In NIST refractory IMN, both TAC* and MPR are comparable, but with different adverse effect profile. PLA2 R Ab has a very good association with proteinuria, and should be regularly monitored on clinical follow-up.

No previous study has compared mycophenolate mofetil (MMF) with low-dose cyclophosphamide (CYC) in the treatment of lupus nephritis (LN). To do so, we recruited patients with LN (class III, IV, or V) and randomized them to receive either low-dose CYC or oral MMF. Those with crescentic LN, a serum creatinine over 265 μmol/l, and neurological or pulmonary lupus were excluded. MMF was prescribed at daily doses of 1.5-3 g for 24 weeks, while CYC was administered as six fortnightly infusions of 500 mg each. All patients received three methylprednisolone injections, followed by oral corticosteroids. Maintenance therapy with azathioprine and low-dose corticosteroid was started at end of induction therapy. The primary end point was treatment response at 24 weeks, while secondary end points were complete remission, Systemic Lupus Erythematosus Disease Activity Index and adverse events. Of the 173 patients recruited, 100 were equally randomized to receive either CYC or MMF. Baseline characteristics were similar, except for higher 24 h proteinuria in the CYC group. At 24 weeks, 37 patients in each group achieved the primary end point. The complete remission rate was 50% in CYC and 54% in MMF group. Gastrointestinal symptoms were significantly more frequent in patients receiving MMF (52 vs. 4%). However, other adverse events were similar. Thus, low-dose intravenous CYC is comparable in safety and efficacy to oral MMF in the induction treatment of less severe LN.

Purpose -The paper seeks to highlight the key value changes in the current economy, which is shifting towards intangible assets such as innovativeness, cognitive intelligence, emotional intelligence, social capital, and also a shift from individual to team working. Design/methodology/approach -The paper takes the form of an examination of the relevant literature and divergent thinking. Findings -On the basis of a critical analysis of the literature it is found that the outcome of all factors (internal as well as external) influencing the functioning of a team/group would lead to a "general ability" which can be conceived as composed of three different and interrelated abilities, termed the "cognitive intelligence", "emotional intelligence" and "social capital" of the team/group. These three abilities could explain a wide range of group behaviors. A conceptual model is developed to explain the innovativeness of work teams in terms of these three group abilities.Research limitations/implications -The general and inclusive nature of the variables proposed in the model hold promise for proving more stable explanations, and thus a robust model, of highly complex phenomena of work team innovativeness. By associating with innovativeness this model brings the emerging concepts of group intelligence to the attention of management researchers. The underlining and classification of the fundamental abilities of groups into three basic categories (i.e. cognitive, emotional and social), provides a direction for future research in the under-studied "cognitive" and "affective" dimensions of groups/teams. The model presented here is a conceptual model and needs to be validated empirically. Practical implications -For intervention and practical purposes, the variables proposed in the model would provide a more comprehensive framework for the assessment of group functioning, and work as a guide for building effective teams and changing the function of the team in desired directions. Originality/value -Although the relevant literature consists of many partial and indirect hints and indications in the direction as conceived by the model, the full model as such is original. The authors' primary contribution is in perceiving the holistic picture of the phenomena (i.e. basic abilities of groups) and relating them to innovativeness.

Biofortified colored wheat (black, blue, and purple) is rich in anthocyanins and phenolic acid compounds that impart positive physiological effects in humans. A large proportion of wheat is consumed in the form of Chapatti in Asian countries. The effect of chapatti cooking on the proximate composition, bioactive compounds (anthocyanins and phenolics), and antioxidant activities of these wheat varieties were checked in this study. Apart from acceptable sensory parameters, good taste, and soft texture of chapatti, biofortified colored wheat chapatti and flour had higher dietary fibers, protein content, and lower carbohydrate content. Higher soluble and insoluble phenolic compounds, anthocyanin content, and antioxidant activity were in the order of black > blue > purple > white. Chapatti making has reduced their antioxidant activity and anthocyanin content in comparison to flour. Moreover, the reduction in antioxidant activity is less as compared to the decrease in anthocyanin content. Our results suggest that colored wheat can be a better alternative to normal wheat for preparing chapatti as it would have additional health-promoting activities.

Background: The paradigms in the surgical management of obstruction and perforation of the left colon – once considered absolute contraindications to primary resection and anastomosis – are changing. The aim of this survey was to poll American Gastrointestinal surgeons on their current approach to left colonic emergencies. Methods: A questionnaire was sent to 500 US-based surgeons, randomly selected members from the membership list of the Society for Surgery of the Alimentary Tract. It surveyed the surgeons on how they would approach ‘good-risk’ and ‘poor-risk’ patients with left colonic obstruction or perforation. Results: 215 (43%) surgeons responded to the questionnaire; 180 fully completed questionnaires (36%) were analyzed. Sigmoid obstruction: 96 responders (53%) selected a one-stage procedure in ‘good-risk’ patients; 78 preferred sigmoid resection with (n = 46) or without (n = 32) ‘on-table’ colonic lavage and 18 opted for a subtotal colectomy and ileo-rectal anastomosis. Most (94%) responders preferred a staged procedure in ‘high-risk’ patients: a Hartmann resection (n = 120) or a transverse colostomy (n = 46). Sigmoid diverticular perforation: only one third of the responders recommended a one-stage procedure in ‘good-risk’ patients: 58 would perform a sigmoidectomy with (n = 19) or without (n = 39) ‘on-table’ colonic lavage; only two opted for subtotal colectomy with ileo-rectal anastomosis. In ‘high-risk’ patients most surgeons opted for a Hartmann’s (88%) procedure or a diverting colostomy (7%). Conclusions: This survey suggests that a half and one-third of the responders would perform a one-stage resection and anastomosis in ‘good-risk’ patients with left colonic obstruction and perforation, respectively. In ‘poor-risk’ patients most responders would still opt for a staged procedure.

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Determination of mechanical loading regimen that would induce a prescribed new bone formation rate and its site-specific distribution, may be desirable to treat some orthopaedic conditions such as bone loss due to muscle disuse, e.g. because of space flight, bed-rest, osteopenia etc. Site-specific new bone formation has been determined earlier experimentally and numerically for a given loading regimen; however these models are mostly non-invertible, which means that they cannot be easily inverted to predict loading parameters for a desired new bone formation. The present work proposes an invertible model of bone remodeling, which can predict loading parameters such as peak strain, or magnitude and direction of periodic forces for a desired or prescribed site-specific mineral apposition rate (MAR), and vice versa. This fast, mathematical model has a potential to be developed into an important aid for orthopaedic surgeons for prescribing exercise or exogenous loading of bone to treat bone-loss due to muscle disuse.