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Here we present the spatially resolved study of six Galactic planetary nebulae (PNe), namely IC 4593, Hen 2-186, Hen 2-429, NGC 3918, NGC 6543, and NGC 6905, from intermediate-resolution spectra of the 2.5 m Isaac Newton Telescope and the 1.54 m Danish telescope. The physical conditions (electron densities, Ne, and temperatures, Te), chemical compositions and dominant excitation mechanisms for the different regions of these objects are derived, in an attempt to go deeper on the knowledge of the low-ionization structures (LISs) hosted by these PNe. We reinforce the previous conclusions that LISs are characterized by lower (or at most equal) Ne than their associated rims and shells. As for the Te, we point out a possible different trend between the N and O diagnostics. Te[N ii] does not show significant variations throughout the nebular components, whereas Te[O iii] appears to be slightly higher for LISs. The much larger uncertainties associated with the Te[O iii] of LISs do not allow robust conclusions. Moreover, the chemical abundances show no variation from one to another PN components, not even contrasting LISs with rims and shells, as also found in a number of other works. By discussing the ionization photon flux due to shocks and stellar radiation, we explore the possible mechanisms responsible for the excitation of LISs. We argue that the presence of shocks in LISs is not negligible, although there is a strong dependence on the orientation of the host PNe and LISs.

Branching enzymes (BE) are responsible for the formation of branching points at the 1,6 position in glycogen and starch, by catalyzing the cleavage of α-1,4-linkages and the subsequent transfer by introducing α-1,6-linked glucose branched points. BEs are found in the large GH13 family, eukaryotic BEs being mainly classified in the GH13_8 subfamily, GH13_9 grouping almost exclusively prokaryotic enzymes. With the aim of contributing to the understanding of the mode of recognition and action of the enzymes belonging to GH13_8, and to the understanding of features distinguishing these enzymes from those belonging to subfamily 13_9, we solved the crystal structure of the glycogen branching enzyme (GBE) from the yeast Candida glabrata, CgGBE, in ligand-free forms and in complex with a maltotriose. The structures revealed the presence of a domain already observed in Homo sapiens and Oryza sativa BEs that we named α-helical N-terminal domain, in addition to the three conserved domains found in BE. We confirmed by phylogenetic analysis that this α-helical N-terminal domain is always present in the GH13_8 enzymes suggesting that it could actually present a signature for this subfamily. We identified two binding sites in the α-helical N-terminal domain and in the carbohydrate binding module 48 (CBM48), respectively, which show a unique structural organization only present in the Saccharomycotina phylum. Our structural and phylogenetic investigation provides new insight into the structural characterization of GH13_8 GBE revealing that unique structural features only present in the Saccharomycotina phylum thereby conferring original properties to this group of enzymes.

We report the validation of a recently proposed infrared selection criterion for symbiotic stars (SySts). Spectroscopic data were obtained for seven candidates, selected from the SySt candidates of Akras et al. (2019, MNRAS, 483, 5077) by employing the new supplementary infrared selection criterion for SySts in the VST/OmegaCAM Photometric H-Alpha Survey (VPHAS+). Five of them turned out to be genuine SySts after the detection of H$\alpha$, He II and [O III] emission lines as well as TiO molecular bands. The characteristic O VI Raman-scattered line is also detected in one of these SySts. According to their infrared colours and optical spectra, all five newly discovered SySts are classified as S-type. The high rate of true SySts detections of this work demonstrates that the combination of the H$\alpha$-emission and the new infrared criterion improves the selection of target lists for follow-up observations by minimizing the number of contaminants and optimizing the observing time., Comment: 5 pages, 2 figures, one table, accepted for publication in MNRAS

Background Background: Increasing evidence supports the use of Ustekinumab (USTK) in patients with moderate to severe Crohn’s disease (CD) and Ulcerative colitis (UC). Comparison of USTK against other biologics is still lacking. Methods AIMS: to perform a propensity score analysis (PSA) for comparison of USTK against conventional Infliximab (IFX), proactive IFX and vedolizumab in CD and UC Methods retrospective study including patients under Ustekinumab (n=71), Vedolizumab (n=98), conventional IFX (n=70) and proactive IFX (n=148). PSA correcting for age, gender, IBD subtype, previous biologic exposure was performed for each comparison. We compared the rates of fecal calprotectin (Fc) remission ( Results Results: after PSP, ustekinumab showed lower rates of treatment discontinuation compared to vedolizumab (7.4% vs 37%, P< 0.001) with a trend for higher rates of Fc remission (42.6% vs 25.9%, P=0.104). Ustekinumab showed higher rates of Fc remission compared to conventional IFX (53.8% vs 19.2%, P= 0.020) with a trend for lower rates of hospitalization (7.7% vs 30.8%, P= 0.075). There were no differences between ustekinumab and proactive IFX in any of the clinical outcomes. Conclusion Conclusion: taking into account the potential limitations of PSP, our results suggest that ustekinumab may be as effective as proactive IFX with some benefits compared to vedolizumab and conventional IFX.

Authors: Molino, A.; Costa-Duarte, M. V.; Sampedro, L.; Herpich, F. R.; Sodré, L., Jr.; Mendes de Oliveira, C.; Schoenell, W.; Barbosa, C. E.; Queiroz, C.; Lima, E. V. R.; Azanha, L.; Muñoz-Elgueta, N.; Ribeiro, T.; Kanaan, A.; Hernandez-Jimenez, J. A.; Cortesi, A.; Akras, S.; Lopes de Oliveira, R.; Torres-Flores, S.; Lima-Dias, C.; Castellon, J. L. Nilo; Damke, G.; Alvarez-Candal, A.; Jiménez-Teja, Y.; Coelho, P.; Pereira, E.; Montero-Dorta, A. D.; Benítez, N.; Gonçalves, T. S.; Santana-Silva, L.; Werner, S. V.; Almeida, L. A.; Lopes, P. A. A.; Chies-Santos, A. L.; Telles, E.; de Souza, Thom; C, R.; Gonçalves, D. R.; de Souza, R. S.; Makler, M.; Buzzo, M. L.; Placco, V. M.; Nakazono, L. M. I.; Saito, R. K.; Overzier, R. A.; Abramo, L. R., In this paper we present a thorough discussion about the photometric redshift (photo-z) performance of the Southern Photometric Local Universe Survey (S-PLUS). This survey combines a seven narrow +5 broad passband filter system, with a typical photometric-depth of r ∼ 21 AB. For this exercise, we utilize the Data Release 1 (DR1), corresponding to 336 deg2 from the Stripe-82 region. We rely on the BPZ2 code to compute our estimates, using a new library of SED models, which includes additional templates for quiescent galaxies. When compared to a spectroscopic redshift control sample of ∼100 k galaxies, we find a precision of σz, AM would like to acknowledge the financial support of the Brazilian funding agency FAPESP (Post-doc fellowship - process number 2014/11806-9), and his colleague Dr. Carlos Lopez-Sanjuan for all his valuable advices regarding PDF analysis. Likewise, AM acknowledges Ulisses Manzo and Carlos E. Paladini at IAG/USP for helping with software installation. In addition, AM would like to dedicate this work to his first son Tiago who was born in Brazil during the time this paper was written. MVCD thanks his scholarship from FAPESP (processes 2014/18632-6 and 2016/052549). This work has used the computing facilities of the Laboratory of Astroinformatics (IAG/USP, NAT/Unicsul), whose purchase was made possible by the Brazilian agency FAPESP (grant 2009/540064) and the INCT-A. LS acknowledges the financial support of the Brazilian funding agency FAPESP (Post-doc fellowship -process number 2016/21664-2). The S-PLUS project, including the T80S robotic telescope and the S-PLUS scientific survey, was founded as a partnership between the Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), the Observatorio Nacional (ON), the Universidade Federal de Sergipe (UFS), and the Universidade Federal de Santa Catarina (UFSC), with important financial and practical contributions from other collaborating institutes in Brazil, Chile (Universidad de La Serena), and Spain (Centro de Estudios de Fisica del Cosmos de Aragon, CEFCA). LSJ acknowledges support from FAPESP and CNPq. CMdO acknowledges support from FAPESP (grants 2009/54202-8, 2011/51680-6, 2014/07684-5, 2016/17119-9, 2017/50277-0, and 2019/11910-4) and CNPq (grant 312333/20145). JLNC is grateful for financial support received from the grant programs FA9550-15-1-0167 and FA9550-18-1-0018 of the Southern Office of Aerospace Research and Development (SOARD), a branch of theAir ForceOffice of the ScientificResearch International Office of the United States (AFOSR/IO). ADMD thanks FAPESP for financial support. SA acknowledges financial support from Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, grant 454794/2015-0). AAC acknowledges support from FAPERJ (grant E26/203.186/2016) and CNPq (grants 304971/20162 and 401669/2016-5). LAA would like to acknowledge the financial support from FAPESP (N 2012/09716-6, 2013/18245-0). AC acknowledges funding from CNPq (403580/2016-1, 311153/20186) and FAPERGS (17/2551-0001). JAHJ thanks Brazilian institution CNPq for financial support through postdoctoral fellowship (project 150237/2017-0) and Chilean institution CONICYT, Programa de Astronomia, Fondo ALMA-CONICYT 2017, Codigo de proyecto 31170038. PAAL thanks the support of CNPq, grant 309398/20185. We are grateful for the contributions of CTIO staff in helping in the construction, comissioning, andmaintenance of the telescope and camera, and we are particularly thankful to the CTIO director, Steve Heathcote, for his support at every phase, without which this project would not have been completed. We thank Cesar Iniguez for making the 2D measurements of the filter transmissions at CEFCA. We warmly thank David Cristobal-Hornillos and his group for helping us to install and run the reduction package JYPE version 0.9.9 in the SPLUS computer system in Chile. We warmly thank Mariano Moles, Javier Cenarro, Tamara Civera, Sergio Chueca, Javier Hernandez Fuertes, AntonioMarin Franch, JesusVareta, Hector-VazquezRamio, and Alessandro Ederoclite - the success of the S-PLUS project relies on the dedication of these and other CEFCA staff members in building OAJ and running J-PLUS and J-PAS. We deeply thank Rene Laporte and INPE, as well as Keith Taylor, for their contributions to the T80S camera.

Despite the many studies in the last decades, the low-ionisation structures (LISs) of planetary nebulae (PNe) still hold several mysteries. Recent imaging surveys have demonstrated that LISs are composed of molecular gas. Here we report H$_2$ emission in the LISs of NGC 7009 and NGC 6543 by means of very deep narrow-band H$_2$ images taken with NIRI@Gemini. The surface brightness of the H2 1-0 S(1) line is estimated to be (0.46-2.9)$\times$10$^{-4}$ erg s$^{-1}$ cm$^{-2}$ sr$^{-1}$ in NGC 7009 and (0.29-0.48)$\times$10$^{-4}$ erg s$^{-1}$ cm$^{-2}$ sr$^{-1}$ in NGC 6543, with signal-to-noise ratios of 10-42 and 3-4, respectively. These findings provide further confirmation of hidden H$_2$ gas in LISs. The emission is discussed in terms of the recent proposed diagnostic diagram R(H$_2$)=H$_2$ 1-0 S(1)/H$_2$ 2-1 S(1) versus R(Br$\gamma$)=H$_2$ 1-0 S(1)/Br$\gamma$, which was suggested to trace the mechanism responsible for the H$_2$ excitation. Comparing our observations to shock and ultraviolet (UV) molecular excitation models, as well as a number of observations compiled from the literature showed that we cannot conclude for either UV or shocks as the mechanism behind the molecular emission., Comment: 11 pages, 6 figures, 2 tables, accepted for Publication in MNRAS

Accurate distance estimates of astrophysical objects such as planetary nebulae (PNe), and nova and supernova remnants, among others, allow us to constrain their physical characteristics, such as size, mass, luminosity, and age. An innovative technique based on the expansion parallax method, the so-called distance mapping technique (DMT), provides distance maps of expanding nebulae as well as an estimation of their distances. The DMT combines the tangential velocity vectors obtained from 3D morpho-kinematic models and the observed proper motion vectors to estimate the distance. We applied the DMT to four PNe (NGC 6702, NGC 6543, NGC 6302, and BD+30 3639) and one nova remnant (GK Persei) and derived new distances in good agreement with previous studies. New simple morpho-kinematic shape models were generated for NGC 6543, NGC 6302, and NGC 6702, whereas for BD+30 3639 and GK Persei published models were used. We demonstrate that the DMT is a useful tool to obtain distance values of PNe, in addition to revealing kinematically peculiar regions within the nebulae. Distances are also derived from the trigonometric Gaia parallaxes. The effect of the non-negligible parallax offset in the second Gaia data release is also discussed., Comment: 16 pages, 9 figures, 5 tables. Accepted for publication in MNRAS

In this study we define a new sample of distant powerful radio galaxies in order to study their host-galaxy properties and provide targets for future observations of HI absorption with new radio telescopes and to understand the fuelling and feedback from such sources. We have cross-matched the Sydney University Molonglo Sky Survey (SUMSS) radio catalogue at 843 MHz with the VISTA Hemisphere Survey (VHS) near-infrared catalogue using the Likelihood Ratio technique. Photometric redshifts from the Dark Energy Survey are then used to assign redshifts to the radio source counterparts. We found a total of 249 radio sources with photometric redshifts over a 148 deg^2 region. By fitting the optical and near-infrared photometry with spectral synthesis models we determine the stellar mass and star-formation rates of the radio sources, finding typical stellar masses of 10^{11} - 10^{12}M$_{\odot}$ for the powerful high-redshift radio galaxies. We also find a population of low-mass blue galaxies. However, by comparing the derived star-formation rates to the radio luminosity, we suggest that these sources are false positives in our likelihood ratio analysis. Follow up, higher-resolution (, 11 pages, 9 figures. Accepted for publication in MNRAS

Background Endoscopic remission (ER) is currently endorsed as one of the main treatment targets in Crohn’s Disease (CD). In a previous study, we have shown that transmural remission (TR) is associated with better clinical outcomes up to 1-year. It is unknown if these results still hold over a longer follow-up Methods This was a multicenter study, including 333 CD patients with magnetic resonance enterography (MRE) and colonoscopy evaluation performed within a 6-month interval and at least 5-years of follow-up. Patients were classified as having TR (inactive MRE and colonoscopy), ER (active MRE and inactive colonoscopy), and no remission (NR) (active colonoscopy). The need for surgery, hospitalization, steroids, and biologics was evaluated at 5-years of follow-up. Results Patients with TR presented lower rates of surgery (1.9% vs 17.9% vs 23.7%, P Conclusion TR was associated with improved clinical outcomes over 5-years of follow-up. Going beyond ER appears to provide significant clinical benefits in the short and long-term.

Background Observational studies are essential to analyse outcome reporting in inflammatory bowel disease. However, such studies are usually heterogeneous. Therefore, the development of core outcome sets to be included in future observational studies is of major importance. Composite and aggregate outcomes (in which an event is classified by the presence of any one or by the combination of every individual variable under assessment, respectively) allow maximizing the statistical power of observational studies. A systematic review and meta-analysis were performed to assess composite and aggregate outcomes in observational studies for Crohn’s disease (CD) and to evaluate whether the number and type of variables affect the frequency of the outcome. Methods Three online databases (PubMed, Scopus and Web of Science) were searched to identify observational studies that enrolled CD patients and evaluated a composite or aggregate outcome. The proportion of patients achieving the outcome was determined and a random-effects meta-analysis was performed to evaluate how the frequency of each outcome varied according to the reporting of predefined variables. Results From the, 10.257 identified records, 46 were included in the systematic review and, 38 in the meta-analysis. The median frequency of composite and aggregate outcomes was, 0.445 [95% confidence interval (CI), 0.389–0.501] and, 0.140 [95% CI, 0.000-, 0.211], respectively. When comparing composite outcomes by the number of included variables, the frequency was, 0.271 [95% CI, 0.000-, 0.405] and, 0.698 [95% CI, 0.651–0.746], for one and six variables, respectively. The frequency of the composite outcome varied according to the set of variables being reported. Specific pairs of predefined variables had a significant effect on the frequency of composite outcomes. Conclusion Composite outcomes with an increasing number of variables and those including the variables “surgery” and “steroids” presented higher frequencies. Moreover, specific variables and pairs of variables had a clear effect on the frequency of composite outcomes. Taking this information into account, future efforts must be made to standardize CD outcome reporting, a yet unmet need.

Background A large body of evidence demonstrates a significant correlation between week 14 infliximab trough levels (IFXTL) and several clinical outcomes. In patients with low IFXTL at week 14, proactive therapeutic drug monitoring (TDM) may potentially improve clinical results. Methods Retrospective study including 181 patients (63.5% with Crohn’s disease) under proactive TDM. IFXTL were measured at week 14 and every 2 infusions using a drug sensitive assay (Theradiag®, Lisa Tracker) with treatment proactively escalated to an IFXTL 5–10 ug/ml. We compared the clinical outcomes between patients with low ( Results Ninety-one patients (50.3%) had low IFXTL at week 14. These patients presented lower rates of clinical remission (69.2% vs 82.2%, P=0.031), Fc remission (41.9% vs 73.4%, P Conclusion IFXTL significantly influence early and long-term treatment outcomes. In patients with inadequate IFXTL at week 14, proactive TDM was associated with improved clinical outcomes.

Background Infliximab is effective as salvage therapy in severe steroid-refractory Ulcerate Colitis. However, up to one third of patients do not respond to this treatment and require surgery. There is still insufficient evidence regarding the benefits of intensified infliximab induction regimens in this setting. Methods Retrospective study including, 51 patients meeting the Truelove and Witts criteria for severe acute Ulcerative Colitis with refractoriness to intravenous steroids requiring infliximab rescue therapy. We compared patients under conventional infliximab induction therapy (n=29) with patients performing an intensified infliximab induction regimen (n=22), defined as a higher dose/shorter interval of treatment during induction. Results There was no difference in respect to median age [IQR] (32.0 [27.0–43.0] vs, 42.0 [29.0–58.0], p=0.116), and male gender (69.0 % vs, 63.6%, p=, 0.458) between patients with conventional or intensified infliximab. Compared to patients with conventional induction, patients under optimized infliximab presented reduced admission to intermediary/intensive care unit (4.5% vs, 31.0%, p=, 0.019), and surgery (13.6% vs, 41.4%, p=, 0.031). There were no differences in deaths (3.4% vs, 9.1%, p=0.396), readmission rates (17.2% vs, 28.6%, p=, 0.270), and median duration [IQR] of hospitalization (19.0 [10.5–31.0] vs, 12.0 [8.0–15.5], p=0.094) between patients with conventional or intensified regimens. In a multivariate analysis, the use of an intensified infliximab induction regimen was associated with a lower risk of surgery (OR, 0.224, 95%CI [0.054–0.929], p=, 0.039). Conclusion In this small cohort, there was some suggestions that intensified infliximab induction may improve treatment outcomes in acute severe steroid refractory Ulcerative Colitis.

Background Capsule endoscopy (CE) is the gold-standard for the evaluation of the enteric mucosa in patients with suspected or known inflammatory bowel disease, particularly Crohn’s disease. Ulcers and erosions of the small bowel are common findings and their identification in CE is paramount for an accurate disease stratification. Several artificial intelligence (AI) algorithms have been developed to aid endoscopists to detect lesions in different endoscopic modalities. With this project we intend to develop and test an AI algorithm for the automatic identification of ulcers and erosions in the small bowel mucosa. Methods A total of 2565 CE exams from two different centers (1483 from São João University Hospital and 1082 from ManopH Gastroenterology Clinic) were used to develop the Convolutional Neural Network (CNN). 55320 frames of the enteric mucosa were obtained, 18396 containing enteric ulcers and erosions, and 36924 containing normal mucosa. 90% of the frames were used to develop the training dataset and 10% were used to test the network. The patients included on the training dataset were excluded from the testing dataset. This patient split brings the technology performance closer to that of a real-life setting. The output provided by the CNN was compared to the classification provided by a consensus of experts. Results Our model was able to automatically detect ulcers and erosions in the enteric mucosa with an accuracy of 93.2%, sensitivity of 90.4% and a specificity of 93.9%. The mean processing time for the validation dataset was 29 seconds (approximately 306 frames/second). An example of the output obtained after the network application can be seen in Figure 1. Conclusion The authors developed a CNN for the automatic identification of enteric ulcers and erosions in CE videos and tested it in AI naïve patients. This represents an evolution in the technology readiness level into a real-life clinical setting, that will surely improve the diagnostic yield of CE exams, which will ultimately translate into better patient care.

Background Available evidence suggests that vedolizumab may be as effective as Infliximab (IFX) in patients with inflammatory bowel disease. However, it is unknown if proactive therapeutic drug monitoring may improve these results. Methods Retrospective study including consecutive patients under conventional management with IFX (n=108), vedolizumab (n=80) and proactive IFX (n=139) aiming at a trough level (IFXTL) between 5–10 µg/mL. We evaluated the rates of fecal calprotectin remission ( Results Proactive IFX was superior to vedolizumab in respect to Fc remission at week 14 (56.8% vs 34.2%; P=0.001) and at 2-years (74.8% vs 35.9%, P Conclusion Our findings suggest that vedolizumab is as effective as conventional IFX. However, proactive IFX was superior to vedolizumab in most clinical outcomes.

Background Crohn’s Disease (CD) is a chronic inflammatory disease primarily affecting the bowel. In the pre-biological era, approximately 40–50% of patients would undergo surgery within the first 2 decades after diagnosis, with a risk of postoperative recurrence up to 50% at 10 years. Although post-operative prophylaxis is recommended to prevent clinical and endoscopic recurrence, little is known about the factors associated with surgical recurrence. Methods Single-center, retrospective study including 992 patients with CD. Demographic and clinical data were retrieved from patients’ medical charts. Patients with 1 or more surgeries were selected for analysis, excluding perianal disease surgeries. Thiopurines and biologics were considered as prophylaxis for surgical recurrence only if initiated within the first year after surgery. A logistic regression analysis was performed to evaluate potential predictors of surgery recurrence. Results Three hundred and nine patients (31.1%) required at least one surgery during follow-up. Two hundred and twenty-four patients (72.5%) underwent a single surgery and 85 (27.5%) required two or more interventions. Patients with surgical recurrence were younger [31 (23–36) vs 34 years (24–44), p=0.009], and had lower rates of prophylaxis with thiopurines (23.5% vs 37.5%, p=0.013), and anti-tumor necrosis factor (TNF) agents (8.2% vs 22.3%, p=0.002) compared with patients without surgical recurrence. Multivariate analysis identified stricturing and penetrating phenotype as risk factor for surgical recurrence (OR 2.292 95%CI [1.500–3.502], p Conclusion Our findings suggest that postoperative prophylaxis with immunosuppressants, especially anti-TNFs, significantly reduces the risk of surgical recurrence. Postoperative prophylaxis should be implemented in high-risk patients, especially younger patients and those with a non-inflammatory phenotype.

Background Inflammatory bowel disease (IBD) affects several dimensions of health-related quality of life. The IBD-Disk scale was designed to provide immediate illustration of disability reported by patients with IBD, previously validated in two cohort studies. The aim of this study is to validate the IBD-Disk in a Portuguese cohort in a clinical setting according to the COnsensus-based Standards for the selection of the health Measurement INstruments (COSMIN) recommendations. Methods After translation to Portuguese, a group of IBD patients was invited to fill-in the IBD-Disk at baseline (T0), after 2 weeks (T1), and after 3 months (T2), from July 2020 to February 2021. At T0 and T2 the patients also completed the IBD-Disability Index. We evaluated reliability (internal consistency, test-retest, and inter-rater reliability and measurement error), construct validity, responsiveness, and interpretability. Results At baseline, 154 patients (107 - Crohn′s disease; 46 - ulcerative colitis) completed the IBD-Disk. After 2 weeks and 3 months, 64 and 114 patients repeated the questionnaire, respectively. Factor analysis confirmed the unidimensionality of the scale and reduced the final version to 10 items. Internal consistency was excellent with a Cronbach’s α of 0.916. The intraclass correlation coefficient was 0.95 for test-retest (baseline and 2 weeks). To evaluate construct validity, the IBD-Disk was compared with the IBD-Disability Index with a significative positive correlation (r=0.850; p Conclusion The Portuguese version of IBD-Disk is a reliable, valid, and responsive tool to assess disability in Portuguese IBD patients. This study confirms the utility of this instrument in the evaluation of IBD patients in diverse populations.

Background Proactive therapeutic drug monitoring (pTDM) may potentially improve disease control and treatment outcomes in inflammatory bowel disease. Methods Using a prospectively maintained database we compared 135 patients following a pTDM protocol aiming at an Infliximab trough level (IFXTL) between 5-10 µg/mL with sequential measurements of Fc, with 108 patients from a retrospective group under conventional management (noTDM). We evaluated the rates of Fc remission ( Results pTDM associated with higher rates of Fc remission (69.6% vs 50.0%; P=0.002), and steroid-free clinical remission (78.4% vs 55.2%, P=0.028) with a trend for clinical remission (79.3% vs 68.5%, P=0.075). There was no difference in treatment discontinuation (P=0.195), hospitalization (P=0.156), and surgery (P=0.110). Higher IFXTL associated with Fc remission at week 14 (6.59 vs 2.96 µg/mL, P Conclusion PTDM was more effective than conventional management in inducing Fc remission which associated with improved clinical outcomes.

Background Anti-TNF agents are used to treat a variety of autoimmune conditions, including psoriasis. Paradoxically, new onset of psoriasis or psoriasiform skin lesions (PPSL) can occur in patients treated with these agents. We report a case series of patients featuring PPSL induced by infliximab (IFX) with pharmacokinetic and fecal calprotectin (Fc) correlation. Methods One hundred and thirty-five consecutive patients with Inflammatory Bowel Disease under proactive therapeutic drug monitoring (TDM) with IFX were evaluated for PPSL. Results Fifteen patients (11.1%) developed PPSL, 12 females (80%), with median age at diagnosis of 52.0 years (38-63). At the onset of PPSL, 6 patients were on 10 mg/kg every 6 weeks, 5 patients on 5 mg/kg every 8 weeks, 2 patients on 10 mg/kg every 4 weeks, 1 patient on 10 mg/kg every 8 weeks, and 1 patent on 5 mg/kg every 6 weeks. In patients with PPSL, IFX trough levels (IFXTL) significantly increased before and after the advent of PPSL: 6.18 µg/mL (3.28-9.91) vs 9.20 µg/mL (5.89-13.91), P= 0.001. At the time of PPSL, all but 2 patients were in Fc remission (< 250 µg/g), median 41 µg/g (30-103). Seven patients improved with topic therapy and 8 patients (53.3%) discontinued IFX (3 switched to ustekinumab) all of which improved. Compared with the overall cohort, IFXTL were higher in patients with PPSL: 7.27 µg/mL (4.02-10.86) vs 6.26 µg/mL (3.37-9.14), P= 0.023. In multivariate regression analysis, female gender [OR 4.84 95%CI (1.23-19.00), P= 0.024], and any IFXTL≥ 10 µg/mL [OR 5.66 95%CI (1.40-22.87), P= 0.015] were independent predictors of developing PPSL. Conclusion Most patients with PPSL presented high IFXTL and low Fc. We hypothesize that high concentrations of IFX in the setting of deep remission may signal aberrant pro-inflammatory pathways potentially responsible for PPSL.

Background Fecal calprotectin (Fc) is an adequate surrogate marker for endoscopic activity in inflammatory bowel disease. The timing of Fc remission may have prognostic implications in patients under biologic therapy. Methods Using a prospectively maintained database we followed 135 patients under a proactive therapeutic drug monitoring (pTDM) protocol aiming at an Infliximab trough level (IFXTL) between 5-10 µg/mL with sequential measurements of Fc. We evaluated the rates of early (at week 14) and late (after week 14) Fc remission ( Results 77 patients (57.0%) reached early Fc remission and 30 patients (22.2%) reached late Fc remission. Patients with late Fc remission presented higher Fc at baseline (1708.5 μg/g [681-3483] vs 803 μg/g [339-1477], P=0.006) and lower IFXTL at week 14 (2.71 µg/mL [1.24-6.30] vs 6.59 µg/mL [3.41-10.63], P=0.001) than patients with early Fc remission. However, by the end of follow-up, IFXTL were similar in both groups: 7.94 µg/mL (4.79-11.25) vs 8.54 µg/mL (6.49-11.07), P=0.514. In patients without early Fc remission, week 14 IFXTL did not differ between those with and without late Fc remission (2.71 µg/mL [1.24-6.30] vs 3.47 µg/mL [0.945-6.94], P=0.957), but significantly increased in late responders by the end of follow-up: 8.54 µg/mL (6.49-11.07) vs 4.37 µg/mL (1.77-7.49), P=0.002. Patients with early and late Fc remission presented similar rates of clinical remission (88.3% vs 83.0%, P=0.493), steroid-free clinical remission (79.1% vs 92.9% P=0.239), lower rates of IFX discontinuation (14.3% vs 16.7%, P=0.756), hospitalization (11.7% vs 13.3%, P=0.815), and surgery (1.3% vs 3.3%, P=0.485). Conclusion The magnitude of Fc at baseline and IFXTL at week 14 significantly influence the timing of Fc remission. The use of PTDM results in similar pharmacokinetics and clinical outcomes in both groups.

Background Anti-TNF blockers are effective drugs in the treatment of inflammatory bowel disease (IBD). Therapeutic drug monitoring (TDM) of Adalimumab (ADA) may potentially improve clinical outcomes in this setting, but data are still scarce. Methods To compare ADA TDM and empirical treatment adjustment (ETA) in patients with IBD. Outcomes were evaluated at 2 years and included hospitalisation, surgery, treatment discontinuation, endoscopic remission and treatment failure (any unfavourable event). Single-centre retrospective study, including patients under ADA therapy. Results 103 patients were included, 86 with Crohn’s disease and 17 with ulcerative colitis. 52.4% male, mean age 28.5 (18–72). 56 patients received ADA TDM and 47 ETA. At 2-years, rates of treatment escalation (57.1% vs. 21.3%, p Conclusion Our results suggest a benefit of TDM in achieving higher rates of mucosal healing The higher rates of treatment discontinuation suggest that TDM improves drug selection as patients switched unhelpful treatment earlier.

Though the small-scale, low-ionization knots, filaments and jets (LISs) of planetary nebulae (PNe) are known for ~30yr, some of their observational properties are not well established. In consequence our ability to include them in the wider context of the formation and evolution of PNe is directly affected. Why most structures have lower densities than the PN shells hosting them? Is their intense emission in low-ionization lines the key to their main excitation mechanism? Therefore, if considered altogether, can LISs line ratios, chemical abundances and kinematics enlighten the interplay between the different excitation and formation processes? Here we present a spectroscopic analysis of five PNe that possess LISs confirming that all nebular components have comparable electron temperatures, whereas the electron density is systematically lower in LISs than in the surrounding nebula. Chemical abundances of LISs versus other PN components do not show significant differences as well. By using diagnostic diagrams from shock models, we demonstrate that LISs' main excitation is due to shocks, whereas the other components are mainly photo-ionized. We also propose new diagnostic diagrams involving a few emission lines ([NII], [OIII], [SII]) and $\rm{log}$(f$_{shocks}$/f$_{\star}$), where f$_{shocks}$ and f$_{\star}$ are the ionization photon fluxes due to the shocks and the central star ionizing continuum, respectively. A robust relation differentiating the structures is found, with the shock-excited clearly having $\rm{log}$(f$_{shocks}$/f$_{\star}$)$>$-1; while the photo-ionized show $\rm{log}$(f$_{shocks}$/f$_{\star}$)$, Comment: 26 pages, 11 figures, MNRAS accepted

We present positions, kinematics and the planetary nebula luminosity function (PNLF) for 35 planetary nebulae (PNe) in the nearest starburst galaxy IC10 extending out to 3 kpc from the galaxy's centre. We take advantage of the deep imaging and spectroscopic capabilities provided by the Faint Object Camera and Spectrograph on the 8.2 m Subaru Telescope. The PN velocities were measured through the slitless-spectroscopy technique, which allows us to explore the kinematics of IC10 with high precision. Using these velocities, we conclude that there is a kinematic connection between the H i envelope located around IC10 and the galaxy's PN population. By assuming that the PNe in the central regions and in the outskirts have similar ages, our results put strong observational constraints on the past tidal interactions in the Local Group. This is so because by dating the PN central stars, we, therefore, infer the epoch of a major episode of star formation likely linked to the first encounter of the H i extended envelope with the galaxy. Our deep [O iii] images also allow us to use the PNLF to estimate a distance modulus of 24.1 ± 0.25, which is in agreement with recent results in the literature based on other techniques.

NGC 185 is a dwarf spheroidal satellite of the Andromeda galaxy. From mid-1990s onwards it was revealed that dwarf spheroidals often display a varied and in some cases complex star formation history. In an optical survey of bright nearby galaxies, NGC 185 was classified as a Seyfert galaxy based on its emission line ratios. However, although the emission lines in this object formally place it in the category of Seyferts, it is probable that this galaxy does not contain a genuine active nucleus. NGC 185 was not detected in radio surveys either in 6 or 20 cm, or X-ray observations, which means that the Seyfert-like line ratios may be produced by stellar processes. In this work, we try to identify the possible ionization mechanisms for this galaxy. We discussed the possibility of the line emissions being produced by planetary nebulae (PNe), using deep spectroscopy observations obtained with GMOS-N, at Gemini. Although the fluxes of the PNe are high enough to explain the integrated spectrum, the line ratios are very far from the values for the Seyfert classification. We then proposed that a mixture of supernova remnants and PNe could be the source of the ionization, and we show that a composition of these two objects do mimic Seyfert-like line ratios. We used chemical evolution models to predict the supernova rates and to support the idea that these supernova remnants should be present in the galaxy.

Because dwarf galaxies are the most abundant type of galaxy, they are crucial for our understanding of the formation and evolution of galaxies. Abundance ratios and their variations as a result of star formation are key constraints in chemical evolution models. Thus, the determination of these abundances in the dwarf galaxies of the Local Universe is extremely important. However, these objects are intrinsically faint, and observational constraints to their evolution can be obtained only for very nearby galaxies. NGC 185 is one of the four brightest dwarf companions of M31. However, unlike the other three – NGC 147, 205 and 221 (M32) – it has an important content of gas and dust. We have obtained deep spectroscopic observations of the Hα emitting population of NGC 185 using the Gemini multi-object spectrograph at the Gemini North telescope. As a result, in addition to the bright planetary nebulae (PNe) previously found in the galaxy and reported in the literature, we have found other, much fainter, PNe. We have then recalculated the electron temperatures and chemical abundances of the brightest PNe and, for the first time, we have derived their electron densities. Our characterization of the population properties of the PNe is interpreted in terms of the chemical evolution of NGC 185, which suggests that it has suffered a significant chemical enrichment within the last ∼8 Gyr. We have also discovered the first symbiotic star in the galaxy and we have determined the properties of a known supernova remnant located close to the centre of NGC 185.

In this paper we present an analysis of the physical and chemical conditions of the planetary nebula NGC 40 through spatially-resolved spectroscopic maps. We also introduce a new algorithm --2D_NEB-- based on the well-established IRAF nebular package, which was developed to enable the use of the spectroscopic maps to easily estimate the astrophysical quantities of ionised nebulae. The 2D_NEB was benchmarked, and we clearly show that it works properly, since it compares nicely with the IRAF nebular software. Using this software, we derive the maps of several physical parameters of NGC 40. From these maps, we conclude that Te[NII] shows only a slight temperature variation from region to region, with its values constrained between ~8,000 K and ~9,500 K. Electron densities, on the other hand, have a much more prominent spatial variation, as Ne[SII] values vary from ~1,000 cm^(-3) to ~3,000 cm^(-3). Maps of the chemical abundances also show significant variations. From the big picture of our work, we strongly suggest that analysis with spatial resolution be mandatory for more complete study of the physical and chemical properties of planetary nebulae.

We have constructed a 3D photoionisation model of a planetary nebula (PN) similar in structure to NGC 7009 with its outer pair of knots (also known as FLIERs --fast, low-ionization emission regions). The work is motivated by the fact that the strong [N II]6583A line emission from FLIERs in many planetary nebulae has been attributed to a significant local overabundance of nitrogen. We explore the possibility that the apparent enhanced nitrogen abundance previously reported in the FLIERs may be due to ionization effects. Our model is indeed able to reproduce the main spectroscopic and imaging characteristics of NGC 7009's bright inner rim and its outer pairs of knots, assuming homogeneous elemental abundances throughout the nebula, for nitrogen as well as all the other elements included in the model. Because of the fact that the (N+/N)/(O+/O) ratio predicted by our models are 0.60 for the rim and 0.72 for the knots, so clearly in disagreement with the N+/N=O+/O assumption of the ionization correction factors method (icf), the icfs will be underestimated by the empirical scheme, in both components, rim and knots, but more so in the knots. This effect is partly responsible for the apparent inhomogeneous N abundance empirically derived. The differences in the above ratio in these two components of the nebula may be due to a number of effects including charge exchange --as pointed out previously by other authors-- and the difference in the ionization potentials of the relevant species --which makes this ratio extremely sensitive to the shape of the local radiation field. Because of the latter, a realistic density distribution is essential to the modelling of a non-spherical object, if useful information is to be extracted from spatially resolved observations, as in the case of NGC 7009.

K 4-47 is an unusual planetary nebula composed of a compact high-ionization core and a pair of low-ionization knots. Long-slit medium-resolution spectra of the knots and core are analyzed in this paper. Assuming photoionization from the central star, we have derived physical parameters for all the nebular components, and the (icf) chemical abundances of the core, which appear similar to Type-I PNe for He and N/O but significantly deficient in oxygen. The nebula has been further modelled using both photoionization (CLOUDY) and shock (MAPPINGS) codes. From the photoionization modelling of the core, we find that both the strong auroral [O III] 4363A and [N II] 5755A emission lines observed and the optical size of the core cannot be accounted for if a homogeneus density is adopted. We suggest that a strong density stratification, matching the high-density core detected at radio wavelengths and the much lower density of the optical core, might solve the problem. From the bow-shock modelling of the knots, on the other hand, we find that knots' chemistry is also represented by Type-I PN abundances, and that they would move with velocities of 250 - 300 km/s., Comment: 9 pages including 4 figures and 2 tables. MNRAS in press

A possible discrepancy found in the determination of mass from gravitational lensing data, and from X-rays observations, has been largely discussed in the latest years (for instance, Miralda-Escude & Babul (1995)). Another important discrepancy related to these data is that the dark matter is more centrally condensed than the X-ray-emitting gas, and also with respect to the galaxy distribution (Eyles et al. 1991). Could these discrepancies be consequence of the standard description of the ICM, in which it is assumed hydrostatic equilibrium maintained by thermal pressure? We follow the evolution of the ICM, considering a term of magnetic pressure, aiming at answering the question whether or not these discrepancies can be explained via non-thermal terms of pressure. Our results suggest that the magnetic pressure could only affect the dynamics of the ICM on scales as small as < 1kpc. Our models are constrained by the observations of large and small scale fields and we are successful at reproducing available data, for both Faraday rotation limits and inverse Compton limits for the magnetic fields. In our calculations the radius (from the cluster center) in which magnetic pressure reaches equipartition is smaller than radii derived in previous works, as a consequence of the more realistic treatment of the magnetic field geometry and the consideration of a sink term in the cooling flow.