4–1.5 with a mean value close to 0.9; data not shown). Fallout patterns of 110mAg:137Cs ratio in soils of Fukushima Prefecture provided a way to delineate three distinctive zones (Fig. 3, Table 1; i.e., ‘eastern’, ‘southern’ and ‘western’ zones). A Kruskal–Wallis H-test was conducted and it confirmed that these three zones were characterized by significantly different values of 110mAg:137Cs ratio (P < 0.001; α = 0.05). The differences in fallout patterns between 110mAg and 137Cs were most

likely due to the fact that those radionuclides were released during different explosions affecting reactors containing different fuel assemblages (Schwantes et al., 2012). Furthermore, even though the overall chronology of the reactor explosions could be reconstructed Adriamycin (e.g., Le Petit et al., 2012), the subsequent radionuclide deposits are still imperfectly understood. To our knowledge, Roxadustat research buy studies that modelled radionuclide deposits across Fukushima Prefecture dealt with 131I and/or 137Cs exclusively (e.g., Morino et al., 2013), and never with 110mAg. The single main operational difference between the FDNPP damaged reactors is that mixed-oxide (MOX) containing plutonium fuel that generates 110mAg as a fission product was only used in reactor 3 (Le Petit et al., 2012),

which may explain this different radionuclide deposition pattern. In the coastal study area, the area covered by both ‘western’ and ‘eastern’ zones was unfortunately only large enough in the Nitta River catchment to be subsequently used to track the dispersion of contaminated Axenfeld syndrome sediment based on values of this ratio measured in soils as well as in river sediment (the area covered by the ‘western’ zone

was too small in the Mano River catchment, and no soil sample was collected by MEXT in the ‘western’ part of the Ota River catchment; Fig. 4). Descriptive statistics of 110mAg:137Cs values in the single Nitta catchment confirmed that the spatial variability of this ratio provided significantly different signatures in both ‘western’ and ‘eastern’ areas in this catchment (Table 2). In order to use this ratio to track sediment pathways, both radionuclides should exhibit a similar behaviour in soils and sediment. A wide range of investigations dealt with 137Cs behaviour in soils, but a much lower number of studies addressed the behaviour of 110mAg in soils and sediment. However, according to our literature review, 137Cs and 110mAg are characterized by similar solid/liquid partition coefficient (Kd) values (9.0 × 101 to 4.4 × 103) in both soils and sediment (IAEA, 1994, IPSN, 1994, Garnier-Laplace et al., 1997 and Roussel-Debet and Colle, 2005). Furthermore, it was demonstrated that 110mAg is not mobile in soils (Alloway, 1995) and that it tends to concentrate in the few first centimetres of the soil uppermost surface, as it was reported for 137Cs in Fukushima region (Kato et al., 2012, Handl et al., 2000 and Shang and Leung, 2003).

Nicholas Hopkinson was also funded by The Wellcome Trust and Mark Dayer by The British Heart Foundation. The study was supported by the NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London. “
“Aluminum refinery workers are constantly exposed to aluminum oxide (Al2O3) obtained from bauxite (Musk et al., 2000), selleckchem reporting respiratory symptoms. Decreased lung function and lung inflammation have been observed

in epidemiologic (Kraus et al., 2000 and Fritschi et al., 2003) and experimental (Halatek et al., 2005, Ichinose et al., 2008 and Mazzoli-Rocha et al., 2010) studies. Neighborhoods of the aluminum oxide industry are also exposed to concentrations of alumina dust, making these communities susceptible to develop respiratory

alterations (Chattopadhyay et al., 2007). High intensity exercise practiced under stressed conditions triggers a transitory state of low immunity (Brenner et al., 1994). On the other hand, while regular exercise can be beneficial to health, a sedentary style of life is detrimental to it (Brines et al., 1996). Daily physical activity may be able to modulate the immune system (Brines et al., 1996), increasing the resistance to respiratory infections (Oliveira et al., 2007 and Malm, 2006). Regular exercise improves histology, decreases free radical production Panobinostat supplier and increases the activity of anti-oxidant enzymes in mice exposed to cigarette smoke (Menegali et al., 2009). Recently, Toledo et al. (2012) demonstrated that physical training minimized the reduction in lung elastance and

reduced oxidative stress in mice exposed to cigarette smoke. Hence, the aim of this study Thalidomide was to evaluate whether regular exercising prevents pulmonary alterations induced in a murine model of acute exposure to alumina dust. Twenty-three female BALB/c mice (20–25 g) were randomly divided into 2 groups: control (C, n = 10) and exercise (E, n = 13) that swam for 15 min/day, 5 days per week during 4 consecutive weeks (E), or remained sedentary (C). After a 4-week training, all animals were exposed for 1 h in a whole-body chamber to either sterile saline (CS, n = 6 or ES, n = 4) or to a suspension of 8 mg/m3 of alumina dust (CA, n = 6 or EA, n = 7) collected in an aluminum refinery, both delivered by an ultrasonic nebulizer. Each animal rested in a container, which was made of high clarity polypropylene falcon tubes whose conical tips were cut off and replaced by metal meshes and whose lids were perforated; the containers rested side by side inside the exposure chamber ( Mazzoli-Rocha et al., 2010). All animals were analyzed 24 h after saline or alumina dust exposure.

dexamethasone on lung mechanics and histology, inflammation, and apoptosis in the lung and distal organs in CLP-induced sepsis. The possible mechanisms

of action of both agents were also investigated, Neratinib research buy focusing on oxidative stress (nuclear factor E2-related factor 2, GPx, CAT, iNOS, and SOD expression in lung tissue) and levels of interleukin (IL)-6, KC and IL-10 in bronchoalveolar lavage fluid (BALF). This study was approved by the local Animal Care Committee and conducted in compliance with the Guide for the Care and Use of Laboratory Animals (National Academy of Sciences, Washington, DC). Seventy-eight male BALB/c mice (20–25 g) were kept under specific pathogen-free conditions and a 12-h light/dark cycle in the Laboratory of Pulmonary Investigation animal care facility. All animals were randomly assigned to two groups. In the

control group (C), mice were subjected to sham surgery, while in the CLP group, cecal ligation and puncture was performed. Briefly, animals were anesthetized with ketamine (65 mg/kg, intraperitoneally [i.p.]) and xylazine (30 mg/kg, i.p.) and a midline laparotomy (2-cm incision) was performed. The cecum was carefully isolated to prevent damage to blood vessels. A 3-0 cotton ligature was placed below the ileocecal valve to prevent bowel obstruction. Finally, the cecum was punctured once with an 18-gauge needle and the animals left to recover from anesthesia (Oliveira et al., 2009 and Chao et al., 2010). In sham surgery, the abdominal cavity was opened and the cecum was isolated without ligation and puncture. The animals received subcutaneous injections of 1 mL of warm (37 °C) saline and check details tramadol hydrochloride (20 mg/kg, i.p.). Both groups were further randomized to receive saline solution (SAL, 0.1 mL, i.p.), oleanolic acid (OA, 10 mg/kg, i.p.), or dexamethasone (DEXA, 1 mg/kg, i.p.) 1 h after sham or CLP surgery. Thirty-six mice (n = 6 per group) were selected for assessment of lung mechanics and histology; cell apoptosis in lung, kidney, Meloxicam liver, and intestine samples; and measurement of CAT, GPx, iNOS, Nrf2 and SOD mRNA expression. The remaining

42 animals (n = 7/group) were subjected to the same protocol described above to obtain BALF aliquots for analysis. 24 h after sham or CLP surgery, animals were sedated (diazepam, 1 mg/kg, i.p.), anesthetized (thiopental sodium, 20 mg/kg, i.p.), tracheotomized, paralyzed (vecuronium bromide, 0.005 mg/kg, intravenously), and ventilated with a constant flow ventilator (Samay VR15; Universidad de la Republica, Montevideo, Uruguay) using the following settings: respiratory frequency 100 breaths min−1, tidal volume (VT) 0.2 mL, and fraction of inspired oxygen (FiO2) 0.21. A positive end-expiratory pressure (PEEP) of 2 cm H2O was applied and the anterior chest wall was surgically removed. After a 10-min ventilation period, static lung elastance (Est,L) was measured by the end-inflation occlusion method (Bates et al., 1985).

California’s climate

variability has been a characteristic component of landscape function over centuries. In contrast, landuse activities after 1850 altered the landscape in a manner not previously experienced. During the late Holocene, Anderson Valley was inhabited by the indigenous Pomo people who depended on regional resources including salmon and abundant tan oak acorns (Anderson Valley Historical Society, 2005) and modified their landscape, but not to the degree of later inhabitants. The first European American settlers that arrived in the early 1850s initiated an agricultural transformation of the valley they first referred to as “the Garden of Eden” (Fig. 3; Adams, 1990 and Anderson Valley Historical Society, 2005). The dominant historical selleck landuses in the watershed include grazing, orchards, logging, and rural/urban development. Grazing, primarily of sheep, began in ∼1860—stock numbers reached a peak of 75,000 sheep in 1880 and 20,000 cattle that persisted from 1850

through 1940 (Adams, 1990). Logging of hillside tan oaks began in the late 1800s initially to clear land for pasture. However, by the early 1900s selling tan bark was a major industry and oxen were used to skid the logs from the hillslope forests to the mills (Anderson Valley Historical Society, 2005). Ivacaftor Extensive logging occurred after World War II, with over 40 mills operating during one period (Adams, 1990). The majority of recent logging has occurred on the steeper forested southwestern hillslopes of the Robinson Creek watershed. Agricultural changes in Anderson Valley beginning with subsistence farms in the 1850s

that grazed sheep and cattle, and grew grain and other produce, to apple orchards that were prominent through the 1950s have transitioned to today’s vineyards (McGourty et al., 2013). Large California Bay Laurel (Umbellularia triclocarban Californica) trees remain along some portions of the Robinson Creek channel where they contribute to the riparian forest including Oak, Madrone, and Willow. California Bay Laurel trees with trunk diameters on the order of 1.0 m or more may be centuries old ( Stein, 1990). In some areas of Robinson Creek without riparian vegetation, recent restoration activities includes modification in grazing practices such as construction of exclusionary cattle fencing and native vegetation planting on the creek banks. Booneville, the town established near the confluence of Anderson and Robinson Creeks in the early 1860s, currently has a resident population greater than 1000 and rural/urban development is still occurring.

4–1.5 with a mean value close to 0.9; data not shown). Fallout patterns of 110mAg:137Cs ratio in soils of Fukushima Prefecture provided a way to delineate three distinctive zones (Fig. 3, Table 1; i.e., ‘eastern’, ‘southern’ and ‘western’ zones). A Kruskal–Wallis H-test was conducted and it confirmed that these three zones were characterized by significantly different values of 110mAg:137Cs ratio (P < 0.001; α = 0.05). The differences in fallout patterns between 110mAg and 137Cs were most

likely due to the fact that those radionuclides were released during different explosions affecting reactors containing different fuel assemblages (Schwantes et al., 2012). Furthermore, even though the overall chronology of the reactor explosions could be reconstructed RO4929097 mouse (e.g., Le Petit et al., 2012), the subsequent radionuclide deposits are still imperfectly understood. To our knowledge, AZD5363 order studies that modelled radionuclide deposits across Fukushima Prefecture dealt with 131I and/or 137Cs exclusively (e.g., Morino et al., 2013), and never with 110mAg. The single main operational difference between the FDNPP damaged reactors is that mixed-oxide (MOX) containing plutonium fuel that generates 110mAg as a fission product was only used in reactor 3 (Le Petit et al., 2012),

which may explain this different radionuclide deposition pattern. In the coastal study area, the area covered by both ‘western’ and ‘eastern’ zones was unfortunately only large enough in the Nitta River catchment to be subsequently used to track the dispersion of contaminated Cell press sediment based on values of this ratio measured in soils as well as in river sediment (the area covered by the ‘western’ zone

was too small in the Mano River catchment, and no soil sample was collected by MEXT in the ‘western’ part of the Ota River catchment; Fig. 4). Descriptive statistics of 110mAg:137Cs values in the single Nitta catchment confirmed that the spatial variability of this ratio provided significantly different signatures in both ‘western’ and ‘eastern’ areas in this catchment (Table 2). In order to use this ratio to track sediment pathways, both radionuclides should exhibit a similar behaviour in soils and sediment. A wide range of investigations dealt with 137Cs behaviour in soils, but a much lower number of studies addressed the behaviour of 110mAg in soils and sediment. However, according to our literature review, 137Cs and 110mAg are characterized by similar solid/liquid partition coefficient (Kd) values (9.0 × 101 to 4.4 × 103) in both soils and sediment (IAEA, 1994, IPSN, 1994, Garnier-Laplace et al., 1997 and Roussel-Debet and Colle, 2005). Furthermore, it was demonstrated that 110mAg is not mobile in soils (Alloway, 1995) and that it tends to concentrate in the few first centimetres of the soil uppermost surface, as it was reported for 137Cs in Fukushima region (Kato et al., 2012, Handl et al., 2000 and Shang and Leung, 2003).

The study of terraces represents a challenge for our modern society and deserves particular attention. The reasons are several: their economic, environmental and historical–cultural implications and their hydrological functions, such as erosion control, slope stabilization, lengthening Selleck Epacadostat of the rainfall concentration time, and the eventual reduction of the surface runoff. However, land abandonment and the different expectations of the young generation (people are moving from farmland to cities where job opportunities are plentiful) are seriously affecting terrace-dominated landscapes. The result is a progressive increase in soil erosion and landslide risk that can be a problem for society when these processes are

triggered in densely populated areas. Another result, less evident but in our opinion still important, is the fact that we are progressively losing and forgetting one of the historical and cultural roots that has characterized entire regions and cultures for centuries. Terraced landscapes need to be maintained, well managed (including the use of new remote sensing technologies such lidar), and protected. While these actions can help overcome the critical issues related to erosion risk and landslides, they can also offer another benefit, possibly more relevant because it is related to the economy. Terrace maintenance can improve tourism, leisure activities, and the commerce of products related to

agricultural production, and can offer new job opportunities ZD1839 price for the younger generations. Analysis resources and terrestrial laser scanner data were provided by the Interdepartmental 2-hydroxyphytanoyl-CoA lyase Research Centre of Geomatics—CIRGEO, at the University of Padova. Aerial lidar data were provided by the Italian Ministry of the Environment and Protection of Land and Sea (Ministero dell’Ambiente

e della Tutela del Territorio e del Mare, MATTM), within the framework of the `Extraordinary Plan of Environmental Remote Sensing’ (Piano Straordinario di Telerilevamento Ambientale, PST-A). We thank the Fattoria di Lamole di Paolo Socci for granting us access to the Lamole study area for the field surveys. This study has been partly supported by the following projects: PRIN 20104ALME4_002 Rete nazionale per il monitoraggio, la modellazione e la gestione sostenibile dei processi erosivi nei territori agricoli, collinari e montani, funded by the Italian Ministry of Education, Universities and Research, and MONACO, funded by the Italian Ministry of Agricultural, Food and Forestry Policies (Ministero delle Politiche Agricole, Alimentari e Forestali, MiPAAF). “
“Welcome to the first issue of Anthropocene, a journal devoted to advancing research on human interactions with Earth systems. The scale and intensity of human interactions with Earth systems have accelerated in recent decades, even though humans have changed the face of Earth throughout history and pre-history. Virtually no place on Earth is left untouched now by human activity.

45%. Deforestation is higher in villages in the north and southeast of Sa Pa district, that are located at greater distance from the tourism centre. Land abandonment

is mostly observed in Sa Pa town and in the communes of Ta Phin, San Sa Ho, Lao Chai, Ta Van and Ban Ho (Fig. 1 and Fig. 3). In some villages (Sa Pa town; Ta Chai village, belonging to Ta Phin commune; Ly Lao Chai village, belonging to Lao Chai commune and Hoang Lien village, belonging to Ban Ho commune), more than 8% of the surface area was abandoned between 1993 and 2014. Over the period 1995–2009, the number of tourists in Sa Pa district has increased by 25 times (Fig. 1). Given the current economic policy, it is expected that the development of tourism activities will further increase in the future (Michaud and Turner, 2006). The statistical results indicate that the cultivation of cardamom is negatively CH5424802 concentration associated with deforestation and expansion of arable land. This means that the involvement in cardamom cultivation (under forest) slows down deforestation and expansion of cultivated land, as cardamom plantations are not classified here as agricultural land. Cardamom production provides higher incomes than traditional crop farming (Sowerwine, 2004a). Recently, cardamom is emerging as an important ABT-888 nmr cash

crop in northern Vietnam that requires little investment and labour but may offer higher income levels (Tugault-Lafleur JAK inhibitor and Turner, 2009). Because

of the requirement of a dense forest canopy for optimal production, the villagers not only protect the remaining old forest but also allow regeneration of some of the swidden lands in order to create the necessary ecological conditions to plant and harvest cardamom (Sowerwine, 2004b). Its impact on forest conservation is similar to the system of shade coffee cultivation in forest that also contributed to a preservation of the afromontane forests in, e.g., the south of Ethiopia (Getahun et al., 2013). The role of ethnicity is complex. After controlling for biophysical and socio-economic settings, Hmong villages are characterized by higher expansion rates of arable land compared to Yao villages. This can be explained by the fact that Hmong villages are more densely populated than Yao villages (Jadin et al., 2013) so they need to expand their arable land more to supply the food demand. In villages with mixed ethnicities, the land abandonment rate is higher than in Yao villages, which can be explained by the fact that mixed ethnicities only occur in the accessible commune centres that are more involved in off-farm activities. The effect of preservation policy is certainly reflected in the difference in land cover changes inside and outside the National park. The estimated coefficients for the explanatory variable ‘Inside NP’ are negative for all land cover change categories whereby the ‘Outside NP’ is taken as a reference value.

It is likely that this channel was one of the Brenta river mouths cited MLN0128 cost by Comel (1968) and by Bondesan and Meneghel (2004) closed by the Venetians in 1191 in order to slow down the filling process of the lagoon. Before this diversion the Brenta river flowed to the city of Venice through the ancient “Canal de Botenigo” into the Giudecca Channel (Fig. 3) through the island of Tronchetto. This

hypothesis is confirmed by the presence of a similar channel deposition in the transect B–B′ between Santa Marta and the Canal Grande shown on page 20 in Zezza (2008). This palaeochannel is further described in Zezza (2010), where it is observed that in the city area “the lithostratigraphic model of the subsoil reveals that alluvial processes lasted until the verge of the Holocene Period and, furthermore, that the Flandrian transgression determined first all the widening and successively the partial Selleck Adriamycin filling of the alluvial channel, incised into the caranto and evolved into a tide channel during the Holocene”. Finally in the southern part of profile 4 (Fig. 2d) one can see the chaotic and structureless filling of a recent superficial palaeochannel (CL3). This kind of acoustic signal probably corresponds to a sandy filling of the channel. The absence

of stratified reflectors implies a highly energetic environment and a fast channel filling. The palaeochannel CL3 corresponds to the “Coa de Botenigo” (Fig. 4b). The map of the areal extension of all palaeochannels reconstructed in the study area is shown in Fig. 4 for five different times: Fig. 4a represents the palaeochannels that were dated between 2000 BC and 0 AD, active during the Bronze, Iron Age and Roman Times reconstructed using as a basis the acoustic survey and the geological data. This corresponds

to a natural environment immediately before the first stable human settlements. Instead, the map of 1691, which is one of the first detailed cartographic representation of the area, refers to a time when some of the main river and channel paths were already modified by the Venetians. Fig. 4b–d depicts not only the reconstructed palaeochannels but also channel paths (and when available the land extension), digitized from the historical maps of Ergoloid 1691, 1810, 1901, respectively. The present situation is shown in Fig. 4e. Many palaeochannels were reconstructed in the area, adding more information to the historical maps. In general they flow almost parallel in the west-east direction, with a slightly sinuous path. This orientation can be explained by the fact that this hydrographic system probably belonged to the Brenta megafan (Bondesan and Meneghel, 2004 and Fontana et al., 2008). A few palaeochannels have a north–south direction. This orientation may be related to the natural development of tidal networks. We show the patterns of the palaeochannels that existed before or that formed immediately after the lagoon expansion in the area (Fig. 4a).

5% agarose gels in TBE buffer, stained with ethidium bromide and visualized under UV light. Purified PCR products were sequenced at Scigenom, India. The sequence homology and the deduced amino acid sequence comparisons were carried out using BLAST algorithm (tblastn) at the National Center for

Biotechnology Information (NCBI) (http://www.ncbi.nlm.nih.gov/blast). Gene translation and prediction of deduced protein were performed with ExPASy (http://www.au.expasy.org/). The signal peptide was predicted by SignalP program (http://www.au.expasy.org/). The multiple sequence alignments were performed with amino acid sequences of known crustins and ALFs from decapod crustaceans using CLUSTALW and GENDOC. Amino acid sequences of all known crustins and ALFs were retrieved from the NCBI GenBank and phylogenetic tree was constructed by the Neighbor-Joining (NJ) method and the Maximum Likelihood (ML) method using MEGA version 4.0 [22]. The structural models BIBW2992 of the AMPs

were created using SWISS-MODEL server. The nucleotide sequences and deduced amino acid sequences of the antimicrobial peptides were submitted to GenBank. In the present study two AMPs belonging to ALF and crustin Ulixertinib solubility dmso families were characterized from the hemocytes of S. serrata, herein after referred to as Sc-ALF and Sc-crustin, respectively. The ORF of Sc-ALF consisted of 123 amino acids ( Fig. 1A). BLAST analysis of the nucleotide sequences revealed the relation of Sc-ALF to other ALFs present in

other decapod crustaceans. Sc-ALF was found to be 93% similar to an ALF isoform characterized from S. serrata. However, a 100% similar ALF molecule was found to be present in S. paramamosain [12]. Sc-ALF also shared similarity to ALFs of Portunus trituberculatus (76%), Pacifastacus leniusculus (52%) and Fenneropenaeus indicus Carnitine palmitoyltransferase II (41%) ( Table 1). Analysis with the SignalP software revealed the presence of a signal peptide with 26 amino acids at the N-terminal region of the Sc-ALF ( Fig. 1A). The mature peptide consisted of 97 amino acid residues with a predicted molecular weight (MW) of 11.17 kDa. The Sc-ALF was highly cationic and the isoelectric point (pI) was estimated to be 9.95 as predicted by the PROTPARAM software. The sequence was deposited in the NCBI GenBank under accession number HQ638024. Sequence comparison of Sc-ALF amino acid revealed conserved amino acid residues in the region of LPS binding domain ( Fig. 1A). The deduced amino acid sequence of Sc-ALF showed a 24 amino acid domain from residue 54 through 77, which was necessary for LPS binding and neutralization [12]. The Sc-ALF molecule also showed the conservation of two cysteine residues at positions Cys55 and Cys76, important for one disulfide bond (loop) formation in the peptide ( Fig. 1A). The deduced amino acid sequence of Sc-ALF was found to be rich in positively charged amino acid residues, arginine (10.3%) and lysine (7.

Clinically, the most telling finding is synovitis, particularly at the finger joints and wrists. A positive squeeze test provides valuable orientation: the pain is caused by putting pressure across the metacarpophalangeal and/or metatarsophalangeal Neratinib cell line joints [20]. Confirmation of the diagnosis of RA relies on a set of converging arguments with

special attention to the absence of clinical and laboratory data pointing to another inflammatory joint disease (Table 2). The most useful criteria are those developed jointly by the American College of Rheumatology (ACR) and EULAR for classifying RA [21] (Fig. 2). In patients with clinical synovitis in at least one joint and no alternative diagnosis that better explains the findings, a score ≥ 6/10 indicates RA (Fig. 2). Another important key to the diagnosis is the presence of specific antibodies (RFs and ACPA), which must be assayed (Table 2, Fig. 2). Imaging studies should consist of anteroposterior radiographs of the hands and wrists, anteroposterior and oblique radiographs of the forefeet, and a chest radiograph [6]. Patients

who fail to meet the clinical and laboratory ACR/EULAR criteria but who have radiographic erosions typical for RA can also be classified as having RA (Fig. 2). The EULAR recently defined typical RA erosions as the presence of erosions in at least three joints among the metacarpophalangeal joints, proximal interphalangeal joints, wrists, and metatarsophalangeal joints [22]. Finally, Doppler ultrasonography can be useful to confirm check details the presence of synovitis, monitor disease activity and progression, and

evaluate persistent inflammation [23]. RA is a therapeutic emergency: early, specialized, personalized, multidisciplinary management must be provided immediately. The promptness triclocarban with which treatment is initiated largely governs the patient outcomes. Abundant published data support the existence of this window of opportunity for effectively treating RA [19], [24], [25] and [26]. Rapid initiation of effective treatment may increase the chances of achieving a remission, limit the functional impairments, and decrease the degree of structural damage [12], [27], [28] and [29]. Achieving a remission or minimal disease activity improves mid-term and long-term structural and functional outcomes [30] and may diminish the excess mortality, particularly due to cardiovascular disease [31]. Achieving a remission should be the main treatment objective in every patient, particularly in early-onset RA. The chances of achieving a remission are lower in patients with advanced RA and/or marked structural damage, and achieving minimal disease activity is an acceptable alternative in this situation [7]. A clinical remission can be defined as the absence of clinical signs and symptoms of inflammation. In practice, patients should be evaluated using composite activity indices such as the Disease Activity Score 28 (DAS28), with values no greater than 2.