pH appeared as a flat line ( Fig. 2a), therefore, P0 could not be determined (dashed curve in Fig.

2a is calculated from the P0 in Fig. 2b). The assay was repeated with cell monolayers grown on Corning Transwell® polycarbonate membrane inserts. The log Papp at pH 7.4 was higher than the value obtained from assay using cells grown on Transwell®-Clear, and pH-dependent permeability was then observed ( Fig. 2b). pKaFLUX was detected at pH 5.9. The approximate log P0 was derived according to Eq. (A.12) and subsequently refined ( Appendix A). The results suggest that the polyester membrane with lower pore density (4 × 106 pores/cm2) than polycarbonate membrane (1 × 108 pores/cm2) restricted permeability of the highly permeable propranolol. Stem Cells inhibitor The measured Papp data (black circles) for compounds of different chemistry: acetylsalicylic acid and phenytoin (acids), diazepam and lamotrigine (bases), leucine (zwitterion), caffeine, and dexamethasone (neutral drugs) were analyzed to derive P0, corrected for permeability through the aqueous boundary layer (PABL) and paracellular permeability (Ppara) ( Fig. 3). The PABL was determined using propranolol as marker based on the initial finding that propranolol permeability was limited by the ABL ( Fig. 2b). From Fig. 3a, it is possible to deduce that the permeability of acetylsalicylic

acid is limited by the ABL at pH < 4, based on the calculated log PABL of −4.40 (propranolol ABL marker) Y-27632 in vivo Adenosine and the refined log P0 of −3.31 ± 0.01. Also, for acetylsalicylic acid, it was possible to refine the Ppara constant (−5.35 ± 0.01) using the measured log Papp vs. pH data. The refined Ppara constant predicts a TEER value of 286 Ω cm2 (Eq. (A.8), Appendix A), which is within the experimental error of the measured TEER of 345 ± 55 Ω cm2 ( Table 2), suggesting that log Papp for pH > 6 ( Fig. 3a) is consistent with paracellular permeability, and not predictive of an uptake process of the acetylsalicylate anion. The measurement at pH 8.5 was reproducibly higher than the model would predict, suggesting a possible increased paracellular leakage at pH 8.5. The data point

was ultimately assigned a zero weight in the refinement. A similar effect appears to have taken place with verapamil at pH 4.8 ( Avdeef et al., 2005). For all of the other molecules in Fig. 3, Ppara was estimated using Eq. (A.8), where TEER measurements were used to calculate Papp of sucrose, from which (ε/δ)2 was calculated (Eq. (A.11)) and applied to each of the drugs in Fig. 3b–g to estimate the corresponding value of Ppara during the refinement step ( Appendix A.5). These log Ppara values ranged from −5.03 (l-leucine) to −5.82 (digoxin). The permeability of caffeine (Fig. 3b), diazepam (Fig. 3d) and leucine (Fig. 3f) were not limited by the ABL. To derive the intrinsic transcellular permeability (P0) of the compounds, the log Papp vs.

Almost

90% of sponge’s species in the world are from Demospongiae class. Here in our sampling area we got 100% of Demospongian classes which divided into 5 orders of Haplosclereida (specimen number 1, 4, 18), Dictyocertida (specimen number 2, 3), Handromerida (specimen number 15). The species of our haplosclereida referred to specimen 1 Xestospongia testudinaria, specimen 4 Callyspongia schulzei, specimen 6 Petrosia contignata, specimen 18 Xestopongi aexigua. Our specimen in group Dictyoceratida consisted of specimen 2 (Fascaplysinopsis reticulata). HSP tumor On the Handromerida orders, only consist of specimen no 15, Aaptos aaptos ( Table 1). The result on our species diversity corresponded with the de Vogd & Clearly 2008 that Aaptos

suberitoides, 8Clathria (Thalysias) reinwardti, Petrosia (Petrosia) nigricans and Xestospongia testudinaria were the most common species in Jakarta bay Indonesia. 9 Antioxidant assay using DPPH method found that only Aaptos suberitoides that had been identified to show strong activity due to IC50 value of <30 μg/mL; meanwhile Fascaplysinopsis reticulata, Acanthella sp, Petrosia contignata and Xestospongia exigua showed moderate antioxidant activity with a IC50 < 100 μg/mL. Xestospongia sp, Callyspongia sp showed a value of IC50 > 100 μg/mL ( Table 2). However, the study was limited to testing coarse extracts; thus, there is a possibility that the pure compounds contained in the extracts have a stronger free-radical muffling activity compared to the extracts themselves. DPPH method was selected since Cilengitide manufacturer it is simple, fast, responsive, and requires fewer samples. The sponge extraction out recruited minimal 100 g weight yield. Therefore among 20 specimens, only

11 specimens fulfilled the minimal weight. Moreover, 11 crude extracts sponges were tested its toxicity with BST test which are the prescreening process for anticancer drug candidate. The probity analysis for LC50 value among sponge species ranged 61.28 ± 8.61–574.58 ± 29.36. Therefore all of those extracts had high toxicity ( Table 3). The A. salina bioassay developed is a useful tool for preliminary biological and pharmacological activity analysis. A. salina is an organism occurring in brackish and marine waters, adaptable to large ranges of salinity (5–250 g L−1) and temperature (6–35 °C).Moreover, this organism is vital to the pelagic ecology of a coastal ecosystem (estuaries, bays, harbors and other near-shore environments). Although it is still considered the basic screening test for cyanobacteria from coastal environments, other sensitive and more specific screening bioassays have been applied, specifically the ones using embryos of invertebrates, viruses and cell lines. As shown in Table 4 the extracts from species number 15, A. suberitoides has the highest toxicity compare to another species which valued level on tumor cell lines (HT-29, T47D and Casky).

These are easily measured by using a crystalline sample of a compound using standard DSC equipment. However, the PLS-DA modelling attempts resulted in non-significant models (data not shown). In the next step, we therefore also included Tg-related parameters, which are assumed to represent properties related to the molecular

mobility of the amorphous state. Interestingly, the most predictive AUY-922 cost model, shown in Fig. 1, did not include any parameter representing an absolute temperature parameter (Tm or Tg), as could be expected since the quality of the amorphous product formed often are related to difference between formation temperature and Tg ( Yamaguchi et al., 1992). Instead it was the balance between thermodynamic and

kinetic properties, i.e. the adjusted parameters involving both Tm and Tg, that carried most information. In this case, the predictivity was 81% for the test set ( Fig. 1A). The model was based on Tg,red, Tm − Tg, ΔSm, ΔGcr × Tg,red, ΔHm, ΔGcr/Tg,red and ΔGcr/Tg,red and hence, the analysis showed that the Tg-related properties indeed carry information of importance for the prediction of glass-forming ability. In a general context, larger molecules are commonly less prone to crystallize from a liquid state (Baird et al., 2010). Therefore, we wanted to evaluate the effect TSA HDAC nmr of Mw on the predictions and hence, a new model was built including all former parameters, together with Mw-related properties. In this analysis, only the adjusted parameter Tg,red × Mw remained after model refinement and this property predicted 91% and 94% correctly of the training and test sets, respectively ( Fig. 1B). We also found that equal predictivity was obtained from Mw alone (accuracy of training and test sets of 88% and 94%, respectively, Fig. 1C). The results obtained herein, based on a large and structurally diverse drug-like dataset, strengthen previous findings of the importance of molecular size and Tg as predictors of glass-forming

ability ( Lin et al., 2009). In the scientific discussion, it is often ADAMTS5 referred to Kauzmann (1948) and Turnbull (1969) who suggested that compounds with a Tg,red higher than 2/3 are good glass-formers. The theoretical rationale for this effect is that compounds with smaller super-cooled liquid regime (i.e. high Tg,red) have a lower probability for nucleation when cooled below its melting temperature due to less time spent in that critical region. This has been confirmed in a study on a homologous series of cyclic stilbenes ( Ping et al., 2011), but in the same publication it was argued not to be true when looking at more diverse chemical structures. Recently it was shown by Baird et al., that for a set of drug compounds the Tg,red is not useful for predicting glass-forming ability ( Baird et al., 2010). This is partially in line with our observation that Mw is a good predictor by itself, and that the Tg,red contributes with minor information.

Surgical trials excluded from this review were almost exclusively conducted on patients with specific pathology, usually a demonstrated neurological compromise. We found no controlled trials that investigated the use of procedures such as fusion or disc

replacement for non-specific neck complaints. Given the high potential for serious adverse events and the high costs associated with surgery there is a need to establish better knowledge about the outcome of these procedures. Despite the extensive evidence identified and summarised by this review, several questions have not been answered comprehensively. click here Although we identified 221 studies that investigated interventions for neck pain, only 33 trials met our criteria of having participants with clearly defined nonspecific neck pain, and using a placebo, sham, or minimal or no intervention as a control. There is a need for greater consistency in classification of neck pain and conditions associated with neck pain. We excluded a large number of trials in which two active interventions were compared, ie, without comparison to a placebo, sham, or minimal or no intervention. This type of comparative trial should be a lower research priority in making determinations about efficacy. This review has identified evidence supporting some interventions for non-specific neck pain. However, none of these Cytoskeletal Signaling inhibitor interventions

was shown to have lasting benefit. There is a need to establish whether simple and inexpensive measures such as reassurance, self-care advice, and simple analgesics provided

by trained practitioners are effective for neck pain. GPX6 Future research might focus on the question of whether the addition of commonly provided or novel interventions confers additional benefits to quality baseline care. This is particularly pertinent for interventions that involve exposure to additional risks or incur additional costs. eAddenda: Appendix 1, Tables 3 to 6 available at jop. physiotherapy.asn.au Support: AL was funded by a University of Sydney scholarship. CM is funded by a NHMRC fellowship. Competing interests: None declared. “
“Both the prevalence and incidence of chronic heart failure have increased due to the improved survival of coronary heart disease patients and to the aging of populations worldwide (Bleumink et al 2004). The major symptoms of chronic heart failure include exertional dyspnoea, fatigue, exercise intolerance, and functional limitations, which may result in poor quality of life. Previous studies suggested that both central and peripheral impairments limit exercise capacity in chronic heart failure patients (Mueller et al 2007, van Tol et al 2006, Volaklis and Tokmakidis, 2005). Aerobic exercise training has been considered a safe and effective strategy to improve clinical symptoms (Flynn et al 2009, Mueller et al 2007, O’Connor et al 2009).

The extent to which CPM may underlie NIPT FP results requires further investigation. We would like

to thank Steven Aldridge and Nia Sengupta for assistance with collecting and tracking follow-up information. EGFR inhibitor We would also like to thank Dr Asim Siddiqui for critical review of the manuscript. N.S. and A.S. are employees of Natera Inc. S.A. was employed by Natera Inc during the study and initial follow-up period. “
“Siristatidis C, Chrelias C. Planned home birth: the professional response. Letters to the Editors. Am J Obstet Gynecol 2013;209:e72-3. The first names and surnames of the authors of a Letter to the Editors were reversed. Their correct names are Charalampos Siristatidis, MD, PhD, and Charalampos Chrelias, MD, PhD. Accordingly, the Reply to their letter by the authors of the article cited

(Chervenak FA, McCullough LB, Brent RL, Levene MI, Arabin B. Planned home birth: the professional responsibility response. Am J Obstet Gynecol 2013;208:31-8) should have been addressed to Dr Siristatidis and Dr Chrelias rather than to “Drs Charalampos. “
“Two references cited in a July 2013 article (Geller EJ, Matthews CA. Impact of robotic operative efficiency on profitability. Am J Obstet Gynecol 2013;209:20.e1-5) require correction, as follows: 18. Sarlos D, Kots L, Stevanovic N, Schaer G. Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case-control all study. Eur J Obstet Gynecol Reprod Selleckchem SCH-900776 Biol 2010;150:92-6. A letter to the

editors and authors’ reply regarding these citations and other matters related to the article appear in this issue of the Journal. See related Letter to the Editors and Reply, page 569 “
“Preeclampsia (PE) remains one of the most common causes of adverse pregnancy outcome in developed and developing countries. The incidence of PE is substantial, about 3% to 8%.1 and 2 PE places the obstetric patient and her infant at substantial risk of preterm birth and perinatal mortality, and severe maternal hypertension and multisystemic organ dysfunction and damage, including eclampsia and abruption placentae.3 and 4 Predictive tests for preeclampsia early in the course of pregnancy would provide sufficient time to intervene and mitigate the risks of PE. There has been an intense interest in biomarkers for the identification of patients at risk for preeclampsia. Although clinical risk factors for preeclampsia are well known, these factors either singly or in combination have limited predictive values and this has led to intense search for predictive biomarkers for PE, particularly in plasma.5 However, plasma-derived predictive biomarkers like the generic disease biomarkers are generally low abundance proteins and their discovery is confounded by the dominance of several high abundance proteins such as albumin and immunoglobulins.

6 ± 3.9 (control), 111.4 ± 13.0 (SP 3 μM), 131.4 ± 9.6 (SP 10 μM), 194.5 ± 19.3 (SP 30 μM), 118.6 ± 14.2 (U0 30 μM) and 106.3 ± 10.2% (SB 30 μM)

(Fig. 3A), showing that SP significantly enhanced the ACh-induced Cl– secretion in a concentration-dependent manner. However, U0 and SB, even at a high concentration (30 μM), did not enhance the ACh-induced Cl− secretion, suggesting that mAChR-mediated JNK signaling is the main driver for the negative regulation of Cl− secretion in mouse intestinal epithelial cells. The representative recording of ACh-induced Cl− secretion under the presence of SP (30 μM) is shown in Fig. 3B. Intestinal epithelial cells maintain body fluid as well as electrolytes homeostasis by regulating the balance of absorption and secretion (2). Numerous reports have established that cholinergic find more stimulation of mAChRs enhances the secretory functions of the colonic epithelium (9) and (10).

However, in order to maintain homeostasis there must be antisecretory signaling along with secretory signaling. Barrett has proposed that there is a negative signaling pathway in the downstream of mAChR, in which ERK or p38 (11) and (12) is the responsible signaling molecule, uncoupling an agonist-stimulated increase in intracellular calcium from the following response of Cl− secretion. Donnellan et al. also demonstrated that secretagogues-induced activation of JNK limits the Ca2+-dependent Cl− secretion in T84 human intestinal cells (6). Our data

showed that inhibition of mAChR-mediated activation of JNK by the pharmacological inhibitor SAHA HDAC Rolziracetam SP, but not that of ERK by U0 or that of p38 by SB, has significantly enhanced the ACh-induced Cl– secretion in mouse intestinal epithelium. It is, thus, possible to speculate that JNK as a major signaling molecule in the MAPK family negatively regulates cholinergic intestinal secretion. Since receptor-mediated activation of MAP kinases is a complicated mechanism (13), further studies are required to elucidate the regulation of intestinal secretion by mAChR via MAP kinases. In conclusion, stimulation of mAChRs in mouse intestinal epithelial cells regulates ERK, JNK and p38 MAPKs phosphorylation in which JNK signaling negatively regulates the secretagogue-induced Cl− secretion, presumably to optimize intestinal fluid secretion. This work was supported in part by JSPS KAKENHI Grant Number 23590329 and 25460378 (Grant-in-Aid for Scientific Research (C)) and 26860170 (Grant-in-Aid for Young Scientists (B)) granted by Japan Society for the Promotion of Science, the Smoking Research Foundation, and the fund for Asahikawa Medical University Creative Research in the Field of Life Science. “
“Cordyceps sinensis is a fungus that parasitizes on larvae of Lepidoptera and has been used as a herbal tonic in traditional Chinese medicine for over 300 years. Many papers have reported the diverse pharmacological activities of C. sinensis (1) and (2).

Statistical analysis was performed by one-way ANOVA using SPSS software. Values were compared between different groups. P values <0.05 were considered to be statistically significant. The codon optimized L1 genes were expressed efficiently in Sf9 cells, and the expression levels were about 2-fold higher

than those of the wild type genes (data not shown). The L1 containing fractions of CsCl ultracentrifugation were examined under electron microscopy, and were confirmed to be fully assembled VLPs (Fig. 1A–C). The purities of HPV 16, 18, 58 L1 VLPs were analyzed by SDS-PAGE with Coomassie blue staining, and only one band was observed when 10 μg of VLPs were loaded each lane (Fig. 1D). To investigate whether co-immunization of different types of VLPs will have some influence on serum antibody levels, we immunized mice with Trivalent-1 vaccine and corresponding monovalent vaccines. Mice sera small molecule library screening were collected and tested by VLP-ELISA Metabolism inhibitor and pseudovirus neutralization assay. The results of VLP-ELISA (Fig. 2) showed that trivalent vaccine and monovalent vaccines could induce high level of circulating antibodies against component types. The antibody titers could reach to 4 × 104 to 8 × 104 2 weeks after the third immunization. No statistical differences were observed

between trivalent group and corresponding monovalent groups (P > 0.05 using one-way ANOVA). The type specific antibody level gradually declined with time, but still could remain above 103 for at least 1 year. At week 52, mice were boosted with an extra injection. Two weeks after that, the serum antibodies increased to or exceeded the highest level after previous three injections. To evaluate the protection ability of multivalent vaccines, we tested the in vitro neutralizing antibody titers of the sera collected 14 days after the second and the third injections by pseudovirus neutralization assay. As illustrated in Fig. 3, the neutralizing antibody levels of trivalent and monovalent vaccine immunized groups could reach to

2 × 103 to 104 after the second injection and 104 to 2.5 × 105 after the third injection, respectively. Different from the results of ELISA, we observed that there were significant differences between the anti-HPV 58 neutralizing antibody levels of trivalent group and HPV 58 monovalent group (P < 0.05, using Rolziracetam one-way ANOVA) after the second injection ( Fig. 3A), and also between the anti-HPV 18 neutralizing antibody levels of trivalent group and HPV 18 monovalent group (P < 0.05, using one-way ANOVA) after the third injection ( Fig. 3B). To analyze the differences between groups more intensively, we also compared percent infection inhibition of sera after second and third injections at dilutions of 1:10,000 and 1:50,000, respectively. At 1:10,000 dilution, the HPV 18 pseudovirus infection inhibition of trivalent group was significantly lower than that of HPV 18 L1 monovalent group ( Fig.

In special circumstances like the DPT-hepatitis B-Hib vaccine issue, the ACCD requests

external technical assistance to inform recommendations. WHO, for instance, was invited to carry out an independent assessment of causality in the DPT-hepatitis B-Hib and rubella vaccine incidents. The WHO assessment provided an unbiased, second opinion for the Committee to consider. The Committee discussed the findings from both the Expert Committee on AEFI and the WHO assessments – both of which found no conclusive evidence that the DPT-hepatitis B-Hib vaccine caused the deaths – before recommending that the NPI reintroduce the vaccine. Though the decision was not unanimous, the discussions that took place between the Expert Committee on AEFI and WHO further strengthened the capacity of the ACCD to arrive at practical, evidence-based conclusions regarding the future course of action for this vaccine. A similar process was used to respond to the rubella incident, learn more which helped the ACCD to counter the widely held belief among the public

and health worker trade unions that it was not anaphylaxis but the inferior quality of the vaccine that caused the death of the child. The ACCD can also recommend health system improvements that will help ensure the success of immunization and other disease control measures. As demonstrated during the DPT-hepatitis B-Hib incident, one INCB018424 mouse drawback in investigating deaths among vaccine recipients in Sri Lanka was the absence of a definitive cause of death, even for deaths in which post mortems had been performed. This was attributed to the fact that Judicial Medical Officers (JMOs), forensic experts who perform autopsies and determine cause of death in homicide cases, conducted these post mortems, but had not been trained to look for pathological causes. The ACCD was able to rectify this by mandating that consultant JMOs use a standardized autopsy protocol when conducting post mortem examinations of all deaths suspected to be immunization-related. A summary of the data required and questions to be answered before the ACCD makes a recommendation about a new vaccine is shown in Fig. 2. To TCL formulate policy recommendations regarding the

introduction of new vaccines, the ACCD requests a set of data from the Epidemiology Unit. The Unit then appoints a working group, consisting of experts from Ministry of Health agencies, major hospitals, universities and the private sector, to help gather and analyze relevant data concerning the disease and vaccine in question. The Epidemiology Unit may also request technical or financial support from international partners for the collection or analysis of data, in the form of, for instance, an expert, such as a health economist, financing to conduct a local clinical trial, or laboratory training for surveillance studies. The compilation of data on the burden of the disease in question in Sri Lanka is a necessity before the ACCD can approve the introduction of any new vaccine.

This result suggests that apart from resistance selleck products due to carbapenemase producing genes in A. baumanii isolates, some other mechanisms also works for carbapenem resistance which may be efflux overexpression or membrane impermability. Current study had a limitation of not evaluating the reasons for differences observed in phenotypic and gentotypic resistance in MDR A. baumanii and need further evaluation of these strains. The concern over pan drug resistant bacteria warrants surveillance on a large scale and need of newer antibiotics. The antimicrobial susceptibility trend of novel Antibiotic

Adjuvant Entity, Elores revealed that it was the most active antibiotic on majority of carbapenemase producing A. baumannii strains isolated from the lower respiratory tract (LRTI) specially catheter based infections which might be due to formation of biofilm disruption by Elores. 25 On the other hand, the rates of reduced susceptibility to multidrug resistant carbapenemase producing A. baumanii were observed

in catheter based LRTI infection more often of intermediate susceptibility or resistant to penems, piperacillin plus tazobactam and colistin than Temozolomide in vitro meningitis, sepsis and other infections. The enhanced susceptibility of ceftriaxone plus disodium edetate plus sulbactam (Elores) against A. baumannii is likely to be associated with synergistic activity of ceftriaxone plus sulbactam plus disodium edetate. Disodium edentate, a non antibiotic adjuvant, present in Elores chelates the divalent metal ions particularly zinc thus de-activating the carbapenemase and enhancing activity against carbapenemase producing organisms synergistically. Parvulin We observed that none of the isolates was found to be susceptible to beta-lactam and beta-lactamase inhibitor combination. Our results revealed that penems (doripenem, imipenem and meropenem) exhibited alarmingly high (71–91%) resistant to carbapenemase producing A. baumannii isolates which was similar to a study conducted by Muthusamy and Boppe 6 who demonstrated imipenem and meropenem resistance to be approximately 100% in A. baumannii.

The major findings of the study were that the overall prevalence of Acinetobacter, including multidrug resistant carbapenemase producing Acinetobacter strains, increased during the study period and is associated with substantial morbidity and mortality due to frequent treatment failures. Newer options like novel antibiotic adjuvant entity Elores appeared promising safer solution in comparison to colistin (a known toxic agent). However, this study had a few limitations like data could not be correlated to the patient age and other complications. We conclude that the incidence of high rates of resistance and reduced susceptibility to penems and piperacillin plus tazobactam is alarming high and is continuously increasing and spreading.

Its sensitivity and specificity is higher than other screening questionnaires for neuropathic pain, including the Douleur Neuropathique 4 (DN4), Leeds Assessment of Neuropathic Symptoms and Signs (LANNS), and the Neuropathic Pain Questionnaire (NPQ) (Freynhagen et al 2006). The painDETECT questionnaire has been used to identify neuropathic pain in patients with knee osteoarthritis (Ohtori et al 2012) and to identify sensory profiles in patients with diabetic neuropathy and postherpetic neuralgia (Baron et al 2009). However, further research is needed to demonstrate its clinimetric properties in these conditions. The painDETECT questionnaire,

in either the electronic or paper format, is a useful AZD6244 cost tool Docetaxel for clinicians, to screen for neuropathic pain in patients with low back pain and aid in patient management. Screening tools should not replace clinical judgment but can alert clinicians of neuropathic pain that may need further diagnostic evaluation. “
“The Work Instability Scale (RA-WIS) is a 23-item self-report questionnaire developed in 2003

to assess risk of work instability in people with rheumatoid arthritis (Gilworth et al 2003). Work instability was defined as a mismatch between an individual’s functional ability and his/her work tasks that place the individual at risk for work disability (lowered productivity/premature job loss, etc). Although the RA-WIS was originally developed to measure work instability in people diagnosed with rheumatoid arthritis, it has subsequently been validated for other musculoskeletal disorders (Roy ADP ribosylation factor et al 2011). It has 23 items with a dichotomous response option of yes/no, dealing with the daily demands of work. It has no subscales.

Instructions to client and scoring: Patients are asked to read the question and answer in terms of yes/no only; it is scored by counting the number of Yes responses. The total score ranges from 0 to 23 with a higher score indicating great work instability. The WIS results can be classified into three categories indicating the risk of work instability, low (less than 10), medium (10–17), and high (above 17). Clinical measurement properties: The RA-WIS has been found to be reliable,valid, and responsive in people with rheumatoid arthritis ( Gilworth et al 2003), osteoarthritis ( Tang et al 2011), and with work related upper extremity disorders ( Tang et al 2009). It has exhibited unidimensionality in both RA and OA populations ( Williams et al 2007, Roy et al 2011). Reliability: It has demonstrated high internal consistency (0.92) and test-retest reliability (0.89) in workers with arthritis ( Beaton et al 2010). Gilworth et al 2003 also found RA-WIS to exhibit excellent test-retest reliability in RA patients (Spearman’s rho = 0.89).