Baseline plasma glucose concentrations prior to the initiation of the 2DG procedure were not different between drug-naïve controls and cocaine-experienced animals (controls, 144.2 ± 6.7 mg/mL; 48 h withdrawal from cocaine, 153.4 ± 17.0 mg/mL). Selumetinib mouse Rates of local cerebral glucose metabolism were measured in 20 brain regions and the data are shown in Table 1. These rates were globally lower in animals with a history

of cocaine self-administration measured 48 h after the final self-administration session as compared with drug-naïve controls (84.5 ± 4.7 vs. 74.6 ± 4.4 μmol/100 g/min cocaine-withdrawal, t11 = 2.245, P < 0.05). This pattern was observed in all 20 of the regions in which glucose utilization rates were measured. In the cortex, two-way anova revealed a main effect of treatment (F1,11 = 5.95, P < 0.05) and brain region (F2,22 = 151.9, P < 0.001), but no interaction. In the basal ganglia, there was a main effect of treatment (F1,11 = 8.10 P < 0.05) and brain region (F5,55 = 125.67, P < 0.001), but no interaction. In limbic brain areas, there was a main effect of treatment (F1,11 = 6.10 P < 0.05) and brain region (F7,77 = 110.3, P < 0.001), and an interaction (F7,70 = 3.041, P < 0.05).

Finally, in the brainstem, there was PD0325901 mw a main effect of treatment (F1,11 = 12.48, P < 0.01) and brain region (F2,22 = 75.21, P < 0.001), but no interaction. Planned multiple comparisons showed that 48 h after cocaine self-administration functional activity was lower in the anterior cingulate cortex (−12%), dorsal caudate putamen (−16%), nucleus accumbens (-16%, Fig. 5), basolateral amygdala

(−16%), medial nucleus of the thalamus (−12%), hippocampal CA1 region (−24%, Fig. 5), dorsal raphe (−18%), locus coeruleus (−13%) and cerebellum (−15%), when compared with controls. Here we demonstrate that there are functional and behavioral reductions present 48 h after 5-day cocaine self-administration. The functional alterations were characterized by reduced brain activity, as indicated by lower rates Methane monooxygenase of cerebral glucose utilization, in circuits involved in learning and memory, attention, sleep, and reward processing. These data are consistent with human studies that have demonstrated marked reductions in functional brain activity, in particular prefrontal cortical and striatal regions, which occur early in the withdrawal period and last for up to 4 months following cocaine misuse (Volkow et al., 1992, 1993). Previously, we have shown that cocaine self-administration resulted in reductions in functional activity, but these effects were measured immediately following the final infusion at a time when cocaine levels were still high (Macey et al., 2004).

Interestingly, the cells were more heavily flagellated when attached to a surface than

when free swimming. It is only in two very recent studies that the roles for surface organelles in archaea that have both pili and flagella have been presented. In Haloferax volcanii, a member of the euryarchaeota kingdom, it was reported that flagella did not play a role in surface attachment and that type IV pili-like structures were responsible (Tripepi et al., 2010). In Sulfolobus solfataricus, Daporinad research buy a member of the crenarchaeota kingdom, it was shown that both pili and flagella were involved in attachment to surfaces (Zolghadr et al., 2010). Both of these studies utilized organisms with genetic systems that allowed the generation of mutants defective in each organelle. In S. solfataricus, it was shown that expression of the major flagella structural protein, FlaB, was dramatically reduced in adherent cells, leading the authors to conclude that flagella may be most important in the initial attachment to surfaces, but not for persistence after the initial attachment

has occurred (Zolghadr et al., 2010). Although M. maripaludis is a euryarchaeon like H. volcanii, the findings with regard to the role of pili and flagella in attachment were unlike that of the halophile, but instead identical to those reported in the more distantly related organism, S. solfataricus. As the M. maripaludis cells are clearly attached firmly by flagella, it begs the question of why the flagellated, nonpiliated strains could not attach well to surfaces. It may be that the pili render the initial attachment Silibinin to a surface and only after this Selleck Selumetinib is formed can the flagella make the more permanent

attachment. Even though abundant, flagella on their own cannot usually bind strongly enough to merit attachment, perhaps because they are involved in swimming until the cells are bound to a surface by pili. Unlike the current belief for S. solfataricus, it appears for M. maripaludis [as well as P. furiosus (Nather et al., 2006) and M. villosus (Bellack et al., 2010)] that the flagella are critical for continued attachment to surfaces, although further research will be necessary to ultimately discriminate between the roles played by pili and flagella in adherence for M. maripaludis. What is emerging in the few studies reported thus far is that the flagella of archaea play multiple roles in addition to their presumed primary role in motility, and that these roles are not consistent across different species. This work was supported by grants from the Natural and Engineering Research Council of Canada (to K.F.J.) and Cancer Research UK (to J.P.J.C.). K.F.J. was the recipient of a Leverhulme Trust Visiting Professorship. “
“Mycinamicin, a 16-membered macrolide antibiotic produced by Micromonospora griseorubida, comprises a macrolactone and two deoxysugars: desosamine and mycinose.

Like HPr, Crh becomes (de)phosphorylated in vitro at residue Ser46 by the metabolite-controlled HPr kinase/phosphorylase HPrK/P. Depending on its phosphorylation state, Crh exerts regulatory functions in connection with carbohydrate metabolism. So far, knowledge on phosphorylation of Crh in vivo has been limited and derived from indirect evidence. Here, we studied the dynamics of Crh phosphorylation directly by non-denaturing gel electrophoresis followed by Western analysis. The results confirm that HPrK/P is the single kinase catalyzing phosphorylation of Crh in vivo. Accordingly, phosphorylation of Crh is triggered by the carbon source as observed

previously for HPr, but with some differences. Phosphorylation of both proteins occurred during SB203580 solubility dmso exponential growth and disappeared upon exhaustion of the carbon source. During exponential growth, ~ 80% of the Crh molecules were phosphorylated when cells utilized a preferred carbon source. The reverse distribution, i.e. around 20% of Crh molecules phosphorylated, was obtained upon utilization of less favorable substrates. This clear-cut classification of the substrates into two groups has not previously been observed for HPr(Ser)~P formation. The likely reason for this difference is the additional

PTS-dependent phosphorylation of HPr at His15, which limits accumulation of HPr(Ser)~P. The histidine protein (HPr) of the carbohydrate : phosphotransferase system (PTS) has a dual role in Firmicutes bacteria. mafosfamide In its transport function HPr delivers phosphoryl-groups from Enzyme ABT-737 mouse I (EI) to the Enzyme II (EII) transport proteins, which phosphorylate their sugar substrates during uptake. During this phosphoryl-group transfer, HPr becomes transiently phosphorylated at residue His15. In addition, HPr also exerts important regulatory functions (Deutscher et al., 2006). It is the key player in carbon catabolite repression (CCR), which allows the bacteria to repress functions for the utilization

of secondary carbon sources when a preferred substrate is simultaneously present (Deutscher, 2008; Görke & Stülke, 2008). To be active in CCR, HPr must be phosphorylated at a different site, Ser46. HPr(Ser)~P binds the global transcriptional regulatory protein CcpA, which thereby gains DNA-binding activity (Fujita, 2009). Phosphorylation as well as de-phosphorylation of HPr at Ser46 is catalyzed by a single enzyme, the HPr kinase/phosphorylase (HPrK/P). The decision as to whether kinase or phosphorylase activity will prevail is controlled by the quality of the available carbon source. Preferred carbon sources such as glucose or fructose, which allow the fastest growth rates, activate the kinase function of HPrK/P and thereby trigger the formation of HPr(Ser)~P.

Resistance tests in ART-naïve patients were conducted, on average, 2 years after HIV-positive diagnosis, although no significant difference in PrEP drug resistance

Selleck CAL-101 was found between tests conducted within 3 months of diagnosis and at least 3 months after diagnosis (p = 0.136). The mean (standard deviation) interval between linked viral load measurements and resistance tests was 41 (40) days for ART-experienced patients and 137 (117) days for ART-naïve patients. Table 1(a)–(c) display the estimated prevalence of PrEP resistance among HIV-infectious MSM by diagnosis/ART status and overall. Median model parameter estimates are included in Table S1 in the supplementary online material. It should be noted that the difference between estimates in Table 1(a) and (c) reflects viruses that are resistant to FTC only. For ART-naïve individuals the level of resistance to either http://www.selleckchem.com/products/apo866-fk866.html TDF or FTC is very low, and the slight increase between 2005 and 2008 may be attributable to chance. The rapid reversion of mutations without selective drug pressure could explain the lack of resistance found in this group. Nonetheless, these individuals account

for the majority of resistance in the overall population. The difference between PrEP resistance estimates for the three PrEP resistance definitions was largest in ART-experienced patients. ART-experienced patients with detectable viral load showed a decline in TDF or FTC PrEP drug resistance over the period of study, although CIs are wide. Patients currently on a treatment break showed similar levels of resistance to patients on treatment who were not virologically suppressed, suggesting that some unsuppressed individuals recorded as

being on therapy could be on an unrecorded Tideglusib treatment interruption. Although there were relatively high levels of resistance among ART-experienced patients who were not suppressed, this group comprised only ∼22% of ART-experienced patients on treatment or ∼13% of the total infectious population at a given time. Overall, combining the various diagnosis/treatment groups, the prevalence (95% CI) of TDF, TDF and FTC, and TDF or FTC resistance in UK HIV-infectious MSM was estimated to be only 1.6% (0.7–2.3%), 0.9% (0.2–1.9%) and 4.1% (1.8–5.8%), respectively, in 2008. If the declining trend has continued, then current levels of PrEP drug resistance may well be considerably lower than this. The Stanford HIVdb program [9] considers a number of codons as being implicated in TDF resistance, and not only the classical K65R and K70E mutations. These are all the TAM positions plus codons 44, 62, 69, 75, 77, 115, 116, 118 and 151. Among samples classified as having intermediate TDF resistance or higher, 70.8% were wild type at positions 65 and 70, with resistance predominantly driven by TAMs [the most common being M41L (75.7%), T215Y/F (63.3%), L210W (59.3%) and K70R (17.3%)]. Other mutations contributing to TDF resistance were K65R/N (18.1%), K70E (0.9%), Y115F (4.4%), V75A/I/M (7.

coli DH5α and P. aeruginosa ATCC 14207, but not S. Typhimurium ATCC 23564. Both CclA and AS-48 target the cytoplasmic membrane, but differ slightly in their mode of action. AS-48 forms nonselective pores (Gálvez et al., 1991), whereas CclA generates anion-selective pores (Gong et al., 2009). It is not clear whether the differences between AS-48 and CclA toward Salmonella arise from differences in the mode of action or from differences in the strains tested. To lend a broader context to our findings with the UAL307 bacteriocins,

we also examined the activity of gallidermin and SubA. Our results show that when tested in combination with EDTA, gallidermin has comparable activity to nisin against Gram-negative bacteria. Because the receptor molecule for nisin and gallidermin (lipid II) is highly conserved across the prokaryotes, once these lantibiotics are able to Pexidartinib mouse access the cytoplasmic membrane, they are more likely to display a killing effect compared with CbnBM1 or PisA, which require a specific EIItman permease receptor for binding. Indeed, upon cotreatment with EDTA, both lantibiotics were more active than either CbnBM1 or PisA against the strains of E. coli and Salmonella that were tested. Conversely, although it had little selleck screening library effect against S.

Typhimurium ATCC 23564, CclA showed activity against E. coli DH5α and P. aeruginosa ATCC 14207 comparable to that of the lantibiotics. Our other point of comparison, SubA, is a non-LAB circular bacteriocin with unusual thioether cross-links. Reports indicate that SubA is able to directly inhibit the growth of some Gram-negative bacteria, including certain strains of E. coli and

Pseudomonas, and is able to inhibit additional Gram-negative strains when subjected to heat stress (Shelburne et al., 2007). In contrast, we found that SubA combined with EDTA did not inhibit Gram-negative bacteria significantly, leading us to speculate whether EDTA was interfering with the activity of SubA. In support of this hypothesis, we found that when EDTA was used in combination with SubA, its activity toward a sensitive Gram-positive organism was reduced. It has been reported that many anionic antimicrobial peptides exert maximal activity when complexed with also cationic species (Brogden, 2005). SubA is an anionic bacteriocin, and because EDTA chelates Mg2+ and Ca2+ ions, it may be that the experimental conditions ‘inactivated’ SubA. If an alternate OM destabilizing strategy was used, it is likely that a greater killing effect from SubA would be observed. However, SubA may also require a membrane-bound receptor: SubA can interact directly with lipid bilayers, causing pore formation, albeit at concentrations higher than those required for antimicrobial activity (Thennarasu et al., 2005).

DNA was then extracted from washed ectomycorrhizae by NucleoSpin Plant II DNA extraction kit (Macherey-Nagel GmbH & Co. KG) and from soil (250-mg sample) by NucleoSpin Soil DNA kit (Macherey-Nagel GmbH & Co. KG) as indicated above. The total DNA concentration in extracts is given in Appendix S1, sheet ‘Field detection’. Undiluted DNA extracts were amplified in nested PCR (first run with the NSI1/NLB4 primer pair, second run with the Tu1sekvF/Tu2sekvR

primer pair, annealing at 59 °C) and cleaved by TaiI restriction endonuclease as described above. Two sequence motifs, common for T. aestivum but not present in ITS region of other Tuber spp. and other identified organisms in GenBank, were found. Two primers targeting these motifs were then designed. According to the analysis of GenBank data, the virtual length of the PCR product amplified using this primer pair selleck chemical is 496–502 bp. The primers binding to 17 bp motifs were called Tu1sekvF (forward, its target motif is localized in ITS1) and Tu2sekvR (reverse, target motif localized in ITS2) (for nucleotide sequence see Table 1). The motifs have 100% homology to corresponding sites in all studied GenBank ITS sequences

of T. aestivum and Tuber uncinatum with the exception of the sequence AJ492216, showing one gap in the motif recognized by the primer Tu1sekvF, and sequence AJ888120, possessing one substitution Oligomycin A in vivo in the motif recognized by the primer Tu2sekvR (Appendix S4). As seen in Table 2, primer pair tubtubf/elytubr designed to amplify Tuber spp. amplified DNA from almost all the samples, indicating good quality DNA extracts. Only two samples (Tuber bellonae and one sample of Tuber rufum) gave no signal. In general, all three primer pairs supposedly specific to T. aestivum showed

some nonspecific amplification of nontarget species DNA. Direct PCR with negative controls A–E showed that the primer pair UncI/UncII was prone to nonspecific DNA amplification. The same trend was noted in the case of primer pair tubtubf/elytubr working at an annealing temperature lower than that recommended by the designers (Zampieri et al., 2009) to increase cAMP its sensitivity to T. aestivum. The primer pair BTAE-F/BTAEMB-R seems to be the most robust to nonspecific amplification and the pair Tu1sekvF/Tu2sekvR is intermediate in this regard. Nested PCR with nontarget DNA samples always gave negative results (Table 2). In the test of the sensitivity to target DNA diluted in a large amount of nontarget DNA, nested PCR with primer pairs NSI1/NLB4 and Tu1sekvF/Tu2sekvR still gave a positive result if nontarget DNA contained 0.01% (1.25 pg per PCR reaction) of T. aestivum S13 DNA (see Appendix S5). Unfortunately, nested PCR using the primers BTAE-F and BTAEMB-R (Bt2a/BTAEMB-R in first amplification and BTAE-F/Bt2b in second amplification) was not successful. TaiI cleavage of T.

5, 3, 5, 7, and 10% NaCl. The pH range for growth was determined in MB, which was adjusted before sterilization to pH 3–11 (at 0.5 pH unit intervals) using HCl and NaOH. Growth in MB at 4, 10, 15, 20, 30, 37, 40, and 45 °C was tested after 3 days of incubation. For the cellular fatty acid determination, fatty acid learn more methyl esters of strain CC-SAMT-1T and reference strains were extracted

from the cells cultivated on MA for 60 h at 30 °C by saponification, methylation, and extraction as described previously (Kämpfer & Kroppenstedt, 1996) and separated by gas chromatography (model 7890A; Agilent). Peaks were automatically integrated, and fatty acid names and percentages were determined using the microbial identification standard software package midi (version 6; Sasser, 1990) by adopting the database RTSBA6. Respiratory quinones of strain CC-SAMT-1T were extracted, separated, and identified by following Minnikin et al. (1984) and analyzed by HPLC (Collins & Jones, 1980). Polar lipids of strain CC-SAMT-1T and

reference strains were extracted and analyzed by two-dimensional TLC according to Minnikin et al. (1984). For the determination of G+C content, the DNA was prepared by thermal denaturation and enzymatic digestion into nucleosides as described previously (Mesbah et al., 1989), and the resultant nucleoside mixture was separated and quantified by liquid chromatography. For the analysis of carotenoids, selleck compound strain CC-SAMT-1T was grown in MB for 3 days and lyophilized. The lyophilized biomass (c. 10 mg) was introduced into 1 mL of methanol, mixed thoroughly, and incubated overnight under dark at 40 °C. The mixture was centrifuged (12 400 g, 10 min, 4 °C) and supernatant was filtered through Millipore filter paper (PVDF; 13 mm, 0.22 μm). The yellow-colored crude methanol extract was Unoprostone subjected to full-wavelength scan (250–700 nm) using a UV-visible spectrophotometer (U3010; Hitachi) for preliminary identification of carotenoids. Chromatographic separation of polar and nonpolar carotenoids was achieved through previously published methods (Asker et al., 2007c). For liquid chromatography, a HPLC pump (l-2130; Hitachi) equipped with an auto sampler (AS-4000) and diode

array detector (l-2455; Hitachi) was used. A reversed-phase column (CAPCELL PAK C18 MG S-5, 35 × 4.6 mm, 5 μm particle size; Shiseido, Tokyo, Japan) connected through a guard column (Phenomenex) maintained at 35 °C was employed. For the confirmation of carotenoids, mass spectrometry was performed by adopting Thermo Finnigan LTQ linear ion trap mass spectrometer (Thermo LTQ XL, San Jose, CA) connected to Thermo Scientific Surveyor LC plus system equipped with a Surveyor MS pump plus and a Surveyor auto sampler (Thermo Scientific, San Jose, CA). An APCI source operated in the positive ion mode during analysis under the following conditions: sheath gas flow (N2), 50 AU; auxiliary gas flow (N2), 10 AU; source voltage, 6 kV; and capillary temperature, 300 °C.

Three out of every 20 samples from HIV-infected patients had discrepant HDL cholesterol values with respect to the ultracentrifugation method. Overestimation was associated with high C-reactive protein concentrations and underestimation with plasma γ-globulin concentrations, an effect that was amplified by any of the storage conditions tested. Caution is needed when using the synthetic polymer/detergent homogeneous method for direct measurement of HDL cholesterol concentrations in HIV-infected

patients. This assay is of limited use in clinical trials in which frozen samples are analysed. Pro-atherogenic metabolic disturbances in HIV-infected patients are increasingly a clinical concern because of the higher cardiovascular disease risk Selleck PD332991 observed in these patients with respect to uninfected populations [1]. Low high-density lipoprotein (HDL) cholesterol concentrations are common and characterize dyslipidaemia in patients undergoing long-term antiretroviral therapy

[2], resulting in an increased incidence of cardiovascular events [3]. Consequently, SP600125 clinical laboratories should provide accurate and reliable measurements of HDL cholesterol as part of the continuous management and evaluation of these patients [4]. Automated homogeneous assays have been adopted for the direct quantification of HDL cholesterol in clinical laboratories. However, although these methods show good agreement with reference methods in healthy subjects [5], falsely low HDL cholesterol concentrations have been observed in patients with different disease states [6,7]. HIV

infection results in persistent inflammatory stimuli [8] and HDL particles have been reported to lose their atheroprotective properties (i.e., cholesterol efflux capacity, and anti-oxidative and anti-inflammatory activities) during inflammation and could be modified during the acute response phase [9]. It is unknown whether major changes in HDL particles are elicited by HIV infection and data on the impact of such changes on HDL cholesterol measurements obtained using the homogeneous assay have not been properly assessed. Moreover, hepatitis C virus (HCV) coinfection may be relevant in Mediterranean area, where injecting drug use is a predominant cause Tideglusib of HIV infection [10]. Multiple viral infections may represent an additional confounding factor in homogeneous assays [11], and progressive liver dysfunction may produce abnormal HDL particles which may be a source of inaccuracies in HDL cholesterol measurements. Additionally, the effect of sample storage on serum HDL cholesterol concentration measurements should be assessed because most epidemiological and research studies are performed on samples that have been stored at different temperatures for different periods of time.

[34] A 32-year-long prospective study in approximately 2000 individuals, meanwhile, concluded that those who developed dementia had higher systolic blood pressure in early life, but that blood pressure then fell to a greater extent in the same individuals in later life[35] a finding partially

supported by Razay et al.[36] who, in a study of 235 control individuals, 141 patients with Alzheimer’s disease, 42 with mild cognitive impairment and 59 with other dementias, determined that faster cognitive decline over 5 years was associated with extremes of blood pressure, both high and low. Paradoxically four studies, selleck kinase inhibitor ranging from 327 to 6249 patients, showed that hypertension is associated with a decreased risk of all dementias[37–40] and hypotension associated with an increased risk.[38] A possible confounding factor in such studies is a history of antihypertensive medication. A small study in 321 memory-clinic patients showed that cognition, as assessed by the MMSE, was equal in individuals receiving

antihypertensive therapy and those not receiving such medication at the outset, but that at 3-year follow-up those receiving antihypertensives had better cognition.[41] Along the same lines, BMS-354825 order Gao et al.[29] reported that hypertension caused a decrease in cognition, but that treated hypertensive patients were not significantly different from normotensive controls. In contradiction to this ‘normalizing effect’ of antihypertensive therapies, Hoffman et al.,[42] who undertook 291 post-mortem examinations, showed that a history of antihypertensive medication was associated with decreased Alzheimer-like neuropathological changes compared with normotensive controls. Hypertensive patients who had not received medication were similar to normotensive Avelestat (AZD9668) controls, who thus had more neuropathological changes than those individuals who had received antihypertensive medication. The antihypertensive therapies therefore are perhaps more ‘protective’ than ‘normalizing’. Two studies have been published recently: a study

of 1054 hypertensive individuals, 158 of whom developed dementia during the 6-year study,[43] and a study of 800 000 individuals receiving antihypertensive drugs, of whom 12 500 had Alzheimer’s disease and 44 500 had dementia.[44] In the first study[43] the class of antihypertensive most robustly associated with a protective effect against dementia was brain-penetrating ACEIs.[43] These results were first reported at a meeting of the American Geriatrics Society in 2007,[45] and they have been replicated in an independent Russian study.[46] Brain-penetrating ACEIs include captopril, fosinopril, lisinopril, perindopril, ramipril and trandolapril. Non-brain-penetrating ACEIs included benazepril, enalapril, moexipril and quinapril.

These results partly support existing literature indicating an increased risk of adverse events with the use of bDMARDs compared to tDMARDs,[6, 15-17] and they provide evidence of elevated risk for patients who use adalimumab versus Staurosporine etanercept among bDMARDs. Other studies have similarly reported higher bDMARD risks for TB infection,[18-21] but they have also reported higher risk for SBI, which was not confirmed here. These findings

also support an association between bDMARD use and lymphoma risk previously supported largely by adverse event reports. Although the relative risk for TB and lymphoma events was higher than for SBI, these events were uncommon. Only 406 TB events occurred in 61 930 patient years of exposure, and 33 lymphoma events occurred in 63 200 patient years of exposure. The increased lymphoma risk in bDMARD compared to tDMARD cohorts observed in this study could also be the result of residual unbalanced disease activity between the two cohorts, despite propensity score matching. Several studies have found a strong relationship between RA inflammatory activity and lymphoma[33-36] which would account for the increase in risk for lymphoma found in this study. Specifically, the observed higher risk of lymphoma could be the result of common genetic risk factors for RA malignancy, Angiogenesis inhibitor predisposition and severity.[33, 37] As an example, the human leukocyte antigen (HLA)-DRB1 shared-epitope

genotype is affiliated with death related to malignancy in RA.[38] Additionally, there is a level of skepticism concerning the potential impact of bDMARD or other treatments on site-specific risk of cancer in RA[33, 36] which further bolsters the theory of the influence of

residual disease activity on increased lymphoma risk in these patients. As noted, previous studies have shown increased bacterial infection risk associated with bDMARD use.[15] However, other studies have applied a broader definition of SBI, most commonly as any infection that led to hospitalization or death, or required intravenous (i.v.) antibiotics.[6, 15, 16, 24] Other research has HAS1 recorded any infection that fell under general adverse event guidelines,[17] while other studies have evaluated only TB events.[18, 25] Additionally, this study followed a population for a total of 10 years, capturing data on all patients who initiated DMARD use in that time period from the time of treatment initiation. To increase the precision of this study, results were based on person years and adjusted to account for the time patients were persistent on DMARDs. Additionally, propensity score matching was used to help determine the extent of events attributable to medication. Patients receiving bDMARDs showed several differences in baseline characteristics than did patients on tDMARDs, which might have confounded infection risk estimates without the use of propensity matching as performed in this study.