bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of rate denominator source on US fatal occupational injury rate estimates
Authors: Richardson David , Loomis Dana , Bailer A. John , Bena James
Published: August 2004

Background

The Current Population Survey (CPS) is often used as a source of denominator information for analyses of US fatal occupational injury rates. However, given the relatively small sample size of the CPS, analyses that examine the cross‐classification of occupation or industry with demographic or geographic characteristics will often produce highly imprecise rate estimates. The Decennial Census of Population provides an alternative source for rate denominator information. We investigate the comparability of fatal injury rates derived using these two sources of rate denominator information.

Methods

Information on fatal occupational injuries that occurred between January 1, 1983 and December 31, 1994 was obtained from the National Traumatic Occupational Fatality surveillance system. Annual estimates of employment by occupation, industry, age, and sex were derived from the CPS, and by linear interpolation and extrapolation from the 1980 and 1990 Census of Population. Fatal injury rates derived using these denominator data were compared.

Results

Fatal injury rates calculated using Census‐based denominator data were within 10% of rates calculated using CPS data for all major occupation groups except farming/forestry/fishing, for which the fatal injury rate calculated using Census‐based denominator data was 24.69/100,000 worker‐years and the rate calculated using CPS data was 19.97/100,000 worker‐years. The choice of denominator data source had minimal influence on estimates of trends over calendar time in the fatal injury rates for most major occupation and industry groups.

Conclusions

The Census offers a reasonable source for deriving fatal injury rate denominator data in situations where the CPS does not provide sufficiently precise data, although the Census may underestimate the population‐at‐risk in some industries as a consequence of seasonal variation in employment. Am. J. Ind. Med. 46:261–270, 2004. Published 2004 Wiley‐Liss, Inc.
Screening for beryllium disease among construction trade workers at Department of Energy nuclear sites
Authors: Welch Laura , Ringen Knut , Bingham Eula , Dement John , Takaro Tim , McGowan William , Chen Anna , Quinn Patricia
Published: August 2004

Background

To determine whether current and former construction workers are at significant risk for occupational illnesses from work at the Department of Energy's (DOE) nuclear weapons facilities, screening programs were undertaken at the Hanford Nuclear Reservation, Oak Ridge Reservation, and the Savannah River Site.

Methods

Medical examination for beryllium disease used a medical history and a beryllium blood lymphocyte proliferation test (BeLPT). Stratified and multivariate logistic regression analyses were used to explore the risk of disease by age, race, sex, trade, duration of DOE employment, reported work in buildings where beryllium was used, and time since last DOE site employment.

Results

Of the 3,842 workers included in this study, 34% reported exposure to beryllium. Overall, 2.2% of workers had at least one abnormal BeLPT test, and 1.4% were also abnormal on a second test. Regression analyses demonstrated increased risk of having at least one abnormal BeLPT to be associated with ever working in a site building where beryllium activities had taken place.

Conclusions

The prevalence of beryllium sensitivity and chronic beryllium disease (CBD) in construction workers is described and the positive predictive value of the BeLPT in a population with less intense exposure to beryllium than other populations that have been screened is discussed. The BeLPT findings and finding of cases of CBD demonstrate that some of these workers had significant exposure, most likely, during maintenance, repair, renovation, or demolition in facilities where beryllium was used. Am. J. Ind. Med. 46:207–218, 2004. © 2004 Wiley‐Liss, Inc.
Effects of data limitations when modeling fatal occupational injury rates
Authors: Bena James F. , Bailer A. John , Loomis Dana , Richardson David , Marshall Steve
Published: August 2004

Background

Occupational fatal injury rate studies are often based upon uncertain and variable data. The numerator in rate calculations is often obtained from surveillance systems that can understate the true number of deaths. Worker‐years, the denominator in many occupational rate calculations, are frequently estimated from sources that exhibit different amounts of variability.

Methods

Effects of these data limitations on analyses of trends in occupational fatal injuries were studied using computer simulation. Fatality counts were generated assuming an undercount. Employment estimates were produced using two different strategies, reflecting either frequent but variable measurements or infrequent, precise estimates with interpolated estimates for intervening years. Poisson regression models were fit to the generated data. A range of empirically motivated fatality rate and employment parameters were studied.

Results

Undercounting fatalities resulted in biased estimation of the intercept in the Poisson regression model. Relative bias in the trend estimate was near zero for most situations, but increased when a change in fatality undercounting over time was present. Biases for both the intercept and trend were larger when small employment populations were present. Denominator options resulted in similar rate and trend estimates, except where the interpolated method did not capture true trends in employment.

Conclusions

Data quality issues such as consistency of conditions throughout the study period and the size of population being studied affect the size of the bias in parameter estimation. Am. J. Ind. Med. 46:271–283, 2004. Published 2004 Wiley‐Liss, Inc.
Upper extremity pain and computer use among engineering graduate students
Authors: Schlossberg Eric B. , Morrow Sandra , Llosa Augusto E. , Mamary Edward , Dietrich Peter , Rempel David M.
Published: August 2004

Background

The objective of this study was to investigate risk factors associated with persistent or recurrent upper extremity and neck pain among engineering graduate students.

Methods

A random sample of 206 Electrical Engineering and Computer Science (EECS) graduate students at a large public university completed an online questionnaire.

Results

Approximately 60% of respondents reported upper extremity or neck pain attributed to computer use and reported a mean pain severity score of 4.5 (±2.2; scale 0–10). In a final logistic regression model, female gender, years of computer use, and hours of computer use per week were significantly associated with pain.

Conclusions

The high prevalence of upper extremity pain reported by graduate students suggests a public health need to identify interventions that will reduce symptom severity and prevent impairment. Am. J. Ind. Med. 46:297–303, 2004. © 2004 Wiley‐Liss, Inc.
Varying loads of the mitochondrial DNA A3243G mutation in different tissues: Implications for diagnosis
Authors: Shanske Sara , Pancrudo Jacklyn , Kaufmann Petra , Engelstad Kristin , Jhung Sarah , Lu Jiesheng , Naini Ali , DiMauro Salvatore , De Vivo Darryl C.
Published: August 2004

Testing for common mutations in mitochondrial DNA (mtDNA), including the A3243G MELAS (mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes) mutation, is routinely done in DNA isolated from blood. Since the blood level of the A3243G mutation may be low in probands and even lower in asymptomatic or oligosymptomatic maternal relatives, we assessed the proportion of A3243G mutant genomes in other accessible tissues. We studied five tissues (leukocytes, skin fibroblasts, hair roots, urinary sediment, and cheek mucosa) in 61 individuals from 22 families harboring the A3243G mutation. Although mutational loads varied widely among these tissues, as a rule DNA from urinary sediment had the highest and blood the lowest proportion of mutant genomes; individual hair roots differed markedly from one another; fibroblasts and cheek mucosa tended to have higher mutation loads than blood but lower than urinary sediment. In all individuals in whom the mutation was detectable in blood, it was also detected in other tissues. Conversely, in some individuals the mutation was undetectable in blood but clearly present in other tissues. We conclude that urinary sediment and cheek mucosa are tissues of choice for the diagnosis of mtDNA mutations, as they are easy to obtain and the mutation load is almost always greater than in blood. © 2004 Wiley‐Liss, Inc.
Diagnostic differences in mandibular P4 shape between Neandertals and anatomically modern humans
Authors: Bailey Shara E. , Lynch John M.
Published: August 2004

This study uses elliptical Fourier analysis to quantify shape differences observed in the P4 crown of Neandertals and anatomically modern humans. Previously, P4 shape was assessed qualitatively, and results suggested marked differences between Neandertals and anatomically modern humans (Bailey [2002] New Anat. 269:148–156). The goal of this study was to investigate the P4 shape in more detail, quantifying it in order to determine its utility for taxonomic classification and phylogenetic analysis. A comparison of mean shapes confirms that the mesiolingual portion of the P4 is truncated in Neandertals, and that this produces a distinctively asymmetrical P4. A randomization test confirms that the shape difference between Neandertals and anatomically modern humans is significant. Principal component and discriminant function analyses indicate that the relative size of the lingual portion of the tooth also affects tooth shape, with the lingual portion of the Neandertal P4 being narrower than that of anatomically modern humans. Classification of P4 crown shapes using discriminant functions analysis is far from perfect. While 86.4% of the teeth were correctly classified, classification was much better for anatomically modern humans (98.1%) than it was for Neandertals (65%). Fortunately, crown shape is but one of several diagnostic characters of the P4 crown. P4 crown asymmetry can be added to the growing list of dental morphological characters distinguishing Neandertals from anatomically modern humans. Moreover, based on a comparison of mean tooth shapes in fossil and recent humans, symmetry, rather than asymmetry, appears to be the primitive state, and the high frequency of P4 asymmetry is likely derived in Neandertals. Am J Phys Anthropol, 2004. © 2004 Wiley‐Liss, Inc.
Cover Picture: Phosphorus Nanorods—Two Allotropic Modifications of a Long‐Known Element (Angew. Chem. Int. Ed. 32/2004)
Authors: Pfitzner Arno , Bräu Michael F. , Zweck Josef , Brunklaus Gunther , Eckert Hellmut
Published: August 2004

Alternatives to the structure of Hittorf phosphorus were predicted a few years ago, and these have now been confirmed experimentally as phosphorus nanorods. A. Pfitzner, H. Eckert, and co‐workers report on page 4228 ff. that these new allotropic forms of phosphorus can be isolated from the adduct compounds (CuI)8P12 and (CuI)3P12 by extraction with an aqueous cyanide solution. The nanorods have been characterized by high‐resolution TEM and 31P magic‐angle spinning NMR spectroscopy.
Prediction of molecular weight distribution of cellulose by using the rheological method
Authors: Zhang Huihui , Zhang Yaopeng , Shao Huili , Hu Xuechao
Published: August 2004

In this article, a rheological method that can predict the molecular weight distribution (MWD) of polymer was introduced. Using this method, the MWDs of four cellulose samples were compared from rheological data of the cellulose / N‐methyl morpholine N‐oxide (NMMO) / H2O solutions. The MWDs of cellulose also were determined by gel permeation chromatography (GPC) calibrated with narrow distribution polystyrene standards, using 0.5% lithium chloride (LiCl) in N,N‐dimethylacetamide (DMAc) as the eluent. Comparison of the results from rheology and GPC showed that the MW and MWD of cellulose could be roughly inferred from their rheological data. Although the differential MWD obtained from the rheological method was bell shaped and can not reflect the fine characteristics of cellulose as GPC, it may be feasible to compare the MWDs of cellulose by using the rheological method. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 598–603, 2004
Synthesis and antimicrobial activities of new water‐soluble bis‐quaternary ammonium methacrylate polymers
Authors: Dizman Bekir , Elasri Mohamed O. , Mathias Lon J.
Published: August 2004

New methacrylate monomers containing pendant quaternary ammonium moieties based on 1,4‐diazabicyclo‐[2.2.2]‐octane (DABCO) were synthesized. The DABCO group contains either a butyl or a hexyl pendant group comprising the hydrophobic segment of the monomers and one tether group to the methacrylate moiety. The monomers were homopolymerized in water by using 2,2′‐azobis(2‐methylpropionamide) dihydrochloride (V‐50) as an initiator. The monomers and polymers were characterized by elemental analysis, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), FTIR, and 13C‐NMR. The antimicrobial activities of the corresponding small molecules (bis‐quaternary ammonium monocarboxylates) and polymers were investigated against Staphylococcus aureus and Escherichia coli. Although the small molecules did not show any antimicrobial activity, the polymers were moderately effective against both Gram‐positive and Gram‐negative bacteria. The minimum inhibitory concentration (MIC) values of the polymers with butyl and hexyl hydrocarbon chains against S. aureus and E. coli were found to be 250 and 62.5 μg/mL, respectively. The minimum bactericidal concentration (MBC) value for the polymer with the butyl group was higher than 1 mg/mL, whereas the MBC value for the polymer with hexyl group was found to be 62.5 μg/mL. Thus, an increase of the alkyl chain length from 4 to 6 significantly increased the antimicrobial activity of the polymer. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 635–642, 2004
Enhanced drug uptake and retention by surface phosporylated polyvinyl alcohol
Authors: Sreenivasan K.
Published: August 2004

Polyvinyl alcohol (PVA) is one of the widely used synthetic polymers for a variety of medical applications. Surface modification of polymers is often used to improve the surface‐mediated interactions with the bioenvironment. When phosphate groups are introduced onto the surface of PVA, the modification enhances the hydrophilicity of the polymer. A severalfold enhancement in the extent of uptake of antibacterial drugs such as ampicillin occurs as a result of the phosphorylation. It is also found that drug retention is prolonged significantly by the modification process. Interestingly, the modification did not alter bulk features like the crystallinity of the PVA. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 651–656, 2004
Preparation of aqueous anionic poly‐(urethane‐urea) dispersions: Influence of the nature and proportion of the urethane groups on the dispersion and polymer properties
Authors: Durrieu Vanessa , Gandini Alessandro , Belgacem Mohamed Naceur , Blayo Anne , Eiselé Gilles , Putaux Jean‐Luc
Published: August 2004

Aqueous poly(urethane‐urea) dispersions were prepared by the prepolymer mixing technique without the use of any organic solvent. Most of the work focused on the use of two aliphatic diisocyanates (α,α, α', α'‐tetramethyl‐1,3‐xylylene diisocyanate and isophorone diisocyanate) and two macrodiols (α,ω‐poly(propylene glycol) (Mn = 1000) and α,ω‐poly(caprolactone) (Mn = 530)) in conjunction with a fixed proportion of emulsifying agent (dimethylol propionic acid, neutralized with triethyl amine) and the same chain extender (1,2‐ethylene diamine). The properties of both the dispersions and the dried polymer films, as well as those of some model prepolymers, were characterized as a function of the initial composition to establish criteria leading to the optimized performance in terms of dispersion stability and particle size and polymer properties. The most important parameter in this search was found to be the [NCO]/[OH] ratio, which gave the best results when it approached a value of 2. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 700–710, 2004
Thermal properties and rheological behavior of biodegradable aliphatic polycarbonate derived from carbon dioxide and propylene oxide
Authors: Li X. H. , Meng Y. Z. , Chen G. Q. , Li R. K. Y.
Published: August 2004

Alternating poly(propylene carbonate)s (PPCs) were synthesized from carbon dioxide and propylene oxide on a relatively larger scale. The thermal properties of the alternating PPC copolymers, with various molecular weights, were investigated with modulated differential scanning calorimetry (MDSC) and thermogravimetric analysis (TGA). The melt‐flow indices of the as‐made PPCs were determined in a melt‐flow indexer, and the rheological properties of the PPCs were studied with a capillary rheometer. The MDSC and TGA results showed that the glass‐transition temperatures of the PPCs increased with increasing molecular weight. The rheological measurements revealed that the PPCs exhibited pseudoplastic flow behavior in the melt. The molecular weight played a key role in the rheological behavior of the PPCs. Moreover, the PPCs with high molecular weights were more sensitive to the temperature and shear rate than those with low molecular weights. The melt viscosity of the PPCs with low molecular weights decreased dramatically with increasing temperature. The flow activation energy of such PPCs diminished with an increase in the shear rate, whereas the flow activation energy of the PPCs with high molecular weights remained nearly unchanged. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 711–716, 2004
Development of a fixed‐bed column with cellulose/chitin beads to remove heavy‐metal ions
Authors: Zhou Dao , Zhang Lina , Zhou Jinping , Guo Shenlian
Published: August 2004

Environmental friendly cellulose/chitin beads, having relatively high mechanical properties, were successfully prepared from a blend of cellulose and chitin in 6 wt % NaOH/5 wt % thiourea aqueous solution by coagulating with 5% H2SO4 aqueous solution. The ability of the beads to adsorb Pb2+ in an aqueous solution was measured with a fixed‐bed column. The effects of important parameters, to design an adsorption column of the cellulose/chitin beads for fixed‐bed columns, were investigated. The breakthrough curves for the adsorption behavior indicated that the column performance was improved with decreasing initial lead concentration, ionic strength, flow velocity or bead size, as well as increasing pH dependence and bed height. Column studies showed that constants, calculated from the experimental data, and the Bed Depth Service Time (BDST) model had a good correlation. The columns were easily regenerated by treating with 0.1 mol/L HCl aqueous solution after the adsorption of metals, providing a simple and economical method for removal and recovery of heavy metals. After four adsorption–desorption cycles, the efficiency of column for the removal of lead was not significantly reduced (not more than 5%). It is shown that heavy‐metal biosorption processes in fixed‐bed columns could give a broad range of potential industrial applications. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 684–691, 2004
Age‐Related mineralization heterogeneity changes in trabecular bone of the proximal femur
Authors: Bloebaum Roy D. , Lundeen Gregg A. , Shea Jill E. , Whitaker Erin L.
Published: August 2004

Although there is extensive documentation in the literature regarding the importance of trabecular bone for proximal femoral integrity and fracture resistance, there remain gaps in our understanding of the basic mineral changes that may occur in trabecular bone attributable to aging. It is unclear what age‐related changes take place in the trabecular bone of the proximal femur, a common fracture site in the elderly. It has been suggested that some explanation for conflicting reports on cancellous bone may be found at a microscopic level. The goal of this study was to document age‐related changes in micromineralization in the proximal femur of Caucasian females using backscattered electron imaging technology. Proximal femurs were obtained from 11 young and 11 elderly females. Sections of bone from the superior and inferior neck and superior and inferior trochanter were analyzed in a scanning electron microscope using the backscatter technique to determine ash percent. Mean ash percent did not change with age in any of the four regions (P > 0.05). However, while the mean ash percent did not change, there was a dramatic increase in variability elderly age group and loss of mineral heterogeneity. This indicates that there are subpopulations with higher or lower ash percents than the mean in the elderly study group in this investigation. While variance changed dramatically, variance within individuals did not change significantly with age (P > 0.05). The results of this study suggest that changes in micromineralization may occur within an individual, adding a possible new dimension to our understanding of fracture risk in the elderly. Future studies should examine a longer population base to confirm this observation. Published 2004 Wiley‐Liss, Inc.
A new marker for osteoarthritis: Cross‐sectional and longitudinal approach
Authors: Reijman M. , Hazes J. M. W. , Bierma‐Zeinstra S. M. A. , Koes B. W. , Christgau S. , Christiansen C. , Uitterlinden A. G. , Pols H. A. P.
Published: August 2004

Objective

To investigate the association between urinary concentrations of C‐telopeptide fragments of type II collagen (CTX‐II) and the prevalence and progression of radiographic osteoarthritis (OA) of the knee and hip.

Methods

The study population consisted of a sample of 1,235 men and women ages ≥55 years who were enrolled in the Rotterdam Study (a population‐based cohort study) and who were followed up for a mean of 6.6 years. Prevalent radiographic OA was defined as a Kellgren/Lawrence score ≥2; progression of radiographic OA was defined as a decrease in joint space width.

Results

Subjects with a CTX‐II level in the highest quartile had a 4.2‐fold increased risk of having radiographic OA of the knee (95% confidence interval [95% CI] 2.5–7.0) and of the hip (95% CI 2.2–7.8) compared with subjects with a CTX‐II level in the lowest quartile. We observed a substantially stronger association between CTX‐II levels and radiographic OA for subjects with hip pain (odds ratio [OR] 20.4, 95% CI 2.3–185.2) than for those without hip pain (OR 3.0, 95% CI 1.5–6.0). Subjects with a CTX‐II level in the highest quartile had a 6.0‐fold increased risk for progression of radiographic OA at the knee (95% CI 1.2–30.8) and an 8.4‐fold increased risk for progression of radiographic OA at the hip (95% CI 1.0–72.9). All of these associations were found to be independent of known risk factors for OA, such as age, sex, and body mass index.

Conclusion

This study shows that CTX‐II is associated with both the prevalence and the progression of radiographic OA at the knee and hip. Importantly, this association is independent of known clinical risk factors for OA and seems stronger in subjects with joint pain.
Induction of interleukin‐1 in articular cartilage by explantation and cutting
Authors: Gruber Johann , Vincent Tonia L. , Hermansson Monika , Bolton Mark , Wait Robin , Saklatvala Jeremy
Published: August 2004

Objective

To investigate the effect of explantation and fine cutting of articular cartilage upon intracellular inflammatory signaling pathways and expression of interleukin‐1 (IL‐1).

Methods

Cartilage from porcine metacarpophalangeal joints was cultured in serum‐free medium. Tissue extracts were examined for ERK activation by phosphorylated–Western blotting, for JNK and p38 MAPK activity by kinase assay, and for IκBα. IL‐1α and IL‐1β messenger RNA (mRNA) was measured by reverse transcriptase–polymerase chain reaction. IL‐1 activity was measured by the induction of serum amyloid A protein in cultured chondrocytes.

Results

All 3 MAPKs (p38, JNK, and ERK) were rapidly activated upon dissection and explantation of the cartilage. IL‐1α and IL‐1β mRNA was also induced: the speed and magnitude of induction were increased if the explants had been finely cut. IL‐1 activity that could be inhibited by IL‐1 receptor antagonist or antibodies to IL‐1α was found in extracts of explants cultured for 20 hours or lysates of cells isolated from them. This activity was likely due to intracellular proIL‐1α that was not secreted. ProIL‐1β would not be detected because it is biologically inactive. The mechanism of inflammatory signaling pathway activation underlying the induction of IL‐1 is unknown.

Conclusion

Explantation and cutting of articular cartilage activates intracellular inflammatory signaling pathways and induces expression of mRNA for IL‐1α and IL‐1β. Biologically active IL‐1α protein was detectable in cartilage lysates and was probably intracellular proIL‐1α. We were unable to show that IL‐1 was secreted by chondrocytes.
The prototypic tissue pentraxin PTX3, in contrast to the short pentraxin serum amyloid P, inhibits phagocytosis of late apoptotic neutrophils by macrophages
Authors: van Rossum André P. , Fazzini Fausto , Limburg Pieter C. , Manfredi Angelo A. , Rovere‐Querini Patrizia , Mantovani Alberto , Kallenberg Cees G. M.
Published: August 2004

Objective

Phagocytosis of apoptotic cells can be facilitated by complement components and short pentraxins, such as serum amyloid P (SAP). In contrast, the long pentraxin PTX3 was shown to inhibit phagocytosis of apoptotic Jurkat cells by dendritic cells and to bind late apoptotic polymorphonuclear leukocytes (PMNs). Recently, levels of the pentraxin PTX3 were shown to parallel disease activity in small‐vessel vasculitis, which is often characterized by leukocytoclasia, a persistence of leukocyte remnants in the vessel wall. We undertook this study to test our hypothesis that PTX3 inhibits phagocytosis of late apoptotic PMNs by macrophages, thereby leading to their accumulation in the vessel wall.

Methods

Macrophages were allowed to phagocytose late apoptotic or secondary necrotic PMNs that were incubated with or without PTX3 for 30 minutes prior to phagocytosis. Phagocytosis was allowed to occur in the presence of 30% normal human serum with or without SAP and with or without depletion of complement. To discriminate between an inhibitory effect of PTX3 on binding and the internalization of apoptotic PMNs into macrophages, internalization was blocked by cytochalasin B.

Results

SAP and complement were both necessary for effective in vitro phagocytosis. In contrast, PTX3 inhibited phagocytosis in a dose‐dependent manner, from 11% inhibition at 6.25 μg/ml to almost complete inhibition at 100 μg/ml. Furthermore, PTX3 partly affected binding of apoptotic PMNs to macrophages.

Conclusion

PTX3, in contrast to SAP and complement, inhibits phagocytosis of late apoptotic PMNs by monocyte‐derived macrophages in a dose‐dependent manner. Therefore, PTX3 can play a role in the development of leukocytoclasia by affecting the clearance of apoptotic PMNs, thereby inducing their accumulation in the vessel wall.
Shedding of mutant tumor necrosis factor receptor superfamily 1A associated with tumor necrosis factor receptor–associated periodic syndrome: Differences between cell types
Authors: Huggins Mary L. , Radford Paul M. , McIntosh Richard S. , Bainbridge Susan E. , Dickinson Peter , Draper‐Morgan Kelly‐Ann , Tighe Patrick J. , Powell Richard J. , Todd Ian
Published: August 2004

Objective

To investigate the effect of mutations in tumor necrosis factor receptor superfamily 1A (TNFRSF1A) on the ability of the receptors to be cleaved from the cell surface upon stimulation. The mutations we studied are associated with clinically distinct forms of TNF receptor–associated periodic syndrome (TRAPS). We also investigated different cell types within the same form of TRAPS.

Methods

The shedding of TNFRSF1A in response to stimulation with phorbol myristate acetate was assessed in leukocytes and dermal fibroblasts from patients with C33Y TRAPS, and in HEK 293 cell lines stably transfected with constructs containing wild‐type TNFRSF1A and/or TNFRSF1A mutants identified in TRAPS patients.

Results

The shedding of TNFRSF1A differed between cell types within the same form of TRAPS. In particular, dermal fibroblasts, but not leukocytes, from C33Y TRAPS patients demonstrated reduced shedding of TNFRSF1A. Shedding of both wild‐type and mutant TNFRSF1A from the transfected HEK 293 cells showed minor differences, but was in all cases induced to a substantial extent.

Conclusion

Differences in TNFRSF1A shedding are not purely a function of the TNFRSF1A structure, but are also influenced by other features of genetic makeup and/or cellular differentiation. It is unlikely that a defect in TNFRSF1A shedding per se can fully explain the clinical features that are common to TRAPS patients with different TNFRSF1A mutations.
Central role of complement membrane attack complex in monosodium urate crystal–induced neutrophilic rabbit knee synovitis
Authors: Tramontini Nicole , Huber Colleen , Liu‐Bryan Ru , Terkeltaub Robert A. , Kilgore Kenneth S.
Published: August 2004

Objective

Monosodium urate monohydrate (MSU) crystals promote gouty inflammation that is critically mediated by neutrophil recruitment and activation. Interleukin‐8 (IL‐8) and closely related chemokines are major neutrophil chemotaxins in experimental gout. But MSU crystals also activate the classical and alternative pathways of complement, and MSU crystals directly cleave C5 on the crystal surface. Unlike IL‐8, the roles in acute gout of individual complement‐derived peptides and of the terminal C5b–9 complement components that comprise the membrane attack complex (MAC) are unclear. Hence, we studied rabbits deficient in the MAC component C6 to determine if MAC mediated urate crystal–induced arthritis.

Methods

We injected C6‐deficient and C6‐sufficient rabbit knee joints with 10 mg of pyrogen‐free urate crystals and analyzed IL‐8 levels, leukocyte influx, and joint inflammation 24 hours later.

Results

There was a significant decrease (>60%) in swelling in MSU crystal–injected knees of C6‐deficient animals as compared with C6‐sufficient animals (P < 0.05). An attenuated rise in MSU crystal–induced joint effusion levels of IL‐8 also was observed, which was concordant with diminished numbers of neutrophils (P < 0.05) but not monocytes in MSU crystal–induced knee synovial fluid from C6‐deficient animals. Synovial tissue analysis confirmed mononuclear leukocyte infiltration in response to MSU crystal injection in all animals, but substantial neutrophil infiltration only in C6‐sufficient animals.

Conclusion

MAC activation appears to play a major role in intraarticular IL‐8 generation and in neutrophil recruitment in experimental acute gouty arthritis of the rabbit knee. C6 and MAC activation may represent novel therapeutic targets for suppression of neutrophil‐mediated joint inflammation in gout.
The rise and decline of nonsteroidal antiinflammatory drug–associated gastropathy in rheumatoid arthritis
Authors: Fries James F. , Murtagh Kirsten N. , Bennett Mihoko , Zatarain Ernesto , Lingala Bharathi , Bruce Bonnie
Published: August 2004

Objective

Nonsteroidal antiinflammatory drug (NSAID)–associated gastropathy is a major cause of hospitalization and death. This study was undertaken to examine whether recent preventive approaches have been associated with a declining incidence of NSAID gastropathy, and, if so, what measures may have caused the decline.

Methods

We studied 5,598 patients with rheumatoid arthritis (RA) over 31,262 patient‐years at 8 sites. We obtained standardized longitudinal information on the patients that had been previously used to establish the incidence of NSAID gastropathy, and also information on patient risk factors and differences in toxicity between NSAIDs. Consecutive patients were followed up with biannual Health Assessment Questionnaires and medical record audits between 1981 and 2000. The major outcome measure was the annual rate of hospitalization involving bleeding, obstruction, or perforation of the gastrointestinal (GI) tract and related conditions.

Results

Rates of GI‐related hospitalizations rose from 0.6% in 1981 to 1.5% in 1992 (P < 0.001), and then declined to 0.5% in 2000 (P < 0.001). The fitted spline curve fit the data well (R2 = 0.70). The period of rise was mainly associated with increasing patient age and the GI risk propensity score. The period of decline was associated with lower doses of ibuprofen and aspirin, a decline in the use of “more toxic” NSAIDs from 52% to 42% of patients, a rise in the use of “safer” NSAIDs from 19% to 48% of patients, and increasing use of proton‐pump inhibitors, but not with change in age, NSAID exposure, or GI risk propensity score.

Conclusion

The risk of serious NSAID gastropathy has declined by 67% in these cohorts since 1992. We estimate that 24% of this decline was the result of lower doses of NSAIDs, while 18% was associated with the use of proton‐pump inhibitors and 14% with the use of less toxic NSAIDs. These declines in the incidence of NSAID gastropathy are likely to continue.
Genetic association of cutaneous neonatal lupus with HLA class II and tumor necrosis factor α: Implications for pathogenesis
Authors: Clancy Robert M. , Backer Chelsea B. , Yin Xiaoming , Chang Mary Wu , Cohen Steven R. , Lee Lela A. , Buyon Jill P.
Published: August 2004

Objective

Cutaneous neonatal lupus resembles subacute cutaneous lupus erythematosus (SCLE), and photosensitivity is a common symptom. Tumor necrosis factor α (TNFα) release by ultraviolet light–exposed keratinocytes may be exaggerated in SCLE patients who have the haplotype TNFα −308A;DRB1*03. Accordingly, this study was undertaken to seek genetic and histologic evidence for a role of TNFα in the pathogenesis of cutaneous neonatal lupus.

Methods

DNA was isolated from 83 children (22 with rash, 35 with congenital heart block [CHB], 26 unaffected siblings) and 58 mothers from the Research Registry for Neonatal Lupus.

Results

The −308A allele (associated with higher TNFα production), HLA–DRQB1*02, and HLA–DRB1*03 were each present in the majority of children with rash (64%, 68%, and 64%, respectively). The frequency of all 3 6p alleles occurring together in 1 individual was greater in children with rash than in children who had either CHB or no manifestation of neonatal lupus (59% versus 30%; P = 0.02). This association with neonatal lupus rash was equivalent to published findings in a cohort of patients with SCLE, but significantly greater than the association in patients with discoid lupus erythematosus. Prominent TNFα staining in the epidermis was observed in lesional skin from 3 children with rash, but not in skin from a healthy neonate.

Conclusion

Taken together, the finding of a genetic predisposition to generate increased levels of TNFα following tissue injury and the histologic demonstration of TNFα in the target organ support the notion that this inflammatory cytokine plays a role in the pathogenesis of cutaneous neonatal lupus. Furthermore, the results of these studies provide evidence of a biologic link between neonatal lupus and the rash of SCLE.
Induction of remission of severe and refractory rheumatoid arthritis by allogeneic mixed chimerism
Authors: Burt Richard K. , Oyama Yu , Verda Larissa , Quigley Kathleen , Brush Mary , Yaung Kimberly , Statkute Laisvyde , Traynor Ann , Barr Walter G.
Published: August 2004

This report describes the first allogeneic hematopoietic stem cell transplantation (HSCT) performed for the indication of rheumatoid arthritis (RA). We used nonmyeloablative allogeneic HSCT to treat a 52‐year‐old woman who had treatment‐refractory RA and a poor prognosis (24 swollen and 38 involved joints). She was treated with fludarabine, cyclophosphamide, CAMPATH‐1H, and CD34‐selected HSCT (8 million CD34+ donor cells/kg); the donor was the patient's HLA‐matched, rheumatoid factor–negative sister. One year post‐HSCT, the patient has had no infection except dermatomal varicella‐zoster virus infection and no acute or chronic graft‐versus‐host disease (GVHD). Her RA has remained in remission with no immunosuppressive or immunomodulatory medications. The patient is a mixed chimera, with 55% donor T (CD3+) cells and 70% donor myeloid (CD33+) cells. This is the first published report of allogeneic HSCT performed for the indication of RA. Mixed chimerism has resulted in marked amelioration of RA, without GVHD.
Measuring quality in arthritis care: The Arthritis Foundation's Quality Indicator set for osteoarthritis
Authors: Pencharz James N. , MacLean Catherine H.
Published: August 2004

Objective

To develop a comprehensive set of explicit process measures to assess the quality of health care for osteoarthritis and to describe the scientific evidence that supports each measure.

Methods

Through a comprehensive literature review, we developed potential quality measures and a summary of existing data to support or refute the relationship between the processes of care proposed in the indicators and relevant clinical outcomes. The proposed measures and literature summary were presented to a multidisciplinary panel of experts in arthritis and pain. The panel rated each proposed measure for its validity as a measure of health care quality.

Results

Among 22 measures proposed for osteoarthritis, the expert panel rated 14 as valid measures of health care quality.

Conclusion

Sufficient scientific evidence and expert consensus exist to support a comprehensive set of measures to assess the quality of heath care for osteoarthritis. These measures can be used to gain an understanding of the quality of care for patients with osteoarthritis.
Perceptions of, and willingness to consider, total joint arthroplasty in a population‐based cohort of individuals with disabling hip and knee arthritis
Authors: Hawker Gillian A. , Wright James G. , Badley Elizabeth M. , Coyte Peter C. ,   Toronto Arthroplasty Health Services Research Consortium
Published: August 2004

Objective

To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA.

Methods

A population‐based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or knee arthritis; 435 English‐speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision‐making style; self efficacy; and willingness to consider TJA by questionnaire.

Results

Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus ≥75 years 2.42, P = 0.01); worse perceived arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01).

Conclusions

Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.
Frequent mental distress status among adults with arthritis age 45 years and older, 2001
Authors: Strine Tara W. , Hootman Jennifer M. , Okoro Catherine A. , Balluz Lina , Moriarty David G. , Owens Michelle , Mokdad Ali
Published: August 2004

Objective

To identify characteristics and behaviors among persons with arthritis through evaluation of self‐perceived mental health status.

Methods

Data were analyzed for adults with arthritis age 45 years or older from the 2001 Behavioral Risk Factor Surveillance System, an ongoing, state‐based, random‐digit‐dialed telephone survey of noninstitutionalized adults living in the United States.

Results

The prevalence of frequent mental distress (FMD; ≥14 self‐reported mentally unhealthy days in the past 30 days) among persons with arthritis was 13.4%. Among persons with arthritis, those with FMD as compared with those without FMD were more likely to be underweight and obese than normal weight; they also were more likely to be insufficiently active or inactive than following recommended physical activity guidelines. In addition, those with arthritis and FMD were more likely to report disability and impaired physical and general health than were those with arthritis but without FMD.

Conclusion

Physicians should encourage their patients with arthritis and mental distress to participate in educational and behavioral interventions shown to have both physical and psychological benefits.
Mutual support groups in rheumatic diseases: Effects and participants' perceptions
Authors: Savelkoul Manon , de Witte Luc P.
Published: August 2004

Objective

To investigate in a randomized controlled trial the effects of mutual support groups in rheumatic diseases on social network size, social skills, loneliness, daily functioning, and life satisfaction as well as to identify patients' perceptions of the support group.

Methods

Participants were 112 patients with chronic rheumatic disorders affecting the joints. Data were collected with self‐report questionnaires and group interviews.

Results

Effects have been found on social skills only. More specifically, mutual support groups at postintervention decreased distress in expressing negative feelings toward other people. This effect did not persist at the 6‐month followup evaluation, but at that time an increase in frequency in making one's wishes known to others was found. In patients who attended at least 5 of all 10 sessions, an increase in expressing positive feelings toward others was found at followup. Mutual support groups were evaluated positively.

Conclusion

Mutual support groups are recommended for patients experiencing difficulties in social interactions.
Positron emission tomography in patients with fibromyalgia syndrome and healthy controls
Authors: Yunus Muhammad B. , Young Carter S. , Saeed S. Atezaz , Mountz James M. , Aldag Jean C.
Published: August 2004

Objective

Abnormal brain findings have previously been described in fibromyalgia syndrome (FMS) by single‐photon–emission computed tomography. Our goal was to investigate change in regional cerebral glucose metabolism in people with FMS by positron emission tomography (PET) using 18F‐fluorodeoxyglucose (FDG).

Methods

Twelve patients with FMS and no comorbid psychiatric diagnosis and 7 healthy pain‐free controls were studied with FDG‐PET in a blinded manner. Those with a psychiatric diagnosis were excluded. Brain scans were obtained using a PET scanner. Semiquantitative analysis of regional 18F‐FDG uptake was performed in both cortical and subcortical brain structures.

Results

In the resting state, there were no significant differences in 18F‐FDG uptake between patients and controls for all brain structures measured.

Conclusion

FDG‐PET scan findings in FMS were not significantly different from healthy controls. Normal results in our study may be explained by discordance between regional cerebral blood flow and regional cerebral glucose metabolism.
Systemic lupus erythematosus in three ethnic groups. XIX. Natural history of the accrual of the American College of Rheumatology criteria prior to the occurrence of criteria diagnosis
Authors: Alarcón Graciela S. , Mcgwin Gerald , Roseman Jeffrey M. , Uribe América , Fessler Barri J. , Bastian Holly M. , Friedman Alan W. , Baethge Bruce , Vilá Luis M. , Reveille John D. ,   Lumina Study Group
Published: August 2004

Objective

To determine how the American College of Rheumatology (ACR) criteria for the classification of systemic lupus erythematosus (SLE) accrue in a multiethnic cohort of SLE patients.

Methods

SLE patients enrolled in a longitudinal study of outcome were analyzed (LUMINA; Lupus in Minorities: Nature versus nurture) for the manner in which ACR criteria manifestations occurred prior to the accrual of 4 of them. Time at which a criterion was said to be present was determined by review of all previously available medical records and interview. Univariable and multivariable Cox proportional hazard models were examined for the association with time to accrual of 4 ACR criteria; results were reported as hazard ratios.

Results

There were 103 Texas Hispanic (of Mexican or Central America ancestry) patients, 55 Puerto Rico Hispanics, 176 African Americans, and 137 Caucasians. The mean ± SD and median (range) time to accrual of 4 ACR criteria were 29.4 ± 52.0 months and 9.1 (0–328.7) months; time was shortest for the Texas Hispanics (18.4 ± 42.8 and 5.0 [0–248] months) and longest for the Caucasians (39.9 ± 59.3 months and 17.7 [0–324.6] months). Arthritis was the most frequent first criterion (34.5%); it was followed by photosensitivity (18.8%). When 2 criteria occurred from the outset, the most frequent combination was arthritis and antinuclear antibody positivity followed by malar rash and photosensitivity. A Cox‐regression multivariable model identified Hispanic ethnicity (from Texas) and HLA–DRB1*0301 as predictors of short time to criteria accrual, whereas older age and married/living together were associated with long time to criteria accrual.

Conclusion

Significant variability in the evolution of ACR criteria manifestations does occur. Texas Hispanics are more likely to have a rapid evolution of criteria manifestations, but several years may elapse before ACR criteria are accrued.
Die verbundlose interne Längsvorspannung
Authors: Fritsche Thomas , Hennecke Markus , Pfisterer Hans , Willberg Uwe
Published: August 2004

Im Zuge der Erweiterung des Autobahnrings BAB A99 München‐West wurden von der Bayerischen Straßenbauverwaltung zwei Pilotprojekte zur verbundlosen internen Längsvorspannung im Brückenbau initiiert. Das Pilotprojekt Streiflacher Weg (BW 92/1) baut auf den Erfahrungen aus einem Schwesterbauwerk in unmittelbarer Nachbarschaft auf. Über die konzeptionellen Ansätze und die konstruktive Umsetzung wird nachfolgend berichtet.
Vorgespannte Bodenplatten – ein brachliegendes Potential
Authors: Friedrich Thomas
Published: August 2004

Bodenplatten stellen eine attraktive Gründungsmöglichkeit dar: Sie übernehmen nicht nur die Tragfunktion, sondern bilden auch, einen dichten und durchgehenden Abschluß der Gebäudekonstruktion, gegenüber dem Baugrund. Allerdings sind Bodenplatten hoch beanspruchte Bauteile, die entsprechend der Einwirkung hohe Biege‐ und Schubwiderstände erfordern. Eine entsprechende Konstruktionstärke mit hohen Bewehrungsgraden für Biegung und insbesondere für den Schub sind die Folge. Diesen hohen Beanspruchungen läßt sich jedoch sehr wirkungsvoll, mit einer Vorspannbewehrung entgegenwirken. Im Gegensatz zur schlaffen Bewehrung ist die Vorspannung ein aktives Bewehrungselement. Der aktive Anteil der Vorspannbewehrung erzeugt Umlenkkräfte, mit denen die einzelnen Einwirkungen direkt aufgenommen und gleichmäßig über die Platte verteilt werden. Diese Direktabtragung reduziert folglich die Beanspruchungen und führt demzufolge zu schlankeren Konstruktionen mit geringeren Bewehrungsgraden. Die durch die Vorspannung erzeugte Druckspannung über den Plattenquerschnitt veringert die Rißbildung und erhöht die Dichtigkeit.