Occupational therapy interventions for adults with rheumatoid arthritis: an appraisal of the evidence.

This article identifies and critically appraises six systematic reviews published from 2007 to 2013 that assessed the efficacy of interventions used by occupational therapists for adults with rheumatoid arthritis. Results suggest there is sufficient evidence to support the use of therapeutic exercise, patient education through joint protection, and splinting for pain, inflammation, and grip strength but insufficient evidence to support the use of Tai Chi. To help guide clinical practice, future studies need to focus on the appropriate levels of intensity and combinations of therapeutic exercise, effective use of splinting, efficacy of specific education programs, and the use of Tai Chi as these relate to important patient outcomes.

Quantitative analysis of influenza virus RNP interaction with RNA cap structures and comparison to human cap binding protein eIF4E.

Influenza virus polymerase uses capped RNA primers for transcription initiation in infected cells. This unique mechanism involves the specific binding of the polymerase to capped mRNA precursors in the nucleus of infected cells. These host RNAs are then cleaved by a polymerase associated endonuclease at a position 10-15 nucleotides downstream of the cap structure. The resulting capped RNA oligonucleotides function as primers for transcription initiation. The viral cap binding site has previously been mapped to the PB2 subunit of the trimeric influenza polymerase complex. We have established a quantitative assay system for the analysis of cap interaction with PB2 as part of the native, viral ribonucleoprotein complex (RNP) using a specific UV cross-linking approach. Cap binding was not affected by the RNase pretreatment of the capped RNA substrate and cap binding was not inhibited by excess uncapped RNA, indicating that under the assay conditions, the majority of the binding energy was contributed by the interaction with the cap structure. Binding to 7-methyl-GTP was found to involve synergistic interaction with 7-methyl guanosine and triphosphate binding subsites. A similar mode of interaction with 7-methyl-GTP was found for human cap binding protein eIF4E. However, the potency of 7-methyl-GTP for cap binding inhibition was 200-fold stronger with eIF4E and had a higher contribution from the triphosphate moiety as compared to influenza RNP. Due to this difference in cap subsite interaction, it was possible to identify novel cap analogues, which selectively interact with influenza virus, but not human cap binding protein.