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Anti-CCP (cyclic citrullinated peptide) is considered the most useful laboratory tool in the diagnosis of rheumatoid arthritis (RA). Some authors have also found this autoantibody in patients with scleroderma (SSc). The study aimed to investigate the prevalence of anti-CCP antibodies in SSc patients from Southern Brazil and their association with clinical and serological profile of the disease. We studied 76 patients with SSc and 100 healthy volunteers for presence of anti-CCP. SSc patients charts were reviewed for clinical and laboratory data. In the SSc group, the diffuse form was present in 20.5%; 62.8% had the limited form; 14.1% had overlap with systemic lupus or polymyositis and 2.5% had SSc sine scleroderma. Anti-CCP was found in nine of 78 (11.5%) SSc patients and in one of 100 healthy volunteers ( p  = 0.0054). No relationship was found with arthritis, skin Rodnan m score, esophageal dysmotility, myocarditis, pulmonary hypertension and lung fibrosis. Positive association was observed with arthralgias ( p  = 0.02). Also, no relationship was noted with the presence of anti-centromere antibodies, anti-Scl-70, anti-RNP or rheumatoid factor. Anti-CCP are more common in SSc patients than in controls. Arthralgias but not arthritis or rheumatoid factor are more frequent in anti-CCP positive patients.

Antinucleosome antibodies have been found with variable prevalence in systemic lupus erythematosus (SLE) and were associated with more severe disease. This research aims to study the prevalence of antinucleosome antibodies in a sample of Brazilian adult SLE patients and their association with clinical findings and disease activity. Ninety-two adult patients (81 females and 11 males, with mean age of 37.29 ± 10.98 years) with SLE were studied for clinical and antibody profile, disease activity by SLE disease activity index (SLEDAI), and presence of antinucleosome antibodies by ELISA. The prevalence of antinucleosome antibodies was 61.9% (mean titer, 87.8 ± 62.6 U). No relationship was found of antinucleosome presence and any of the studied clinical features. A positive association was detected with anti-DNA ( p  = 0.001) and SLEDAI ( p  < 0.0001), but not with anti-Sm, anti-Ro, anti-La, and anti-RNP. No specific disease feature could be associated with the presence of antinucleosome; however, a positive relationship was detected with disease activity measured by SLEDAI and with anti-DNA presence.

Patients with juvenile idiopathic arthritis (JIA) may need further care in the adult clinic as this disease frequently has continuous inflammatory activity during adult life. To identify which pediatric JIA patients will need continuing care into adulthood. We compared the clinical, serological, and demographic data of 45 JIA patients followed up by the pediatric clinic to those of 49 JIA patients in the adult rheumatology clinic. Patients in the adult clinic have older age at disease onset ( p  < 0.0001) and higher prevalence of positive anti-cyclic citrullinated peptide (CCP) ( p  = 0.05). No differences were observed in JIA form, presence of rheumatoid factor (RF), uveitis, and gender. Anti-CCP and older age at disease onset may identify pediatric JIA patients that will need further care in the adult clinic.

Pathogens that traffic in blood, lymphatics, or interstitial fluids must adopt strategies to evade innate immune defenses, notably the complement system. Through recruitment of host regulators of complement to their surface, many pathogens are able to escape complement-mediated attack. The Lyme disease spirochete, Borrelia burgdorferi, produces a number of surface proteins that bind to factor H related molecules, which function as the dominant negative regulator of the alternative pathway of complement. Relatively less is known about how B. burgdorferi evades the classical pathway of complement despite the observation that some sensu lato strains are sensitive to classical pathway activation. Here we report that the borrelial lipoprotein BBK32 potently and specifically inhibits the classical pathway by binding with high affinity to the initiating C1 complex of complement. In addition, B. burgdorferi cells that produce BBK32 on their surface bind to both C1 and C1r and a serum sensitive derivative of B. burgdorferi is protected from killing via the classical pathway in a BBK32-dependent manner. Subsequent biochemical and biophysical approaches localized the anti-complement activity of BBK32 to its globular C-terminal domain. Mechanistic studies reveal that BBK32 acts by entrapping C1 in its zymogen form by binding and inhibiting the C1 subcomponent, C1r, which serves as the initiating serine protease of the classical pathway. To our knowledge this is the first report of a spirochetal protein acting as a direct inhibitor of the classical pathway and is the only example of a biomolecule capable of specifically and noncovalently inhibiting C1/C1r. By identifying a unique mode of complement evasion this study greatly enhances our understanding of how pathogens subvert and potentially manipulate host innate immune systems.

PurposeThe purpose of this study is to show that the neo-documentary – or complimentary – approach in Library and Information Science by no means is conservative, but highly necessary also in today's digitized media landscape. An example from a digitized photo archive is chosen to demonstrate the importance of a complimentary analysis that considers both material aspects as well as social and mental ones.Design/methodology/approachBy taking Jenna Hartel's description of the neo-documentary turn as point of departure, the paper focuses on one case, the portrait of Johannes Abrahamsen Motka taken by Sophus Tromholt in 1883 and discusses different versions of the photograph from glass plate negatives to digitized versions in different contexts and media.FindingsMany of the same paratextual elements can be found in different versions, also the digitized ones, to help the viewer to establish a historical context, but the images exhibited today are nevertheless no longer the same ones taken by Tromholt at the end of the 19th century. Not only have the material properties changed, but also – and probably even more important in most cases – the social and mental aspects. More re-contextualization is needed for today's audiences to recognize and understand a historical photograph taken in a colonial context. Focusing on document's material elements is not novel within the LIS-field, but the so-called neo-documentary turn was also a reaction on political and technological developments during the 1980s and 1990s. The increased focus on understanding a document in a complimentary way has demonstrated its impact during the last decades and is, at the same time, still work in progress.Research limitations/implicationsAs a scholar in the humanities the author can only relate to and therefore analyze what the author can experience and observe on screen level.Originality/valueIn providing a case study, this article illustrates the necessity of employing a complimentary approach when analyzing documents. This also implicates the claim that the neo-documentary turn – or complimentary as it rather should be called – by no means is a conservative one, but a highly necessary one in today's digitized media landscape.

The study of the link between production, measured in gross domestic product and CO 2 emissions, is a topic under intense research. Carbon emissions are moving together with economic shocks (high synchronicity), particularly at troughs and peaks of a business cycle. This research investigates the influence of economic shocks to carbon emissions. Previous studies do not provide a direct empirical evidence on the impact of economic shocks to carbon emissions that are available. We employ structural vector autoregression to explore the impact of economic shocks on carbon emissions in 20 advanced economies from 1870 to 2016. Our empirical results prove a strong, statistically significant connection between emissions and output with a coefficient of elasticity > 1. We identify a strong empirical link using panel structural vector autoregression between carbon emissions and real GDP growth per capita. Up to 40% of the fluctuations in CO 2 emissions is explained by combined economic factors (output, population, oil prices, stock exchange). The findings further indicate that carbon emission is determined by energy policy (energy intensity, carbon intensity, relative costs of renewable energy). Our findings contribute to energy policy management, energy, and business cycle research to inspire novel research on energy cycles.

PurposeThe purpose of this study is to provide a discussion on how to apply Genette's concept of the paratext to analyze digital documents. The article argues that the concept, despite its shortcomings, is useful because it gives us the terminology to analyze elements often ignored and overlooked.Design/methodology/approachBy taking Gérard Genette's concept of the paratext as point of departure, the paper focuses on three controversial issues in the scholarly work about paratext and digital documents: the division of paratext into peritext and epitext, the explosive growth of paratext and the question of authorization of text and paratext.FindingsQuestions related to the spatial division of the paratext into peritext and epitext, the difficulty of where to draw the line between text and paratext and the question of authorization are not new for digital documents but did already occur in the analog world. Even if many decisions like what to include and what to exclude in an analysis are left to the researcher, this does not mean that Genette's concept is unsuitable for digital documents. On the contrary, the concept gives us the terminology to analyze elements of often ignored and overlooked, also for digital documents.Research limitations/implicationsAs a scholar in the humanities the author can only relate to and therefore analyze what the author can experience and observe on screen level.Originality/valueIn providing a discussion of digital documents and some of the controversial issues discussed by other researchers, this article shows the relevance of Genette's concept, also for our work with digital documents.

Tissue- and cell-specific deletion of the Aqp4 gene is required to differentiate between the numerous pools of aquaporin-4 (AQP4) water channels. A glial-conditional Aqp4 knockout mouse line was generated to resolve whether astroglial AQP4 controls water exchange across the blood–brain interface. The conditional knockout was driven by the glial fibrillary acidic protein promoter. Brains from conditional Aqp4 knockouts were devoid of AQP4 as assessed by Western blots, ruling out the presence of a significant endothelial pool of AQP4. In agreement, immunofluorescence analysis of cryostate sections and quantitative immunogold analysis of ultrathin sections revealed no AQP4 signals in capillary endothelia. Compared with litter controls, glial-conditional Aqp4 knockout mice showed a 31% reduction in brain water uptake after systemic hypoosmotic stress and a delayed postnatal resorption of brain water. Deletion of astroglial Aqp4 did not affect the barrier function to macromolecules. Our data suggest that the blood–brain barrier (BBB) is more complex than anticipated. Notably, under certain conditions, the astrocyte covering of brain microvessels is rate limiting to water movement.

Background HPV16/18 detection may improve cervical cancer risk stratification and better guide which HPV-positive women warrant immediate colposcopy/biopsy. We estimated risks of cervical precancer and cancer by HPV genotype and cytology during the implementation phase of primary HPV testing in Norway. Methods A total of 3111 women, aged 34–69 years, testing HPV-positive at baseline and undergoing cytology testing from February 2015 to April 2018 had data available for analysis. Risk estimates with 95% confidence intervals (95%CIs) of cervical intraepithelial neoplasia grade 3 or more severe (CIN3+) were estimated for cytology results and HPV genotypes (HPV16, HPV18, and other high-risk HPV). Results CIN3+ risks were higher for HPV16/18 than other high-risk HPV genotypes. Among women with any cytologic abnormality [atypical squamous cells of undetermined significance or worse], immediate risks were 57.8% (95%CI = 53.0–62.6%) for HPV16, 40.2% (95%CI = 32.3–49.2%) for HPV18, and 31.4% (95%CI = 28.7–34.3%) for other high-risk HPV. Among those with normal cytology, CIN3+ risks were 19.9% (95%CI = 15.0–26.1%) for HPV16 positives, 10.8% (95%CI = 5.6–20.5%) for HPV18 positives, and 5.5% (95%CI = 4.2–7.1%) for other high-risk HPV. Conclusions The benefits and harms of managing women based on HPV positivity and cytology results can be better balanced by inclusion of HPV genotyping in screening and choosing more conservative management for other high-risk HPV compared to HPV16/18.

Existing literature argues that the militants and suicide bombers of the Islamic Resistance Movement (Hamas) and Palestinian Islamic Jihad (PIJ) come from relatively advantaged socioeconomic and educational backgrounds compared to the average Palestinian in the Occupied Palestinian Territories. Analyzing 2,448 martyr biographies from Hamas's military wing and PIJ from 1992 to 2012, I argue that these militants reflect Palestinian labor divisions and educational enrollment rates. There is thus little to suggest that Palestinian Islamist militants are recruited from any particular socioeconomic stratum within the wider popula tion. I demonstrate that, instead, kinship and geographic clusters are more significant variables.