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The 12-month drug-survival rate was 72.3%, while the respective rates of good EULAR response and remission (DAS28-ESR 35 mm/h, HR 1.16, p = 0.071) predicted drug survival. Conclusions In anti-TNF-treated RA patients, fulfilment of treatment preferences was independently associated with a good EULAR response and correlated with drug persistence at 12 months, emphasising the importance of patient preferences in treatment outcomes.Key Points• In anti-TNF treated RA patients, fulfilment of patients' treatment preferences is associated with a good clinical response at 12 months.• A shared decision-making process can maximise treatment's outcome in anti-TNF treated patients.Background Jab1 has been reported to regulate various proteins in signal transduction pathways and be implicated in carcinogenesis or tumor progression. However, the precise role and molecular mechanism of Jab1 in gastric tumorigenesis have not yet been fully elucidated. Methods Jab1 staining in gastric cancer tissues and paired non-cancerous tissues was measured using tissue microarray (TMA) technology. The impact of Jab1 on tumor growth in vivo was analyzed using xenotransplantation experiments in Balb/c mice. The expression of Jab1 and p14ARF in gastric cancer cells was analyzed by western blot and confocal immunofluorescence. CCK-8 and cell cycle experiment were used to evaluate the cell proliferation. Ubiquitination assay was performed to validate whether ubiquitination is involved in Jab1-mediated p14ARF degradation. Results The expression level of protein p14ARF was inversely correlated with the protein level of Jab1. find more Then, we investigated the mechanism that how Jab1 induced p14ARF depletion. Mechanistic studies showed that Jab1 induced ubiquitin-independent proteasomal p14ARF degradation in gastric cancer cells. Our data demonstrated that Jab1 protein was a vital upstream negative modulation factor of p14ARF, and Jab1 could promote cell proliferation and tumor growth via inhibiting the expression of p14ARF in vivo and in vitro. Moreover, silencing Jab1 protein expression declined tumor growth and further increased the apoptosis rate of gastric cancer cells. In further studies of gastric cancer specimens, we found the increased level of Jab1 protein shortened the overall survival. Conclusion Jab1 is upstream of p14ARF and promote gastric cancer cell proliferation in vitro and in vivo. Furthermore, Jab1 decreased the expression of p14ARF though ubiquitination independent proteasomal degradation. Therefore, the connection of Jab1 and p14ARF may provide new methods for the treatment of gastric cancer.Purpose To establish whether new indices on plain chest X-ray (CXR) can replace those on computed tomography (CT) for the follow-up of children who have undergone the Nuss procedure. Methods The subjects of this retrospective study were 45 children who underwent the Nuss procedure between 2000 and 2016. The Haller index (HI) was measured by preoperative CT. Preoperative and postoperative chest deformities were evaluated by two CXR measurements the concave rate on the lateral view (CR; the depth of the concavity divided by the anterior-posterior diameter of the rib cage) and the tracheal bifurcation angle (TBA) on the anterior view. Data are expressed as the median with range. Results The median age and HI of the children, when they underwent the Nuss procedure, was 9.3 (3.8-17.3) years and 4.5 (3.2-10.1), respectively. The preoperative CR was correlated significantly with the HI. The postoperative CR was significantly lower than the preoperative CR [pre 0.17 (0.08-0.37), post 0.09 (0.01-0.18), p less then 0.05], and the low value was sustained after bar removal. The TBA decreased significantly after the Nuss procedure from 74.2° (55-104) preoperatively to 65.0° (45-92) postoperatively (p less then 0.05). Conclusions These results suggest that CXR can replace CT for the follow-up of patients after the Nuss procedure, with lower radiation exposure.Purpose To assess whether there are temporal differences altering the clinical outcomes of severe trauma patients in Japan. Methods This was a retrospective cohort study that used recorded data from the Japan Trauma Data Bank. Severe trauma patients who had an injury severity score of greater than 16 were included. The hospital arrival time was categorized into daytime (8 a.m.-759 p.m.) and nighttime (8 p.m.-759 a.m.). The hospital arrival day of the week was categorized into business days and non-business days. The primary outcome was in-hospital mortality. Results A total of 65,136 severe trauma patients were analyzed. In-hospital mortality was 15.6% in the daytime and 14.4% in the nighttime, and 15.5%, and 14.6% on business days and non-business days, respectively. Nighttime was associated with decreased in-hospital mortality compared to daytime (odds ratio = 0.817, 95% confidence interval = 0.764-0.874) and a non-business day was not associated with in-hospital mortality. Conclusions We did not find a negative off-hour effect on in-hospital mortality among severe trauma patients.Purpose To establish the clinicopathological importance of serum p53 autoantibody (s-p53-Ab) titrations in patients with gastric cancer. Methods Preoperative s-p53-Ab titers were analyzed in 448 gastric cancer patients between 2010 and 2017. Seropositive patients were divided into three groups based on their antibody titers 1.31-10.0 U/mL (low group); 10.1-100 U/mL (medium group); and > 100 U/mL (high group). We evaluated the associations between the s-p53-Abs and clinicopathological factors, carcinoembryonic antigen (CEA) levels, and cancer antigen 19-9 (CA19-9) levels. Overall survival was analyzed by multivariate analyses. Results A total of 72 patients (16%) were positive for s-p53-Abs. The rate of positivity for s-p53-Abs + CEA + CA19-9 was significantly higher than that for CEA + CA19-9, even in stage I gastric cancers. Gender, tumor depth, lymphatic node metastases, and distant metastases were all significantly associated with the presence of s-p53-Abs; however, overall survival was not associated with the antibodies. The patients in the high titer group (> 100 U/mL) had a relatively worse survival than those in the other groups. Conclusions Based on our findings, s-p53-Abs improve the overall rate of positivity for detecting gastric cancer, but the prognostic value of a high s-p53-Ab titer for predicting overall survival is limited.Zagaria et al. identified fundamental issues and inconsistencies in the understanding of the fundamentals of psychological science. This paper attempts to trace the roots of the inconsistency and incompleteness of definitions of basic psychological concepts in the historical development of psychological science that led to the fragmentation of psychology into the various reductionistic and monological "schools of thoughts". A systematic approach is proposed as a way for a reconsideration of the understanding of mental processes in a holistic way that could serve as the starting point for the proper theoretical reflection of the catalytic interplay between subjective (intentionality), situational and cultural factors. It is argued that the anthropologisation of psychology and bringing back the focus on phenomenological aspects of experiencing which are characterised by intra-individual, cross-situational and inter-cultural variety is especially significant for the rebuilding of the integrity of psychology. The principle of "organic selection" is proposed as the basis for individual subjectivity and innovations throughout the irreversible ontogenetic developmental dynamics that allows individuals to jump beyond the phylogenetically prescribed schemata.Background A speckle tracking echocardiographic (STE) strain imaging can predict myocardial viability. The study compared the STE strain imaging using low-dose dobutamine stress with 18fluoro-deoxyglucose positron emission tomographic (18FDG-PET) imaging for the detection of myocardium viability. Methods We studied 57 patients with ST-elevation myocardial infarction (STEMI) having angiographic evidence of total arterial cut off and akinetic myocardium. These patients underwent low-dose dobutamine echocardiography and 18FDG-PET imaging. The STE was used to measure the peak systolic longitudinal and circumferential strain and strain rate at rest and after low-dose dobutamine stress. Results A total of 298 akinetic segments were evaluated. The viable myocardium showed an increased strain and strain rate values following the dobutamine stress in comparison to the nonviable myocardium. The peak longitudinal strain rate [AUC 0.83 (95% confidence interval (CI) 0.67-0.99], p = 0.001; optimal cutoff - 0.64 s-1 for sensitivity 0.87 and specificity 0.81), post-dobutamine peak longitudinal strain rate [AUC 0.94 (95% CI 0.87-1.00), p = 0.001; optimal cutoff - 0.85 s-1 for sensitivity 0.89 and specificity 0.77), change in peak longitudinal strain rate [AUC 0.93 (95% CI 0.86-1), p = 0.001; optimal cutoff - 0.2 s-1 for sensitivity 0.87 and specificity 0.87] predicted viability. The post-dobutamine peak circumferential strain rate [AUC 0.92 (95% CI 0.81-1.0), p = 0.001; optimal cutoff - 1.1 s-1 for sensitivity and specificity 0.86], were predictor of viability. Both resting and post-dobutamine longitudinal and circumferential strain rate had better accuracy for the prediction of viability. Conclusions The resting and post-dobutamine stress STE strain and strain rate parameters can assess the viability in akinetic segments.Background The World Health Organization estimates that over 50% medicines are prescribed inappropriately and the main driver of antimicrobial resistance globally. There have only been a limited number of studies evaluating prescribing patterns against national standard treatment guidelines (STGs) in sub-Saharan African countries including Namibia. This is important given the high prevalence of both infectious and non-infectious diseases in sub-Saharan Africa alongside limited resources. Objective Our aim was to assess prescribing practices and drivers of compliance to National guidelines among public health care facilities in Namibia to provide future guidance. Setting Three levels of public healthcare in Namibia. Method A mixed method approach including patient exit and prescriber interviews at three levels of health care in Namibia, i.e. hospital, health centre and clinic. Main outcome measures Medicine prescribing indicators, compliance to and attitudes towards National guidelines. Results Of the 1243 prescriptions analysed, 73% complied with the STGs and 69% had an antibiotic. Of the 3759 medicines (i.e. mean of 3.0 ± 1.1) prescribed, 64% were prescribed generically. The vast majority of prescribers were aware of, and had access to, the Namibian STGs (94.6%), with the majority reporting that the guidelines are easy to use and they regularly refer to them. The main drivers of compliance to guidelines were programmatic, that is access to up-to date objective guidelines, support systems for continued education on their use, and ease of referencing. Lack of systems to regulate noncompliance impacted on their use. Conclusion Whilst the findings were encouraging, ongoing concerns included limited prescribing of generic medicines and high use of antibiotics. A prescribing performance management system should be introduced to improve and monitor compliance to prescribing guidelines in public healthcare.
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