MG600237 and MG600238) were 99.8% (identity: 610/611) similar to L. taurica on C. spinosa and Rosa sp. from Iran (accession nos. AB045002 and AB667881) (Khodaparast et al. 2001). It also indicated that the 28S sequences (GenBank accession nos. MG600239 and MG600240) were 100% similar to L. taurica on Glancium oxylobum and Alcea sp. from Iran (accession nos. AB080474 and AB080467) (Takamatsu et al. 2008). Pathogenicity was confirmed through inoculation by gently pressing diseased leaves onto leaves of healthy potted plants. Six inoculated plants were kept under a plastic humid chamber, and three noninoculated plants served as the control. The plants were placed under greenhouse conditions at 25 to 30°C for 7 days. Typical symptoms of powdery mildew developed on the inoculated plants, with identical morphology to the original observation on diseased leaves. No symptoms were seen on the control plants. To our knowledge, this is the first report of powdery mildew caused by L. taurica on C. spinosa subsp. himalayensis. This study extends the host range of L. taurica.

Background:With the promising efficacy and the prevalent use of anti-tumor necrosis factor-α (TNF) agents in managing AS, the risk for reactivation of latent tuberculosis infection (LTBI) still is a concern. Although guidelines include the screening and treatment of LTBI prior to the initiation of anti-TNF agent by QuantiFERON-TB Gold (QFT-G) or tuberculin test, there is a lack of evidence whether treatment of LTBI before initiation of anti-TNF agent may reduce the risk of reactivation to the same as LTBI patient without anti-TNF agent or anti-TNF agent users without LTBI. Furthermore, evidence on the need for follow-up testing and the association between seroconversion and the development of active tuberculosis is also limited.Objectives:This study aims to investigate the real-world impact of QFT-G test on the development of active tuberculosis in patients with AS.Methods:This retrospective study investigated 2,930 patients who had a diagnosis of AS and conducted QFT-G testing during the period of March 1998 to June 2019. 191 patients with history of treatment for LTBI or acute tuberculosis prior to the first QFT-G test and 157 patients whose hospital visits or prescription was less than 3 were excluded. Observational period was defined from the firs QFT-G test to the last hospital visit of development of active tuberculosis. The screening for development of active tuberculosis was conducted by reviewing the diagnosis, prescription of anti-tuberculosis medication, chest images and electronic medical record. Treatment of LTBI was defined when a patient was prescribed isoniazid for at least 220 for 12 months, rifampin for at least 90 days for 6 months, or concurrently prescribed isoniazid and rifampin for at least 70 days for 4 months. Wilcoxon rank-sum test, chi-square test and cox-proportional hazard analysis were performed.Results:A total of 2687 patients (median age 32.7 years, 78.4% male, anti-TNF agent user 16.7%) were included. Baseline QFT-G was positive in 426 (20.3%) patients, and 15 active tuberculosis was observed [Incidence rate 1.5/1000 person years (PY)]. Compared with baseline QFT-G (-) patients, baseline QFT-G (+) patients were older (41.2 years vs. 31.3 years, pThen we conducted subgroup analysis on 965 patients with baseline QFT-G (-) and follow-up QFT-G tests. Seroconversion was documented in 65 patients (6.7%). Active tuberculosis was observed in 4 patients, and seroconversion was occurred before the development of active tuberculosis in all patients. The incidence of active tuberculosis in seroconversion patients were 10.5/1000PY.Conclusion:QFT-G (+) and QFT-G seroconversion is associated with increased risk of the development of active tuberculosis in patients with AS.Figure 1.Overview of patient flowDisclosure of Interests:None declared

The femoral arteries (FA) and femoral veins (FV) are useful access sites for diagnostic and interventional procedures. In adults, the usual puncture sites are 1-3 cm distal from the inguinal crease. In children, however, the optimal puncture site vessels are not known. The aim of our study was to assess the number of branches and bifurcation sites of the femoral vessels in children by using ultrasonography.Color Doppler ultrasonography was used to determine bifurcation sites of the FA and FV, relative to the inguinal crease, in 48 children (median age, 4 yr; median weight, 18.7 kg) with American Society of Anesthesiologists (ASA) Physical Status (PS) score 1-2 and who were scheduled for general anesthesia.The numbers of FAs and FVs at the inguinal crease were 1.83 +/- 0.39 and 1.08 +/- 0.29, respectively, in infants, and 1.83 +/- 0.58 and 1.0 +/- 0.0, respectively, in 10-year-old children. The bifurcation site of the FA in infants and those aged 10 years was 0.78 +/- 0.30 cm and 1.47 +/- 0.27 cm proximal to the inguinal crease, respectively (P0.05), whereas the bifurcation site of the FV in these two age groups was -0.96 +/- 0.27 cm and -2.29 +/- 1.09 cm distal to the inguinal crease, respectively (P0.05).In children, the FA frequently bifurcates proximal to the inguinal crease, whereas the FV bifurcates distal to the inguinal crease. However, there are anatomical differences among age groups, so care should be taken to avoid complications during femoral vessel cannulation.

Seckel syndrome, also called bird-headed dwarfism, is an extremely rare, inherited, autosomal recessive disorder. The patients with Seckel syndrome are characterized by growth retardation, microcephaly with mental retardation, proportional dwarfism, bird like faces, and beak-like triangular nose. A literature review reveals that they have multiple anesthetic problems such as difficult airway management, difficult venous cannulation and concomitant medical diseases. We describe our experience in anesthetic management of a 21-month-old male patient with Seckel syndrome associated with pneumonia who underwent orchiopexy for bilateral cryptochidism.

As the most feasible solution beyond FinFET technology, a gate-all-around Multi-Bridge-Channel MOSFET (MBCFET) technology is successfully demonstrated including a fully working high density SRAM. MBCFETs are fabricated using 90% or more of FinFET processes with only a few revised masks, allowing easy migration from FinFET process. Not only on-target but also multiple Vt is achieved in challengingly limited vertical spacing between channels. Also, reliability of MBCFETs is shown to be comparable to that of FinFETs. Three representative superior characteristics of MBCFET compared to FinFET have been demonstrated — better gate control with 65 mV/dec sub-threshold swing (SS) at short gate length, higher DC performance with a larger effective channel width (Weff) at reference footprint, and design flexibility with variable nanosheet (NS) widths. The optimization of the standard cell design by using variable NS width is evaluated. The usefulness of MBCFET as a multi-purpose performance provider is proven by the modulation of effective capacitance (Ceff), effective resistance (Reff) and frequency by Weff control. Finally, mass production feasibility with MBCFET is proven through a fully working high density SRAM circuit.

To evaluate pathological lesions in New Zealand white rabbits with acute kidney injury (AKI) of septic shock and to explore the potential role of poly (ADP-ribose) polymerase (PARP) in regulating AKI development.Endotoxic shock model in New Zealand white rabbits was first constructed. CVP (central venous pressure) was maintained at the baseline level by the saline administration. Rabbits were randomly assigned into sham group, LPS group, and LPS+3-AB group, respectively. Blood samples and kidney samples of rabbits were collected 4 h after LPS administration. Pathological kidney lesions were observed by HE (hematoxylin-eosin) staining and immunohistochemistry. Serum levels of renal damage markers (Scr, Cys-C, KIM-1, and NGAL) were detected by an automatic biochemical analyzer, immunoturbidimetry, and ELISA (enzyme-linked immunosorbent assay), respectively. Kidney energy metabolism changes (ATP, ADP, PCr, and NAD) were detected by HPLC (high performance liquid chromatography analysis). Western blot was conducted to detect protein expressions of NF-κB (nuclear factor-kappa B), TNF-α (tumor necrosis factor-α), ICAM-1 (intercellular cell adhesion molecule-1) and P-selectin in kidney tissues.Significant pathological lesions in kidney tissues and higher pathological grade were seen in the LPS group. Multiple PARP-positive nuclei were found in renal tubular cells at the junction of renal cortex and renal cortex in the LPS group. Serum levels of Scr, KIM-1, NGAL, and Cys-C were remarkably higher in the LPS group than those of sham group. HPLC results showed decreased levels of ATP, ADP, PCr, and NAD in kidney cortex of LPS group compared with those of sham group. Western blot results suggested that protein expressions of NF-κB, TNF-α, ICAM-1, and P-selectin were remarkably upregulated in kidney tissues of LPS group. 3-AB pretreatment, the PARP inhibitor, remarkably alleviated pathological lesions and inflammation induced by AKI.Inhibition of PARP overactivation alleviated pathological kidney lesions, improved kidney energy metabolism and inhibited inflammatory response resulted from AKI.

The present study centers on a largely unnoticed seventeenth century Chinese map entitled Tianxia jiubian fenye renji lucheng quantu 天下九邊分野人跡路程全圖 (Complete Map of the Allotted Fields, Human Traces, and Routes within and without the Nine Borders under Heaven, 1644). Printed by a lesser-known scholar Cao Junyi 曹君義, this map carried remarkable features that mixed a number of concepts and techniques from both Chinese and European cartographic traditions. It borrowed some information, including the oval layout, lines of longitude, and names of foreign places, from a few widely circulated Jesuit world maps, especially the one made by Matteo Ricci in 1602. Meanwhile, the map continued to represent a Sinocentric world order and the stereotyped concept of Chinese-Barbarian distinction. While the ‘Middle Kingdom’ remains at the center and occupies the largest area, regions such as Europe, Africa, and America are reduced disproportionally in size and put near the borders of China. By converging two very different cartographic traditions, Cao made a conscious effort to re-locate China in the newly known greater world. In-depth analysis of this particular map suggests that the seventeenth century encounter of Chinese and European cartographies should not be treated with a simplistic characterization of acceptance versus resistance, or, advancement versus backwardness. It was instead a complex process of negotiation and appropriation conditioned by various factors across scientific, ideological, cultural, and religious boundaries.

Objective To establish accurate and rapid methods to identify four new synthetic cannabinoids （JWH-203, JWH-122, 5F-APINACA and AB-CHMINACA） in blood samples. Methods The whole blood samples were extracted by acetonitrile and methanol, screened by gas chromatography-mass spectrometry （GC-MS） then confirmed by liquid chromatography-tandem mass spectrometry （LC-MS/MS） method, and multiple reaction monitoring （MRM） mode was used for quantitative analysis. Results The GC-MS method needed 21 min to complete the analysis, while the LC-MS/MS method needed 5 min. The AB-CHMINACA, JWH-203, 5F-APINACA and JWH-122 all used quasi molecular ion peak as a parent ion. The precursor-product ion combinations were全血中4种新型合成大麻素的快速检测.目的 建立准确、快速的方法鉴定血液中4种新型合成大麻素（JWH-203、JWH-122、5F-APINACA和AB-CHMINACA）。 方法 全血样品经乙腈-甲醇提取后，经气相色谱-质谱（gas chromatography-mass spectrometry，GC-MS）进行筛选，采用液相色谱-串联质谱（liquid chromatography-tandem mass spectrometry，LC-MS/MS）进行确认，采用多反应监测模式进行定量分析。 结果 GC-MS法于21 min完成分析，LC-MS/MS法于5 min完成分析，AB-CHMINACA、JWH-203、5F-APINACA和JWH-122均采用准分子离子峰作为母离子，定量离子对分别为法医毒理学；气相色谱-质谱法；液相色谱-串联质谱法；合成大麻素类；血液.

Background The second-generation ALK tyrosine kinase inhibitor (TKI) ALC has demonstrated efficacy and acceptable safety in ALK+ NSCLC pts who have progressed on CRZ. However, resistance to ALC eventually develops, with secondary resistance mutations detected in approximately 50% of pts and a median progression-free survival (PFS) Trial design The second-generation ALK tyrosine kinase inhibitor (TKI) ALC has demonstrated efficacy and acceptable safety in ALK+ NSCLC pts who have progressed on CRZ. However, resistance to ALC eventually develops, with secondary resistance mutations detected in approximately 50% of pts and a median progression-free survival (PFS) Table . 1586TiP Primary Endpoint Blinded independent review committee (BIRC)−assessed PFS per RECIST v1.1 Secondary Endpoints BIRC-assessed intracranial PFS Overall survival Investigator- and BIRC-assessed ORR, time to response, and duration of response (DOR) BIRC-assessed intracranial ORR and DOR Safety/tolerability Health-related quality of life Selected Exploratory Endpoints BIRC-assessed CNS efficacy per Response Assessment in Neuro-Oncology Brain Metastases criteria (intracranial ORR, DOR, and PFS) Molecular determinants of efficacy and safety with BRG and ALC Clinical trial identification NCT03596866. Editorial acknowledgement Peloton Advantage, LLC, an OPEN Health Company; funded by Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Legal entity responsible for the study ARIAD Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Funding ARIAD Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Disclosure S. Popat: Research grant / Funding (institution): Boehringer Ingelheim, Epizyme, BMS, Clovis Oncology, Roche, Lilly, Takeda; Honoraria (self): Boehringer Ingelheim, AstraZeneca, Roche, Takeda, Chugai Pharma; Advisory / Consultancy: Boehringer Ingelheim, Roche, Novartis, Pfizer, AstraZeneca, BMS, MSD, Guardant Health, AbbVie; Travel / Accommodation / Expenses: Boehringer Ingelheim, BMS, Merck Sharp & Dohme. G. Liu: Research grant / Funding (institution): Takeda, AstraZeneca, Roche, Bayer, Boehringer Ingerheim; Honoraria (self): Roche, Takeda, AstraZeneca, Bristol-Myers Squibb, AbbVie, Pfizer, Merck,Novartis, EMD Serano, Bayer; Advisory / Consultancy: Roche, Novartis, Pfizer. S. Lu: Advisory / Consultancy: AstraZeneca, Boehringer Ingelheim, Hutchison MediPharma, Simcere, Roche, JS InnoPharm; Speaker Bureau / Expert testimony: AstraZeneca, Roche; Research grant / Funding (self): AstraZeneca, Hutchison MediPharma. G. Song: Full / Part-time employment: Takeda. V. Samnotra: Full / Part-time employment: Takeda. J.C. Yang: Advisory / Consultancy: Boehringer Ingelheim, Eli Lilly, Bayer, Roche/Genentech/Chugai, Astellas, MSD, Merck Serono, Pfizer, Novartis, Celgene, Merrimack, Yuhan Pharmaceuticals, BMS, Ono Pharmaceutical, Daiichi Sankyo, Takeda, AstraZeneca, Hansoh Pharmaceuticals.

The thermal barrier coatings of nanostructured and micrometre structured 8 wt-% yttria partially stabilised zirconia (8YSZ) were prepared by atmospheric plasma spraying on 316L stainless steel. The microstructure, phase composition, hardness, adhesion strength, friction wear, oxidation resistance and thermal shock behaviour of the as sprayed coatings were studied. The X-ray diffraction pattern showed that the phase composition of nanostructured 8YSZ coating was different from the powder. The wear resistance of nanostructured 8YSZ coating significantly increased compared with that of the micrometre structured coating. The hardness, adhesion strength and thermal shock lifetime of nanostructured 8YSZ coating is higher than that of the micrometre structured one. In addition, the antioxygenic property of the nanostructured 8YSZ coating was slightly better than that of the micrometre structured 8YSZ coating.

The microarc oxidation (MAO) TiO2 films were fabricated in phosphate based electrolyte under different voltages on titanium to study the optimum voltage for photocatalysis, and then the doping process was carried out under the optimum condition above. The surface morphology and composition of MAO films were examined by scanning electron microscopy and X-ray diffraction. The photocatalytic activities of MAO films with and without cation dopant were evaluated by photocatalytic decolourisation of methylene blue in aqueous solution as a model pollutant under simulated sunlight irradiation. The results showed that the photocatalytic activity of MAO–TiO2 films first increased and then decreased with increasing the voltage, and the cation dopant enhanced the photocatalytic activity of MAO–TiO2 films. Moreover, the transition metal cation Cu2+ was more suitable for dope than the rare earth metal cation Ce4+ to some extent.

Plasma electrolytic oxidation (PEO) coatings were formed in silicate based electrolytes without and with the addition of sodium tungstate on AA 6063 aluminium alloy. Microstructure, composition and corrosion resistance of PEO coatings were investigated by scanning electron microscopy, X-ray diffraction and electrochemical impedance spectroscopy and potentiodynamic polarisation test respectively. The effects of additive sodium tungstate were examined. The results showed that the additive containing PEO coatings were of dense structure with additional phase (WO3) and of less cracks than the additive free PEO coating. In addition, additive containing coatings were of better corrosion resistance than the additive free PEO coating, which was confirmed by electrochemical impedance spectroscopy and potentiodynamic polarisation tests. Furthermore, long time immersion test revealed that the PEO coated alloy with the addition of 12 g L− 1 sodium tungstate maintained high impedance over 82 h in 3.5 wt-%NaCl, while t...

This paper presents the design and implementation of a robust model reference controller (RMRC) for active vibration suppression of a flexible structure, a cantilevered beam. The flexible beam is an aluminum beam in the cantilever configuration and is equipped with surface-bonded PZT (lead zirconate titanate) sensors/actuators. PZT is a piezoelectric material with a strong piezoelectric effect, and is a commonly used smart material. Since the fundamental vibration mode of the beam is the major concern in this paper, a linear model which represents the dominant vibration mode is developed and used as the plant model for the control design. Based on this linear model, a robust model reference controller (RMRC) is developed to suppress the beam’s vibration. Vibration suppression simulations and experiments are conducted. Both results show that the proposed controller achieves effective vibration suppression of the flexible beam using PZT sensors and actuators.

In this work, plasma electrolytic oxidation coating was formed on aluminium alloy in a cheap and inexpensive electrolyte to improve its wear resistance. It was found the micro-hardness of coatings increased first and then decreased with increasing the oxidised time. It was showed that the specimen treated under the time of 35 minutes exhibited the highest micro-hardness and lowest wear loss. The surface and cross-sectional morphology indicated that the coatings have a dense structure with low porosity. The presence of wear scars on the worn surface morphology demonstrates that the three-body rolling was the main wear mechanism for coated specimen. X-ray diffraction results showed the coating was formed mainly from α-Al2O3 and γ-Al2O3.

Objective The aim of this study was to determine whether polymorphisms of the Toll-like receptor ( TLR) genes are associated with susceptibility to systemic lupus erythematosus (SLE). Methods The authors conducted a meta-analysis of the relationship between 12 TLR polymorphisms and SLE susceptibility. Results In total, 26 studies that involved 11,984 patients and 14,572 controls were included in the meta-analysis. The meta-analysis showed no association between the two alleles of the rs352140, rs5743836, and rs352139 polymorphisms of TLR9 and SLE, but indicated an association between the two alleles of the rs187084 polymorphism ( TLR9) and SLE in the overall population (OR = 0.869, 95% CI = 0.762–0.992, P = 0.038). No association was detected between rs3764880 ( TLR8) and SLE; however, our meta-analysis indicated an association between rs3764879 ( TLR8) and SLE in Caucasians (OR = 1.414, 95% CI = 1.139–1.756, P = 0.002). An association between rs179008 ( TLR7) and SLE was found in the African (OR = 0.430, 95% CI = 0.238–0.775, P = 0.005), but not in the Caucasian population (OR = 1.206, 95% CI = 0.932–1.614, P = 0.145). Furthermore, our meta-analysis indicated a significant association between rs3853839 ( TLR7) and SLE in the Asian population (OR = 0.773, 95% CI = 0.735, 0.823, P −9). No associations were found between rs5744168 ( TLR5), rs4986791 ( TLR4), rs4986790 ( TLR4), and rs3775291 ( TLR3) polymorphisms and SLE susceptibility. Conclusions Our meta-analysis suggests that TLR7, TLR8, and TLR9 polymorphisms are associated with the development of SLE in Caucasian, Asian, and African populations.

First, microarc oxidation (MAO)-TiO2 films were prepared on titanium in a phosphate electrolyte to study the optimum treatment time for photocatalysis, and then, the doping process was carried out under the condition above. The phase composition and morphology of the films with two doping agents were characterised by X-ray diffraction (XRD) and scanning electron microscopy. The photocatalytic activity of the films was evaluated by photocatalytic decolorisation of methylene blue (MB) in aqueous solution. The results showed that the Ag2O–TiO2 composite film is composed of anatase and rutile, while the V2O5–TiO2 composite film is only composed of anatase. The photocatalytic tests proved that the composite films were of the ability to enhance the photocatalytic activity of MAO-TiO2 film, but exhibited different photocatalytic efficiency. In addition, V2O5 was more suitable for doping to some extent on photocatalytic activity for MAO-TiO2 film than Ag2O.

Plasma electrolytic oxidation (PEO) treated 6063 aluminum alloy was applied in a silicate- and borate-based alkaline solution. The microstructure and electrochemical corrosion behavior were studied by scanning electron microscopy, electrochemical impedance spectroscopy (EIS), and potentiodynamic polarization techniques. The results showed that the silicate-based PEO coating was of a denser structure compared with that of borate-based PEO coating. In addition, the silicate-based PEO coating was composed of more phased (Al9Si) than borate-based PEO coating. The results of corrosion test indicated that the silicate-based PEO coating provided a superior protection to 6063 aluminum alloy substrate, while borate-based PEO coating with a porous structure showed an inferior conservancy against corrosive electrolyte. Furthermore, the EIS tests proved that both coatings were capable to resist the aggressive erosion in 0.5 M NaCl solution after 72 h of immersion. However, the borate-based PEO coating could not provide sufficient protection to the substrate after 72-h immersion in 1 M NaCl solution.

The aim of this study was to investigate whether the C3435T polymorphism in the gene encoding multidrug resistance protein 1 (ABCB1) can predict responsiveness to or toxicity of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA).We conducted a meta-analysis of studies on the association between the ABCB1 C3435T polymorphism and nonresponsiveness to or toxicity of DMARDs in RA patients, using the PUBMED and EMBASE electronic citation databases. Subsequent inclusion/exclusion procedures were performed and then data were extracted for association analysis.A total of 14 comparison studies from 9 articles met our inclusion criteria. This final group comprised 4 studies containing data on associations between the ABCB1 C3435T polymorphism and RA susceptibility, 5 studies on the response to DMARDs, and 5 on toxicity of DMARDs in RA patients according to ABCB1 polymorphism status. Meta-analysis revealed no association between RA susceptibility and the ABCB1 C3435T polymorphism [odds ratio (OR) for the T allele = 0.948, 95 % confidence interval (CI) 0.756-1.189, p = 0.645]. Meta-analysis showed no association between the ABCB1 C3435T T allele and a nonresponse to DMARD therapy (OR 0.952, 95 % CI 0.516-1.685, p = 0.817). Stratification by DMARD type indicated no association between the ABCB1 C3435T T allele and nonresponse to methotrexate (MTX) treatment (OR 1.201, 95 % CI 0.456-3.164, p = 0.711). However, the analysis did indicate that MTX toxicity was associated with the ABCB1 C3435T polymorphism in RA under an overdominant model (TC vs. TT + CC; OR 0.483, 95 % CI 0.259-0.900, p = 0.022), evidencing a lower risk of MTX toxicity for heterozygotes (TC) than homozygotes (TT and CC).This meta-analysis demonstrated that the ABCB1 C3435T polymorphism may be not associated with responsiveness to DMARD therapy, but may be associated with MTX toxicity in RA.

Hydrogen embrittlement susceptibility of 7050 aluminum alloy under various aging states has been investigated by means of cathodic hydrogen permeation, slow strain rate test, hydrogen determinator, x-ray diffraction, and scanning electron microscope, and effect of hydrogen on atomic binding force of charged alloy has been calculated by free electron theory in this paper. Simultaneously, hydrogen-induced additive stress (σad) of 7050 aluminum alloy hydrogen charged with different current densities under various aging states have been investigated by flowing stress differential method. The results showed that hydrogen concentration of examined alloy increased with increasing charging time or current density under the same aging state. Hydrogen segregation occurred at grain boundaries which enlarged the crystal lattice constant, meanwhile, it reduced the average bonding energy and interatomic bonding force of the grain boundary atoms, thus resulting in hydrogen embrittlement; moreover, σad of 7050 aluminum alloy increased linearly with increasing hydrogen concentration under the same aging state, i.e., under aged: σad = −1.61 + 9.93 × 105 C H, peak aged: σad = −1.55 + 9.67 × 105 C H, over aged: σad = −0.16 + 9.35 × 105 C H, correspondingly, σad increased the susceptibility to hydrogen embrittlement (I HE) further. Under the same charging condition, aging states had a great influence on σad and I HE, the under-aged state alloy was of the highest, the over-aged state alloy was of the lowest, and peak-aged was in the middle.

Aims This study aimed to assess the relative efficacy and safety of tacrolimus, mycophenolate mofetil (MMF) and cyclophosphamide (CYC) as induction therapy for lupus nephritis. Methods Randomized controlled trials (RCTs) examining the efficacy and safety of tacrolimus, MMF and CYC for induction therapy in patients with lupus nephritis were included. We performed a Bayesian random-effects network meta-analysis to combine direct and indirect evidence from the RCTs. Results Nine RCTs including 972 patients met the inclusion criteria and pair-wise comparisons were performed, including 11 direct comparisons. Tacrolimus showed a significantly higher overall response rate (complete remission plus partial remission) than CYC (OR 2.35, 95% confidence interval (CI) 1.03–5.45), and was more efficacious than MMF (OR 1.60, 95% CI 0.70–3.57). MMF was superior to CYC in terms of overall response (OR 1.45, 95% CI 0.96–2.42). Ranking probability based on the surface under the cumulative ranking curve (SUCRA) indicated that tacrolimus had the highest probability of being the best treatment for achieving the overall response (SUCRA = 0.9321), followed by MMF (SUCRA = 0.5385) and CYC (SUCRA = 0.0294). In terms of safety, tacrolimus showed the highest probability of decreasing the risk of serious infections (SUCRA = 0.9253), followed by MMF (SUCRA = 0.4027) and CYC (SUCRA = 0.1720). Conclusions Tacrolimus was the most efficacious induction treatment for patients with lupus nephritis, and had the highest probability of decreasing the risk of serious infections. Higher remission rates combined with a more favorable safety profile suggest that MMF is superior to CYC as induction treatment in these patients.

The objective of this study was to explore the linkage of oxidative stress occurring in mitochondria, skeletal muscles, and plasma in heat stress-challenged broilers. At d 35, 24 broilers were randomly assigned to 2 treatments: rearing at high temperature (32 ± 1°C; heat stress group) or normal temperature (21 ± 1.2°C; control) for 7 d. The oxidative damage of lipid, DNA, and protein and the activities of antioxidative enzymes were measured, respectively, in plasma, skeletal muscles (breast and thigh muscles), and skeletal muscle mitochondria. The result showed that heat exposure increased (P 0.05). Heat stress increased SOD (P < 0.05) and decreased GSH-Px activities (P < 0.05) of mitochondria regardless of muscle types. Plasma allantoin level increased (P < 0.01) correspondingly with urate (P < 0.001) in heat-stressed broilers, indicating that urate could serve as an antioxidant to enhance the antioxidative capacity during stress in a concentration-dependent manner. The activities of respiratory chain complexes I and III were estimated in skeletal muscle mitochondria. Mitochondrial complex I activity was suppressed (P < 0.01) by heat exposure in breast and thigh muscles but complex III activity was elevated only in breast muscle (P < 0.01) of heat-stressed broiler. The fatty acid composition in skeletal muscle was not influenced by heat stress. In conclusion, suppressed mitochondrial complex I activity is associated with oxidative stress induced by heat exposure, which, in turn, is linked with the oxidative damages in muscle tissues and plasma.

Objective The aim of this study was to determine whether the functional CD40 rs4810485 G/T polymorphism is associated with susceptibility to rheumatoid arthritis (RA) or with susceptibility to systemic lupus erythematosus (SLE). Methods A series of meta-analyses were conducted to test for association between the CD40 rs4810485 G/T polymorphism and RA or SLE. Results A total of 21 comparisons involving 15,095 patients and 27,050 controls for RA, and 1353 patients and 2342 controls for SLE were considered. Meta-analysis showed a significant association between the CD40 rs4810485 T allele and RA in all subjects (odds ratio (OR) 0.890, 95% confidence interval (CI) 0.846–0.936, p = 5.5 × 10−7). After stratification by ethnicity, the CD40 T allele was found to be significantly associated with RA in Europeans (OR 0.879, 95% CI 0.848–0.901, p = 3.0 × 10−9). A similar pattern of association was observed between the CD40 T allele and RA when the analysis was performed using the recessive, dominant, and additive models. Meta-analysis also showed a significant association between the CD40 polymorphism and SLE in Europeans (OR for the T allele 0.715, 95% CI 0.641–0.832, p = 1.4 × 10−6). Conclusions Our meta-analyses confirm that the CD40 rs4810485 G/T polymorphism is associated with susceptibility to RA and SLE in Europeans.