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Infliximab and golimumab are intravenously (IV) administered tumor necrosis factor inhibitors approved to treat moderate-to-severe rheumatoid arthritis (RA) with concomitant methotrexate. Owing to differences in biologic construct, patients with IV-infliximab treatment failure may benefit from switching to IV-golimumab. Utilizing the ACR's Rheumatology Informatics System for Effectiveness (RISE), a large electronic health records registry based in the USA, we assessed RA disease activity in patients switching from IV-infliximab to IV-golimumab. This retrospective, longitudinal, single-arm study included adults (≥ 18 years) with ≥ 1 RA diagnosis code between 2014 and 2018 and ≥ 1 IV-infliximab prescription within 6 months of a new IV-golimumab order (index date). Longitudinal assessments of disease activity using the Clinical Disease Activity Index (CDAI) were calculated in patients continuing IV-golimumab for 6-9- and 9-12-months post-switch. Paired t-tests evaluated significance of mean improvements during the follow-up periods. Most RA patients with disease activity assessments during the 6-month follow-up (N = 100; mean age: 65.3 years; 81% female; 74% white) demonstrated moderate-to-high disease activity (CDAI: 73% [38/52]) at enrollment. On average, patients showed significant improvement in disease activity within 6-9 months of switching; mean CDAI scores improved from 21.3 to 14.1 (p < 0.0001) and were durable through 9-12 months of treatment. Real-world patients with moderate-to-high disease activity who switched from IV-infliximab to IV-golimumab demonstrated significant and sustained improvements post-switch as measured by the CDAI. Key Points • This study used real-world data from the Rheumatology Informatics System for Effectiveness (RISE) registry to evaluate the efficacy of directly switching from intravenous (IV)-infliximab to IV-golimumab to control rheumatoid arthritis (RA) disease activity. • Most IV-infliximab patients

Infliximab and golimumab are intravenously (IV) administered tumor necrosis factor inhibitors approved to treat moderate-to-severe rheumatoid arthritis (RA) with concomitant methotrexate. Owing to differences in biologic construct, patients with IV-infliximab treatment failure may benefit from switching to IV-golimumab. Utilizing the ACR's Rheumatology Informatics System for Effectiveness (RISE), a large electronic health records registry based in the USA, we assessed RA disease activity in patients switching from IV-infliximab to IV-golimumab. This retrospective, longitudinal, single-arm study included adults (≥ 18 years) with ≥ 1 RA diagnosis code between 2014 and 2018 and ≥ 1 IV-infliximab prescription within 6 months of a new IV-golimumab order (index date). Longitudinal assessments of disease activity using the Clinical Disease Activity Index (CDAI) were calculated in patients continuing IV-golimumab for 6-9- and 9-12-months post-switch. Paired t-tests evaluated significance of mean improvements during the follow-up periods. Most RA patients with disease activity assessments during the 6-month follow-up (N = 100; mean age: 65.3 years; 81% female; 74% white) demonstrated moderate-to-high disease activity (CDAI: 73% [38/52]) at enrollment. On average, patients showed significant improvement in disease activity within 6-9 months of switching; mean CDAI scores improved from 21.3 to 14.1 (p < 0.0001) and were durable through 9-12 months of treatment. Real-world patients with moderate-to-high disease activity who switched from IV-infliximab to IV-golimumab demonstrated significant and sustained improvements post-switch as measured by the CDAI. Key Points • This study used real-world data from the Rheumatology Informatics System for Effectiveness (RISE) registry to evaluate the efficacy of directly switching from intravenous (IV)-infliximab to IV-golimumab to control rheumatoid arthritis (RA) disease activity. • Most IV-infliximab patients

Researchers in organizational behaviors have long been interested in exploring behaviors benefiting to organisations and sought to better understand the relation with work engagement. This study aims at understanding the role of the three components of organizational commitment (i.e., affective, normative, and continuance commitment) and job satisfaction as a mediator between work engagement and Organizational Citizenship Behaviors (OCB). Within this cross-sectional study, the data (N =151) was analyzed via a parallel mediation analysis using the PROCESS-tool. Drawing upon the Social Exchange Theory, the current study found evidence that work engagement positively relates to OCB. Moreover, affective commitment was found to partially mediate the relation between work engagement and OCB. However, normative and continuance commitment were not found to mediate the relationship. In addition, job satisfaction was not a significant mediator through which work engagement affects OCB. This study contributes to existing literature as it is among the first to provide insight into the role of all three components of organizational commitment and job satisfaction on the proposed work engagement – OCB relation. Implications for results and suggestions for further research are discussed. As affective commitment is found to mediate the relation between work engagement and OCB, the importance of identification with, involvement in, and emotional attachment towards organizations is underlined for managers and organizations in order to increase OCB among engaged employees.

The internalization of apoptotic cells by non-phagocytic cells has been observed in different tissues and could be an important mechanism for the elimination of dying cells. Here, we describe a probable event of phagocytosis of apoptotic cells mediated by urothelial cells in urinary sediment. A 90-years-old male patient was admitted unconscious to the hospital, visible signs included: pale skin and dry mucous membranes, presumptively diagnosed as dehydration. Blood test revealed anaemia (haemoglobin 130 g/L) and hyperglycaemia (glucose 7.8 mmol/L), urinalysis showed a picture of urinary tract infection (leukocyturia and bacteriuria). The microscopic analysis of urinary sediment revealed the presence of urothelial cells and leukocytes internalized in urothelial cells. Anti-CD68 (membrane marker of macrophages) was tested by immunocytochemistry and a negative result was observed. Based on the findings phagocytosis of apoptotic cells mediated by urothelial cells was identified. This phenomenon can be observed in urinary sediment and should not be confused with a neoplastic process since it is a physiological event of cell elimination.

The inclusion brought discussions to all spheres of society, being in emphasis in the last decades. At school, laws direct who should be the target audience, including people with disabilities and/or special educational needs, while researchers discuss who, in fact, is part of this inclusion. From this perspective, the basic education census provides enrollment data at all stages and types of education in Brazil, which can give clues about the public inserted in schools in the country. In order to understand this reality, this article brings discussions about these enrollments based on the National Policy for Special Education in the Perspective of Inclusive Education of 2008, the Statute of Persons with Disabilities of 2015 and the National Policy for Special Education of 2020. We conclude that, despite the laws trying to present provisions towards inclusion, we evidence several social and economic barriers for it to be effective in school., A inclusão trouxe discussões para todos os âmbitos da sociedade, estando em ênfase nas últimas décadas. Na escola, as leis direcionam quem deveria ser o público-alvo, abrangendo as pessoas com deficiência e/ou necessidades educacionais especiais, enquanto os pesquisadores discutem quem, de fato, faz parte desta inclusão. Nessa ótica, o censo da educação básica fornece dados de matrículas em todas as etapas e modalidades de ensino no Brasil que podem dar indícios sobre o público inserido nas escolas do país. Com a finalidade de compreender esta realidade, este artigo traz discussões acerca destas matrículas, pautadas na Política Nacional de Educação Especial na Perspectiva da Educação Inclusiva de 2008, no Estatuto da Pessoa com Deficiência de 2015 e na Política Nacional de Educação Especial de 2020. Concluímos que, apesar das leis tentarem apresentar dispositivos no sentido da inclusão, evidenciamos diversas barreiras sociais e econômicas para que ela se efetive na escola., La inclusión trajo discusiones a todos los ámbitos de la sociedad, siendo un énfasis en las últimas décadas. En la escuela, las leyes determinan quién debe ser su público, incluidas las personas con discapacidades y/o necesidades educativas especiales, mientras que los investigadores discuten quién, de hecho, es parte de esta inclusión. Desde esta perspectiva, el censo de educación básica proporciona datos de matrícula en todas las etapas y tipos de educación en Brasil, lo que puede dar pistas sobre el público insertado en las escuelas del país. Para entender esta realidad, este artículo trae discusiones sobre estas matrículas basadas en la Política Nacional de Educación Especial en la Perspectiva de la Educación Inclusiva de 2008, el Estatuto de la Persona con Discapacidad de 2015 y la Política Nacional de Educación Especial de 2020. Concluimos que, a pesar de que las leyes intentan presentar disposiciones hacia la inclusión, evidenciamos varias barreras sociales y económicas para que sea efectiva en la escuela.

The internalization of apoptotic cells by non-phagocytic cells has been observed in different tissues and could be an important mechanism for the elimination of dying cells. Here, we describe a probable event of phagocytosis of apoptotic cells mediated by urothelial cells in urinary sediment. A 90-years-old male patient was admitted unconscious to the hospital, visible signs included: pale skin and dry mucous membranes, presumptively diagnosed as dehydration. Blood test revealed anaemia (haemoglobin 130 g/L) and hyperglycaemia (glucose 7.8 mmol/L), urinalysis showed a picture of urinary tract infection (leukocyturia and bacteriuria). The microscopic analysis of urinary sediment revealed the presence of urothelial cells and leukocytes internalized in urothelial cells. Anti-CD68 (membrane marker of macrophages) was tested by immunocytochemistry and a negative result was observed. Based on the findings phagocytosis of apoptotic cells mediated by urothelial cells was identified. This phenomenon can be observed in urinary sediment and should not be confused with a neoplastic process since it is a physiological event of cell elimination.

Researchers in organizational behaviors have long been interested in exploring behaviors benefiting to organisations and sought to better understand the relation with work engagement. This study aims at understanding the role of the three components of organizational commitment (i.e., affective, normative, and continuance commitment) and job satisfaction as a mediator between work engagement and Organizational Citizenship Behaviors (OCB). Within this cross-sectional study, the data (N =151) was analyzed via a parallel mediation analysis using the PROCESS-tool. Drawing upon the Social Exchange Theory, the current study found evidence that work engagement positively relates to OCB. Moreover, affective commitment was found to partially mediate the relation between work engagement and OCB. However, normative and continuance commitment were not found to mediate the relationship. In addition, job satisfaction was not a significant mediator through which work engagement affects OCB. This study contributes to existing literature as it is among the first to provide insight into the role of all three components of organizational commitment and job satisfaction on the proposed work engagement – OCB relation. Implications for results and suggestions for further research are discussed. As affective commitment is found to mediate the relation between work engagement and OCB, the importance of identification with, involvement in, and emotional attachment towards organizations is underlined for managers and organizations in order to increase OCB among engaged employees.

The dynamics of a population expanding into unoccupied habitat has been primarily studied for situations in which growth and dispersal parameters are uniform in space or vary in one dimension. Here, we study the influence of finite-sized individual inhomogeneities and their collective effect on front speed if randomly placed in a two-dimensional habitat. We use an individ- ual-based model to investigate the front dynamics for a region in which dispersal or growth of individuals is reduced to zero (obstacles) or increased above the background (hotspots), respectively. In a regime where front dynamics is determined by a local front speed only, a principle of least time can be employed to predict front speed and shape. The resulting analytical solutions motivate an event-based algorithm illustrating the effects of several obstacles or hotspots. We finally apply the principle of least time to large heterogeneous environments by solving the Eikonal equation numerically. Obstacles lead to a slow-down that is dominated by the number density and width of obstacles, but not by their precise shape. Hotspots result in a speed-up, which we characterize as function of hotspot strength and density. Our findings emphasize the importance of taking the dimensionality of the environment into account.

The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient., A fagocitose de estruturas fúngicas por neutrófilos é uma função bem documentada destas células imunes. No entanto, a fagocitose de hifas por neutrófilos no sedimento urinário não é normalmente observada durante avaliação de rotina de amostras. Este é um caso de fagocitose de hifas por neutrófilos na urina de um paciente receptor de aloenxerto renal.

The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient., A fagocitose de estruturas fúngicas por neutrófilos é uma função bem documentada destas células imunes. No entanto, a fagocitose de hifas por neutrófilos no sedimento urinário não é normalmente observada durante avaliação de rotina de amostras. Este é um caso de fagocitose de hifas por neutrófilos na urina de um paciente receptor de aloenxerto renal.

The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient., A fagocitose de estruturas fúngicas por neutrófilos é uma função bem documentada destas células imunes. No entanto, a fagocitose de hifas por neutrófilos no sedimento urinário não é normalmente observada durante avaliação de rotina de amostras. Este é um caso de fagocitose de hifas por neutrófilos na urina de um paciente receptor de aloenxerto renal.

The dynamics of a population expanding into unoccupied habitat has been primarily studied for situations in which growth and dispersal parameters are uniform in space or vary in one dimension. Here, we study the influence of finite-sized individual inhomogeneities and their collective effect on front speed if randomly placed in a two-dimensional habitat. We use an individ- ual-based model to investigate the front dynamics for a region in which dispersal or growth of individuals is reduced to zero (obstacles) or increased above the background (hotspots), respectively. In a regime where front dynamics is determined by a local front speed only, a principle of least time can be employed to predict front speed and shape. The resulting analytical solutions motivate an event-based algorithm illustrating the effects of several obstacles or hotspots. We finally apply the principle of least time to large heterogeneous environments by solving the Eikonal equation numerically. Obstacles lead to a slow-down that is dominated by the number density and width of obstacles, but not by their precise shape. Hotspots result in a speed-up, which we characterize as function of hotspot strength and density. Our findings emphasize the importance of taking the dimensionality of the environment into account.

The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient., A fagocitose de estruturas fúngicas por neutrófilos é uma função bem documentada destas células imunes. No entanto, a fagocitose de hifas por neutrófilos no sedimento urinário não é normalmente observada durante avaliação de rotina de amostras. Este é um caso de fagocitose de hifas por neutrófilos na urina de um paciente receptor de aloenxerto renal.

The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient., A fagocitose de estruturas fúngicas por neutrófilos é uma função bem documentada destas células imunes. No entanto, a fagocitose de hifas por neutrófilos no sedimento urinário não é normalmente observada durante avaliação de rotina de amostras. Este é um caso de fagocitose de hifas por neutrófilos na urina de um paciente receptor de aloenxerto renal.

In this study, we present an innovative technique for speaker adaptation in order to improve the accuracy of segmentation with application to unit-selection Text-To-Speech (TTS) systems. Unlike conventional techniques for speaker adaptation, which attempt to improve the accuracy of the segmentation using acoustic models that are more robust in the face of the speaker's characteristics, we aim to use only context dependent characteristics extrapolated with linguistic analysis techniques. In simple terms, we use the intuitive idea that context dependent information is tightly correlated with the related acoustic waveform. We propose a statistical model, which predicts correcting values to reduce the systematic error produced by a state-of-the-art Hidden Markov Model (HMM) based speech segmentation. Our approach consists of two phases: (1) identifying context-dependent phonetic unit classes (for instance, the class which identifies vowels as being the nucleus of monosyllabic words); and (2) building a regression model that associates the mean error value made by the ASR during the segmentation of a single speaker corpus to each class. The success of the approach is evaluated by comparing the corrected boundaries of units and the state-of-the-art HHM segmentation against a reference alignment, which is supposed to be the optimal solution. In conclusion, our work supplies a first analysis of a model sensitive to speaker-dependent characteristics, robust to defective and noisy information, and a very simple implementation which could be utilized as an alternative to either more expensive speaker-adaptation systems or of numerous manual correction sessions., Comment: isbn:978-88-7870-619-4

Introduction: It has already been reported that subinhibitory concentrations of β-lactam antibiotics can cause abnormal changes of bacterial forms, such as spheroplasts. Herein we report a case of Croatian male patient with Escherichia coli spheroplasts present in urine after treatment with tazobactam, on the tenth day of hospitalization. The aim of this report is to emphasize the inability of imaging based automated urine analysers to recognize some relatively uncommon forms of bacterial presentation in urine sediment. Materials and methods: During routine urine analysis, unusual particles were observed in patient urine. Urine sediment was examined by two urine analysers: Atellica 1500 (Siemens, Germany) and Iris iQ200 (Beckman Coulter, USA). Additionally, urine was sent for culture testing to Microbiology department. Results: Both urine analysers didn’t indicate presence of bacteria in urine sediment. Unusual particles observed on the tenth day were classified as erythrocytes by both instruments. Dipstick test showed blood trace and microscopic analysis revealed bacteria in urine. Urine culture was positive for Escherichia coli. Careful examination of urine sediment has confirmed that shapes present in urine were abnormal bacterial forms called spheroplasts. Conclusions: Imaging based automated urine analysers are not able to recognize bacterial spheroplasts in urine sediment misclassifying it as erythrocytes. Microscopic examination remains the gold standard for urines with blood trace or negative blood, in which erythrocytes are reported by urine analyser in urine sediment. Failure to identify and follow up such cases may lead to inaccurate treatment decisions and puts patient safety at risk.

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata, Open Access APC beslut 11/2019

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata, Open Access APC beslut 11/2019

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata, Open Access APC beslut 11/2019

Background: Cyanobacterium Athrospira platensis (Spirulina) is a potential fishmeal (FM) substitute in fish diets because of its high protein content, antioxidant and immunostimulant properties. Objective: To evaluate the effects of total and partial substitution of FM with A. platensis (0, 30, 50, 70 and 100% substitution) in juvenile mullet (Mugil liza). Methods: Juvenile mullets (n=210) were maintained in a recirculation system under optimal water parameters for the species. Mullets were fed five experimental diets for 80 days. Each diet was tested in triplicate tanks. At the end of the experimental period growth parameters were measured and samples of blood, liver and spleen were taken to evaluate the immune system. Results: Full replacement (100%) of FM resulted in growth deficits and low survival. The FM replacement induced changes in the proportion of macrophages and lymphocytes. Up to 50% FM replacement increased the expression of CD3 receptors in spleen T lymphocytes (T-Cells), whereas >50% FM replacement decreased the expression of CD3 receptors. We also found that partial FM substitution diminished the apoptotic process. Conclusions: Up to 50% FM substitution with A. platensis can improve performance of non-specific immune system of mullets., Resumo Antecedentes: A cianobactéria Athrospira platensis (Spirulina) é um potencial substituto da farinha de peixe (FP) pelo seu alto conteúdo de proteína, antioxidantes e características imune estimulantes. Objetivo: Foram avaliados os efeitos da substituição parcial e total da FP por A. platensis (0, 30, 50, 70 e 100% substituição) em juvenis de tainha (Mugil liza). Métodos: Juvenis de tainha (n=210) foram mantidos em um sistema de recirculação com os parâmetros da água sendo mantidos em níveis ótimos para a espécie. As tainhas foram alimentadas com as dietas experimentais por 80 dias, cada dieta foi testada em triplicata, ao final do período experimental foram avaliados os parâmetros de crescimento e amostras de sangue, fígado e baço foram coletadas para a avaliação do sistema imune. Resultados: A substituição total de FP resultou em redução do crescimento e baixa sobrevivência. A avaliação do sistema imune demostrou que a substituição da FP produz alterações nas proporções de macrófagos e linfócitos. Provou-se que até 50% de substituição da FP incrementa a expressão de receptores CD3. Além disso, a substituição parcial da FP diminui o processo de apoptose. Conclusão: Baseado em nossos descobrimentos, se propõe a substituição de até 50% da FP por A. platensis que melhorará o desempenho do sistema imunológico não específico das tainhas., Resumen Antecedentes: La cianobacteria Arthrospira platensis (Spirulina) puede usarse como substituto potencial de la harina de pescado (HP) por su alto contenido de proteína, sus antioxidantes y sus propiedades inmunoestimulantes. Objetivo: Analizar el efecto de la substitución parcial y total de HP por A. platensis (0, 30, 50, 70 y 100% de substitución) en juveniles de lisa (Mugil liza). Métodos: Juveniles de lisa (n=210) se mantuvieron en un sistema de recirculación con parámetros de calidad de agua en niveles óptimos para la especie. Las lisas se alimentaron con las dietas experimentales durante 80 días. Cada dieta fue evaluada en triplicado. Al final del periodo experimental se midieron los parámetros de crecimiento y se colectaron muestras de sangre, hígado y bazo para evaluación del sistema inmune. Resultados: La substitución total (100%) resultó en deficiente crecimiento y baja sobrevivencia. El remplazo de HP produjo cambios en las proporciones de macrófagos y linfocitos. La substitución de hasta un 50% HP aumentó la expresión de receptores CD3 en linfocitos T del bazo. Por otro lado, la substitución mayor a 50% HP disminuyó la expresión de receptores CD3. La substitución parcial de HP disminuyó el proceso de apoptosis. Conclusiones: Proponemos una substitución de HP del 50% por A. platensis, lo cual mejora el desempeño del sistema inmune no especifico de las lisas.

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata, Open Access APC beslut 11/2019

Background: Cyanobacterium Athrospira platensis (Spirulina) is a potential fishmeal (FM) substitute in fish diets because of its high protein content, antioxidant and immunostimulant properties. Objective: To evaluate the effects of total and partial substitution of FM with A. platensis (0, 30, 50, 70 and 100% substitution) in juvenile mullet (Mugil liza). Methods: Juvenile mullets (n=210) were maintained in a recirculation system under optimal water parameters for the species. Mullets were fed five experimental diets for 80 days. Each diet was tested in triplicate tanks. At the end of the experimental period growth parameters were measured and samples of blood, liver and spleen were taken to evaluate the immune system. Results: Full replacement (100%) of FM resulted in growth deficits and low survival. The FM replacement induced changes in the proportion of macrophages and lymphocytes. Up to 50% FM replacement increased the expression of CD3 receptors in spleen T lymphocytes (T-Cells), whereas >50% FM replacement decreased the expression of CD3 receptors. We also found that partial FM substitution diminished the apoptotic process. Conclusions: Up to 50% FM substitution with A. platensis can improve performance of non-specific immune system of mullets., Resumo Antecedentes: A cianobactéria Athrospira platensis (Spirulina) é um potencial substituto da farinha de peixe (FP) pelo seu alto conteúdo de proteína, antioxidantes e características imune estimulantes. Objetivo: Foram avaliados os efeitos da substituição parcial e total da FP por A. platensis (0, 30, 50, 70 e 100% substituição) em juvenis de tainha (Mugil liza). Métodos: Juvenis de tainha (n=210) foram mantidos em um sistema de recirculação com os parâmetros da água sendo mantidos em níveis ótimos para a espécie. As tainhas foram alimentadas com as dietas experimentais por 80 dias, cada dieta foi testada em triplicata, ao final do período experimental foram avaliados os parâmetros de crescimento e amostras de sangue, fígado e baço foram coletadas para a avaliação do sistema imune. Resultados: A substituição total de FP resultou em redução do crescimento e baixa sobrevivência. A avaliação do sistema imune demostrou que a substituição da FP produz alterações nas proporções de macrófagos e linfócitos. Provou-se que até 50% de substituição da FP incrementa a expressão de receptores CD3. Além disso, a substituição parcial da FP diminui o processo de apoptose. Conclusão: Baseado em nossos descobrimentos, se propõe a substituição de até 50% da FP por A. platensis que melhorará o desempenho do sistema imunológico não específico das tainhas., Resumen Antecedentes: La cianobacteria Arthrospira platensis (Spirulina) puede usarse como substituto potencial de la harina de pescado (HP) por su alto contenido de proteína, sus antioxidantes y sus propiedades inmunoestimulantes. Objetivo: Analizar el efecto de la substitución parcial y total de HP por A. platensis (0, 30, 50, 70 y 100% de substitución) en juveniles de lisa (Mugil liza). Métodos: Juveniles de lisa (n=210) se mantuvieron en un sistema de recirculación con parámetros de calidad de agua en niveles óptimos para la especie. Las lisas se alimentaron con las dietas experimentales durante 80 días. Cada dieta fue evaluada en triplicado. Al final del periodo experimental se midieron los parámetros de crecimiento y se colectaron muestras de sangre, hígado y bazo para evaluación del sistema inmune. Resultados: La substitución total (100%) resultó en deficiente crecimiento y baja sobrevivencia. El remplazo de HP produjo cambios en las proporciones de macrófagos y linfocitos. La substitución de hasta un 50% HP aumentó la expresión de receptores CD3 en linfocitos T del bazo. Por otro lado, la substitución mayor a 50% HP disminuyó la expresión de receptores CD3. La substitución parcial de HP disminuyó el proceso de apoptosis. Conclusiones: Proponemos una substitución de HP del 50% por A. platensis, lo cual mejora el desempeño del sistema inmune no especifico de las lisas.

INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes. OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study. METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group. ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenata

OBJECTIVE: To evaluate the safety and efficacy of intravenous golimumab + methotrexate (MTX) in patients with active rheumatoid arthritis (RA) aged < 65 years and those ≥ 65 years who were enrolled in the GO-FURTHER study. METHODS: In the phase III, double-blind, randomized, placebo-controlled GO-FURTHER trial, patients with active RA were randomized to intravenous (IV) golimumab 2 mg/kg + MTX or placebo + MTX at weeks 0 and 4, then every 8 weeks thereafter (with crossover to golimumab at week 16 [early escape] or week 24 [per-protocol]). The final golimumab infusion was at week 100. Assessments included American College of Rheumatology (ACR) 20/50/70 response criteria. Efficacy and adverse events (AEs) were monitored through 2 years. Efficacy and AEs were summarized for patients aged < 65 years or ≥ 65 years; AEs were also summarized for patients < or ≥ 70 years and patients < or ≥ 75 years. RESULTS: In GO-FURTHER, 592 patients were randomized to receive placebo (n = 197) or golimumab (n = 395), 515 were aged < 65 years and 77 were ≥ 65 years. At week 24, ACR20 response rates were greater for golimumab + MTX patients compared with placebo + MTX for patients < 65 years (61.6% vs 31.3%, p < 0.001) and those ≥ 65 years (69.5% vs 33.3%; p < 0.01). Infections were the most common AE through week 112 (51.6% in patients < 65 years; 55.3% in patients ≥ 65 years); upper respiratory infections were the most common infection in patients < 65 years (13.2%) and those ≥ 65 years (11.8%). Serious AEs occurred in 17.7% in patients < 65 years and 25.0% of patients ≥ 65 years and included malignancies, pneumonia, fractures, acute pancreatitis, cellulitis, and bacterial arthritis. CONCLUSIONS: In GO-FURTHER, ACR response rates were similar between patients < 65 years and patients ≥ 65 years within each treatment group. AEs in elderly patients were similar to the known safety profile of IV golimumab. Immunosenescence is known to increase the risk of infections in the elderly. Elderly

This paper aimed to evaluate the genetic diversity of upland rice varieties, determine the components that contributes most to productivity and evaluate the yield of varieties grown in conventional and organic farming systems. The experiment was carried out during the 2011/2012, 2012/2013 and 2013/2014 crop years, with 11 local upland rice varieties (Agulha, Rosa 15, Mato Grosso, Gomes, Preto, Argentino, Kinsel, Camilo, Piriquito, Casca Roxa and Caipira) and two commercial varieties (Primavera and Cambará). Genetic diversity was observed among the varieties for all evaluated variables and the thousand grain weight was the character that contributed most to the divergence between varieties. The number of panicles m-2 was the yield component that presented the highest association with grain yield of varieties in organic farming systems. The average yield of the varieties was 2.303, 1.711 and 3.534 kg ha-1 for the seasons 1, 2 and 3 respectively, and the highest yields were obtained with earlier sowing and temperature during grains maturation about 20°C. The ‘Piriquito’, ‘Argentino’, ‘Gomes’ and ‘Kinsel’ varieties presented yield above 2.000 kg ha-1 for all seasons, in both systems, indicating better adaptation to the region of the study and can be indicated as the most promising for the crop under organic cultivation.

This paper aimed to evaluate the genetic diversity of upland rice varieties, determine the components that contributes most to productivity and evaluate the yield of varieties grown in conventional and organic farming systems. The experiment was carried out during the 2011/2012, 2012/2013 and 2013/2014 crop years, with 11 local upland rice varieties (Agulha, Rosa 15, Mato Grosso, Gomes, Preto, Argentino, Kinsel, Camilo, Piriquito, Casca Roxa and Caipira) and two commercial varieties (Primavera and Cambará). Genetic diversity was observed among the varieties for all evaluated variables and the thousand grain weight was the character that contributed most to the divergence between varieties. The number of panicles m-2 was the yield component that presented the highest association with grain yield of varieties in organic farming systems. The average yield of the varieties was 2.303, 1.711 and 3.534 kg ha-1 for the seasons 1, 2 and 3 respectively, and the highest yields were obtained with earlier sowing and temperature during grains maturation about 20°C. The ‘Piriquito’, ‘Argentino’, ‘Gomes’ and ‘Kinsel’ varieties presented yield above 2.000 kg ha-1 for all seasons, in both systems, indicating better adaptation to the region of the study and can be indicated as the most promising for the crop under organic cultivation.

The expansion of a population into new habitat is a transient process that leaves its footprints in the genetic composition of the expanding population. How the structure of the environment shapes the population front and the evolutionary dynamics during such a range expansion is little understood. Here, we investigate the evolutionary dynamics of populations consisting of many selectively neutral genotypes expanding on curved surfaces. Using a combination of individual-based off-lattice simulations, geometrical arguments, and lattice-based stepping-stone simulations, we characterise the effect of individual bumps on an otherwise flat surface. Compared to the case of a range expansion on a flat surface, we observe a transient relative increase, followed by a decrease, in neutral genetic diversity at the population front. In addition, we find that individuals at the sides of the bump have a dramatically increased expected number of descendants, while their neighbours closer to the bump's centre are far less lucky. Both observations can be explained using an analytical description of straight paths (geodesics) on the curved surface. Complementing previous studies of heterogeneous flat environments, the findings here build our understanding of how complex environments shape the evolutionary dynamics of expanding populations.

The expansion of biological species in natural environments is usually described as the combined effect of individual spatial dispersal and growth. In the case of aquatic ecosystems flow transport can also be extremely relevant as an extra, advection induced, dispersal factor. We designed and assem- bled a dedicated microfluidic device to control and quantify the expansion of populations of E.coli bacteria under both co-flowing and counter-flowing conditions, measuring the front speed at varying intensity of the imposed flow. At variance with respect to the case of classic advective-reactive- diffusive chemical fronts, we measure that almost irrespective of the counter-flow velocity, the front speed remains finite at a constant positive value. A simple model incorporating growth, dispersion and drift on finite-size hard beads allows to explain this finding as due to a finite volume effect of the bacteria. This indicates that models based on the Fisher-Kolmogorov-Petrovsky-Piscounov equation (FKPP) that ignore the finite size of organisms may be inaccurate to describe the physics of spatial growth dynamics of bacteria.

The expansion of biological species in natural environments is usually described as the combined effect of individual spatial dispersal and growth. In the case of aquatic ecosystems flow transport can also be extremely relevant as an extra, advection induced, dispersal factor. We designed and assem- bled a dedicated microfluidic device to control and quantify the expansion of populations of E.coli bacteria under both co-flowing and counter-flowing conditions, measuring the front speed at varying intensity of the imposed flow. At variance with respect to the case of classic advective-reactive- diffusive chemical fronts, we measure that almost irrespective of the counter-flow velocity, the front speed remains finite at a constant positive value. A simple model incorporating growth, dispersion and drift on finite-size hard beads allows to explain this finding as due to a finite volume effect of the bacteria. This indicates that models based on the Fisher-Kolmogorov-Petrovsky-Piscounov equation (FKPP) that ignore the finite size of organisms may be inaccurate to describe the physics of spatial growth dynamics of bacteria.

John RP Tesser,1 Daniel E Furst,2 Ira Jacobs3 1Arizona Arthritis & Rheumatology Associates, Phoenix, AZ, 2UCLA Health, Los Angeles, CA, 3Pfizer Inc, New York, NY, USA Abstract: Extrapolation is the approval of a biosimilar for use in an indication held by the originator biologic not directly studied in a comparative clinical trial with the biosimilar. Extrapolation is a scientific rationale that bridges all the data collected (ie, totality of the evidence) from one indication for the biosimilar product to all the indications originally approved for the originator. Regulatory approval and marketing authorization of biosimilars in inflammatory indications are made on a case-by-case and agency-by-agency basis after evaluating the totality of evidence from the entire development program. This totality of the evidence comprises extensive comparative analytical, functional, nonclinical, and clinical pharmacokinetic/pharmacodynamic, efficacy, safety, and immunogenicity studies used by regulators when evaluating whether a product can be considered a biosimilar. Extrapolation reduces or eliminates the need for duplicative clinical studies of the biosimilar but must be justified scientifically with appropriate data. Understanding the concept, application, and regulatory decisions based on the extrapolation of data is important since biosimilars have the potential to significantly impact patient care in inflammatory diseases. Keywords: biosimilar, extrapolation, inflammatory disease, rheumatology

Prosodic prominence is an umbrella term encompassing various related but conceptually and functionally different phenomena such as phonological stress, paralinguistic emphasis, lexical, syntactic, semantic or pragmatic salience, to mention a few. Due to the high interest prominence has received from various disciplines, it has been studied from multiple perspectives (functional, physical, cognitive). It also has been operationalised and annotated across different descriptive levels (syllable, word), based on different scales (categorical, multi-level, continuous), and measured across a large variety of signal domains (acoustic, articulatory, gestural). The present paper offers an overview of the various perspectives involved and defines a preliminary roadmap for a better and more unified understanding of this multi-faceted phenomenon.

To assess Guillain-Barre syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged ≥18 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population ≥18 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies.

To assess Guillain-Barre syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged ≥18 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population ≥18 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies.

Background: knowing the essential amino acid (EAA) requirement values is fundamental to formulate good quality and cost-effective fish feeds. However, such requirements have been established for few fish species. The estimation of amino acid requirements based on amino acid composition of fish is a fast and reliable alternative. Objective: to determine whole-body and muscle amino acid composition of Plata pompano (Trachinotus marginatus) and estimate its EAA requirements. Methods: EAA requirements were estimated using A/E ratios [(Individual EAA / Total EAA) * 1000]. Results: hystidine, leucine, lysine and phenylalanine were present in higher concentrations in muscle tissue in comparison with the whole-body. On the other hand, arginine, isoleucine, methionine, tryptophan and valine concentration were not different between whole-body and muscle. A/E ratios for Plata pompano determined in the present study are similar to those reported in other fish species, although valine A/E ratios were slightly smaller. Conclusion: until dose-response experiments are conducted to precisely determine EAA requirements, the estimated EAA values using whole-body EAA-as proposed in this study-could be used to formulate diets for Plata pompano., Antecedentes: estimar as necessidades por aminoácidos essenciais (AAE) é importante para formular dietas de boa qualidade e com bom custo-benefício. No entanto, poucas espécies de peixes possuem suas necessidades por (AAE) estabelecidas. A determinação das necessidades por (AAE) baseada na composição de aminoácidos do peixe é uma alternativa rápida e viável. Objetivo: determinar a composição de aminoácidos da carcaça e do músculo do Pampo prateado (Trachinotus marginatus) e estimar suas necessidades por (AAE). Métodos: as necessidades por AAE foi estimada usando o índice A/E [(AAE individual/AAE total) * 1000]. Resultados: histidina, leucina, lisina e fenilalanina estavam em maior concentração no músculo do que na carcaça. Por outro lado, arginina, isoleucina, metionina, triptofano e valina não apresentaram diferenças significativas entre a composição da carcaça e do músculo. O índice A/E determinado no presente estudo para o Pampo prateado é similar ao reportado para outras espécies de peixe, entretanto o valor do índice A/E para a valina foi ligeiramente menor. Conclusão: até que experimentos dose resposta sejam realizados para determinar com exatidão as necessidades por aminoácidos essenciais, os valores estimados para as necessidades por aminoácidos essenciais usando a composição da carcaça como proposto neste estudo pode ser usada na formulação de dietas para o Pampo prateado., Antecedentes: conocer los requerimientos de aminoácidos esenciales (EAA) es fundamental para la formulación de raciones rentables y de buena calidad para peces. Sin embargo, dichos requerimientos se han establecido solo para unas pocas especies de peces. La determinación de las necesidades de aminoácidos basada en la composición de aminoácidos de los peces es un método alternativo rápido y viable. Objetivo: determinar la composición de aminoácidos del cuerpo completo y del músculo del Pámpano (Trachinotus marginatus) y estimar sus necesidades de EAA. Métodos: el requerimiento de aminoácidos esenciales se calculó utilizando el índice A/E [(Individual EAA/Total EAA) * 1000]. Resultados: la histidina, leucina, fenilalanina y lisina estaban en una mayor concentración en el músculo que en el cuerpo. Por otro lado, arginina, isoleucina, metionina, triptófano y valina no mostraron ninguna diferencia significativa entre la composición del músculo y el cuerpo. Los valores de A/E para Pámpano determinados en este estudio son similares a los reportados para otras especies de peces, pero no los de valina, que fue levemente menor. Conclusiones: hasta que no sean realizados experimentos de dosis-respuesta para determinar con precisión los requerimientos de EAA, el cálculo de los requerimientos de aminoácidos esenciales a partir de la concentración de aminoácidos del cuerpo -como se propone en este estudio- puede ser utilizado en la formulación de dietas para pámpano.

Background: knowing the essential amino acid (EAA) requirement values is fundamental to formulate good quality and cost-effective fish feeds. However, such requirements have been established for few fish species. The estimation of amino acid requirements based on amino acid composition of fish is a fast and reliable alternative. Objective: to determine whole-body and muscle amino acid composition of Plata pompano (Trachinotus marginatus) and estimate its EAA requirements. Methods: EAA requirements were estimated using A/E ratios [(Individual EAA / Total EAA) * 1000]. Results: hystidine, leucine, lysine and phenylalanine were present in higher concentrations in muscle tissue in comparison with the whole-body. On the other hand, arginine, isoleucine, methionine, tryptophan and valine concentration were not different between whole-body and muscle. A/E ratios for Plata pompano determined in the present study are similar to those reported in other fish species, although valine A/E ratios were slightly smaller. Conclusion: until dose-response experiments are conducted to precisely determine EAA requirements, the estimated EAA values using whole-body EAA-as proposed in this study-could be used to formulate diets for Plata pompano., Antecedentes: estimar as necessidades por aminoácidos essenciais (AAE) é importante para formular dietas de boa qualidade e com bom custo-benefício. No entanto, poucas espécies de peixes possuem suas necessidades por (AAE) estabelecidas. A determinação das necessidades por (AAE) baseada na composição de aminoácidos do peixe é uma alternativa rápida e viável. Objetivo: determinar a composição de aminoácidos da carcaça e do músculo do Pampo prateado (Trachinotus marginatus) e estimar suas necessidades por (AAE). Métodos: as necessidades por AAE foi estimada usando o índice A/E [(AAE individual/AAE total) * 1000]. Resultados: histidina, leucina, lisina e fenilalanina estavam em maior concentração no músculo do que na carcaça. Por outro lado, arginina, isoleucina, metionina, triptofano e valina não apresentaram diferenças significativas entre a composição da carcaça e do músculo. O índice A/E determinado no presente estudo para o Pampo prateado é similar ao reportado para outras espécies de peixe, entretanto o valor do índice A/E para a valina foi ligeiramente menor. Conclusão: até que experimentos dose resposta sejam realizados para determinar com exatidão as necessidades por aminoácidos essenciais, os valores estimados para as necessidades por aminoácidos essenciais usando a composição da carcaça como proposto neste estudo pode ser usada na formulação de dietas para o Pampo prateado., Antecedentes: conocer los requerimientos de aminoácidos esenciales (EAA) es fundamental para la formulación de raciones rentables y de buena calidad para peces. Sin embargo, dichos requerimientos se han establecido solo para unas pocas especies de peces. La determinación de las necesidades de aminoácidos basada en la composición de aminoácidos de los peces es un método alternativo rápido y viable. Objetivo: determinar la composición de aminoácidos del cuerpo completo y del músculo del Pámpano (Trachinotus marginatus) y estimar sus necesidades de EAA. Métodos: el requerimiento de aminoácidos esenciales se calculó utilizando el índice A/E [(Individual EAA/Total EAA) * 1000]. Resultados: la histidina, leucina, fenilalanina y lisina estaban en una mayor concentración en el músculo que en el cuerpo. Por otro lado, arginina, isoleucina, metionina, triptófano y valina no mostraron ninguna diferencia significativa entre la composición del músculo y el cuerpo. Los valores de A/E para Pámpano determinados en este estudio son similares a los reportados para otras especies de peces, pero no los de valina, que fue levemente menor. Conclusiones: hasta que no sean realizados experimentos de dosis-respuesta para determinar con precisión los requerimientos de EAA, el cálculo de los requerimientos de aminoácidos esenciales a partir de la concentración de aminoácidos del cuerpo -como se propone en este estudio- puede ser utilizado en la formulación de dietas para pámpano.

Borders in Central and Eastern Europe witnessed stark changes in recent decades. Frontiers went from high security zones during the Cold War to far more open borders as socialism retreated. Yet, the subsequent eastward shift of the European Union's Schengen border control system returned some borders to high security status, with only a few later shedding such status as the system moved further eastwards. Beyond discerning how the Schengen border undercuts the EU's effort to promote non-discrimination and other liberal values, this article also shows how Schengen holds the power to further entrench perceptions of ethnic hierarchy.

Borders in Central and Eastern Europe witnessed stark changes in recent decades. Frontiers went from high security zones during the Cold War to far more open borders as socialism retreated. Yet, the subsequent eastward shift of the European Union's Schengen border control system returned some borders to high security status, with only a few later shedding such status as the system moved further eastwards. Beyond discerning how the Schengen border undercuts the EU's effort to promote non-discrimination and other liberal values, this article also shows how Schengen holds the power to further entrench perceptions of ethnic hierarchy.

Analisaram-se programas e ações de fitoterapia na atenção primária à saúde brasileira (APS) a partir da literatura. O metaestudo incluiu seis bases de dados, de 1988 a 2012, sendo registradas 24 publicações. A inserção da fitoterapia acontece a partir de motivações diversas: aumentar os recursos terapêuticos, resgatar saberes populares, preservar a biodiversidade, educação ambiental e popular, agroecologia e desenvolvimento social. Há uma ambivalência que ora pende para o reforço da autoatenção, as ações educativas, intersetoriais e a participação comunitária, constituindo-se em forma de cuidado e promoção da saúde; ora restringe o processo à incorporação de fitoterápicos manipulados ou industrializados à farmácia dos serviços de APS, para uso estritamente profissional. Ressalta-se uma visão ampliada da fitoterapia que incorpore esses dois enfoques, numa perspectiva de uma ecologia de saberes e práticas em saúde.

Analisaram-se programas e ações de fitoterapia na atenção primária à saúde brasileira (APS) a partir da literatura. O metaestudo incluiu seis bases de dados, de 1988 a 2012, sendo registradas 24 publicações. A inserção da fitoterapia acontece a partir de motivações diversas: aumentar os recursos terapêuticos, resgatar saberes populares, preservar a biodiversidade, educação ambiental e popular, agroecologia e desenvolvimento social. Há uma ambivalência que ora pende para o reforço da autoatenção, as ações educativas, intersetoriais e a participação comunitária, constituindo-se em forma de cuidado e promoção da saúde; ora restringe o processo à incorporação de fitoterápicos manipulados ou industrializados à farmácia dos serviços de APS, para uso estritamente profissional. Ressalta-se uma visão ampliada da fitoterapia que incorpore esses dois enfoques, numa perspectiva de uma ecologia de saberes e práticas em saúde.

Analisaram-se programas e ações de fitoterapia na atenção primária à saúde brasileira (APS) a partir da literatura. O metaestudo incluiu seis bases de dados, de 1988 a 2012, sendo registradas 24 publicações. A inserção da fitoterapia acontece a partir de motivações diversas: aumentar os recursos terapêuticos, resgatar saberes populares, preservar a biodiversidade, educação ambiental e popular, agroecologia e desenvolvimento social. Há uma ambivalência que ora pende para o reforço da autoatenção, as ações educativas, intersetoriais e a participação comunitária, constituindo-se em forma de cuidado e promoção da saúde; ora restringe o processo à incorporação de fitoterápicos manipulados ou industrializados à farmácia dos serviços de APS, para uso estritamente profissional. Ressalta-se uma visão ampliada da fitoterapia que incorpore esses dois enfoques, numa perspectiva de uma ecologia de saberes e práticas em saúde.

Analisaram-se programas e ações de fitoterapia na atenção primária à saúde brasileira (APS) a partir da literatura. O metaestudo incluiu seis bases de dados, de 1988 a 2012, sendo registradas 24 publicações. A inserção da fitoterapia acontece a partir de motivações diversas: aumentar os recursos terapêuticos, resgatar saberes populares, preservar a biodiversidade, educação ambiental e popular, agroecologia e desenvolvimento social. Há uma ambivalência que ora pende para o reforço da autoatenção, as ações educativas, intersetoriais e a participação comunitária, constituindo-se em forma de cuidado e promoção da saúde; ora restringe o processo à incorporação de fitoterápicos manipulados ou industrializados à farmácia dos serviços de APS, para uso estritamente profissional. Ressalta-se uma visão ampliada da fitoterapia que incorpore esses dois enfoques, numa perspectiva de uma ecologia de saberes e práticas em saúde.

The purpose of this study was to examine combined and relative contributions of perceived readiness for change, trait anxiety, self-efficacy, and perfectionism on illness severity among adolescents who have met DSM-IV diagnostic criteria for anorexia nervosa. Another goal was to evaluate the relationship between readiness for change and other factors such as the egosyntonic nature of the disorder and motivation to recover. A final objective was to explore whether factors such as treatment setting and length of treatment had an impact on the aforementioned predictors. The sample consisted of 122 adolescent participants. All of the participants completed the measures online and provided informed consent or assent as well as parental consent (if necessary) prior to beginning the survey. There was a significant correlation between the individual factors of readiness for change, self-efficacy, and perfectionism on illness severity. In addition, there was a significant correlation between egosyntonic nature of the illness as well as motivation to recover on readiness for change. Multiple regression analyses indicated that perceived readiness for change, self-efficacy, trait anxiety, and perfectionism taken together accounted for a significant amount of variance in adolescent anorexia nervosa illness severity. However, only self-efficacy emerged as a significant predictor of illness severity. Taken together, these findings emphasize the need for providers to take the above psychological factors into account when developing treatment plans and targeted interventions for adolescents.