Search

Clinical response to discontinuation of anti-TNF therapy in patients with ankylosing spondylitis after 3 years of continuous treatment with infliximab. Risk of infection in patients with spondyloarthritis and ankylosing spondylitis receiving antitumor necrosis factor therapy: a meta-analysis of randomized controlled trials. Moreover, when ax-SpA patients are in remission for 48 weeks, dose reduction seems to be acceptable with limited adverse events for most patients,[31] but complete discontinuation of TNF inhibitor treatments would increase the risk of flare-up significantly. Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor alpha inhibitor therapy: results from the Danish nationwide DANBIO registry. [Extracted from the article]

The author describes the case of a 42-year-old female patient who had been diagnosed with ankylosing spondylitis because she presented with chronic back pain, more in the lower spine, likely of the inflammatory type (IBP). He discusses the prevalence of items of potential relevance for a diagnosis of axial spondyloarthritis (axSpA), how mild disease would look like, and prediction of disease progression.

The adoption of digital technologies is expected to impact the social sustainability of agriculture, in particular in the case of small and mid-sized family farms in Western Europe. Goal of this research was to assess these impacts, however widely accepted impact assessment schemes of social sustainability are missing. Against this background, a qualitative, two-stage Delphi survey was conducted in order to identify relevant impact categories of the adoption of digital technologies in family-operated small-scale farms of South-West Germany. The participating experts stated, for example, that the adoption of digital technologies on the farm could mean that new business models can be based on the use of digital technologies. However, they also stated that digital technology could overburden farmers, which could hinder digitization in this sector as a whole. Data protection and data security were also issues ranked highly important by the participants in the Delphi Process. [ABSTRACT FROM AUTHOR]

The authors comment on a study which asked whether the presence of joint shape variations has an impact on the frequency and morphology of inflammatory lesions in the sacro-iliac joints (SIJ) as assessed by magnetic resonance imaging (MRI). Topics discussed include anatomy and SIJ and joint shape variations, differences related to sex and age, and SIJ shape variations in patients with axial spondyloarthritis (axSpA).

Background: Axial spondyloarthritis including ankylosing spondylitis (AS) is characterized by chronic inflammation and new bone formation in the axial skeleton. On the other hand, bone loss, osteoporosis and an increased risk of vertebral fractures is known to frequently occur in AS. In the MEASURE 1 study, the clinically efficacious interleukin-17A inhibitor secukinumab was shown to have limited radiographic progression through 4 years in patients with active AS. Here we present a post hoc analysis to evaluate the effect of secukinumab on bone mineral density (BMD) and bone turnover biomarkers over 2 years in this study.Methods: BMD was measured by dual-energy X-ray absorptiometry at the lumbar spine, total hip, and femoral neck. Spinal radiographs performed at baseline and Week 104 were assessed by modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and analyzed in relation to BMD change, considering baseline syndesmophytes. Bone turnover biomarkers were assessed at baseline and at Weeks 52 or 104.Results: Among 104 patients included in this analysis, 66% were male, with a mean (SD) age of 40.4 (12.3) years. In postmenopausal women and men ≥50 years of age (T-score), the proportion of patients having normal BMD at baseline and Week 104 were 54.5%/54.5% (lumbar spine), 31.6%/55.6% (total hip), and 42.1%/44.4% (femoral neck). Similarly, at baseline, the proportion of patients with osteopenia/osteoporosis was 31.8%/13.6% (lumbar spine), 57.9%/10.5% (total hip), 42.1%/15.8% (femoral neck), and 36.4%/9.1% (lumbar spine), 44.4%/0% (total hip) and 55.6%/0% (femoral neck) at Week 104, respectively. In premenopausal women and men < 50 years of age (Z-score), the proportion of patients having BMD below the expected range for age at baseline and Week 104 were 25.0%/21.2% (lumbar spine), 11.3%/17.8% (total hip), and 9.9%/8.9% (femoral neck). In relation to mSASSS change scores ≥2 over 2 years, the increase in lumbar spine BMD was not related to radiographic progression and syndesmophyte formation. No significant changes were observed in the bone turnover markers over time.Conclusion: The high proportion of AS patients with diminished BMD was confirmed in this study. An increase of BMD in the lumbar spine after 2 years of secukinumab treatment in patients with AS was found that was probably unrelated to radiographic progression. No relevant effects of secukinumab on bone turnover biomarkers were documented.Trial Registration: MEASURE 1 (post hoc analysis) Clinicaltrials.gov, NCT01358175 ; Registered, 23 May 2011. [ABSTRACT FROM AUTHOR]

In patients with axial spondyloarthritis (axSpA), pain, functional and structural impairments, reduced mobility and potential deformity of the axial skeleton are the most prominent health concerns. Limitations in physical function and spinal mobility are caused by both inflammation and structural damage, and therefore restrictions to physical function must be monitored throughout a patient's life. Consequently, the assessment of physical function is recommended as a key domain in the Assessment of Spondyloarthritis International Society-OMERACT Core Outcome Set. However, in comparison with disease activity, physical function seems to be a relatively neglected target of intervention in patients with axSpA, even though physical function is a major contributor to costs and disability in this disease. This Review aims to reacquaint rheumatologists with the targets for physical function, physical activity and performance by giving guidance on determinants of physical function and how physical function can be examined in patients with axSpA. [ABSTRACT FROM AUTHOR]

Due to many important technical developments over the past two decades angle‐resolved (inverse) photoemission has become the method of choice to study experimentally the bulk and surface‐related electronic states of solids in the most detailed way. Due to new powerful photon sources as well as efficient analyzers and detectors extremely high energy and angle resolution are achieved nowadays for spin‐integrated and also for spin‐resolved measurements. These developments allow in particular to explore the influence of spin–orbit coupling on image potential states of simple metals like Ir, Pt, or Au with a high atomic number as well as new types of materials as for example topological insulators. Herein, fully relativistic angle‐ and spin‐resolved inverse photoemission calculations are presented that make use of the spin‐density matrix formulation of the one‐step model. This way a quantitative analysis of all occupied and unoccupied electronic features in the vicinity of the Fermi level is achieved for a wide range of excitation energies. Using this approach, in addition, it is possible to deal with arbitrarily ordered but also disordered systems. Because of these features, the one‐step or spectral function approach to photoemission permits detailed theoretical studies on a large variety of interesting solid‐state systems. [ABSTRACT FROM AUTHOR]

Background: In Germany, the care of patients with inflammatory arthritis could be improved. Although specialized rheumatology nurses could take over substantial aspects of patient care, this hardly occurs in Germany. Thus, the aim of the study is to examine structured nursing consultation in rheumatology practices.Methods/design: In total, 800 patients with a stable course of rheumatoid arthritis or psoriatic arthritis in 20 centers in North Rhine-Westphalia and Lower Saxony will be randomized to either nurse-led care or standard care. Participating nurses will study for a special qualification in rheumatology and trial-specific issues. It is hypothesized that nurse-led care is non-inferior to standard care provided by rheumatologists with regard to a reduction of disease activity (DAS28) while it is hypothesized to be superior regarding changes in health-related quality of life (EQ-5D-5L) after 1 year. Secondary outcomes include functional capacity, patient satisfaction with treatment, and resource consumption.Discussion: Since there is insufficient care of rheumatology patients in Germany, the study may be able to suggest improvements. Nurse-led care has the potential to provide more efficient and effective patient care. This includes a more stringent implementation of the treat-to-target concept, which may lead to a higher percentage of patients reaching their treatment targets, thereby improving patient-related outcomes, such as quality of life, functional capacity, and participation. Additionally, nurse-led care may be highly cost-effective. Finally, this project may form the basis for a sustainable implementation of nurse-led care in standard rheumatology care in Germany.Trial Registration: German Clinical Trials Register, DRKS00015526. Registered on 11 January 2019. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of secukinumab, a fully human anti-interleukin-17A monoclonal antibody, on efficacy, imaging outcomes, and safety through 4 years (208 weeks) in patients with ankylosing spondylitis. Methods Patients opting to enrol had completed 2 years' treatment in the MEASURE 1 core study with subcutaneous secukinumab 150 or 75 mg every 4 weeks (q4Wk), following intravenous loading to Week (Wk) 4, or placebo treatment to Wk16/24. Up-titration from secukinumab 75–150 mg q4Wk was permitted following a protocol amendment. Efficacy is reported for patients originally randomized to secukinumab. Radiographic changes were assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and changes in MRI measures of inflammation using the Berlin scoring method. Safety and tolerability were evaluated. Results Among 274 extension study participants, 89.7% (78/87) and 93.0% (93/100) originally randomized to secukinumab 150 and 75 mg, respectively, completed 208Wk. Through Wk208, Assessment of Spondyloarthritis International Society 20/40 (observed) were 79.7%/60.8% (150 mg), 71.0%/43.5% (75 mg) and 80.0%/76% (up-titrators; n = 25). Mean (s.d.) changes in mSASSS were 1.2 (3.91) (150 mg), 1.8 (4.32) (75 mg) and 1.6 (5.67) (up-titrators). No radiographic progression (mSASSS change from Baseline < 2) was observed in 79% of patients receiving either secukinumab dose. Exposure-adjusted incidence rates per 100 patient-years were: serious infections (1.0), Candida infections (0.4), Crohn's disease (0.6), ulcerative colitis (0.2), and malignant/unspecified tumours (0.5), with no new safety signals. Conclusion Through 4 years, secukinumab provided sustained efficacy on signs and symptoms, and MRI outcomes, a low rate of radiographic progression and a consistent safety profile. Trial registration NCT01863732. [ABSTRACT FROM AUTHOR]

In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural damage is currently assessed by conventional radiography and scoring systems that reliably assess radiographic structural damage are needed to capture the differential effects of drugs on structural damage progression. The validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the effect of AS treatments on radiographic progression rates was assessed in this review. The mSASSS has not been used, to date, as a primary outcome measure in a prospective randomized controlled clinical trial of biologic therapy in AS. This review of the medical literature confirmed that the mSASSS is the most validated and widely used method for assessing radiographic progression in AS, correlating with worsening measures of disease signs and symptoms, spinal mobility and physical function, with a 2-year interval being required to ensure sufficient sensitivity to change. [ABSTRACT FROM AUTHOR]

Various apparative developments extended the potential of angle-resolved photoemission spectroscopy tremendously during the last two decades. Modern experimental arrangements consisting of new photon sources, analyzers and detectors supply not only extremely high angle and energy resolution but also spin resolution. This provides an adequate platform to study in detail new materials like low-dimensional magnetic structures, Rashba systems, topological insulator materials or high T C superconductors. The interest in such systems has grown enormously not only because of their technological relevance but even more because of exciting new physics. Furthermore, the use of photon energies from few eV up to several keV makes this experimental technique a rather unique tool to investigate the electronic properties of solids and surfaces. The following article reviews the corresponding recent theoretical developments in the field of angle-resolved photoemission with a special emphasis on correlation effects, temperature and relativistic aspects. The most successful theoretical approach to deal with angle-resolved photoemission is the so-called spectral function or one-step formulation of the photoemission process. Nowadays, the one-step model allows for photocurrent calculations for photon energies ranging from a few eV to more than 10 keV, to deal with arbitrarily ordered and disordered systems, to account for finite temperatures, and considering in addition strong correlation effects within the dynamical mean-field theory or similar advanced approaches. [ABSTRACT FROM AUTHOR]

CT-P13, the biosimilar of infliximab, has been recently approved in the EU, Australia, Canada, Japan and many other countries. Thus, it was the first biosimilar approved in the field of rheumatology, dermatology and gastroenterology. Since there has been debate about the issue of switching from RMP to the biosimilar and some national societies have expressed concerns, this review was written with the following objectives: - Review the data evaluating the safety and effectiveness of switching to CT-P13 accumulated thus far from clinical studies and real-world experience. - Assess the paradigm shift around the use of biosimilar products in terms of recent national decisions and stakeholder perspectives. The review concludes that whilst prudent switching practices should be employed, growing safety experience accumulated thus far with CT-P13 and other biosimilars is favorable and does not raise any specific concerns. [ABSTRACT FROM AUTHOR]

The article offers information on axial spondyloarthritis, or axSpA, and ankylosing spondylitis (AS). AS is a prevalent rheumatic condition with incidence rates ranging from 0.44 to 0.73/100,000 and prevalence rates of 0.007 to 1.7 percent. It can be classified into two subgroups according to the Assessment of SpondyloArthritis International Society 2009 criteria. The hallmark for a diagnosis of AS is the detection and grading of sacroiliitis using conventional radiographs.

The article presents a comment on the research "Efficacy and safety of continuing versus withdrawing adalimumab therapy in maintaining remission in patients with non-radiographic axial spondyloarthritis" by R. Landewe and colleagues. Topics include nonradiographic axial spondyloarthritis and ankylosing spondylitis; outcomes of patients with nonradiographic axial spondyloarthritis reaching remission on therapy with TNF inhibitors; and clinical response to discontinuation of anti-TNF therapy.

Novel imaging spin-filter techniques, which are based on low-energy electron diffraction, are currently of high scientific interest. To improve the spin-detection efficiency a variety of new materials have been introduced in recent years. A new class of promising spin-filter materials are represented by multiferroic systems, as both magnetic and electric ordering exist in these materials. We have investigated Fe/BaTiO3(001) for spin-filter applications, which is a prominent candidate due to its moderate spontaneous polarization of the BaTiO3 substrate. Therefore we calculated diffraction patterns for spin polarized electrons incident on the Fe surface. Motivated by the fact that spin polarized low-energy electron diffraction is a surface sensitive method, we investigated the alterations of exchange and spin orbit scattering induced by switching the BaTi03 polarization. As shown by our studies the system obviously offers the possibility of realizing a multiferroic spin filter and manipulating the spin-orbit and exchange scattering by an external electric field. The calculations have been done for a large range of kinetic energies and polar angles of the diffracted electrons considering different numbers of Fe monolayers. [ABSTRACT FROM AUTHOR]

For a steeply sloped part of the "Heumöser", a creeping landslide in Vorarlberg (Austria), it is postulated that subsurface macropore flow results in high pore water pressures at the base of the slope and thus triggers mass movement or may even cause slope failure. To quantify saturated hydraulic conductivity and anisotropy in a soil containing macropores, a novel method was required to obtain a "very large" (L/w/H ≈ 30/30/60 cm) undisturbed soil sample. A square column was carved out from the slope, wrapped in cling wrap, surrounded with timber walls on the four lateral sides and stabilized by injection of polyurethane foam. The sample was then cut off at the base and carefully transported to the laboratory where it was installed in a constant head permeameter to obtain values for vertical hydraulic conductivity (Kv). After completing the vertical flow measurements, the sample was divided into two cubes with approximately 30 cm side length and the respective vertical hydraulic conductivities were determined. Then the cubes were turned by 90° to obtain the horizontal saturated hydraulic conductivities (Kh). This new method allowed thus for a directional characterization of the hydraulic conductivity of soils containing macropores. It could be shown that the vertical hydraulic conductivity decreased by a factor of two from the upper sample to the lower sample. A similar anisotropy factor (Kh/Kv) of approximately 0.5 was determined for both layers, in other words, it was shown that macropores can reverse the expected "natural" anisotropy (Kh/Kv > 1). [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of pharmacological treatment of SpA on depressive symptoms and explore whether this effect differs between drug classes. Methods Data from the observational Assessment of SpondyloArthritis international Society Health Index Validation Study were used. Patients were assessed at baseline and after initiation of NSAIDs/conventional synthetic DMARDs (csDMARDs)/TNF inhibitors (TNFis). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale depression subscale [HADS-D; 0–21 (best–worst)]. Covariables included demographics and disease characteristics, including disease activity [Ankylosing Spondylitis Disease Activity Score (ASDAS)/BASDAI]. The change in HADS-D from baseline was compared between treatments (NSAIDs/csDMARDs/TNFis) with analysis of variance and multivariable regression analysis. Results A total of 304 patients were included; 102/45/157 initiated NSAIDs/csDMARDs/TNFis and 260 (85%) / 44 (15%) had axial/peripheral SpA. At baseline, the mean HADS-D was 6.9 (s. d. 4.2); 126 (42%) were possibly depressed (HADS-D ≥8) and 66 (22%) were probably depressed (HADS-D ≥11). At follow-up, depressive symptoms significantly improved in all treatment groups. In multivariable regression without disease activity measures, initiating TNFis compared with NSAIDs was associated with greater improvement in depressive symptoms [β = −1.27 (95% CI −2.23, −0.32)] and lower odds of possible depression at follow-up [odds ratio 0.47 (95% CI 0.23, 0.94)]. This association was attenuated after additional adjustment for disease activity (ASDAS/BASDAI) but not CRP. csDMARDs did not differ from NSAIDs regarding their effect on HADS-D. Between-drug class results were confirmed in axial SpA (axSpA), although less clear in peripheral SpA. Conclusion Treatment of active SpA also improves depressive symptoms. Especially in axSpA, TNFis have a greater effect than NSAIDs, which is mainly explained by a stronger effect on disease activity. We found no evidence for a direct link between CRP-mediated inflammation and depressive symptoms in SpA. [ABSTRACT FROM AUTHOR]

Abstract: Magnetic resonance elastography (MRE) is capable of measuring the viscoelastic properties of brain tissue in vivo. However, MRE is still limited in providing high-resolution maps of mechanical constants. We therefore introduce 3D multifrequency MRE (3DMMRE) at 7T magnetic field strength combined with enhanced multifrequency dual elasto-visco (MDEV) inversion in order to achieve high-resolution elastographic maps of in vivo brain tissue with 1mm3 resolution. As demonstrated by phantom data, the new MDEV-inversion method provides two high resolution parameter maps of the magnitude (|G*|) and the phase angle (ϕ) of the complex shear modulus. MDEV inversion applied to cerebral 7T-3DMMRE data of five healthy volunteers revealed structures of brain tissue in greater anatomical details than previous work. The viscoelastic properties of cortical gray matter (GM) and white matter (WM) could be differentiated by significantly lower values of |G*| and ϕ in GM (21% [P<0.01]; 8%, [P<0.01], respectively) suggesting that GM is significantly softer and less viscous than WM. In conclusion, 3DMMRE at ultrahigh magnetic fields and MDEV inversion open a new window into characterizing the mechanical structure of in vivo brain tissue and may aid the detection of various neurological disorders based on their effects to mechanical tissue properties. [Copyright &y& Elsevier]

The authors discuss a study by Anna Molto and colleagues, published within the issue on the impact of a nurse-led program of self-management on coping in patients with axial spondyloarthritis (SpA) (axSpA). Topics discussed include international recommendations on the management of axSpA and rheumatoid arthritis (RA), possible reason why no effect on disease activity was found, and how the mental and physical well-being of patients may be improved.

The diagnosis of axial spondyloarthritis (axSpA) is based on detection of characteristic inflammatory or structural changes (or a combination of both) in the spine and sacroiliac joints. Imaging of the axial skeleton is, therefore, useful for the identification of these pathological changes. Both inflammation (best detected by MRI) and bone formation (best visualized by conventional radiography) can predict the development of future structural changes. In addition, a high degree of spinal inflammation on MRI is predictive of a successful response to anti-TNF therapy. Emerging data indicate that the combination of acute and chronic changes on MRI has an important influence on progression of nonradiographic axSpA to ankylosing spondylitis. This Perspectives article provides an overview of the role of imaging in the diagnosis and management of axSpA, and also discusses open questions and future perspectives in this field. [ABSTRACT FROM AUTHOR]

Objective. To compare the abilities of three enthesitis indices to detect improvement in entheseal tenderness with the TNF antagonist golimumab in AS.Methods. Adult patients with active AS were randomly assigned to receive s.c. injections of placebo or golimumab (50 or 100 mg) every 4 weeks. Patients with inadequate week 16 responses were switched (blinded) from placebo to golimumab 50 mg or from golimumab 50 mg to 100 mg. At week 24, all patients still receiving placebo crossed over to golimumab 50 mg. Enthesitis data through week 52 are reported herein. Enthesitis was measured by a trained, independent assessor who recorded the presence or absence of tenderness in 27 entheses, which allowed simultaneous determination of three different indices [12-point Berlin Index, 17-point University of California, San Francisco (UCSF) Index and 13-point Maastricht AS Enthesitis Score (MASES)].Results. Three hundred and fifty-six AS patients were randomized to placebo (n = 78), golimumab 50 mg (n = 138) or golimumab 100 mg (n = 140); 355 had enthesitis data available for analysis. Using the UCSF Index, significant improvement from baseline vs placebo was observed for golimumab 100 mg at weeks 14 and 24. Using the MASES, significant improvement for golimumab 100 mg vs placebo at week 14 and a trend toward improvement at week 24 were observed. Using the Berlin Index, significant improvement for golimumab 100 mg vs placebo at week 14 was observed. Effect size determinations for changes to weeks 14, 24 and 52, respectively, in the Berlin (−0.27, −0.34, −0.42), UCSF (−0.44, −0.61, −0.55) and MASES (−0.30, −0.55, −0.39) indices suggested small to moderate effect sizes.Conclusion. In patients with active AS, the UCSF Index appeared most sensitive in detecting the effect of golimumab 100 mg vs placebo on enthesitis.Trial registration. clinicaltrials.gov, http://www.clinicaltrials.gov, NCT00265083. [ABSTRACT FROM AUTHOR]

Abstract: In the field of aquifer restoration and civil engineering, fluids and suspensions are delivered in porous media via well injection. The flow field resulting around the well is three-dimensional. Since two and three-dimensional experiments which can be used to reproduce such flow fields are, although accurate, extremely elaborate and time consuming, the authors suggest to substitute them by a cascade of interdependent, one-dimensional (column) experiments. The new method is used to simulate the injection in aquifers of micro-iron particles dispersed in a shear thinning gel of guar gum and allows the prediction of iron particle distribution around the well and of injection pressure. The method respects the mass balance at the field scale and its predictions are in good agreement with those of a mathematical model proposed in the literature. The method is consistent with the Triad Approach, a way to improve remediation efficiency proposed by the U.S. Environmental Protection Agency. The representativeness of the proposed tests combined with their simplicity and relative inexpensiveness make this new method applicable and useful in the planning and design of real remediation. [Copyright &y& Elsevier]

Objectives. The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a new composite clinical tool combining subjective and objective measures. Using data from the randomized double-blind Ankylosing Spondylitis Study Comparing Enbrel with Sulfasalazine Dosed Weekly (ASCEND) trial, we tested ASDAS validity and assessed its capacity to discriminate between treatment effects and change-from-baseline improvements.Methods. These post hoc analyses were conducted in patients who received etanercept (50 mg/week) or SSZ (&leq;3 g/day) for 16 weeks. The ASDAS was tested for its capacity to discriminate between those who achieved and did not achieve Assessment of Spondyloarthritis International Society (ASAS) partial remission and ASAS20. Week 16 adjusted treatment differences and effect sizes of improvement from baseline of 42 outcomes were calculated.Results. Means for ASDAS were less than half in patients with ASAS partial remission compared with patients without partial remission across the entire study population (1.2 vs 2.6; P < 0.0001). Patients who achieved ASAS20 had greater mean changes from baseline in ASDAS than those who did not (−1.8 vs −0.3; P < 0.0001). ASDAS was consistently shown to have one of the highest discriminatory capacities compared with other measurements (including subjective measurements) regardless of normal vs high CRP, presence or absence of peripheral arthritis and high vs very high ASDAS at baseline. As a dichotomous variable using different thresholds for improvement and disease severity, ASDAS had slightly better discriminatory capacity than all corresponding ASAS measures.Conclusion. ASDAS is a validated and highly discriminatory tool for the detection of significant differences between treatments for AS as well as for detecting a significant improvement from baseline with etanercept and SSZ. [ABSTRACT FROM PUBLISHER]

We have investigated valence-band properties of Pt(l 11) surface covered by an Ag layer. Aside from showing significant changes in the d bands and the sp-like Shockley-type surface resonance depending on the thickness of the Ag layer, our spectroscopic data suggest the formation of an Ag-Pt mixture that progressively develops at the interface upon increasing the annealing temperature of the sample. On a 2-ML system, the Shockley resonance band is partially occupied and exhibits a large Rashba spin-orbit splitting that can be described by a first-principles band-structure calculation based on multiple-scattering theory. For the interface alloy, we have used the coherent potential approximation, which is one of the best models among the so-called single-site (local) theory. We observe a shift of the Shockley resonance due to the alloying process at the interface that probably favors the formation of the well-known triangular reconstruction. [ABSTRACT FROM AUTHOR]

Abstract: The distribution of micro Fe particles injected into a porous medium via a well highly depends on flow velocity and slurry properties. Column experiments were conducted to predict the filtration behavior and, hence, the micro-iron distribution around a well. Packed-bed column experiments were conducted in different experimental conditions: seepage velocity, volume of injected suspension, iron particle and guar gum concentration (viscosity) were varied. Results are used to calculate a parameter “space removal efficiency” (ηspace). Space removal efficiency is defined as the fraction of particle concentration lost by the slurry (and retained by the porous medium) while it crosses a unit length of the porous medium. ηspace was found to be inversely proportional to seepage velocity and viscosity, while it is independent of the volume of injected slurry (or injection time) and particle concentration. The obtained relationships for ηspace are used in an empirical numerical model to predict the distribution of iron particles around an injection well at a realistic field injection. To this purpose, the flow domain is discretized in shells, each characterized by a value of seepage velocity and by a distinct volume of slurry that flows through a unit of its surface. The resulting model, which is based on a large number of experimental observations (about 50 packed-bed column tests), overcomes the limit of current approaches for predicting iron particle transport, as they consider mono-dimensional flow conditions, while during injection the flow field is radial. The proposed approach ought to help bridging the gap between laboratory scale research and the field scale application of micro-iron particle technology. [Copyright &y& Elsevier]

Objectives. To compare the clinical manifestations of spinal disease, peripheral arthritis and enthesitis, and to evaluate the effectiveness of adalimumab in a large cohort of patients with AS in relation to the presence or absence of psoriasis. [ABSTRACT FROM PUBLISHER]

Kolmogorov (Dokl. Akad. Nauk USSR, 14(5):953–956, ) showed that any multivariate continuous function can be represented as a superposition of one-dimensional functions, i.e., The proof of this fact, however, was not constructive, and it was not clear how to choose the outer and inner functions Φ q and ψ q, p, respectively. Sprecher (Neural Netw. 9(5):765–772, ; Neural Netw. 10(3):447–457, ) gave a constructive proof of Kolmogorov’s superposition theorem in the form of a convergent algorithm which defines the inner functions explicitly via one inner function ψ by ψ p, q:= λ p ψ( x p+ qa) with appropriate values λ p, a∈ℝ. Basic features of this function such as monotonicity and continuity were supposed to be true but were not explicitly proved and turned out to be not valid. Köppen (ICANN 2002, Lecture Notes in Computer Science, vol. 2415, pp. 474–479, ) suggested a corrected definition of the inner function ψ and claimed, without proof, its continuity and monotonicity. In this paper we now show that these properties indeed hold for Köppen’s ψ, and we present a correct constructive proof of Kolmogorov’s superposition theorem for continuous inner functions ψ similar to Sprecher’s approach. [ABSTRACT FROM AUTHOR]

The article focuses on ankylosing spondylitis, which is defined as a common inflammatory rheumatic disease, which affects the axial skeleton and is characterized by inflammatory back pain. Sufferers can have structural and functional impairments and decreased quality of life as a result of this type of spondyloarthritis. The condition is treated and managed long-term with non-steroidal anti-inflammatory drugs and physiotherapy. A new treatment is also mentioned that uses tumor necrosis factor blockers for patients refractory to conventional treatment.

NSAIDs are first line therapy for patients with axial spondyloarthritis and are recommended to be taken continuously in patients with active disease, but their ability to affect radiographic disease progression has been uncertain. Does a new meta-analysis shed light on this matter, or is it too soon to tell? [ABSTRACT FROM AUTHOR]

Abstract: In neutral atom lithography, a collimated beam of atoms is sent through a region of standing light waves created by interfering laser beams. The intensity distribution of the light field modulates the density distribution of the atoms transversal to the beam direction. The atomic beam materializes on a substrate, and the atoms are deposited in a pattern which mimics the intensity distribution of the light. It is thus possible to create nanostructures by a suitable adjustment of the light field. While the computation of the pattern of atoms generated by any given setup of laser beams with known amplitudes and phases is straightforward, the inverse problem of deducting the appropriate amplitude and phase of each single beam to create a prescribed pattern has to our knowledge not yet been addressed. We propose a numerical method to derive these values for a fixed setup of laser beams. We consider first the general case of unrelated beam directions and then specialize to setups which induce periodic patterns. The solution of the inverse problem is a two-step process: we use Fourier techniques to compute a set of characteristic amplitude values which enter the right-hand side of a nonlinear system of equations. This system is then solved iteratively by a coordinate descent method. [Copyright &y& Elsevier]

We investigated the surface and bulk properties of the pristine (110) surface of silver using threshold photoemission by excitation with light of 5.9 eV. Using a momentum microscope, we identified two distinct transitions along the G Y direction of the crystal. The first one is a so far unknown surface resonance of the (110) noble-metal surface, exhibiting an exceptionally large bulk character that has so far been elusive in surface sensitive experiments. The second one stems from the well-known bulklike Mahan cone oriented along the G L direction inside the crystal but projected onto the (110)-surface cut. The existence of the new state is confirmed by photocurrent calculations, and its character is analyzed. [ABSTRACT FROM AUTHOR]

The article discusses research on the usefulness of some biomarkers in monitoring patients with axial spondyloarthritis (SpA). It references two studies by S. J. Pedersen and colleagues published in "Arthritis & Rheumatism" and "Annals of the Rheumatic Diseases." The first study suggested that clinical disease activity is associated with inflammatory biomarkers in patients with SpA. It also observed a disconnect between inflammation and new bone formation.

• Excavating technique to gain large undisturbed soil samples for laboratory experiments. • Improved evaporation method helps to better determine the point of full saturation. • Evaporation method is faster than multi-step outflow method. • Both methods get similar soil hydraulic properties in middle water saturation zone. • Fitting approach worked well although the soils have very high macropore ratios. The aim of the study was the comparison of the soil hydraulic properties determined based on two different experimental methods of four large and macroporous soil samples. An undisturbed cylindrical soil column (h = 60 cm and d = 30 cm) was obtained at a natural slope and quartered horizontally in the laboratory. The four sub-samples were saturated and subsequently drained using the extended multi-step outflow method (XMSO). Retention curves and unsaturated hydraulic conductivity curves were derived via inverse modeling based on the measured drainage and corresponding pore water pressure. After resaturation the evaporation method (EVA) was used on the same four samples. The samples were exposed to evaporation and the effective water contents and the average pore water pressures were recorded over time to determine soil hydraulic functions. While both methods yielded similar results in the medium moisture range, the advantage of the XMSO-method is its higher information content with respect to the hydraulic conductivity close to water saturation whereas the advantage of the EVA-method is its fast execution. Moreover, the EVA-method is easier to handle and has significantly lower computational requirements than the XMSO-method. Furthermore, since the four soil samples represent a soil profile in the field, a depth dependent characterizing of the soil profile was possible and showed that the soil properties near saturation are greatly dominated by the ratio of macropores in the sample and that a decrease in the macropore ratio with soil depth was clearly reflected in the hydraulic functions. [ABSTRACT FROM AUTHOR]

Individuals with anti-citrullinated protein antibodies (ACPAs) and subclinical inflammatory changes in joints are at high risk of developing rheumatoid arthritis. Treatment strategies to intercept this pre-stage clinical disease remain to be developed. We aimed to assess whether 6-month treatment with abatacept improves inflammation in preclinical rheumatoid arthritis. The abatacept reversing subclinical inflammation as measured by MRI in ACPA positive arthralgia (ARIAA) study is a randomised, international, multicentre, double-blind, placebo-controlled trial done in 14 hospitals and community centres across Europe (11 in Germany, two in Spain, and one in the Czech Republic). Adults (aged ≥18 years) with ACPA positivity, joint pain (but no swelling), and signs of osteitis, synovitis, or tenosynovitis in hand MRI were randomly assigned (1:1) to weekly subcutaneous abatacept 125 mg or placebo for 6 months followed by a double-blind, drug-free, observation phase for 12 months. The primary outcome was the proportion of participants with any reduction in inflammatory MRI lesions at 6 months. The primary efficacy analysis was done in the modified intention-to-treat population, which included participants who were randomly assigned and received study medication. Safety analyses were conducted in participants who received the study medication and had at least one post-baseline observation. The study was registered with the EUDRA-CT (2014–000555–93). Between Nov 6, 2014, and June 15, 2021, 139 participants were screened. Of 100 participants, 50 were randomly assigned to abatacept 125 mg and 50 to placebo. Two participants (one from each group) were excluded due to administration failure or refusing treatment; thus, 98 were included in the modified intention-to-treat population. 70 (71%) of 98 participants were female and 28 (29%) of 98 were male. At 6 months, 28 (57%) of 49 participants in the abatacept group and 15 (31%) of 49 participants in the placebo group showed improvement in MRI subclinical inflammation (absolute difference 26·5%, 95% CI 5·9–45·6; p=0·014). Four (8%) of 49 participants in the abatacept group and 17 (35%) of 49 participants in the placebo group developed rheumatoid arthritis (hazard ratio [HR] 0·14 [0·04–0·47]; p=0·0016). Improvement of MRI inflammation (25 [51%] of 49 participants in the abatacept group, 12 [24%] of 49 in the placebo group; p=0·012) and progression to rheumatoid arthritis (17 [35%] of 49, 28 [57%] of 49; HR 0·14 [0·04–0·47]; p=0·018) remained significantly different between the two groups after 18 months, 12 months after the end of the intervention. There were 12 serious adverse events in 11 participants (four [8%] of 48 in the abatacept group and 7 [14%] of 49 in the placebo group). No deaths occurred during the study. 6-month treatment with abatacept decreases MRI inflammation, clinical symptoms, and risk of rheumatoid arthritis development in participants at high risk. The effects of the intervention persist through a 1-year drug-free observation phase. Innovative Medicine Initiative. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a chronic neuroinflammatory disease that involves both white and gray matter. Although gray matter damage is a major contributor to disability in MS patients, conventional clinical magnetic resonance imaging (MRI) fails to accurately detect gray matter pathology and establish a clear correlation with clinical symptoms. Using magnetic resonance elastography (MRE), we previously reported global brain softening in MS and experimental autoimmune encephalomyelitis (EAE). However, it needs to be established if changes of the spatiotemporal patterns of brain tissue mechanics constitute a marker of neuroinflammation. Here, we use advanced multifrequency MRE with tomoelastography postprocessing to investigate longitudinal and regional inflammation-induced tissue changes in EAE and in a small group of MS patients. Surprisingly, we found reversible softening in synchrony with the EAE disease course predominantly in the cortex of the mouse brain. This cortical softening was associated neither with a shift of tissue water compartments as quantified by T2-mapping and diffusion-weighted MRI, nor with leukocyte infiltration as seen by histopathology. Instead, cortical softening correlated with transient structural remodeling of perineuronal nets (PNNs), which involved abnormal chondroitin sulfate expression and microgliosis. These mechanisms also appear to be critical in humans with MS, where tomoelastography for the first time demonstrated marked cortical softening. Taken together, our study shows that neuroinflammation (i) critically affects the integrity of PNNs in cortical brain tissue, in a reversible process that correlates with disease disability in EAE, (ii) reduces the mechanical integrity of brain tissue rather than leading to water accumulation, and (iii) shows similar spatial patterns in humans and mice. These results raise the prospect of leveraging MRE and quantitative MRI for MS staging and monitoring treatment in affected patients. [ABSTRACT FROM AUTHOR]

The authors comments on studies which show an increased risk of smoking in patients with spondyloarthritides. They emphasize that smoking has an unfavorable influence on other outcomes of rheumatic diseases and that more intensive therapy is required for rheumatoid arthritis (RA) patients who smoke. The authors also cite the need for a close cooperation between the general practitioner and the rheumatologist to ensure best patient care.

The photoelectron spin polarization in angle-resolved photoemission from the topological surface state in Bi2Te3(0001) has been investigated in a combined experimental and theoretical study. Our measurements show significant photon-energy-dependent deviations in the three-dimensional spin polarization of the photoelectron when compared to the expected intrinsic spin polarization of the surface state. The experimental observations are in line with relativistic one-step photoemission calculations. Our theoretical analysis confirms that spin-orbit coupling in the initial-state wave functions in combination with the dipole selection rules strongly influences the photoelectron spin polarization. Furthermore, spin-dependent final-state effects are found to influence the spin polarization significantly. A quantitative access to the three-dimensional spin-polarization vector in topological insulators is thus challenged by a complex interplay of initial- and final-state effects in the photoemission process. [ABSTRACT FROM AUTHOR]

By means of one-step model calculations the strong in-plane anisotropy seen in angle-resolved photoemission of the well-known iron pnictide prototype compounds BaFe2 As2 and Ba(Fe1-x Cox)2 As2 in their low-temperature antiferromagnetic phases is investigated. The fully relativistic calculations are based on the Korringa-Kohn-Rostoker-Green function approach combined with the coherent potential approximation alloy theory to account for the disorder induced by Co substitution on Fe sites in a reliable way. The results of the calculations can be compared directly to experimental spectra of detwinned single crystals. One finds very good agreement with experiment and can reveal all features of the electronic structure contributing to the in-plane anisotropy. In particular the local density approximation can capture most of the correlation effects for the investigated system without the need for more advanced techniques. In addition, the evolution of the anisotropy for increasing Co concentration x in Ba(Fe1-x Cox)2 As2 can be tracked almost continuously. The results are also used to discuss surface effects and it is possible to identify clear signatures to make conclusions about different types of surface termination. [ABSTRACT FROM AUTHOR]

The article presents the author's opinion on Canadian recommendations for the management of spondyloarthritis. The author discusses the effect of various recommendations published in different publications among physicians in their diagnostic and therapeutic decision-making. According to the author, even though different groups and expert initiatives are keen to publish recommendations, the availability of too many recommendations on the same topic could lead to confusion.

Cancer progression is caused by genetic changes and associated with various alterations in cell properties, which also affect a tumor's mechanical state. While an increased stiffness has been well known for long for solid tumors, it has limited prognostic power. It is hypothesized that cancer progression is accompanied by tissue fluidization, where portions of the tissue can change position across different length scales. Supported by tabletop magnetic resonance elastography (MRE) on stroma mimicking collagen gels and microscopic analysis of live cells inside patient derived tumor explants, an overview is provided of how cancer associated mechanisms, including cellular unjamming, proliferation, microenvironment composition, and remodeling can alter a tissue's fluidity and stiffness. In vivo, state‐of‐the‐art multifrequency MRE can distinguish tumors from their surrounding host tissue by their rheological fingerprints. Most importantly, a meta‐analysis on the currently available clinical studies is conducted and universal trends are identified. The results and conclusions are condensed into a gedankenexperiment about how a tumor can grow and eventually metastasize into its environment from a physics perspective to deduce corresponding mechanical properties. Based on stiffness, fluidity, spatial heterogeneity, and texture of the tumor front a roadmap for a prognosis of a tumor's aggressiveness and metastatic potential is presented. [ABSTRACT FROM AUTHOR]

The construction of a multichannel vector spin polarimeter requires the development of a detector type, which works as a spin polarizing mirror with high reflectivity and asymmetry properties to guarantee for a high figure of merit. Technical realizations are found by spin-polarized electron scattering from a surface at low energies. A very promising candidate for such a detector suitable material consists of an oxygen passivated iron surface, as for example a Fe(001)-p(1×1)O surface. We investigate in detail the electronic structure of this adsorbate system and calculate the corresponding spin-polarized low-energy electron scattering. Our theoretical study is based on the fully relativistic SPRKKR method in the framework of density functional theory. Furthermore, we use the local spin-density approximation in combination with dynamical mean field theory to determine the electronic structure of Fe(001)-p(1×1)O and demonstrate that a significant impact of correlation effects occurs in the calculated figure of merit. [ABSTRACT FROM AUTHOR]

Objectives: Application of multifrequency magnetic resonance elastography (MMRE) of the brain parenchyma in patients with neuromyelitis optica spectrum disorder (NMOSD) compared to age matched healthy controls (HC).Methods: 15 NMOSD patients and 17 age- and gender-matched HC were examined using MMRE. Two three-dimensional viscoelastic parameter maps, the magnitude |G*| and phase angle φ of the complex shear modulus were reconstructed by simultaneous inversion of full wave-field data in 1.9-mm isotropic resolution at 7 harmonic drive frequencies from 30 to 60 Hz.Results: In NMOSD patients, a significant reduction of |G*| was observed within the white matter fraction (p = 0.017), predominantly within the thalamic regions (p = 0.003), compared to HC. These parameters exceeded the reduction in brain volume measured in patients versus HC (p = 0.02 whole-brain volume reduction). Volumetric differences in white matter fraction and the thalami were not detectable between patients and HC. However, phase angle φ was decreased in patients within the white matter (p = 0.03) and both thalamic regions (p = 0.044).Conclusions: MMRE reveals global tissue degeneration with accelerated softening of the brain parenchyma in patients with NMOSD. The predominant reduction of stiffness is found within the thalamic region and related white matter tracts, presumably reflecting Wallerian degeneration.Key Points: • Magnetic resonance elastography reveals diffuse cerebral tissue changes in patients with NMOSD. • Premature tissue softening in NMOSD patients indicates tissue degeneration. • Hypothesis of a widespread cerebral neurodegeneration in form of diffuse tissue alteration. [ABSTRACT FROM AUTHOR]

The article discusses the use of infliximab in ankylosing spondylitis. Most patients with ankylosing spondylitis experience clinical relevant benefits from infliximab therapy. The drug has been shown to be efficacious after two weeks and clinical experience indicates that initial relief of symptoms may occur after twenty-four hours. Around 10% of patients discontinue infliximab therapy annually, mainly because of adverse side effects and for pragmatic reasons. Serious adverse events are rare with infliximab therapy, with the major concern being infection. In general, infliximab therapy improves signs, symptoms and function of patients with ankylosing spondylitis. Furthermore, there is an indication that structural damage can be influenced by infliximab.