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We present a comprehensive simulation study on the solid-liquid phase transition of the ionic liquid 1,3-dimethylimidazolium chloride in terms of the changes in the atomic structure and their effect on the Compton profile. The structures were obtained by using ab initio molecular dynamics simulations. Chosen radial distribution functions of the liquid structure are presented and found generally to be in good agreement with previous ab initio molecular dynamics and neutron scattering studies. The main contributions to the predicted difference Compton profile are found to arise from intermolecular changes in the phase transition. This prediction can be used for interpreting future experiments. [ABSTRACT FROM AUTHOR]

The isomers of small molecule alcohols propanol (PrOH) and butanol (BuOH) are studied by x-ray Compton scattering experiments with synchrotron radiation and density-functional theory calculations. The lineshape of the measured spectra, i.e., the Compton profile, is a momentum-space property, and its changes reflect changes in the electronic charge density between the isomers. Compared to the linear alcohols (n-PrOH and n-BuOH), the Compton profiles of the branched alcohols (iso-PrOH, iso-BuOH, sec-BuOH) are found to be narrower, which indicates a more delocalized charge for the latter. The calculations are performed for systems consisting of one to three monomer units and are found to reproduce reasonably the experimental spectral features. The influence of the basis set and exchange-correlation scheme is studied in more detail. The results provide new insight into the isomeric differences in small molecule alcohols and show that quantum chemical calculations can be increasingly tested against the x-ray Compton scattering data. [ABSTRACT FROM AUTHOR]

The isotope quantum effects in the ground-state electron momentum density of water are studied at temperatures ranging from 5 to 90 °C by combining Compton scattering experiments utilizing synchrotron radiation and computational analysis within density functional theory. We observe clear differences in the momentum density between normal and heavy water at room temperature, which are interpreted as predominantly reflecting intramolecular structural differences. The changes in the momentum density upon increasing the temperature are found to be larger for heavy than for normal water, which is attributed primarily to temperature-induced intramolecular structural effects. Both model computations and an ab initio approach qualitatively reproduce the changes in the momentum density as a function of temperature. [ABSTRACT FROM AUTHOR]

The temperature-dependent hydrogen-bond geometry in liquid water is studied by x-ray Compton scattering using synchrotron radiation combined with density functional theory analysis. Systematic changes, related to the weakening of hydrogen bonding, are observed in the shape of the Compton profile upon increasing the temperature. Using model calculations and published distribution functions of hydrogen-bond geometries obtained from a NMR study we find a significant correlation between the hydrogen-bond length and angle. This imposes a new constraint on the possible local structure distributions in liquid water. In particular, the angular distortions of the short hydrogen bonds are significantly restricted. [ABSTRACT FROM AUTHOR]

We have performed first principles calculations to investigate the structure and electronic properties of several different Si–HfOx interfaces. The atomic structure has been obtained by growing HfOx layer by layer on top of the Si(100) surface and repeatedly annealing the structure using ab initio molecular dynamics. The interfaces are characterized via their geometric and electronic properties, and also using electron transport calculations implementing a finite element based Green’s function method. We find that in all interfaces, oxygen diffuses towards the interface to form a silicon dioxide layer. This results in the formation of dangling Hf bonds in the oxide, which are saturated either by hafnium diffusion or Hf–Si bonds. The generally poor performance of these interfaces suggests that it is important to stabilize the system with respect to lattice oxygen diffusion. [ABSTRACT FROM AUTHOR]

We have modeled transport properties of nanostructures using Green’s-function method within the framework of the density-functional theory. The scheme is computationally demanding, so numerical methods have to be chosen carefully. A typical solution to the numerical burden is to use a special basis-function set, which is tailored to the problem in question, for example, the atomic-orbital basis. In this paper we present our solution to the problem. We have used the finite-element method with a hierarchical high-order polynomial basis, the so-called p elements. This method allows the discretation error to be controlled in a systematic way. The p elements work so efficiently that they can be used to solve interesting nanosystems described by nonlocal pseudopotentials. We demonstrate the potential of the implementation with two different systems. As a test system a simple Na-atom chain between two leads is modeled and the results are compared with several previous calculations. Secondly, we consider a thin hafnium dioxide (HfO2) layer on a silicon surface as a model for a gate structure of the next generation of microelectronics. [ABSTRACT FROM AUTHOR]

The native defects in GaSb have been studied with first-principles total-energy calculations. We report the structures and the formation energies of the stable defects and estimate the defect concentrations under different growth conditions. The most important native defect is the Ga[sub Sb] antisite, which acts as an acceptor. The other important defects are the acceptor-type Ga vacancy and the donor-type Ga interstitial. The Sb vacancies and interstitials are found to have much higher formation energies. A metastable state is observed for the Sb[sub Ga] antisite. The significantly larger concentrations of the Ga vacancies and interstitials compared to the corresponding Sb defects is in accordance with the asymmetric self-diffusion behavior in GaSb. The data supports the next-nearest-neighbor model for the self-diffusion, in which the migration occurs independently in the different sublattices. Self-diffusion is dominated by moving Ga atoms. © 2002 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Objectives: Self-rated health (SRH) is a well-known overall health status measure used in the general population but it is rarely examined in a clinical setting. We assessed SRH-related factors in clinic-based patients with rheumatoid arthritis (RA).Method: The study included 123 consecutive outpatients treated in 1998-1999. Patient questionnaires, including a single SRH item, sociodemographics, the Health Assessment Questionnaire (HAQ) for functional ability, and the Nottingham Health Profile (NHP) for health-related quality of life (QoL), were collected at baseline. Comorbidities were measured by the Charlson Comorbidity Index (CCI) and data on the use of drugs and surgery for RA were verified from medical records and by querying patients. Factors associated with SRH were examined using regression models with the propensity score as the covariate. Mortality rates were collected up to 31 December 2014. Hazard ratios (HRs) were used to estimate SRH-associated mortality.Results: In univariate analysis, poor SRH was associated with higher age and poorer patient-reported outcomes (PROs) but not with gender and clinical variables. After adjustment for the propensity score, the NHP dimensions for pain, energy, emotional reactions, and mobility remained significantly associated with SRH. The age- and sex-adjusted HR for death was 2.38 [95% confidence interval (CI) 1.13-5.04, p = 0.034] for the patients with poor vs. good SRH. The propensity score-adjusted HR for death was 1.69 (95% CI 0.74-3.86, p = 0.21). Conclusions  In patients with RA, SRH was associated with health-related QoL dimensions, reflecting patients' well-being rather than clinical factors. During the 16 years of follow-up, SRH had no independent association with mortality. [ABSTRACT FROM AUTHOR]

Objectives: Better treatment strategies and therapeutic options have changed the treatment of rheumatoid arthritis (RA) during the past decade. Our objective was to examine clinical and patient-reported outcomes in patients with RA treated in 1998–99 and 2011–12. Method: The cross-sectional observational study included 303 consecutive outpatients (n = 103 in 1998–99 and n = 200 in 2011–12) from the same outpatient clinic. Patient questionnaires included patients’ sociodemographics, the Health Assessment Questionnaire (HAQ) for functional ability, the Nottingham Health Profile (NHP) for health-related quality of life (HRQoL), self-reported general health (GH), and operations performed due to RA. A clinical examination was conducted for all patients. Comorbidities according to the Charlson Comorbidity Index (CCI), anti-rheumatic drugs and medications were recorded and the HAQ and NHP dimensions calculated. The results from these two patient cohorts were compared. Results: The cohorts were comparable with regard to age, sex, and RA duration while the patients in the 2011–12 cohort were less often seropositive for rheumatoid factor (RF), had a better socioeconomic situation, better functional and working ability, and a decreased rate of RA surgery. The patients in 2011–12 had higher comorbidities and poorer GH while the HRQoL dimensions did not differ between the cohorts except for better mobility in 2011–12. Methotrexate (MTX) and combinations of conventional anti-rheumatic drugs were more frequently used in 2011–12. Biologicals were used only in 2011–12. Conclusions: According to our results, more active anti-rheumatic therapy coincides with better RA-related outcomes. However, the result was the opposite with regard to overall health and comorbidities. Is this a new challenge in the treatment RA? [ABSTRACT FROM AUTHOR]

Objective We describe the epidemiological and microbiological process in the clearing of a foodborne outbreak of O:1 linked to Yersinia pseudotuberculosis raw carrots and frequency of the associated reactive extra-gastrointestinal manifestations. Methods The patient samples were investigated by routine culture or antibody testing methods. The real-time bacterial PCR was used to detect Y pseudotuberculosis in samples from the grated carrots and in those taken from the carrot storage. Genotype of bacterial isolates was determined by pulsed-field gel electrophoresis. For case identification, we retrospectively looked over the laboratory les of the central hospital focusing on the time period of the outbreak. Results Altogether 49 case patients were identified. Y pseudotuberculosis was detected by real-time PCR analysis in samples taken from grated carrots and from the carrot distributor. Bacterial isolates originating from the farm environment showed identical serotype (O:1) and genotype (S12) with the patients' isolates. Among 37 adults, reactive arthritis (ReA) was found in 8 (22%) and three adults had probable ReA. Six (67%) out of nine human leucocyte antigen (HLA) typed patients with ReA were HLA-B27 positive. Erythema nodosum was found in 42% of the 12 children, whereas none of them had definite ReA. Conclusions In this outbreak, Y pseudotuberculosis was for the first time detected in both patient and food samples. ReA was more common than earlier reported in the outbreaks associated with this pathogen; the reason may be that the previous outbreaks have occurred among children. HLA-B27 frequency was higher than usually reported in single-source outbreaks of ReA. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of abdominal obesity (AO) on disease severity, cardiovascular risk factors, and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA). Method: Two hundred and thirty consecutive outpatients were cross-sectionally assessed. Waist circumference (WC) with a cut-off point of ≥ 102 cm in men and ≥ 88 cm in women indicated AO. Clinical assessment included joint counts, radiographs of small joints, and laboratory tests. Comorbidities and medication were verified from the patients' database. Patient questionnaires included sociodemographics, pain intensity, global disease activity, the Beck Depression Inventory (BDI), the Health Assessment Questionnaire (HAQ), physical activity level, and the 36-item Short Form Health Survey (SF-36). Metabolic syndrome (MetS) was defined according to the criteria of National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). The association of AO with the 28-joint count Disease Activity Score (DAS28) and mental (MCS) and physical component scores (PCS) of the SF-36 and the HAQ was assessed by using regression models with the propensity score as a covariate. Results: The AO prevalence was 52% in the 200 eligible patients. In a univariate analysis, AO was associated with cardiovascular risk factors, low HAQ score, physical inactivity, disease activity parameters, impaired MCS, higher pain, and increased use of biological drugs and antidepressants. In a multivariable model, only poorer DAS28 (p = 0.018) and poorer HAQ score (p = 0.004) remained significantly associated with AO. Conclusions: AO is highly prevalent in patients with RA. In addition to cardiovascular risk factors, AO is associated with higher disease activity, higher disability, physical inactivity, more patients' perception of pain, and poorer mental health. Multifaceted promotion of lifestyle habits would be beneficial for improving AO-related health outcomes in patients with RA. [ABSTRACT FROM AUTHOR]

Objectives: To study the efficacy and safety of once-monthly oral ibandronate in the prevention of glucocorticoid (GC)-induced osteoporosis (GIOP) in postmenopausal women with inflammatory rheumatic diseases.Method: A randomized, double-blind, placebo-controlled, parallel-group study of 140 postmenopausal women was conducted. At baseline, the mean lumbar spine (LS) (L1-L4) bone mineral density (BMD) was normal or osteopaenic (T-score ≥ -2.0) and the patients were receiving treatment with 5-15 mg/day of prednisone equivalent. Patients were randomized 1:1 to receive either monthly oral ibandronate 150 mg or placebo for 12 months. All patients received vitamin D and calcium supplements. The primary endpoint was the relative change in mean LS BMD from baseline to 12 months.Results: Mean LS BMD increased significantly by 2.6% and 3.2% from baseline to 6 and 12 months with ibandronate compared to 0.3% and -0.1% with placebo, respectively (p < 0.001). Comparable significant mean increases were also found in trochanter, femoral neck and total hip BMDs at 12 months. Reductions in the serum levels of bone turnover markers C-terminal telopeptide of type I collagen (sCTX), N-terminal propeptide of type I procollagen (P1NP), and tartrate-resistant acid phosphatase (TRACP) were significantly more marked in the ibandronate group than in the placebo group at 1, 6, and 12 months. Adverse events (AEs) were reported at a similar frequency in both groups. A higher proportion of serious AEs (SAEs) were reported in the ibandronate group without emergence of any single SAE.Conclusions: Once-monthly oral ibandronate provides a significant increase in LS and total hip BMD with an acceptable safety profile in postmenopausal women treated with low-dose GCs for inflammatory rheumatic diseases. [ABSTRACT FROM AUTHOR]

Objective: To investigate how inflammation and metabolic syndrome (MetS) are associated with adipokine levels in patients with inflammatory arthritis. Methods: Fifty-four female patients with arthritis were enrolled in the study. Twenty (37%%) of these patients had MetS, which was diagnosed according to the definition of the International Diabetes Federation (IDF). Interleukin (IL)-6 and four adipokines (resistin, leptin, adiponectin, and adipsin) were determined by immunoassay. Healthy women with body mass index (BMI) between 22 and 25 kg//m2 served as controls. Results: The patients with arthritis had higher levels of resistin than the healthy controls. This difference was clear in patients without MetS (17.4 in patients vs. 10.8 ng//mL in controls, p < 0.001), and even higher resistin levels were found in the patients with MetS (20.7 ng//mL; p < 0.001 vs. healthy controls; and p == 0.095 vs. patients without MetS). In the patients with arthritis and MetS, resistin correlated positively with IL-6 (Pearson's r == 0.5, p == 0.03). Leptin levels were increased in arthritis patients with MetS as compared to healthy controls, but not in patients without MetS. The statistically significant difference between patients with MetS and controls remained when leptin was adjusted with BMI. Accordingly, adiponectin levels were lower in patients with MetS than in healthy controls (p < 0.05). Leptin, adiponectin, and adipsin did not correlate with the inflammatory cytokine IL-6 or with C-reactive protein (CRP). Conclusions: The results show that high resistin levels are associated with arthritis independently of MetS, whereas leptin is increased only in arthritis patients with MetS. [ABSTRACT FROM AUTHOR]

We report non-resonant inelastic X-ray scattering experiments of several gaseous samples in the inner-shell excitation energy range. The experimental near-edge spectra from all the K-edges of N2, N2O, and CO2including the momentum transfer dependence are presented. The results are analyzed using density functional theory calculations that accurately reproduce the experimental spectral features. We observe vibrational effects in the measured spectrum and in the calculations the atomic motion is modeled using the Franck–Condon approximation and the linear coupling model. Our findings show that vibrational effects cannot be neglected in the analysis of high resolution inelastic X-ray scattering spectroscopy. The results also support the validity of the transition potential approximation for calculating core excited state potential energy surfaces. [ABSTRACT FROM AUTHOR]

Objective: To assess the incidence, prevalence, and outcome of amyloidosis associated with inflammatory rheumatic diseases. Methods: An observational study was performed in the outpatient department of Kainuu Central Hospital from 1993 to 2007. The following criteria were used for the performance of abdominal subcutaneous fat aspiration (ASFA) and/or rectal biopsies: erythrocyte sedimentation rate (ESR) > 40 mm/h at two consecutive visits; and proteinuria (> 0.5 g/day) or serum creatinine > 150 μmol/L. Renal biopsy was performed when there was a high suspicion of amyloidosis in cases with negative findings in the above-mentioned biopsies. In addition, amyloid staining was used routinely for mucosal specimens taken in gastroscopy and colonoscopy. The patients were followed until death or to the end of 2007. Results: New diagnoses of amyloidosis in the consecutive 5-year periods from 1993 onwards numbered 11, 3, and 5, respectively. During the study period, there was a mean annual incidence of amyloidosis of 1.8 [95% confidence interval (CI) 1.1-2.8)/100 000]. At the end of 2007 there were eight subjects with amyloidosis, giving a point prevalence of 12.0/100 000 (95% CI 5.2-23.6). Five patients out of the 19 underwent haemodialysis because of terminal uraemia and three of them also had renal transplantation. Overall, 12 (63%) patients died after a median survival time of 6 (95% CI 4-8) years, one-third from amyloidosis. The 5-year survival rate of the series was 67% (95% CI 41-86). Conclusion: Amyloidosis is rarely encountered today. ASFA or rectal biopsy facilitates its early diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To examine magnetic resonance imaging (MRI) scans for bone lesions typical of rheumatoid arthritis (RA) in the wrist joints of healthy individuals. Methods: Thirty-one symptomless healthy persons (13/18 men/women), mean age 49 years (range 32–64 years), were included. MRI scans and radiographs of both wrists were obtained (62 wrists). The MRI scans and the radiographs were evaluated by two specialists according to the OMERACT recommendations and the Larsen method, respectively. Results: MRI showed erosive-like lesions in either one or both wrists in 14 [45%, 95% confidence interval (CI) 27–64] out of 31 subjects. Altogether, 24 erosive-like changes were found in the 930 wrist bones evaluated (15 bones in each wrist). No more than two lesions per wrist were detected. All the changes were small (22 were grade 1 and two were grade 2; scale 0–10) and were found more often in the older subjects (55 vs. 43 years, p<0.001). Most lesions (54%) were located on the volar side of the wrist and adjacent to the ligament insertions. Intravenous administration of the contrast medium gadolinium diethylenetriaminepentaacetate (Gd-DTPA) was used in 10 subjects, and mild to moderate Gd-DTPA enhancement in the synovial compartments was seen in six of them: five had enhancement in both wrists and one in one wrist. The plain radiographs showed one erosive-like change in the wrist (pisiforme) that was not recorded with MRI. Conclusions: A few small bone lesions that could potentially be confused as erosions were detected in about half of the normal volunteers. These findings should always be evaluated with reference to the clinical picture. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the evolution of functional and clinical outcomes over 11 years in patients with early rheumatoid arthritis (RA) initially treated with a combination of 3 disease-modifying antirheumatic drugs (DMARDs) or with a single DMARD. METHODS: A cohort of 199 patients with early active RA were initially randomized to receive treatment with a combination of methotrexate, sulfasalazine, and hydroxychloroquine with prednisolone or treatment with a single DMARD (initially, sulfasalazine) with or without prednisolone. After 2 years, the drug treatment strategy became unrestricted, but still targeted remission. At 11 years, function was assessed with the Health Assessment Questionnaire (HAQ), and clinical outcomes were assessed with the modified Minimal Disease Activity (MDA) measure and the American College of Rheumatology (ACR) criteria for remission. RESULTS: At 11 years, 138 patients were assessed (68 in the combination-DMARD group and 70 in the single-DMARD group). The mean +/- SD HAQ scores were 0.34 +/- 0.54 in the combination-DMARD group and 0.38 +/- 0.58 in the single-DMARD group (P = 0.88). Modified MDA was achieved by 63% (95% confidence interval [95% CI] 51, 77) and by 43% (95% CI 32, 55) (P = 0.016) of the combination-DMARD group and the single-DMARD group, respectively, and ACR remission by 37% (95% CI 26, 49) and by 19% (95% CI 11, 29) (P = 0.017), respectively. CONCLUSION: Initial therapy with a combination of DMARDs in early RA results in higher rates of patients achieving modified MDA and strict ACR remission even over the long term than initial single-DMARD therapy. Targeting remission with tight clinical controls results in good functional and clinical outcomes in most RA patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the utility of the Stanford Health Assessment Questionnaire (HAQ) in the estimation of loss of productivity due to early rheumatoid arthritis (RA) and to develop a simple model for analysis of the cost-benefit of therapies. Methods: In the Finnish Rheumatoid Arthritis Combination Therapy (FIN-RACo) trial, 162 patients with recent-onset RA who were available for the workforce were randomized to receive either a combination of three disease-modifying anti-rheumatic drugs (DMARDs) or a single DMARD for 2 years and were followed up for 5 years. No biological drugs were used. Data on sick leave and RA-related disability pensions came from official register records. Loss of productivity was computed by both the human capital approach (HCA) and the friction cost approach (FCA). Functional capacity was assessed by the HAQ at baseline and at 6 months. Results: Over 5 years, mean loss of productivity per year was EUR 8344 by the HCA and EUR 1928 by the FCA. The level of the HAQ index at 6 months, but not the change in HAQ from baseline, determined productivity costs. With the HCA, a monotonous association between annual loss of productivity and the 6-month HAQ was found: EUR 2087 [95% confidence interval (CI) 1340-2903] per one step (0.13) on the HAQ scale from 0 to 1.88. With the FCA, the increase in loss of productivity was cut at the HAQ level of 0.5 to 0.75 (EUR 17 740 in 5 years). Conclusion: The HAQ index at 6 months may serve as a determinant of long-term RA-related indirect costs in economic analyses in early RA. [ABSTRACT FROM AUTHOR]

Atomistic simulations of the chemistry of thiol-gold-systems have been restricted by the lack of interatomic interaction models for the involved elements. The ReaxFF framework already has potentials for hydrocarbons, making it an attractive basis for extending to the complete AuSCH-system. Here, an interatomic potential for gold, based on the ReaxFF framework, is presented and compared to existing gold potentials available in the literature. [ABSTRACT FROM AUTHOR]

Objective: To assess whether serum C-terminal cross-linking telopeptide of type I collagen (ICTP), a marker of type I collagen degradation, has any additional value in the assessment of treatment effect in patients with early rheumatoid arthritis (RA). Methods: A total of 182 patients were randomized to treatment either with three disease-modifying anti-rheumatic drugs (DMARDs) and low-dose prednisolone (COMBI) or with a single DMARD with or without low-dose prednisolone (SINGLE). We investigated the prognostic value of serum ICTP level for the progression of joint destruction in X-rays (Larsen's score) from baseline to 2 years. Results: There was a statistically significant decrease in serum ICTP levels from baseline to 1 year. At 6 months, the serum ICTP level was lower in the COMBI patients compared to that of the SINGLE cases (p = 0.008, after adjustment for baseline ICTP). When grouping the patients according to serum ICTP tertiles at 6 months, there was a statistically significant trend for increasing median change in Larsen score from baseline to 2 years from lowest to highest ICTP tertile in the SINGLE patients [p = 0.008, after adjustment for 28-joint Disease Activity Score (DAS28) score and RF status at baseline], while in the COMBI, the change remained low in all ICTP tertiles. Conclusions: The COMBI strategy for recent-onset RA results in early suppression of type I collagen degradation, which is reflected in radiological joint damage at 2 years. Serum ICTP at 6 months may be useful for identifying those RA patients whose treatment should be intensified to prevent further joint damage. [ABSTRACT FROM AUTHOR]

Objective: To observe the effect of mandibular distraction osteogenesis (DO) on developing molars. Design: Descriptive clinical study. Setting: University hospital setting. Seventeen children (mean age 7.6 years) with various syndromes (hemifacial/craniofacial microsomia, Goldenhar syndrome, Treacher Collins syndrome, Nager syndrome and Pyle-Bakwin-Krida syndrome) participated. experimental variable - Severely retrognathic lower jaws were distracted (mean 30 days) with an extraoral bicortically fixed DO device. Outcome Measure: Consecutive panoramic tomograms were analysed after a mean follow-up period of 3.6 years, range 1-6.9 years. Results: The mandibular molars were affected by DO in 13 of the 17 patients which included 18 of 63 mandibular molars studied. Structural changes included root malformations, hindered tooth development and the destruction of tooth follicles. Positional changes such as shifted and tilted teeth were also found. Three injured teeth failed to erupt. These changes were because of splitting of the tooth follicle during the osteotomy (22%), piercing of the tooth follicle by the pin (39%) or migration of tooth germ towards the newly created bone (39%). Fifteen per cent of first molars, 43% of second molars and 31% of third molars were affected during the distraction process. Of all dental injuries, 44% were noticed while the appliance was in place. A further 17% of injuries were noted between 3 months and 1 year postoperatively and 33% during the second postoperative year. Conclusions: Although dental injuries are a minor disadvantage compared with the vast benefits offered by DO, focusing on these drawbacks might lead to re-consideration of the type of the device as well as the timing of DO. [ABSTRACT FROM AUTHOR]

Objective: Infliximab is effective and well tolerated in the treatment of juvenile idiopathic arthritis (JIA). The aim of the present study was to measure circulating levels of inflammatory mediators in patients with JIA during treatment with infliximab. Methods: Eight patients with active JIA refractory to standard treatments were treated with infliximab (3-4 mg/kg) at weeks 0, 2 and 6 and thereafter at approximately 6-week intervals up to 24 weeks. Results: All patients (n = 8) responded to the treatment. By 6 weeks of treatment the number of active joints had reduced from 16±4 (mean±SEM) to 4±1 (p<0.01) and C-reactive protein (CRP) levels had fallen from 31±8 to 8±3 (p<0.001). Infliximab treatment also reduced the serum concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO), and soluble adhesion molecules ICAM-1 (intercellular adhesion molecule-1), and E-selectin. Tumour necrosis factor-α (TNFα) levels tended to increase while the concentrations of endogenous TNF antagonists (sTNF-RI and sTNF-RII) reduced in most patients during treatment. Conclusions: Infliximab reduced serum levels of IL-6, MPO and soluble adhesion molecules in JIA patients, producing a good clinical response to the treatment. [ABSTRACT FROM AUTHOR]

We describe the new CDF Level 2 Trigger, which was commissioned during Spring 2005. The upgrade was necessitated by several factors that included increased bandwidth requirements, in view of the growing instantaneous luminosity of the Tevatron, and the need for a more robust system, since the older system was reaching the limits of maintainability. The challenges in designing the new system were interfacing with many different upstream detector subsystems, processing larger volumes of data at higher speed, and minimizing the impact on running the CDF experiment during the system commissioning phase. To meet these challenges, the new system was designed around a general purpose motherboard, the PULSAR, which is instrumented with powerful FPGAs and modern SRAMs, and which uses mezzanine cards to interface with upstream detector components and an industry standard data link (S-LINK) within the system. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the long-term outcome of polymyositis (PM) and dermatomyositis (DM) and the factors predictive of this outcome in a nationwide series in Finland. One hundred and seventy-six patients with PM and 72 patients with DM diagnosed in Finland in 1969–1985 were selected from the national hospital discharge register according to the diagnostic criteria of Bohan and Peter and followed up until death or till the end of August 1995. Gender, age, delay of therapy, serum creatine kinase, erythrocyte sedimentation rate, initial dose of corticosteroids and duration of cytostatic therapy were assessed as factors prognostic of death. The 5-year survival rate for PM was 75% [95% confidence interval (CI): 68–81%] and that for DM 63% (50–73%), and the respective 10-year survival rates were 55% (47–62%) and 53% (41–64%). The median survival for polymyositis was 11.0 years (95% CI: 9.5–13.3) and that for DM 12.3 years (5.5–20.7). The standardized mortality ratio for the combined group of PM and DM showed approximately threefold mortality compared to the general population. Compared to PM patients, the subjects with DM had a 1.47-fold (95% CI: 0.99–2.12) age- and sex-adjusted risk of mortality. Except for age in both groups and the delay in diagnosis in the PM group, no other individual factor reached significance as a predictor of death. However, cancer had a hazard ratio (HR) of 2.16 for death (95% CI: 0.95–4.50) in the DM group and 1.99 (95% CI: 1.01–3.94) in the PM group. A comparison of the causes of death in the PM and DM groups showed that the patients with DM had a greater risk of dying from cancer (age-adjusted HR 5.11, 95% CI: 2.31–11.3). According to this nationwide analysis of survival and its prognostic factors in patients with PM and DM, the latter group had an increased age-adjusted risk for mortality compared to the former. The difference seems to be mostly explained by the fact that the patients with DM had a higher risk of dying from cancer. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the incidence of radiographic osteolysis following insertion of 89 Swanson and 126 Sutter metacarpophalangeal implants in rheumatoid arthritis patients. The mean follow-up time in the two groups of patients was 57 (40–80) and 55 (36–79) months, respectively. This paper proposes a new method of classifying radiographic osteolysis. The remarkable number of osteolytic changes seen in the bones adjacent to MCP prostheses in this study would suggest that silastic prostheses should only be used when other surgical alternatives cannot be used and that long-term control by radiography be maintained after implantation of silicone prostheses into the MCP joint. In all grades of our classification, osteolysis was more frequent in the Sutter than in the Swanson group in this study, suggesting that use of the Sutter rather than the Swanson implant is questionable. [Copyright &y& Elsevier]

OBJECTIVE: To explore the impact of an early treatment response on maintenance of work capacity in patients with early, active rheumatoid arthritis (RA). METHODS: In the Finnish Rheumatoid Arthritis Combination Therapy trial, 195 patients with recent-onset RA were randomized to receive either a combination of disease-modifying antirheumatic drugs (DMARDs) with prednisolone or a single DMARD with or without prednisolone for 2 years. Treatment responses were evaluated according to the American College of Rheumatology (ACR) criteria. After a 5-year followup, the cumulative number of days of sick leave and RA-related permanent work disability was calculated for each of the 162 patients who were available for the active work force at baseline. RESULTS: Of the 159 patients assessed at 6 months, 29 were in clinical remission, 66 achieved an ACR50 response but not remission, 29 achieved an ACR20 response but not an ACR50 response, and 35 failed to achieve an ACR20 response. In these 4 groups, the median numbers of work disability days per patient-year from 6 months through 60 months of followup were 0 (interquartile range [IQR] 0-3), 4 (IQR 0-131), 16 (IQR 0-170), and 352 (16-365), respectively (P < 0.001). Pairwise multiple comparisons showed a statistically significant difference between all groups except the ACR50 and ACR20 groups. At 12 months, 30 patients were in remission. None of the 44 patients in remission at 6 or 12 months became permanently work disabled over the 5-year followup, as compared with 15 patients in the ACR50 group (23%), 6 in the ACR20 group (21%), and 19 without an ACR20 response at 6 months (56%). CONCLUSION: Prompt induction of remission translates into maintenance of work capacity. At 6 months, an ACR50 response is no better than an ACR20 response with regard to future productivity, while failure to achieve an ACR20 response carries a high risk for work disability. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the long-term frequency of disease remissions and the progression of joint damage in patients with early rheumatoid arthritis (RA) who were initially randomized to 2 years of treatment with either a combination of 3 disease-modifying antirheumatic drugs (DMARDs) or a single DMARD. METHODS: In this multicenter prospective followup study, a cohort of 195 patients with early, clinically active RA was randomly assigned to treatment with a combination of methotrexate, sulfasalazine, hydroxychloroquine, and prednisolone or with a single DMARD (initially, sulfasalazine) with or without prednisolone. After 2 years, the DMARD and prednisolone treatments became unrestricted, but were still targeted toward remission. The long-term effectiveness was assessed by recording the frequency of remissions and the extent of joint damage seen on radiographs of the hands and feet obtained annually up to 5 years. Radiographs were assessed by the Larsen score. RESULTS: A total of 160 patients (78 in the combination group and 82 in the single group) completed the 5-year extension study. At 2 years, 40% of the patients in the combination-DMARD group and 18% in the single-DMARD group had achieved remission (P < 0.009). At 5 years, the corresponding percentages were 28% and 22% (P not significant). The median Larsen radiologic damage scores at baseline, 2 years, and 5 years in the combination-DMARD and single-DMARD groups were 0 and 2 (P = 0.50), 4 and 12 (P = 0.005), and 11 and 24 (P = 0.001), respectively. CONCLUSION: Aggressive initial treatment of early RA with the combination of 3 DMARDs for the first 2 years limits the peripheral joint damage for at least 5 years. Our results confirm the earlier concept that triple therapy with combinations of DMARDs contributes to an improved long-term radiologic outcome in patients with early and clinically active RA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the efficacy of therapy with a combination of disease-modifying antirheumatic drugs (DMARDs) versus therapy with a single DMARD in the prevention of work disability in patients with early rheumatoid arthritis (RA). METHODS: In the Finnish Rheumatoid Arthritis Combination Therapy trial, 195 patients with recent-onset RA were randomly assigned to receive either combination therapy with DMARDs (sulfasalazine, methotrexate, hydroxychloroquine) plus prednisolone or single therapy with a DMARD with or without prednisolone. After 2 years, the drug treatment strategy was no longer restricted. At baseline, 162 patients (80 in the combination-treatment group and 82 in the single-treatment group) were still working or at least available for work. After 5 years of followup, data on all sick leave and retirement were obtained from social insurance registers or case records. The main outcome for each patient was the cumulative duration of all sick leaves and RA-related disability pensions, divided by the observation period during which the patient was not retired because of another disease or because of age. RESULTS: The cumulative duration of work disability per patient-observation year was significantly lower in those randomized to combination therapy than in those randomized to single therapy: median 12.4 days (interquartile range [IQR] 0-54) versus 32.2 days (IQR 6-293) (P = 0.008, sex- and age-adjusted P = 0.009). This was mainly due to the difference in sick leaves (i.e., work disability periods

The sugar and acid compositions of six strawberry ( Fragaria×ananassa Duch.) varieties from 1997 and 1998, grown in different conditions, 26 samples in all, were investigated by GC as trimethylsilyl derivatives. The major sugars were glucose (1.89–4.52 g/100 ml), fructose (2.14–4.14 g/100 ml) and sucrose (0.90–3.87 g/100 ml), the major acids being citric (0.73–1.58 g/100 ml) and malic (0.22–0.69 g/100 ml). Total sugar content (glucose+fructose+sucrose) varied from 5.35 g/100 ml to 10.96 g/100 ml in accordance with soluble solids (°Brix). The correlation between them showed a linear regression y=0.873 x-0.420, the percentage of determination of the regression model being 82.1%. Among one variety only, ‘Senga Sengana’, the percentage of the model was 86.9%. No significant differences were found between the strawberries from conventional versus those from organic farms. Contents of sugars and soluble solids were lower in varieties ‘Jonsok’ and ‘Honeoye’ than in ‘Korona’, ‘Bounty’ and ‘Polka’. The concentrations of malic acid were significantly higher in Senga Sengana, Jonsok and Bounty than in other varieties. [ABSTRACT FROM AUTHOR]

Objectives: To examine the motor performance of the hand in a sample of patients with rheumatoid arthritis (RA).Subjects: The patient group comprised 21 (two men, 19 women) patients with RA. Twenty one control subjects matched for age and sex were selected from a larger reference group, which had been drawn from the local population.Methods: The measured motor performance aspects were simple reaction time, choice reaction time, speed of movement, finger tapping speed, and coordination (that is, speed of movement/accuracy). Results were compared for age and sex matched pairs. The measurements were made with the Human Performance Measurement/Basic Elements of Performance system, which is a multifunctional system designed to measure different motor aspects of the hands, including reaction time, movement speed, tapping speed, and coordination.Results: A comparison of the results for the patient and control groups indicated that the motor functions of patients with RA were impaired in all the measured aspects (with the exception of the index finger tapping test). The difference between the groups varied between 11% and 21% for the reaction time tasks, between 12% and 18% for the speed of movement tasks, and between 15% and 17% for the coordination task.Conclusion: Based on the results of our research, it seems that RA decreases some motor performance functions of the hand expressed as simple reaction time, choice reaction time, speed of movement, and coordination. The changes were emphasised in movements performed with several joints. [ABSTRACT FROM AUTHOR]

Objective: To assess anxiety and depression and their explanatory factors in rheumatoid arthritis (RA) in a community-based population.Methods: The subscales of the Arthritis Impact Measurement Scales (AIMS) for anxiety and depression were used, and the Health Assessment Questionnaire (HAQ) was used for the assessment of disability. Cross-tabulation and multivariate logistic regression analysis were used to evaluate which variables best describe the patients with either high or low depression and anxiety scores.Results: Nearly 20% of our patients had probable depression (AIMS depression subscale score > or =4), a figure comparable to earlier hospital-based series. Most of the AIMS anxiety subscale variability was explained by poor physical function and the male sex, while the AIMS depression subscale variability was mostly explained by poor physical function, comorbidities, and social inactivity.Conclusion: In our cross-sectional, community-based RA series, depression was equal to the figures previously reported from hospital-based series. Poor physical function was a powerful explanatory factor of both depression and anxiety. [ABSTRACT FROM AUTHOR]

Objective: To search for possible immunogenetic differencies between the patients with familial and non-familial rheumatoid arthritis (RA).Methods: The study compared 129 familial RA patients with 217 non-familial patients for the frequencies of HLA-DR antigens including DR4 subtypes, DR4-DQB1*0301 and DR4-DQB1*0302 haplotypes and HLA-B27 antigen as well as the age of disease onset and existence of rheumatoid factor or joint erosions.Results: Two major differences between familial and non-familial groups were found: firstly, familial RA patients had increased frequency of HLA-DR4 as compared with the non-familial RA group (68.2 v. 54.8%; p = 0.019). Secondly, the mean age at onset of RA was significantly lower in the familial than in the sporadic RA patients (42.0 v. 46.5 years; p = 0.0020) and the difference still remained when the DR4 positive and negative subgroups were compared separately.Conclusion: These results confirm the more prominent association with HLA-DR4 in familial than in the non-familial cases and suggest that accumulation of HLA risk genes may, at least partly, explain the familial occurrence of the disease. Other susceptibility genes may also be concentrated in multiplex case families as suggested by an earlier age at the onset of RA in both HLA-DR4 positive and negative familial patients. [ABSTRACT FROM AUTHOR]

: The objective of this study was to use the Arthritis Impact Measurement Scales (AIMS) in a community-based rheumatoid arthritis (RA) population to describe the patient population, analyse health status changes and predict survival. The AIMS was assessed in 91 RA patients in a community-based RA population in Kuusamo, Northern Finland. A 5-year follow-up study was performed. The mean AIMS scores in this series of RA patients were comparable to those reported in previous studies. Dexterity correlated with disease duration. Lower extremity function was well preserved and only slightly dependent on disease duration. The AIMS scores changed for the worse in all the subscales over the follow-up period. Of all the AIMS subscale scores, poor functional status, as measured by the AIMS lower extremity function and social activity subscales, best predicted mortality. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the T cell cytokines IFN-gamma, IL-2, IL-4 and IL-5 in labial salivary glands (LSG) in Sjögren's syndrome (SS) and healthy controls using RT-PCR and immunohistochemistry. IFN-gamma is always or almost always produced in SS and in healthy controls. IL-2 was also found in some samples, but IL-4 and IL-5 were not. Less than 2% of all inflammatory mononuclear cells contained immuoreactive IFN-gamma or IL-2. Cytokine mRNA profile in LSGs in SS is skewed towards a T(H)1 pattern. The classical T(H)1 cytokines are also produced in normal glands, even in the absence of foci. T(H)1 type response may play an active role as part of the mucosal associated lymphoid tissue/responses, perhaps in prevention of reactivation of latent viruses. This may also make the exocrine glands a locus minoris resistentiae when the self tolerance is broken. [ABSTRACT FROM AUTHOR]

The value of ultrasonography (US), magnetic resonance imaging (MRI), computed tomography (CT) and plain radiography (PR) in detecting bone erosions on the humeral head was evaluated in a study of 26 in-patients (26 shoulders) with rheumatoid arthritis (RA). MRI depicted humeral erosions in 25 (96%), US in 24 (92%), CT in 20 (77%) and PR in 19 (73%) of the 26 shoulders. MRI and US were superior to CT in detecting small erosions. US was the most sensitive method to show surface erosions on the greater tuberosity. US, CT and MRI detected large erosions quite similarly. PR frequently missed small erosions. In the evaluation of early erosions in the rheumatoid shoulder, US and MRI are more sensitive methods than the traditionally used PR. US and MRI are suitable for the evaluations of soft-tissue involvement in the rheumatoid shoulder, but also for the detection of bone erosions of the humeral head. [ABSTRACT FROM PUBLISHER]

We evaluated 31 painful shoulders of 30 patients with chronic arthritis by ultrasonography (US) and compared the results with those of magnetic resonance imaging (MRI). Both US and MRI revealed effusion in the subacromial-subdeltoid (SA-SD) bursa, biceps tendon sheath (BTS) and glenohumeral (GH) joint, but MRI was more accurate in depicting joint inflammation because of its ability to visualize synovial hypertrophy. US visualized biceps tendon ruptures equally well as MRI. MRI was better able to reveal full-thickness tear of the supraspinatus tendon, whereas US showed better other changes of the supraspinatus tendon (degeneration or partial-thickness tear). Both of the imaging methods were able to depict erosions of the humeral head, but the locations occasionally differed. Inexpensive and easily available US can be recommended as the first imaging method for the detection of soft-tissue changes in the arthritic shoulder, but in rotator cuff problems both methods may be needed. [ABSTRACT FROM PUBLISHER]