Search

Background The vast majority of patients with rheumatoid arthritis (RA) included in the national database of the German Collaborative Arthritis Centers are treated with disease-modifying antirheumatic drugs (DMARD). The clinical and patient-related characteristics of patients who did not have DMARD treatment in the longer term were investigated. Methodology Between 2012 and 2016 a total of 10,289 patients with RA were documented. Patient characteristics, disease activity and severity, comorbidities and concomitant treatment were descriptively evaluated. Patients who were without DMARDs for more than 1 year and not in remission (disease activity score 28, simple disease activity index or Boolean remission) were analyzed separately. Logistic regression was used to investigate which variables were associated with DMARD treatment. Results A total of 426 patients were ≤1 year without DMARDs, 1090 > 1 year without DMARDs and 8773 (85%) currently had DMARD treatment. Of the patients who were without DMARDs for more than 1 year, 51% were in remission. Even if no remission criteria were met, the rheumatologists nevertheless found the strived for RA situation in the majority of patients. Of the patients who were without DMARDs for more than 1 year, 13% received glucocorticoid treatment >5 mg/day. In patients with a high degree of severity (odds ratio, OR severe vs. asymptomatic/mild 2.33, 95% confidence interval, CI 1.80;3.02) or positive rheumatoid factor (OR 2.24, CI 1.96;2.56) the chance of receiving DMARD treatment was twice as high. Existing comorbidities did not reduce the chance of receiving DMARD treatment. Conclusion The RA patients in the national database who had no DMARDs for more than 1 year were mostly in remission or with low disease activity. Signs of inadequate disease control were found in only 11% of all patients without DMARD treatment.

To quantify vitamin D status among pregnant women in the Pacific Northwest (Portland, OR, and Seattle, WA) and examine pregnancy and newborn outcomes in relationship to maternal serum blood samples obtained during pregnancy.A retrospective cohort design.Data from 2009 to 2013 were abstracted from the health records of two out-of-hospital midwifery practices in the Pacific Northwest.Women with recorded serum blood samples for vitamin D during pregnancy were included. We reviewed health records of 663 women, and 357 met criteria.We extracted demographic, biometric, and pregnancy outcome data from participants' records and analyzed them using regression models.Mean serum 25-hydroxy vitamin D (25[OH]D) was 29.96 ± 10.9 ng/ml; 45.5% of participants were sufficient (≥30 ng/ml), and 55.5% were insufficient or deficient (29 ng/ml). Lower vitamin D levels were predicted by Seattle location, greater prepregnancy body mass index, and blood samples drawn during the winter. Vitamin D status was not a predictor of spontaneous abortion, glucose tolerance test result, cesarean birth, infant birth weight, or any other outcome investigated.Although there is a high prevalence of vitamin D insufficiency and deficiency in pregnant women in the Pacific Northwest, adverse health effects were not observed. This may be attributable to the overall healthy profile of the women in our sample. Further research on maternal vitamin D status should focus on identification of optimal vitamin D levels in pregnancy and long-term outcomes among offspring of women who are vitamin D deficient, particularly those from high-risk, vulnerable populations.

Introduction: Mothers and infants are at high risk for inadequate vitamin D status. Mechanisms by which vitamin D may affect maternal and infant DNA methylation are poorly understood. Objective: This study quantified the effects of vitamin D(3) supplementation on DNA methylation in pregnant and lactating women and their breastfed infants. Materials and Methods: In this randomized controlled pilot study, pregnant women received vitamin D(3) 400 international units (IU) (n = 6; control) or 3,800 IU (n = 7; intervention) daily from late second trimester through 4–6 weeks postpartum. Epigenome-wide DNA methylation was quantified in leukocytes collected from mothers at birth and mother–infant dyads at 4–6 weeks postpartum. Results: At birth, intervention group mothers showed DNA methylation gain and loss at 76 and 89 cytosine–guanine (CpG) dinucleotides, respectively, compared to controls. Postpartum, methylation gain was noted at 200 and loss at 102 CpGs. Associated gene clusters showed strongest biologic relevance for cell migration/motility and cellular membrane function at birth and cadherin signaling and immune function at postpartum. Breastfed 4–6-week-old infants of intervention mothers showed DNA methylation gain and loss in 217 and 213 CpGs, respectively, compared to controls. Genes showing differential methylation mapped most strongly to collagen metabolic processes and regulation of apoptosis. Conclusions: Maternal vitamin D supplementation during pregnancy and lactation alters DNA methylation in mothers and breastfed infants. Additional work is needed to fully elucidate the short- and long-term biologic effects of vitamin D supplementation at varying doses, which could hold important implications for establishing clinical recommendations for prenatal and offspring health promotion.

In recent years, a growing number of wealthy families entering the equity market have been seeking direct investments. But how do these actively investing families (family investors, henceforth) behave compared to non-family investors such as private equity (PE) firms? Answering this is particularly interesting from the investee firms’ perspective of family businesses, as the mindset of family investors might be more similar to their own. However, studies so far have neglected to distinguish between different investors in family firms. Thus, this conceptual paper aims to improve the understanding of family and PE investors and to consider the conditions and decision criteria under which family firms seek an external investor. To fulfil this goal, the two investor types are systematically compared, and based on multiple theoretical perspectives, a model of which investor type would best fit with family firms and their specific challenges is proposed. Thereby, we argue that the two investor types might be suitable partners for the investee firms depending on the challenges they face. In recent years, a growing number of wealthy families entering the equitymarket have been seeking direct investments. But how do these actively investingfamilies (family investors, henceforth) behave compared to non-family investorssuch as private equity (PE) firms? Answering this is particularly interesting from theinvestee firms’ perspective of family businesses, as the mindset of family investorsmight be more similar to their own. However, studies so far have neglected todistinguish between different investors in family firms. Thus, this conceptual paperaims to improve the understanding of family and PE investors and to consider theconditions and decision criteria under which family firms seek an external investor.To fulfil this goal, the two investor types are systematically compared, and based onmultiple theoretical perspectives, a model of which investor type would best fit withfamily firms and their specific challenges is proposed. Thereby, we argue that thetwo investor types might be suitable partners for the investee firms depending on thechallenges they face.

Prognostisch ungunstige Faktoren sollen in Therapieentscheidungen bei rheumatoider Arthritis (RA) einbezogen werden. Es gibt kaum Daten uber die Haufigkeit der einzelnen Faktoren bei Patienten in der Routineversorgung. Krankheitsaktivitat (Disease Activity Score DAS28), Erosionen, Antikorper gegen citrullinierte Peptide oder Rheumafaktoren (ACPA/RF), vorheriges Therapieversagen, Entzundungsmarker sowie Funktionseinschrankungen (FFbH 5,1, 64 % waren ACPA/RF+, 13 % hatten Erosionen und 37 % einen FFbH 5,1 von 33 % auf 52 % und FFbH von 41 % auf 66 %. In der Kerndokumentation waren zwischen 47 % (DMARD naiv) und 82 % (≥2 vorherige DMARD-Therapien) ACPA/RF+. 5 bis 11 % hatten unter Therapie einen DAS28 > 5,1. Der Anteil von Patienten mit FFbH < 70 stieg mit der Zahl der Vortherapien von 26 % auf 50 %. Der mit zunehmender Zahl abgesetzter DMARD-Therapien steigende Anteil von Patienten mit ungunstigen Prognosefaktoren unterstreicht deren Bedeutung im Hinblick auf einen schwer zu kontrollierenden Krankheitsverlauf.

Prevention of disease is a cornerstone of nursing care. Through our endeavors in research, teaching, and clinical care, nurses consistently seek to change the trajectory of disease development. The theoretical framework known as the Developmental Origins of Health and Disease (DOHaD) offers a new lens that shifts the current disease prevention paradigm upstream, encouraging intensified care of pregnant girls/women, neonates, and infants. This new focus parallels other emerging ecobiodevelopmental, life-course theories, which identify the long-term impact of early environments and stressors on the later risk of chronic adult diseases. Nurses have the potential to influence the health of multiple generations by incorporating DOHaD perspectives and interventions into their research and patient care.

This study examined how corporate governance codes specific to private family firms encourage the bright side and restrict the dark side of family influence. Moreover, it investigated whether these codes foster agency or stewardship tendencies of the family’s involvement in the business. The results of this qualitative research study revealed that the eight analyzed codes are not consistent in their recommendations and focus on different aspects of family influence. Nevertheless, some common recommendations could be identified-for instance, the relevance of family governance mechanisms to avoid conflicts.

This study examines private equity minority investors’ exit from family firms and its consequences for owner families. The authors theoretically discuss potential conflicts that might influence the exit decision, alternative exit routes, and the intentions of the family owners to exit the business along with the private equity investors. Subsequently, the theoretical insights were tested empirically using a case-based research approach. Four private equity firms provided data on 14 cases of completed minority private equity investments from Germany. Semi-structured interviews with investment managers offered further information regarding the analysed cases. Empirical findings reveal that conflicts of interest over the exit of private equity minority investors only rarely arise. Moreover, differences between planned and applied exit routes are mainly caused by changes in the economic situation of the company and/or in the conditions of financial markets and are related to changes in family owners’ exit intentions

Family firms commonly prefer internal funding and retention of control. Under certain circumstances, however, equity investments from outside the family can be a relevant alternative source of capital. To facilitate further knowledge about the interaction of family-owned businesses and external equity investors, the present work reviews 42 studies and suggests possible directions for future research. Results reveal that extant studies focus mainly on five key areas—corporate finance, contract design and collaboration, succession and exit route, strategy and performance, and corporate governance. Moreover, the paper discusses various gaps in the extant work and presents three opportunities for future research in a detailed manner. These include a comparison of different types of investors in the context of family-owned businesses, an investigation of minority investor exits from family firms, and an analysis of the impact of investors on family firm boards. All in all, the findings can guide the future development of this emerging field of research and have implications for theory and practice.

In aktuellen Leitlinien der Deutschen Gesellschaft fur Rheumatologie (DGRh) wird eine koordinierte multiprofessionelle Behandlung und Rehabilitation von Patienten mit entzundlich-rheumatischen Krankheiten gefordert. In der Realitat sind Rehabilitationsleistungen der Deutschen Rentenversicherung (DRV) bei diesen Patienten von 2000 bis 2012 bundesweit zuruckgegangen, am deutlichsten bei Mannern mit ankylosierender Spondylitis (AS) um fast ein Drittel. Daruber hinaus zeigen sich fur stationare Rehabilitationsleistungen der DRV wegen rheumatoider Arthritis (RA) zwischen den Bundeslandern Unterschiede um den Faktor 2,6. Rehabilitationsleistungen wegen RA oder AS werden von der DRV bis zu 14-mal haufiger durchgefuhrt als von einer der grosten Krankenkassen, die gesetzlich fur die Rehabilitation jenseits des Erwerbslebens zustandig sind. Die Struktur- und Prozessqualitat sind in Rehabilitationseinrichtungen mit hohen Zahlen von Patienten mit entzundlich-rheumatischen Krankheiten deutlich erhoht. Unter den RA-Patienten in deutschen Rheumazentren sind im Jahr 2011 noch 40 % von mittelgradigen bis erheblichen Alltagseinschrankungen (Funktionsfragebogen Hannover [FFBH] ≤ 70) betroffen. Dennoch halbierten sich nach den Daten der Kerndokumentation von 1995 bis 2011 die stationaren Rehabilitationsleistungen fur RA-Patienten mit FFBH ≤ 70 um etwa die Halfte. In ambulanter rheumatologischer Versorgung erhielten nach eigenen Angaben innerhalb der letzten 12 Monate 38 % der RA-Kranken mit FFBH

Positive therapeutic effects on the work force participation derived from international clinical trials may not be directly transferable to the community based care in Germany. Therefore recent changes of data regarding sick leave (SL), work disability pension (WDP) and employment from the social insurance and from the national database of the German collaborative arthritis centers were analyzed covering a time period of at least 10 years. Health insurance data showed a steeper decline in the average duration of SL caused by rheumatoid arthritis (RA), ankylosing spondylitis (AS) and systemic lupus erythematosus (SLE) compared with all other diseases. In RA patients from the collaborative arthritis centers the mean duration of SL was much more reduced than the average duration of SL for members of the compulsory health insurance. The proportion of gainfully employed RA patients in collaborative arthritis centers has particularly increased in women. According to data from the pension insurance fund less incident cases of WDP due to RA, AS, and SLE have been observed than WDP caused by all other diseases. Thus different nationwide data show positive changes of the work force participation of individuals suffering from inflammatory rheumatic diseases in Germany.

Objective To identify the combined effect of prenatal and postnatal vitamin D3 supplementation on the vitamin D status of pregnant and lactating women and their exclusively breastfed infants. Design Double-blind, randomized controlled trial. Setting Upper Midwestern U.S., hospital-based obstetric practice. Participants Pregnant women (N = 13) planning to exclusively breastfeed were randomized at 24 to 28 weeks gestation to receive vitamin D3 at a dosage of 400 IU (control group, n = 6) or 3,800 IU (intervention group, n = 7) daily through 4 to 6 weeks postpartum. Vitamin D status was determined at enrollment and in mother–infant dyads at 24 to 72 hours after birth and 4 to 6 weeks postpartum. Methods Serum 25-hydroxyvitamin D levels were measured to determine the effect of vitamin D3 supplementation on the vitamin D status of mothers and infants. Analysis of covariance was used to compare differences in 25-hydroxyvitamin D levels between the control and intervention groups. Results The mothers' vitamin D levels were significantly higher in the intervention group than in the control group at birth (p = .044) and at 4 to 6 weeks postpartum (p = .002). Infants in the intervention group had significantly higher vitamin D levels at birth (p = .021) and nonsignificant, clinically relevant increases at 4 to 6 weeks of age (p = .256). No differences were found between maternal groups in serum calcium or parathyroid hormone levels. Conclusion Prenatal to postpartum vitamin D3 supplementation is an effective intervention to increase a mother's vitamin D status and to promote optimal vitamin D status in newborns and exclusively breastfed infants.

Glucocorticoide (GC) sind unverzichtbarer Bestandteil einer zeitgemasen Behandlung in der Rheumatologie. Aufgrund des schnellen Wirkungseintritts und des hohen antiinflammatorischen Potentials sind sie in vielen Fallen unverzichtbar. Dies gilt trotz des bekannten Spektrums an unerwunschten Wirkungen und trotz einer eher bescheidenen Evidenz aus kontrollierten klinischen Studien. Umso bedeutsamer sind in dieser Situation Ergebnisse aus Beobachtungsdaten, die sowohl Auskunft geben uber typische Therapieentscheidungen von Rheumatologen im Hinblick auf die Verordnung von GC und die Kombination mit anderen Medikamenten als auch im Hinblick auf die Vermeidung der wichtigsten unerwunschten Wirkung, der GCinduzierten Osteoporose. Diese Daten liefert die Kerndokumentation der Rheumazentren. Sie zeigt als Querschnitt durch die rheumatologische Versorgung, dass 60% der Patienten mit rheumatoider Arthritis unter einer Therapie mit GC stehen, 85% davon mit einer Dosierung bis zu 7,5 mg/d. GC ersetzen nicht die Therapie mit DMARDs sondern sie werden verstarkt in Kombination mit neueren oder als besonders wirksam geltenden DMARDs eingesetzt, was die Orientierung der Therapie am Schweregrad der Krankheit unterstreicht. Die Variationsbreite zwischen den rheumatologischen Einrichtungen hinsichtlich des Einsatzes von GC ist gros und verdeutlicht die insgesamt ungesicherte empirische Evidenz. Hinsichtlich der GC-induzierten Osteoporose wird unter Rheumatologen eine umfangreiche, risikoadaptierte Therapie vorgenommen. Zwei Drittel der Patienten unter GC-Therapie erhalten eine Osteoporoseprophylaxe, Hochrisikogruppen deutlich mehr. Die Daten unterstreichen den hohen Stellenwert der GC in der modernen Rheumatherapie.

Offset and 1/f noise have been major enemies for analog IC designers since the enormous increase of the market for digital applications forced them to develop analog front ends in standard CMOS technology. Because static techniques like trimming cannot reduce 1/f noise, solutions had to be found in dynamic offset cancellation. The current work presents an improvement of the chopper amplifier concept, called the nested chopper amplifier. It is shown that with this architecture the residual offset is reduced to

The electronic system developed for the SpaCal lead/scintillating-fibre calorimeters of the H1 detector in operation at the HERA ep collider is described in detail and the performance achieved during H1 data-taking is presented. The 10 MHz bunch crossing rate of HERA puts severe constraints on the requirements of the electronics. The energy and time readout are performed respectively with a 14-bit dynamic range and with a resolution of about 0.4 ns. The trigger branch consists of a nanosecond-resolution calorimetric time-of-flight for background rejection and an electron trigger based on analog `sliding windows'. The on-line background rejection currently achieved is o(10**6). The electron trigger allows a low energy trigger threshold to be set at about 0.50 +/- 0.08 (RMS) GeV with an efficiency >99.9%. The energy and time performance of the readout and trigger electronics is based on a newly-developed low noise (sigma_noise ca. 0.4 MeV) wideband (f < 200 MHz) preamplifier located at the output of the photomultipliers which are used for the fibre light readout in the ca. 1 Tesla magnetic field of H1.

In this paper, experience gathered during the measurement of the geometry of microhardness indenters using a scanning force microscope is discussed. Reasonable accuracy of the geometrical parameters of a microhardness indenter can be obtained only if the scanning force microscope has been calibrated. The effect of the geometrical deviations on the result measured for the universal hardness is discussed.

The new lead/scintillating-fibre calorimeter (“SpaCal”) for the backward region of the H1 experiment at HERA (DESY) is equipped with fine mesh phototubes which operate in a magnetic field close to 1 T. A large sample of these tubes of the types Hamamatsu R5505 and R5506, and Hamamatsu R2490-05, have been tested in fields of up to 1.2T. We have investigated the cathode homogeneity with and without magnetic field, the gain loss under the influence of the magnetic field, and stability with time. For a subsample of tubes, we have performed additional studies on stability with respect to temperature changes, variation of gain as a function of the magnetic field, high voltage discharges, single photo-electron response, and linearity. We finally summarize the experience with these tubes after one year of operation in the experiment.

A commercial metrological scanning force microscope (SFM) has been modified to further improve its metrological performance and calibration. For this purpose, a three-dimensional (3D) measuring system consisting of three miniature laser interferometers has been incorporated into the SFM. Special attention is paid to the 3D nature of SFM measurements. The metrological characteristics are spatially dependent. The goal therefore is to calibrate the scales of the movement axes, as well as cross-talk and Abbe errors, with respect to the entire measurement volume of the SFM. The effects can be significantly reduced by compensating for measured spatially dependent non-linearities, cross-talk and Abbe errors by modification of the SFM control software using regression functions. For characterizing the metrological performance, we have applied a model introduced in a three-coordinate measurement technique. Herewith, the spatially dependent performance is given by linear superposition of a set of one-dimensional functions. Further progress is achievable by logical reference to spatially distributed calibration points given by output signals of the laser interferometers. At the stage reached in the work at present, an expanded uncertainty U = 5 nm + 2 x 10 -4 . I (where I = distance) is estimated for the distance measured between two points within a measured volume. The SFM is used for topographical measurement of the thickness of coatings, evaluation of the topography of microstructures and determination of dimensional parameters arising from microhardness measurements.

The backward region of the H1 detector has been upgraded in order to provide improved measurement of the scattered electron in deep inelastic scattering events. The centerpiece of the upgrade is a high-resolution lead/scintillating-fibre calorimeter. The main design goals of the calorimeter are: good coverage of the region close to the beam pipe, high angular resolution and energy resolution of better than 2% for 30 GeV electrons. The calorimeter should be capable of providing coarse hadronic energy measurement and precise time information to suppress out-of-time background events at the first trigger level. It must be compact due to space restrictions. These requirements were fulfilled by constructing two separate calorimeter sections. The inner electromagnetic section is made of 0.5 mm scintillating plastic fibres embedded in a lead matrix. Its lead-to-fibre ratio is 2.3:1 by volume. The outer hadronic section consists of 1.0 mm diameter fibres with a lead-to-fibre ratio of 3.4:1. The mechanical construction of the new calorimeter and its assembly in the H1 detector are described.

Maternal vitamin D insufficiency during lactation, related to lack of sun exposure and minimal intake of vitamin D from the diet, contributes to low breast milk vitamin D content and, therefore, infant vitamin D deficiency. The objective of this review was to examine the literature regarding evidence for achieving maternal vitamin D status that promotes sufficient vitamin D transfer from mother to infant exclusively from breast milk. PubMed and CINAHL databases were searched using the terms lactation or breastfeeding or milk, human and vitamin D. The resulting articles were further limited to those written in English, published within the last 10 years, and involving clinical or randomized controlled trials of humans. The search yielded 13 studies, 3 of which provide evidence for maternal intake of vitamin D and the correlation with exclusively breastfed infants’ serum 25-hydroxyvitamin D level. A strong positive correlation exists between maternal vitamin D intake during exclusive breastfeeding and infant serum 25-hydroxyvitamin D levels. There is support to conclude that when maternal vitamin D intake is sufficient, vitamin D transfer via breast milk is adequate to meet infant needs. In the reviewed studies, doses up to 10 times the current recommended daily intake of vitamin D were needed to produce sufficient transfer from mother to breastfed infant. Further research is needed to refine the dose and gestational timing of maternal vitamin D supplementation. Due to the high rates of vitamin D deficiency during lactation and the correlations between vitamin D deficiency and multiple diseases, providers should consider monitoring lactating mothers’ vitamin D status.

Objective To synthesize published research to determine the evidence for the association between maternal vitamin D status during pregnancy and the development of gestational diabetes mellitus (GDM). Data Sources Literature searches were conducted for data based articles that examined maternal vitamin D during pregnancy, GDM, glucose tolerance, and insulin resistance using the PubMed, CINAHL, and SCOPUS data bases and reference lists from reviewed papers. Study Selection Primary research studies published in the English language between 1999 and 2011 reporting findings regarding the association of vitamin D with glucose homeostasis during pregnancy and GDM. Data Extraction Study characteristics and findings related to vitamin D status determinants, gestational timing, and measures of glucose homeostasis and insulin resistance. Data Synthesis Six data based articles met the criteria for study inclusion. Study findings comprised solely Level‐2 evidence for the association of maternal vitamin D deficiency and risk of GDM. The majority of studies (66%) were conducted between 24 and 30 weeks gestation. Five (83%) studies reported an inverse relationship between circulating vitamin D levels and markers of glucose homeostasis associated with gestational diabetes or an increased risk for GDM associated with reduced maternal levels of vitamin D. In one study, researchers did not identify an association between vitamin D and GDM but did identify an association between higher vitamin D levels and lower fasting glucose and insulin levels. Conclusion Maternal vitamin D deficiency and insufficiency is prevalent among gravid women and is associated with markers of altered glucose homeostasis. These findings underscore the need for mechanistic and clinical studies to determine optimal vitamin D status in pregnancy for reduction in the risk for GDM with implications for vitamin D supplementation as a potential target for GDM prevention.

LV segmentation is often an important part of many automated cardiac diagnosis strategies. However, the segmentation of echocardiograms is a difficult task because of poor image quality. In echocardiography, we note that radio-frequency (RF) signal is a rich source of information about the moving LV as well. In this paper, first, we will investigate currently used, important RF derived parameters: integrated backscatter coefficient(IBS), mean central frequency (MCF) and the maximum correlation coefficients (MCC) from speckle tracking. Second, we will develop a new segmentation algorithm for the segmentation of the LV boundary, which can avoid local minima and leaking through uncompleted boundary. Segmentations are carried out on the RF signal acquired from a Sonos7500 ultrasound system. The results are validated by comparing to manual segmentation results.

We model the process of imaging soft tissues with a 3D ultrasound probe using a linear convolution model, and obtain analytical expressions of both the ultrasound image and its spectrum. We use this model to study the ultrasound decorrelation caused by tissue motion both in the spatial domain and spectral domain. Finally, we propose a spectral-feature-based algorithm to analyze tissue motion. The comparison with intensity-based algorithm shows promising results.

Interleukin-17 (IL-17) has been characterized as a proinflammatory cytokine produced by CD4+ CD45RO+ memory T cells. Overproduction of IL-17 was detected in the synovium of patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis. This study examines differentially expressed genes after the stimulation of fibroblast-like synoviocytes of RA patients by IL-17. Among these genes we identified the following: tumor necrosis factor-stimulated gene-6 (TSG-6), IL-6, IL-8, GRO-β, and bone morphogenetic protein-6 with an expression 3.6–10.6-fold that in the unstimulated control. IL-17 augmented the expression of TSG-6, a hyaluronan-binding protein, in a time- and dose-dependent manner. IL-17 showed additive effects with IL-1β and tumour necrosis factor-α on the expression of TSG-6, IL-6 and IL-8. The mitogen-activated protein kinase p38 seems to be necessary for the regulation of TSG-6 expression by IL-17, as shown by inhibition with SB203580. Our results support the hypothesis that IL-17 is important in the pathogenesis of RA, contributing to an unbalanced production of cytokines as well as participating in connective tissue remodeling.

Some of the more important requirements specified by Hydro-Quebec are presented. The resulting design optimization is discussed and special features of the design are pointed out. Testing requirements as compared to International Electrotechnical Commission (IEC) Standards are discussed and results presented.

In vitro studies suggest that cerebrovascular contraction is more dependent on the influx of calcium to smooth muscle than general systemic arteries. The present study tested the in vivo effects of a calcium influx blocker (nimodipine) on cerebral blood flow and metabolism in 16 baboons. The 133xenon clearance technique was used together with careful control of EEG and blood gases. With normal blood gases intravenous nimodipine infusion (1 microgram/kg/min) produced an 18% increase in cerebral blood flow with no alteration in cerebral oxidative metabolism or blood pressure. Higher doses (above 10 micrograms/kg/min) resulted in a decreased arterial blood pressure and a return to control cerebral flow. Infusion of the dose producing maximal increase in flow, decreased the cerebral reactivity to altered PCO2 (n = 5). These results suggest that nimodipine may be a relatively selective cerebrovascular dilator.