bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Remission and Low Disease Activity State in Systemic Lupus Erythematosus: Data from a Multiethnic, Multinational Latin American Cohort
Authors: Ugarte-Gil Manuel F. , Wojdyla Daniel , Pons-Estel Guillermo J. , Quintana Rosana , Gómez-Puerta José A. , Catoggio Luis J. , Alvarellos Alejandro , Saurit Verónica , Borba Eduardo , Sato Emilia , Costallat Lilian , Da Silva Nilzio A. , Iglesias-Gamarra Antonio , Neira Oscar , Reyes-Llerena Gil , Cardiel Mario H. , Amigo Mary Carmen , Acevedo-Vásquez Eduardo , Esteva-Spinetti María H. , Alarcón Graciela S. , Pons-Estel Bernardo A. 
Published: March 2019

Objective.To determine the predictors of remission and low disease activity state (LDAS) in patients with systemic lupus erythematosus (SLE).Methods.Three disease activity states were defined: Remission = SLE Disease Activity Index (SLEDAI) = 0 and prednisone ≤ 5 mg/day and/or immunosuppressants (maintenance dose); LDAS = SLEDAI ≤ 4, prednisone ≤ 7.5 mg/day and/or immunosuppressants (maintenance dose); and non-optimally controlled state = SLEDAI > 4 and/or prednisone > 7.5 mg/day and/or immunosuppressants (induction dose). Antimalarials were allowed in all groups. Patients with at least 2 SLEDAI reported and not optimally controlled at entry were included in these analyses. Outcomes were remission and LDAS. Multivariable Cox regression models (stepwise selection procedure) were performed for remission and for LDAS.Results.Of 1480 patients, 902 were non-optimally controlled at entry; among them, 196 patients achieved remission (21.7%) and 314 achieved LDAS (34.8%). Variables predictive of a higher probability of remission were the absence of mucocutaneous manifestations (HR 1.571, 95% CI 1.064–2.320), absence of renal involvement (HR 1.487, 95% CI 1.067–2.073), and absence of hematologic involvement (HR 1.354, 95% CI 1.005–1.825); the use of immunosuppressive drugs before the baseline visit (HR 1.468, 95% CI 1.025–2.105); and a lower SLEDAI score at entry (HR 1.028, 95% CI 1.006–1.051 per 1-unit decrease). These variables were predictive of LDAS: older age at entry, per 5-year increase (HR 1.050, 95% CI 1.004–1.098); absence of mucocutaneous manifestations (HR 1.401, 95% CI 1.016–1.930) and renal involvement (HR 1.344, 95% CI 1.049–1.721); and lower SLEDAI score at entry (HR 1.025, 95% CI 1.009–1.042).Conclusion.Absence of mucocutaneous, renal, and hematologic involvement, use of immunosuppressive drugs, and lower disease activity early in the course of the disease were predictive of remission in patients with SLE; older age was predictive of LDAS.
Pregnancy Outcomes in Couples with Males Exposed to Longterm Anti–tumor Necrosis Factor–α Inhibitor Therapies: A Prospective Study
Authors: Micu Mihaela C. , Ostensen Monika , Bojincă Violeta , Șerban Oana , Mihai Minodora , Suța Cristina , Ramazan Anamaria , Enache Luminița , Bobircă Anca , Pătcaș Sergiu F. , Micu Romeo , Ionescu Ruxandra 
Published: March 2019

Objective.To examine the pregnancy achievement and outcomes in couples in which men with spondyloarthritis (SpA) were exposed to tumor necrosis factor inhibitors (TNFi).Methods.Information about pregnancies involving fathers with SpA was prospectively collected by 6 Romanian rheumatology centers.Results.Twenty-seven patients achieved 33 pregnancies and fathered 30 healthy children. Three elective abortions (personal reasons) and no spontaneous abortions, preeclampsia/eclampsia, stillbirths, congenital malformations, or pathologies in the children were recorded. Five patients showed normospermia before and after longterm TNFi treatment.Conclusion.Pregnancy and child outcomes in male patients with SpA exposed to longterm TNFi therapy were reassuring.
Safety and Efficacy of Intravenous Golimumab in Adults with Ankylosing Spondylitis: Results through 1 Year of the GO-ALIVE Study
Authors: Reveille John D. , Deodhar Atul , Caldron Paul H. , Dudek Anna , Harrison Diane D. , Kim Lilianne , Lo Kim Hung , Leu Jocelyn H. , Hsia Elizabeth C. 
Published: March 2019

Objective.Evaluate safety and efficacy of intravenous (IV) golimumab (GOL) in patients with active ankylosing spondylitis (AS) through 1 year.Methods.A total of 208 patients were randomized to IV infusions of GOL 2 mg/kg (n = 105) at weeks 0, 4, and every 8 weeks thereafter or placebo (n = 103) at weeks 0, 4, and 12, then crossover to GOL at weeks 16, 20, and every 8 weeks thereafter through Week 52. Efficacy was assessed using the Assessment of Spondyloarthritis international Society (ASAS) criteria, the Ankylosing Spondylitis Disease Activity Score (ASDAS), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI). Health-related quality of life was assessed using the AS Quality of Life (ASQoL) index. Efficacy and safety were monitored through Week 52 and Week 60, respectively.Results.The primary endpoint (ASAS20) and all controlled endpoints at Week 16 were achieved. At Week 52, 69.5% and 65.0% of patients in the GOL group and placebo crossover group, respectively, achieved an ASAS20; 56.2% and 51.5% achieved an ASAS40; 56.2% and 55.3% achieved a BASDAI50; 24.8% and 24.3% achieved ASAS partial remission; and 25.7% and 26.2% met ASDAS inactive disease criteria (all last observation carried forward). Mean changes from baseline to Week 52 in BASFI and ASQoL scores were similar between the GOL group and the placebo crossover group (BASFI: −2.7 and −2.6; ASQoL: −5.5 and −5.4). Through Week 60, 55.4% of all GOL-treated patients had ≥ 1 adverse events (AE); 3.4% had ≥ 1 serious AE.Conclusion.Efficacy was maintained through 1 year with IV GOL 2 mg/kg among patients with active AS. AE were consistent with the known safety profile of GOL.
Association of Physical Activity and Medication with Enthesitis on Ultrasound in Psoriatic Arthritis
Authors: Wervers Kim , Herrings Irene , Luime Jolanda J. , Tchetverikov Ilja , Gerards Andreas H. , Hazes Johanna M.W. , Vis Marijn 
Published: March 2019

Objective.Enthesitis is a manifestation of psoriatic arthritis (PsA), but its symptoms are difficult to interpret clinically. We investigated the associations of ultrasonographic changes in entheses with clinical characteristics in patients with PsA, and compared enthesis changes of patients aged 35 to 60 years with healthy volunteers of that age.Methods.Consecutive patients with PsA participated in this cross-sectional study, irrespective of enthesitis complaints and age. We collected data about complaints, physical activity and activity avoidance, medication, and clinical enthesitis. Inflammatory and structural enthesis changes were scored with the modified MAdrid Sonographic Enthesitis Index (MASEI). Among all patients, associations between ultrasound (US) scores and clinical characteristics were investigated using linear regression. We compared US scores of healthy volunteers and patients with PsA aged 35–60 years using Wilcoxon rank-sum tests.Results.Eighty-four patients with PsA and 25 healthy volunteers participated. In patients with PsA, we found a small association between higher inflammatory-modified MASEI score and older age (β 0.07, 95% CI 0–0.13) and current use of biologics (β 1.56, 95% CI 0.16–2.95). Patients who reported avoiding activities had significantly lower inflammatory-modified MASEI scores (β −1.71, 95% CI −3.1 to −0.32) than those who did not. The patients with PsA aged 35–60 years (n = 50) had similar inflammatory scores as healthy volunteers but higher structural scores (median 6 vs 2; p = 0.01).Conclusion.Within patients with PsA, avoiding physical activity, younger age, and not using biologics were associated with less enthesis inflammation. Patients with PsA and healthy volunteers aged 35 to 60 years displayed similar levels of inflammatory changes of the entheses, but patients had more structural damage.
Breastfeeding among Women with Rheumatoid Arthritis Compared with the General Population: Results from a Nationwide Prospective Cohort Study
Authors: Ince-Askan Hilal , Hazes Johanna M.W. , Dolhain Radboud J.E.M. 
Published: March 2019

Objective.The World Health Organization recommends that infants be exclusively breastfed until the age of 6 months. The first objective was to compare breastfeeding frequencies and time of cessation between women with rheumatoid arthritis (RA) and the general population. The second objective was to identify why patients with RA discontinue breastfeeding.Methods.This study was embedded in the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) study, a nationwide prospective cohort study. From 2002 to 2008, a total of 249 pregnancies were followed from pregnancy until 6 months postpartum. Data on lactation and medication use were collected. Proportion tests were used to compare percentages of breastfeeding between the study population and the general/reference population.Results.At 4–6, 12, and 26 weeks postpartum, 43%, 26%, and 9% of the RA patients breastfed their offspring, respectively, compared with 63%, 46%, and 41% in the general population, respectively (p < 0.001). The main reason for women to discontinue breastfeeding was the restart of medication (n = 129, 57.8%). Nevertheless, more than 40% of these patients restarted medication that was considered compatible with breastfeeding.Conclusion.This large prospective study demonstrates that RA is associated with lower proportions of women breastfeeding their offspring and earlier cessation compared with the general population. A considerable number of patients discontinued breastfeeding so that they could start medication, even though many of the medications are considered safe to use during lactation. Using the results of this study, intervention strategies supporting RA patients who wish to breastfeed may be developed.
Intraarticular Glucocorticoid Injection as Second-line Treatment for Lyme Arthritis in Children
Authors: Horton Daniel B. , Taxter Alysha J. , Davidow Amy L. , Groh Brandt P. , Sherry David D. , Rose Carlos D. 
Published: March 2019

Objective.To determine whether second-line intraarticular glucocorticoid (IAGC) injection improves outcomes in children with persistently active Lyme arthritis after initial antibiotics.Methods.We conducted an observational comparative effectiveness study through chart review within 3 pediatric rheumatology centers with distinct clinical approaches to second-line treatment of Lyme arthritis. We primarily compared children receiving second-line IAGC to children receiving a second course of antibiotics alone. We evaluated the risk of developing antibiotic-refractory Lyme arthritis (ARLA) using logistic regression and the time to clinical resolution of Lyme arthritis using Cox regression.Results.Of 112 children with persistently active Lyme arthritis after first-line antibiotics, 18 children received second-line IAGC (13 with concomitant oral antibiotics). Compared to children receiving second-line oral antibiotics alone, children treated with IAGC had similar baseline characteristics but lower rates of ARLA (17% vs 44%; OR 0.3, 95% CI 0.1–0.95; p = 0.04) and faster rates of clinical resolution (HR 2.2, 95% CI 1.2–3.9; p = 0.01). Children in IAGC and oral antibiotic cohorts did not differ in treatment-associated adverse events. Among children receiving second-line IAGC, outcomes appeared similar irrespective of use of concomitant antibiotics. Outcomes were also similar between intravenous (IV) and oral antibiotic-treated cohorts, but older children seemed to respond more favorably to IV therapy. IV antibiotics were also associated with higher rates of toxicity.Conclusion.IAGC injection appears to be an effective and safe second-line strategy for persistent Lyme arthritis in children, associated with rapid clinical resolution and reduced need for additional treatment.
The design and implementation of an Arabic pronunciation application for early childhood
Authors: Aljojo Nahla , Munshi Asmaa , Almukadi Wafa , Alanaya Ihdaa , Zainol Azida , Albalawi Hawazin , Alharbi Ghadeer , Almadani Nada , Almohammadi Elaf , Kadu Alaa , Abdulghaffar Nadia , Almohammadi Elaf , Kadu Alaa , Abdulghaffar Nadia A. 
Published: March 2019

Learning is not limited to a certain age group or a formal study environment. However, the first eight years, and particularly the first three years, are most important, as the effects of the care and attention provided to the child during this period will continue throughout his or her life. A child’s early learning processes develop their educational abilities and skills, and fosters their academic achievements.Preschool can be very benefit to development and learning for children, but there are differences between countries in this area. It can reduce the repetition in the classroom and can raise achievement scores for students through the preschool programs of high quality (Jacobson and Linda 2008). There are many applications in the Middle East that teach kids, but there is didn't link between the vowels of the Arabic alphabet characters and verbally voice for each character and training to select correct format of Arabic alphabet like (fatha, dama and kasra). This study aims to develop an educational application for children from the ages of 3 to 5 to help them improve their skills and abilities. The application will also prepare them for school by teaching them the Arabic letters, pronunciation and the short vowels (fatha, dama and kasra). The application also aims to help children communicate and interact more effectively with their external environment by employing several theories about learning skills, such as Piaget’s Theory of Cognitive Development, Edger Dale’s Cone of Learning and Bloom's Taxonomy of Cognitive Goals. The application will focus on the first three levels of Bloom's Taxonomy Pyramid which are ‘Remember’, ‘Understand’ and ‘Apply’. Furthermore, the application will be designed to aid children with their Arabic pronunciation, and aural and oral skills, and train and educate them in preparation for attending school. The expected result is that it will be considerably better than educational books for children’s education. Combining education and play in e-learning applications is an important way to attract children.
Mechanisms of Anterior Cruciate Ligament Injury
Authors: Boden Barry P , Dean G Scott , Feagin John A , Garrett William E 
Published: March 2019

ABSTRACT
This study examined the mechanisms of anterior cruciate ligament (ACL) injury. In the first part of the study, using a comprehensive, standardized questionnaire, 89 athletes (100 knees) were interviewed about the events surrounding their ACL injury. A noncontact mechanism was reported in 71 (72%) knees and a contact injury in 28 (28%) knees; one patient was unsure if there was any contact. Most of the injuries were sustained at footstrike with the knee close to full extension. Noncontact mechanisms were classified as sudden deceleration prior to a change of direction or landing motion, while contact injuries occurred as a result of valgus collapse of the knee. Hamstring flexibility parameters revealed a statistically higher level of laxity in the injured athletes compared with a matched group of 28 controls.
In the second part of the study, videotapes of 27 separate ACL disruptions were reviewed and confirmed that most noncontact injuries occur with the knee close to extension during a sharp deceleration or landing maneuver. Because the knee is in a position to allow the extensor mechanism to strain the ACL and maximum, eccentric muscle force conditions usually apply, the quadriceps may play an important role in ACL disruption. Passive protection of the ACL by the hamstring muscles may be reduced in patients with above-average flexibility.
Simulating the effects of weather and climate on large wildfires in France
Authors: Barbero Renaud , Curt Thomas , Ganteaume Anne , Maillé Eric , Jappiot Marielle , Bellet Adeline 
Published: March 2019

Abstract. Large wildfires across parts of France can cause devastating damage which
puts lives, infrastructure, and the natural ecosystem at risk. In the climate
change context, it is essential to better understand how these large
wildfires relate to weather and climate and how they might change in a warmer
world. Such projections rely on the development of a robust modeling
framework linking large wildfires to present-day atmospheric variability.
Drawing from a MODIS product and a gridded meteorological dataset, we derived
a suite of biophysical and fire danger indices and developed generalized
linear models simulating the probability of large wildfires (>100 ha) at
8 km spatial and daily temporal resolutions across the entire country over
the last two decades. The models were able to reproduce large-wildfire
activity across a range of spatial and temporal scales. Different
sensitivities to weather and climate were detected across different
environmental regions. Long-term drought was found to be a significant
predictor of large wildfires in flammability-limited systems such as the
Alpine and southwestern regions. In the Mediterranean, large wildfires were
found to be associated with both short-term fire weather conditions and
longer-term soil moisture deficits, collectively facilitating the occurrence
of large wildfires. Simulated probabilities on days with large wildfires were
on average 2–3 times higher than normal with respect to the mean seasonal
cycle, highlighting the key role of atmospheric variability in wildfire
spread. The model has wide applications, including improving our
understanding of the drivers of large wildfires over the historical period
and providing a basis on which to estimate future changes to large wildfires
from climate scenarios.
Dynamics of the North Balearic Front during an autumn tramontane and mistral storm: air–sea coupling processes and stratification budget diagnostic
Authors: Seyfried Léo , Estournel Claude , Marsaleix Patrick , Richard Evelyne 
Published: March 2019

Abstract. The North Balearic Front forms the southern branch of the cyclonic
gyre in the northwestern Mediterranean Sea. Its dynamics exhibit significant seasonal variability. During autumn, the front spreads northward
during the calm wind periods and rapidly moves back southward when it is
exposed to strong northerly wind events such as the tramontane and mistral.
These strong winds considerably enhance the air–sea exchanges. To investigate
the role of air–sea exchanges in the dynamics of the North Balearic front, we
used observations and a high-resolution air–sea coupled modelling system. We
focused on a strong-wind event observed in late October 2012, which was
well-documented during the Hydrological Cycle Mediterranean Experiment. The
coupled model was able to correctly reproduce the 4 ∘C sea surface
temperature drop recorded in the frontal zone together with the observed
southwestward displacement of the front. The comparison between the weak wind
period preceding the event and the strong-wind event itself highlighted the
impact of the wind regime on the air–sea coupling. During the low-wind period
the coupling is thermal and dynamical whereas during the strong-wind period
the coupling is mainly thermal. The effect of air–sea exchanges on the
stratification variations in the frontal zone was investigated with a
stratification budget diagnosis. The stratification variations are controlled
by diabatic air–sea buoyancy flux, adiabatic Ekman buoyancy flux, and
advective processes. During the strong-wind period, the Ekman buoyancy flux
was found to be 3 times greater than the air–sea buoyancy flux and thus
played a major role in the de-stratification of the frontal zone. The role of
Ekman pumping and inertial wave in the advective processes is also discussed.
Sentinel-3 Delay-Doppler altimetry over Antarctica
Authors: McMillan Malcolm , Muir Alan , Shepherd Andrew , Escolà Roger , Roca Mònica , Aublanc Jérémie , Thibaut Pierre , Restano Marco , Ambrozio Américo , Benveniste Jérôme 
Published: March 2019

Abstract. The launch of Sentinel-3A in February 2016 represented the beginning of a new
long-term series of operational satellite radar altimeters, which will
provide Delay-Doppler altimetry measurements over ice sheets for decades to
come. Given the potential benefits that these satellites can offer to a range
of glaciological applications, it is important to establish their capacity to
monitor ice sheet elevation and elevation change. Here, we present the first
analysis of Sentinel-3 Delay-Doppler altimetry over the Antarctic ice sheet,
and assess the accuracy and precision of retrievals of ice sheet elevation
across a range of topographic regimes. Over the low-slope regions of the ice
sheet interior, we find that the instrument achieves both an accuracy and a
precision of the order of 10 cm, with ∼98 % of the data
validated being within 50 cm of co-located airborne measurements. Across the
steeper and more complex topography of the ice sheet margin, the accuracy
decreases, although analysis at two coastal sites with densely surveyed
airborne campaigns shows that ∼60 %–85 % of validated data are
still within 1 m of co-located airborne elevation measurements. We then
explore the utility of the Sentinel-3A Delay-Doppler altimeter for mapping
ice sheet elevation change. We show that with only 2 years of available
data, it is possible to resolve known signals of ice dynamic imbalance and
to detect evidence of subglacial lake drainage activity. Our analysis
demonstrates a new, long-term source of measurements of ice sheet elevation
and elevation change, and the early potential of this operational system for
monitoring ice sheet imbalance for decades to come.
Modeling the response of northwest Greenland to enhanced ocean thermal forcing and subglacial discharge
Authors: Morlighem Mathieu , Wood Michael , Seroussi Hélène , Choi Youngmin , Rignot Eric 
Published: March 2019

Abstract. Calving-front dynamics is an important
control on Greenland's ice mass balance. Ice front retreat of
marine-terminating glaciers may, for example, lead to a loss in resistive
stress, which ultimately results in glacier acceleration and thinning. Over
the past decade, it has been suggested that such retreats may be triggered by
warm and salty Atlantic Water, which is typically found at a depth below
200–300 m. An increase in subglacial water discharge at glacier ice fronts
due to enhanced surface runoff may also be responsible for an intensification
of undercutting and calving. An increase in ocean thermal forcing or
subglacial discharge therefore has the potential to destabilize
marine-terminating glaciers along the coast of Greenland. It remains unclear
which glaciers are currently stable but may retreat in the future and how far
inland and how fast they will retreat. Here, we quantify the sensitivity and
vulnerability of marine-terminating glaciers along the northwest coast of
Greenland (from 72.5 to 76∘ N) to ocean forcing and subglacial
discharge using the Ice Sheet System Model (ISSM). We rely on a
parameterization of undercutting based on ocean thermal forcing and
subglacial discharge and use ocean temperature and salinity from
high-resolution ECCO2 (Estimating the Circulation and Climate of the Ocean,
Phase II) simulations at the fjord mouth to constrain the ocean thermal
forcing. The ice flow model includes a calving law based on a tensile von
Mises criterion. We find that some glaciers, such as Dietrichson Gletscher or
Alison Glacier, are sensitive to small increases in ocean thermal forcing,
while others, such as Illullip Sermia or Cornell
Gletscher, are remarkably stable,
even in a +3 ∘C ocean warming scenario. Under the most intense
experiment, we find that Hayes Gletscher retreats by more than 50 km inland by 2100 into a deep trough,
and its velocity increases by a factor of 3 over only 23 years. The model
confirms that ice–ocean interactions can trigger extensive and rapid glacier
retreat, but the bed controls the rate and magnitude of the retreat. Under
current oceanic and atmospheric conditions, we find that this sector of the
Greenland ice sheet alone will contribute more than 1 cm to sea level rise
and up to 3 cm by 2100 under the most extreme scenario.