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Background Many people with rheumatoid arthritis (RA) are physically inactive despite proven health benefits. Effective methods for physical activity (PA) promotion have been developed, but little is known about their use among health professionals in rheumatology. A previous study described factors related to promotion of PA, defined as any bodily movement resulting in energy expenditure, among Dutch health professionals. The results indicated that a majority agrees that PA is important and regularly recommend it to their patients, but do feel a need for additional education in the area. Objectives The objective of our study was to describe and compare the attitudes of Italian and Swedish health professionals towards PA, to what extent they promote PA among their patients with RA, their perceived competencies to promote PA and their related educational needs. Methods A questionnaire was sent to 1402 Italian and 837 Swedish health professionals (rheumatologists, nurse specialists and physiotherapists). The 23-item questionnaire on PA promotion, originally developed for the Dutch study (1), was translated into Italian and Swedish according to standard procedures. Results The response rate was 25 % in Italy and 29 % in Sweden. Sixty-four percent of the respondents were female, mean age was 45,6 years and mean experience within rheumatology 12,8 years. Ninety-six percent of Italian health professionals and 99 % of those in Sweden agreed that PA is an important health goal for patients with RA and regularly advised their patients to engage in it. Public health recommendations for moderate-intensity PA were found attainable in patients with RA by 89 % and 96 % and were used by 90 % and 91% of those in Italy and Sweden respectively. On average, respondents in Italy and Sweden rated their competency to promote PA as 7,1 and 5,6 out of 10 respectively, and 89 % and 69 % of them expressed a need for additional education. Conclusions Our results indicated similar attitudes to PA as an important health goal, higher rating of this as attainable for people with RA and more than twice as high use of public health recommendations compared to their Dutch peers. The only major differences between Italy and Sweden concerned the lower perceived competency, but less expressed need for education found among the Swedish respondents compared to those in Italy. The response rate of our study was less than half of that in the Dutch study and, in addition to threatening the external validity of the study, might indicate less interest in PA promotion among Italian and Swedish health professionals compared to those in the Netherlands. However, assuming that the responders were mainly those considering PA a suitable intervention for their patients, this would only strengthen the case for attitude changes and raised competencies for physical activity promotion among health professionals in rheumatology. References Hurkmans EJ et al. Promoting physical activity in patients with rheumatoid arthritis: rheumatologists’ and health professionals’ practice and educational needs. Clin Rheumatol 2011;30:1603–1609 Acknowledgements This study was funded by ‘the EULAR Health Professionals Research Grant 2012’. Disclosure of Interest None Declared

Introduction A role of vitamin D in the immune system has been proposed [1, 2]. [...]vitamin D is believed to enhance innate immune response and inhibit the adaptive immune system, although these effects depend on the context and on the cell type, as vitamin D is not always stimulatory on innate immunity or inhibitory on adaptive immunity [1, 2]. Because there was a correlation between 25-hydroxyvitamin D and BMI (R= − 0.192; 95% CI from − 0.202 to − 0.182; P= 0.0084), we adjusted comparisons for BMI, but again, we found no differences (not shown). Because vitamin D levels changes according to season, 25-hydroxyvitamin D was evaluated based on the time of year, but, once more, there was no difference (Fig. 1c). [...]in confirmation of previous studies [10], there was no relationship between vitamin D and TRAbs. Whether Vitamin D supplementation has any effects on the course of GO remains to be established, both by in vitro studies in orbital fibroblasts and by randomized clinical trials in GO patients. [...]previous studies have suggested a beneficial role of vitamin D supplementation in thyroid diseases [11].

Synthetic Aperture Radar (SAR) is considered as a useful tool for sea surface monitoring, thanks to its capability to acquire images day and night and in all weather conditions. In particular, SAR is extensively used to detect oil slicks on the sea surface. Since the early 90s SAR acquisitions were routinely available with C-band sensors (such as ERS-1 and 2, Envisat, Radarsat 1 and 2). More recently, also L-band (ALOS PALSAR 1 and 2) and X-band (Terrasar X, COSMO/SkyMed constellation) sensors became operational. In this framework we developed a new software called SEASAFE (Slick Emissions And Ship Automatic Features Extraction), able to process SAR data in C- L- and X-bands. Moving from previous experience, new features have been added such as an enhanced land masking algorithm and oil spill characterization. Modules for ship detection and wind and wave evaluation are also available. The new improved system is here described; detection capabilities are evaluated, overall performances are described.

The morphology of the sperm head has often been correlated with the outcome of in vitro fertilization, and has been shown to be the sole parameter in semen of value in predicting the success of intracytoplasmic sperm injection and intracytoplasmic morphologically selected sperm injection. In this paper, we have studied whether digital holographic microscopy (DHM) may be useful to obtain quantitative data on human sperm head structure and compared this technique with high-power digitally enhanced Nomarski optics. The main advantage of digital holography is that high-resolution three-dimensional quantitative sample imaging may be automatically produced by numerical refocusing of a two-dimensional image at different object planes without any mechanical scanning. We show that DHM generates useful information on the dimensions and structure of human sperm, not revealed by conventional phase-contrast microscopy, in particular the volume of vacuoles, and suggest its use as an additional prognostic tool in assisted reproduction technology.

Mesozooplankton present a wide range of functionally diverse heterotrophic organisms ranging from 200 µm to 2 cm that are essential to marine ecosystems and biogeochemical cycles. In most ocean biogeochemical models, mesozooplankton are represented as a single compartment along with microzooplankton (<0.2 mm), thereby overlooking their large functional diversity. Yet, observational and modelling studies relying on functional trait-based approaches showed how important the functional traits diversity of marine zooplankton is in driving ecosystem dynamics and biogeochemical cycles. Here, we use such a functional trait-based approach by modelling the effect of various mesozooplankton feeding strategies on the ocean carbon cycle, using the global ocean biogeochemical model PISCES. Three new mesozooplankton functional types (PFTs) and their associated trade-offs were integrated into PISCES: cruisers (active swimmers feeding on suspension particles), ambushers (passive suspension feeder, relying on a sit-and-wait strategy) and flux-feeders (passively feeding on particles). An additional foraging effort was implemented for cruisers to account for the optimization of their active behaviour. Our new configuration shows that these functional groups have distinct latitudinal and vertical distributions: the two suspension feeding groups (cruisers and ambushers) share the epipelagic zone, with ambushers being the dominant group globally (0.11 Gt C yr−1, 54.8 % of total mesozooplankton in the top 150 m) and cruise feeders (0.03 Gt C yr−1) prevailing in the productive regions near the poles. Meanwhile, flux-feeders (0.06 Gt C yr−1) dominate in the mesopelagic zone of coastal regions. The change of parameters, thus trade-offs, in our sensitivity experiments also shows how we can modulate and even reverse the latitudinal pattern of suspension feeders. Finally, we demonstrate how the deep-dwelling flux-feeders directly affect carbon export at depth more strongly by consuming the particles that would otherwise be transported to deeper layers (the carbon export increases by 40.8 % when flux-feeders are removed). This study emphasizes the necessity for a better integration of the trophic strategies of this planktonic compartment within global biogeochemical models.

Background Tocilizumab (TCZ) is a humanised monoclonal antibody that inhibits binding of interleukin-6 (IL-6) to its receptors1, preventing IL-6–mediated pro-inflammatory activity. TCZ in combination with methotrexate (MTX) is indicated in patients with moderate to severe Rheumatoid Arthritis (RA) with inadequate clinical response or intolerance to one or more DMARDs or TNF-α antagonists. Moreover, TCZ is indicated as monotherapy in patients intolerant to MTX or for whom MTX is considered inappropriate1. So far few data are available about the use and clinical impact of TCZ in the real clinical practice. Objectives Objectives: The primary objective of this multicenter, retrospective and prospective, observational study was to evaluate the percentage of RA patients who achieved low disease activity (DAS28 ≤3.2) and remission (DAS28 <2.6) after 6 months of TCZ treatment. Here are presented the results from a preliminary descriptive analysis conducted on the totality of the enrolled patients, with the aim to describe and compare baseline clinical characteristics of patients treated with TCZ monotherapy versus patients undergoing TCZ combination therapy. Methods Eligible patients where those with moderate to severe RA who had started TCZ in the 6 months prior to the opening of the center and who were still on treatment at the beginning of the study. Patients were then followed up prospectively to a maximum of 12 months after the first TCZ infusion. Results One hundred and five (32.6%) patients in the TCZ-monotherapy group and 217 (67.4%) in the TCZ-combination group were enrolled in 58 Italian sites. The two groups were comparable in terms of age, gender, and race. TCZ-mono patients had longer disease duration compared to TCZ-combo (144.9±96.2 months vs 111.9±94.7, respectively). Concerning the pharmacological anamnesis, a greater number of patients assuming TCZ as monotherapy had been previously treated with anti-TNFα (81% vs 67.3% for TCZ mono- and combo therapy respectively) and other non-DMARDs therapies indicated for RA (92.4% vs 80.7%). Baseline clinical characteristics, i.e. DAS28 ≥3.2 (94.6% vs 97.4%, for TCZ mono- and combo, respectively) and VAS fatigue (62.8% vs 58.4%), were comparable between groups. Health-related quality of life, HAQ score, was higher in patients treated with TCZ as monotherapy than in those in combination therapy (2.1±3.1 vs 1.5±0.9 respectively). Concerning the pathological anamnesis, no difference was observed between groups, except for a greater number of patients with heart failure, who were treated with TCZ monotherapy. Conclusions In the real clinical practice, rheumatologists appear more confident in choosing the option of TCZ as monotherapy in patients with (i) longer disease duration, (ii) previous failures to other therapies - especially TNFα inhibitors, (iii) worst quality of life, and (iv) history of heart failure, suggesting that TCZ as monotherapy is considered a valid option in patients intolerant to MTX or for whom MTX is inappropriate. References: Navarro-Millán I et al. Clin Ther. 2012;34:788-802 Disclosure of Interest: None Declared

Parametric and nonparametric estimation techniques are compared in estimating the relationship between income and health expenditures with implications for the reliability of past estimates of health expenditure income elasticity. Relative to a more flexible nonparametric approach, a parametric approach can generate over or underestimates in health expenditure. Three time series cross-section data sets are used: (a) United States state level data from 1980-1997, (b) Canadian province level data from 1965-2000, and (c) national level data for 16 OECD countries from 1960-1997. Relative to ordinary least squares, locally weighted scatterplot smoothing allows for variability in the income elasticity of health spending as income varies. Generally, results of the latter suggest that income elasticities are higher at low-income levels and lower at higher income levels. As well, these results confirm that income elasticity does vary by level of analysis with international income elasticities being generally larger than national or regional studies.

A bstract Searches for invisible decays of the Higgs boson are presented. The data collected with the CMS detector at the LHC correspond to integrated luminosities of 5.1, 19.7, and 2.3 fb −1 at centre-of-mass energies of 7, 8, and 13 TeV, respectively. The search channels target Higgs boson production via gluon fusion, vector boson fusion, and in association with a vector boson. Upper limits are placed on the branching fraction of the Higgs boson decay to invisible particles, as a function of the assumed production cross sections. The combination of all channels, assuming standard model production, yields an observed (expected) upper limit on the invisible branching fraction of 0.24 (0.23) at the 95% confidence level. The results are also interpreted in the context of Higgs-portal dark matter models.

Results are presented from a search for particle dark matter (DM), extra dimensions, and unparticles using events containing a jet and an imbalance in transverse momentum. The data were collected by the CMS detector in proton–proton collisions at the LHC and correspond to an integrated luminosity of 19.7 fb -1 at a centre-of-mass energy of 8 TeV . The number of observed events is found to be consistent with the standard model prediction. Limits are placed on the DM-nucleon scattering cross section as a function of the DM particle mass for spin-dependent and spin-independent interactions. Limits are also placed on the scale parameter M D in the Arkani-Hamed, Dimopoulos, and Dvali (ADD) model of large extra dimensions, and on the unparticle model parameter Λ U . The constraints on ADD models and unparticles are the most stringent limits in this channel and those on the DM-nucleon scattering cross section are an improvement over previous collider results.

A bstract A search is presented for decays beyond the standard model of the 125 GeV Higgs bosons to a pair of light bosons, based on models with extended scalar sectors. Light boson masses between 5 and 62.5 GeV are probed in final states containing four τ leptons, two muons and two b quarks, or two muons and two τ leptons. The results are from data in proton-proton collisions corresponding to an integrated luminosity of 19.7 fb −1 , accumulated by the CMS experiment at the LHC at a center-of-mass energy of 8 TeV. No evidence for such exotic decays is found in the data. Upper limits are set on the product of the cross section and branching fraction for several signal processes. The results are also compared to predictions of two-Higgs-doublet models, including those with an additional scalar singlet.