bluuebunny/crossref_metadata_2025 huggingface dataset:
HAVLU KALİTE ALGISININ SUBJEKTİF VE OBJEKTİF DEĞERLENDİRİLMESİ
Authors: Susurluk Gülşah , Turker Erkan , İkiz Yüksel
Published: June 2024

Bu çalışmada, tekstil sektöründe ev tekstili ürünleri içerisinde önemli bir yere sahip olan havlu kumaşların kalite algısı öncelikle havlu alanında profesyonel deneyime sahip uzman kişiler tarafından subjektif olarak değerlendirilmiş, daha sonra havlu kumaşlar Kawabata KES sistemi ile ölçülerek objektif olarak değerlendirilmiştir. Havlu kalite algısının hem subjektif hem de objektif olarak değerlendirilmesi amacıyla 10 farklı havlu üretici firma ziyaret edilmiş ve bu firmalardan 73 adet havlu numunesi toplanmıştır. Yapılan değerlendirme sonuçları incelendiğinde; herhangi bir havlu kumaşın kalite değerini yapılan testler sonucunda belirli limitler içinde veren, üretici ve kullanıcıların kabul edeceği objektif bir yöntem geliştirerek, ölçülen veriler arasında korelasyon kurulup TQV (Total Quality Value) değeri için, subjektif ve objektif değerlendirmeler arasında max korelasyon katsayısı 0,963 olarak bulunmuştur.
The Impact of Street Humanisation on Road Safety
Authors: Mockus Aivaras , Jasiūnienė Vilma
Published: June 2024

To enhance the safety and integration of vulnerable road users (pedestrians and cyclists) into the transportation system, a growing number of European cities, including Vilnius, are aligning their traffic management solutions with the concept of street humanisation. The Naujamiestis district is the first city district in Vilnius to undergo these changes. To assess the impact of street humanisation strategies on road safety, this preliminary paper analyses data from the road accident history database for the period 2018–2021 and results from instantaneous vehicle speed analysis. The results of the road accident database history are presented graphically and using heat maps. The data from the instantaneous speed analysis are analysed using the Kruskal- Wallis and Mann-Whitney-Wilcoxon non-parametric statistical criteria. The findings indicate that the concept of street humanisation is effective in enforcing 30 km/h speed limit. The analysis of road accident data history shows a decrease in the number of accidents and their consequences in the study area and the entire city of Vilnius between 2018 and 2022. However, it is currently challenging to determine whether street humanisation concept directly contributes to the decline in road accidents. Therefore, it is proposed to revisit the analysis in the future.
Pinging the Hidden Attentional Priority Map: Suppression Needs Attention
Authors: Huang Changrun , van Moorselaar Dirk , Foster Joshua J. , Donk Mieke , Theeuwes Jan
Published: June 2024

Attentional capture by an irrelevant salient distractor is attenuated when the distractor is presented more frequently in one location compared to other locations, suggesting that people learn to suppress an irrelevant salient location. However, to date it is unclear whether this suppression is proactive, applied before attention has been directed to the distractor location, or reactive, occurring after attention has been directed to that specific location. The aim of the present study is to investigate how suppression is accomplished by using the pinging technique which allows one to probe how attention is distributed across the visual field prior to the presentation of the search display. In an EEG experiment, participants performed a visual search task wherein they were tasked with identifying a shape singleton in the presence of an irrelevant color singleton. Compared to all other locations, this color singleton appeared more frequently at a specific location, which was termed the high-probability location. Prior to the search task, we introduced a continuous recall spatial memory task to reveal the hidden attentional priority map. Participants had to memorize the location of a memory cue continuously and report this location after the visual search task. Critically, after the presentation of the memory cue but before the onset of the search display, a neutral placeholder display was presented to probe how hidden priority map is reconfigured by the learned distractor suppression. Behaviorally, there was clear evidence that the high-probability location was suppressed, as search was more efficient when the distractor appeared at this location. To examine the priority map prior to search, we adopted an inverted encoding approach to reconstruct the tuning profile of the memorized position in the spatial memory task. Inverted modeling resulted in reliable tuning profiles during memory maintenance that gradually decayed and that were revived again by the onset of a neutral placeholder display preceding search. After the onset of the placeholders, the tuning profile observed was characterized by a spatial gradient centered over the high-probability location, with tuning being most pronounced at the-to-be suppressed location. This finding suggests that while learned suppression is initiated prior to search display onset, it is preceded by an initial phase of spatial selection, which is in line with a reactive suppression account. Together these results further our understanding of the mechanism of spatial distractor suppression.
Analytical code sharing practices in biomedical research
Authors: Sharma Nitesh Kumar , Ayyala Ram , Deshpande Dhrithi , Patel Yesha , Munteanu Viorel , Ciorba Dumitru , Bostan Viorel , Fiscutean Andrada , Vahed Mohammad , Sarkar Aditya , Guo Ruiwei , Moore Andrew , Darci-Maher Nicholas , Nogoy Nicole , Abedalthagafi Malak , Mangul Serghei
Published: June 2024

Data-driven computational analysis is becoming increasingly important in biomedical research, as the amount of data being generated continues to grow. However, the lack of practices of sharing research outputs, such as data, source code and methods, affects transparency and reproducibility of studies, which are critical to the advancement of science. Many published studies are not reproducible due to insufficient documentation, code, and data being shared. We conducted a comprehensive analysis of 453 manuscripts published between 2016–2021 and found that 50.1% of them fail to share the analytical code. Even among those that did disclose their code, a vast majority failed to offer additional research outputs, such as data. Furthermore, only one in ten articles organized their code in a structured and reproducible manner. We discovered a significant association between the presence of code availability statements and increased code availability. Additionally, a greater proportion of studies conducting secondary analyses were inclined to share their code compared to those conducting primary analyses. In light of our findings, we propose raising awareness of code sharing practices and taking immediate steps to enhance code availability to improve reproducibility in biomedical research. By increasing transparency and reproducibility, we can promote scientific rigor, encourage collaboration, and accelerate scientific discoveries. We must prioritize open science practices, including sharing code, data, and other research products, to ensure that biomedical research can be replicated and built upon by others in the scientific community.
Connect attack in IoT-WSN detect through cyclic analysis based on forward and backward elimination
Authors: S. Tamil Selvi , P. Visalakshi
Published: June 2024

IoT-wireless sensor networks (WSN) have extensive applications in diverse fields such as battlegrounds, commercial sectors, habitat monitoring, buildings, smart homes, and traffic surveillance. WSNs are susceptible to various types of attacks, such as malicious attacks, false data injection attacks, traffic attacks, and HTTP flood attacks. CONNECT attack is a novel attack in WSN. CONNECT attack plays a crucial role through disrupting packet transmission and node connections and significantly impacts CPU performance. Detecting and preventing CONNECT attacks is imperative for enhancing WSN efficiency. During a CONNECT attack, nodes fail to respond to legitimate requests, resulting in connectivity delays, acknowledgment delays, and packet drop attacks in IoT-WSN nodes. This article introduces an Intrusion Detection Algorithm based on the Cyclic Analysis Method (CAM), which incorporates a forward selection approach and backward elimination method. CAM analyzes routing information and behavior within the WSN, facilitating the identification of malicious paths and nodes. The proposed approach aims to pinpoint and mitigate the risks associated with CONNECT attacks, emphasizing the identification of malevolent pathways and nodes while establishing multiple disjoint loop-free routes for seamless data delivery in the IoT-WSN. Furthermore, the performance of CAM is assessed based on metrics such as malicious node detection accuracy, connectivity, packet loss, and network traffic. Simulation results using Matlab software demonstrate superior accuracy in malicious node detection, achieving accuracy in attack detection of approximately 99%, surpassing traditional algorithms accuracy of attack detection.
Effects of wheat intercropping on growth and occurrence of Fusarium wilt in watermelon
Authors: Lv HuiFang , Yan CongSheng
Published: June 2024

Watermelon is commonly affected by Fusarium wilt in a monoculture cropping system. Wheat intercropping alleviates the affection of Fusarium wilt of watermelon. The objective of this study was to determine the effects of wheat and watermelon intercropping on watermelon growth and Fusarium wilt. Our results showed that wheat and watermelon intercropping promoted growth, increased chlorophyll content, and photosynthesis of watermelon. Meanwhile, wheat and watermelon intercropping inhibited watermelon Fusarium wilt occurrence, decreased spore numbers, increased root vigor, increased antioxidant enzyme activities, and decreased malondialdehyde (MDA) content in watermelon roots. Additionally, wheat and watermelon intercropping enhanced the bacterial colonies and total microbes growth in soil, decreased fungi and Fusarium oxysporum f. sp. niveum (FON) colonies, and increased soil enzyme activities in watermelon rhizosphere soil. Our results indicated that wheat and watermelon intercropping enhanced watermelon growth and decreased the incidence of Fusarium wilt in watermelon. These effects could be due to intercropping inducing physiological changes, regulating soil enzyme activities, and/or modulating soil microbial communities.
Response of soil arbuscular mycorrhizal fungal community to chemical fertilization in sugarcane
Authors: Kang Yi-Hao , Jiang Shang-Tao , Wang Qian , Nong Ying-Jie , Song Juan , Li Dong-Ping , Wen Yun-Ying , Xu Jie , Chen Ting-Su , Zhang Jin-Lian , Li Yang-Rui
Published: June 2024

Most sugarcane cultivation areas in China have undergone over 30 years of continuous monocropping, and long-term chemical fertilizer application has led to severe soil degradation. Arbuscular mycorrhizal fungi (AMF) play a crucial role in promoting plant nutrient uptake, enhancing plant stress tolerance, and improving soil quality and restoration. However, in agroecosystems, AMF are susceptible to the effects of cultivation, fertilization, and other factors. The goal of this study was to investigate the influence of chemical fertilization on the AMF community in the rhizosphere soil of plant crop of sugarcane. In this study, sugarcane varieties GT58 and GT29 were selected for experiment. Four different chemical fertilization rates were established using controlled-release compound chemical fertilizer (N: P: K = 17:7:17): T1 (0.0 kg/ha), T2 (562.5 kg/ha), T3 (1,125.0 kg/ha), and T4 (2,250.0 kg/ha). The results showed that different fertilization rates significantly affected the cane yield in GT58. T3 and T4 increased the cane yield by 12.67% and 11.11%, respectively, compared to the control T1 (P < 0.05). The impact on the cane yield in GT29 was not significant. The diversity indices of root-associated AMF in GT58 (Chao index and Shannon index) varied significantly in different fertilization rates. T3 had the highest diversity, showing no significant difference from T1 and T2 but significantly higher than T4. For GT29, there were no significant differences in the diversity indices of root-associated AMF among different fertilization rates. Analyzing the differential species in root-associated soil with different fertilization rates in GT58 at the OTU level revealed that T3 had significantly higher abundances for 5 OTUs compared to the other treatments, and all the differentially abundant species belonged to Glomus. The Mantel analysis revealed that the genus Acaulospora was significantly and positively correlated with millable stalks (P < 0.001), and significantly and positively correlated with tiller number (P < 0.05). The genus Scutellospora showed a significant positive correlation with sprouting rate (P < 0.05). However, the other AMF genera did not show significant correlations with the agronomic traits of sugarcane. In summary, different chemical fertilization rates significantly affected the cane yield in GT58 and the AMF community in the rhizosphere soil, but not in GT29, which suggests that sugarcane chemical fertilization should consider different sugarcane varieties and the diversity of AMF communities in soil.
Comparative in-vivo bond failure rate of orthodontic brackets when bracket base is treated with micro-abrasive blasting vs. acid etching: eighteen month randomized control trial and scanning electron microscope study
Authors: Durrani Owais Khalid , Raja Ulfat Bashir , Chaudhary Farooq Ahmad , Hamid Umar , Javed Muhammad Qasim , Atique Sundus , Habib Syed Rashid
Published: June 2024

Background

The aim of this study was threefold. Firstly, it aimed to introduce and detail a novel method for chemically etching the bases of stainless-steel orthodontic brackets. Secondly, the study sought to investigate the structural alterations within the brackets’ microstructure following chemical etching compared to those with sandblasted bases, using electron microscopy analysis. Lastly, the study aimed to evaluate and compare the long-term durability and survivability of orthodontic brackets with chemically etched bases versus those with sandblasted bases, both bonded using the conventional acid etch technique with Transbond XT adhesive, over an 18-month follow-up period.

Methods

The study was a randomized clinical control trial with triple blinding and split-mouth study design and consisted of two groups. The brackets in the sandblasted group were prepared by sandblasting the intaglio surface of the base of the bracket with 50 µm SiO2 particles. Hydrofluoric acid was used to roughen the base in the acid-etched group. The bases of the brackets were viewed under an electron microscope to analyze the topographical changes.

Results

A total of 5,803 brackets (3,006 acid-etch, 2,797 sandblasted) in 310 patients were bonded, in a split-mouth design by the same operator. The patients were followed for 18 months. The failure rate of 2.59% and 2.7% was noted in an acid-etched and sandblasted group, respectively. There was a close approximation of curves in the Kaplan-Meier plot, and the survival distribution of the two groups in the log-rank (Mantel-Cox) test was insignificant; x2 = 0.062 (P value = 0.804).

Conclusion

Acid etching if the bases of the brackets can be used as an alternative to sandblasting furthermore acid etching can be performed on the chair side.
Enhancing small-scale acetification processes using adsorbed Acetobacter pasteurianus UMCC 2951 on κ-carrageenan-coated luffa sponge
Authors: Sriphochanart Wiramsri , Krusong Warawut , Samuela Nialmas , Somboon Pichayada , Sirisomboon Panmanas , Onmankhong Jiraporn , Pornpukdeewattana Soisuda , Charoenrat Theppanya
Published: June 2024

Background

This study explored the utilization of luffa sponge (LS) in enhancing acetification processes. LS is known for having high porosity and specific surface area, and can provide a novel means of supporting the growth of acetic acid bacteria (AAB) to improve biomass yield and acetification rate, and thereby promote more efficient and sustainable vinegar production. Moreover, the promising potential of LS and luffa sponge coated with κ-carrageenan (LSK) means they may represent effective alternatives for the co-production of industrially valuable bioproducts, for example bacterial cellulose (BC) and acetic acid.

Methods

LS and LSK were employed as adsorbents for Acetobacter pasteurianus UMCC 2951 in a submerged semi-continuous acetification process. Experiments were conducted under reciprocal shaking at 1 Hz and a temperature of 32 °C. The performance of the two systems (LS-AAB and LSK-AAB respectively) was evaluated based on cell dry weight (CDW), acetification rate, and BC biofilm formation.

Results

The use of LS significantly increased the biomass yield during acetification, achieving a CDW of 3.34 mg/L versus the 0.91 mg/L obtained with planktonic cells. Coating LS with κ-carrageenan further enhanced yield, with a CDW of 4.45 mg/L. Acetification rates were also higher in the LSK-AAB system, reaching 3.33 ± 0.05 g/L d as opposed to 2.45 ± 0.05 g/L d for LS-AAB and 1.13 ± 0.05 g/L d for planktonic cells. Additionally, BC biofilm formation during the second operational cycle was more pronounced in the LSK-AAB system (37.0 ± 3.0 mg/L, as opposed to 25.0 ± 2.0 mg/L in LS-AAB).

Conclusions

This study demonstrates that LS significantly improves the efficiency of the acetification process, particularly when enhanced with κ-carrageenan. The increased biomass yield, accelerated acetification, and enhanced BC biofilm formation highlight the potential of the LS-AAB system, and especially the LSK-AAB variant, in sustainable and effective vinegar production. These systems offer a promising approach for small-scale, semi-continuous acetification processes that aligns with eco-friendly practices and caters to specialized market needs. Finally, this innovative method facilitates the dual production of acetic acid and bacterial cellulose, with potential applications in biotechnological fields.
Developing a Training Program to Improve Communication Skills among Fire Officials in Managerial Roles: Insights from a Generational Gap Perception Survey
Authors: Kim Bo-Min , Lee Jeong-Eun , Hur Mira
Published: June 2024

This study developed and evaluated an educational program tailored to improve the communication skills of fire officials in managerial roles, drawing from insights gathered through a survey on perception of generation gap among fire officials. The final program was modularized into communication-style exploration, listening and empathy, emotional reflection, intergenerational conversations, and contextual conversation techniques. A program consisting of eight 50 min sessions was conducted exclusively within the experimental group. The communication abilities and levels of self-reflection among both experimental and control groups were measured before and after the program. The study noted that communication and self-reflection abilities of the experimental group improved significantly compared to those of the control group. Notably, the program's components were derived from survey results on the perception of generational differences among fire officials. In addition, the study underscored the effectiveness of the program in improving communication abilities and fostering better generational relationships among managerial staff. This highlights the potential of educational programs that consider generational differences to contribute to the cultural development and performance improvement of fire service organizations.
Mental Health and Quality Sleep among Brazilian Medical Students during Covid-19 Pandemic: Prevalence and Associated Factors
Authors: Mendonça Gabriel S. , Medeiros Gabriel R. , Sampaio Gilsiane S. , Rabello Eduarda R. , Freitas Daniela R. , Oliveira Gabriella M. L. , Lima Paulo M. A.
Published: June 2024

Aims: Due the pandemic of the new coronavirus (COVID-19), stricter measures to limit unessential interactions were adopted, including the suspension of classroom lessons and the implementation of the distance learning regime. As these restrictions change lifestyles, this study aimed to assess the impacts of social distancing on mental health and sleep quality in medical students during the COVID-19 pandemic.
Study Design: Cross-sectional study.
Place and Duration of Study: Medical school in Goiânia, Goiás, Brazil. Data collection took place from June 1 to July 1, 2020.
Methodology: This study used self-administered questionnaires answered by students from a Public University in Brazil. The collection instrument consisted of four parts: socioeconomic variables, self-perception of health, Self-Report Questionnaire (SRQ-20), and Pittsburgh Sleep Quality Index (PSQI). Absolute and relative frequencies described the sample, Chi-square test and Student’s t-test tested associations between the variables, Pearson’s correlation tested the relationship between PSQI and SRQ-20.
Results: Of the 210 participants, 138 students (65.7%) had scores suggestive of mental distress by the SRQ-20; women had a higher risk when compared to men (women 67.7% vs. men 49%, p < .01). 186 students (88.6%) had poor sleep quality according to the PSQI; women also had higher sleep disturbance (women 1.26 ± 0.06 vs. men 1.35 ± 0.04, p < .05). Mental distress measures were positively correlated with sleep quality (r = 0.611, p < .001).
Conclusion: The strict preventive measures, and the radical changes in the lifestyle of medical students had a negative impact on the quality of their sleep and mental state. The students showed high levels of mental distress and poor sleep quality, and women appear to be an important risk factor. Implementation of interventions for well-being in pandemic condition by universities, and special focus to the most affected groups (such as women), should be stimulated.
Understanding College Students’ Perspectives on Religion Classes and Importance of Edukasyon sa Pagpapakatao Classes to the Philippine Public School Curriculum
Authors: B. Carreon Erine Raeane
Published: June 2024

Aims: This paper aims to understand the relevance of EsP classes, given that its roots stem from religion, and the current climate of the Philippine public school education system.
Study Design: Quantitative Research.
Place and Duration of Study: De La Salle University – Manila, social media (I.e., Facebook and Facebook Messenger) between, between March 2024 – May 2024.
Methodology: The author administrated surveys to seventy-six (76) non-secular school graduates and asked them about their experiences during religion class, and their perspectives towards EsP.
Results: The major findings of the paper show that religion does have a slight hand in their perspectives towards EsP. From the gathered responses, the research shows that while learning values and morals are still important in society, the basis should be rooted on social morality rather than religion.
Conclusion: Participants believed that the basis of the subject’s curriculum must be aligned with the social morality of the Filipino people, or the general common good. To them, the idea of “God” or being “Maka-Diyos” in the subject’s objectives is quite aligned with the religious views. This could potentially divide or discriminate public school students who do not identify with the country’s major religion. To them, Edukasyon ng Pagpapakatao (EsP) should focus solely on values education and ethics.
Proximate Analysis, Extraction, and Characterization of Oil from Terminalia catappa Fruit in Anambra State, Nigeria
Authors: Patrick Aniekwensi Obinna , Ozioma Ogbonna Esther , Shine Gemadi Kwasi , Michael Akinpelu Toyosi , Nwosu Samuel Nzube , Bassey Etim Blessing , Favour Nwachukwu Chinemerem , Damilola Awoyungbo Modupeoluwa , Tochi Nkwocha Stephen
Published: June 2024

Context: Terminalia catappa, also known as tropical almond, is a well-known plant recognized for its edible parts, including fruit, bark, leaves, and roots. It is also noted for its medicinal usefulness and numerous pharmacological actions.
Aim: This study aims to analyze the proximate composition of the seeds of tropical almonds, extract and characterize the oil from Terminalia catappa seeds and mesocarp. The goal is to assess the nutritional value of Terminalia catappa and to evaluate the oil's physicochemical properties.
Materials and Methods: Standard methods were used to assess physicochemical parameters such as saponification, acid, peroxide, iodine, and specific gravity. The seed's proximate composition was also analyzed, revealing moisture, ash, crude fiber, fat, protein, and carbohydrate content.
Results: The results indicate that the saponification value (mg KOH/g), acid value (mg KOH/g), iodine value (mg iodine/mg), peroxide value (mg/peroxide/kg), and specific gravity of the oil are 162, 1.68, 89, 1.40, and 0.95 respectively. The proximate composition reveals that the seed contains 23.24% moisture, 5.50% ash, 12.30% crude fiber, 16.51% fat, 21.22% protein, and 39.99% carbohydrate. These findings suggest that tropical almond seed is a good source of protein, carbohydrates, and oil and contains minerals that can contribute valuable amounts of essential nutrients to the human diet. The low acid value suggests that the oil is edible, while the high saponification value indicates its potential in industrial applications such as cosmetics. The low iodine value reveals that it is a non-drying oil unsuitable for the paint industry. Additionally, the low peroxide value of the oil indicates low susceptibility to oxidative rancidity and deterioration, confirming the presence of antioxidants in the seed oil.
Conclusion: Terminalia catappa seeds exhibit a high level of most chemical components, making them a promising raw material for various industries. Their high protein value and low level of anti-nutrients indicate their potential usefulness in animal and poultry feed supplements. They also serve as beneficial dietary supplements and should be encouraged in diets.
Review of Indigenous Fruit Crops Status and their Scenarios Existence, Conservation and Utilization in the Bundelkhand Region of India
Authors: Vikram Balaji , Tiwari Chandrakant , Singh Bijendra Kumar , Mishra Vigya , Rajpoot Shankar , Sikarwar Purnima Singh , Gautam Dharmendra Kumar
Published: June 2024

The contemporary era witnesses a significant demand for nutrient-dense fruits to enhance human health from both nutritional and metabolic perspectives. Consequently, the cultivation of commercial fruit crops is increasingly reliant on inputs to mitigate losses attributed to biotic and a biotic stress. Concurrently, a diverse array of underutilized crops, predominantly cultivated, commercialized and consumed locally, emerges as a viable alternative. These underutilized fruits exhibit notable advantages in terms of cultivation feasibility, resilience to climatic variations and nutritional richness compared to major commercially grown counterparts. Moreover, they boast an abundance of essential phytochemicals and possess medicinal properties. Consequently, integrating these fruits into local diets holds promise for addressing the nutritional deficiencies prevalent among rural populations inhabiting fragile arid and semi-arid regions globally. Additionally, local communities possess profound knowledge regarding the nutritional and medicinal attributes of these crops, emphasizing the imperative for rigorous investigation into their conservation and nutritional profiles. This review delves into the ethno botanical significance, medicinal and nutritional values, biodiversity conservation and utilization strategies of 20 underutilized fruit crops prevalent in Bundelkhand region of India. These include Indian jujube, Indian gooseberry, lasora, bael, kair, karonda, tamarind, wood apple, fig, custard apple, jamun, jharber, mahua, pilu, khejri, mulberry, chironji, manila tamarind, timroo and khirni, collectively enriching the spectrum of available foods with enhanced functional and nutritional attributes.
Management of coccidioidomycosis in patients receiving biologic response modifiers or disease‐modifying antirheumatic drugs
Authors: Taroumian Sara , Knowles Susan L. , Lisse Jeffrey R. , Yanes James , Ampel Neil M. , Vaz Austin , Galgiani John N. , Hoover Susan E.
Published: November 2012

Objective

Coccidioidomycosis (valley fever) is an endemic fungal infection of the American Southwest, an area with a large population of patients with rheumatic diseases. There are currently no guidelines for management of patients who develop coccidioidomycosis while under treatment with biologic response modifiers (BRMs) or disease‐modifying antirheumatic drugs (DMARDs). We conducted a retrospective study of how both concurrent diseases were managed and the patient outcomes at 2 centers in Tucson, Arizona.

Methods

A retrospective chart review identified patients who developed coccidioidomycosis during treatment with DMARDs or BRMs. Patients were seen at least once in a university‐affiliated or Veterans Affairs outpatient rheumatology clinic in Tucson, Arizona, between 2007 and 2009.

Results

Forty‐four patients were identified. Rheumatologic treatment included a BRM alone (n = 11), a DMARD alone (n = 8), or combination therapy (n = 25). Manifestations of coccidioidomycosis included pulmonary infection (n = 29), disseminated disease (n = 9), and asymptomatic positive coccidioidal serologies (n = 6). After the diagnosis of coccidioidomycosis, 26 patients had BRMs and DMARDs stopped, 8 patients had BRMs stopped but DMARD therapy continued, and 10 patients had no change in their immunosuppressive therapy. Forty‐one patients had antifungal therapy initiated for 1 month or longer. Followup data were available for 38 patients. BRM and/or DMARD therapy was continued or resumed in 33 patients, only 16 of whom continued concurrent antifungal therapy. None of the patients have had subsequent dissemination or complications of coccidioidomycosis.

Conclusion

Re‐treating rheumatic disease patients with a BRM and/or a DMARD after coccidioidomycosis appears to be safe in some patients. We propose a management strategy based on coccidioidomycosis disease activity.
Glucocorticoid‐related changes in body mass index among children and adolescents with rheumatic diseases
Authors: Shiff Natalie J. , Brant Rollin , Guzman Jaime , Cabral David A. , Huber Adam M. , Miettunen Paivi M. , Roth Johannes , Scuccimarri Rosie , Alos Nathalie , Atkinson Stephanie A. , Collet Jean Paul , Couch Robert , Cummings Elizabeth A. , Dent Peter B. , Ellsworth Janet , Hay John , Houghton Kristin , Jurencak Roman , Lang Bianca , Larche Maggie , LeBlanc Claire , Rodd Celia , Saint‐Cyr Claire , Stein Robert , Stephure David , Taback Shayne , Rauch Frank , Ward Leanne M. ,   and The Canadian Steroid‐associated Osteoporosis in the Pediatric Population Consortium
Published: November 2012

Objective

To examine the temporal and dose‐related effects of glucocorticoids (GCs) on body mass index (BMI) in children with rheumatic diseases.

Methods

Children initiating GCs for a rheumatic disease (n = 130) were assessed every 3 months for 18 months. BMI, weight, and height Z score trajectories were described according to GC starting dosage in prednisone equivalents: high (≥1.0 mg/kg/day), low (<0.2 mg/kg/day to a maximum of 7.5 mg/day), and moderate (between high and low) dosage. The impact of GC dosing, underlying diagnosis, pubertal status, physical activity, and disease activity on BMI Z scores and on percent body fat was assessed with longitudinal mixed‐effects growth curve models.

Results

The GC starting dose was high in 59% and moderate in 39% of patients. The peak BMI Z score was +1.29 at 4 months with high‐dose GCs and +0.69 at 4.2 months with moderate‐dose GCs (P < 0.001). Overall, 50% (95% confidence interval 41–59%) of the children returned to within +0.25 SD of their baseline BMI Z score. Oral GC dose over the preceding 3 months was the most significant determinant of BMI Z score and percent body fat. The proportion of days in receipt of GCs, disease activity, and a diagnosis of systemic‐onset juvenile idiopathic arthritis were also associated with BMI Z scores. The correlation between changes in BMI and changes in percent body fat was 0.09.

Conclusion

In children with rheumatic diseases starting moderate and high doses of GCs, BMI Z scores peaked at 4 months, and only half returned to within +0.25 SD of their baseline BMI Z score after 18 months.
Comprehensive tuberculosis screening program in patients with inflammatory arthritides treated with golimumab, a human anti–tumor necrosis factor antibody, in Phase III clinical trials
Authors: Hsia Elizabeth C. , Cush John J. , Matteson Eric L. , Beutler Anna , Doyle Mittie K. , Hsu Benjamin , Xu Stephen , Rahman Mahboob U.
Published: November 2012

Objective

Reactivation of Mycobacterium tuberculosis infection is a major complication in patients treated with anti–tumor necrosis factor (anti‐TNF) agents. We report on the 5 cases of active tuberculosis (TB) that developed in the Golimumab Phase III Program (3 with rheumatoid arthritis, 1 with psoriatic arthritis, and 1 with ankylosing spondylitis) through 1 year among 2,210 patients receiving golimumab.

Methods

Data from global studies were used for an in‐depth evaluation of the 5 cases of TB through week 52. Integrated safety data were evaluated for potential hepatotoxicity in patients treated with anti‐TB therapy.

Results

No active TB developed among 317 patients receiving golimumab and treated for latent TB with isoniazid. Active TB occurred in 5 patients not treated with isoniazid by week 52 (in 2 patients by week 24); all of the patients had negative TB screening tests (per the local guidelines) and resided in countries with high background rates of TB. No deaths were due to TB. Across all of the groups (placebo and golimumab), alanine aminotransferase and aspartate aminotransferase elevations occurred in greater proportions of patients treated for latent TB infection versus not treated; elevations were largely mild (<3 times the upper limit of normal).

Conclusion

Comprehensive TB screening kept the number of active TB cases relatively low despite conducting the studies in TB‐endemic regions. Treatment for latent TB infection appeared effective, since no patients treated for latent TB had TB reactivation. Concurrent treatment with golimumab and anti‐TB medication was generally well tolerated. Clinicians should remain vigilant for development of active TB after initiation of TNF inhibitors, since prompt diagnosis and treatment can improve outcomes.
Body mass index, obesity, and prevalent gout in the United States in 1988–1994 and 2007–2010
Authors: Juraschek Stephen P. , Miller Edgar R. , Gelber Allan C.
Published: November 2012

Objective

To determine the association and prevalence of gout among overweight, obese, and morbidly obese segments of the US population.

Methods

Among participants (age ≥20 years) of the National Health and Nutrition Examination Surveys in 1988–1994 and 2007–2010, gout status was ascertained by self‐report of a physician diagnosis. Body mass index (BMI) was examined in categories of <18.5 kg/m2, 18.5–24.9 kg/m2, 25–29.9 kg/m2, 30–34.9 kg/m2, and ≥35 kg/m2 and as a continuous variable. The cross‐sectional association of BMI category with gout status was adjusted for demographic and obesity‐related medical disorders.

Results

In the US, the crude prevalence of gout was 1–2% among participants with a normal BMI (18.5–24.9 kg/m2), 3% among overweight participants, 4–5% with class I obesity, and 5–7% with class II or class III obesity. The adjusted prevalence ratio comparing the highest to a normal BMI category was 2.46 (95% confidence interval [95% CI] 1.44–4.21) in 1988–1994 and 2.21 (95% CI 1.50–3.26) in 2007–2010. Notably, there was a progressively greater prevalence ratio of gout associated with successively higher categories of BMI. In both survey periods, for an average American adult standing 1.76 meters (5 feet 9 inches), a 1‐unit higher BMI, corresponding to 3.1 kg (∼6.8 pounds) greater weight, was associated with a 5% greater prevalence of gout, even after adjusting for serum uric acid (P < 0.001).

Conclusion

Health care providers should be aware of the elevated burden of gout among both overweight and obese adults, applicable to both women and men, and observed among non‐Hispanic whites, non‐Hispanic African Americans, and Mexican Americans in the US.
Contribution of assessing forefoot joints in early rheumatoid arthritis patients: Insights from item response theory
Authors: Siemons Liseth , ten Klooster Peter M. , Taal Erik , Kuper Ina H. , van Riel Piet L. C. M. , Glas Cees A. W. , van de Laar Mart A. F. J.
Published: November 2012

Objective

To evaluate the contribution of assessing forefoot joints to the measurement range and measurement precision of joint counts in early rheumatoid arthritis (RA) using item response theory.

Methods

Baseline measures of tender and swollen joint counts were analyzed in 459 early RA patients from the Dutch Rheumatoid Arthritis Monitoring remission induction cohort. The contribution of forefoot joints was studied by evaluating their effect on the measurement range and measurement precision of measures based on 28‐joint counts. In addition, the alignment between the patient and joint distributions was investigated to determine whether the forefoot joints were informative for measuring joint tenderness or swelling of an early RA patient.

Results

In total, 233 patients (50.76%) experienced tenderness and 200 patients (43.57%) experienced swelling in ≥1 forefoot joint. Forefoot joints were more informative for measuring joint tenderness than joint swelling, but did not significantly improve the measurement range and measurement precision of the 28‐joint counts. Furthermore, including forefoot joints did not remove the existing discrepancy between the joint and patient distributions in both joint counts.

Conclusion

Forefoot joints were frequently affected on an individual level, but did not significantly improve the measurement range or precision of 28‐joint counts in patients with early RA. From a measurement perspective, reduced joint counts are appropriate for use on a population level. The contribution of assessing forefoot joints on an individual level requires further investigation. Additionally, the results should be cross‐validated in patients with longer disease durations to determine whether the pattern of joint involvement is similar in later stages of RA.
Serious infections in a population‐based cohort of 86,039 seniors with rheumatoid arthritis
Authors: Widdifield Jessica , Bernatsky Sasha , Paterson J. Michael , Gunraj Nadia , Thorne J. Carter , Pope Janet , Cividino Alfred , Bombardier Claire
Published: November 2012

Objective

To assess risk and risk factors for serious infections in seniors with rheumatoid arthritis (RA) using a case–control study nested within an RA cohort.

Methods

We assembled a retrospective RA cohort age ≥66 years from Ontario health administrative data across 1992–2010. Nested case–control analyses were done, comparing RA patients with a primary diagnosis of infection (based on hospital or emergency department records) to matched RA controls. We assessed independent effects of drugs, adjusting for demographics, comorbidity, and markers of RA severity.

Results

A total of 86,039 seniors with RA experienced 20,575 infections, for a rate of 46.4 events/1,000 person‐years. The most frequently occurring events included respiratory infections, herpes zoster, and skin/soft tissue infections. Factors associated with infection included higher comorbidity, rural residence, markers of disease severity, and history of previous infection. In addition, anti–tumor necrosis factor agents and disease‐modifying antirheumatic drugs were associated with a several‐fold increase in infections, with an adjusted odds ratio (OR) ranging from 1.2–3.5. The drug category with the greatest effect estimate was glucocorticoids, which exhibited a clear dose response with an OR ranging from 4.0 at low doses to 7.6 at high doses.

Conclusion

Seniors with RA have significant morbidity related to serious infections, which exceeds previous reports among younger RA populations. Rural residence, higher comorbidity, markers of disease severity, and previous infection were associated with serious infections in seniors with RA. Our results emphasize that many RA drugs may increase the risk of infection, but glucocorticoids appear to confer a particular risk.
Silent cardiovascular involvement in patients with diffuse systemic sclerosis: a controlled cross‐sectional study
Authors: Turiel Maurizio , Gianturco Luigi , Ricci Cristian , Sarzi‐Puttini Piercarlo , Tomasoni Livio , Colonna Vito de Gennaro , Ferrario Paolo , Epis Oscar , Atzeni Fabiola
Published: November 2012

Objective

An association between systemic autoimmune diseases and atherosclerosis has been described in many connective tissue diseases, and this association is known to lead to increased cardiovascular morbidity and mortality. Systemic sclerosis (SSc) is characterized by multisystem organ inflammation, endothelial wall damage, and vasculopathy. There are many markers of endothelial dysfunction and/or atherosclerotic risk, such as asymmetric dimethylarginine (ADMA), arterial stiffness parameters, carotid intima‐media thickness (CIMT), and coronary flow reserve (CFR) assessed by transthoracic echocardiography. The aim of this pilot study was to use various endothelial and atherosclerosis markers to identify early cardiovascular involvement in a group of SSc patients.

Methods

The study involved 20 patients (2 men and 18 women with a mean ± SD age of 52.96 ± 12.51 years) with diffuse SSc who had no signs or symptoms of cardiovascular disease (CVD) and 20 age‐ and sex‐matched controls. All subjects underwent a dipyridamole echocardiographic stress test that included a determination of CFR and an evaluation of CIMT, arterial stiffness, and plasma ADMA levels.

Results

All of the arterial wall measurements of the patients with diffuse SSc were significantly different from those of the controls, and both right and left CIMT, pulse wave velocity, and stiffness index (β) were significantly elevated in the SSc patients compared to the healthy controls. Moreover, in patients with diffuse SSc, CFR was significantly lower (P = 0.0033) and plasma ADMA levels were higher (P < 0.0001) than in healthy controls.

Conclusion

SSc patients without any clinical evidence of CVD seem to have had subclinical atherosclerosis, which was suggested by early impairment of coronary microcirculation and macrovascular involvement.
Abatacept and reduced immune response to pandemic 2009 influenza A/H1N1 vaccination in patients with rheumatoid arthritis
Authors: Ribeiro Ana C. , Laurindo Ieda M. , Guedes Lissiane K. , Saad Carla G. , Moraes Julio C. , Silva Clóvis A. , Bonfa Eloisa
Published: November 2012

Objective

To evaluate the influence of abatacept (ABA) and associated contributing factors on pandemic 2009 influenza A/H1N1 vaccine immunogenicity in rheumatoid arthritis (RA) patients.

Methods

The response to a nonadjuvanted monovalent pandemic 2009 influenza A/H1N1 killed virus vaccine was analyzed in 11 RA patients using ABA (RA‐ABA), most with concomitant nonbiologic disease‐modifying antirheumatic drugs (DMARDS), and compared to 33 age‐matched RA patients on methotrexate (MTX) and 55 healthy controls, all without previous seroprotection. Clinical and laboratory evaluations were performed before and 21 days after vaccination. Anti‐influenza antibody titers were measured by hemagglutination inhibition assay. Seroprotection (antibody titers ≥1:40) and the factor increase (FI) in the geometric mean titers (GMTs) were calculated. Prevaccination lymphocyte counts and gammaglobulin levels were determined.

Results

Sex distribution, disease duration, and the Disease Activity Score in 28 joints were similar in the RA groups (P > 0.05). After vaccination, seroprotection was significantly reduced in RA‐ABA patients compared to RA‐MTX patients (9% versus 58%; P = 0.006) and controls (69%; P ≤ 0.001). FI‐GMT was severely reduced in RA‐ABA patients compared to RA‐MTX patients (1.8 [1.4–2.3] versus 8.7 [5.2–17.4]; P < 0.001) and controls (11.5 [8.0–16.7]; P ≤ 0.001). Lymphocyte counts were comparable in RA groups (P > 0.05), but RA‐ABA patients had slightly lower gammaglobulin levels than RA‐MTX patients (0.9 gm/dl [0.6–1.8] versus 1.2 gm/dl [0.8–1.7]; P = 0.03), although almost all were within the normal range values.

Conclusion

The current study established that ABA, in association with traditional DMARDs, significantly reduces the humoral response to pandemic 2009 influenza A/H1N1 vaccine in RA patients. The results suggest an influence of costimulatory modulation in humoral response to this vaccine.
Speech and hearing in adults with 22q11.2 deletion syndrome
Authors: Persson Christina , Friman Vanda , Óskarsdóttir Sólveig , Jönsson Radi
Published: November 2012

The purpose of the study was to investigate the prevalence of velopharyngeal impairment, compensatory articulation, reduced intelligibility, and to rate the general impression of speech in adults with 22q11.2 deletion syndrome. The second purpose was to study the prevalence and type of hearing impairment in these adults. A referred, consecutive series of 24 adults with confirmed 22q11.2 deletion, 16 female and 8 males, with a mean age of 25 years (19–38 years) was included in the study. A blind assessment of speech by three experienced speech‐ language pathologists was performed. Sixteen (66%) patients had a mild to severe velopharyngeal impairment. The most prevalent symptoms of velopharygeal impairment were hypernasality and audible nasal airflow. The mean nasalance score was 33% (6–66%). Only two patients had disordered articulation; one of these had glottal articulation. A mean of 96% (88–100%) of single words were rated to be intelligible. To achieve these results half of the patients previously had velopharyngeal flap surgery. Forty‐one percent (9/22) had mild–moderate hearing impairment; three had sensorineural type, four conductive and two had a mixed type. In conclusion the majority of the patients had no articulation errors and good intelligibility; while one‐third still had moderate to severe problems with velopharyngeal impairment. Around 40% still had some hearing impairment, in most cases with a mild to moderate conductive component. Thus, a high prevalence of speech and hearing problems seems to be a part of the phenotype in adults with 22q11.2DS. © 2012 Wiley Periodicals, Inc.