bluuebunny/crossref_metadata_2025 huggingface dataset:
UJI AKTIVITAS ANTIDIABETES EKSTRAK ETANOL BUAH CABAI MERAH ( Capsicum annuum L. ) TERHADAP MENCIT PUTIH JANTAN
Authors: Zulkarni Zulkarni
Published: September 2019

This Research was conducted to determine the effect of ethanol extract from red chilli (Capsicum annuum L)in lowering blood glucose levels of hyperglycemic male white mices. This study used 30 malewhitemices and divided into 6 groups: negative control group, the positive control group, the treatmentgroup withdosage of 200 mg / kgweight, 400 mg / kgwieght, 600 mg / kg weight and a comparison group with glibenclamide with dosage of 5 mg / kgweightadministered orally for 21 days. The level of fasting blood glucose was checked 6 days after dexamethasone induced, and after the ethanol extract of red chilies on day 7th, 14th, and 21st. The data was analyzed statistically with one –way and two-way Anova by usingSPSS16 program and proceed with the test Duncan to look the significant difference between treatments. The results showed that the ethanol extract from red chilies with a dosage of 200mg / kgweight, 400mg / kgweight, 600 mg / kgweight showed the effect in lowering blood sugar levels in male white mices hyperglycemia significantly (p <0.05). The duration ethanol extract of red chili affected blood glucose levels. The most effective duration in lowering blood glucose levels is the administration of a preparation within 21 days.
The Evolution of The Handball Talent Care System in Hungary - pilot study
Authors: Juhász Bernadett , Bácsné Bába Éva
Published: September 2019

Development of talents care systems plays an important role in handball today. The goal of the Hungarian Handball Association is to ensure that all children of the same age receive the same training throughout the country. The Association recently introduced a standard feed-back education system. The aim of this research was to demonstrate the evolution of the talent care system, especially the innovations introduced by the Association.

The research method was interviewing handball experts. Five experts answered our questions, former elite players, currently coaches. Based on their responses, it was possible to compare the old and the current status of the training programmes. We may conclude, that the structure of handball training has significantly developed both technically and tactically. Professionals agree, that there are a number of changes have occurred in the theory and methodology of handball. The newly introduced regional, electronic control system – described in the Age Handbook were considered to be useful by the interviewees. According to the results of our pilot study, the new unified educational training system may result in a more successful international presence in the long term.
Compliance with antimicrobials de-escalation in septic patients and mortality rates
Authors: Wadi Al Ramahi M.D, FIDSA Jamal , Abu Khalaf Omran , Abu Shanab Lamya , Obaidat Pharm Mohammad , Al Hasan Maha , Mhanna Mohammed , Abdulghani Maha Hashim
Published: September 2019

Background

To compare the recent de-escalations rates with a six-year earlier study, and mortality associated with de-escalation.

Methods

Settings

A prospective multicenter study including septic patients, all were on broad-spectrum antimicrobials (BSA). Excluded from the study patients on antimicrobial prophylaxis, and patients without a microbiological diagnosis, or bacteria were solely BSA-susceptible. The study team made recommendations for antimicrobials de-escalation to the treating physician(s) must an opportunity loomed.

Results

182 patients were available for analysis. De-escalation was achieved in 43 (24%) patients. The clinical diagnoses, comorbidities, commonly used antimicrobials, the microbiological diagnoses were not different between the two groups (patients with and without de-escalation). Logistic regression analysis showed no correlation between bacterial species and de-escalation (Nagelkerke R2 = 0.076). Relapsing sepsis and reinfection were not different (P > 0.05). The in-hospital mortality rates for the de-escalated patients were lower (P = 0.015), not on day 30 (P = 0.354). The length of the ICU stay and ward stay were not different (P >0.05), but more de-escalated patients were discharged home from the ICU (P = 0.034), however, patients without de-escalation were discharged more from the ward (P = 0.002).

   Conclusion

De-escalation rates increased within six years from 6.7% - 24% (P = 0.000), with added benefits of shorter ICU stay and less in-hospital mortality
TRANSPORTATION NETWORK COMPANIES AND DRIVERS DILEMMA IN CHINA: AN EVOLUTIONARY GAME THEORETIC PERSPECTIVE
Authors: Lei Licai , Gao Shang
Published: September 2019

The ridesourcing services market in China has recently experienced significant changes, which stem from its legalization and management policy. These changes impact multiple stakeholders of this market (e.g., drivers, passengers, government, competing services) and present them with new opportunities and challenges. This paper develops an evolutionary game model to analyse the Evolutionary Stable Strategy (ESS) between the Transportation Network Companies (TNCs) and drivers. The new model is explored and analysed with simulation experiments to observe the dynamic route of multiple stakeholders. The theoretical research and simulation results indicate that under the authorities’ control over the TNCs, when the net income under strict management is higher than that of the loose management for the TNCs, the final ESS is “Legal Operation, Strict Management”. When the net income under strict management is less than that of the loose management for the THCs, the strategy of “Illegal Operation, Loose Management” may gain popularity and continue to grow; in this case, the ESS may also not exist. The model indicates the strength of the government’s control plays a significant role in leading the achievement of “Legal Operation, Strict Management”. As a consequence, to achieve the perfect evolution of “Legal Operation, Strict Management”, it is necessary for the government to impose a greater penalty on illegal drivers and ensure appropriate compensation measures. The results of the study provide a useful reference for the sustainable development of the ridesourcing services market.
The Quadratic Programming Method for Extracting Emission Line Maps from Line-blended Narrowband Images
Authors: Ueta 植田 Toshiya 稔也 , Mito 三戸 Hiroyuki 洋之 , Otsuka 大塚 Masaaki 雅昭 , Nakada 中田 Yoshikazu 好一 , Conn Blair C. , Ladjal Djazia
Published: September 2019

We present a method to separate blended line emission from a set of narrowband (NB) images whose distinct throughput profiles overlap with each other. This method, based on the principle of quadratic programming (QP), treats line blending as a linearly constrained quadratic optimization problem and finds the solution by imposing a condition that the desired individual line intensities are always positive while allowing measurement uncertainties. We demonstrate the method for the quintessential example of line blending in the Hα complex by the Hα and [N ii] lines using the archived Hubble Space Telescope WFPC2 and WFC3 NB images of the planetary nebula NGC 6720, in comparison with its genuine line maps extracted from a spectral cube obtained by our own long-slit scan mapping observations with the Gemini Multi-Object Spectrograph at Gemini-North. Such line-blended NB images typically permit only qualitative line diagnostics, which can lead to a factor of a few difference in the line flux ratios. This novel QP method, however, can extract individual line emission maps as long as the number of line-blended but well-calibrated NB images of differing throughputs is equal to or grater than the number of emission line maps to be extracted. The proposed QP method provides a viable alternative to the existing line emission calibration methods: a simple but innovative way to enable quantitative fully 2D plasma diagnostics at the pixel scale of input NB images available from various instruments, telescopes, and archives.
Constraining the Metallicities, Ages, Star Formation Histories, and Ionizing Continua of Extragalactic Massive Star Populations∗
Authors: Chisholm J. , Rigby J. R. , Bayliss M. , Berg D. A. , Dahle H. , Gladders M. , Sharon K.
Published: September 2019

We infer the properties of massive star populations using the far-ultraviolet stellar continua of 61 star-forming galaxies: 42 at low redshift observed with the Hubble Space Telescope and 19 at z ∼ 2 from the MegaSaura sample. We fit each stellar continuum with a linear combination of up to 50 single-age and single-metallicity starburst99 models. From these fits, we derive light-weighted ages and metallicities, which agree with stellar wind and photospheric spectral features, and infer the spectral shapes and strengths of the ionizing continua. Inferred light-weighted stellar metallicities span 0.05–1.5 Z
⊙ and are similar to the measured nebular metallicities. We quantify the ionizing continua using the ratio of the ionizing flux at 900 Å to the non-ionizing flux at 1500 Å and demonstrate the evolution of this ratio with stellar age and metallicity using theoretical single-burst models. These single-burst models only match the inferred ionizing continua of half of the sample, while the other half are described by a mixture of stellar ages. Mixed-age populations produce stronger and harder ionizing spectra than continuous star formation histories, but, contrary to previous studies that assume constant star formation, have similar stellar and nebular metallicities. Stellar population age and metallicity affect the far-UV continua in different and distinguishable ways; assuming a constant star formation history diminishes the diagnostic power. Finally, we provide simple prescriptions to determine the ionizing photon production efficiency (ξ
ion) from the stellar population properties. The ξ
ion inferred from the observed star-forming galaxies has a range of log(ξ
ion) = 24.4–25.7 Hz erg−1 that depends on the stellar population age, metallicity, star formation history, and contributions from binary star evolution. These stellar population properties must be observationally determined to accurately determine the number of ionizing photons generated by massive stars.
Conflicting Disk Inclination Estimates for the Black Hole X-Ray Binary XTE J1550−564
Authors: Connors Riley M. T. , García Javier A. , Steiner James F. , Grinberg Victoria , Dauser Thomas , Sridhar Navin , Gatuzz Efrain , Tomsick John , Markoff Sera B. , Harrison Fiona
Published: September 2019

The dynamical characteristics of XTE J1550−564, a black hole X-ray binary, are well established, and the broadband spectral evolution of the source has been well studied. Its orbital inclination is known to be high, at ∼75°, with the jet estimated to align well with the orbital axis. We explore simultaneous observations made with the Advanced Satellite for Cosmology and Astrophysics and Rossi X-ray Timing Explorer covering the 1–200 keV band during the early stages of the first outburst of XTE J1550−564 in its hard-intermediate state on 1998 September 23/24. We show that the most up-to-date reflection models applied to these data yield an inclination estimate much lower than that found in previous studies at ∼40°, grossly disagreeing with the dynamically estimated orbital inclination. We discuss the possible explanations for this disagreement and its implications for reflection models, including possible physical scenarios in which either the inner disk is misaligned with both the binary orbit and the outer jet or the inner accretion flow, corona, and/or jet have vertical structure that leads to lower inferred disk inclination through various physical means.
Fragmentation in Population III Galaxies Formed through Ionizing Radiation
Authors: Kulkarni Mihir , Visbal Eli , Bryan Greg L.
Published: September 2019

Population III stars forming in minihalos tend to be relatively inefficient, with each minihalo hosting one or a small number of stars which are more massive than local stars, but still challenging to observe directly at high redshift. Here we explore a possible mechanism for the generation of larger clusters of such stars: a nearby ionizing source that ionizes a late forming halo, delaying its collapse until the halo is sufficiently large enough that the core can self-shield and suffer runaway collapse. We use simulations with a simple but accurate model for the radiative ionizing flux and confirm the basic predictions of previous work: higher ionizing fluxes can delay the collapse to lower redshifts and higher masses, up to an order of magnitude above the atomic cooling limit. In a limited number of runs we also examine the fragmentation of the cores at even higher resolution, using both simple estimates and sink particles to show that the number of fragments is generally small, at most a handful, and that the mass accretion rate on the fragments is of order 10−3
M
⊙ yr−1. This rate is sufficiently high enough that the descent on the main sequence (and hence the suppression of accretion) is delayed until the stellar masses are of order 100–1000 M
⊙, but not high enough to produce direct collapse black holes of mass ∼105
M
⊙. The resulting clusters are larger than those produced in minihalos, but are still likely to fall short of being easily detectable in James Webb Space Telescope blind fields.
Chemical Abundance Analysis of Tucana III, the Second r-process Enhanced Ultra-faint Dwarf Galaxy*
Authors: Marshall J. L. , Hansen T. , Simon J. D. , Li T. S. , Bernstein R. A. , Kuehn K. , Pace A. B. , DePoy D. L. , Palmese A. , Pieres A. , Strigari L. , Drlica-Wagner A. , Bechtol K. , Lidman C. , Nagasawa D. Q. , Bertin E. , Brooks D. , Buckley-Geer E. , Burke D. L. , Rosell A. Carnero , Kind M. Carrasco , Carretero J. , Cunha C. E. , D’Andrea C. B. , Costa L. N. da , Vicente J. De , Desai S. , Doel P. , Eifler T. F. , Flaugher B. , Fosalba P. , Frieman J. , García-Bellido J. , Gaztanaga E. , Gerdes D. W. , Gruendl R. A. , Gschwend J. , Gutierrez G. , Hartley W. G. , Hollowood D. L. , Honscheid K. , Hoyle B. , James D. J. , Kuropatkin N. , Maia M. A. G. , Menanteau F. , Miller C. J. , Miquel R. , Plazas A. A. , Sanchez E. , Santiago B. , Scarpine V. , Schubnell M. , Serrano S. , Sevilla-Noarbe I. , Smith M. , Soares-Santos M. , Suchyta E. , Swanson M. E. C. , Tarle G. , Wester W. ,   (DES Collaboration)
Published: September 2019

We present a chemical abundance analysis of four additional confirmed member stars of Tucana III, a Milky Way satellite galaxy candidate in the process of being tidally disrupted as it is accreted by the Galaxy. Two of these stars are centrally located in the core of the galaxy while the other two stars are located in the eastern and western tidal tails. The four stars have chemical abundance patterns consistent with the one previously studied star in Tucana III: they are moderately enhanced in r-process elements, i.e., they have

dex. The non-neutron-capture elements generally follow trends seen in other dwarf galaxies, including a metallicity range of 0.44 dex and the expected trend in α-elements, i.e., the lower metallicity stars have higher Ca and Ti abundances. Overall, the chemical abundance patterns of these stars suggest that Tucana III was an ultra-faint dwarf galaxy, and not a globular cluster, before being tidally disturbed. As is the case for the one other galaxy dominated by r-process enhanced stars, Reticulum II, Tucana III’s stellar chemical abundances are consistent with pollution from ejecta produced by a binary neutron star merger, although a different r-process element or dilution gas mass is required to explain the abundances in these two galaxies if a neutron star merger is the sole source of r-process enhancement.
Detailed Chemical Composition and Orbit of the Newly Discovered Globular Cluster FSR 1758: Implications for the Accretion of the Sequoia Dwarf Galaxy onto the Milky Way*
Authors: Villanova Sandro , Monaco Lorenzo , Geisler Doug , O’Connell Julia , Minniti Dante , Assmann Paulina , Barbá Rodolfo
Published: September 2019

We present detailed chemical abundances, radial velocity, and orbital parameters for FSR 1758, a recently discovered massive cluster in the direction of the Galactic bulge. High-resolution (R ∼ 42,000) spectra were obtained for nine members using the Magellan/Clay telescope instrumented with the MIKE echelle spectrogragh in the wavelength range of ∼4900–8700 Å. Cluster membership was determined using Gaia DR2 proper motions and confirmed with our radial velocity measurements. We find a metallicity of [Fe/H] = −1.58 ± 0.03, consistent with previous photometric estimates, and no significant iron spread. While other studies have suggested that this massive object could be the remnant of a captured dwarf galaxy, our results are consistent with a globular cluster (GC) nature, given its lack of any intrinsic metallicity spread and the Na–O anticorrelation similar to those of other GC. In addition, the small velocity dispersion of 4.9 ± 1.2 km s−1 we find is that typical of a GC. We also confirm a retrograde orbit that appears to be highly eccentric suggesting it is a halo interloper currently in the bulge. We support the hypothesis that FSR 1758 was part of a disrupted dwarf galaxy named Sequoia.
H2 Ortho–Para Spin Conversion on Inhomogeneous Grain Surfaces
Authors: Furuya Kenji , Aikawa Yuri , Hama Tetsuya , Watanabe Naoki
Published: September 2019

We investigate the evolution of the ortho-to-para ratio of overall (gas + ice)

via the nuclear spin conversion on grain surfaces coated with water ice under physical conditions that are relevant to star- and planet-forming regions. We utilize the rate equation model that considers adsorption of gaseous

on grain surfaces, which have a variety of binding sites with a different potential energy depth, thermal hopping, desorption, and the nuclear spin conversion of adsorbed

. It is found that the spin conversion efficiency depends on the

gas density and the surface temperature. As a general trend, enhanced

gas density reduces the efficiency, while the temperature dependence is not monotonic; there is a critical surface temperature at which the efficiency is the maximum. At low temperatures, the exchange of gaseous and icy

is inefficient (i.e., adsorbed

does not desorb and hinders another gaseous

to be adsorbed), while at warm temperatures, the residence time of

on surfaces is too short for the spin conversion. Additionally, the spin conversion becomes more efficient with lowering the activation barriers for thermal hopping. We discuss whether the spin conversion on surfaces can dominate over that in the gas phase in star- and planet-forming regions. Finally, we establish a simple, but accurate way to implement the

spin conversion on grain surfaces in existing gas-ice astrochemical models.
Hunting Young White Dwarfs at the Center of Planetary Nebulae
Authors: Ahumada Javier A. , Weidmann Walter A. , Miller Bertolami Marcelo M. , Saker Leila
Published: September 2019

We present Gemini-South observations of nine faint and extended planetary nebulae (PNe). Using direct images taken with the spectrograph Gemini-South multi-object spectrograph (GMOS), we built the

versus

diagrams of the stars in the observed areas which allowed us to consider their geometrical positions and identify the probable central stars of the nebulae. Our stellar spectra of seven stars, also taken with GMOS, indicate that four (and probably two more) objects are white dwarfs of the DAO subtype. Moreover, the white dwarf status of the four stars is confirmed by the parameters T
eff and log g derived with the help of theoretical stellar spectra. Given this evidence, we propose that these hot stars are the central ionizing sources of the nebulae. With this work we hope to help improve the current scarce statistics on central white dwarfs in PNe.
The West Palaearctic genera of Nematinae (Hymenoptera, Tenthredinidae)
Authors: Prous Marko , Liston Andrew , Kramp Katja , Savina Henri , Vårdal Hege , Taeger Andreas
Published: September 2019

Keys to adults and larvae of the genera of West Palaearctic nematine sawflies are presented. Species of some of the smaller genera are keyed, and their taxonomy, distribution, and host plants reviewed, with a geographic focus on north-western Europe, particularly Sweden.DinematusLacourt, 2006 is a new junior subjective synonym ofPristiphoraLatreille, 1810, resulting in the new combinationPristiphora krausi(Lacourt, 2006) for the type species ofDinematus.Hemichroa monticolaErmolenko, 1960 is a new junior subjective synonym ofHemichroa australis(Serville, 1823). Lectotypes are designated forTenthredo opacaFabricius, 1775, Mesoneura opaca var. nigerrima Enslin, 1914, Mesoneura opaca var. obscuriventris Enslin, 1914,Nematus hypogastricusHartig, 1837,Nematus alnivorusHartig, 1840,Leptopus rufipesFörster, 1854,Nematus protensusFörster, 1854, and Platycampus luridiventris var. pleuritica Enslin, 1915. A phylogenetic analysis based on four genes (mitochondrial COI and nuclear NaK, POL2, and TPI) supports the current generic classification.
Magnetic Resonance Imaging Followup of Temporomandibular Joint Inflammation, Deformation, and Mandibular Growth in Juvenile Idiopathic Arthritis Patients Receiving Systemic Treatment
Authors: Bollhalder Andrea , Patcas Raphael , Eichenberger Martina , Müller Lukas , Schroeder-Kohler Silke , Saurenmann Rotraud Katharina , Kellenberger Christian Johannes
Published: September 2019

Objective.

To investigate the course of temporomandibular joint (TMJ) inflammation, osseous deformation, and mandibular ramus growth in children with juvenile idiopathic arthritis (JIA) during systemic therapy.

Methods.

Longitudinal study of 38 consecutive patients with JIA (29 female, median age 9.0 yrs, interquartile range 6.2–10.7 yrs) receiving systemic therapy with TMJ involvement, with 2 TMJ magnetic resonance imaging (MRI) examinations ≥ 2 years apart and no TMJ corticosteroid injection. Clinical and MRI findings were compared between initial and followup examinations and between TMJ with and without active inflammation at baseline.

Results.

Over a median period of 3.6 years (range, 2.0–8.7 yrs), MRI grade of TMJ inflammation improved (p = 0.009) and overall osseous deformity tended to become less severe (p = 0.114). In TMJ with arthritis at baseline (46 TMJ), both the grades of inflammation (p < 0.001) and deformity (p = 0.011) improved. In TMJ with no arthritis at baseline (30 TMJ), the frequency and grade of condylar deformation remained stable. Mandibular ramus growth rates were not significantly different between TMJ with and without arthritis at baseline (1.3 mm/yr vs 1.5 mm/yr, p = 0.273), and were not correlated with the degree of inflammation at baseline or followup. The frequency of facial asymmetry tended to be lower at followup than at initial examination (24% vs 45%, p = 0.056).

Conclusion.

Our results suggest that systemic treatment of TMJ arthritis in children with JIA decreases the degree of inflammation seen on MRI, preserves osseous TMJ morphology, and maintains normal mandibular ramus growth.
Analysis of 47 Non-MHC Ankylosing Spondylitis Susceptibility Loci Regarding Associated Variants across Whites and Han Chinese
Authors: Zheng Xuqi , Li Qiuxia , Li Xiaomin , Zhang Yanli , Wu Xinyu , Wei Qiujing , Cao Shuangyan , Yang Mingcan , Lin Zhiming , Liao Zetao , Qi Jun , Lv Qing , Wang Ling , Li Yi , Irwanto Astrid , Cheng Ching-Yu , Chai Xiaoran , Khor Chiea Chuen , Heng Chew-Kiat , Koh Woon-Puay , Yuan Jian-Min , Bei Jinxin , Zhang Furen , Zhang Xuejun , Zeng Yixin , Shen Yan , Liu Jianjun , Gu Jieruo
Published: September 2019

Objective.

To present a systematic evaluation of 47 non-MHC ankylosing spondylitis (AS) susceptibility loci that have been initially discovered through white genome-wide association studies in Han Chinese.

Methods.

Originally, 10,743 samples representing north and south Chinese in 4 datasets were obtained. After data quality control and imputation, metaanalysis results of 94,621 variants within 47 loci were extracted. Four ERAP1 single-nucleotide polymorphisms (SNP) and HLA-B27 tag SNP rs13202464 were used for interaction analysis. Population-attributable risk percentages of AS-associated variants were compared. Functional annotations of AS-associated variants were conducted using HaploReg, RegulomeDB, and rVarBase databases.

Results.

We revealed 16 AS-associated variants with nominal evidence in Han Chinese, including rs10865331 (p = 6.30 × 10−10), rs10050860 (p = 4.09 × 10−5) and rs8070463 (p = 1.03 × 10−4). Potential susceptible SNP within these 47 loci were also identified, such as rs13024541 (2p15), rs17401719 (5q15), and rs62074054 (17q21). Epistatic interactions between 3 ERAP1 SNP (rs17401719, rs30187, and rs10050860) and HLA-B27 were confirmed. Among the 16 AS-associated variants, rs30187 showed weaker risk effect, while rs10050860 and rs12504282 seemed to attribute more risk in Han Chinese than in whites. Further genomic annotation pinpointed 35 candidate functional SNP, especially in the 2p15, ERAP1, and NPEPPS-TBKBP1 regions.

Conclusion.

Our results provided a detailed spectrum of all the reported non-MHC AS susceptibility loci in Han Chinese, which comprehensively exhibited the ethnic heterogeneity of AS susceptibility and highlighted that 2p15, ERAP1, and NPEPPS-TBKBP1 regions may play a critical role in AS pathogenesis across diverse populations.
Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis: 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort
Authors: Glerup Mia , Stoustrup Peter , Matzen Louise H. , Rypdal Veronika , Nordal Ellen , Frid Paula , Arnstad Ellen Dalen , Rygg Marite , Thorarensen Olafur , Ekelund Maria , Berntson Lillemor , Fasth Anders , Nilsson Håkan , Peltoniemi Suvi , Aalto Kristiina , Arte Sirpa , Toftedal Peter , Nielsen Susan , Kreiborg Sven , Herlin Troels , Pedersen Thomas Klit
Published: September 2019

Objective.

To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.

Methods.

Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.

Results.

Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.

Conclusion.

This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.
Sjögren Syndrome in Systemic Lupus Erythematosus: A Subset Characterized by a Systemic Inflammatory State
Authors: Ruacho Guillermo , Kvarnström Marika , Zickert Agneta , Oke Vilija , Rönnelid Johan , Eketjäll Susanna , Elvin Kerstin , Gunnarsson Iva , Svenungsson Elisabet
Published: September 2019

Objective.

An often-neglected subset of patients with systemic lupus erythematosus (SLE) is those with secondary Sjögren syndrome (SLE-sSS). Further, primary SS overlaps and can be difficult to delineate from SLE. To shed light on the SLE-sSS subset, we investigated a large and well-characterized SLE cohort, comparing patients with SLE-sSS and SLE patients without SS (SLE-nonsSS) and controls.

Methods.

We included 504 consecutive patients with SLE, fulfilling the 1982 revised American College of Rheumatology criteria, and 319 controls from the general population, matched for age and sex to the first 319 patients. SLE-sSS was defined according to the American-European Consensus Criteria (AECC). A thorough clinical examination, including subjective and objective quantifications of sicca symptoms, was performed in all participants. Autoantibodies and 20 selected cytokines were measured by luminex and multiplex analysis, respectively.

Results.

SLE-sSS, as defined by AECC, occurred in 23% of the patients with SLE. In comparison to SLE-nonsSS, the SLE-sSS group was older and more frequently female. Leukopenia and peripheral neuropathy were more frequent and nephritis less frequent. Circulating levels of 6/20 investigated proinflammatory cytokines [tumor necrosis factor-α, interleukin (IL) 6, monocyte chemoattractant protein 4, macrophage inflammatory protein 1β, IL-12/IL-23p40, and interferon γ–induced protein 10], total IgG, anti-SSA/Ro52, anti-SSA/Ro60, anti-SSB/La antibodies, and rheumatoid factor (IgM and IgA) were higher in the SLE-sSS group (p < 0.05 for all comparisons).

Conclusion.

The frequency of SLE-sSS increased with age and affected roughly one-quarter of all patients with SLE. Despite less internal organ involvement, a systemic inflammatory state with high levels of proinflammatory cytokines is present in the SLE-sSS subgroup. This is a novel observation that may affect future understanding and treatment of the SLE-sSS subset.
Rising Incidence of Acute Hospital Admissions due to Gout
Authors: Russell Mark D. , Yates Mark , Bechman Katie , Rutherford Andrew I. , Subesinghe Sujith , Lanyon Peter , Galloway James B.
Published: September 2019

Objective.

To describe trends in acute hospital admissions due to gout in England, with rheumatoid arthritis (RA) as a comparator, alongside prescribing trends for common gout medications.

Methods.

An ecological study was performed using UK National Health Service (NHS) Digital Hospital Episode Statistics data to calculate the incidence of unplanned admissions with primary diagnoses of gout or RA in adults in England between April 2006 and March 2017. NHS Digital Community Prescription data for allopurinol, febuxostat, and colchicine were considered over a similar period.

Results.

The incidence of unplanned gout admissions increased by 58.4% over the study period, from 7.9 admissions per 100,000 population in 2006/07 to 12.5 admissions per 100,000 population in 2016/17 (p < 0.0001). Gout admissions increased as a proportion of all hospital admissions, and accounted for 349,768 bed-days cumulatively. Unplanned RA admissions halved over the study period, from 8.6 admissions per 100,000 population in 2006/07 to 4.3 admissions per 100,000 population in 2016/17 (p < 0.0001). Community prescriptions dispensed for allopurinol and colchicine have increased by 71.4% and 165.6%, respectively, since 2006 (p < 0.0001). Febuxostat prescriptions have increased 20-fold since 2010 (p < 0.0001), when prescription data became available.

Conclusion.

Acute gout admissions in England increased between 2006 and 2017, accompanied by increasing prescription of gout therapies. Acute admissions due to RA halved over the same time period. These data call for aggressive target-driven therapy for this highly treatable disease.
Reliability of Magnetic Resonance Imaging (MRI) Scoring of the Metatarsophalangeal Joints of the Foot according to the Rheumatoid Arthritis MRI Score
Authors: Dakkak Yousra J. , Matthijssen Xanthe M.E. , van der Heijde Désirée , Reijnierse Monique , van der Helm-van Mil Annette H.M.
Published: September 2019

Objective.

The Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) is validated for hand MRI. Its reliability applied to metatarsophalangeal (MTP 1–5) joints is unknown and was studied in early arthritis and clinically suspect arthralgia.

Methods.

Patients underwent 1.5 Tesla MRI of MTP, metacarpophalangeal (MCP 2–5), and wrist joints. Two paired readers scored bone marrow edema (BME), synovitis, tenosynovitis, and erosions. Interreader reliability was assessed of 441 consecutive early arthritis patients at baseline, 215 by 2 readers, and the remaining 226 by 2 different readers. Two readers scored baseline MRI of 82 consecutive patients with clinically suspect arthralgia, and 40 randomly selected patients by 9 readers. Intrareader reliability was determined on a random set of 15 early arthritis patients, scored twice by 2 readers. For change scores, 30 early arthritis patients with baseline and 1-year followup MRI were scored by 2 readers. Intraclass correlation coefficients (ICC), Bland-Altman (BA) plots, and smallest detectable change (SDC) were determined. MRI data of MTP joints were compared to wrist and MCP joints.

Results.

Interreader ICC and mean scores in early arthritis were BME ICC 0.91–0.92 (mean 1.5 ± SD 2.6), synovitis 0.90–0.92 (1.3 ± 1.7), tenosynovitis 0.80–0.85 (1.1 ± 1.8), and erosions 0.88–0.89 (0.7 ± 1.0). In patients with clinically suspect arthralgia, ICC were comparable. Intrareader ICC for inflammatory MRI features were 0.84–0.98, for erosions 0.71 (reader 1), and 0.92 (reader 2). Change score ICC were ≥ 0.90, except erosions (0.77). SDC were ≤ 1.0. BA plots showed no systematic bias. Reliability scores of MTP joints were similar to MCP and wrist joints.

Conclusion.

Status and change MRI scores of BME, synovitis, tenosynovitis, and erosions of MTP joints can be assessed reliably by RAMRIS.
Adherence to Treat-to-target Management in Rheumatoid Arthritis and Associated Factors: Data from the International RA BIODAM Cohort
Authors: Sepriano Alexandre , Ramiro Sofia , FitzGerald Oliver , Østergaard Mikkel , Homik Joanne , van der Heijde Désirée , Elkayam Ori , Thorne J. Carter , Larché Maggie J. , Ferraccioli Gianfranco , Backhaus Marina , Burmester Gerd R. , Boire Gilles , Combe Bernard , Schaeverbeke Thierry , Saraux Alain , Dougados Maxime , Rossini Maurizio , Govoni Marcello , Sinigaglia Luigi , Cantagrel Alain , Barnabe Cheryl , Bingham Clifton O. , Tak Paul P. , van Schaardenburg Dirkjan , Hammer Hilde Berner , Paschke Joel , Dadashova Rana , Hutchings Edna , Landewé Robert , Maksymowych Walter P.
Published: September 2019

Objective.

Compelling evidence supports a treat-to-target (T2T) strategy for optimal outcomes in rheumatoid arthritis (RA). There is limited knowledge regarding the factors that impede implementation of T2T, particularly in a setting where adherence to T2T is protocol-specified. We aimed to assess clinical factors that associate with failure to adhere to T2T.

Methods.

Patients with RA from 10 countries who were starting or changing conventional synthetic disease-modifying antirheumatic drugs and/or starting tumor necrosis factor inhibitors were followed for 2 years. Participating physicians were required per protocol to adhere to the T2T strategy. Factors influencing adherence to T2T low disease activity (T2T-LDA; 44-joint count Disease Activity Score ≤ 2.4) were analyzed in 2 types of binomial generalized estimating equations models: (1) including only baseline features (baseline model); and (2) modeling variables that inherently vary over time as such (longitudinal model).

Results.

A total of 571 patients were recruited and 439 (76.9%) completed 2-year followup. Failure of adherence to T2T-LDA was noted in 1765 visits (40.5%). In the baseline multivariable model, a high number of comorbidities (OR 1.10, 95% CI 1.02–1.19), smoking (OR 1.32, 95% CI 1.08–1.63) and high number of tender joints (OR 1.03, 95% CI 1.02–1.04) were independently associated with failure to implement T2T, while anticitrullinated protein antibody/rheumatoid factor positivity (OR 0.63, 95% CI 0.50–0.80) was a significant facilitator of T2T. Results were similar in the longitudinal model.

Conclusion.

Lack of adherence to T2T in the RA BIODAM cohort was evident in a substantial proportion despite being a protocol requirement, and this could be predicted by clinical features. [Rheumatoid Arthritis (RA) BIODAM cohort; ClinicalTrials.gov: NCT01476956].
The Association of Airway Comorbidities With the Clinical Phenotypes and Outcomes of Patients With Antineutrophil Cytoplasmic Autoantibody–associated Vasculitis
Authors: Ono Nobuyuki , Inoue Yasushi , Miyamura Tomoya , Ueda Naoyasu , Nagano Shuji , Inoue Hisako , Oryoji Kensuke , Ota Shun-ichiro , Sawabe Takuya , Yoshizawa Seiji , Takeyama Yukiko , Sadanaga Yuri , Takamori Ayako , Kimoto Yasutaka , Miyake Katsuhisa , Horiuchi Takahiko , Nakashima Hitoshi , Niiro Hiroaki , Tada Yoshifumi
Published: September 2019

Objective.

We investigated the association of airway comorbidities with the clinical phenotypes and outcomes of myeloperoxidase (MPO)–antineutrophil cytoplasmic antibodies (ANCA)–positive ANCA-associated vasculitis (AAV).

Methods.

An AAV patient multicenter cohort trial was established in 13 hospitals in western Japan between 2012 and 2018. We examined 143 of the new-onset MPO-ANCA–positive AAV patients. Their clinical characteristics and comorbidities at disease onset were compared based on clinical phenotypes. Multivariate analysis was performed to identify factors predictive of remission and death.

Results.

Twenty-seven cases with granulomatosis with polyangiitis (GPA), 10 with eosinophilic GPA (EGPA), 81 with microscopic polyangiitis (MPA), and 25 with unclassified AAV were identified. The average age of MPO-ANCA–positive patients was 71.4 years. Comorbidity (87.4%) and airway comorbidity (70.6%) were frequently observed in these patients. Examination of the clinical phenotypes revealed that the cases of GPA were frequently accompanied by infectious airway comorbidity (upper airway disease, bronchiectasis, pulmonary infections), and most of the cases of MPA and unclassified AAV were accompanied by fibrotic interstitial lung disease (fILD) or emphysema. Among MPO-ANCA–positive patients, infectious airway comorbidity was predictive of both remission (HR 1.58, P = 0.03) and mortality (HR 2.64, P = 0.04), and fILD was predictive of mortality (HR 7.55, P = 0.008). The combination of infectious airway comorbidities and fILD caused the worst survival outcomes in patients.

Conclusion.

MPO-ANCA–positive AAV was frequently accompanied by airway comorbidities. In addition to fILD, infectious airway comorbidities were closely associated with those clinical phenotypes and outcomes.
Le prix de l’énergie demain
Authors: Chevalier Jean-Marie
Published: September 2019

S’il est un secteur emblématique, ces dernières décennies, de la difficulté à anticiper la façon dont il va évoluer à l’échelle mondiale, c’est bien celui de l’énergie. Alerte sur les risques de pénurie d’hydrocarbures, annonce de la survenue du peak oil, boom du gaz et du pétrole de schiste… : les prévisions reposant sur les tendances lourdes ont été révisées à l’aune de l’émergence de sources non conventionnelles, avec un impact conséquent sur le niveau des prix. S’ajoute à cela la nécessité de faire face au réchauffement climatique, et donc de revoir les modes de production énergétique pour renforcer le recours aux énergies renouvelables. Dans un tel contexte, comme le souligne ici Jean-Marie Chevalier, il est bien délicat de se prononcer sur ce que sera l’évolution des prix de l’énergie et d’envisager la façon dont se transformeront les systèmes de production énergétique. C’est pourquoi au-delà du panorama des évolutions possibles des prix du pétrole, du gaz naturel et du charbon, que propose dans un premier temps cet article, celui-ci insiste aussi tout particulièrement sur les nombreux éléments d’incertitude qui dominent en la matière. Jean-Marie Chevalier montre ainsi la pluralité des facteurs et des acteurs impliqués dans l’évolution des prix de l’énergie et des systèmes énergétiques, et met en exergue les éléments clefs qui joueront un rôle moteur ou frein dans cette évolution à moyen-long terme. S.D.
Les prévisions énergétiques et leurs aléas
Authors: Greggio Rodolphe , Mafféi Benoît
Published: September 2019

Comme le souligne Jean-Marie Chevalier dans ce même numéro, il est bien délicat de se prononcer aujourd’hui sur ce que sera l’évolution des prix de l’énergie et d’envisager la façon dont se transformeront les systèmes de production énergétique. C’est bien ce que confirment ici Rodolphe Greggio et Benoît Mafféï, qui se sont intéressés à la façon dont sont élaborées les prévisions énergétiques à long terme et dont la conclusion est qu’en l’état, elles sont vouées à l’échec. Ceci résulte en particulier de la difficulté à faire des prévisions fiables en termes d’évolution de la demande d’énergie, celle-ci résultant d’évolutions exogènes et opaques à long terme (croissance démographique, croissance économique, productivité, efficience énergétique…). Cela tient également à un certain nombre d’erreurs d’anticipation de ruptures technologiques : un « âge d’or » du gaz naturel anticipé trop tôt, la valse du pic pétrolier, un pic minéralier n’ayant pas eu les incidences envisagées initialement, un déclin du nucléaire à relativiser, etc. Cela résulte enfin de divers facteurs d’ordre politique et géopolitique en lien avec les atouts respectifs des pays en matière énergétique et leur stratégie d’indépendance en ce domaine : États-Unis et gaz de schiste, France et nucléaire, Allemagne et renouvelables, par exemple. Bien évidemment, le contexte actuel laisse à penser que l’heure est à une transition progressive des énergies carbonées vers les énergies renouvelables, mais de là à prévoir précisément à quel horizon, dans quelles proportions et selon quelle ampleur géographique, il y a un pas qui paraît encore difficile à franchir. S.D.
Science-fiction et innovation
Authors: Michaud Thomas
Published: September 2019

Futuribles a lancé, dans son numéro de juillet-août 2016 (n° 413), une « saga » sur les relations et apports de la science-fiction à la prospective, afin de discerner si, et dans quelle mesure, les auteurs de science-fiction ont eu une influence sur les imaginaires collectifs et sur les réflexions prospectives. Après avoir traité ces questions sous l’angle sociopolitique et environnemental, nous reprenons cette série en abordant la science et la technologie : quels sont les rapports entre la science, la technologie et la science-fiction ? Thomas Michaud s’intéresse ici au rôle de la science-fiction dans la recherche et l’innovation, en particulier au sein des centres de R&D (recherche-développement), publics ou privés. S’appuyant sur les cas spécifiques de l’Agence spatiale européenne, de la Nano Regions Alliance (NANORA), des Orange Labs, et d’Intel et Microsoft, il montre ainsi comment la science-fiction a pu nourrir (et nourrit encore) certains projets de recherche futuristes, mais aussi comment elle peut être utilisée pour susciter des investissements ou la confiance de l’opinion afin de promouvoir certaines recherches ou technologies spécifiques. Thomas Michaud souligne enfin comment certaines entreprises stimulent ou sponsorisent les auteurs de science-fiction (SF) afin de développer un imaginaire SF en phase avec leur propre stratégie de long terme et les innovations sur lesquelles elles travaillent. Autant d’interactions que les prospectivistes doivent examiner avec un regard critique, de sorte de tracer des lignes d’avenir plausibles. S.D.
Visions politiques et défis civilisationnels
Authors: Haëntjens Jean
Published: September 2019

Le thème du manque de vision est devenu récurrent dans les commentaires de la vie politique française. C’est pourquoi, à quelques semaines des élections présidentielles (dont on pourrait souhaiter qu’elles soient une occasion de proposer de réelles visions d’avenir à moyen-long terme aux citoyens français), Futuribles a décidé de creuser cette question en publiant une série d’articles sur le déficit de vision politique, les raisons de ce déficit et les moyens d’y remédier. Jean Haëntjens nous livre ici son analyse, en s’appuyant sur les enseignements à tirer des politiques locales. Après avoir souligné les défis civilisationnels, nombreux, auxquels les sociétés, en particulier européennes et occidentales, sont confrontées, et auxquels leurs dirigeants sont appelés à répondre, il montre comment, à l’échelon local, des villes et des territoires ont pris le contrepied du paradigme dominant du développement à tout prix, et proposé de nouveaux modèles civilisationnels. Agissant concrètement, en concertation et coproduction des politiques avec des acteurs de tous horizons, ces territoires ont développé des initiatives en matière culturelle, écologique, de mobilité, etc., qui offrent de nouvelles visions d’avenir à leurs habitants, assises sur d’autres valeurs. Ces nouveaux modèles politiques, que l’on retrouve dans de nombreux pays européens, constituent un premier socle qui pourrait inspirer l’Union européenne dans sa recherche d’un modèle civilisationnel en phase avec les exigences actuelles (réchauffement, transition, respect des droits et libertés humaines…) si tant est que les dirigeants politiques de ses États membres soient en mesure de les apprivoiser collectivement… S.D.
Croissance économique et productivité
Authors: Bergeaud Antonin , Cette Gilbert , Lecat Rémy
Published: September 2019

Depuis quelques années, les débats se multiplient, en particulier dans le milieu des économistes, quant aux perspectives d’évolution de la productivité et, par extension, de la croissance économique. Alors que l’on n’a jamais autant parlé de l’essor des technologies numériques et des bouleversements qu’elles pourraient entraîner, on constate en effet, sur la période récente et dans un grand nombre de pays dits avancés, une tendance à la baisse du rythme de croissance de la productivité. Or, si elle se confirmait, celle-ci pourrait aller de pair avec une ère de stagnation économique durable. C’est pourquoi Futuribles engage, dans ce numéro, une réflexion sur la question du ralentissement des gains de productivité et ses conséquences sur l’évolution économique des pays concernés, ainsi que sur l’évolution de l’emploi et des métiers. Antonin Bergeaud, Gilbert Cette et Rémy Lecat, qui travaillent sur le sujet depuis plusieurs années, ouvrent le dossier par un panorama de l’évolution sur longue période de la productivité du travail dans les principaux pays développés, avec un focus sur le ralentissement observé ces deux dernières décennies. Ils présentent, au regard des travaux publiés sur le sujet, les origines possibles de cette baisse et les perspectives envisageables, à plus long terme, en matière d’évolution du rythme de croissance de la productivité (tassement ou rebond ?). Ils montrent enfin, compte tenu des divergences observées entre pays développés (en particulier vis-à-vis des États-Unis), quelles sont les marges de rattrapage pour l’Europe. S.D.
Les métiers de l’assurance à l’épreuve du numérique
Authors: Girard Norbert
Published: September 2019

Dans le contexte des débats actuels relatifs aux perspectives d’évolution de la productivité (en lien notamment avec le progrès technologique), Futuribles engage, dans ce numéro, une réflexion sur la question du ralentissement des gains de productivité et ses conséquences, notamment sur l’évolution de l’emploi et des métiers. Cet article de Norbert Girard apporte à ce dossier un éclairage concret sur un secteur particulièrement concerné par la vague numérique issue de l’évolution et la diffusion des technologies de l’information : celui de l’assurance. S’appuyant sur le dernier Baromètre prospectif des métiers et compétences dans l’assurance , il montre en quoi cette vague numérique a réellement affecté les métiers du secteur. Il souligne ainsi qu’elle n’a pas entraîné de baisse des effectifs mais, en revanche, une redéfinition des métiers et donc des compétences. Et c’est eu égard à ces évolutions de la nature des métiers et des modalités de la relation avec les assurés que le secteur doit s’adapter et faire en sorte de former les personnels. S.D.