Intravenous tocilizumab in the management of rheumatoid arthritis: Clinical practice findings from a 6-month international, multicentre, observational study in Central America and the Caribbean / El tocilizumab intravenoso en el tratamiento de la artritis reumatoide: resultados de la práctica clínica de un estudio internacional, multicéntrico y observacional de 6 meses de duración en América Central y el Caribe

ABSTRACT Tocilizumab (TCZ), an 1interieukin-6 receptor-α Inhibitor, is Indicated in patients with moderate to severe rheumatoid arthritis with inadequate response to disease modifying drugs. ACT UP is a multinational project co11ecting information from severa1 post-marketing TCZ studies. Aim: To determine the proportion of patients in the routine clinical care setting receiving intravenous TCZ after 6 months treatment. Identification of TCZ treatment patterns, efficacy, and safety were also recorded. Method: This prospective non-interventional 6-month study, collected real-world information from 169 Central American and Caribbean patients. No interventional procedures or additional visits outside routine clinical care practice were performed. Statistical analysis was essentially descriptive. Results: Adherence rate was 74.0%, with 97% of patients receiving TCZ as first biological therapy line and there were no deviations from the local label. Almost 85% of patients started with combination therapy, and the majority remained under this scheme throughout the study. A significant decrease in disease activity assessments and acute phase reactants values were detected during TCZ treatment. The percentage of patients that achieved improvement according to the different levels of the American College of Rheumatology (ACR) increased during the study, and relevant enhancements in quality of life were also accomplished. Adverse events (AEs) occurred in 35 patients, with metabolic and nutritional disorders being the most common. Serious AEs were reported in 3% of patients, and special interest AEs occurred in 6 patients. Conclusion: Treatment adherence was mainly determined by follow-up and compliance with the administration schedule. Efficacy analysis showed better results than those reported in international literature. The incidence of AEs was also lower than in previously published data.

RESUMEN El tocilizumab (TCZ) está indicado en la artritis reumatoide moderada a severa, principalmente en respuestas inadecuadas a fármacos convencionales. ACT UP es un proyecto multinacional que recopila información relacionada con varios estudios de poscomercialización. Objetivo: Determinar la proporción de pacientes en la atención clínica de rutina que continúan en tratamiento con TCZ intravenoso después de 6 meses. Se llevó a cabo la identificación de patrones de administración, eficacia y seguridad. Método: Este estudio observacional prospectivo recopiló información de la vida real de 169 pacientes de América Central y el Caribe. No se hicieron intervenciones ni visitas adicionales fuera de la práctica clínica habitual. El análisis estadístico fue esencialmente descriptivo. Resultados: La tasa de adherencia al tratamiento fue del 74,0%, el 97% de los pacientes reci bieron TCZ como primera línea biológica y no existieron desviaciones en las indicaciones de administración según el inserto local. Aproximadamente el 85% de los pacientes inició TCZ como terapia combinada, y la mayoría permaneció bajo este esquema. Se evidenció una dis minución en la actividad de la enfermedad y un aumento en el porcentaje de pacientes que lograron respuesta según los diferentes grados del Colegio Americano de Reumatología. En 35 pacientes se presentaron eventos adversos (EA), siendo los relacionados con metabolismo y nutrición los más comunes. Se informaron EA graves en el 3% de los pacientes y de interés especial en 6 casos. Conclusión: El seguimiento de los pacientes y el cumplimiento del programa fueron los prin cipales determinantes en la adherencia. El análisis de eficacia mostró mejores resultados que los reportados previamente y la incidencia de EA fue menor que en otros estudios.

Diseño de un instrumento de preferencias vocacionales en Administración, Materiales y Biotecnología / Design of an Instrument for Vocational Preferences in Administration, Materials and Biotechnology

Resumen Este estudio buscó diseñar y evaluar una prueba de preferencias vocacionales para las carreras de Administración de Empresas, Ingeniería en Materiales e Ingeniería en Biotecnología en el Instituto Tecnológico de Costa Rica (ITCR). Para ello, se construyó previamente el perfil vocacional de cada carrera a partir del cual se redactaron los ítems de la prueba. Participaron 480 estudiantes con una media de edad de 22.07 años, 53.19% mujeres y 46.81% hombres. Se obtuvo información del perfil de cada carrera por parte de estudiantes y docentes. Posteriormente, la revisaron grupos de expertos. A partir del perfil definido, se redactaron los ítems de la prueba. Luego, se evaluaron sus características psicométricas con análisis factoriales. Se obtuvieron adecuados indicadores de bondad de ajuste. La prueba vocacional incluyó tres escalas: habilidades, intereses y tareas vocacionales. La escala de habilidades evaluó seis factores: lógico-matemática, física, química, biológica, liderazgo y autorregulación- disciplina. Por su parte, las escalas de tareas e interés se utilizaron para definir las preferencias por los tres factores evaluados: Administración, Materiales y Biotecnología. Finalmente, se evidenciaron diferencias según sexo, carrera y nivel de satisfacción vocacional.

Abstract: This study sought to design and evaluate a vocational preference test for Business Administration, Materials Engineering and Biotechnology Engineering majors at the Instituto Tecnológico de Costa Rica (ITCR). For this goal, first of all a vocational profile of each career was constructed, from which the test items were written. 480 students took part, with an average age of 22.07 years, 53.19% of them women and 46.81% men. Descriptions of the profile of each career were collected by students and teachers, and later analyzed by expert groups. From the defined profile, items were drawn up and later evaluated with factor analysis, for the selection of the items, obtaining adequate indicators of goodness of fit. The vocational test includes three factors: Skills, Interests and Vocational Tasks. In turn, the Skills scale evaluated six areas: Mathematics, Chemistry, Physics, Biology, Leadership and Self-regulationdiscipline. For its part, the scale of preferences contemplated the three areas evaluated: Administration, Materials and Biotechnology. On the other hand, there were differences according to sex, major and level of vocational satisfaction.

Root biomass, turnover and net primary productivity of a coffee agroforestry system in Costa Rica: effects of soil depth, shade trees, distance to row and coffee age.

Background and Aims In Costa Rica, coffee (Coffea arabica) plants are often grown in agroforests. However, it is not known if shade-inducing trees reduce coffee plant biomass through root competition, and hence alter overall net primary productivity (NPP). We estimated biomass and NPP at the stand level, taking into account deep roots and the position of plants with regard to trees. Methods Stem growth and root biomass, turnover and decomposition were measured in mixed coffee/tree (Erythrina poeppigiana) plantations. Growth ring width and number at the stem base were estimated along with stem basal area on a range of plant sizes. Root biomass and fine root density were measured in trenches to a depth of 4 m. To take into account the below-ground heterogeneity of the agroforestry system, fine root turnover was measured by sequential soil coring (to a depth of 30 cm) over 1 year and at different locations (in full sun or under trees and in rows/inter-rows). Allometric relationships were used to calculate NPP of perennial components, which was then scaled up to the stand level. Key Results Annual ring width at the stem base increased up to 2·5 mm yr-1 with plant age (over a 44-year period). Nearly all (92 %) coffee root biomass was located in the top 1·5 m, and only 8 % from 1·5 m to a depth of 4 m. Perennial woody root biomass was 16 t ha-1 and NPP of perennial roots was 1·3 t ha-1 yr-1. Fine root biomass (0-30 cm) was two-fold higher in the row compared with between rows. Fine root biomass was 2·29 t ha-1 (12 % of total root biomass) and NPP of fine roots was 2·96 t ha-1 yr-1 (69 % of total root NPP). Fine root turnover was 1·3 yr-1 and lifespan was 0·8 years. Conclusions Coffee root systems comprised 49 % of the total plant biomass; such a high ratio is possibly a consequence of shoot pruning. There was no significant effect of trees on coffee fine root biomass, suggesting that coffee root systems are very competitive in the topsoil.