Abstract Upper-arm evaluation including shoulder motion in physiotherapy has no three-dimensional tool for an arm-functioning evaluation, which hampers an uniform, objective comparison. Human ...shoulder complex models suffer from lack of shoulder girdle kinematic data. A kinematic shoulder-complex model with six degrees of freedom is proposed as the composition of the inner joint representing the shoulder-girdle joints and outer joint representing the glenohumeral joint. The outer shoulder joint has three perpendicular rotations: adduction/abduction, retroflexion/flexion and internal/external rotation of the humerus. The inner shoulder joint has two rotations, depression/elevation and retraction/protraction, and one translation, which are all dependent on the elevation angle of the humerus. The human arm-reachable workspace that represents the area within reach of the wrist is calculated on the basis of the shoulder-complex model and the additional elbow-joint direct kinematics. It was demonstrated that cross-sections of the calculated workspace are in agreement with the measured arm-reachable workspace in all three anatomical planes. The arm-reachable workspace volume and graphics were calculated and a comparison of the arm's workspaces during a patient's shoulder treatment was made. The obtained numerical and graphical arm-reachable workspaces can be used for arm-functioning evaluations in rehabilitation and ergonomics.
To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion ...reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA).
Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment.
Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi.
Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi.
Objective
A task force of scientists at the International Congress on Antiphospholipid Antibodies recognized that phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) might contribute to ...a better identification of antiphospholipid syndrome (APS). Accordingly, initial and replication retrospective, cross-sectional multicentre studies were conducted to ascertain the value of aPS/PT for APS diagnosis.
Methods
In the initial study (eight centres, seven countries), clinical/laboratory data were retrospectively collected. Serum/plasma samples were tested for IgG aPS/PT at Inova Diagnostics (Inova) using two ELISA kits. A replication study (five centres, five countries) was carried out afterwards.
Results
In the initial study (n = 247), a moderate agreement between the IgG aPS/PT Inova and MBL ELISA kits was observed (k = 0.598). IgG aPS/PT were more prevalent in APS patients (51%) than in those without (9%), OR 10.8, 95% CI (4.0–29.3), p < 0.0001. Sensitivity, specificity, positive (LR+) and negative (LR–) likelihood ratio of IgG aPS/PT for APS diagnosis were 51%, 91%, 5.9 and 0.5, respectively. In the replication study (n = 214), a moderate/substantial agreement between the IgG aPS/PT results obtained with both ELISA kits was observed (k = 0.630). IgG aPS/PT were more prevalent in APS patients (47%) than in those without (12%), OR 6.4, 95% CI (2.6–16), p < 0.0001. Sensitivity, specificity, LR + and LR– for APS diagnosis were 47%, 88%, 3.9 and 0.6, respectively.
Conclusions
IgG aPS/PT detection is an easily performed laboratory parameter that might contribute to a better and more complete identification of patients with APS.
Increased levels of serum prolactin have been reported in patients with various autoimmune diseases and have been associated with lupus disease activity. Currently, there is a lack of data regarding ...hyperprolactinaemia in patients with the antiphospholipid syndrome. Hence, this study was carried out in order to evaluate the prevalence and clinical significance of hyperprolactinaemia in antiphospholipid syndrome. A total of 172 European patients with antiphospholipid syndrome and 100 geographically and sex-matched healthy controls were included in the study; none had obvious causes of hyperprolactinaemia. All patients underwent clinical assessment for disease manifestations, in addition to laboratory assessment for serum prolactin, antiphospholipid antibodies and some other biomarkers of autoimmune diseases. The tests were performed utilizing the LIAISON® Analyzer (DiaSorin, Sallugia Italy). Hyperprolactinaemia was detected in 21/172 patients with antiphospholipid syndrome and 0/100 controls (p < 0.001). This significant difference was present in both genders and was obvious even after subgrouping the patients into primary and secondary antiphospholipid syndrome. When clinical features were compared, hyperprolactinaemia was associated with reproductive failure, including early and late pregnancy loss (p < 0.05), as well as intrauterine growth retardation (p < 0.05). Hyperprolactinaemia was negatively related to arthralgias, venous thrombosis, pulmonary microthrombosis, pulmonary hypertension in both primary antiphospholipid syndrome and antiphospholipid syndrome secondary to other diseases, and to neurological manifestations in primary antiphospholipid syndrome (p<0.05). The data indirectly imply that prolactin may play a role in the pathogenesis of antiphospholipid syndrome, especially antiphospholipid syndrome-related reproductive failure.
This paper presents the results of a study of 2-dimensional normal zone propagation (NZP) in winding pack models comprised of 12 straight YBCO tapes stacked with wet, i.e., epoxied, insulating ...spacers. In each winding pack, the YBCO tapes were connected electrically in series in such a way that a transport current through the YBCO tapes zigzagged from one end of the winding pack to the other end of the winding pack. An insulated heater strip placed at the middle of the stack was energized to trigger a quench in YBCO tapes with a combination of heater taps which permits the length of the heated section to be varied for 1- or 2-dimensional NZP. Voltage taps of various lengths were placed within the winding packs to measure the transverse and longitudinal NZP speeds. Measurements with wet-spacers in which a large contact thermal resistance at each YBCO tape and spacer interface is chiefly responsible for very slow transverse NZP velocities, effectively eliminate the interface thermal resistance, resulting in faster transverse NZP speeds. Numerical simulation that neglects interface thermal resistance agrees quite well with experiment.
Vapor-solid reactions were applied to monofilament and 6-filament AIMI MgB2 wires. A layer Jc of ∼ 105 A cm−2 was achieved by the generation of a highly dense MgB2 layer after reaction at 625 °C for ...8 to 16 h. It was found that the critical current, Ic, and engineering current density, Je, reached maximum values of 92.3 A and 1.15 × 104 A cm−2 at 4.2 K, 10 T when the multifilament AIMI wire was heat-treated at 625 °C for 14 h. Transport Ics were also measured at 10–20 K for the wire heat-treated at 625 °C for 16 h. Phase formation investigations suggested that even better performance of Ic and Je could be attained in multifilamentary AIMI MgB2 wires after further conductor optimization.
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Background. RA patients have a higher incidence of cardiovascular diseases compared to the general population. Serum amyloid A (SAA) is an acute-phase protein, upregulated in sera of RA patients. ...Aim. To determine the effects of medications on SAA-stimulated human coronary artery endothelial cells (HCAEC). Methods. HCAEC were preincubated for 2 h with medications from sterile ampules (dexamethasone, methotrexate, certolizumab pegol, and etanercept), dissolved in medium (captopril) or DMSO (etoricoxib, rosiglitazone, meloxicam, fluvastatin, and diclofenac). Human recombinant apo-SAA was used to stimulate HCAEC at a final 1000 nM concentration for 24 hours. IL-6, IL-8, sVCAM-1, and PAI-1 were measured by ELISA. The number of viable cells was determined colorimetrically. Results. SAA-stimulated levels of released IL-6, IL-8, and sVCAM-1 from HCAEC were significantly attenuated by methotrexate, fluvastatin, and etoricoxib. Both certolizumab pegol and etanercept significantly decreased PAI-1 by an average of 43%. Rosiglitazone significantly inhibited sVCAM-1 by 58%. Conclusion. We observed marked influence of fluvastatin on lowering cytokine production in SAA-activated HCAEC. Methotrexate showed strong beneficial effects for lowering released Il-6, IL-8, and sVCAM-1. Interesting duality was observed for NSAIDs, with meloxicam exhibiting opposite-trend effects from diclofenac and etoricoxib. This represents unique insight into specific responsiveness of inflammatory-driven HCAEC relevant to atherosclerosis.
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