bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disease-modifying Antirheumatic Drug Use in the Treatment of Juvenile Idiopathic Arthritis: A Cross-sectional Analysis of the CARRA Registry
Authors: BEUKELMAN TIMOTHY , RINGOLD SARAH , DAVIS TREVOR E. , DeWITT ESI MORGAN , PELAJO CHRISTINA F. , WEISS PAMELA F. , KIMURA YUKIKO 
Published: August 2012

Objective.To characterize disease-modifying antirheumatic drug (DMARD) use for children with juvenile idiopathic arthritis (JIA) in the United States and to determine patient factors associated with medication use.Methods.We analyzed cross-sectional baseline enrollment data from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from May 2010 through May 2011 for children with JIA. Current and prior medication use was included. We used parsimonious backward stepwise logistic regression models to calculate OR to estimate associations between clinical patient factors and medication use.Results.We identified 2748 children with JIA with a median disease duration of 3.9 years from 51 US clinical sites. Overall, 2023 (74%) had ever received a nonbiologic DMARD and 1246 (45%) had ever received a biologic DMARD. Among children without systemic arthritis, methotrexate use was most strongly associated with uveitis (OR 5.2, 95% CI 3.6–7.6), anticitrullinated protein antibodies (OR 4.5, 95% CI 1.7–12), and extended oligoarthritis (OR 4.1, 95% CI 2.5–6.6). Among children without systemic arthritis, biologic DMARD use was most strongly associated with rheumatoid factor (RF)-positive polyarthritis (OR 4.3, 95% CI 2.9–6.6), psoriatic arthritis (PsA; OR 3.0, 95% CI 2.0–4.4), and uveitis (OR 2.8, 95% CI 2.1–3.7). Among children with systemic arthritis, 160 (65%) ever received a biologic DMARD; tumor necrosis factor inhibitor use was associated with polyarthritis (OR 2.5, 95% CI 3.8–16), while interleukin 1 inhibitor use was not.Conclusion.About three-quarters of all children with JIA in the CARRA Registry received nonbiologic DMARD. Nearly one-half received biologic DMARD, and their use was strongly associated with RF-positive polyarthritis, PsA, uveitis, and systemic arthritis.
Efficacy of Incentive Spirometer Exercise on Pulmonary Functions of Patients with Ankylosing Spondylitis Stabilized by Tumor Necrosis Factor Inhibitor Therapy
Authors: SO MIN WOOK , HEO HYUN MI , KOO BON SAN , KIM YONG-GIL , LEE CHANG-KEUN , YOO BIN 
Published: August 2012

Objective.To evaluate the effect of combining incentive spirometer exercise (ISE) with a conventional exercise (CE) on patients with ankylosing spondylitis (AS) stabilized by tumor necrosis factor (TNF) inhibitor therapy by comparing a combination group with a CE-alone group.Methods.Forty-six patients (44 men, 2 women) were randomized to the combination group (ISE plus CE; n = 23) or the CE group (n = 23). The CE regimen of both groups consisted of 20 exercises performed for 30 min once a day. The ISE was performed once a day for 30 min. The trial duration was 16 weeks. Patients were assessed before and at the end of treatment by measuring the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), chest expansion, finger to floor distance, pulmonary function measures, and 6-min walk distance.Results.Both groups improved significantly in terms of chest expansion (p < 0.01), finger to floor distance (p < 0.01), and BASFI (p < 0.05) after completing the exercise program. However, only the combination group showed significant improvements in the forced vital capacity (p < 0.05), total lung capacity (p < 0.01), and vital capacity (p < 0.05). Although this did not achieve statistical significance, the combination group was mildly superior to the CE-alone group in functional disability and pulmonary function measures.Conclusion.Combining ISE with a CE can provide positive results in patients whose AS has been clinically stabilized by TNF inhibitor therapy.
Hydroxychloroquine Use Is Associated with Lower Odds of Persistently Positive Antiphospholipid Antibodies and/or Lupus Anticoagulant in Systemic Lupus Erythematosus
Authors: BRODER ANNA , PUTTERMAN CHAIM 
Published: August 2012

Objective.Antiphospholipid antibodies (aPL) play an active role in the pathogenesis of the antiphospholipid syndrome (APS). Primary prevention in APS may be aimed at decreasing existing elevated aPL levels, or preventing high aPL titers and/or lupus anticoagulant (LAC) from developing in the first place. Hydroxychloroquine (HCQ) has been shown in retrospective studies to decrease aPL titers in laboratory studies, and to decrease thrombosis risk in patients with systemic lupus erythematosus (SLE). We investigated an association between HCQ use and persistent aPL and/or LAC in SLE.Methods.We identified all patients over 21 years old with SLE from an urban tertiary care center who had aPL and LAC measured on at least 2 occasions at least 12 weeks apart. We defined the presence of persistent LAC+ and/or at least 1 aPL ≥ 40 U [immunoglobulin A (IgA), IgG, or IgM] as the main outcome variable.Results.Among 90 patients included in the study, 17 (19%) had persistent LAC+ and/or at least 1 aPL ≥ 40 U. HCQ use was associated with significantly lower odds of having persistent LAC+ and/or aPL ≥ 40 U (OR 0.21, 95% CI 0.05, 0.79, p = 0.02), adjusted for age, ethnicity, and sex.Conclusion.This is the first study to show that HCQ use is associated with lower odds of having persistently positive LAC and/or aPL. Data from this study provide a basis for the design of future prospective studies investigating the role of HCQ in primary and secondary prevention of APS.
Psoriatic Arthritis in Canadian Clinical Practice: The PsA Assessment in Rheumatology
Authors: GLADMAN DAFNA D. , CHANDRAN VINOD , THAVANESWARAN ARANE , ZUMMER MICHEL 
Published: August 2012

Objective.We aimed to determine disease severity and treatment of patients with psoriatic arthritis (PsA) in rheumatology practices in Canada through the PsA Assessment in Rheumatology (PAIR) study.Methods.Rheumatologists who were members of the Canadian Rheumatology Association were asked to complete a form for each patient addressing demographic questions, history, clinical examination, and patient-reported outcomes. Results were compared with a cohort seen in a PsA clinic during the same period.Results.From across Canada, 22 rheumatologists from 5 provinces submitted information about 233 consecutive patients with PsA [145 men (62.2%), 88 women (37.8%), mean age 53.2 yrs (± 12.7), 88.4% disease duration > 2 yrs]. A majority (80.7%) fulfilled ClASsification for Psoriatic ARthritis (CASPAR) criteria, and 30% had taken no disease-modifying antirheumatic drugs. Clinical joint damage was documented in 60% of the patients, active skin disease in 70%, and nail lesions in 32%. Only 22% were rated as having moderate to high disease activity, while 52% were rated as low disease activity and 26% were deemed in remission. The decision was based on joint counts, patient global assessment, physician global assessment, and acute-phase reactants. Twenty-seven percent of the patients were to have their medications changed based on the current visit, the majority for inadequate response to medications. Patients in the PAIR cohort had more inflamed joints but similar damage to those in the PsA clinic.Conclusion.Patients with PsA seen in regular rheumatology practice fulfill CASPAR criteria, have active disease, and more than half have joint damage. The majority have low activity or are in remission.
Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms
Authors: EMAD YASSER , RAGAB YASSER , GHEITA TAMER , ANBAR ASHRAF , KAMAL HODA , SAAD AHMED , DARWEESH HANAN , EL-SHAARAWY NASHWA , AZAB AMR , ISMAIL AHMED , RASKER JOHANNES J. , RASKER JOHANNES J. 
Published: August 2012

Objective.This case-control study was designed to evaluate magnetic resonance imaging (MRI) findings of knee joints in patients with psoriasis without clinical peripheral or axial joint involvement, and to correlate MRI findings with disease and demographic variables.Methods.In total 48 patients with psoriasis and no clinical evidence of synovitis or enthesitis in any peripheral or axial joints were enrolled. A random sample of 20 healthy subjects without knee or other joint complaints and matched for age and sex served as controls. All patients and controls underwent enhanced MRI studies of both knee joints, and MRI findings were compared.Results.Among 48 patients (96 knees), a total of 90 entheseal lesions were detected, with no enthesitis in 2 cases (6.3%). Signs of continuing inflammation bilaterally were frequently found: soft tissue edema (STE; n = 52), bone marrow edema (BME; n = 20), perientheseal BME (n = 3), cartilaginous erosions (n = 42), and bone erosions (n = 27). In controls, 2 (10%) subjects had BME and another 5 (25%) showed cartilaginous erosions. None showed evidence of enthesitis. Significant correlations were observed between the number of entheseal lesions of both knees vs STE (present vs absent; r = 0.314, p = 0.030) and STE (number of lesions; r = 0.351, p = 0.014). Enthesitis (unilateral vs bilateral) was significantly and positively correlated with STE (r = 0.304, p = 0.036), cartilaginous erosions (r = 0.304, p = 0.036), and villous projections (r = 0.347, p = 0.016).Conclusion.Subclinical synovitis and enthesitis are frequently found in the knee joint of patients with psoriasis. These may be an early sign of psoriatic arthritis.
Vitamin D Receptor Polymorphism rs2228570 (Fok1) Is Associated with Rheumatoid Arthritis in North American Natives
Authors: HITCHON CAROL A. , SUN YE , ROBINSON DAVID B. , PESCHKEN CHRISTINE A. , BERNSTEIN CHARLES N. , SIMINOVITCH KATHERINE A. , EL-GABALAWY HANI S. 
Published: August 2012

Objective.Vitamin D (VitD) has immunomodulatory activity relevant to rheumatoid arthritis (RA) and acts by binding nuclear receptors that regulate gene transcription. VitD receptor polymorphisms have been variably associated with RA. Because North American Native (NAN) populations have a high prevalence of RA with a strong genetic contribution, we studied potential associations of the rs2228570 (Fok1) VitD receptor polymorphism in a Canadian NAN population.Methods.The single-nucleotide polymorphism (SNP) Fok1 was tested by sequencing NAN patients with RA (n = 448) and unrelated NAN controls (n = 704). Associations were tested using genotypic, dominant, and recessive models.Results.The minor allele frequency (F/C) in the NAN control population was 0.44 and lower than reported in white subjects of the same geographical area. The Fok1 VitD receptor SNP was significantly associated with RA. Comparing patients with RA to unaffected NAN controls, the Fok1 SNP was associated with RA using both genotypic [FF vs Ff vs ff: RA 20%, 54%, 26% vs control 22%, 44%, 34% (chi-square 13.35, p = 0.003)] and dominant models [FF/Ff vs ff: RA 74% vs 26% control 66% vs 34% (OR 1.5, 95% CI 1.16–1.96, p = 0.003)]. This association was strongest in shared-epitope-positive RA.Conclusion.VitD receptor polymorphisms may contribute to the high prevalence of RA in NAN populations.
Interleukin 21 Correlates with T Cell and B Cell Subset Alterations in Systemic Lupus Erythematosus
Authors: TERRIER BENJAMIN , COSTEDOAT-CHALUMEAU NATHALIE , GARRIDO MARLÈNE , GERI GUILLAUME , ROSENZWAJG MICHELLE , MUSSET LUCILE , KLATZMANN DAVID , SAADOUN DAVID , CACOUB PATRICE 
Published: August 2012

Objective.Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by alterations of the B cell subset, global regulatory T cell (Treg) depletion, and an increase in Th17 cells. Interleukin 21 (IL-21) plays a critical role in T cell and B cell homeostasis. Our objective was to determine the implication of IL-21 and IL-21-producing CD4+ T cells in the pathogenesis of SLE.Methods.Twenty-five patients with SLE and 25 healthy donor controls were included. Analysis of CD4+ T cells producing IL-21, Th1, Th2, Th17, Treg, follicular helper T (TFH) cells, and B cells was performed in peripheral blood, and levels of cytokines were measured in culture supernatants.Results.Circulating CD4+ T cells producing IL-21 were markedly expanded in patients with SLE compared to controls and were correlated with increased Th17, decreased Treg, and increased memory B cells. CD4+ T cells producing IL-21 were composed of CXCR5+ and CXCR5–CD4+ T cell subsets. Both IL-21-producing CXCR5+CD4+ T cells and CXCR5–CD4+ T cells were increased in patients with SLE, the CXCR5–CD4+ subset correlating with Th17 cells and Treg, while the CXCR5+CD4+ subset was correlated with alterations of the B cell subset. The CXCR5+CD4+ subset comprised mainly circulating Bcl6+CXCR5+CD4+ TFH cells that were markedly expanded in patients with SLE and were correlated with increased circulating Bcl6+CXCR5+ germinal center B cells.Conclusion.These findings suggest that IL-21, produced by distinct cellular CD4+ T cells, correlates with alterations of T cell and B cell subsets in SLE, and that targeting IL-21 could provide beneficial effects on both T cell and B cell alterations.
Palindromic Rheumatism with Positive Anticitrullinated Peptide/Protein Antibodies Is Not Synonymous with Rheumatoid Arthritis. A Longterm Followup Study
Authors: SANMARTÍ RAIMON , CABRERA-VILLALBA SONIA , GÓMEZ-PUERTA JOSÉ A. , RUIZ-ESQUIDE VIRGINIA , HERNÁNDEZ M. VICTORIA , SALVADOR GEORGINA , RAMIREZ JULIO , VIÑAS ODETTE , CAÑETE JUAN D. 
Published: August 2012

Objective.To analyze longterm progression to rheumatoid arthritis (RA) and the predictive value of anticitrullinated peptide/protein antibodies (ACPA) in palindromic rheumatism (PR).Methods.We selected all patients in our clinic with PR who had at least 1 ACPA measurement. We included only patients with pure PR, defined as no evidence of associated rheumatic disease at the first serum ACPA measurement. Clinical characteristics, serum ACPA levels, duration of PR until serum ACPA measurement, and total followup time were recorded. The outcome variable was the definitive diagnosis of RA. The prognostic value of ACPA status in pure PR for a definite diagnosis of RA was analyzed by different statistical methods.Results.Seventy-one patients (54 women/17 men) with a PR diagnosis were included. Serum ACPA were positive in 52.1%. After a mean followup of 7.6 ± 4.7 years since the first ACPA measurement, 24 patients (33.8%) progressed to chronic disease: 22% RA, 5.6% systemic lupus erythematosus, and 5.6% other diseases. The positive likelihood ratio of ACPA status for RA was 1.45, and the area under the receiver-operating characteristic curve of ACPA titers was 0.60 (95% CI 0.45−0.75). Progression to RA was more frequently seen in ACPA-positive than in ACPA-negative patients (29.7% vs 14.7%), but the difference was not significant (hazard ratio 2.46, 95% CI 0.77−7.86). Mean ACPA levels of patients with pure PR did not differ significantly from those of patients who progressed to RA.Conclusion.ACPA are frequently found in the sera of patients with PR, and a significant proportion of these patients do not progress to RA in the long term.
The Acute-phase Response Is Not Predictive for the Development of Arthritis in Seropositive Arthralgia – A Prospective Cohort Study
Authors: LIMPER MAARTEN , van de STADT LOTTE , BOS WOUTER , de KRUIF MARTIJN , SPEK ARNOLD , WOLBINK GERTJAN , van SCHAARDENBURG DIRKJAN , van GORP ERIC 
Published: August 2012

Objective.To evaluate whether markers of the acute-phase response in patients presenting with arthralgia and positive anticitrullinated protein antibodies (ACPA) and/or immunoglobulin M rheumatoid factor (IgM-RF) could be predictive for the development of arthritis.Methods.In total, 137 ACPA- and/or IgM-RF-positive patients were included. Patients were followed annually for the development of arthritis, defined as presence of 1 or more swollen joints at clinical examination. High-sensitivity C-reactive protein (hsCRP), procalcitonin (PCT), secretory phospholipase A2 (SPLA2), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), IL-12p70, IL-10, and interferon-γ (IFN-γ) were measured in baseline serum samples. Gene expression focusing on a predefined panel of genes coding for inflammatory molecules was measured by multiplex ligation-dependent probe amplification.Results.Thirty-five patients (26%) developed arthritis within a median time of 11 months (interquartile range 3.7–18 mo). Circulating levels of cytokines, SPLA2, hsCRP, and PCT were not different between patients with progression to clinical arthritis and those without progression. However, a trend for IL-12p70, TNF-α, IL-10, IL-6, and SPLA2 was observed. No correlation between messenger RNA (mRNA) expression levels of inflammatory genes and progression to arthritis was found. Subgroup analysis of patients with early progression to arthritis showed higher levels of mRNA expression of poly(A)-specific ribonuclease and polycomb complex protein BMI-1 compared to patients without progression to arthritis.Conclusion.Although low-grade inflammation is present before onset of clinical arthritis in large cohorts and can be detected using consecutive measurements, a single measurement of acute-phase reactants seems to have limited value for prediction of development of arthritis in individual patients.
Une notion encombrante dans l'histoire de la sculpture grecque : le « dédalisme »
Authors: Aurigny Hélène 
Published: August 2012

Résumé L’utilisation récurrente du mot « dédalique » dans les études récentes sur la sculpture grecque du haut-archaïsme fait apparaître une grande diversité dans le contenu de cette notion, formée à l’origine d’après le nom de l’artisan légendaire Dédale. « Dédalique » peut ainsi avoir un sens stylistique, géographique et, surtout, un sens chronologique plus ou moins précis. Mais ces différents emplois reposent sur un ensemble de présupposés et de conceptions anciennes qui ne sont pour ainsi dire jamais explicitées. Si l’on veut comprendre pourquoi les chercheurs continuent de s’y référer, malgré la confusion qui en résulte, il paraît donc nécessaire de retracer les différentes étapes de l’histoire de la notion même de « dédalisme ». On pourra ainsi s’interroger sur son utilité réelle et se demander si elle est encore susceptible de nous aider à comprendre la sculpture grecque du haut-archaïsme.
Les premiers voyageurs et la dorure du Parthénon : mise au point sur une controverse ancienne
Authors: Zambon Alessia 
Published: August 2012

Résumé Au‑delà des sources anciennes, les arguments régulièrement avancés en faveur d’une dorure des marbres du Parthénon tiennent aux récits des voyageurs de la fin du xviii e et du début du xix e s. Les noms le plus souvent évoqués à ce sujet sont ceux de Haygarth, Dodwell, Clarke, Brøndsted, Cockerell, Fauvel et Millin. L’auteur soumet leurs témoignages et ceux de quelques autres voyageurs à une critique rigoureuse pour en vérifier la nature exacte. Il apparaît ainsi que, bien que les remarques des premiers voyageurs aient contribué à forger les avis sur l’emploi de la polychromie et de la dorure dans l’Antiquité, elles ne reposent pas toujours sur des observations de première main.
Verres de l'Antiquité gréco‑romaine : trois ans de publication (2008‑2010)
Authors: Nenna Marie-Dominique 
Published: August 2012

Résumé Recension des publications parues dans les années 2008‑2010 sur le verre de l’Antiquité ( viii e s. av. J.‑C.- vii e s. apr. J.‑C.) : ouvrages généraux, bibliographies et sites internet, expositions, méthodologie et terminologie, colloques, collections, ventes, musées, études thématiques par technique et par fonction, production et commerce, clientèle et centres de consommation.
El índice de credibilidad: una propuesta metodológica para incrementar la eficacia de los planes de empresa
Authors: Retolaza José Luis , San José Leire , Iturralde Txomin 
Published: August 2012

El instrumento más utilizado para realizar la previsión de éxito en la creación de empresas, el plan de empresa, no tiene un alto grado de garantía y, por tanto, su credibilidad es mínima. En este trabajo se desarrolla una metodología con objeto de proporcionar una eficiencia relativa mayor que la de metodologías previas, para lo cual se efectúa un proceso de benchmarking a través del DEA (Data Envelopment Analysis –Análisis Envolvente de Datos–). Las principales aportaciones de este trabajo son dos: por un lado, se propone una metodología que permite valorar un nuevo proyecto empresarial mediante la comparación de la eficiencia de las empresas; por otro, esta metodología permite obtener un índice de credibilidad del propio proyecto de viabilidad o plan de empresa, lo que aporta valor añadido al tradicional plan, que carece de indicadores que ofrezcan información sobre las garantías de éxito empresarial del proyecto. Esta metodología no está exenta de limitaciones. Las principales son la necesidad de establecer un grupo de empresas de referencia, con los problemas que ello conlleva, y la falta de contraste empírico que valide esta metodología.
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The business plan, the most frequently tool used for the provision of the success of entrepreneurship has not a high degree of assurance, and therefore its credibility is minimal. This paper develops a methodology in order to provide a relative efficiency greater than previous methods for which a benchmarking process is carried out through the DEA (Data Envelopment Analysis). The main contributions of this paper are twofold. On the one hand, we propose a methodology to assess a new business plan by comparing the efficiency of enterprises. On the other hand, this methodology would produce an index of credibility of own project feasibility or business plan; what adds value to the traditional plan with lack of indicators that provide information about the guarantee of business success of the project. This methodology is not without limitations. The main ones are: the need to establish a reference group of companies with the problems that this entails and the lack of empirical test to validate this methodology.
Airway Epithelial Expression of TLR5 Is Downregulated in Healthy Smokers and Smokers with Chronic Obstructive Pulmonary Disease
Authors: Wang Rui , Ahmed Joumana , Wang Guoqing , Hassan Ibrahim , Strulovici-Barel Yael , Salit Jacqueline , Mezey Jason G. , Crystal Ronald G. 
Published: August 2012

AbstractThe TLRs are important components of the respiratory epithelium host innate defense, enabling the airway surface to recognize and respond to a variety of insults in inhaled air. On the basis of the knowledge that smokers are more susceptible to pulmonary infection and that the airway epithelium of smokers with chronic obstructive pulmonary disease (COPD) is characterized by bacterial colonization and acute exacerbation of airway infections, we assessed whether smoking alters expression of TLRs in human small airway epithelium, the primary site of smoking-induced disease. Microarrays were used to survey the TLR family gene expression in small airway (10th to 12th order) epithelium from healthy nonsmokers (n = 60), healthy smokers (n = 73), and smokers with COPD (n = 36). Using the criteria of detection call of present (P call) ≥50%, 6 of 10 TLRs (TLRs 1–5 and 8) were expressed. Compared with nonsmokers, the most striking change was for TLR5, which was downregulated in healthy smokers (1.4-fold, p &lt; 10−10) and smokers with COPD (1.6-fold, p &lt; 10−11). TaqMan RT-PCR confirmed these observations. Bronchial biopsy immunofluorescence studies showed that TLR5 was expressed mainly on the apical side of the epithelium and was decreased in healthy smokers and smokers with COPD. In vitro, the level of TLR5 downstream genes, IL-6 and IL-8, was highly induced by flagellin in TLR5 high-expressing cells compared with TLR5 low-expressing cells. In the context that TLR5 functions to recognize pathogens and activate innate immune responses, the smoking-induced downregulation of TLR5 may contribute to smoking-related susceptibility to airway infection, at least for flagellated bacteria.