Suchergebnisse

Objective: This review aims to summarize the current literature on patient-reported outcomes (PROs) in spondyloarthritis (SpA). Patients and methods: We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews) regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence) in SpA patients published in the European Union through December 2016. International databases (Medline/ PubMed, Cochrane Library, ISI Web of Knowledge, Scopus) were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria. Results: A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients' HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs) greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that besides efficacy and safety, frequency and route of administration may influence patients' preferences for BAs. Conclusion: Implementing management programs for SpA patients focuses on the physical, emotional, and social consequences of the disease, in addition to assessing and including patient preferences in the treatment decision-making process, could be crucial to improve patients' HRQoL and ensure their satisfaction and compliance with treatment.

Bacteria have evolved complex regulatory controls in response to various environmental stresses. Protein toxins of the ζ superfamily, found in prominent human pathogens, are broadly distributed in nature. We show that ζ is a uridine diphosphate-N-acetylglucosamine (UNAG)-dependent ATPase whose activity is inhibited in vitro by stoichiometric concentrations of ε2 antitoxin. In vivo, transient ζ expression promotes a reversible multi-level response by altering the pool of signaling purine nucleotides, which leads to growth arrest (dormancy), although a small cell subpopulation persists rather than tolerating toxin action. High c-di-AMP levels (absence of phosphodiesterase GdpP) decrease, and low c-di-AMP levels (absence of diadenylate cyclase DisA) increase the rate of ζ persistence. The absence of CodY, a transition regulator from exponential to stationary phase, sensitizes cells to toxin action, and suppresses persisters formed in the ΔdisA context. These changes, which do not affect the levels of stochastic ampicillin (Amp) persistence, sensitize cells to toxin and Amp action. Our findings provide an explanation for the connection between ζ-mediated growth arrest (with alterations in the GTP and c-di-AMP pools) and persistence formation. ; Spanish Ministerio de Economía y Competividad and the European Union (MINECO-FEDER) BFU2015-67065-P ; 4.019 JCR (2017) Q1, 31/125 Microbiology ; UEM

A fraction of otherwise antimicrobial-sensitive Bacillus subtilis cells, called persisters, are phenotypically tolerant of antimicrobial treatment. We report that, independently of B. subtilis' growth phase, transient ζ toxin expression induces a dormant state and alters cellular responses so that cells are more sensitive to antimicrobials with different modes of action. This outcome is modulated by fine tuning (p)ppGpp and GTP levels: i) in the presence of low >dysregulated> (p)ppGpp levels (as in relA- cells) hyper-tolerance to both toxin and antimicrobials was observed; ii) physiological or low (p)ppGpp levels (as in the wild-type, sasA-, sasB- and relA- sasA- context) show a normal toxin and antimicrobial tolerance; and iii) lower levels (in relA- sasB -) or absence of (p)ppGpp (in the relA- sasA- sasB- context), in concert with elevated GTP levels, potentiate the efficacy of both toxin and antimicrobial action, rendering tolerance vulnerable to eradication. © 2014 Tabone et al. ; The research was partially financed by the European Union (Grant Health-F3-2009-223111) and by the Ministerio de Economia y Competividad (MINECO) (BFU2012-39879-C02-01) to J.C.A., by the MINECO (BFU2012-39879-C02-02) and by the Comunidad de Madrid (CM-BIO0260-2006) to S.A. ; Peer Reviewed

Gallocanta lagoon, NE Spain, is one of the main stopover and wintering areas of Common Cranes (Grus grus) migrating through Western Europe. We investigated how the water level of the lagoon where cranes roost, precipitation, and air temperature might have influenced the species' migration and wintering patterns in this area between 1973 and 2018. Over the study period, the mean annual air temperature increased at 0.3 °C per decade. Simultaneously, cranes advanced the spring peak migration date at a rate of 0.37 days/year. Water level and rainfall during spring were also positively correlated with the date of spring migration peak. Because cranes need shallow water to roost, and must drink water from streams because the lagoon is saline, these correlations suggest that low water levels at roosting sites and drinking water shortage may have further accelerated the onset of northward spring migration. The water level was also positively correlated with peak crane numbers in autumn, suggesting that the roosting capacity of the lagoon may limit numbers of cranes that can stopover in the area. We conclude that global warming, variations in the water level of the lagoon, and precipitation during spring have determined changes in the use of Gallocanta as a staging and wintering area by Common Cranes during the last decades. Because climatic models predict further decreases in rainfall and higher temperatures in the area, further advances in the migration phenology of cranes should be expected, which might also have implications for the conservation and management of the species and the study area. ; This work was performed within the framework of project AgroSOS (CGL2015-66016-R Spanish Ministry of Economy and Competitiveness - FEDER funds [EU]) and the Government of Aragón (Spain) through a predoctoral internship to J. M. Orellana (BOA 20/07/2017).

[EN] The next reform ofthe EU Common Agricultural Policy (CAP) for the period 2021-2027 (currently extended to 2023-2030) requires the approval by the European Commission of a Strategic Plan with environmental objectives for each Member State. Here we use the best available scientific evidence on the relationships between agricultural practices and biodiversity to delineate specific recommendations for the development of the Spanish Strategic Plan. Scientific evidence shows that Spain should (1) identify clear regional biodiversity targets and the landscape-level measures needed to achieve them; (2) define ambitious and complementary criteria across the three environmental instruments (enhanced conditionality, eco-schemes, and agri-environmental and climate measures) of the CAP's Green Architecture, especially in simple and complex landscapes; (3) ensure that other CAP instruments (areas of nature constraints, organic farming and protection of endangered livestock breeds and crop varieties) really support biodiversity; (4) improve farmers' knowledge and adjust measures to real world constraints; and (5) invest in biodiversity and ecosystem service monitoring in order to evaluate how the Plan achieves regional and national targets andto improve measures if targets are not met. We conclude that direct assessments of environmental objectives are technically and economi- cally feasible, can be attractive to farmers, and are socially fair and of great interest for improving the environmental effectiveness of CAP measures. The explicit and rigorous association of assessments and monitoring, relating specific environmental indicators to regional objectives, should be the main criterion for the approval of the Strategic Plan in an environmentally-focused CAP2023-2030. ; [ES] La reforma de la Política Agraria Común (PAC) para el periodo 2021-2027 (extendido en la actualidad a 2023-2030) exige que la Comisión Europea apruebe un Plan Estratégico por cada Estado Miembro con claros objetivos ambientales. En este trabajo desarrollamos recomendaciones específicas para la elaboración del Plan Estratégico para los sistemas agrícolas españoles, basadas en la mejor evidencia científica disponible sobre las relaciones entre la gestión agrícola y los componentes de la biodiversidad. La evidencia científica muestra que España debe 1) identificar objetivos regionales claros relativos a la biodiversidad de los medios agrarios y las medidas a nivel paisajístico necesarias para alcanzarlas; 2) definir criterios ambiciosos y complementarios para los tres instrumentos ambientales (condicionalidad extendida, eco-esquemas y medidas agroambientales y climáticas) de la Arquitectura Verde de la PAC, especialmente en paisajes sencillos y complejos; 3) garantizar que otros instrumentos de la PAC (zonas desfavorecidas, agricultura ecológica y protección de razas ganaderas y variedades de cultivos en peligro de extinción) favorecen realmente la diversidad biológica; 4) mejorar el conocimiento de los agricultores y ajustar las medidas a las limitaciones del mundo real; y 5) invertir en seguimiento de la biodiversidad y sus servicios ecosistémicos asociados con el fin de evaluar si el Plan alcanza los objetivos regionales y nacionales y mejorarlos adaptativamente si no lo consigue. Concluimos que la evaluación directa de los objetivos ambientales es técnica y económicamente viable, puede ser atractiva para los agricultores, es socialmente justa y de gran utilidad en la mejora de la efectividad de las medidas de la PAC. Una combinación rigurosa de seguimiento y evaluación de medidas y objetivos adaptados regionalmente mediante indicadores ambientales directos y claros debería ser el criterio que guíe la aprobación del Plan Estratégico para una PAC 2023-2030 centrada en el medio ambiente y orientada a la conservación de la biodiversidad. ; Peer reviewed