The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of ≤1 on the patient global assessment (PGA, 0-10 scale). We explored the relation ...between the PGA criterion and the patient's clinical disease state in an observational dataset.
Data of 512 newly diagnosed RA patients of the Dutch Rheumatoid Arthritis Monitoring (DREAM) remission induction cohort were analysed. Both 28-joint counts and more comprehensive joint counts (tender joint count-53, swollen joint count-44) were used.
ACR/EULAR remission was present in 20.1% of the patients when using 28-joint counts and in 17.4% of the patients when applying more comprehensive joint counts. In 108 patients, the PGA score was >1 despite fulfilment of the remaining criteria (TJC28, SJC28 and CRP in mg/dl ≤1). Residual disease activity was observed in 31.5% (34/108) and median (interquartile range) scores on PGA, pain and fatigue were 2.4 (1.8-4.0), 2.0 (1.1-3.0) and 2.7 (1.3-5.0), respectively. Applying more comprehensive joint counts showed comparable results. In 19.5% (100/512) of patients, disease activity was absent (TJC53 = 0, SJC44 = 0, and CRP ≤1). In 41% (n = 41) of these patients, the PGA score was >1. Receiver operating characteristic analysis showed moderate accuracy of the PGA to discriminate between fulfilment and no fulfilment of all remaining criteria.
Frequently, patients did not meet the PGA criterion despite a good clinical disease state. Apparently the PGA is not solely influenced by RA disease activity. In patients with marked divergence between the PGA and objective clinical measurements, caution should be taken when applying the provisional ACR/EULAR definition of remission.
Quantifying lymphocyte vacuolization in peripheral blood smears (PBSs) serves as a measure for disease severity in CLN3 disease—a lysosomal storage disorder of childhood‐onset. However, thus far ...quantification methods are based on labor‐intensive manual assessment of PBSs. As machine learning techniques like convolutional neural networks (CNNs) have been deployed quite successfully in detecting pathological features in PBSs, we explored whether these techniques could be utilized to automate quantification of lymphocyte vacuolization. Here, we present and validate a deep learning pipeline that automates quantification of lymphocyte vacuolization. By using two CNNs in succession, trained for cytoplasm‐segmentation and vacuolization‐detection, respectively, we obtained an excellent correlation with manual quantification of lymphocyte vacuolization (r = 0.98, n = 40). These results show that CNNs can be utilized to automate the otherwise cumbersome task of manually quantifying lymphocyte vacuolization, thereby aiding prompt clinical decisions in relation to CLN3 disease, and potentially beyond.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Using the 1.32
pb
-
1
statistics collected at the
J
/
ψ
peak with the KEDR detector at the VEPP-4M
e
+
e
-
collider, we measured the branching fractions of
J
/
ψ
meson decays to the final states 2(
π
...+
π
-
)
π
0
,
K
+
K
-
π
+
π
-
π
0
, 2(
π
+
π
-
)
and
K
+
K
-
π
+
π
-
. The results obtained for the decays
J
/
ψ
→
2(
π
+
π
-
)
π
0
,
J
/
ψ
→
K
+
K
-
π
+
π
-
π
0
contradict the measurements performed by other groups in the last century, but agree well with recent results of BABAR and BESIII collaborations.
Objective
Treat‐to‐target (T2T) leads to improved clinical outcomes in early rheumatoid arthritis (RA). The question is whether these results sustain in the long term. Our objective was to ...investigate the 3‐year results of a protocolized T2T strategy in daily clinical practice.
Methods
In the Dutch Rheumatoid Arthritis Monitoring remission induction cohort, patients newly diagnosed with RA were treated according to a T2T strategy aimed at remission (Disease Activity Score in 28 joints DAS28 <2.6). Patients were treated with methotrexate, followed by the addition of sulfasalazine, and exchange of sulfasalazine with anti–tumor necrosis factor α agents in case of failure. Primary outcomes were disease activity, Health Assessment Questionnaire (HAQ) score, Short Form 36 physical component summary (PCS) and mental component summary (MCS) scores, and the Sharp/van der Heijde score (SHS) after 3 years. Secondary outcomes were sustained DAS28 remission (≥6 months) and remission according to the provisional American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) definition.
Results
After 3 years (n = 342), 61.7% of patients were in DAS28 remission and 25.3% met the provisional ACR/EULAR definition of remission. Sustained remission was experienced by 70.5%, which in the majority was achieved with conventional disease‐modifying antirheumatic drugs only. The median scores were 0.4 (interquartile range IQR 0.0–1.0) for the HAQ, 45.0 (IQR 38.4–53.2) for the PCS, 53.1 (IQR 43.2–60.8) for the MCS, and 6.0 (IQR 3.0–13.0) for the total SHS.
Conclusion
In very early RA, T2T leads to high (sustained) remission rates, improved physical function and health‐related quality of life, and limited radiographic damage after 3 years in daily clinical practice.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract
Using the 1.32
$$\hbox {pb}^{-1}$$
pb
-
1
statistics collected at the
$$J/\psi $$
J
/
ψ
peak with the KEDR detector at the VEPP-4M
$$e^{+}e^{-\, }$$
e
+
e
-
collider, we measured the ...branching fractions of
$$J/\psi $$
J
/
ψ
meson decays to the final states 2(
$$\pi ^{+}\pi ^{-})\pi ^{0}$$
π
+
π
-
)
π
0
,
$$K^{+}K^{-}\pi ^{+}\pi ^{-}\pi ^{0}$$
K
+
K
-
π
+
π
-
π
0
, 2(
$$\pi ^{+}\pi ^{-})$$
π
+
π
-
)
and
$$K^{+}K^{-}\pi ^{+}\pi ^{-}$$
K
+
K
-
π
+
π
-
. The results obtained for the decays
$$J/\psi \rightarrow $$
J
/
ψ
→
2(
$$\pi ^{+}\pi ^{-})\pi ^{0}$$
π
+
π
-
)
π
0
,
$$J/\psi \rightarrow K^{+}K^{-}\pi ^{+}\pi ^{-}\pi ^{0}$$
J
/
ψ
→
K
+
K
-
π
+
π
-
π
0
contradict the measurements performed by other groups in the last century, but agree well with recent results of BABAR and BESIII collaborations.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The electronic width of the
J
/
ψ
meson and its product by the branching fractions of
J
/
ψ
meson decay to hadrons and electrons measured with the KEDR detector at the VEPP-4M
e
+
e
−
collider have ...been reported in ref. 1.
Measurement of Γee(J/ψ) with KEDR detector Anashin, V. V; Aulchenko, V. M; Baldin, E. M ...
The journal of high energy physics,
05/2018, Volume:
2018, Issue:
5
Journal Article
Peer reviewed
Open access
A
bstract
The product of the electronic width of the
J/ψ
meson and the branching fractions of its decay to hadrons and electrons has been measured using the KEDR detector at the VEPP-4M
e
+
e
−
...collider. The obtained values are
Γ
e
e
J
/
ψ
=
5.550
±
0.056
±
0.089
keV
,
Γ
e
e
J
/
ψ
·
ℬ
hadrons
J
/
ψ
=
4.884
±
0.048
±
0.078
keV
,
Γ
e
e
J
/
ψ
·
ℬ
e
e
J
/
ψ
=
0.3331
±
0.0066
±
0.0040
keV
.
The uncertainties shown are statistical and systematic, respectively. Using the result presented and the world-average value of the electronic branching fraction, one obtains the total width of the
J/ψ
meson:
Γ
=
92.94
±
1.83
keV
.
These results are consistent with the previous experiments.
Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in ...youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.
Participants (
= 148; ages 9-18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (
= 25 puberty suppression only;
= 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.
Affirmed males reported greater depression and anxiety at baseline, but these differences were small (
< .01). Youth reported large improvements in body dissatisfaction (
< .001), small to moderate improvements in self-report of depressive symptoms (
< .001), and small improvements in total anxiety symptoms (
< .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.
Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.
Background:Randomised controlled trials (RCTs) evaluating the efficacy of antagonists to tumour necrosis factor α (TNFα) showed high response percentages in the groups treated with active ...drugs.Objective:To compare the efficacy of anti-TNF treatments for rheumatoid arthritis (RA) patients in RCTs and in daily clinical practice, with an emphasis on the efficacy for patients eligible and not eligible for RCTs of anti-TNF treatments.Methods:First, randomised placebo-controlled trials written in English for etanercept, infliximab and adalimumab for patients with RA were selected by a systematic review. Second, the DREAM (Dutch Rheumatoid Arthritis Monitoring) register with patients starting for the first time on one of the TNF-blocking agents was used. Patient characteristics, doses of medication and co-medication as well as the ACR20 response percentages were compared between RCTs and DREAM data, stratified for trial eligibility.Results:In 10 of 11 comparisons, the ACR20 response percentages were lower in daily clinical practice than in the RCT active drug group, which was significant in five of 11 comparisons. Only 34–79% of DREAM patients fulfilled the selection criteria for disease activity in the several RCTs examined. DREAM patients eligible for RCTs had higher response percentages than ineligible DREAM patients. ACR20 response percentages of eligible DREAM patients were comparable with the ACR20 response percentages of the RCT active drug group in 10 of 11 comparisons.Conclusion:The efficacy of TNF-blocking agents in RCTs exceeded the efficacy of these drugs in clinical practice. However, in clinical practice more patients with lower disease activity were treated with TNF-blocking agents compared with those treated in RCTs. For daily practice patients who were eligible for RCTs, responses were more similar to responses reached in RCTs.
The KEDR detector Anashin, V. V.; Aulchenko, V. M.; Baldin, E. M. ...
Physics of particles and nuclei,
07/2013, Volume:
44, Issue:
4
Journal Article
Peer reviewed
The KEDR detector is a universal magnetic detector designed for studying the
c
- and
b
-quarks and two-photon physics, and is employed at the VEPP-4M
e
+
e
−
collider. A specific feature of the ...experiment is the measurement of absolute beam energy using two methods: the resonant depolarization and the faster but less precise Compton backscattering of laser photons. This allowed a large series of measurements to be performed, in which the accuracy of determination of such fundamental parameters of particles as mass and total and leptonic widths was improved.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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