WorldWideScience

Sample records for axial spondyloarthritis treated

  1. Axial spondyloarthritis.

    Science.gov (United States)

    Sieper, Joachim; Braun, Jürgen; Dougados, Maxime; Baeten, Dominique

    2015-07-09

    The term axial spondyloarthritis covers both non-radiographic disease and radiographic disease (also known as ankylosing spondylitis). Some studies have been performed to investigate the prevalence of axial spondyloarthritis, although most are limited to patients with radiographic disease. A strong genetic association has been shown between axial spondyloarthritis and human leukocyte antigen-B27 (HLA-B27), but the pathogenetic role of HLA-B27 has not yet been clarified. Tumour necrosis factor (TNF), IL-17, IL-23 and downstream pathways also seem to be important - based on the good results of therapies directed against these molecules - but their exact role in the inflammatory process is also not yet clear. Elucidating the interaction between osteoproliferation and inflammation will be crucial for the prevention of long-term structural damage of the bone. The development of new criteria for classification, diagnosis and screening of patients with axial spondyloarthritis will enable earlier intervention for this chronic inflammatory disease. MRI has become an important tool for the early detection of axial spondyloarthritis. NSAIDs and TNF blockers are effective therapies, including in the early non-radiographic stage. Therapeutic blockade of IL-17 or IL-23 seems to be a promising new treatment option. Tools for measuring quality of life in axial spondyloarthritis have become relevant to assess the impact that the disease has on patients. These diagnostic and therapeutic advances will continue to change the management of axial spondyloarthritis, and new insights into the disease pathogenesis will hopefully accelerate this process. For an illustrated summary of this Primer, visit: http://go.nature.com/51b1af.

  2. Acute tubulointerstitial nephritis in an HLA-B27-positive patient with axial spondyloarthritis being treated with adalimumab.

    Science.gov (United States)

    Castro Corredor, David; Sánchez de la Nieta, María Dolores; de Lara Simón, Isabel María

    2017-06-14

    Antagonists of tumor necrosis factor-alpha (ATNF) are used for the treatment of multiple diseases such as psoriatic arthritis, Crohn's disease, ankylosing spondylitis and juvenile idiopathic arthritis, usually, when they are refractory to first-line treatment 1 . The use of ATNF has been associated with the induction of autoimmune diseases such as systemic lupus erythematosus-like disease, vasculitis, sarcoidosis-like diseases and, recently, acute granulomatous tubulointerstitial nephritis. We report a case of acute nongranulomatous tubulointerstitial nephritis in an HLA-B27-positive patient with axial spondyloarthritis and Crohn's disease being treated with adalimumab. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  3. Bone formation in axial spondyloarthritis.

    Science.gov (United States)

    Lories, Rik J; Haroon, Nigil

    2014-10-01

    The success of targeted therapies directed against tumor necrosis factor for patients with spondyloarthritis has shifted the focus of physicians and scientists towards the prevention of structural damage to the involved structures, in particular the sacroiliac joints and the spine, to avoid loss of function and disability. Structural damage to the skeleton as witnessed by radiography mainly consists of new bone formation potentially progressively leading to spine or joint ankylosis. This important long-term outcome parameter has been difficult to study, not alone because the time window for change may be long but also because human tissues with direct translational relevance are rarely available. Data from rodent models have identified growth factor signaling pathways as relevant targets. Both human and animal studies have tried to understand the link between inflammation and new bone formation. At the current moment, most evidence points towards a strong link between both but with the question still lingering about the sequence of events, disease triggers, and the interdependence of both features of disease. New discoveries such as a masterswitch T cell population that carries the IL23 receptor and the analysis of auto-antibodies directed again noggin and sclerostin are contributing to innovative insights into the pathophysiology of disease. Long-term data with tumor necrosis factor (TNF) inhibitors also suggest that some window of opportunity may exist to inhibit structural disease progression. All these data provide support for a further critical analysis of the available datasets and boost research in the field. The introduction of novel disease definitions, in particular the characterization of non-radiographic axial spondyloarthritis patients, will likely be instrumental in our further understanding of structural damage. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Health and imaging outcomes in axial spondyloarthritis

    NARCIS (Netherlands)

    Machado, P.M.

    2016-01-01

    This thesis focuses on the assessment and monitoring of health and imaging outcomes in axial spondyloarthritis (SpA) and the relationship between these outcomes. Four major contributions to the understanding and management of axial SpA were made: 1) the improvement and facilitation of the assessment

  5. Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis

    DEFF Research Database (Denmark)

    Glintborg, Bente; Sørensen, Inge J; Østergaard, Mikkel

    2017-01-01

    OBJECTIVE: To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders....../disease duration/TNFi-type/smoking/baseline disease activity) on TNFi adherence and response [e.g., Bath Ankylosing Spondylitis Activity Index (BASDAI) 50%/20 mm]. RESULTS: The study included 1250 TNFi-naive patients with axSpA (29% nr-axSpA, 50% AS, 21% lacked radiographs of sacroiliac joints). Patients...

  6. The Nonradiographic Axial Spondyloarthritis, the Radiographic Axial Spondyloarthritis, and Ankylosing Spondylitis: The Tangled Skein of Rheumatology

    Science.gov (United States)

    Rawat, Roopa; Agrawal, Neha; Patil, Nilesh S.

    2017-01-01

    Since 1984 the diagnosis of ankylosing spondylitis (AS) has been based upon the modified New York (mNY) criteria with mandatory presence of radiographic sacroiliitis, without which the diagnosis is not tenable. However, it may take years or decades for radiographic sacroiliitis to develop delaying the diagnosis for long periods. It did not matter in the past because no effective treatment was available. However, with the availability of a highly effective treatment, namely, tumour necrosis factor-α inhibitors (TNFi), the issue of early diagnosis of AS acquired an urgency. The Assessment of SpondyloArthritis International Society (ASAS) classification criteria published in 2009 was a significant step towards this goal. These criteria described an early stage of the disease where sacroiliitis was demonstrable only on MRI but not on standard radiograph. Therefore, this stage of the disease was labelled “nonradiographic axial SpA” (nr-axSpA). But questions have been raised if, in search of early diagnosis, specificity was compromised. The Federal Drug Administration (FDA, USA) withheld approval for the use of TNFi in patients with nr-axSpA because of issues related to the specificity of these criteria. This review attempts to clarify some of these aspects of the nr-axSpA-AS relationship and also tries to answer the question whether ASAS classifiable radiographic axial spondyloarthritis (r-axSpA) term can be interchangeably used with the term AS. PMID:28555158

  7. Effectiveness of Adalimumab in Non-radiographic Axial Spondyloarthritis

    Science.gov (United States)

    Cantarini, Luca; Fabbroni, Marta; Talarico, Rosaria; Costa, Luisa; Caso, Francesco; Cuneo, Gian Luca; Frediani, Bruno; Faralli, Gabriele; Vitale, Antonio; Brizi, Maria Giuseppina; Sabadini, Luciano; Galeazzi, Mauro

    2015-01-01

    Abstract The primary aim of the study was to evaluate the long-term effectiveness of adalimumab (ADA) in a cohort of non-radiographic axial spondyloarthritis (nr-axSpA), and the secondary aims were to identify predictive factors of response and evaluate radiological progression. We evaluated 37 patients (male/female: 12/25; mean age 49 ± 14; mean disease duration: 6.3 ± 5.8) with active nr-axSpA (Assessment of SpondyloArthritis International Society criteria), despite the treatment with ≥1 nonsteroidal anti-inflammatory drug for at least 3 months, initiating the treatment with ADA 40 mg every other week. Patients were treated for 24 months, and evaluated at baseline, 6, 12, and 24 months. Outcome measures included Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index. Radiograph of the spine and sacroiliac joints and magnetic resonance of the sacroiliac joints were performed at baseline and according to the standard of assessment for the disease. The proportion of patients that achieved a BASDAI50 response at 6, 12 and 24 months was 51.3%, 70.3%, and 76.8%, respectively. Treatment was well tolerated with no unexpected adverse events and/or serious adverse events. All patients remained on treatment for 2 years, with a good compliance. We did not identify any predictive factor of response to therapy. Moreover, modified Stoke Ankylosing Spondylitis Spine Score and Spondyloarthritis Research Consortium of Canada scores showed a trend of improvement during the study period. ADA was effective on clinical and radiological outcomes at 2-year follow-up; thus, early treatment with ADA may prevent radiographic damage and be associated with low disease activity or remission. Moreover, data from this cohort study have confirmed safety and tolerability profile of ADA in nr-axSpA in the long term. PMID:26222847

  8. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis

    DEFF Research Database (Denmark)

    Lambert, Robert G W; Bakker, Pauline A C; van der Heijde, Désirée

    2016-01-01

    OBJECTIVES: To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). METHODS: The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI...... for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording....... CONCLUSION: The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of 'active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility...

  9. Non-steroidal anti-inflammatory drugs (NSAIDs) for axial spondyloarthritis (ankylosing spondylitis and non-radiographic axial spondyloarthritis)

    NARCIS (Netherlands)

    Kroon, Feline P. B.; van der Burg, Lennart R. A.; Ramiro, Sofia; Landewé, Robert B. M.; Buchbinder, Rachelle; Falzon, Louise; van der Heijde, Désirée

    2015-01-01

    Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (radiographic axSpA) and non-radiographic (nr-)axSpA and is associated with psoriasis, uveitis and inflammatory bowel disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line drug treatment. To determine

  10. Treatment with tumor necrosis factor inhibitors in axial spondyloarthritis

    DEFF Research Database (Denmark)

    Ciurea, A.; Weber, U.; Stekhoven, D.

    2015-01-01

    in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings. (First Release Nov 1 2014; J Rheumatol 2015; 42:101-5; doi 10.3899/jrheum.140229).......Objective. To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. The Journal of Rheumatology, Methods.We compared newly initiated TNF inhibition for axSpA in 363 patients...... was slightly higher in the hospital setting. Mean levels (+/- SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 +/- 1.0 vs 3.4 +/- 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response...

  11. Patients with fibromyalgia rarely fulfil classification criteria for axial spondyloarthritis.

    Science.gov (United States)

    Baraliakos, Xenofon; Regel, Andrea; Kiltz, Uta; Menne, Hans-Jürgen; Dybowski, Friedrich; Igelmann, Manfred; Kalthoff, Ludwig; Krause, Dietmar; Saracbasi-Zender, Ertan; Schmitz-Bortz, Elmar; Braun, Jürgen

    2017-09-06

    The Assessments of Spondyloarthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA) have been criticized because of insufficient differentiation towards FM. The aim of this study was to compare the performance of currently used classification criteria in patients diagnosed with axSpA or FM. Patients were prospectively included if diagnosed with axSpA or FM by the treating rheumatologist and evaluated by an independent examiner for fulfilment of the classification criteria for axSpA (ASAS criteria) and/or FM (1990 ACR classification and 2010 ACR diagnostic criteria). Patients with axSpA were stratified based on classification as non-radiographic axSpA (nr-axSpA) or AS. Symptom severity was assessed by established disease-related questionnaires. Overall, 300 patients were included, 100 with FM and 200 with axSpA of which 100 each had nr-axSpA and AS. Almost all FM patients fulfilled the 2010 (100%) and 1990 ACR criteria (98%) for FM, but only 2% fulfilled the ASAS criteria. When calculations were based on only the FM patients with available HLA-B27 results (n = 40), the proportion fulfilling the ASAS criteria was 5%. All axSpA patients met the ASAS criteria but also the 2010 (24%) and 1990 (13.5%) FM criteria. More patients with AS (29% and 19%) than with nr-axSpA (19% and 8%) fulfilled the 2010 and 1990 FM criteria, respectively. FM patients only rarely fulfil classification criteria for axSpA but some axSpA patients also fulfil FM criteria. Since this was more frequent in patients with AS it may be related to the severity and duration of chronic pain in axSpA patients. Assessment instruments evaluated in axSpA are not disease-specific. The phenomenon of central pain sensitization in rheumatic diseases deserves more study. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Evaluation of physiotherapy in a prospective cohort of early axial spondyloarthritis. Data from the DESIR cohort.

    Science.gov (United States)

    Escalas, Cécile; Dalichampt, Marie; Dougados, Maxime; Poiraudeau, Serge

    2016-03-01

    To evaluate the effect of physiotherapy on functional limitation in an observational cohort of early axial spondyloarthritis. prospective population-based cohort study. 708 patients with early axial spondyloarthritis between 2007 and 2010 naive of TNF blockers. early physiotherapy defined by at least eight supervised sessions of physical therapy during the first six months. the primary outcome was functional improvement defined by a relative improvement of at least 20% in BASFI at six months. Secondary outcomes were improvement in BASFI at one and two years and ASAS20 response criteria at six months. a propensity score of having physiotherapy was developed and multivariate analysis using propensity score weighting were used to assess the effect of physiotherapy on outcome. Overall, 166 (24%) patients had physiotherapy during the first six months. After using propensity score weighting, there was no functional improvement on the primary outcome in patients treated with early physical therapy (relative risk [IC95%]: 1.15 [0.91-1.45]). No differences were observed on secondary outcomes (relative risk [IC95%]: 0.94 [0.80-1.11]). It seems there is no functional benefit for patients with early spondyloarthritis to be treated early by physiotherapy in daily practice, even though the efficacy of physiotherapy has been shown in several randomized controlled studies. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  13. [Inflammatory spinal diseases: axial spondyloarthritis : Central importance of imaging].

    Science.gov (United States)

    Baraliakos, X; Fruth, M; Kiltz, U; Braun, J

    2017-03-01

    The diagnosis of axial spondyloarthritis (axSpA) includes classical ankylosing spondylitis (AS) as well as earlier stages and abortive courses of the disease, in which structural alterations have not yet occurred. These are classified as non-radiographic axSpA (nr-axSpa). Inflammatory changes in the entire axial skeleton are characteristic for axSpA and can be visualized by magnetic resonance imaging (MRI), while in most patients structural alterations, such as new bone formation with syndesmophytes and ankylosis develop in the later course of the disease. These bony alterations can best be visualized by conventional radiography and by computed tomography. Certain MRI sequences are nowadays considered as the standard method for depiction of inflammatory changes in axSpA. The introduction of MRI has led to a paradigm shift for this disease because the inflammatory lesions characteristic for the disease can be visualized at an early stage using appropriate MRI sequences.

  14. Chondrocyte activity is increased in psoriatic arthritis and axial spondyloarthritis

    DEFF Research Database (Denmark)

    Gudmann, Natasja Stæhr; Munk, Heidi Lausten; Christensen, Anne Friesgaard

    2016-01-01

    BACKGROUND: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory rheumatic diseases with complex origins. Both are characterized by altered extracellular matrix remodeling in joints and entheses that results in destructive and osteochondral proliferative lesions.......30 ng/ml, 0.16-0.41) (p treatment. C-Col10 was slightly but equally elevated in the PsA and axSpA groups vs. the control group, but it was significantly lower in patients with axSpA undergoing tumor necrosis factor-α inhibitor (TNFi) treatment. ROC curve......SpA undergoing TNFi treatment may reflect that hypertrophic chondrocytes in axSpA are targeted by TNFi. ROC curve analysis showed a diagnostic potential for Pro-C2 in axSpA and PsA....

  15. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II)

    DEFF Research Database (Denmark)

    Rudwaleit, M; van der Heijde, D; Landewé, R

    2009-01-01

    A was diagnosed in 60.2% of the cohort. Of these, 70% did not fulfil modified New York criteria and, therefore, were classified as having "non-radiographic" axial SpA. Refinement of the candidate criteria resulted in new ASAS classification criteria that are defined as: the presence of sacroiliitis by radiography......OBJECTIVE: To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA). METHODS: All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back...... pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%. RESULTS: Upon diagnostic work-up, axial Sp...

  16. Complementary medicine for axial spondyloarthritis: is there any scientific evidence?

    Science.gov (United States)

    Danve, Abhijeet; Deodhar, Atul

    2018-04-09

    Majority of patients with axial spondyloarthritis (axSpA) report use of complementary and alternative medicine (CAM) therapies before and even after the diagnosis, due to perceived efficacy and wide-spread belief that these modalities lack side effects. In this review, we describe the available scientific evidence for the CAM therapies in axSpA. Clinical trials of the CAM therapies in axSpA are generally hampered by small sample size, short duration, difficulties in blinding, lack of control groups and strong placebo effect. Nonetheless, exercise programs like Pilates and mind-body techniques such as Tai Chi may have favorable effect on the disease activity and function. Although not yet confirmed, the modulation of the microbiome with the help of probiotics or fecal transplant has face validity given the evolving scientific rationale. Diet has only limited role in the management of axSpA. Deep tissue massage, omega-3 fatty acids and Stanger bath were found to be useful in small studies. CAM therapies are not always entirely well tolerated, particularly the manipulative techniques like chiropractic and Tui-na in patients with advanced disease and osteoporosis. There are no trials of yoga in axSpA despite the wider acceptance and use of yoga as an effective mind-body technique. Larger and better quality clinical trials of CAM therapies are needed to confirm their efficacy and safety in the management of axSpA and to include them in the 'mainstream' medicine.

  17. Structural Disease Progression in Axial Spondyloarthritis: Still a Cause for Concern?

    Science.gov (United States)

    Neerinckx, Barbara; Lories, Rik J

    2017-03-01

    Progressive ankylosis is a feared consequence of long-standing axial spondyloarthritis. We aim to critically review current insights into the effect of therapy, the molecular pathways involved in this process, and to present a model explaining the sequence of events. Long-term follow-up data suggest that successful control of inflammation may slow down radiographic progression of disease in axial spondyloarthritis. Structural effects of new therapies such as interleukin-17 targeting need to be further studied. Bone loss and architectural changes could act as driver for the tissue remodeling process trying to maintain spinal stability in the presence of inflammation. Despite some progress, the nature and mechanisms of new bone formation in axial spondyloarthritis still remain incompletely understood. However, long-term control of inflammation appears critical to avoid progressive disability due to structural damage.

  18. Effectiveness of tumor necrosis factor α blockers in early axial spondyloarthritis: data from the DESIR cohort.

    Science.gov (United States)

    Moltó, Anna; Paternotte, Simon; Claudepierre, Pascal; Breban, Maxime; Dougados, Maxime

    2014-07-01

    To estimate the frequency of use and effectiveness in daily practice of tumor necrosis factor α (TNFα) blockers in a population with inflammatory back pain suggestive of early axial spondyloarthritis (SpA). The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort is a prospective, multicenter, observational cohort of 708 patients with early (<3 years' duration) inflammatory back pain suggestive of axial SpA. The percentage of patients receiving TNFα blockers over the first 2 years of followup was estimated by survival analysis. To evaluate effectiveness, the primary outcome (40% improvement in disease activity according to the Assessment of SpondyloArthritis international Society criteria [ASAS40]) was compared in patients who received TNFα blockers versus control patients who received any other treatment (usual care). Controls were matched to the patients based on a propensity score method. A total of 30.2% (95% confidence interval [95% CI] 26.7-33.7) patients received at least 1 TNFα blocker during the 24 months of followup. The percentage of ASAS40 responders was 31.5% (62 of 197 patients) in the group receiving TNFα blockers versus 13.2% (26 of 197) in the control group (OR 2.99 [95% CI 1.80-4.99], P = 0.0002). This effectiveness was more pronounced in the subgroup of patients with sacroiliitis identified on magnetic resonance imaging, with 46% of ASAS40 responders receiving TNFα blockers versus 15% of ASAS40 responders receiving usual care (OR 4.99 [95% CI 2.17-11.51]). Our study shows that TNFα blockers are frequently used in daily practice to treat patients with early axial SpA. Our findings confirm the effectiveness of TNFα blockers as compared to any other treatment, especially in the subgroup of patients with sacroiliitis on MRI. Copyright © 2014 by the American College of Rheumatology.

  19. Advances in classification, basic mechanisms and clinical science in ankylosing spondylitis and axial spondyloarthritis.

    Science.gov (United States)

    Robinson, P C; Benham, H

    2015-02-01

    The field of spondyloarthritis (SpA) has seen huge advances over the past 5 years. The classification of axial disease has been redefined by the axial SpA criteria that incorporate disease captured before radiographic damage is evident as well as established erosive sacroiliac joint disease. Our knowledge of genetics and basic immunological pathways has progressed significantly. In addition, revolutionary progress has been achieved with the availability of tumour necrosis factor inhibitors for treating patients with moderate to severe disease. In parallel, several of novel biomarkers have been identified that show significant promise for the future. Advances in magnetic resonance imaging have helped define positive disease. We have identified that T1 and short tau inversion recovery sequences are best for the diagnosis of axial SpA, and gadolinium contrast is not additive for diagnosis. Progress has been made in identifying potential agents and strategies that reduce radiographic progression. Several referral strategies aimed at appropriate identification of patients have been trialled and found to be effective. There is still substantial work ahead, but the advances of the last 5 years have made a huge and tangible difference at the clinical coalface, and we suggest that this trend will continue. © 2014 Royal Australasian College of Physicians.

  20. Non-steroidal anti-inflammatory drugs (NSAIDs) for axial spondyloarthritis (ankylosing spondylitis and non-radiographic axial spondyloarthritis).

    Science.gov (United States)

    Kroon, Féline P B; van der Burg, Lennart R A; Ramiro, Sofia; Landewé, Robert B M; Buchbinder, Rachelle; Falzon, Louise; van der Heijde, Désirée

    2015-07-17

    Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (radiographic axSpA) and non-radiographic (nr-)axSpA and is associated with psoriasis, uveitis and inflammatory bowel disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line drug treatment. To determine the benefits and harms of NSAIDs in axSpA. We searched CENTRAL, MEDLINE and EMBASE to 18 June 2014. Randomised controlled trials (RCTs) or quasi-RCTs of NSAIDs versus placebo or any comparator in adults with axSpA and observational cohort studies studying the long term effect (≥ six months) of NSAIDs on radiographic progression or adverse events (AEs). The main comparions were traditional or COX-2 NSAIDs versus placebo. The major outcomes were pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), radiographic progression, number of withdrawals due to AEs and number of serious AEs Two review authors independently selected trials for inclusion, assessed the risk of bias, extracted data and assessed the quality of evidence for major outcomes using GRADE. We included 39 studies (35 RCTs, two quasi-RCTs and two cohort studies); and 29 RCTs and two quasi-RCTs (n = 4356) in quantitative analyses for the comparisons: traditional NSAIDs versus placebo, cyclo-oxygenase-2 (COX-2) versus placebo, COX-2 versus traditional NSAIDs, NSAIDs versus NSAIDs, naproxen versus other NSAIDs, low versus high dose. Most trials were at unclear risk of selection bias (n = 29), although blinding of participants and personnel was adequate in 24 trials. Twenty-five trials had low risk of attrition bias and 29 trials had low risk of reporting bias. Risk of bias in both cohort studies was high for study participation, and low or unclear for all other criteria. No trials in the meta-analyses assessed patients with nr-axSpA.Traditional NSAIDs were more beneficial than placebo at six

  1. Evaluation of circulating levels of inflammatory and bone formation markers in axial spondyloarthritis.

    Science.gov (United States)

    de Andrade, Kenia Rodrigues; de Castro, Gláucio Ricardo Werner; Vicente, Geison; da Rosa, Julia Salvan; Nader, Marina; Pereira, Ivanio Alves; Fröde, Tânia Silvia

    2014-08-01

    Studies have demonstrated the important role of bone remodelling and osteoimmunology in the progression of inflammatory lesions in axial spondyloarthritis (SpA) disease. This study was conducted to evaluate the inflammatory response by analysis of the serum levels of pro-inflammatory and new bone formation markers in patients with axial SpA who were treated or not treated with anti-tumour necrosis factor-α (anti-TNF-α) or non-steroidal drugs (NSAIDs) and to identify whether these drugs modify the activity and severity of the disease. The serum levels of myeloperoxidase (MPO), adenosine deaminase (ADA), nitric oxide metabolites (NOx), bone alkaline phosphatase (BAP), Dickkopf-1 (DKK-1), and osteoprotegerin (OP) were measured in 52 SpA patients who were treated or not with anti-TNF-α or NSAIDs and in 26 healthy controls using colourimetric and enzyme immunoassay tests. The activity and the severity of illness in patients with SpA were assessed using questionnaires (Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)). A significant difference between the controls and the patients without medication was observed in relation to NOx, BAP, and OP (p0.05). In conclusion, The NOx, BAP, and OP are emerging as important inflammatory pathways in axial SpA. Also the anti-TNF-α or non-steroidal drugs reduce the inflammation and destructions, however these treatments do not modify the serum levels of these biomarkers. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Descriptions of spinal MRI lesions and definition of a positive MRI of the spine in axial spondyloarthritis

    DEFF Research Database (Denmark)

    Hermann, Kay-Geert A; Baraliakos, Xenofon; van der Heijde, Désirée M F M

    2012-01-01

    The aim of this study was to define characteristic MRI findings in the spine of patients with axial spondyloarthritis (SpA) and provide a definition of a positive spinal MRI for inflammation and structural changes.......The aim of this study was to define characteristic MRI findings in the spine of patients with axial spondyloarthritis (SpA) and provide a definition of a positive spinal MRI for inflammation and structural changes....

  3. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor alpha inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Hermann, Kay-Geert A

    2010-01-01

    To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).......To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA)....

  4. A comparison of disease burden in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.

    Directory of Open Access Journals (Sweden)

    Brigitte Michelsen

    Full Text Available The main objective of this study was to compare disease burden in rheumatoid arthritis (RA, psoriatic arthritis (PsA and axial spondyloarthritis (ax-SpA.In this cross-sectional study, all the RA (1093, PsA (365 and ax-SpA (333 patients who visited the out-patient clinic of the Hospital of Southern Norway Trust during the year 2013 were included; the RA patients all had a RA diagnosis verified by the treating rheumatologist, the PsA patients all fulfilled the ClASsification for Psoriatic ARthritis (CASPAR criteria and the ax-SpA patients all fulfilled the Assessment of SpondyloArthritis international Society (ASAS classification criteria for ax-SpA. Patient-reported health status, demographic variables, medications, and composite scores of disease activity were assessed. The main analyses were performed using General Linear Models adjusted for age, sex and multiple comparisons. Correlation analyses were performed using Spearman's rho.The reported pain, joint pain, patient's global assessment and fatigue were similar in PsA and ax-SpA, but significantly lower in RA. The 28-joint Disease Activity Score (DAS28 (0.3±0.1, p = 0.003, Clinical Disease Activity Index (CDAI (1.0±0.4, p = 0.028 and Routine Assessment of Patient Index Data 3 (RAPID3 (0.4±0.1, p = 0.004 were all significantly higher in PsA vs. RA. RAPID3 showed moderate to high correlation with DAS28 (rho = 0.521, p<0.001 and CDAI (rho = 0.768, p<0.001 in RA and PsA, and with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI (rho = 0.902, p<0.001 and Bath Ankylosing Spondylitis Functional Index (BASFI (0.865, p<0.001 in ax-SpA and PsA.In conclusion, patient- reported outcome measures were similar in our population of PsA and ax-SpA patients, but significantly lower for the RA patients. Composite disease activity measures were lower in RA than in PsA and ax-SpA, but the magnitude of these differences was small and probably not of clinical significance. Our study indicates that

  5. Disease activity in axial spondyloarthritis after discontinuation of TNF inhibitors therapy.

    Science.gov (United States)

    Sebastian, Agata; Wojtala, Patryk; Lubiński, Łukasz; Mimier, Małgorzata; Chlebicki, Arkadiusz; Wiland, Piotr

    2017-01-01

    Use of tumour necrosis factor inhibitors (TNFi) has proved to be an important step forward in the treatment of axial spondyloarthritis (axSpA), but the duration of the therapy as well as the management in case of low disease activity (LDA) or remission are not clearly established. Currently, the identification of potential predictors associated with the treatment discontinuation is the basic purpose of many clinical studies. The aim of this study was to analyze the influence of the discontinuation of TNFi therapy on the disease activity in patients with low disease activity. The study included 65 patients; 47 of patients (72%) were treated with etanercept, 16 (2%) with adalimumab and 2 (3%) with infliximab. The mean age of the patients was 45 years, the mean BASDAI score was 6.8 and VAS for low back pain was 76 mm at baseline. 54 patients with axSpA (83%) achieved LDA after 9 months of anti-TNF therapy. During follow-up 40 patients (74% of patients with LDA) had an increase of the disease activity after mean 14 weeks and needed to restart the treatment with TNFi. After restart of the therapy LDA was regained in all patients after mean 7 weeks. 11 patients (17%) have never achieved LDA and 14 patients (22%) had LDA longer than 6 months without relapse. At baseline higher levels of CRP and ESR were observed in patients with relapse of the disease at the end of treatment and with LDA shorter than 6 months. Changes in the values of disease activity indicators (CRP, ESR) correlated with more stable response to TNFi therapy. Over 50% of patients who were treated with TNFi needed to restart the therapy. Treatment resumption allowed to regain a good clinical effect among affected patients.

  6. Is IL-6 an appropriate target to treat spondyloarthritis patients refractory to anti-TNF therapy? a multicentre retrospective observational study

    Science.gov (United States)

    2012-01-01

    Introduction The aim of this study was to evaluate, under real-life conditions, the safety and efficacy of tocilizumab in patients having failed anti-TNFα therapy for spondyloarthritis. Methods French rheumatologists and internal-medicine practitioners registered on the Club Rhumatismes et Inflammations website were asked to report on patients given tocilizumab (4 or 8 mg/kg) to treat active disease meeting Assessment of SpondyloArthritis International Society (ASAS) criteria for axial or peripheral spondyloarthritis, after anti-TNFα treatment failure. Safety and efficacy after 3 and 6 months were assessed retrospectively using standardised questionnaires. Results Data were obtained for 21 patients, 13 with axial spondyloarthritis (46% men; median age, 42 years; disease duration, 11 years; HLA-B27-positive, 92.3%) and eight with peripheral spondyloarthritis (25% men; median age, 40 years; disease duration, 10 years; HLA-B27-positive, 62.5%). No patients with axial disease had at least a 20 mm decrease in the BASDAI, nor a BASDAI50 response or major ASAS-endorsed disease activity score improvements after 3 or 6 months; an ASAS-endorsed disease activity score clinically important improvement was noted at month 3 in five of 13 patients and at month 6 in one of four patients. A good DAS28 response was achieved in four patients with peripheral disease, including one in EULAR remission at month 3. Four patients were still taking tocilizumab at month 6, including one in EULAR remission and one with a good DAS28 response. Tocilizumab was well tolerated, with no serious adverse events. Initially elevated acute-phase reactants declined during tocilizumab therapy. Conclusion In patients having failed anti-TNFα therapy, tocilizumab decreased acute-phase reactants but failed to substantially improve axial spondyloarthritis and was inconsistently effective in peripheral spondyloarthritis. PMID:22404969

  7. An appraisal of golimumab in the treatment of severe, active nonradiographic axial spondyloarthritis

    Directory of Open Access Journals (Sweden)

    Paccou J

    2016-07-01

    Full Text Available Julien Paccou, René-Marc Flipo Department of Rheumatology, Lille University Hospital, Lille, France Abstract: Golimumab (Simponi® is a fully human tumor necrosis factor α inhibitor (TNFi antibody administered subcutaneously. In the European Union, golimumab is indicated for the treatment of adults with severe, active axial spondyloarthritis (axSpA, which includes both ankylosing spondylitis (AS and nonradiographic axSpA (nr-axSpA. In the US, it is indicated for the treatment of adults with active AS only. This article reviews the efficacy and tolerability of golimumab in nr-axSpA patients compared to other TNFi agents (adalimumab, infliximab, etanercept, and certolizumab pegol. In one ongoing, well-designed controlled study (GO-AHEAD, data at 16 weeks showed that treatment with golimumab (50 mg every 4 weeks was effective in improving the clinical signs and symptoms of disease in nr-axSpA patients. In addition, 16 weeks of treatment with golimumab reduced inflammation in the sacroiliac joints and spine in patients with nr-axSpA. Moreover, objective evidence of active inflammation at baseline, such as a positive magnetic resonance imaging scan and/or an elevated CRP level, was a good predictor of treatment response to golimumab. Golimumab was generally well tolerated in this study, with a tolerability profile consistent with that seen in previous clinical trials for other indications. Although additional long-term data are needed, current evidence indicates that golimumab is an effective option for the treatment of nr-axSpA. However, in the absence of comparative head-to-head trials, there is no recommended hierarchy for the first prescription of a TNFi agent for the treatment of either nr-axSpA or AS. Keywords: axial spondyloarthritis, nonradiographic axial spondyloarthritis, ankylosing spondylitis, golimumab, tumor necrosis factor α inhibitor, therapy

  8. Diagnostic utility of candidate definitions for demonstrating axial spondyloarthritis on magnetic resonance imaging of the spine

    DEFF Research Database (Denmark)

    Weber, Ulrich; Zhao, Zheng; Rufibach, Kaspar

    2015-01-01

    A to patients with nonspecific back pain. A threshold of ≥6 CILs had moderate to substantial diagnostic utility (positive LR 13.26 and 6.74 in cohorts A and B, respectively) in nonradiographic axial SpA, while ≥4 CILs showed small diagnostic utility (positive LR 3.83 and 2.72 in cohorts A and B, respectively......OBJECTIVE: A recent consensus statement has suggested ≥3 corner inflammatory lesions (CILs) or several corner fatty lesions (CFLs) as candidate criteria indicative of axial spondyloarthritis (SpA) on magnetic resonance imaging (MRI) of the spine. The aim of this study was to evaluate the diagnostic...... utility of these cutoffs in nonradiographic axial SpA and ankylosing spondylitis (AS). METHODS: One hundred thirty consecutive patients with back pain who were ≤50 years of age and newly referred to 2 university clinics (cohorts A and B) were classified according to rheumatologist expert opinion based...

  9. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS), and clinical and magnetic resonance imaging measures of disease activity in a 1 year follow-up study of patients with axial spondyloarthritis treated with TNF-{alpha} inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Sørensen, Inge J; Hermann, Kay-Geert A

    2010-01-01

    OBJECTIVES: To investigate construct validity and responsiveness of the novel ankylosing spondylitis disease activity score (ASDAS) in patients with spondyloarthritis (SpA). METHODS: In a 46 weeks prospective, longitudinal multi-center study of 60 SpA patients (80% men, median age 40 years (range...

  10. Fatigue in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Analysis from a Longitudinal Observation Cohort.

    Science.gov (United States)

    Bedaiwi, Mohamed; Sari, Ismail; Thavaneswaran, Arane; Ayearst, Renise; Haroon, Nigil; Inman, Robert D

    2015-12-01

    In this study, we aimed to address the prevalence of fatigue, its associated factors, and the effect of tumor necrosis factor inhibitors (TNFi) on this subgroup of patients in a large axial spondyloarthritis (axSpA) cohort. The study included 681 patients [ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA)]. The Fatigue Severity Scale (FSS) and the Bath AS Disease Activity Index question 1 (BASDAI Q1) indices were used for fatigue assessment. Severe fatigue was defined as an FSS ≥ 4 or a BASDAI Q1 ≥ 5. Disease activity, function, and quality of life (QoL) measures were recorded. Patients who had been treated with TNFi were identified, and baseline and followup data were analyzed. Of the cohort, 67.3% had severe fatigue, and the prevalence was similar between AS (67.2%) and nr-axSpA (68.2%). Severely fatigued patients tended to have higher disease activity scores, increased acute-phase proteins, and decreased QoL measures. TNFi therapy was associated with improvement in disease activity, and although this treatment led to significantly decreased fatigue scores, this reduction was not optimal in the majority of patients with 80% continuing to have severe fatigue according to their posttreatment scores. Health Assessment Questionnaire, mean scores of BASDAI Q5 and Q6, and BASDAI enthesitis were independent predictors of fatigue severity. Fatigue is a common symptom in axSpA, and the burden of fatigue among patients with nr-axSpA is similar to that seen in AS. While biologics are effective in improving disease activity, their effect on fatigue is more limited. In axSpA, fatigue remains unresponsive to TNFi in nearly 80% of patients.

  11. [Ankylosing spondylitis and non-radiographic axial spondyloarthritis: Two stages of disease?

    Science.gov (United States)

    Rumyantseva, D G; Dubinina, T V; Demina, A B; Rumyantseva, O A; Agafonova, E M; Smirnov, A V; Erdes, Sh F

    To compare the clinical manifestations of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nrAxSpA). A Moscow early spondyloarthritis cohort has now included 132 patients with axial spondyloarthritis, of whom 69 patients who have been followed up at least 12 months are to be involved in a preliminary analysis. The mean age at the time of inclusion in the study was 28.1±5.5 years; the mean disease duration was 24.7±15.8 months; 63 (91.3%) patients were HLA-B27 positive; 41 and 28 included patients were diagnosed with AS and nrAxSpA, respectively. Men were significantly more in the AS group than in the nrAxSpA group (58.5 and 32.1%, respectively; p=0.05). The patients of the two groups did not differ in main clinical parameters (the presence of arthritis and enthesitis), disease activity (BASDAI, ASDAS-CRP) and functional status (BASFI). All indicators of inflammatory activity decreased nearly 2-fold in both groups after 12 months of follow up. In 7 (25%) patients with nrAxSpA, radiologically detectable sacroiliitis (SI) developed over 12 months and the diagnosis of AS was verified. Among them, 2 (28.5%) patients had initially active SI detected by magnetic resonance imaging (MRI); 4 (57.1%) had chronic SI, and 1 (14.4%) had no pathological MRI changes. Due to the fact that the clinical manifestations of AS and nrAxSpA are comparable, it can be assumed that the latter is an early stage of AS.

  12. Clinical characteristics of importance to outcome in patients with axial spondyloarthritis

    DEFF Research Database (Denmark)

    Andreasen, Rikke Asmussen; Kristensen, Lars Erik; Ellingsen, Torkell

    2017-01-01

    INTRODUCTION: Spondyloarthritis (SpA) is a heterogeneous spectrum of rheumatic diseases with either predominantly axial inflammatory symptoms of the spine and sacroiliac joints or predominantly peripheral arthritis. The two main entities of axial SpA (axSpA) are ankylosing spondylitis or non...... of the PDQ regarding treatment response in patients with axSpA 3 months after initiating a biological agent. Secondary aim is to evaluate the impact of extra-articular manifestations, comorbidities and patient-reported outcomes and elucidate if these factors influence treatment response. METHOD AND ANALYSIS......: We will include 60 participants (≥18 years of age) diagnosed with axSpA independent of main entity, who initiate or switch treatment of a biologic. Data will be collected at baseline and at endpoint following Danish clinical practice (≥3 months) of treatment with biologics. We will explore whether...

  13. DOES BONE MINERAL DENSITY CHANGE IN EARLY AXIAL SPONDYLOARTHRITIS?

    Directory of Open Access Journals (Sweden)

    E. E. Gubar

    2016-01-01

    Full Text Available The rate of osteoporosis (OP and the mechanism  of its development in patients with ankylosing spondylitis (AS and other spondyloarthrititides (SpA have not been sufficiently investigated. Steady-state  inflammatory disease activity is anticipated  to be the leading factor of OP in AS.Objective: to investigate lumbar spine (LS and femoral neck (FN  bone mineral density (BMD  in patients with early axial SpA (axSpA and to reveal its association with inflammatory disease activity.Subjects and methods. A total of 150 patients (59 men and 91 women aged 18 to 45 years with inflammatory back pain for ≥3 months and ≤5 years were examined. The diagnosis of axSpA was established in accordance  with the 2009 ASAS criteria. BASDAI and ASDAS-CRP were used to assess activity and functional status was evaluated with BASFI. The examination  included determination of HLA-B27, X-ray of the pelvis and LS, magnetic resonance imaging (MRI  of the sacroiliac joints, LS, and hip joints (in the presence of clinical signs of their involvement,  and densitometry of LS (LI–IV  and FN. By taking into account the patients’ young age, the Z score was used to estimate BMD. The Z-score -2 SD or lower in at the least one of the regions examined is considered to be diminished BMD. Results and discussion. The median Z-score was -0.7 [-1.3; -0.2] SD for FN and -0.9 [-1.6; -0.6] SD for LS. Reduced BMD in at the least one of the regions examined was diagnosed in 27 (18.0% patients. There was lower BMD in LS in 21 (14.0% patients and in FN in 8 (5.3%. Two (1.3% patients were diagnosed as having osteopenia in the two examined regions. There was no association between diminished BMD and age, gender, disease activity assessed with BASDAI, ASDAS-СRP, erythrocyte sedimentation rate (ESR and C-reactive protein (CRP. An association was found between inflammatory LS changes, as evidenced by MRI (MRI spondylitis, and reduced BMD in at least one of the examined regions. MRI

  14. Human brucellosis mimicking axial spondyloarthritis: a challenge for rheumatologists when applying the 2009 ASAS criteria.

    Science.gov (United States)

    Ye, Cong; Shen, Gui-Fen; Li, Shou-Xin; Dong, Ling-Li; Yu, Yi-Kai; Tu, Wei; Zhu, Ying-Zi; Hu, Shao-Xian

    2016-06-01

    Although the development of the 2009 SpA classification criteria by Assessment of SpondyloArthritis international Society (ASAS) represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis (axSpA), the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including SpA. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having axSpA in central China. The results showed that clinical manifestations of axSpA could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from axSpA according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.

  15. Prevalence of Axial Spondyloarthritis Among Patients With Fibromyalgia: A Magnetic Resonance Imaging Study With Application of the Assessment of SpondyloArthritis International Society Classification Criteria.

    Science.gov (United States)

    Ablin, Jacob N; Eshed, Iris; Berman, Mark; Aloush, Valerie; Wigler, Irena; Caspi, Dan; Likhter, Maria; Wollman, Jonathan; Paran, Daphna; Anouk, Marina; Elkayam, Ori

    2017-05-01

    To evaluate the prevalence of sacroiliitis, the radiographic hallmark of inflammatory spondyloarthropathy, among patients diagnosed with fibromyalgia syndrome (FMS), using the current Assessment of SpondyloArthritis International Society (ASAS) criteria and magnetic resonance imaging. Patients experiencing FMS (American College of Rheumatology 1990 criteria) were interviewed regarding the presence of spondyloarthritis (SpA) features and underwent HLA-B27 testing, C-reactive protein (CRP) level measurement, and magnetic resonance imaging examinations of the sacroiliac joints. FMS severity was assessed by the Fibromyalgia Impact Questionnaire and the Short Form 36 health survey. SpA severity was assessed by the Bath Ankylosing Spondylitis Disease Activity Index. Sacroiliitis was demonstrated among 8 patients (8.1%) and ASAS criteria for diagnosis of axial SpA were met in 10 patients (10.2%). Imaging changes suggestive of inflammatory involvement (e.g., erosions and subchondral sclerosis) were demonstrated in 15 patients (17%) and 22 patients (25%), respectively. The diagnosis of axial SpA was positively correlated with increased CRP level and with physical role limitation at recruitment. Imaging changes suggestive of axial SpA were common among patients with a diagnosis of FMS. These findings suggest that FMS may mask an underlying axial SpA, a diagnosis with important therapeutic implications. Physicians involved in the management of FMS should remain vigilant to the possibility of underlying inflammatory disorders and actively search for such comorbidities. © 2016, American College of Rheumatology.

  16. Portuguese recommendations for the use of biological therapies in patients with axial spondyloarthritis – 2016 update

    Directory of Open Access Journals (Sweden)

    Pedro Machado

    2017-07-01

    Full Text Available Objective: To update the recommendations for the treatment of axial spondyloarthritis (axSpA with biological therapies, endorsed by the Portuguese Society of Rheumatology. Methods: These treatment recommendations were formulated by Portuguese rheumatologists based on literature evidence and consensus opinion. At a national meeting, the 7 recommendations included in this document were discussed and updated. A draft of the full text of the recommendations was then circulated and suggestions were incorporated. A final version was again circulated before publication and the level of agreement among Portuguese Rheumatologists was anonymously assessed using an online survey. Results: A consensus was achieved regarding the initiation, assessment of response and switching of biological therapies in patients with axSpA. In total, seven recommendations were produced. The first recommendation is a general statement indicating that biological therapy is not a first-line drug treatment option and should only be used after conventional treatment has failed. The second recommendation is also a general statement about the broad concept of axSpA adopted by these recommendations that includes both non-radiographic and radiographic axSpA. Recommendations 3 to 7 deal with the definition of active disease (including the recommended threshold of 2.1 for the Ankylosing Spondylitis Disease Activity Score [ASDAS] or the threshold of 4 [0-10 scale] for the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], conventional treatment failure (nonsteroidal anti-inflammatory drugs being the first-line drug treatment, assessment of response to treatment (based on an ASDAS improvement  of at least 1.1 units or a BASDAI improvement of at least 2 units [0-10 scale] or at least 50%, and strategy in the presence of an inadequate response (where switching is recommended or in the presence of long-term remission (where a process of biological therapy optimization can be

  17. Portuguese recommendations for the use of biological therapies in patients with axial spondyloarthritis - 2016 update.

    Science.gov (United States)

    Machado, Pedro; Cerqueira, Marcos; Ávila-Ribeiro, Pedro; Aguiar, Renata; Bernardo, Alexandra; Sepriano, Alexandre; Águeda, Ana; Cordeiro, Ana; Raposo, Ana; Rodrigues, Ana M; Barcelos, Anabela; Malcata, Armando; Lopes, Carina; Vaz, Cláudia C; Nour, Dolores; Godinho, Fátima; Alvarenga, Fernando; Pimentel-Santos, Fernando; Canhão, Helena; Santos, Helena; Cunha, Inês; Neves, Joana Sousa; Fonseca, João Eurico; Gomes, João Lagoas; Tavares-Costa, José; Costa, Lúcia; Cunha-Miranda, Luís; Maurício, Luís; Cruz, Margarida; Afonso, Maria Carmo; Santos, Maria José; Bernardes, Miguel; Valente, Paula; Figueira, Ricardo; Pimenta, Sofia; Ramiro, Sofia; Pedrosa, Teresa; Costa, Tiago Afonso; Vieira-Sousa, Elsa

    2017-01-01

    To update the recommendations for the treatment of axial spondyloarthritis (axSpA) with biological therapies, endorsed by the Portuguese Society of Rheumatology. These treatment recommendations were formulated by Portuguese rheumatologists based on literature evidence and consensus opinion. At a national meeting, the 7 recommendations included in this document were discussed and updated. A draft of the full text of the recommendations was then circulated and suggestions were incorporated. A final version was again circulated before publication and the level of agreement among Portuguese Rheumatologists was anonymously assessed using an online survey. A consensus was achieved regarding the initiation, assessment of response and switching of biological therapies in patients with axSpA. In total, seven recommendations were produced. The first recommendation is a general statement indicating that biological therapy is not a first-line drug treatment option and should only be used after conventional treatment has failed. The second recommendation is also a general statement about the broad concept of axSpA adopted by these recommendations that includes both non-radiographic and radiographic axSpA. Recommendations 3 to 7 deal with the definition of active disease (including the recommended threshold of 2.1 for the Ankylosing Spondylitis Disease Activity Score [ASDAS] or the threshold of 4 [0-10 scale] for the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), conventional treatment failure (nonsteroidal anti-inflammatory drugs being the first-line drug treatment), assessment of response to treatment (based on an ASDAS improvement  of at least 1.1 units or a BASDAI improvement of at least 2 units [0-10 scale] or at least 50%), and strategy in the presence of an inadequate response (where switching is recommended) or in the presence of long-term remission (where a process of biological therapy optimization can be considered, either a gradual increase in the

  18. An epidemiological survey of low back pain and axial spondyloarthritis in a Chinese Han population.

    Science.gov (United States)

    Liao, Z T; Pan, Y F; Huang, J L; Huang, F; Chi, W J; Zhang, K X; Lin, Z M; Wu, Y Q; He, W Z; Wu, J; Xie, X J; Huang, J X; Wei, Q J; Li, T W; Wu, Z; Yu, B Y; Gu, J R

    2009-01-01

    To investigate the prevalence of low back pain (LBP) and axial spondyloarthritis (SpA) in a Chinese Han population. A face-to-face investigation was performed in the Han population of Dalang Town, Yangshan County, Guangdong Province, China, using a questionnaire established in France in 1999. First the clinical features associated with SpA were investigated, then the human leucocyte antigen (HLA)-B27 and sacroiliac joint radiographic examinations were carried out. Finally, the diagnosis of SpA was determined by rheumatologists. A total of 13 315 subjects participated in the study and 10 921 were aged >16 years; of these, 787 (7.21%) had LBP. There were 92 axial SpA patients (0.782% in subjects >16 years old and 11.96% in subjects with LBP). There were 29 (0.253%) cases of ankylosing spondylitis (AS), 60 (0.507%) undifferentiated axial SpA (USpA), and three (0.022%) psoriatic arthritis (PsA). Patients in the SpA groups had higher percentages in onset 3 months compared with those in other LBP groups. Simultaneous symptoms associated with spondylitis, such as buttock pain, heel pain, psoriasis, and SpA family history, were more commonly present. Of the axial SpA patients, 82.67% were HLA-B27 positive, clearly a greater percentage than those (11.65%) in other LBP groups. The survey questionnaire for SpA in this study is useful for axial SpA screening in China. In southern China, the prevalence of LBP is 7.21%. The prevalence of axial SpA is 0.782%. USpA is the most common subtype of SpA, followed by AS.

  19. Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy

    DEFF Research Database (Denmark)

    Wallman, Johan K; Jöud, Anna; Olofsson, Tor

    2017-01-01

    Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before......Objective.: The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA). Methods.: Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international...... to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends. Results.: The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean...

  20. Golimumab in radiographic and nonradiographic axial spondyloarthritis: a review of clinical trials

    Directory of Open Access Journals (Sweden)

    Toussirot E

    2016-07-01

    Full Text Available Eric Toussirot,1–5 Charline Vauchy,1 Delphine Binda,1 Fabrice Michel6 1Clinical Investigation Center in Biotherapy, Intitut National de la Santé et de la Recherche Médicale CIC-1431, 2Fédération Hospitalo-Universitaire Integrated Center for Research in inflammatory Diseases, 3Department of Rheumatology, University Hospital of Besançon, Besançon, France; 4Department of Therapeutics, 5Equipe d’accueil EA 4266: “Pathogenic Agents and Inflammation”, University of Franche-Comté, 6Department of Neuromuscular Examinations and Diseases, University Hospital of Besançon, Besançon, FranceAbstract: Axial spondyloarthritis (Ax SpA refers to chronic inflammatory rheumatic diseases that mainly affect the axial skeleton, leading to erosions and new bone formation in the sacroiliac joints and/or the spine. Ax SpA includes the radiographic form of the disease, ie, ankylosing spondylitis (AS, and the nonradiographic Ax SpA (non-Rx Ax SpA forms. Anti-tumor necrosis factor alpha (TNFα agents are used in the treatment of Ax SpA in patients who do not respond to or are intolerant to nonsteroidal anti-inflammatory drugs. In these patients, anti-TNFα agents show promising results by targeting the inflammatory process and providing symptomatic relief. Golimumab is a fully human anti-TNFα agent that is currently approved for the treatment of both AS and non-Rx Ax SpA in Europe. This review focuses on the results of clinical trials with golimumab for the treatment of AS (GO-RAISE studies and non-Rx Ax SpA (GO-AHEAD study and on the effects of this agent on imaging findings (radiographic progression, magnetic resonance imaging inflammation as well as on biological parameters. Overall, golimumab is a valid therapeutic option in patients with AS and non-Rx Ax SpA in Europe.Keywords: anti-TNFα, golimumab, axial spondyloarthritis

  1. New treatment options and emerging drugs for axial spondyloarthritis: biological and targeted synthetic agents.

    Science.gov (United States)

    Toussirot, Eric

    2017-02-01

    Ankylosing spondylitis (AS) and axial spondyloarthritis (ax SpA) are chronic inflammatory diseases mainly involving the axial skeleton. Pharmacological treatments for AS and ax SpA usually include local glucocorticoid injections, NSAIDs and anti-TNFα agents. Since around 30% to 40% of patients are non responders or intolerant to anti-TNFα agents, we need new therapeutic options for AS and ax SpA. Areas covered: This review describes the new biological agents that can be used or are in development for AS or ax SpA as well as emerging synthetic targeted drugs. Expert opinion: Based on the rationale of the involvement of the IL-23/Th17 axis in AS, novel biological agents have been developed and include secukinumab, an anti-IL-17A agent and ustekinumab, an anti-IL-23 antibody. New compounds in the class of synthetic drugs are apremilast, a PDE4 inhibitor, and inhibitors of kinase pathways. Secukinumab gave positive results in the treatment of AS. Ustekinumab yielded promising results in AS in an open labeled study. Apremilast is not effective in AS while results with kinase inhibitors are preliminary. Future studies will clarify the place of secukinumab in the therapeutic management of AS, its influence on radiographic progression and its effects on the non radiographic form of the disease.

  2. Cartilage collagen type II seromarker patterns in axial spondyloarthritis and psoriatic arthritis

    DEFF Research Database (Denmark)

    Munk, Heidi Lausten; Gudmann, Natasja Staehr; Christensen, Anne Friesgaard

    2016-01-01

    The aim of the study was to assess the possible association between type II collagen turnover seromarkers and disease profile in patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA). Outpatients with axial SpA (n = 110) or PsA (n = 101) underwent clinical examination including......-smokers, 0.43 ng/ml (p = 0.02), while PIIANP was higher in HLA-B27 positive, 2312 ng/ml versus negative patients, 2021 ng/ml (p = 0.03). In PsA, PIIANP and C2M did not differ between patients and controls, but PIIANP was elevated in patients not receiving DMARDs, 2726 ng/ml. In PsA, PIIANP and C2M did...... not differ according to smoking and HLA-B27. Cartilage degradation assessed by C2M is increased in SpA irrespective of treatment but not in PsA. Cartilage synthesis reflected by PIIANP is increased in untreated SpA and PsA. PIIANP correlates with CRP in SpA while not in PsA. In DMARD-naïve SpA but not in PsA...

  3. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis.

    Science.gov (United States)

    van der Heijde, Désirée; Ramiro, Sofia; Landewé, Robert; Baraliakos, Xenofon; Van den Bosch, Filip; Sepriano, Alexandre; Regel, Andrea; Ciurea, Adrian; Dagfinrud, Hanne; Dougados, Maxime; van Gaalen, Floris; Géher, Pál; van der Horst-Bruinsma, Irene; Inman, Robert D; Jongkees, Merryn; Kiltz, Uta; Kvien, Tore K; Machado, Pedro M; Marzo-Ortega, Helena; Molto, Anna; Navarro-Compàn, Victoria; Ozgocmen, Salih; Pimentel-Santos, Fernando M; Reveille, John; Rudwaleit, Martin; Sieper, Jochen; Sampaio-Barros, Percival; Wiek, Dieter; Braun, Jürgen

    2017-06-01

    To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009. After a discussion of the results in the steering group and presentation to the task force, overarching principles and recommendations were formulated, and consensus was obtained by informal voting. A total of 5 overarching principles and 13 recommendations were agreed on. The first three recommendations deal with personalised medicine including treatment target and monitoring. Recommendation 4 covers non-pharmacological management. Recommendation 5 describes the central role of non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice drug treatment. Recommendations 6-8 define the rather modest role of analgesics, and disprove glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for axSpA patents with predominant axial involvement. Recommendation 9 refers to biological DMARDs (bDMARDs) including TNFi and IL-17 inhibitors (IL-17i) for patients with high disease activity despite the use (or intolerance/contraindication) of at least two NSAIDs. In addition, they should either have an elevated C reactive protein and/or definite inflammation on MRI and/or radiographic evidence of sacroiliitis. Current practice is to start with a TNFi. Switching to another TNFi or an IL-17i is recommended in case TNFi fails (recommendation 10). Tapering, but not stopping a bDMARD, can be considered in patients in sustained remission (recommendation 11). The final two recommendations (12, 13) deal with surgery and

  4. Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome.

    Science.gov (United States)

    Corli, Justine; Flipo, René-Marc; Philippe, Peggy; Bera-Louville, Anne; Béhal, Hélène; Wibaux, Cécile; Paccou, Julien

    2015-12-01

    The purpose of this study was to (1) evaluate baseline characteristics of nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) treated with tumor necrosis factor-α inhibitors (TNFi), (2) assess the response to first TNFi treatment, and (3) compare drug-survival duration and rates. Inclusion criteria were patients with axSpA who initiated first TNFi treatment between April 2001 and July 2014 and were followed up for at least 3 months. Efficacy criteria were an improvement of at least 2 points (on a 0-10 scale) or a 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Baseline characteristics, responses at 12 months, and drug survival were compared between AS and nr-axSpA. A total of 361 patients were included in the study (AS, n = 263 and nr-axSpA, n = 98). Patients with AS were more often men (65.02% vs 45.92%, p = 0.001) and had longer symptom duration (11.71 ± 9.52 vs 7.34 ± 9.30 yrs, p Treatment response and drug survival were similar in patients with AS and nr-axSpA after first TNFi initiation.

  5. Anti-CD74 antibodies have no diagnostic value in early axial spondyloarthritis: data from the spondyloarthritis caught early (SPACE) cohort.

    Science.gov (United States)

    de Winter, Janneke J; van de Sande, Marleen G; Baerlecken, Niklas; Berg, Inger; Ramonda, Roberta; van der Heijde, Désirée; van Gaalen, Floris A; Witte, Torsten; Baeten, Dominique L

    2018-03-01

    Anti-CD74 IgG antibodies are reported to be elevated in patients with axial spondyloarthritis (axSpA). This study assessed the diagnostic value of anti-CD74 antibodies in patients with early axSpA. Anti-CD74 IgG and IgA antibodies were first measured in an exploratory cohort of patients with radiographic axSpA (138 patients with ankylosing spondyloarthritis (AS)) and 57 healthy controls and then were measured in patients with early axSpA (n = 274) and with non-SpA chronic back pain (CBP) (n = 319), participating in the spondyloarthritis caught early (SPACE) prospective cohort study of patients under 45 years old with early back pain (for ≥ 3 months, but ≤ 2 years). In the exploratory cohort, anti-CD74 IgG antibodies were present in 79.7% of patients with AS vs. 43.9% of healthy controls (p present in 28.5% of patients with AS vs. 5.3% of healthy controls (p present in 46.4% of the patients with axSpA vs. 47.9% of the patients with CBP (p = 0.71). Anti-CD74 IgA antibodies were present in 54.7% of the patients with axSpA and 37.0% of the patients with CBP (p value of 58.8% (compared to a prior probability of 46.2%) and a negative predictive value of 59.1% (compared to a prior probability of 53.8%). In a regression model, total serum IgA was associated with axSpA odds ratio (OR) 1.19, p value in patients under 45 years old presenting with early back pain.

  6. Brief Report: Nonsteroidal Antiinflammatory Drug-Sparing Effect of Tumor Necrosis Factor Inhibitors in Early Axial Spondyloarthritis: Results From the DESIR Cohort.

    Science.gov (United States)

    Moltó, Anna; Granger, Benjamin; Wendling, Daniel; Breban, Maxime; Dougados, Maxime; Gossec, Laure

    2015-09-01

    To evaluate the effect of tumor necrosis factor (TNF) inhibitors on nonsteroidal antiinflammatory drug (NSAID) intake in a cohort of patients with early axial spondyloarthritis (SpA) over the first 2 years of followup. The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort is a prospective, multicenter, observational study cohort of patients with early inflammatory back pain. The management and treatment of these patients were decided by their treating rheumatologists. Data regarding NSAID intake (yes/no) and the Assessment of SpondyloArthritis international Society NSAID score were collected at each visit over 2 years of followup. Patients receiving a TNF inhibitor were matched with those receiving usual care, based on a propensity score. The NSAID-sparing effect of TNF inhibitors was estimated by comparing the percentage of patients reaching several end points (e.g., a decrease in the NSAID score to 50% or to <10 or in whom NSAID treatment was discontinued was greater in the TNF inhibitor group (67.6% versus 46.2%). Treatment with TNF inhibitors was associated with a decrease in the proportion of patients taking NSAIDs and with a rapid and sustained decrease in NSAID intake. This study is the first to confirm the NSAID-sparing effect of TNF inhibitors in patients with early axial SpA in a real-life clinical setting. © 2015, American College of Rheumatology.

  7. Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis

    Science.gov (United States)

    2015-01-01

    With the growing awareness of the impact of chronic back pain and axial spondyloarthritis and recent breakthroughs in genetics and the development of novel treatments which may impact best on early disease, the need for markers that can facilitate early diagnosis and profiling those individuals at the highest risk for a bad outcome has never been greater. The genetic basis of ankylosing spondylitis has been considerably advanced, and HLA-B27 testing has a role in the diagnosis. Knowledge is still incomplete of the rest of the genetic contribution to disease susceptibility, and it is likely premature to use extensive genetic testing (other than HLA-B27) for diagnosis. Serum and plasma biomarkers have been examined extensively in assessing disease activity, treatment response, and as predictors or radiographic severity. For assessing disease activity, other than C-reactive protein and erythrocyte sedimentation rate, the most work has been in examining cytokines (particularly interleukin 17 and 23), matrix metalloproteinase (MMP) markers (particularly MMP3). For assessing those at the highest risk for radiographic progression, biomarkers of bony metabolism, cartilage and connective tissue degradation products, and adipokines have been most extensively assessed. The problem is that no individual biomarkers has been reproducibly shown to assess disease activity or predict outcome, and this area still remains an unmet need, of relevance to industry stakeholders, to regulatory bodies, to the healthcare system, to academic investigators, and finally to patients and providers. PMID:25939520

  8. Cancer risk in patients with spondyloarthritis treated with TNF inhibitors

    DEFF Research Database (Denmark)

    Hellgren, Karin; Dreyer, Lene; Arkema, Elizabeth V.

    2017-01-01

    Background Safety data on cancer risks following tumour necrosis factor a inhibitors (TNFi) in patients with spondyloarthritis (SpA) (here defined as ankylosing spondylitis (AS), undifferentiated spondarthropaties (SpA UNS), psoriatic arthritis (PsA)) are scarce. Our objective was to assess risks...

  9. Factors associated with radiographic lesions in early axial spondyloarthritis. Results from the DESIR cohort.

    Science.gov (United States)

    Blachier, Martin; Canouï-Poitrine, Florence; Dougados, Maxime; Lethuaut, Aurélie; Fautrel, Bruno; Ferkal, Salah; Le Corvoisier, Philippe; Farrenq, Valérie; Poulain, Cécile; Ghaleh, Bijan; Bastuji-Garin, Sylvie; Claudepierre, Pascal

    2013-09-01

    To assess whether factors such as inflammation by laboratory tests and MRI differ between early axial SpA with and without radiographic lesions. Cross-sectional analysis of baseline data from Devenir des Spondylarthropathies Indifferenciées Récentes (DESIR) cohort patients having recent-onset inflammatory back pain and meeting Assessment of SpondyloArthritis international Society criteria. The baseline evaluation included radiographs and MRI of the SI joints (SIJs) and spine. Patients were classified as having radiographic lesions if they had at least one obvious sacroiliitis, grade 2 for at least one vertebral corner or grade 1 for at least two vertebral corners (at the cervical or lumbar level, according to the modified Stoke Ankylosing Spondylitis Spine Score). Associations between baseline characteristics and the presence of radiographic lesions were evaluated by estimating multi-adjusted odd ratios (aORs) and their 95% CIs using a logistic regression model. Of 475 patients, 180 (37.9%) had radiographic lesions. Factors positively associated with radiographic lesions were alcohol use (aOR 2.42; 95% CI 1.31, 4.44; P = 0.005), CRP level (aOR 1.44; 95% CI 1.13, 1.84; P = 0.003) and SIJ inflammation by MRI (aOR 2.25; 95% CI 1.40, 3.60; P = 0.001); negative associations occurred with good NSAID responsiveness (aOR 0.44; 95% CI 0.24, 0.81; P = 0.008); spinal MRI inflammation was associated with radiographic lesions only in smokers (aOR 1.99; 95% CI 1.01, 3.92; P = 0.048). Alcohol use, poor responsiveness to NSAIDs, CRP elevation, SIJ MRI inflammation and spinal MRI inflammation in smokers were independently associated with radiographic lesions in early axial SpA.

  10. Disease activity trajectories in early axial spondyloarthritis: results from the DESIR cohort.

    Science.gov (United States)

    Molto, Anna; Tezenas du Montcel, Sophie; Wendling, Daniel; Dougados, Maxime; Vanier, Antoine; Gossec, Laure

    2017-06-01

    Disease activity may change over time in axial spondyloarthritis (axSpA). The objectives were to identify patterns of disease activity evolution in patients with early axSpA. Patients from the prospective early axSpA cohort (DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR)) who fulfilled the Assessment in SpondyloArthritis Society (ASAS) criteria for axSpA at baseline and with at least three Ankylosing Spondylitis Disease Activity Score (ASDAS) values available over the 3 years of follow-up were analysed. Statistical analyses: trajectories were estimated by group-based trajectory modelling; predisposing baseline factors for such trajectories were identified by univariate and multivariable multinomial (logit) regression; work disability over time was compared between the trajectories by Cox hazard model. In all, 370 patients were analysed: mean disease duration was 1.6 (±0.9) years. The five distinct trajectories of disease activity over the 3 years were (t1) 'persistent moderate disease activity' (n=134 (36.2%)); (t2) 'persistent inactive disease' (n=66 (17.8%); (t3) 'changing from very high disease activity to inactive disease' ((n=29 (7.8%)); (t4) 'persistent high disease activity' (n=126 (34.1%)) and (t5) 'persistent very high disease activity' (n=15 (4.1%)). After adjustment for other characteristics, t2 was associated with a white-collar job (OR=2.6 (95% CI 1.0 to 6.7)) and t3 with male gender (OR=7.1 (1.6 to 32.2)), higher education level (OR=9.4 (1.4 to 63.4)) and peripheral joint involvement (OR=6.2 (1.23 to 31.32)). Patients from (t4) and (t5) were more often declared work disabled over follow-up (HR=5.2 (1.5 to 18.0) and HR=8.0 (1.3 to 47.9), respectively). Trajectory modelling of disease activity was feasible in early axSpA: more than 30% patients (141/370) were in a trajectory with a persistent high disease activity. Persistent high disease activity trajectories were significantly associated with consequences on work. NCT01648907

  11. Effectiveness of Adalimumab in Non-radiographic Axial Spondyloarthritis: Evaluation of Clinical and Magnetic Resonance Imaging Outcomes in a Monocentric Cohort.

    Science.gov (United States)

    Cantarini, Luca; Fabbroni, Marta; Talarico, Rosaria; Costa, Luisa; Caso, Francesco; Cuneo, Gian Luca; Frediani, Bruno; Faralli, Gabriele; Vitale, Antonio; Brizi, Maria Giuseppina; Sabadini, Luciano; Galeazzi, Mauro

    2015-07-01

    The primary aim of the study was to evaluate the long-term effectiveness of adalimumab (ADA) in a cohort of non-radiographic axial spondyloarthritis (nr-axSpA), and the secondary aims were to identify predictive factors of response and evaluate radiological progression.We evaluated 37 patients (male/female: 12/25; mean age 49 ± 14; mean disease duration: 6.3 ± 5.8) with active nr-axSpA (Assessment of SpondyloArthritis International Society criteria), despite the treatment with ≥1 nonsteroidal anti-inflammatory drug for at least 3 months, initiating the treatment with ADA 40 mg every other week. Patients were treated for 24 months, and evaluated at baseline, 6, 12, and 24 months. Outcome measures included Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index. Radiograph of the spine and sacroiliac joints and magnetic resonance of the sacroiliac joints were performed at baseline and according to the standard of assessment for the disease.The proportion of patients that achieved a BASDAI50 response at 6, 12 and 24 months was 51.3%, 70.3%, and 76.8%, respectively. Treatment was well tolerated with no unexpected adverse events and/or serious adverse events. All patients remained on treatment for 2 years, with a good compliance. We did not identify any predictive factor of response to therapy. Moreover, modified Stoke Ankylosing Spondylitis Spine Score and Spondyloarthritis Research Consortium of Canada scores showed a trend of improvement during the study period.ADA was effective on clinical and radiological outcomes at 2-year follow-up; thus, early treatment with ADA may prevent radiographic damage and be associated with low disease activity or remission. Moreover, data from this cohort study have confirmed safety and tolerability profile of ADA in nr-axSpA in the long term.

  12. Development, sensibility, and reliability of the Toronto Axial Spondyloarthritis Questionnaire in inflammatory bowel disease.

    Science.gov (United States)

    Alnaqbi, Khalid A; Touma, Zahi; Passalent, Laura; Johnson, Sindhu R; Tomlinson, George A; Carty, Adele; Inman, Robert D

    2013-10-01

    There is an unacceptable delay in the diagnosis of axial spondyloarthritis (axSpA) in its early stages among patients at high risk, in particular those with inflammatory bowel disease (IBD). Our objectives were to develop a sensible and reliable questionnaire to identify undetected axSpA among patients with IBD. Literature was reviewed for item generation in the Toronto axSpA Questionnaire on IBD (TASQ-IBD). Sensibility of the questionnaire was assessed among healthcare professionals and patients. This assessment was related to purpose and framework (clinical function, clinical justification, and clinical applicability), face validity, comprehensiveness [oligo-variability (limiting the questionnaire to important items) and transparency], replicability, content validity, and feasibility. The test-retest reliability study was administered to 77 patients with established IBD and axSpA. Kappa agreement coefficients and absolute agreement were calculated for items. Three domains included IBD, inflammatory back symptoms, and extraaxial features. The entry criterion required a patient to have IBD and back pain or stiffness that ever persisted for ≥ 3 months. Iterative sensibility assessment involved 16 items and a diagram of the back. Kappa coefficients ranged from 0.81-1.00 for each item. Absolute agreement across all items ranged from 91% to 100%. TASQ-IBD is a newly developed, sensible, and reliable case-finding questionnaire to be administered to patients with IBD who have ever had chronic back pain or stiffness persisting for ≥ 3 months. It should facilitate identification and timely referral of patients with IBD to rheumatologists and minimize the delay in diagnosis of axSpA. Consequently, it should assess the prevalence of axSpA in IBD.

  13. Implication of osteoprotegerin and sclerostin in axial spondyloarthritis cardiovascular disease: study of 163 Spanish patients.

    Science.gov (United States)

    Genre, Fernanda; Rueda-Gotor, Javier; Remuzgo-Martínez, Sara; Corrales, Alfonso; Ubilla, Begoña; Mijares, Verónica; Fernández-Díaz, Carlos; Portilla, Virginia; Blanco, Ricardo; Hernández, José Luis; Llorca, Javier; López-Mejías, Raquel; González-Gay, Miguel Angel

    2017-12-15

    Due to the high incidence of cardiovascular disease in axial spondyloarthritis (axSpA), the search of potential biomarkers that may help to identify patients with high cardiovascular risk is of main importance. Therefore, in this study we assessed the implication of osteoprotegerin (OPG) and sclerostin (SCL), two biomarkers associated with cardiovascular disease and bone metabolism, in the clinical spectrum and atherosclerotic disease of patients with axSpA. OPG and SCL serum levels were determined in 163 axSpA Spanish patients (119 ankylosing spondylitis and 44 non-radiographic axSpA) and 63 healthy controls by enzyme-linked immunosorbent assay. Carotid ultrasound was performed in axSpA patients to determine the presence of subclinical atherosclerosis (by the identification of abnormally increased carotid intima-media thickness [cIMT] and presence of plaques). Patients displayed higher OPG but lower SCL levels than controls (p=0.02 and 0.001, respectively). Association of these molecules with some metabolic syndrome features was seen. In this regard, OPG negatively correlated with body mass index (p=0.04) whereas SCL levels were higher in hypertensive patients (p=0.01) and in men (p=0.002). However, serum OPG and SCL were not significantly correlated with cIMT values or presence of plaques when data were adjusted by age at the time of the study, sex, classic cardiovascular risk factors and anti-TNF therapy. Our results suggest an association of OPG and SCL in axSpA with some metabolic syndrome features that are associated with an increased risk of CV disease.

  14. COMPARATIVE EVALUATION OF PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS

    Directory of Open Access Journals (Sweden)

    I. А. Cherentsova

    2016-01-01

    Full Text Available Objective: to study clinical presentations, disease activity, and functional impairments  in patients with ankylosing spondylitis (AS and non-radiographic axial spondyloarthritis  (nr-axSpA.Subjects and methods. A total of 153 patients were examined in the period 2010 to 2013. They were divided into two groups: 1 119 patients with a valid diagnosis of AS; 2 34 with nr-axSpA. BASDAI, BASFI, BASMI, MASES, erythrocyte sedimentation rate, and HLA-B27 antigen were determined  in both groups. The mean age of the patients was 36.5±0.7 years and 27.0±1.2 years and the disease duration 14.7±0.6 and 4.1±0.5 years in Groups 1 and 2, respectively.Results and discussion. Among the patients with AS and those with nr-axSpA, men accounted  for 68.9 and 70.6%, respectively. The axial type was predominant in both groups (53.7% in Group 1 and 67.6% in Group 2. The mean visual analogue scale (VAS pain score was 40.6±1.6 mm in Group 1 and 31.6±2.4 mm in Group 2 (p < 0.01. High BASDAI was seen in 51.2% of the patients with AS and 41.1% of those with nr-axSpA. Group 2 had significantly lower mean BASDAI values (3.4±0.2  than Group 1 (4.0±0.1.  Functional impairments  by BASFI were more obvious in the patients with AS ((3.2±0.2 than in those with nr-axSpA (1.5±0.2.  BASFI >4 was not noted in Group 2. Higher BASMI scores were found in the patients with AS (1.9±0.1  than in those with nr-axSpA (0.5±0.1. Conclusion. The ASAS criteria for axSpA enable one to establish its diagnosis in the early stage until stable functional impairments  emerge. In the pre-radiographic stage, the patients have lower disease activity and pain.

  15. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.

    Science.gov (United States)

    Ward, Michael M; Deodhar, Atul; Akl, Elie A; Lui, Andrew; Ermann, Joerg; Gensler, Lianne S; Smith, Judith A; Borenstein, David; Hiratzka, Jayme; Weiss, Pamela F; Inman, Robert D; Majithia, Vikas; Haroon, Nigil; Maksymowych, Walter P; Joyce, Janet; Clark, Bruce M; Colbert, Robert A; Figgie, Mark P; Hallegua, David S; Prete, Pamela E; Rosenbaum, James T; Stebulis, Judith A; van den Bosch, Filip; Yu, David T Y; Miller, Amy S; Reveille, John D; Caplan, Liron

    2016-02-01

    To provide evidence-based recommendations for the treatment of patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (SpA). A core group led the development of the recommendations, starting with the treatment questions. A literature review group conducted systematic literature reviews of studies that addressed 57 specific treatment questions, based on searches conducted in OVID Medline (1946-2014), PubMed (1966-2014), and the Cochrane Library. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method. A separate voting group reviewed the evidence and voted on recommendations for each question using the GRADE framework. In patients with active AS, the strong recommendations included use of nonsteroidal antiinflammatory drugs (NSAIDs), use of tumor necrosis factor inhibitors (TNFi) when activity persists despite NSAID treatment, not to use systemic glucocorticoids, use of physical therapy, and use of hip arthroplasty for patients with advanced hip arthritis. Among the conditional recommendations was that no particular TNFi was preferred except in patients with concomitant inflammatory bowel disease or recurrent iritis, in whom TNFi monoclonal antibodies should be used. In patients with active nonradiographic axial SpA despite treatment with NSAIDs, we conditionally recommend treatment with TNFi. Other recommendations for patients with nonradiographic axial SpA were based on indirect evidence and were the same as for patients with AS. These recommendations provide guidance for the management of common clinical questions in AS and nonradiographic axial SpA. Additional research on optimal medication management over time, disease monitoring, and preventive care is needed to help establish best practices in these areas. © 2015, American College of Rheumatology.

  16. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group

    NARCIS (Netherlands)

    Rudwaleit, M.; Jurik, A. G.; Hermann, K.-G. A.; Landewé, R.; van der Heijde, D.; Baraliakos, X.; Marzo-Ortega, H.; Ostergaard, M.; Braun, J.; Sieper, J.

    2009-01-01

    Magnetic resonance imaging (MRI) of sacroiliac joints has evolved as the most relevant imaging modality for diagnosis and classification of early axial spondyloarthritis (SpA) including early ankylosing spondylitis. To identify and describe MRI findings in sacroiliitis and to reach consensus on

  17. No diagnostic utility of antibody patterns against Klebsiella pneumoniae capsular serotypes in patients with axial spondyloarthritis vs. patients with non-specific low back pain

    DEFF Research Database (Denmark)

    Hermansen, L T; Loft, A G; Christiansen, A A

    2017-01-01

    OBJECTIVES: To investigate whether antibody response patterns against Klebsiella pneumoniae capsular serotypes can discriminate patients with axial spondyloarthritis (axSpA) from patients with non-specific low back pain (LBP). METHOD: Immunoglobulin (Ig)G and IgA antibodies against K. pneumoniae...

  18. Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort.

    Science.gov (United States)

    Tournadre, A; Pereira, B; Lhoste, A; Dubost, J J; Ristori, J M; Claudepierre, P; Dougados, M; Soubrier, M

    2013-09-01

    To clarify sex differences in early axial spondyloarthritis (SpA). In total, 475 patients included in the Devenir des Spondylarthropathies Indifférenciées Récentes (Outcome of Recent Undifferentiated Spondylarthropathies) cohort, a prospective multicenter French cohort of patients with early inflammatory back pain suggestive of SpA, and fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial SpA were studied. The clinical and imaging features were compared between sexes and according to the clinical or imaging arm of the ASAS criteria using univariate and multivariate analysis. Comparisons between the 239 men and 236 women showed that women had higher disease activity when measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Patient Global Score and higher fatigue and functional scores despite having less radiographic sacroiliitis and magnetic resonance imaging (MRI) inflammation of sacroiliac joints and the spine than men. Disease activity measured by the C-reactive protein (CRP)-based Ankylosing Spondylitis Disease Activity Score was not different between men and women. In contrast to patients classified with the clinical arm, disease activity and functional scores did not differ between women and men with sacroiliitis on imaging scans, except for fatigue and the Ankylosing Spondylitis Quality of Life questionnaire. Women with sacroiliitis had more peripheral involvement and more family history, whereas HLA-B27 positivity, elevated CRP, and MRI inflammation of the spine were associated with male sex. Women with early axial SpA according to the ASAS criteria had greater disease activity when measured by the BASDAI and worse functioning despite fewer radiologic abnormalities than men. The differences in disease expression may be confounding factors to establish the diagnosis of SpA and to assess disease activity in women, suggesting that the imaging arm

  19. Relationships between ultrasound enthesitis, disease activity and axial radiographic structural changes in patients with early spondyloarthritis: data from DESIR cohort.

    Science.gov (United States)

    Ruyssen-Witrand, Adeline; Jamard, Bénédicte; Cantagrel, Alain; Nigon, Delphine; Loeuille, Damien; Degboe, Yannick; Constantin, Arnaud

    2017-01-01

    To search for association between ultrasound (US) enthesis abnormalities and disease activity, spine and sacro-iliac joints (SIJ) MRI inflammatory lesions and spine structural changes in a cohort of patients suspected for axial spondyloarthritis (SpA). Patients: Of 708 patients included in the DESIR(Devenir des Spondyloarthrites Indifférenciées Récentes) cohort, 402 had an US enthesis assessment and were selected for this study. Imaging: Achilles, lateral epicondyles, superior patellar ligament, inferior patellar ligament entheses were systematically US scanned and abnormalities were summed in US structural and power Doppler (PDUS) scores. Spine radiographs, SIJ and spine MRI scans were centrally scored modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), presence of MRI sacro-iliitis, Spondyloarthritis Research Consortium of Canada and Berlin scores. Analysis: The associations between the US structural/PDUS scores and disease activity, C reactive protein (CRP), MRI SIJ and spine inflammatory lesions and mSASSS were tested by Spearman's correlation tests. Among the 402 patients included (median age: 33.5 years, males: 48.5%), 55% had US enthesis structural abnormalities while 14% had PDUS abnormalities. There was no association between US scores and Bath Ankylosing Spondylitis Disease Activity Index, CRP or inflammatory lesions on SIJ and spine MRI. There was a correlation between US structural and PDUS scores and the mSASSS (respectively, r=0.151, p=0.005; r=0.143, p=0.007). The proportion of patients with syndesmophytes was higher in the case of US enthesophytes (26% of syndesmophytes vs 6% in the absence of US enthesophytes, p<0.0001). While the US abnormalities do not seem to be a helpful tool for monitoring disease activity in axial SpA, US enthesophytes, strongly associated with axial syndesmophytes, might be a marker of interest for disease severity. NCT01648907, date of registration : 20 July 2012.

  20. Disease activity decrease is associated with improvement in work productivity over 1 year in early axial spondyloarthritis (SPondyloArthritis Caught Early cohort).

    Science.gov (United States)

    van Lunteren, Miranda; Ez-Zaitouni, Zineb; Fongen, Camilla; Landewé, Robert; Ramonda, Roberta; van der Heijde, Désirée; van Gaalen, Floris A

    2017-12-01

    To assess if a change in disease activity is associated with a change in work productivity loss (WPL) over 1 year in early axial SpA (axSpA) patients. Baseline and 1 year data of axSpA patients in the SPondyloArthritis Caught Early cohort were analysed. Linear regression models were built explaining the change in the Ankylosing Spondylitis Disease Activity Score (ASDAS) over time by the change in absenteeism, presenteeism, WPL and activity impairment over time. Effect modification and confounding were tested for age, gender, arm of Assessment of SpondyloArthritis international Society classification criteria, HLA-B27, duration of chronic back pain, profession and medication. At baseline, in 105 axSpA patients (48% female, mean age 30.8 years, mean symptom duration 13.6 months, 92% HLA-B27 positive, 24% radiographic sacroiliitis), the mean ASDAS was 2.4 (s.d. 1.0), absenteeism 9% (s.d. 23), presenteeism 33% (s.d. 28), WPL 36% (s.d. 30) and activity impairment 37% (s.d. 25). After 1 year, the mean ASDAS decreased to 2.0 (s.d. 0.8) and absenteeism, presenteeism, WPL and activity impairment improved to 6% (s.d. 22), 26% (s.d. 26), 27% (s.d. 29) and 27% (s.d. 26), respectively. Models showed that if ASDAS decreased 1 unit, absenteeism, presenteeism, WPL and activity impairment improved by 5, 17, 16 and 18%, respectively. The impact of disease activity on work productivity was higher in patients with shorter symptom duration and the impact on absenteeism was higher in patients starting pharmacological treatment. In early axSpA patients, work productivity and daily activities are seriously impacted at baseline and 1 year. However, decreasing disease activity is associated with marked improvements in work productivity and daily activities. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  1. Anti-TNF agents for the treatment of active non-radiographic axial spondyloarthritis

    Directory of Open Access Journals (Sweden)

    I. Olivieri

    2013-03-01

    Full Text Available The spondyloarthritis (SpA complex includes ankylosing spondylitis (AS, reactive arthritis, psoriatic arthritis, arthritis related to inflammatory bowel disease and forms that do not meet established criteria for these definite categories which are designated as undifferentiated SpA. In the early 1990s, two sets of classification criteria were suggested with the purpose to cover the whole clinical spectrum of SpA: the Amor criteria and the European Spondylarthropathy Study Group (ESSG criteria...

  2. Maintenance of biologic-free remission with naproxen or no treatment in patients with early, active axial spondyloarthritis: results from a 6-month, randomised, open-label follow-up study, INFAST Part 2.

    Science.gov (United States)

    Sieper, J; Lenaerts, J; Wollenhaupt, J; Rudwaleit, M; Mazurov, V I; Myasoutova, L; Park, S; Song, Y; Yao, R; Chitkara, D; Vastesaeger, N

    2014-01-01

    To investigate whether biologic-free remission can be achieved in patients with early, active axial spondyloarthritis (SpA) who were in partial remission after 28 weeks of infliximab (IFX)+naproxen (NPX) or placebo (PBO)+NPX treatment and whether treatment with NPX was superior to no treatment to maintain disease control. Infliximab as First-Line Therapy in Patients with Early Active Axial Spondyloarthritis Trial (INFAST) Part 1 was a double-blind, randomised, controlled trial in biologic-naïve patients with early, active, moderate-to-severe axial SpA treated with either IFX 5 mg/kg+NPX 1000 mg/d or PBO+NPX 1000 mg/d for 28 weeks. Patients achieving Assessment of SpondyloArthritis international Society (ASAS) partial remission at week 28 continued to Part 2 and were randomised (1:1) to NPX or no treatment until week 52. Treatment group differences in ASAS partial remission and other efficacy variables were assessed through week 52 with Fisher exact tests. At week 52, similar percentages of patients in the NPX group (47.5%, 19/40) and the no-treatment group (40.0%, 16/40) maintained partial remission, p=0.65. Median duration of partial remission was 23 weeks in the NPX group and 12.6 weeks in the no-treatment group (p=0.38). Mean Bath Ankylosing Spondylitis Disease Activity Index scores were low at week 28, the start of follow-up treatment (NPX, 0.7; no treatment, 0.6), and remained low at week 52 (NPX, 1.2; no treatment, 1.7). In axial SpA patients who reached partial remission after treatment with either IFX+NPX or NPX alone, disease activity remained low, and about half of patients remained in remission during 6 months in which NPX was continued or all treatments were stopped.

  3. Maintenance of biologic-free remission with naproxen or no treatment in patients with early, active axial spondyloarthritis: results from a 6-month, randomised, open-label follow-up study, INFAST Part 2

    OpenAIRE

    Sieper, J; Lenaerts, J; Wollenhaupt, J; Rudwaleit, M; Mazurov, V I; Myasoutova, L; Park, S; Song, Y; Yao, R; Chitkara, D; Vastesaeger, N

    2013-01-01

    Objective To investigate whether biologic-free remission can be achieved in patients with early, active axial spondyloarthritis (SpA) who were in partial remission after 28 weeks of infliximab (IFX)+naproxen (NPX) or placebo (PBO)+NPX treatment and whether treatment with NPX was superior to no treatment to maintain disease control. Method Infliximab as First-Line Therapy in Patients with Early Active Axial Spondyloarthritis Trial (INFAST) Part 1 was a double-blind, randomised, controlled tria...

  4. Electronic assessment of disease activity and functioning in patients with axial spondyloarthritis: challenges and unmet needs.

    Science.gov (United States)

    Kiltz, Uta; Boonen, Annelies; Braun, Juergen; Richter, Jutta G

    2016-01-01

    The dynamic clinical course of rheumatic conditions indicates a need for regular collection of information on health status to monitor disease activity and functional status. Patient-reported outcomes measures (PROMs) are playing a key role in the evaluation of symptoms and functioning and health, and are crucial in the initiation of treatment in those patients. In recent years, electronic assessments of PROMs (so called ePROMs) have been introduced. This report summarises some of the rationale, opportunities, and results using ePROMs in patients with spondyloarthritis (SpA).

  5. Are Additional Tests Needed to Rule Out Axial Spondyloarthritis in Patients Ages 16-45 Years With Short-Duration Chronic Back Pain and Maximally One Spondyloarthritis Feature?

    NARCIS (Netherlands)

    Bakker, P. A. C.; Ez-Zaitouni, Z.; van Lunteren, M.; van den Berg, R.; de Hooge, M.; Fagerli, K. M.; Landewé, R.; van Oosterhout, M.; Ramonda, R.; Reijnierse, M.; van der Heijde, D.; van Gaalen, F. A.

    2016-01-01

    To investigate whether HLA-B27 testing and imaging of the sacroiliac joints are needed in patients with ≤1 spondyloarthritis (SpA) feature, referred to a secondary care setting, after medical history collection, clinical examination, and measurement of acute phase reactants. Baseline data from

  6. Candidate lesion-based criteria for defining a positive sacroiliac joint MRI in two cohorts of patients with axial spondyloarthritis

    DEFF Research Database (Denmark)

    Weber, Ulrich; Østergaard, Mikkel; Lambert, Robert G W

    2015-01-01

    OBJECTIVE: To determine candidate lesion-based criteria for a positive sacroiliac joint (SIJ) MRI based on bone marrow oedema (BMO) and/or erosion in non-radiographic axial spondyloarthritis (nr-axSpA); to compare the performance of lesion-based criteria with global evaluation by expert readers....... METHODS: Two independent cohorts A/B of 69/88 consecutive patients with back pain aged ≤50 years, with median symptom duration 1.3/10.0 years, were referred for suspected SpA (A) or acute anterior uveitis plus back pain (B). Patients were classified according to rheumatologist expert opinion based...... on clinical examination, pelvic radiography and laboratory values as having nr-axSpA (n=51), ankylosing spondylitis (n=34) or non-specific back pain (n=72). Four blinded readers assessed SIJ MRI, recording the presence/absence of SpA by concomitant global evaluation of T1-weighted spin echo (T1SE) and short τ...

  7. Does evaluation of the ligamentous compartment enhance diagnostic utility of sacroiliac joint MRI in axial spondyloarthritis?

    DEFF Research Database (Denmark)

    Weber, Ulrich; Maksymowych, Walter P; Chan, Stanley M

    2015-01-01

    in the ligamentous compartment and their potential diagnostic utility in axial SpA. We therefore aimed to evaluate the ligamentous compartment on sacroiliac joint MRI for lesion distribution and potential incremental value towards diagnosis of SpA over and above the traditional assessment of the cartilaginous...... compartment alone. METHODS: Two independent cohorts of 69 and 88 consecutive back pain patients ≤50 years were referred for suspected SpA (cohort A) or acute anterior uveitis plus back pain (cohort B). Patients were classified according to rheumatologist expert opinion based on clinical, radiographic...... and laboratory examination as having nonradiographic axial SpA (nr-axSpA; n = 51), ankylosing spondylitis (n = 34), or nonspecific back pain (NSBP; n = 72). Five blinded readers assessed SIJ MRI globally for presence/absence of SpA. Bone marrow edema (BME) and fat metaplasia were recorded in the cartilaginous...

  8. Factors Associated With Initiation of Biologics in Patients With Axial Spondyloarthritis in an Urban Asian City: A PRESPOND Study.

    Science.gov (United States)

    Png, Wan Yu; Kwan, Yu Heng; Lee, Yi Xuan; Lim, Ka Keat; Chew, Eng Hui; Lui, Nai Lee; Tan, Chuen Seng; Thumboo, Julian; Østbye, Truls; Fong, Warren

    2018-04-05

    The aim of this study was to examine if patients' sociodemographic, clinical characteristics, and patient-reported outcomes were associated with biologics initiation in patients with axial spondyloarthritis in Singapore. Data from a dedicated registry from a tertiary referral center in Singapore from January 2011 to July 2016 were used. Initiation of first biologics was the main outcome of interest. Logistic regression analyses were used to explore the association of various factors on biologics initiation. Of 189 eligible patients (aged 37.7 ± 13.3 years; 76.2% were males), 30 (15.9 %) were started on biologics during follow-up. In the multivariable analysis model, age (odds ratio [OR]; 0.93; 95% confidence interval [CI], 0.89-0.98; P < 0.01), mental component summary score of Short-Form 36 Health Survey (OR, 0.18; 95% CI, 0.03-0.89; P = 0.04), erythrocyte sedimentation rate (OR, 1.02; 95% CI, 1.00-1.04; P = 0.02), presence of peptic ulcer disease (OR, 10.4; 95% CI, 2.21-48.8; P < 0.01), and lack of good response to nonsteroidal anti-inflammatory drugs (OR, 4.44; 95% CI, 1.63-12.1; P < 0.01) were found to be associated with biologics initiation. Age, erythrocyte sedimentation rate, mental component summary score, comorbidities of peptic ulcer disease, and responsiveness to nonsteroidal anti-inflammatory drugs were associated with biologics initiation. It is essential that clinicians recognize these factors in order to optimize therapy.

  9. Adherence to recommendations for the use of anti-tumour necrosis factor and its impact over 5 years of follow-up in axial spondyloarthritis.

    Science.gov (United States)

    López-Medina, Clementina; Dougados, Maxime; Collantes-Estévez, Eduardo; Moltó, Anna

    2018-02-20

    To describe adherence to recommendations for TNFα blocker (TNFb) initiation and continuation in early axial Spondyloarthropathy (axSpA); and to evaluate the impact of adherence to these recommendations over 5 years of follow-up in the DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR) cohort. The first 5 years of follow-up of the DESIR early axSpA cohort were analysed. We evaluated adherence to Assessment of SpondyloArthritis International Society (ASAS) 2003/2006, 2016 and European Medicines Agency recommendations in axSpA patients for: TNFb initiation (patients were adherent if they either commenced TNFb therapy when they met the conditions for initiation or if they did not commence TNFb therapy when conditions were not met) and; TNFb continuation (either when they continued TNFb therapy when conditions to continue were met or when they discontinued when conditions were not met). The impact of adherence to these recommendations on functional disability, quality of life and sick-leave days over 5 years was explored. A total of 708 patients were analysed: 440 (62.15%), 389 (54.94%) and 335 (47.32%) were considered adherent to ASAS 2003/2006, 2016 and European Medicines Agency recommendations for TNFb initiation, respectively. Adherence to 2003/2006 and 2016 recommendations for TNFb continuation was observed in 47.37 and 49.39% of patients, respectively. According to over 5 years of follow-up, better outcomes (lower BASFI, higher SF-36 and fewer days of sick leave) were found in patients adhering to recommendations for TNFb commencement and continuation. Less than 50% of patients were treated in agreement with recommendations for TNFb initiation and continuation. Nevertheless, adherence to such recommendations leads to better functional outcomes and fewer days of sick leave, according to long-term follow-up.

  10. Enthesitis in patients with psoriatic arthritis, axial spondyloarthritis and healthy subjects assessed by ‘head-to-toe’ whole-body MRI and clinical examination

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Eshed, Iris; Østergaard, Mikkel

    2015-01-01

    OBJECTIVES: To investigate the ability of whole-body MRI (WBMRI) to detect axial and peripheral enthesitis in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), and in healthy subjects (HS). Furthermore, to develop MRI enthesitis indices based on WBMRI and validate...... these by use of clinical measures of disease activity. METHODS: Prospective cross-sectional study of patients with PsA (n=18) and axSpA (n=18) with moderate to high disease activity, and HS (n=12). Enthesitis at 35 individual sites located at upper and lower limbs, chest and pelvis were evaluated by WBMRI...... and clinical examination, and compared. Three new WBMRI enthesitis indices were developed. RESULTS: WBMRI allowed evaluation of 888 (53%) of 1680 sites investigated, and 19 (54%) of 35 entheses had a readability >70%. The percentage agreement between WBMRI and clinical enthesitis was 49-100%, when compared...

  11. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1

    OpenAIRE

    Sieper, J; Lenaerts, J; Wollenhaupt, J; Rudwaleit, M; Mazurov, V I; Myasoutova, L; Park, S; Song, Y; Yao, R; Chitkara, D; Vastesaeger, N

    2013-01-01

    Objectives To assess whether combination therapy with infliximab (IFX) plus nonsteroidal anti-inflammatory drugs (NSAIDs) is superior to NSAID monotherapy for reaching Assessment of SpondyloArthritis international Society (ASAS) partial remission in patients with early, active axial spondyloarthritis (SpA) who were naïve to NSAIDs or received a submaximal dose of NSAIDs. Methods Patients were randomised (2 : 1 ratio) to receive naproxen (NPX) 1000 mg daily plus either IFX 5 mg/kg or placebo (...

  12. Persistence with golimumab in immune-mediated rheumatic diseases: a systematic review of real-world evidence in rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Svedbom A

    2017-04-01

    estimates of OLE trials.Conclusion: The data reviewed in this study indicate that golimumab may have higher persistence than other TNFis, a notion that is supported by indirect comparisons of persistence data from OLEs of randomized controlled trials (RCTs. Furthermore, the study suggests that persistence may be lower in biologic-experienced compared with biologic-naive patients and higher in axial spondyloarthritis compared with rheumatoid arthritis and psoriatic arthritis. Keywords: golimumab, Simponi, Treatment persistence, drug survival, retention rates, real-world evidence (RWE

  13. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group

    DEFF Research Database (Denmark)

    Rudwaleit, M; Jurik, A G; Hermann, K-G A

    2009-01-01

    and to reach consensus on which MRI findings are essential for the definition of sacroiliitis. METHODS: Ten doctors (two radiologists and eight rheumatologists) from the ASAS/OMERACT MRI working group reviewed and discussed in three workshops MR images depicting sacroiliitis associated with SpA and other......BACKGROUND: Magnetic resonance imaging (MRI) of sacroiliac joints has evolved as the most relevant imaging modality for diagnosis and classification of early axial spondyloarthritis (SpA) including early ankylosing spondylitis. OBJECTIVES: To identify and describe MRI findings in sacroiliitis...... conditions which may mimic SpA. Descriptions of the pathological findings and technical requirements for the appropriate acquisition were formulated. In a consensual approach MRI findings considered to be essential for sacroiliitis were defined. RESULTS: Active inflammatory lesions such as bone marrow oedema...

  14. Discriminant validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis: a cohort study.

    Science.gov (United States)

    Kilic, Erkan; Kilic, Gamze; Akgul, Ozgur; Ozgocmen, Salih

    2015-06-01

    The aim of this study was to assess discriminant validity of Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) and to compare with The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) as clinical tools for the measurement of disease activity in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). Also, the cut-off values for ASDAS-CRP in nr-axSpA and AS is revisited. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and were assessed for disease activity, quality of life and functional measures. The discriminatory ability of ASDAS-CRP and ASDAS-ESR was assessed using standardized mean differences and receiver operating characteristic (ROC) curves analysis. Optimal cut-off values for disease activity scores were calculated. Two hundred and eighty-seven patients with axSpA (nr-axSpA:132, AS:155) were included in this study. Two ASDAS versions and BASDAI had good correlations with patient's and physician's global assessment in both groups. Discriminatory ability of ASDAS-CRP, ASDAS-ESR and BASDAI were similar in patients with nr-axSpA and AS when the patients were assigned into low and high disease activity according to the ASAS partial remission, patient's and physician's global assessment scores (based on the comparison of ROC curves). ASDAS cut-off values are quite similar between groups indicating that ASDAS-CRP works similarly well in nr-axSpA and AS. The performance of ASDAS to discriminate low and high disease activity and cut-off values are quite similar in patients with AS and non-radiographic axial SpA.

  15. Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy: a population-based regional cohort study from southern Sweden.

    Science.gov (United States)

    Wallman, Johan K; Jöud, Anna; Olofsson, Tor; Jacobsson, Lennart T H; Bliddal, Henning; Kristensen, Lars E

    2017-05-01

    The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA). Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends. The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean work-loss days (including both sick leave and disability pension) in the nr-axSpA group decreased significantly from 3.4 to 1.9 times more than among the population references. The effect was seen on sick leave, whereas disability pension levels remained similar in both groups throughout. Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. However, the proportion of work-loss days remained almost twice as high as in the general population at the end of follow-up. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  16. Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi.

    Science.gov (United States)

    Malaviya, Anand N; Kalyani, Alok; Rawat, Roopa; Gogia, Shashi Bhushan

    2015-09-01

    Comparison of ankylosing spondylitis (AS) with non-radiographic axial spondyloarthritis (nr-axSpA) classified with the recent ASsessment of spondyloArthritis International Society (ASAS) criteria. This study included 288 patients clinically diagnosed as having spondyloarthritis (SpA) where a satisfactory radiograph of sacroiliac (S-I) joints was available. The AS and the nr-axSpA groups were compared for the various SpA-related variables. Of 288 axSpA patients, there were 187 with AS. Of the remaining 101 patients without radiographic sacroiliitis, S-I joint magnetic resonance imaging (MRI) was available in 72; 54 of them showed active sacroiliitis thus classified as nr-axSpA according to the ASAS criteria. The remaining 18 patients with normal MRI and the other 29 patients without MRI of the S-I joints (total 47 patients), were classified as nr-axSpA using the 'clinical arm' of the ASAS criteria. On comparing the 187 AS with 101 patients in the nr-axSpA group, the AS group showed significantly more males, longer disease duration, more axial symptoms at disease onset, higher Bath Ankylosing Spondylitis Metrology Index and more syndesmophytes. Biologicals were offered significantly more often to the AS group but methotrexate as monotherapy or in combination with other disease-modifying anti-rheumatic drugs was offered more often in nr-axSpA group. There was no statistically significant difference between AS and nr-axSpA in other SpA parameters. The differences brought out between AS and nr-axSpA groups show that they may not be the same disease. A prospective long-term follow-up of large cohorts may help in clarifying if nr-axSpA is simply an early stage in the spectrum of SpA evolving into AS over time or is there inherent difference between them. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  17. The yield of a positive MRI of the spine as imaging criterion in the ASAS classification criteria for axial spondyloarthritis: results from the SPACE and DESIR cohorts.

    Science.gov (United States)

    Ez-Zaitouni, Zineb; Bakker, Pauline Ac; van Lunteren, Miranda; de Hooge, Manouk; van den Berg, Rosaline; Reijnierse, Monique; Fagerli, Karen Minde; Landewé, Robert Bm; Ramonda, Roberta; Jacobsson, Lennart Th; Saraux, Alain; Lenczner, Gregory; Feydy, Antoine; Pialat, Jean Baptiste; Thévenin, Fabrice; van Gaalen, Floris A; van der Heijde, Désirée

    2017-10-01

    To assess the prevalence of spinal inflammation on MRI in patients with chronic back pain (CBP) of maximally 3 years duration and to evaluate the yield of adding a positive MRI-spine as imaging criterion to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA). Baseline imaging of the sacroiliac joints (X-SI), MRI of the sacroiliac joints (MRI-SI) and MRI-spine were scored by ≥2 experienced central readers per modality in the SPondyloArthritis Caught Early (SPACE) and DEvenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohorts. Inflammation suggestive of axSpA was assessed in the entire spine. A positive MRI-spine was defined by the presence of ≥5 inflammatory lesions. Alternative less strict definitions were also tested. In this study, 541 and 650 patients with CBP from the SPACE and DESIR cohorts were included. Sacroiliitis on X-SI and MRI-SI was found in 40/541 (7%) and 76/541 (14%) patients in SPACE, and in DESIR in 134/650 (21%) and 231/650 (36%) patients, respectively. In SPACE and DESIR, a positive MRI-spine was seen in 4/541 (1%) and 48/650 (7%) patients. Of the patients without sacroiliitis on imaging, 3/447 (1%) (SPACE) and 8/382 (2%) (DESIR) patients had a positive MRI-spine. Adding positive MRI-spine as imaging criterion led to new classification in only one patient in each cohort, as the other patients already fulfilled the clinical arm. Other definitions of a positive MRI-spine yielded similar results. In two cohorts of patients with CBP with a maximum symptom duration of 3 years, a positive MRI-spine was rare in patients without sacroiliitis on MRI-SI and X-SI. Addition of MRI-spine as imaging criterion to the ASAS axSpA criteria had a low yield of newly classified patients and is therefore not recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

  18. Disease activity is longitudinally related to sacroiliac inflammation on MRI in male patients with axial spondyloarthritis: 2-years of the DESIR cohort.

    Science.gov (United States)

    Navarro-Compán, Victoria; Ramiro, Sofia; Landewé, Robert; Dougados, Maxime; Miceli-Richard, Corinne; Richette, Pascal; van der Heijde, Désirée

    2016-05-01

    To investigate the longitudinal relationship between inflammatory lesions in sacroiliac joints on MRI (MRI-SI) and clinical disease activity measures (DA) in patients with axial spondyloarthritis (axSpA). Two-year follow-up data from 167 patients (50% males, mean (SD) age 33 (9) years) fulfilling the Assessment of SpondyloArthritis international Society axSpA criteria in the DEvenir des Spondylarthopathies Indifférenciées Récentes cohort with MRI-SI at baseline, 1 year and 2 years were analysed. The relationship between MRI-SI (as dependent variable) and DA (Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patient's global DA, night pain, C reactive protein and erythrocyte sedimentation rate, as independent variables) was investigated using two types of generalised estimating equations (GEE) models: model of absolute scores and model of change scores. In the model of absolute scores, the relationship between DA and MRI-SI was different for males and females: in males, but not in females, a statistically significant relationship with MRI-SI was found for all DA except BASDAI. In the model of changes, only ASDAS (beta (95% CI): 2.79 (0.85 to 4.73) and pain at night (0.97 (0.04 to 1.90)) were significantly associated in males while again in females no significant relationship was found. ASDAS fitted the data best. In male patients, but not in female patients, with axSpA, clinical DA, especially if measured by ASDAS, is longitudinally associated with MRI-SI inflammatory lesions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Responsiveness of a simple RAPID-3-like index compared to disease-specific BASDAI and ASDAS indices in patients with axial spondyloarthritis.

    Science.gov (United States)

    Castrejón, Isabel; Pincus, Theodore; Wendling, Daniel; Dougados, Maxime

    2016-01-01

    To evaluate the responsiveness of a simple routine assessment of patient index data (RAPID3)-like index that includes only 3 patient self-report measures (physical function, pain and patient global estimate) compared to that of traditional composite indices to assess change in patients with axial spondyloarthritis (Ax-SpA). Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) is a prospective cohort of patients with inflammatory back pain suggestive of Ax-SpA. The study included 461 patients, who met the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for Ax-SpA. A simple RAPID3-like index was compared with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the AS Disease Activity Score (ASDAS) scores for responsiveness over 6 months. Construct validity was also evaluated through Pearson correlations and discrimination of disease activity through standardised mean differences for the 3 indices. The RAPID3-like index was correlated significantly with BASDAI (r=0.84, p<0.005) and ASDAS-C-reactive protein (CRP) (r=0.74, p<0.005), similar to correlations of BASDAI with ASDAS-CRP (r=0.76, p<0.005). The percentage of patients with inactive disease ranged from 9% to 25% and with high activity from 10% to 45%, according to various measures. The capacity to discriminate between high and low disease activity was similar for the 3 indices. The strength of agreement of RAPID3 with ASDAS-CRP was moderate (0.44) and lower with BASDAI (0.37). Responsiveness over 6 months was slightly higher for ASDAS-CRP and the RAPID3-like index than that for BASDAI. The RAPID3-like index provides similar information to BASDAI and ASDAS-CRP concerning responsiveness over 6 months. RAPID3 appears feasible to assess patients with Ax-SpA quantitatively over time in busy clinical settings.

  20. Assessment of MRI abnormalities of the sacroiliac joints and their ability to predict axial spondyloarthritis: a retrospective pilot study on 110 patients

    Energy Technology Data Exchange (ETDEWEB)

    Larbi, Ahmed; Viala, Pierre; Baron, Marie Pierre; Taourel, Patrice; Cyteval, Catherine [Hopital Lapeyronie, Medical Imaging Department, Montpellier Cedex 5 (France); Molinari, Nicolas [Hopital Lapeyronie, Medical Data Processing Department, Montpellier Cedex 5 (France); Lukas, Cedric [Hopital Lapeyronie, Rheumatology Department, Montpellier Cedex 5 (France)

    2014-03-15

    To assess sacroiliac joint (SIJ) modifications on MRI and their ability to predict axial spondyloarthritis (SpA) with the purpose of identifying parameters for future prospective studies. Retrospective study was carried out of 110 consecutive patients referred for SIJ MRI with coronal, axial short TI inversion recovery (STIR), and axial T1 sequences over 6 months. Factors associated with SpA, including MRI SIJ modifications (fat deposition, structural abnormalities on T1-weighted images, and bone marrow edema [BME] on STIR sequences) and age were explored using multivariate logistic regression. The reference diagnosis was made 1-1.5 years later based on clinical, radiological, and biological findings, according to Assessment of SpondyloArthritis International Society (ASAS) criteria. Twenty-eight patients were diagnosed with SpA (female/male: 19/9, age 41 ± 13 years). Abnormal findings were found in up to 21 % of patients without SpA (including 11 % with BME), versus 64 % of SpA patients (50 % with BME). A threshold age of 42.6 years was found to discriminate SpA patients (ROC AUC: 0.71, 95 % CI: 0.59-0.81). BME location in the sacral (OR: 7.07 [1.05, 47.6], p = 0.044) and both sacral and iliac areas (OR: 36.0 [5.61, 231], p = 0.0002), as well as age (OR: 0.95 [0.92, 0.98], p = 0.0019) were found to be independent predictors of SpA. 83.6 % of patients were effectively diagnosed using BME location and patient age in a classification and regression tree (CART) algorithm (sensitivity: 61 %, specificity: 91 %, PPV: 71 %, NPV: 87 %). The BME location combined with the patient's age (threshold 42.6 years) could help predict SpA. Further studies are required before these features can be used by radiologists to boost their confidence in reporting SIJ MRI. (orig.)

  1. High disease activity according to the Ankylosing Spondylitis Disease Activity Score is associated with accelerated radiographic spinal progression in patients with early axial spondyloarthritis: results from the GErman SPondyloarthritis Inception Cohort.

    Science.gov (United States)

    Poddubnyy, Denis; Protopopov, Mikhail; Haibel, Hildrun; Braun, Jürgen; Rudwaleit, Martin; Sieper, Joachim

    2016-12-01

    The aim of this work was to investigate the association between disease activity measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS) and radiographic spinal progression in patients with early axial spondyloarthritis (axSpA). Altogether, 178 patients with definite axSpA (100 with ankylosing spondylitis and 78 with non-radiographic axSpA) were included. Spinal radiographs (baseline and year 2) were assessed according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and for the presence of syndesmophytes. Clinical and lab data were collected at baseline and every 6 months thereafter. Time-averaged (over 2 years) values of the C-reactive protein based ASDAS were calculated. There was a clear positive association between disease activity according to ASDAS and radiographic spinal progression. In the logistic regression analysis, mSASSS progression by ≥2 points over 2 years was significantly associated with the time-averaged ASDAS: unadjusted OR=1.64 (95% CI 1.03 to 2.62), adjusted (for presence of syndesmophytes at baseline, smoking status and intake of non-steroidal anti-inflammatory drugs) OR=1.80 (95% CI 1.04 to 3.13). Syndesmophyte formation/progression demonstrated an even stronger association with the time-averaged ASDAS: unadjusted OR=2.62 (95% CI 1.46 to 4.68), adjusted OR=2.45 (95% CI 1.26 to 4.77). Persisting high disease activity according to the ASDAS is associated with accelerated radiographic spinal progression in early axSpA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set

    DEFF Research Database (Denmark)

    Kiltz, U; van der Heijde, D; Boonen, A

    2016-01-01

    INTRODUCTION: The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English vers...

  3. Is the current ASAS expert definition of a positive family history useful in identifying axial spondyloarthritis? Results from the SPACE and DESIR cohorts

    NARCIS (Netherlands)

    Ez-Zaitouni, Zineb; Hilkens, Andrea; Gossec, Laure; Berg, Inger Jorid; Landewe, Robert; Ramonda, Roberta; Dougados, Maxime; van der Heijde, Desiree; van Gaalen, Floris

    2017-01-01

    Background: The Assessment of SpondyloArthritis international Society (ASAS) definition of a positive family history (PFH) of spondyloarthritis (SpA) includes the following diseases in first-or second-degree relatives: ankylosing spondylitis (AS), acute anterior uveitis (AAU), reactive arthritis

  4. Evaluation of the impact of concomitant fibromyalgia on TNF alpha blockers' effectiveness in axial spondyloarthritis: results of a prospective, multicentre study.

    Science.gov (United States)

    Moltó, Anna; Etcheto, Adrien; Gossec, Laure; Boudersa, Nadia; Claudepierre, Pascal; Roux, Nicolas; Lemeunier, Lucie; Martin, Antoine; Sparsa, Lartitia; Coquerelle, Pascal; Soubrier, Martin; Perrot, Serge; Dougados, Maxime

    2018-04-01

    To describe the prevalence of fibromyalgia (FM) in an axial spondyloarthritis (axSpA) population and to confirm that concomitant FM had a negative impact on tumour necrosis factor blockers' (TNFb) response. Prospective observational study with two visits 3 months apart. Adult patients with AxSpa initiating a TNFb. FM was defined by the Fibromyalgia Rapid Screening Tool (FiRST) at baseline and also by a sustained positive FiRST (both visits) and by a fulfilment of the 1990 American College of Rheumatology criteria for FM. Prevalence of FM; evaluation of the impact of a concomitant FM on TNFb response (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) as primary endpoint), adjusted by factors known to have an impact on TNFb response. Among the 508 patients included in the main analysis, 192 (37.8%) were screened at baseline as FM. Percentage of success after 12 weeks of treatment was lower in the FM group for most of the effectiveness endpoints (eg, BASDAI 50: 45.3% vs 54.1% in the FM/not FM groups according to the FiRST), except for the C reactive protein change endpoints which were not different across groups. This study confirms that FM coexists in patients with axSpA and that its presence seems to have a negative impact on TNFb response, which seems more related to the self-reported instruments used in its evaluation, rather than a different treatment effect of the molecule in this subgroup of patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Comparison of non-radiographic axial spondyloarthritis and ankylosing spondylitis patients - baseline characteristics, treatment adherence, and development of clinical variables during three years of anti-TNF therapy in clinical practice

    DEFF Research Database (Denmark)

    Wallman, Johan K; Kapetanovic, Meliha C; Petersson, Ingemar F

    2015-01-01

    BACKGROUND: The relationship between non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) is currently debated. Using observational data from the South Swedish Arthritis Treatment Group register, we thus aimed to compare clinical development and treatment adherence ...... of constantly lower CRP levels in the nr-axSpA group, three years anti-TNF therapy resulted in similar clinical outcomes and treatment adherence in nr-axSpA and AS patients, thus strengthening the hypothesis that these diagnoses represent different aspects/phases of the same disease....

  6. Optimizing the MRI protocol of the sacroiliac joints in Spondyloarthritis: which para-axial sequence should be used?

    Energy Technology Data Exchange (ETDEWEB)

    Giraudo, Chiara; Weber, Michael; Platzgummer, Hannes; Kainberger, Franz; Schueller-Weidekamm, Claudia [Medical University of Vienna, Vienna General Hospital, Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging und Image-guided Therapy, Vienna (Austria); Magnaldi, Silvia [Fondazione Poliambulanza Istituto Ospedaliero, Dipartimento di Radiologia e Diagnostica per Immagini, Brescia (Italy); Puchner, Antonia [Medical University of Vienna, Vienna General Hospital, Division of Rheumatology, Department of Internal Medicine III, Vienna (Austria)

    2016-01-15

    To assess the diagnostic value of para-axial T2w-TSE (paT2) and fat-suppressed proton density (paPD-FS) MRI sequences for the evaluation of the sacroiliac joint (SIJ) of patients with axial Spondylarthritis (SpA). One hundred and six patients with clinical findings suggestive of SpA underwent an MR protocol of the SIJ with additional paPD-FS (41 patients) and paT2 (105 patients). Acute (bone marrow oedema [BME], enthesitis, capsulitis, synovitis) and chronic findings (erosions, ankylosis) were assessed by paPD-FS and compared with the gold standard post-contrast sequences, whereas chronic features (because of the lack of fat suppression) were evaluated on paT2 and compared with pcT1. paPD-FS demonstrated high sensitivity (98.9 %) and specificity (99.1 %) for BME; sensitivity and specificity for synovitis and enthesitis were 100 %; 85.7 % and 100 %, respectively, for capsulitis. paPD-FS and paT2 showed 100 % sensitivity and specificity for ankylosis; for erosions, paT2 demonstrated 85.3 % sensitivity and 100 % specificity, whereas paPD-FS, respectively, 98 % and 100 %. PaT2 and paPD-FS provided precious information enabling an accurate interpretation of the heterogeneous findings of SpA. paPD-FS showed good results in detecting acute and chronic lesions and its inclusion in a routine MR examination of the SIJ could increase the diagnostic performance of a pre-contrast protocol. (orig.)

  7. Relationship between optimism and quality of life in patients with two chronic rheumatic diseases: axial spondyloarthritis and chronic low back pain: a cross sectional study of 288 patients.

    Science.gov (United States)

    Kreis, Sarah; Molto, Anna; Bailly, Florian; Dadoun, Sabrina; Fabre, Stéphanie; Rein, Christopher; Hudry, Christophe; Zenasni, Franck; Rozenberg, Sylvie; Pertuiset, Edouard; Fautrel, Bruno; Gossec, Laure

    2015-06-10

    Axial Spondyloarthritis (AxSpA) and chronic low back pain are rheumatic diseases that impact patients' health-related quality of life (HRQoL). In other chronic conditions, HRQoL was positively associated with dispositional optimism, a personality trait. The objective was to explore the relationship between optimism and HRQoL in these two diseases. A cross-sectional study was performed in 2 tertiary care hospitals and 2 private practices in France. Patients had definite AxSpA or chronic low back pain according to the rheumatologist. A generic HRQoL questionnaire (Short Form, SF-12) with physical and mental composite scores (PCS and MCS respectively) and an optimism questionnaire (the Life Orientation Test-revised, LOT-R) were collected. Analyses included non-parametric correlations and multiple regression analyses to study the effect of optimism on PCS and MCS. In all, 288 (199 AxSpA and 89 low back pain) patients were included: mean age, 47.3 ± 11.9 years, 48.6 % were males. Pain levels (0-10) were 4.5 ± 2.4 and 4.3 ± 2.4 in AxSpA and LOW BACK PAIN patients, respectively. HRQoL was similarly altered in both diseases, for both physical and mental composite scores (mean PCS: 43.7 ± 8.2 vs. 41.9 ± 7.1; mean 45.9 ± 7.8 vs. 46.7 ± 8.1 for AxSpA and low back pain respectively). Optimism was moderate and similar in both populations. Optimism was positively correlated to MCS in both diseases (rho = 0.54 and 0.58, respectively, both p Optimism was similar in these 2 chronic diseases and was an explanatory factor of the mental component of HRQoL, but not physical HRQoL. Physical HRQoL may reflect more the disease process than character traits.

  8. Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population.

    Science.gov (United States)

    Lee, Yi Xuan; Kwan, Yu Heng; Png, Wan Yu; Lim, Ka Keat; Tan, Chuen Seng; Lui, Nai Lee; Chew, Eng Hui; Thumboo, Julian; Østbye, Truls; Fong, Warren

    2017-10-01

    To determine if obesity is associated with poorer patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA), we conducted a cross-sectional study using data of the PRESPOND registry from a tertiary referral center in Singapore between 2011 and 2015. Demographics, clinical, and PRO variables were collected. Patients were divided into three categories: normal (BMI < 23 kg/m 2 ), overweight (23 kg/m 2  ≤ BMI < 27.5 kg/m 2 ) and obese (BMI ≥ 27.5 kg/m 2 ), using Asian BMI classification. The dependent variables are Pain score, Bath Ankylosing Spondylitis Patient Global Score (BAS-G), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Health Assessment Questionnaire (HAQ), and Medical Outcomes Study Short Form 36 version 2 (SF-36). Multivariate regression analyses were performed with these dependent variables and obesity categories, adjusting for confounders. Among 194 patients with axSpA, 32% are overweight while 22% are obese. We found that obese patients had significant poorer pain (β: 11.87, 95%CI 2.13, 21.60) and BAS-G scores (β: 10.18, 95%CI 1.59, 18.76) when compared to normal BMI patients. However, obesity was not associated with BASDAI (β 0.50, 95%CI -0.22, 1.22), BASFI (β 0.08, 95%CI -0.66, 0.81), HAQ (β -0.07, 95%CI -0.21, 0.06), physical component summary (β -0.02, 95%CI -4.47, 4.44), and mental component summary (β -2.85, 95%CI -7.57, 1.88) of SF-36. Obesity was associated with pain score and BAS-G but not with BASDAI, BASFI, HAQ, and SF-36. Further study is needed to examine the causal relationship between obesity and poorer PROs.

  9. Autoantibodies to Osteoprotegerin are Associated with Low Hip Bone Mineral Density and History of Fractures in Axial Spondyloarthritis: A Cross-Sectional Observational Study.

    Science.gov (United States)

    Hauser, Barbara; Zhao, Sizheng; Visconti, Micaela R; Riches, Philip L; Fraser, William D; Piec, Isabelle; Goodson, Nicola J; Ralston, Stuart H

    2017-10-01

    Osteoporosis is a recognised complication of axial spondyloarthritis (axSpA) and is thought to be due to functional impairment and the osteoclast-activating effects of proinflammatory cytokines. The development of autoantibodies to OPG (OPG-Ab) has been associated with severe osteoporosis and increased bone resorption in rheumatoid arthritis. In this study, we screened for the presence of OPG-Ab in axSpA and reviewed their clinical significance. We studied 134 patients, recruited from two centres in the United Kingdom. Their mean age was 47.5 years and 75% were male. Concentrations of OPG-Ab were related to bone mineral density (BMD) and fracture history using linear and logistic regression models adjusting for age, gender, disease duration and activity, body mass index and bisphosphonate use. We detected OPG-Ab in 11/134 patients (8.2%). Femoral neck and total hip BMD were significantly reduced in OPG-Ab positive patients (0.827 vs. 0.967 g/cm 2 , p = 0.008 and 0.868 vs. 1.028 g/cm 2 , p = 0.002, respectively). Regression analysis showed that the presence of OPG-Ab was independently associated with total hip osteopenia (OR adj 24.2; 95% CI 2.57, 228) and history of fractures (OR adj 10.5; 95% CI 2.07, 53.3). OPG-Ab concentration was associated with total hip BMD in g/cm 2 (ß = -1.15; 95% CI -0.25, -0.04). There were no associations between OPG-Ab concentration and bone turnover markers, but free sRANKL concentrations were lower in OPG-Ab-positive patients (median 0.04 vs. 0.11 pmol/L, p = 0.050). We conclude that OPG-Ab are associated with hip BMD and fractures in axSpA suggesting that they may contribute to the pathogenesis of bone loss in some patients with this condition.

  10. The yield of a positive MRI of the spine as imaging criterion in the ASAS classification criteria for axial spondyloarthritis: results from the SPACE and DESIR cohorts

    NARCIS (Netherlands)

    Ez-Zaitouni, Zineb; Bakker, Pauline A. C.; van Lunteren, Miranda; de Hooge, Manouk; van den Berg, Rosaline; Reijnierse, Monique; Fagerli, Karen Minde; Landewé, Robert B. M.; Ramonda, Roberta; Jacobsson, Lennart T. H.; Saraux, Alain; Lenczner, Gregory; Feydy, Antoine; Pialat, Jean Baptiste; Thévenin, Fabrice; van Gaalen, Floris A.; van der Heijde, Désirée

    2017-01-01

    To assess the prevalence of spinal inflammation on MRI in patients with chronic back pain (CBP) of maximally 3 years duration and to evaluate the yield of adding a positive MRI-spine as imaging criterion to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for

  11. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1.

    Science.gov (United States)

    Sieper, J; Lenaerts, J; Wollenhaupt, J; Rudwaleit, M; Mazurov, V I; Myasoutova, L; Park, S; Song, Y; Yao, R; Chitkara, D; Vastesaeger, N

    2014-01-01

    To assess whether combination therapy with infliximab (IFX) plus nonsteroidal anti-inflammatory drugs (NSAIDs) is superior to NSAID monotherapy for reaching Assessment of SpondyloArthritis international Society (ASAS) partial remission in patients with early, active axial spondyloarthritis (SpA) who were naïve to NSAIDs or received a submaximal dose of NSAIDs. Patients were randomised (2 : 1 ratio) to receive naproxen (NPX) 1000 mg daily plus either IFX 5 mg/kg or placebo (PBO) at weeks 0, 2, 6, 12, 18 and 24. The primary efficacy measure was the percentage of patients who met ASAS partial remission criteria at week 28. Several other measures of disease activity, clinical symptoms and patient-rated outcomes were evaluated. Treatment group differences were analysed with Fisher exact tests or analysis of covariance. A greater percentage of patients achieved ASAS partial remission in the IFX+NPX group (61.9%; 65/105) than in the PBO+NPX group (35.3%; 18/51) at week 28 (p=0.002) and at all other visits (p<0.05, all comparisons). Results of most other disease activity and patient-reported endpoints (including Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, multiple quality of life measures and pain measures) showed greater improvement in the IFX+NPX group than the PBO+NPX group, with several measures demonstrating early and consistent improvement over 28 weeks of treatment. Patients with early, active axial SpA who received IFX+NPX combination treatment were twice as likely to achieve clinical remission as patients who received NPX alone. NPX alone led to clinical remission in a third of patients.

  12. Tumor necrosis factor inhibitor therapy but not standard therapy is associated with resolution of erosion in the sacroiliac joints of patients with axial spondyloarthritis

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Wichuk, Stephanie; Chiowchanwisawakit, Praveena

    2014-01-01

    INTRODUCTION: Radiography is an unreliable and insensitive tool for the assessment of structural lesions in the sacroiliac joints (SIJ). Magnetic resonance imaging (MRI) detects a wider spectrum of structural lesions but has undergone minimal validation in prospective studies. The Spondyloarthritis...... Research Consortium of Canada (SPARCC) MRI Sacroiliac Joint (SIJ) Structural Score (SSS) assesses a spectrum of structural lesions (erosion, fat metaplasia, backfill, ankylosis) and its potential to discriminate between therapies requires evaluation. METHODS: The SSS score assesses five consecutive coronal......). Two readers independently scored 147 pairs (baseline, 2 years) of scans from a prospective cohort of patients with SpA who received either standard (n = 69) or tumor necrosis factor alpha (TNFα) inhibitor (n = 78) therapy. Smallest detectable change (SDC) was calculated using analysis of variance...

  13. Can we use structural lesions seen on MRI of the sacroiliac joints reliably for the classification of patients according to the ASAS axial spondyloarthritis criteria? Data from the DESIR cohort.

    Science.gov (United States)

    Bakker, Pauline A C; van den Berg, Rosaline; Lenczner, Gregory; Thévenin, Fabrice; Reijnierse, Monique; Claudepierre, Pascal; Wendling, Daniel; Dougados, Maxime; van der Heijde, Désirée

    2017-02-01

    Investigating the utility of adding structural lesions seen on MRI of the sacroiliac joints to the imaging criterion of the Assessment of SpondyloArthritis (ASAS) axial SpondyloArthritis (axSpA) criteria and the utility of replacement of radiographic sacroiliitis by structural lesions on MRI. Two well-calibrated readers scored MRI STIR (inflammation, MRI-SI), MRI T1-w images (structural lesions, MRI-SI-s) and radiographs of the sacroiliac joints (X-SI) of patients in the DEvenir des Spondyloarthrites Indifférenciées Récentes cohort (inflammatory back pain: ≥3 months, <3 years, age <50). A third reader adjudicated MRI-SI and X-SI discrepancies. Previously proposed cut-offs for a positive MRI-SI-s were used (based on <5% prevalence among no-SpA patients): erosions (E) ≥3, fatty lesions (FL) ≥3, E/FL ≥5. Patients were classified according to the ASAS axSpA criteria using the various definitions of MRI-SI-s. Of the 582 patients included in this analysis, 418 fulfilled the ASAS axSpA criteria, of which 127 patients were modified New York (mNY) positive and 134 and 75 were MRI-SI-s positive (E/FL≥5) for readers 1 and 2, respectively. Agreement between mNY and MRI-SI-s (E/FL≥5) was moderate (reader 1: κ: 0.39; reader 2: κ: 0.44). Using the E/FL≥5 cut-off instead of mNY classification did not change in 478 (82.1%) and 469 (80.6%) patients for readers 1 and 2, respectively. Twelve (reader 1) or ten (reader 2) patients would not be classified as axSpA if only MRI-SI-s was performed (in the scenario of replacement of mNY), while three (reader 1) or six (reader 2) patients would be additionally classified as axSpA in both scenarios (replacement of mNY and addition of MRI-SI-s). Similar results were seen for the other cut-offs (E≥3, FL≥3). Structural lesions on MRI can be used reliably either as an addition to or as a substitute for radiographs in the ASAS axSpA classification of patients in our cohort of patients with short symptom duration

  14. Efficacy and safety of non-pharmacological and non-biological pharmacological treatment: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

    Science.gov (United States)

    Regel, Andrea; van der Heijde, Désirée; Braun, Jürgen; Landewé, Robert; Van den Bosch, Filip; Falzon, Louise; Ramiro, Sofia

    2017-01-01

    To assess the efficacy and safety of non-biological therapies in patients with axial spondyloarthritis (axSpA) to inform the update of the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of axSpA. A systematic literature review (2009–2016) of all non-pharmacological treatments, non-biological drugs (except targeted synthetic disease-modifying antirheumatic drugs (DMARDs)) and surgical therapies was performed. Randomised controlled trials (RCTs) and clinical controlled trials were assessed for efficacy and safety, while observational studies with a comparator were assessed for safety. All relevant efficacy and safety outcomes were included. Study heterogeneity precluded data pooling. If possible, Cohen's effect size was calculated for non-pharmacological treatments. In total, 45 papers and 2 abstracts were included. Studies on non-pharmacological treatments were very heterogeneous but overall confirmed a benefit for regular exercises, with small improvements in disease activity, function and spinal mobility. New studies on non-steroidal anti-inflammatory drugs (NSAIDs) confirmed their efficacy and new safety signals were not found. NSAIDs used continuously compared with on-demand did not reduce the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) mean change over 2 years in patients with ankylosing spondylitis with normal C reactive protein (CRP; ≤5 mg/L) (1 ‘negative’ RCT (0.9 vs 0.8; p=0.62)), while for patients with high CRP, conflicting results were found (1 ‘positive’ RCT (0.2 vs 1.7; p=0.003), 1 ‘negative’ RCT (1.68 vs 0.96; p=0.28)). No new trials were found for conventional synthetic DMARDs (csDMARDs). Short-term high-dose systemic glucocorticoids showed limited efficacy. Regular exercises may improve several outcomes. Efficacy and safety of NSAIDs in axSpA are confirmed. Glucocorticoids are not proven to be effective in axSpA and new

  15. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study

    Science.gov (United States)

    Landewé, R; Braun, J; Deodhar, A; Dougados, M; Maksymowych, W P; Mease, P J; Reveille, J D; Rudwaleit, M; van der Heijde, D; Stach, C; Hoepken, B; Fichtner, A; Coteur, G; de Longueville, M; Sieper, J

    2014-01-01

    Objectives To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Methods Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear. Results Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p≤0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (−2.28 vs −0.40), BASDAI (−3.05 vs −1.05), and BASMI (−0.52 vs −0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported. Conclusions CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients. PMID:24013647

  16. IgG subclass antibodies to human and bacterial HSP60 are not associated with disease activity and progression over time in axial spondyloarthritis

    DEFF Research Database (Denmark)

    Carlsen, Thomas Gelsing; Hjelholt, Astrid; Jurik, Anne Grethe

    2013-01-01

    in the same serum sample, IgG1 and IgG3, respectively, indicating that there was no cross-reaction. CONCLUSIONS: A significant association was observed between axial SpA and the presence of IgG1/IgG3 antibodies to human HSP60 and of IgG1 to S. enterica Enteritidis and C. trachomatis. Generation of antibodies...... and patient follow-up. In this study, we have focused on these parameters in a cohort of axial SpA patients with a well-established set of clinical characteristics, including MRI changes and human leukocyte antigen B27. METHODS: IgG subclass antibodies (IgG1, IgG2, IgG3 and IgG4) against recombinant HSP60...... of three reactive arthritis-related bacteria; human HSP60; and the microorganisms Chlamydia trachomatis and C. pneumoniae were determined by ELISA. Serum samples collected from 2004 to 2006 and in 2010 and 2011 from 39 axial SpA patients were analyzed and compared with samples from 39 healthy controls...

  17. Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis: Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry.

    Science.gov (United States)

    Glintborg, Bente; Sørensen, Inge J; Østergaard, Mikkel; Dreyer, Lene; Mohamoud, Abdiweli A; Krogh, Niels S; Hendricks, Oliver; Andersen, Lis S; Raun, Johnny L; Kowalski, Marcin R; Danielsen, Laura; Pelck, Randi; Nordin, Henrik; Pedersen, Jens K; Kraus, Dorte G A; Christensen, Susan R; Hansen, Inger M J; Esbesen, Jakob; Schlemmer, Annette; Loft, Anne G; Al Chaer, Nabil; Salomonsen, Lone; Hetland, Merete L

    2017-01-01

    To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders (e.g., HLA-B27 status). Observational cohort study based on prospectively registered data in the nationwide DANBIO registry. We used Kaplan-Meier plots, Cox, and logistic regression analyses to study the effect of diagnosis (nr-axSpA vs AS) and potential confounders (sex/age/start yr/HLA-B27/disease duration/TNFi-type/smoking/baseline disease activity) on TNFi adherence and response [e.g., Bath Ankylosing Spondylitis Activity Index (BASDAI) 50%/20 mm]. The study included 1250 TNFi-naive patients with axSpA (29% nr-axSpA, 50% AS, 21% lacked radiographs of sacroiliac joints). Patients with nr-axSpA were more frequently women (50%/27%) and HLA-B27-negative (85/338 = 25%), compared to AS (81/476 = 17%; p 0.05). Response rates were similar in AS and nr-axSpA (p > 0.05). HLA-B27 negativity was associated with poorer treatment adherence [HLA-B27 negative/positive, nr-axSpA: HR 1.74 (1.29-2.36), AS: HR 2.04 (1.53-2.71), both p < 0.0001]; and lower response rates (nr-axSpA: 18/61 = 30% vs 93/168 = 55%; AS: 17/59 = 29% vs 157/291 = 54%, both p < 0.05). In this nationwide cohort, patients with nr-axSpA had higher subjective disease activity at start of first TNFi treatment, but similar outcomes to patients with AS after confounder adjustment. HLA-B27 positivity was associated with better outcomes irrespective of axSpA subdiagnosis.

  18. Usability of an innovative and interactive electronic system for collection of patient-reported data in axial spondyloarthritis: comparison with the traditional paper-administered format.

    Science.gov (United States)

    Salaffi, Fausto; Gasparini, Stefania; Ciapetti, Alessandro; Gutierrez, Marwin; Grassi, Walter

    2013-11-01

    To evaluate the validity, in terms of the patients' acceptance, preference, feasibility and reliability of an innovative, interactive computerized system for collection of patient-reported outcome (PRO) data on axial SpA against the paper-and-pencil version. Fifty-five patients with axial SpA completed both the touch screen and the paper-and-pencil set of questionnaires. A computerized touch-screen system, SPEAMonitor, was developed to capture PRO data. Variables recorded included demographic data, patient's assessment of general health status, BASDAI, BASFI, BASMI and acute-phase reactant levels. In order to assess the patient's acceptance of, preference for and feasibility of computer-based questionnaires, the participants filled in an additional questionnaire. The time taken to complete both formats was measured. In a further test-retest study, 25 patients were re-evaluated. The agreement between the paper-administered and computer touch-screen format of the BASFI, BASDAI questionnaires and the Ankylosing Spondylitis Disease Activity Scores was excellent. Intraclass correlation coefficients (ICCs) between data ranged from 0.90 to 0.96. Additionally the test-retest study showed a very good agreement between the scores for the two administrations (ICC ≥ 0.90). Age, computer experience and education level had no significant impact on the results. The computerized questionnaires were reported to be easier to use. The mean time spent completing the questionnaires on a touch screen was 5.1 min and on paper 7.9 min. Our newly developed computer-assisted touch-screen questionnaires for PRO in axial SpA were well accepted by patients, with good data quality, reliability and score agreement.

  19. Early tumor necrosis factor α antagonist therapy in everyday practice for inflammatory back pain suggesting axial spondyloarthritis: results from a prospective multicenter french cohort.

    Science.gov (United States)

    Canouï-Poitrine, Florence; Poulain, Cécile; Molto, Anna; Le Thuaut, Aurélie; Lafon, Cécile; Farrenq, Valérie; Ferkal, Salah; Le Corvoisier, Philippe; Ghaleh, Bijan; Bastuji-Garin, Sylvie; Fautrel, B; Dougados, Maxime; Claudepierre, Pascal

    2014-09-01

    To determine the frequency of and factors associated with early tumor necrosis factor α (TNFα) antagonist therapy in everyday clinical practice in patients with suspected axial spondyloarthropathy (SpA). We used data from the prospective observational study in the French Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; Outcome of Recent Undifferentiated Spondylarthropathies) cohort of 708 patients with recent-onset (50 (OR 1.88, 95% CI 1.24-2.87, P = 0.003), current or past disease-modifying antirheumatic drug use (OR 2.09, 95% CI 1.22-3.59, P = 0.008), systemic corticosteroid use (OR 2.48, 95% CI 1.43-4.34, P = 0.002), and mild to severe radiographic hip abnormalities (OR 9.43, 95% CI 2.11-42.09, P = 0.003). After adjustment on these factors, Achilles enthesis hypervascularization by power Doppler and number of work days missed were associated with TNFα antagonist therapy. In the DESIR cohort, approximately one-fourth of patients with recent IBP suggestive of axial SpA were under anti-TNFα therapy after 1 year of followup. All factors associated with this early initiation reflected higher disease activity, refractoriness, or severity, which suggests compliance of French rheumatologists with current treatment guidelines. Copyright © 2014 by the American College of Rheumatology.

  20. Inflammatory pathways in spondyloarthritis.

    Science.gov (United States)

    Hreggvidsdottir, Hulda S; Noordenbos, Troy; Baeten, Dominique L

    2014-01-01

    Spondyloarthritis is the second most common form of chronic inflammatory arthritis and a unique hallmark of the disease is pathologic new bone formation. Several cytokine pathways have been genetically associated with ankylosing spondylitis (AS), the prototypic subtype of SpA, and additional evidence from human and animal studies support a role of these pathways in the disease. TNF has a key role in SpA as blockade significantly reduces inflammation and destruction, however the treatment does not halt new bone formation. New insights into the TNF pathway were recently obtained from an animal model specifically overexpressing the transmembrane form of TNF. This model leads to axial and peripheral new bone formation which is not seen in soluble TNF overexpression models, indicating different pathogenic roles of soluble and transmembrane TNF in arthritis development. Besides TNF, the IL-23/IL-17 axis is emerging as an important inflammatory pathway in SpA, as a SNP in the IL-23R locus has been associated with developing AS, mice overexpressing IL-23 develop SpA-like features and IL-17 blockade has been shown to be efficacious for AS patients in a phase II trial. In this review, we focus on the cytokine pathways that have recently been genetically associated with SpA, i.e. TNF, IL-1, IL-6 and IL-23/IL-17. We review the current genetic, experimental and human in vivo data available and discuss how these different pathways are involved in the pathophysiology of SpA. Additionally, we discuss how these pathways relate to the pathogenic new bone formation in SpA. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Comparison of non-radiographic axial spondyloarthritis and ankylosing spondylitis patients--baseline characteristics, treatment adherence, and development of clinical variables during three years of anti-TNF therapy in clinical practice.

    Science.gov (United States)

    Wallman, Johan K; Kapetanovic, Meliha C; Petersson, Ingemar F; Geborek, Pierre; Kristensen, Lars Erik

    2015-12-24

    The relationship between non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) is currently debated. Using observational data from the South Swedish Arthritis Treatment Group register, we thus aimed to compare clinical development and treatment adherence between nr-axSpA and AS patients during three years of anti-TNF (tumor necrosis factor) therapy in clinical practice, and to explore the impact of inflammatory activity measured by CRP (C-reactive protein) at treatment initiation. Nr-axSpA and AS patients (n = 86/238) in southern Sweden, commencing anti-TNF therapy 1999-2011, were followed during three years. Anti-TNF cessation was defined as stopping therapy, without restarting another anti-TNF agent within three months. Differences in the three year developments of patient's visual analogue scale (VAS) scores for global health and pain, EuroQol 5-Dimensions utility, evaluator's global disease activity assessment, CRP, and ESR (erythrocyte sedimentation rate) were assessed by repeated ANOVA. Anti-TNF adherence was compared by Log rank test and Cox regression. In a subanalysis, the same outcomes were studied after splitting both groups into patients with/without baseline CRP elevation. Nr-axSpA patients were more often female and had lower acute phase reactants at baseline. Apart from CRP, which remained lower in the nr-axSpA group throughout follow-up (p = 0.004), no between-group differences were detected regarding clinical developments (p >0.1 for all comparisons) or anti-TNF adherence (hazard ratio: 1.1 (95% CI 0.7 to 1.8) for the nr-axSpA vs. AS group) during three years. Elevated baseline CRP was similarly associated with superior clinical outcomes and treatment adherence in both groups. With the exception of constantly lower CRP levels in the nr-axSpA group, three years anti-TNF therapy resulted in similar clinical outcomes and treatment adherence in nr-axSpA and AS patients, thus strengthening the hypothesis that

  2. Spondylodiscitis (Andersson lesion in psoriatic spondyloarthritis: a rare event successfully treated with an anti-TNF therapy.

    Directory of Open Access Journals (Sweden)

    Vincenzo Bruzzese

    2016-04-01

    Full Text Available Spondylodiscitis (Andersson lesion is an infrequent and late complication of advanced ankilosing arthritis. Scanty data on the efficacy of anti-TNF therapy for these lesions are available. To our knowledge, only few cases of spondylodiscitis occurring in patients with psoriatic arthritis were reported in literature. We describe the case of a patient with psoriatic arthritis who early developed Andersson lesions successfully treated with infliximab plus methotrexate therapy.

  3. Boundaries between familial Mediterranean fever and juvenile spondyloarthritis: Analysis of three French retrospective cohorts.

    Science.gov (United States)

    Cherqaoui, Bilade; Rossi-Semerano, Linda; Georgin-Lavialle, Sophie; Dusser, Perrine; Galeotti, Caroline; Piram, Maryam; Hentgenb, Véronique; Touitou, Isabelle; Koné-Paut, Isabelle

    2018-02-13

    Children with Familial Mediterranean fever may suffer from musculoskeletal involvement, somewhat difficult to distinguish from juvenile spondyloarthritis. The association of these two diseases has been scarcely reported in children. Objective of this work was to define the association of familial Mediterranean fever and juvenile spondyloarthritis in France. Three cohorts of children with familial Mediterranean fever, juvenile spondyloarthritis, familial Mediterranean fever related juvenile spondyloarthritis, were retrospectively identified in the French reference center of auto-inflammatory diseases. Familial Mediterranean fever was defined according to Tel-Hashomer or Turkish pediatric criteria with at least one exon-10 MEFV-gene mutation. Juvenile spondyloarthritis was defined according to ILAR criteria. Patients with familial Mediterranean fever or juvenile spondyloarthritis were respectively compared to familial Mediterranean fever related juvenile spondyloarthritis patients. Sixteen children were identified as having familial Mediterranean fever related juvenile spondyloarthritis. The male/female-ratio was 0.6, with median age at spondyloarthritis onset of 7.5years (3-16years). All carried at least one M694V variant in MEFV gene; 16.7% were HLA-B27-carriers. Compared to 83 familial Mediterranean fever patients, familial Mediterranean fever related juvenile spondyloarthritis patients had less frequently fever (PMediterranean fever related juvenile spondyloarthritis patients less often received non-steroidal anti-inflammatory drugs (PMediterranean fever may be associated with typical pattern of juvenile spondyloarthritis. These patients, with less response to colchicine, should be diagnosed earlier and treated as for jSpA. Copyright © 2018 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  4. Molecular Pathogenesis of Spondyloarthritis

    DEFF Research Database (Denmark)

    Carlsen, Thomas Gelsing

    This dissertation includes a presentation of knowledge on the molecular pathogenesis of spondyloarthritis achieved through a PhD programme at Aalborg University from 1.12.2011 - 1.12.2014. Work was carried out in the Laboratory of Medical Mass Spectrometry, headed by: Professor Svend Birkelund...

  5. Inflammatory pathways in spondyloarthritis

    NARCIS (Netherlands)

    Hreggvidsdottir, Hulda S.; Noordenbos, Troy; Baeten, Dominique L.

    2014-01-01

    Spondyloarthritis is the second most common form of chronic inflammatory arthritis and a unique hallmark of the disease is pathologic new bone formation. Several cytokine pathways have been genetically associated with ankylosing spondylitis (AS), the prototypic subtype of SpA, and additional

  6. Secukinumab: a promising therapeutic option in spondyloarthritis.

    Science.gov (United States)

    Maldonado-Ficco, Hernan; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A

    2016-09-01

    Psoriatic arthritis (PsA) is the second most common chronic inflammatory joint disease. Ankylosing spondylitis (AS) is another less common but equally chronic and disabling spondyloarthritis (SpA). Therapeutic agents for the treatment of these diseases have been somewhat lacking as compared with those available for rheumatoid arthritis, which represents a significant challenge for both the treating physician and the pharmaceutical industry. A promising development for our understanding of the physiopathology of PsA and AS involves new targets to interrupt IL-17 and IL-12/IL-23 pathways. Up to 30-40 % of SpA patients have inadequate or poor response, or are intolerant to anti-TNF therapies. Therefore, there has been a clear unmet medical need in an important group of these patients. As a result, new therapeutic targets have emerged for the treatment of both axial and peripheral SpA. Interleukin 17 (IL-17) is a pro-inflammatory cytokine that is increased in psoriatic lesions as well as in the synovial fluid of patients with PsA and in sites of enthesitis in SpA. IL-23 has been shown to play an important role in the polarization of CD4+ T-cells to become IL-17 producers. Based on these evidences, blockade of the cytokine IL-17 or its receptors was considered to have therapeutic implications for the treatment of psoriasis, as well as PsA and AS.This article presents a thorough review of an IL-17 A blocking agent, its mechanism of action, its clinical efficacy and its therapeutic safety.

  7. Study protocol for a cluster randomized controlled trial to evaluate a referral strategy for axial spondyloarthritis in young primary care patients with chronic low back pain; an impact study.

    Science.gov (United States)

    van Hoeven, Lonneke; Vergouwe, Yvonne; Koes, Bart W; Hazes, Johanna M W; Weel, Angelique E A M

    2016-07-12

    Axial spondyloarthritis (axSpA) is a disabling inflammatory joint disease with chronic low back pain (CLBP) as leading symptom. Recognizing axSpA in the large amount of CLBP patients is difficult for general practioners (GP). This evaluation aims to assess the effect of a referral strategy for axSpA in young primary care patients with CLBP by comparing the use of the strategy with usual care. The effect is measured at three different levels; by patient reported outcomes (the clinical effect), process and costs evaluation. This study design is a cluster randomized controlled trial with GP as clusters. GPs throughout the Netherlands are invited to participate and randomized to either the intervention or the control group. Patients from participating GPs are invited to participate if they have ever been registered with low back pain, without radiation (ICPC L03) and aged 18-45 years. To be included in the study, patients need to have current low back pain and chronic low back pain (>12 weeks). In the intervention arm a referral strategy for axSpA will be applied in CLBP patients, in the control arm care as usual will be provided for CLBP patients. The referral strategy consists of four easy to use variables. All are questions about the back pain complaints of the patients. Data is prospectively collected in an online database at baseline (T0), 4 months (T1), 12 months (T2) and 24 months (T3). After time point T1 (4 months) patients from the control group will also receive the intervention i.e. the application of a referral strategy for axSpA. The effect of the referral strategy is measured at three different levels, by patient outcomes (e.g. pain scores, quality of life), process measures (e.g. number of axSpA diagnoses by rheumatologists) and by costs (work productivity and health care resources use). Our primary outcome is the Roland Morris Disability Questionnaire after 4 months, secondary outcomes are pain and quality of life. Costs will be assessed before

  8. Magnetic resonance imaging in spondyloarthritis--how to quantify findings and measure response

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Poggenborg, René Panduro; Axelsen, Mette Bjørndal

    2010-01-01

    of inflammation in peripheral and axial joints, and peripheral and axial entheses, and has dramatically improved the possibilities for early diagnosis and objective monitoring of the disease process in spondyloarthritis. Truthful, discriminative and feasible scoring systems are available for the assessment...

  9. Animal models of spondyloarthritis.

    Science.gov (United States)

    Lories, Rik J U

    2006-07-01

    The aim of this article is to review new insights into spondyloarthritis obtained in animal models during the last year. HLA-B27 misfolding has been demonstrated in HLA-B27/human beta2-microglobulin transgenic rats. HLA-B27 misfolding is associated with a typical unfolded protein stress response and with an interferon-response signature. Prebiotic treatment of these rats reduced colitis and arthritis. Proteoglycan-induced spondylitis is distinct from proteoglycan-induced arthritis. Specific susceptibility loci for proteoglycan-induced spondylitis have been demonstrated. Bone morphogenetic proteins are important in new cartilage and bone formation in ankylosing enthesitis. Psoriasis and psoriatic arthritis-like disease develops in conditional double JunB/c-Jun knockout mice. Insights into the molecular signaling pathways driving HLA-B27 associated spondylitis, autoimmune spondylitis, ankylosing enthesitis and psoriasis, resulting from animal models, identify new and specific therapeutic targets in spondyloarthritis.

  10. The FAt Spondyloarthritis Spine Score (FASSS)

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Zhao, Zheng; Lambert, Robert Gw

    2013-01-01

    an important measure of treatment efficacy as well as a surrogate marker for new bone formation. The aim of this study was to develop and validate a new scoring method for fat lesions in the spine, the Fat SpA Spine Score (FASSS), which in contrast to the existing scoring method addresses the localization......Studies have shown that fat lesions follow resolution of inflammation in the spine of patients with axial spondyloarthritis (SpA). Fat lesions at vertebral corners have also been shown to predict development of new syndesmophytes. Therefore, scoring of fat lesions in the spine may constitute both...... and phenotypic diversity of fat lesions in patients with axial SpA....

  11. Physical activity in spondyloarthritis: a systematic review.

    Science.gov (United States)

    O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona

    2015-03-01

    Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.

  12. Physical activity in spondyloarthritis: a systematic review

    LENUS (Irish Health Repository)

    O’Dwyer, Tom

    2014-10-01

    Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE\\/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.

  13. Diagnostic accuracy of enthesis ultrasound in the diagnosis of early spondyloarthritis.

    Science.gov (United States)

    de Miguel, Eugenio; Muñoz-Fernández, Santiago; Castillo, Concepción; Cobo-Ibáñez, Tatiana; Martín-Mola, Emilio

    2011-03-01

    To determine the sensitivity and specificity of enthesis ultrasound for the diagnostic classification of early spondyloarthritis. A cross-sectional, blinded and controlled study. Standardised bilateral ultrasound of six entheses (Madrid sonography enthesitis index (MASEI)) was performed. Accepted diagnostic classification criteria were used as the gold standard. Validity was analysed by receiver operating characteristic (ROC) curves. Values of pwomen/55 men), 57 non-inflammatory control individuals (29 women/28 men) and 24 inflammatory control individuals (11 women/13 men). The evolution time of spondyloarthritis was 10.9±7.1 months. At least some grade of sacroiliitis on x-ray was present in 59 patients, but only five fulfilled the radiographic sacroiliitis New York criteria. Human leucocyte antigen B27 (HLA-B27) was positive in 42% of patients. No statistical differences were found for the enthesis score among diagnostic spondyloarthritis subtypes form of presentation (axial, peripheral or mixed) or HLA-B27 positivity. The MASEI score achieved statistical significance for gender. The ultrasound score was 23.36±11.40 (mean±SD) in spondyloarthritis patients and 12.26±6.85 and 16.04±9.94 in the non-inflammatory and inflammatory control groups (phigher in men and independent of the spondyloarthritis diagnostic subtype, HLA-B27 status or presentation pattern. The enthesis ultrasound score seems to have diagnostic accuracy and may be useful for improving the diagnostic accuracy of early spondyloarthritis.

  14. Chronic widespread pain in spondyloarthritis

    Directory of Open Access Journals (Sweden)

    F. Atzeni

    2014-06-01

    Full Text Available The pain associated with spondyloarthritis (SpA can be intense, persistent and disabling. It frequently has a multifactorial, simultaneously central and peripheral origin, and may be due to currently active inflammation, or joint damage and tissue destruction arising from a previous inflammatory condition. Inflammatory pain symptoms can be reduced by non-steroidal anti-inflammatory drugs, but many patients continue to experience moderate pain due to alterations in the mechanisms that regulate central pain, as in the case of the chronic widespread pain (CWP that characterises fibromyalgia (FM. The importance of distinguishing SpA and FM is underlined by the fact that SpA is currently treated with costly drugs such as tumour necrosis factor (TNF inhibitors, and direct costs are higher in patients with concomitant CWP or FM than in those with FM or SpA alone. Optimal treatment needs to take into account symptoms such as fatigue, mood, sleep, and the overall quality of life, and is based on the use of tricyclic antidepressants or selective serotonin reuptake inhibitors such as fluoxetine, rather than adjustments in the dose of anti-TNF agents or disease-modifying drugs.

  15. Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies.

    Science.gov (United States)

    Caso, Francesco; Costa, Luisa; Del Puente, Antonio; Di Minno, Matteo Nicola Dario; Lupoli, Gelsy; Scarpa, Raffaele; Peluso, Rosario

    2015-11-01

    Spondyloarthritis represents a heterogeneous group of articular inflammatory diseases that share common genetic, clinical and radiological features. The therapy target of spondyloarthritis relies mainly in improving patients' quality of life, controlling articular inflammation, preventing the structural joints damage and preserving the functional abilities, autonomy and social participation of patients. Among these, traditional disease-modifying antirheumatic drugs have been demonstrated to be effective in the management of peripheral arthritis; moreover, in the last decade, biological therapies have improved the approach to spondyloarthritis. In patients with axial spondyloarthritis, tumor necrosis factor α inhibitors are currently the only effective therapy in patients for whom conventional therapy with nonsteroidal anti-inflammatory drugs has failed. The aim of this review is to summarize the current experience and evidence about the pharmacological approach in spondyloarthritis patients.

  16. ON THE TERMINOLOGY OF SPONDYLOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2015-01-01

    Full Text Available By the end of the first decade of the 21st century, spondyloarthritis studies have accumulated a certain number of terms that are obsolete, but used by physicians in their everyday speech, on the one hand, and a great variety of different definitions, on the other hand. In January 2014, the first organizational meeting of the Expert Group on Spondyloarthritis, Association of Rheumatologists of Russia, decided that its primary task should be to order the terminology used in this area. The authors primarily collected the terms, which had been already used in medical vocabulary, and then divided them into two categories: obsolete definitions and terms to be finalized and unified. This publication gives guidelines for using the medical terms relevant to spondyloarthritis and separately discusses how to correctly write the term sacroiliitis.

  17. [The early diagnosis of spondyloarthritis].

    Science.gov (United States)

    Novak, Srdan

    2011-01-01

    The most frequent early symptoms of spondyloarthritides are inflammatory back pain and asymetric peripheral arthritis. Currently the mean delay between the onset of first symptoms and diagnosing ankylosing spondylitis which is the frequent type of spondyloarthritis is over 5 years. The availability of effective therapies makes an early diagnosis mandatory. The clinical symptoms of inflammatory back pain, active inflamation on MR, and positivity for HLA-B27 are the most important parameters for an early diagnosis of spondyloarthritis, especially in combination. Moreover, the combination of clinical and laboratory parameters is necessary for the early diagnosis.

  18. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general

    DEFF Research Database (Denmark)

    Rudwaleit, M; van der Heijde, D; Landewé, R

    2011-01-01

    OBJECTIVE: To evaluate new classification criteria for peripheral spondyloarthritis (SpA) in patients with SpA with peripheral manifestations only. METHODS: In this Assessment of SpondyloArthritis international Society (ASAS) study, two prespecified sets of criteria were compared against the Euro...

  19. Acute anterior uveitis and other extra-articular manifestations of spondyloarthritis.

    Science.gov (United States)

    Mitulescu, T C; Popescu, C; Naie, A; Predeţeanu, D; Popescu, V; Alexandrescu, C; Voinea, L M

    2015-01-01

    Spondyloarthritis (SpA) is associated with an array of peripheral manifestations. Our study aims to evaluate extra-articular manifestations of SpA in a Romanian academic clinical setting and to observe their associations with different disease measures. The study was designed to note the extra-articular manifestations of SpA patients in a cross-sectional and retrospective manner. Records included demographics, inflammation markers, SpA clinical characteristics, treatment regimes, associated osteoporosis and cardiovascular morbidity. Data were assessed by using appropriate non-parametric tests. A total of 126 SpA patients were included. The most common extra-articular manifestations were skin involvement in the form of psoriasis (34.1%), eye involvement in the form of acute anterior uveitis (8.7%) and dactylitis (7.2%). Compared to patients with no record of uveitis, uveitis-affected cases were more frequently males, more frequently diagnosed with ankylosing spondylitis, but less frequently dyslipidemic and diagnosed with psoriasis. Psoriasis-affected patients were older and had a higher prevalence of peripheral SpA diagnosis, but a lower prevalence of radiographic sacroiliitis. Acute anterior uveitis in SpA predominantly affects males with AS. This is relevant both to clinical and fundamental science, since its management requires both ophthalmology and rheumatology clinical settings. Psoriasis was associated more frequently with peripheral SpA. AHT = arterial hypertension, AS = ankylosing spondylitis, ASAS = Assessment in SpondyloArthritis international Society, aSpA = axial spondyloarthritis, BASFI = Bath Ankylosing Spondylitis Functional Index, BASDAI = Bath Ankylosing Spondylitis Disease Activity Index, CRP = C-reactive protein, ESR = erythrocyte sedimentation rate, DM2 = type 2 diabetes mellitus, HLA = human leukocyte antigen, IBD = inflammatory bowel disease, MRI = magnetic resonance imaging, mSpA = mixed (peripheral and axial) spondyloarthritis, NSAIDs = non

  20. Spondyloarthritis: from unifying concepts to improved treatment

    NARCIS (Netherlands)

    Paramarta, Jacqueline E.; Baeten, Dominique

    2014-01-01

    Spondyloarthritis (SpA) is a chronic immune-mediated inflammatory disease with diverse phenotypic manifestations including spondylitis, arthritis, enthesitis and extra-articular manifestations (psoriasis, uveitis, inflammatory bowel disease). The common genetic risk factors, the strong familial

  1. Biologics in spondyloarthritis: TNFα inhibitors and other agents.

    Science.gov (United States)

    Toussirot, Éric

    2015-01-01

    TNFα inhibitors are currently the only class of biological agent that has proven to be effective in the treatment of patients with ankylosing spondylitis and/or spondyloarthritis (SpA). These agents have been shown to control inflammatory pain of the axial skeleton, peripheral clinical manifestations, certain extra-articular manifestations as well as systemic and spinal MRI inflammation. Conversely, they are unable to slow radiographic progression in the spine. Since around 20-30% of patients with SpA are considered as nonmajor responders to TNFα inhibitors, there is a need for alternative therapies. Biological agents that target IL-1, IL-6, B cells and costimulatory pathways are not effective in SpA. Conversely, novel biological agents blocking IL-23 or IL-17 are promising in SpA, especially secukinumab, an anti-IL-17A monoclonal antibody.

  2. Emerging drugs for axial spondyloarthritis including ankylosing spondylitis.

    Science.gov (United States)

    Busquets-Perez, Noemi; Marzo-Ortega, Helena; Emery, Paul

    2013-03-01

    Only non-steroidal anti-inflammatories (NSAIDs) and TNF inhibitors (TNFi) are effective in ankylosing spondylitis (AS). However, not all patients successfully respond to these drugs and a subset may have contraindications to their use. In the last decade, an earlier diagnosis of AS has been achieved due to the increasing availability of MRI. This has led to prompt treatment initiation with improved outcomes. NSAIDs and TNFi are the current treatments for AS which lead to sustained clinical responses in the long term. Recent studies have shown other potential biomarkers in AS, such as the IL-17/IL-23 axis. This has translated into the development of new drugs which interfere with these pathways, such as apremilast and secukinumab, which have shown efficacy in early clinical trials. AS carries considerable short- and long-term disabilities. Anti-TNF-α therapies reduce pain, improve function and decrease inflammation as seen by MRI. New treatment options are being developed which may prove efficacious on those patients not responding to anti-TNF. The ultimate research goal should focus on treatments to prevent and stop new bone formation.

  3. Results from Polish Spondyloarthritis Initiative registry (PolSPI) - methodology and data from - the first year of observation.

    Science.gov (United States)

    Guła, Zofia; Barczyńska, Tacjana; Brzosko, Marek; Gąsowski, Jerzy; Jeka, Sławomir; Jodłowska-Cicio, Katarzyna; Kwaśny-Krochin, Beata; Leszczyński, Piotr; Lubiński, Łukasz; Łosińska, Katarzyna; Pawlak-Buś, Katarzyna; Przepiera-Będzak, Hanna; Samborski, Włodzimierz; Schlabs, Małgorzata; Siedlar, Maciej; Sikorska, Dorota; Świerkot, Jerzy; Węgierska, Małgorzata; Wiland, Piotr; Korkosz, Mariusz

    2017-01-01

    Report on one-year results from the Polish Spondyloarthritis Initiative registry (PolSPI), containing the cross-sectional analysis of clinical and imaging data as well as database methodology. The PolSPI registry includes patients with axial (axSpA) and peripheral (perSpA) spondyloarthritis according to ASAS classification criteria, and/or patients with ankylosing spondylitis according to modified New York criteria, psoriatic arthritis according to CASPAR criteria, arthropathy in inflammatory bowel disease, reactive arthritis, juvenile spondyloarthritis or undifferentiated spondyloarthritis. Epidemiologic data and history of signs, symptoms and treatment of spondyloarthritis are collected and assessment of disease activity is performed. Radiographic images of sacroiliac joint, cervical and lumbar spine, and results of bone densitometry are collected. Every 6 months blood samples for inflammatory markers, and for long-term storage are taken. During a one-year period from September 2015 to August 2016, 63 patients were registered on an electronic database; 44 (69.8%) of patients were classified as axial spondyloarthritis (axSpA) and 19 (30.2%) as peripheral spondyloarthritis (perSpA) according to ASAS criteria. Statistically significant differences between axSpA and perSpA were discovered in the percentage of HLA-B27 antigen occurrence (92.6% and 50%, respectively), BASDAI (2.8% and 4.1%, respectively), DAS 28 (2.66% and 4.03%, respectively), percentage of peripheral arthritis (20% and 88.8%, respectively), enthesitis (26.7% and 70.6%, respectively), dactylitis (6.7% and 88.9%, respectively), as well as extra-articular symptoms: acute anterior uveitis (26.7% and 5.6%, respectively) and psoriasis (6.9% and 55.6%, respectively). Patients with axSpA had significantly higher mean grade of sacroiliac involvement according to New York criteria, higher mSASSS score, and lower T-score in femoral neck in bone densitometry. At the early stage of the disease patients with ax

  4. [Effects of an exercise and relaxation aquatic program in patients with spondyloarthritis: A randomized trial].

    Science.gov (United States)

    Fernández García, Rubén; Sánchez Sánchez, Laura de Carmen; López Rodríguez, María Del Mar; Sánchez Granados, Gema

    2015-11-06

    Spondyloarthritis is a general term referring to a group of chronic rheumatic illnesses that share clinical, genetic, radiological and epidemiological features. The clinical presentation of spondyloarthritis is characterized by the compromise of both the axial and peripheral articular skeleton. We aimed to evaluate the efficacy of an aquatic exercise plus relaxation program in patients with spondyloarthritis. This was a randomized single blind study including 30 patients with spondylitis who were randomly assigned to an experimental or control group. For 2 months, the experimental group underwent an aquatic fitness plus relaxation program (3 sessions per week). Evaluations were also performed in the control group the same days as the experimental group but they did not participate in any supervised exercise program. The following data were obtained at baseline and immediately after application of the last session: Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Health Questionnaire SF-12 and Sigma PC3(®) (Sigma-Elektro GmbH, Neustadt, Germany) Heart Rate Monitor. The Mann-Whitney test showed statistically significant differences in the quality of life (physical function [P=.05]), Bath Ankylosing Spondylitis Functional Index (P=.015), Bath Ankylosing Spondylitis Disease Activity Index (fatigue [P=.032], neck pain, back and hips [P=.045], pain or swelling in other joints [P=.032] and in waking morning stiffness [P=.019]). The results of the present study suggest that therapy with physical exercise plus relaxation provides benefits to spondyloarthritis patients and these are advised as a part of their usual treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  5. Killer immunoglobulin receptor genes in spondyloarthritis

    NARCIS (Netherlands)

    Kuijpers, Taco W.; Vendelbosch, Sanne; van den Berg, Merlijn; Baeten, Dominique L. P.

    2016-01-01

    We focus on the role of killer immunoglobulin receptor (KIR) interactions with the human leukocyte antigens (HLA)-B27 ligand and the potential contribution of KIR-expressing natural killer and T cells in spondyloarthritis, more specifically in ankylosing spondylitis (AS). In AS strong

  6. Increased IL-20 and IL-24 target osteoblasts and synovial monocytes in spondyloarthritis

    DEFF Research Database (Denmark)

    Kragstrup, Tue Wenzel; Andersen, Morten Nørgaard; Schiøttz-Christensen, Berit

    2017-01-01

    The pathogenesis of spondyloarthritis (SpA) involves activation of the innate immune system, inflammation and new bone formation. The two cytokines interleukin (IL)-20 and IL-24 have been shown to link innate immune activation and tissue homeostasis. We hypothesized that these two cytokines...... are secreted as part of activation of the innate immune system and affect bone homeostasis in SpA. IL-20 and IL-24 were measured in plasma from axial SpA patients (n = 83). Peripheral SpA patients (n = 16) were included for in-vitro cell culture studies. The plasma IL-20 and IL-24 levels were increased in Sp...

  7. Comparative Analysis and Predictors of 10-year Tumor Necrosis Factor Inhibitors Drug Survival in Patients with Spondyloarthritis: First-year Response Predicts Longterm Drug Persistence.

    Science.gov (United States)

    Flouri, Irini D; Markatseli, Theodora E; Boki, Kyriaki A; Papadopoulos, Ioannis; Skopouli, Fotini N; Voulgari, Paraskevi V; Settas, Loukas; Zisopoulos, Dimitrios; Iliopoulos, Alexios; Geborek, Pierre; Drosos, Alexandros A; Boumpas, Dimitrios T; Sidiropoulos, Prodromos

    2018-04-01

    To evaluate the 10-year drug survival of the first tumor necrosis factor inhibitor (TNFi) administered to patients with spondyloarthritis (SpA) overall and comparatively between SpA subsets, and to identify predictors of drug retention. Patients with SpA in the Hellenic Registry of Biologic Therapies, a prospective multicenter observational cohort, starting their first TNFi between 2004-2014 were analyzed. Kaplan-Meier curves and Cox regression models were used. Overall, 404 out of 1077 patients (37.5%) discontinued treatment (followup: 4288 patient-yrs). Ten-year drug survival was 49%. In the unadjusted analyses, higher TNFi survival was observed in patients with ankylosing spondylitis (AS) compared to undifferentiated SpA and psoriatic arthritis [PsA; significant beyond the first 2.5 (p = 0.003) years and 7 years (p < 0.001), respectively], and in patients treated for isolated axial versus peripheral arthritis (p = 0.001). In all multivariable analyses, male sex was a predictor for longer TNFi survival. Use of methotrexate (MTX) was a predictor in PsA and in patients with peripheral arthritis. Absence of peripheral arthritis and use of a monoclonal antibody (as opposed to non-antibody TNFi) independently predicted longer TNFi survival in axial disease because of lower rates of inefficacy. Achievement of major responses during the first year in either axial or peripheral arthritis was the strongest predictor of longer therapy retention (HR 0.33, 95% CI 0.26-0.41 for Ankylosing Spondylitis Disease Activity Score inactive disease, and HR 0.35, 95% CI 0.24-0.50 for 28-joint Disease Activity Score remission). The longterm retention of the first TNFi administered to patients with SpA is high, especially for males with axial disease. The strongest predictor of longterm TNFi survival is a major response within the first year of treatment.

  8. Two Phenotypes Are Identified by Cluster Analysis in Early Inflammatory Back Pain Suggestive of Spondyloarthritis: Results From the DESIR Cohort.

    Science.gov (United States)

    Costantino, Félicie; Aegerter, Philippe; Dougados, Maxime; Breban, Maxime; D'Agostino, Maria-Antonietta

    2016-07-01

    To determine whether disease manifestations at baseline would combine according to distinguishable ordered phenotypes in patients with early inflammatory back pain (IBP) suggestive of spondyloarthritis (SpA). Baseline clinical and demographic characteristics as well as imaging features and biologic data on patients included in the French multicenter Devenir des Spondyloarthropathies Indifferérenciées Récentes cohort were analyzed by multiple correspondence analysis and cluster analysis to identify subgroups of patients based on shared characteristics. Cluster analysis allowed us to classify the 679 patients with no missing data into 2 major groups-one with a predominance of isolated axial manifestations and the other with associated peripheral symptoms. The application of the same analysis to selected subsets of the cohort, such as HLA-B27-positive and -negative patients and patients fulfilling the Assessment of SpondyloArthritis international Society classification criteria for axial SpA, resulted again in an optimal division of the samples into 2 recurrent clusters of patients similar to those observed in the whole cohort. Cluster analysis of SpA manifestations among patients with early IBP highly suggestive of SpA allowed us to clearly identify at baseline 2 different clinical phenotypes-one with predominant axial manifestations and the other with predominant peripheral manifestations. Ongoing follow-up will allow us to determine whether these clusters correspond to different patterns of disease severity. © 2016, American College of Rheumatology.

  9. Killer immunoglobulin receptor genes in spondyloarthritis.

    Science.gov (United States)

    Kuijpers, Taco W; Vendelbosch, Sanne; Berg, Merlijn van den; Baeten, Dominique L P

    2016-07-01

    We focus on the role of killer immunoglobulin receptor (KIR) interactions with the human leukocyte antigens (HLA)-B27 ligand and the potential contribution of KIR-expressing natural killer and T cells in spondyloarthritis, more specifically in ankylosing spondylitis (AS). In AS strong epidemiological evidence of significant genetic associations with the major histocompatibility complex was convincingly identified. HLA-B27-positive first-degree relatives of AS cases are 5-16 times more likely to develop disease than HLA-B27-positive carriers in the general community. The GWAS era has enabled rapid progress in identifying non-major histocompatibility complex associations of AS. These findings show a number of important pathways in AS pathogenesis, including the IL-23-IL-17 pathway, aminopeptidases, peptide presentation, and KIR-HLA-B27 interactions. Studies using genetic markers, including KIRs may be used for a risk assessment about whom may benefit most from the various treatment protocols in spondyloarthritis, now that alternative therapeutic options have become feasible.

  10. Axial myopathy

    DEFF Research Database (Denmark)

    Witting, Nanna; Andersen, Linda K; Vissing, John

    2016-01-01

    Classically, myopathies are categorized according to limb or cranial nerve muscle affection, but with the growing use of magnetic resonance imaging it has become evident that many well-known myopathies have significant involvement of the axial musculature. New disease entities with selective axial...

  11. Carotid intima-media thickness in spondyloarthritis patients

    Directory of Open Access Journals (Sweden)

    Thelma Larocca Skare

    Full Text Available CONTEXT AND OBJECTIVE Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT in spondyloarthritis (SpA patients and correlate this with clinical parameters and inflammatory markers. DESIGN AND SETTING Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba. METHODS IMTs (measured using Doppler ultrasonography of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR, C-reactive protein (CRP and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI and lipid profile. RESULTS The mean IMT in SpA patients was 0.72 ± 0.21 mm; in controls, 0.57 ± 0.13 mm (P = 0.0007. There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65; higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64; and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72. CONCLUSION SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients.

  12. Large vessel vasculitis and spondyloarthritis: coincidence or associated diseases?

    Science.gov (United States)

    Ernst, D; Baerlecken, N T; Schmidt, R E; Witte, T

    2014-01-01

    Although cardiac complications have been reported in established spondyloarthritis (SpA), little is known about peripheral axial SpA in large vessel vasculitis (LVV). The aim of this study was to assess the prevalence of SpA in patients with newly diagnosed LVV. Retrospective single-centre analysis of all newly diagnosed LVV patients was performed between January 2011 and December 2012. Vasculitides were confirmed on thoracic magnetic resonance imaging (MRI) or 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). Patients completed a standardized questionnaire incorporating the Berlin criteria to assess inflammatory back pain. Existing scans were reassessed for sacroiliitis and ferritin antibodies measured in all patients. Fifteen patients exhibiting new LVV were identified. Diagnosis was confirmed using MRI in nine patients and FDG-PET/CT in six. Six patients (40%) fulfilled American College of Rheumatology (ACR) criteria for giant cell arteritis (GCA) and polymyalgia rheumatica (PMR), and nine PMR only. Four patients fulfilled the Berlin criteria for inflammatory back pain, with three demonstrating sacroiliitis on imaging. All remaining patients demonstrated no sacroiliitis. One further patient with LVV lacking features of inflammatory back pain had known psoriatic arthritis (PsA). Patients with coexisting SpA were younger (mean age 57 years vs. 66 years) and had higher C-reactive protein (CRP) levels (200 mg/L vs. 85 mg/L) at presentation. Four SpA patients and seven out of nine patients with isolated LVV had ferritin antibodies. We have demonstrated a higher than anticipated prevalence of SpA in LVV, given the reported 0.5-1% prevalence in the general population. Coexisting SpA should be considered in LVV patients exhibiting inflammatory back pain despite steroid initiation. Ferritin antibodies demonstrated a similarly high prevalence in aortitis and SpA as reported previously in untreated GCA and PMR.

  13. Defining enthesitis in spondyloarthritis by ultrasound

    DEFF Research Database (Denmark)

    Terslev, Lene; Naredo, E; Iagnocco, A

    2014-01-01

    Objective: To standardize ultrasound (US) in enthesitis. Methods: An Initial Delphi exercise was undertaken to define US detected enthesitis and its core components. These definitions were subsequently tested on static images taken from Spondyloarthritis (SpA) patients in order to evaluate...... elementary component. On static images the intra-observer reliability showed a high degree of variability for the detection of elementary lesions with kappa coefficients ranging from 0.14 - 1. The inter-observer kappa value was variable with the lowest kappa for enthesophytes (0.24) and the best for Doppler...... their reliability. Results: High-good agreement (>80%) was obtained for including hypoechogenicity, increased thickness of the tendon insertion, calcifications, enthesophytes, erosions and Doppler activity as core elementary lesions of US detected enthesitis. US definitions were subsequently obtained for each...

  14. Spondyloarthritis: clinical suspicion, diagnosis, and sports.

    Science.gov (United States)

    Harper, Brock E; Reveille, John D

    2009-01-01

    Spondyloarthritis (SpA), a family of inflammatory back diseases including ankylosing spondylitis, is an important and under-recognized cause of chronic back pain in younger patients who are likely to participate in sports and athletic activities. These diseases are characterized by the presence of inflammatory back pain--lumbar or buttock/hip pain lasting longer than 3 months associated with improvement with activity, worsening with rest, relief with non-steroidal anti-inflammatory drugs (NSAIDs), and morning stiffness lasting longer than 30 min. There are also characteristic radiographic findings involving the sacroiliac joints, vertebrae, and in certain diseases, the peripheral joints. Exercise has long been recognized as a key component of the therapy of SpA, yielding benefits in mobility, pain, stiffness, functionality, and depression. Sports also pose a risk to patients with SpA as these patients are at high risk of spinal fracture and spinal cord injury.

  15. Frequency of HLA alleles class I and II in a cohort of northwestern Colombian patients with spondyloarthritis Frecuencia de alelos HLA de clase I y II en una cohorte de pacientes del noroccidente colombiano con espondiloartritis

    OpenAIRE

    Luis F ernando Pinto; Javier Darío Márquez; Carlos Jaime Velásquez; Julio Cesar Quintero; Beatriz Helena Aristizábal; Olga Lucía Rincón; Eliana Patricia Velásquez

    2011-01-01

    Introduction. Spondyloarthritis are chronic rheumatic diseases that affect the axial skeleton and peripheral joints, with several extra-articular manifestations. The association with HLA-B27 remains one of the strongest links known between these entities and the major histocompatibility complex, but the global distribution of HLA-B27 varies considerably and associations with non-HLA-B27 genes have been described.
    Objective. To determine the frequency of HLA class I and II in north...

  16. Exercise therapy for spondyloarthritis: a systematic review.

    Science.gov (United States)

    O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona

    2014-07-01

    To evaluate the effects of therapeutic exercise on pain, stiffness, quality of life, physical function, disease activity, health-related fitness and cardiovascular risk factors in adults with spondyloarthritis (SpA). Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to October 2013 using medical subject headings and keywords. This was supplemented by searching conference abstracts and a hand search of reference lists of included studies. Randomised and quasi-randomised studies of adults with SpA in which at least one of the comparison groups received an exercise intervention were included. Outcomes of interest were pain, stiffness, quality of life, physical function and disease activity. Secondary outcomes were health-related fitness and cardiovascular risk factors. Two reviewers independently screened studies for inclusion. Methodological quality was assessed by two reviewers using the Cochrane risk of bias tool and the PEDro scale. Twenty-four studies, involving 1,498 participants, were included. Meta-analyses were not undertaken due to clinical heterogeneity, and this review focuses on qualitative synthesis. Moderate evidence supports exercise interventions in improving physical function, disease activity and chest expansion compared to controls; there is low-level evidence of improved pain, stiffness, spinal mobility and cardiorespiratory function. Supervised group exercise yields better outcomes than unsupervised home exercise. The addition of aerobic components to flexibility programmes improves cardiorespiratory outcomes, but not cardiovascular risk factors. The most effective exercise protocol remains unclear. Current evidence suggests that therapeutic exercises are beneficial for adults with ankylosing spondylitis; effects on other SpA subtypes are unknown.

  17. The diagnostic utility of MRI in spondyloarthritis

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Weber, Ulrich; Østergaard, Mikkel

    2012-01-01

    and fat infiltrations, and recent studies suggest that assessment of both inflammatory and structural changes of the sacroiliac joints may improve the diagnostic utility of MRI. The present article reviews the evidence for the use of sacroiliac joint and spinal MRI to assess patients with axial...... and peripheral SpA, focussing on controlled studies of patients with early SpA, which also included patients with mechanical back pain and healthy subjects, published within the last 5 years....

  18. Are there new emerging drugs for ankylosing spondylitis or spondyloarthritis?

    Science.gov (United States)

    Wendling, Daniel

    2013-03-01

    New emerging drugs in the treatment of ankylosing spondylitis (AS), and spondyloarthritis in general, should be compared to anti-TNF agents, which provided clear evidence of efficacy in these conditions. To date, other biologic agents used in rheumatoid arthritis failed to demonstrate efficacy in AS, even in anti-TNF naïve patients. Some new potential options may target cytokines such as IL-17, or molecules involved in entheseal ossification or signaling pathways, but need confirmatory evaluation.

  19. Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis: correlation with anatomy and histology.

    Science.gov (United States)

    Hermann, K-G A; Bollow, M

    2014-03-01

    Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis. Correlation with anatomy and histology

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, K.G.A. [Charite Medical School, Campus Mitte, Berlin (Germany). Dept. of Radiology; Bollow, M. [Augusta Hospital, Bochum (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclear Medicine

    2014-03-15

    Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. (orig.)

  1. Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis. Correlation with anatomy and histology

    International Nuclear Information System (INIS)

    Hermann, K.G.A.; Bollow, M.

    2014-01-01

    Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. (orig.)

  2. Development and validation of an MRI reference criterion for defining a positive SIJ MRI in spondyloarthritis

    DEFF Research Database (Denmark)

    Weber, Ulrich; Zubler, Veronika; Pedersen, Susanne J

    2012-01-01

    OBJECTIVE: To validate an MRI reference criterion for a positive SIJ MRI based on the level of confidence in classification of spondyloarthritis (SpA) by expert MRI readers. METHODS: Four readers assessed SIJ MRI in two inception cohorts (A/B) of 157 consecutive back pain patients ≤50 years......, and in 20 healthy controls. Patients were classified according to clinical examination and pelvic radiography as having non-radiographic axial SpA (n=51), ankylosing spondylitis (n=34), or non-specific back pain (n=72). Readers recorded their level of confidence in the classification of SpA on a 0-10 scale...... (0=definitely not; 10=definite). The MRI reference criterion was pre-specified as the majority of readers recording a confidence of 8-10; absence of SpA required all readers to record Non-SpA (confidence 0-4). We calculated inter-reader reliability and agreement between MRI-based and clinical...

  3. Golimumab in radiographic and nonradiographic axial spondyloarthritis: a review of clinical trials [Corrigendum

    Directory of Open Access Journals (Sweden)

    Toussirot E

    2017-01-01

    Full Text Available Toussirot E, Vauchy C, Binda D, Michel F. Drug Des Devel Ther. 2016;10:2087–2094.On page 2089, a column heading in Table 1 was incorrectly presented. The last column heading was presented as “Golimumab 60 mg”, whereas this should have been presented as “Golimumab 100 mg” as shown below:Read the original article 

  4. Head-to-toe whole-body MRI in psoriatic arthritis, axial spondyloarthritis and healthy subjects

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Pedersen, Susanne Juhl; Eshed, Iris

    2015-01-01

    OBJECTIVES: By whole-body MRI (WBMRI), we aimed to examine the frequency and distribution of inflammatory and structural lesions in PsA patients, SpA patients and healthy subjects (HSs), to introduce global WBMRI inflammation/damage scores, and to assess WBMRI's reproducibility and correlation wi...

  5. Atlantoaxial subluxation as an early manifestation in an adolescent with undifferentiated spondyloarthritis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jea Andrew

    2011-07-01

    Full Text Available Abstract Introduction Atlantoaxial instability has been described as a manifestation of ankylosing spondylitis (juvenile and adult onset, reactive arthritis, juvenile idiopathic arthritis, and rheumatoid arthritis; however, it has rarely been reported as an early manifestation of these disorders. We present this case report to increase awareness of the condition in the hope that earlier recognition of this disease may prevent further serious injury. Case presentation We report the case of a 17-year-old Hispanic adolescent woman who was initially diagnosed with undifferentiated spondyloarthritis due to peripheral arthritis, enthesitis, a positive human leukocyte antigen B27 result, and inflammatory spinal pain lasting two months. Our patient experienced persistent and worsening occipitocervical pain and signs of myelopathy three months after diagnosis; consequently, we found atlantoaxial instability along with cervical spine bone erosion and pannus formation. She was treated surgically with a C1-2 posterior instrumented fusion and at six weeks post-operatively was started on tumor necrosis factor α blockade. Her occipitocervical symptoms subsided following surgery and initiation of immunomodulation. Conclusions Our report serves to emphasize to pediatric and adult general practitioners, pediatricians, internists, family physicians, pediatric and adult rheumatologists and spine surgeons that atlantoaxial subluxation may be an early manifestation of spondyloarthritis, and that the condition is treatable by surgical intervention and immunomodulation.

  6. Engineered, axially-vascularized osteogenic grafts from human adipose-derived cells to treat avascular necrosis of bone in a rat model.

    Science.gov (United States)

    Ismail, Tarek; Osinga, Rik; Todorov, Atanas; Haumer, Alexander; Tchang, Laurent A; Epple, Christian; Allafi, Nima; Menzi, Nadia; Largo, René D; Kaempfen, Alexandre; Martin, Ivan; Schaefer, Dirk J; Scherberich, Arnaud

    2017-11-01

    Avascular necrosis of bone (AVN) leads to sclerosis and collapse of bone and joints. The standard of care, vascularized bone grafts, is limited by donor site morbidity and restricted availability. The aim of this study was to generate and test engineered, axially vascularized SVF cells-based bone substitutes in a rat model of AVN. SVF cells were isolated from lipoaspirates and cultured onto porous hydroxyapatite scaffolds within a perfusion-based bioreactor system for 5days. The resulting constructs were inserted into devitalized bone cylinders mimicking AVN-affected bone. A ligated vascular bundle was inserted upon subcutaneous implantation of constructs in nude rats. After 1 and 8weeks in vivo, bone formation and vascularization were analyzed. Newly-formed bone was found in 80% of SVF-seeded scaffolds after 8weeks but not in unseeded controls. Human ALU+cells in the bone structures evidenced a direct contribution of SVF cells to bone formation. A higher density of regenerative, M2 macrophages was observed in SVF-seeded constructs. In both experimental groups, devitalized bone was revitalized by vascularized tissue after 8 weeks. SVF cells-based osteogenic constructs revitalized fully necrotic bone in a challenging AVN rat model of clinically-relevant size. SVF cells contributed to accelerated initial vascularization, to bone formation and to recruitment of pro-regenerative endogenous cells. Avascular necrosis (AVN) of bone often requires surgical treatment with autologous bone grafts, which is surgically demanding and restricted by significant donor site morbidity and limited availability. This paper describes a de novo engineered axially-vascularized bone graft substitute and tests the potential to revitalize dead bone and provide efficient new bone formation in a rat model. The engineering of an osteogenic/vasculogenic construct of clinically-relevant size with stromal vascular fraction of human adipose, combined to an arteriovenous bundle is described. This

  7. Light axial vector mesons

    Science.gov (United States)

    Chen, Kan; Pang, Cheng-Qun; Liu, Xiang; Matsuki, Takayuki

    2015-04-01

    Inspired by the abundant experimental observation of axial-vector states, we study whether the observed axial-vector states can be categorized into the conventional axial-vector meson family. In this paper we carry out an analysis based on the mass spectra and two-body Okubo-Zweig-Iizuka-allowed decays. Besides testing the possible axial-vector meson assignments, we also predict abundant information for their decays and the properties of some missing axial-vector mesons, which are valuable for further experimental exploration of the observed and predicted axial-vector mesons.

  8. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis...

  9. Magnetic resonance imaging in spondyloarthritis--how to quantify findings and measure response

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Poggenborg, René Panduro; Axelsen, Mette Bjørndal

    2010-01-01

    Sensitive and reliable tools for monitoring disease activity and damage, and for prognostication, are essential in the management of patients with spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis. Magnetic resonance imaging (MRI) allows direct visualisation of inflammat...

  10. Adherence to Antitumor Necrosis Factor Use Recommendations in Spondyloarthritis: Measurement and Effect in the DESIR Cohort.

    Science.gov (United States)

    Harvard, Stephanie; Guh, Daphne; Bansback, Nick; Richette, Pascal; Saraux, Alain; Fautrel, Bruno; Anis, Aslam H

    2017-10-01

    To evaluate a classification system to define adherence to axial spondyloarthritis (axSpA) anti-tumor necrosis factor (anti-TNF) use recommendations and examine the effect of adherence on outcomes in the DESIR cohort (Devenir des Spondylarthropathies Indifférenciées Récentes). Using alternate definitions of adherence, patients were classified as adherent "timely" anti-TNF users, nonadherent "late" anti-TNF users, adherent nonusers ("no anti-TNF need"), non-adherent nonusers ("unmet anti-TNF need"). Multivariate models were fitted to examine the effect of adherence on quality-adjusted life-years (QALY), total costs, and nonbiologic costs 1 year following an index date. Generalized linear regression models assuming a γ-distribution with log link were used for costs outcomes and linear regression models for QALY outcomes. Using the main definition of adherence, there were no significant differences between late anti-TNF users and timely anti-TNF users in total costs (RR 0.86, 95% CI 0.54-1.36, p = 0.516) or nonbiologic costs (RR 0.72, 95% CI 0.44-1.18, p = 0.187). However, in the sensitivity analysis, late anti-TNF users had significantly increased nonbiologic costs compared with timely users (RR 1.58, 95% CI 1.06-2.36, p = 0.026). In the main analysis, there were no significant differences in QALY between timely anti-TNF users and late anti-TNF users, or between timely users and patients with unmet anti-TNF need. In the sensitivity analysis, patients with unmet anti-TNF need had significantly lower QALY than timely anti-TNF users (-0.04, 95% CI -0.07 to -0.01, p = 0.016). The effect of adherence to anti-TNF recommendations on outcomes was sensitive to the definition of adherence used, highlighting the need to validate methods to measure adherence.

  11. Quality of life in spondyloarthritis: analysis of a large Brazilian cohort.

    Science.gov (United States)

    Ribeiro, Sandra L E; Albuquerque, Elisa N; Bortoluzzo, Adriana B; Gonçalves, Célio R; da Silva, José Antonio Braga; Ximenes, Antonio Carlos; Bértolo, Manoel B; Keiserman, Mauro; Menin, Rita; Skare, Thelma L; Carneiro, Sueli; Azevedo, Valderílio F; Vieira, Walber P; Bianchi, Washington A; Bonfiglioli, Rubens; Campanholo, Cristiano; Carvalho, Hellen M S; Costa, Izaias P; Duarte, Angela L B Pinto; Kohem, Charles L; Leite, Nocy H; Lima, Sonia A L; Meirelles, Eduardo S; Pereira, Ivânio A; Pinheiro, Marcelo M; Polito, Elizandra; Resende, Gustavo G; Rocha, Francisco Airton C; Santiago, Mittermayer B; Sauma, Maria de Fátima L C; Valim, Valéria; Sampaio-Barros, Percival D

    2016-01-01

    To analyze quality of life and demographic and clinical variables associated to its impairment in a large Brazilian cohort of patients with spondyloarthritis (SpA). A common protocol of investigation was applied to 1465 Brazilian patients classified as SpA according to the European Spondyloarthropaties Study Group (ESSG) criteria, attended at 29 reference centers for Rheumatology in Brazil. Clinical and demographic variables were recorded. Quality of life was analyzed through the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. The mean ASQoL score was 7.74 (+5.39). When analyzing the specific diseases in the SpA group, the ASQoL scores did not present statistical significance. Demographic data showed worse scores of ASQoL associated with female gender (p=0.014) and African-Brazilian ethnicity (p<0.001). The analysis of the clinical symptoms showed that buttock pain (p=0.032), cervical pain (p<0.001) and hip pain (p=0.001) were statistically associated with worse scores of ASQoL. Continuous use of nonsteroidal anti-inflammatory drugs (p<0.001) and biologic agents (p=0.044) were associated with higher scores of ASQoL, while the other medications did not interfere with the ASQoL scores. In this large series of patients with SpA, female gender and African-Brazilian ethnicity, as well as predominant axial symptoms, were associated with impaired quality of life. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  12. MODERN IDEA ON THE PATHOGENESIS OF SPONDYLOARTHRITIS: MOLECULAR MECHANISMS

    Directory of Open Access Journals (Sweden)

    E. L. Nasonov

    2015-01-01

    Full Text Available As of now, impaired immune homeostasis of the intestinal mucosa in genetically predisposed individuals is considered to be one of the major components in the pathogenesis of spondyloarthritis (SpA, which leads to systemic chronic inflammation. The results of recent studies may suggest that the interleukin-23/interleukin-17 (IL-23/IL-17 axis plays a leading role in the development of these diseases. The multifactorial components of the pathogenesis of SpA are characterized by not only the hyperproduction of IL-23, but also by the change in cell target susceptibility to this cytokine with aconcurrent increase in their number, resulting in the chronic autoinflammatory process that occurs via a wide spectrum of clinical manifestations of different types of SpA

  13. Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

    Directory of Open Access Journals (Sweden)

    Gheorghe Andrada

    2017-06-01

    Full Text Available Background and aims. As already known, spondyloarthritis patients present a striking resemblance in intestinal inflammation with early Crohn’s disease. Moreover, the frequent use of nonsteroidal anti-inflammatory drugs is an important part of their treatment. Both conditions could lead to intestinal stenoses. Therefore we proposed to investigate the usefulness of the patency capsule test in patients with spondyloarthritis.

  14. Symptomatic, MRI Confirmed, Lumbar Disc Herniations: A Comparison of Outcomes Depending on the Type and Anatomical Axial Location of the Hernia in Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation.

    Science.gov (United States)

    Ehrler, Marco; Peterson, Cynthia; Leemann, Serafin; Schmid, Christof; Anklin, Bernard; Humphreys, B Kim

    2016-01-01

    The purpose of this study was to evaluate whether specific MRI features, such as axial location and type of herniation, are associated with outcomes of symptomatic lumbar disc herniation patients treated with spinal manipulation therapy (SMT). MRI and treatment outcome data from 68 patients were included in this prospective outcomes study. Pain numerical rating scale (NRS) and Oswestry physical disability questionnaire (OPDQ) levels were measured at baseline. The Patients Global Impression of Change scale, the NRS and the OPDQ were collected at 2 weeks, 1, 3, 6 months and 1 year. One radiologist and 2 chiropractic medicine master's degree students analyzed the MRI scans blinded to treatment outcomes. κ statistics assessed inter-rater reliability of MRI diagnosis. The proportion of patients reporting relevant improvement at each time point was compared based on MRI findings using the chi-square test. The t test and ANOVA compared the NRS and OPDQ change scores between patients with various MRI abnormalities. A higher proportion of patients with disc sequestration reported relevant improvement at each time point but this did not quite reach statistical significance. Patients with disc sequestration had significantly higher reduction in leg pain at 1 month compared to those with extrusion (P = .02). Reliability of MRI diagnosis ranged from substantial to perfect (K = .733-1.0). Patients with sequestered herniations treated with SMT to the level of herniation reported significantly higher levels of leg pain reduction at 1 month and a higher proportion reported improvement at all data collection time points but this did not reach statistical significance. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  15. Limited reliability of radiographic assessment of sacroiliac joints in patients with suspected early spondyloarthritis

    DEFF Research Database (Denmark)

    Christiansen, Alice Ashouri; Hendricks, Oliver; Kuettel, Dorota

    2017-01-01

    Objective. To determine the reproducibility of evaluation of sacroiliac joint (SIJ) radiographs among readers with varying levels of experience, and to identify potential drivers of disagreement in classification among 5 predefined radiographic lesion types. Methods. The study sample consisted of...... of 104 consecutive patients aged 18-40 with low back pain ≥ 3 months of duration who met the Assessment of SpondyloArthritis international Society (ASAS) definition for a positive SIJ magnetic resonance image, or were HLA-B27-positive and had ≥ 1 spondyloarthritis (SpA)-related clinical...

  16. Baixa prevalência das manifestações extra-articulares renais, cardíacas, pulmonares e neurológicas nas espondiloartrites: análise do Registro Brasileiro de Espondiloartrites Low prevalence of renal, cardiac, pulmonary, and neurological extra-articular clinical manifestations in spondyloarthritis: analysis of the Brazilian Registry of Spondyloarthritis

    Directory of Open Access Journals (Sweden)

    Carlos Ewerton Maia Rodrigues

    2012-06-01

    Full Text Available OBJETIVO: Descrever as manifestações extra-articulares (cardíacas, renais, pulmonares e neurológicas geralmente não relacionadas às espondiloartrites (EpA em uma grande coorte de pacientes brasileiros. MÉTODOS: Este estudo retrospectivo analisou 1.472 pacientes com o diagnóstico de EpA atendidos em 29 centros distribuídos pelas cinco principais regiões geográficas do Brasil, integrantes do Registro Brasileiro de Espondiloartrites. Todos os pacientes foram avaliados para a prevalência das principais manifestações extra-articulares (cardíacas, renais, pulmonares e neurológicas, divididas por diagnóstico [espondilite anquilosante (EA, artrite psoriásica (AP, artrite reativa (ARe, artrite associada a doença inflamatória intestinal (DII, EpA indiferenciada (EI e EpA juvenil] e por forma clínica (axial, periférica, mista e entesítica. RESULTADOS: Dentre os pacientes avaliados com EpA, 963 apresentavam EA, 271 AP, 49 ARe, 48 artrite associada a DII, 98 EI e 43 EpA juvenil. Acometimento cardíaco foi observado em 44 pacientes (3,0%, seguido por acometimento pulmonar em 19 (1,3%, renal em 17 (1,2% e neurológico em 13 pacientes (0,9%. A maioria dos casos de acometimento visceral ocorreu nos pacientes com EA ou AP e naqueles com forma clínica mista (axial e periférica e/ou predominantemente axial. CONCLUSÃO: As manifestações extra-articulares cardíacas, renais, pulmonares e neurológicas são muito pouco frequentes nas EpA, variando de 0,9%-3% nesta grande coorte brasileira, estando mais associadas a EA e AP.OBJECTIVE: To describe the extra-articular manifestations (cardiac, renal, pulmonary, and neurological, usually not related to spondyloarthritis (SpA, in a large cohort of Brazilian patients. MATERIALS AND METHODS: This retrospective study analyzed 1,472 patients diagnosed with SpA and cared for at 29 health care centers distributed in the five major geographic regions in the country, participating in the Brazilian

  17. Axial static mixer

    Science.gov (United States)

    Sandrock, H.E.

    1982-05-06

    Static axial mixing apparatus includes a plurality of channels, forming flow paths of different dimensions. The axial mixer includes a flow adjusting device for adjustable selective control of flow resistance of various flow paths in order to provide substantially identical flows through the various channels, thereby reducing nonuniform coating of interior surfaces of the channels. The flow adjusting device may include diaphragm valves, and may further include a pressure regulating system therefor.

  18. Fears and beliefs in rheumatoid arthritis and spondyloarthritis: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Francis Berenbaum

    Full Text Available To explore beliefs and apprehensions about disease and its treatment in patients with rheumatoid arthritis and spondyloarthritis.25 patients with rheumatoid arthritis and 25 with spondyloarthritis participated in semi-structured interviews about their disease and its treatment. The interviews were performed by trained interviewers in participants' homes. The interviews were recorded and the main themes identified by content analysis.Patients differentiated between the underlying cause of the disease, which was most frequently identified as a hereditary or individual predisposition. In patients with rheumatoid arthritis, the most frequently cited triggering factor for disease onset was a psychological factor or life-event, whereas patients with spondyloarthritis tended to focus more on an intrinsic vulnerability to disease. Stress and overexertion were considered important triggering factors for exacerbations, and relaxation techniques were frequently cited strategies to manage exacerbations. The unpredictability of the disease course was a common source of anxiety. Beliefs about the disease and apprehensions about the future tended to evolve over the course of the disease, as did treatment expectations.Patients with rheumatoid arthritis and spondyloarthritis hold a core set of beliefs and apprehensions that reflect their level of information about their disease and are not necessarily appropriate. The physician can initiate discussion of these beliefs in order to dispel misconceptions, align treatment expectations, provide reassurance to the patient and readjust disease management. Such a dialogue would help improve standards of care in these chronic and incapacitating diseases.

  19. The role of innate immune cells in tissue inflammation in spondyloarthritis

    NARCIS (Netherlands)

    Noordenbos, T.

    2017-01-01

    It is increasingly clear that the two most common forms of chronic inflammatory arthritis, rheumatoid arthritis and spondyloarthritis, have a distinct pathophysiology. Where failure of the acquired immune system is a major contributor for rheumatoid arthritis, this is not the case for

  20. Whole-body MRI of juvenile spondyloarthritis: protocols and pictorial review of characteristic patterns

    Energy Technology Data Exchange (ETDEWEB)

    Aquino, Michael R. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Tse, Shirley M.L.; Rachlis, Alisa C. [Hospital for Sick Children, Department of Rheumatology, Toronto (Canada); Gupta, Sumeet; Stimec, Jennifer [Hospital for Sick Children, Department of Radiology, Toronto (Canada)

    2015-05-01

    Spondyloarthritides are a group of inflammatory rheumatological diseases that cause arthritis with a predilection for spinal or sacroiliac involvement in addition to a high association with HLA-B27. Juvenile spondyloarthritis is distinct from adult spondyloarthritis and manifests more frequently as peripheral arthritis and enthesitis. Consequently juvenile spondyloarthritis is often referred to as enthesitis-related arthritis (ERA) subtype under the juvenile idiopathic arthritis (JIA) classification criteria. The American College of Rheumatology Treatment Recommendations for JIA, including ERA, are based on the following clinical parameters: current treatment, disease activity and the presence of poor prognostic features. The MRI features of juvenile spondyloarthritis include marrow edema, peri-enthesal soft-tissue swelling and edema, synovitis and joint or bursal fluid. Marrow edema is nonspecific and can be seen with other pathologies as well as in healthy subjects, and this is an important pitfall to consider. With further longitudinal study and validation, however, whole-body MRI with dedicated images of the more commonly affected areas such as the spine, sacroiliac joints, hips, knees, ankles and feet can serve as a more objective tool compared to clinical exam for early detection and monitoring of disease activity and ultimately direct therapeutic management. (orig.)

  1. Circulating levels of interleukin-6, vascular endothelial growth factor, YKL-40, matrix metalloproteinase-3, and total aggrecan in spondyloarthritis patients during 3 years of treatment with TNFα inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Hetland, Merete Lund; Sørensen, Inge Juul

    2010-01-01

    The objectives of the study were to investigate short and long-term changes and relations to treatment response of plasma interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), YKL-40, matrix metalloproteinase-3 (MMP-3), and total aggrecan in patients with spondyloarthritis (SpA) treated...... changes of plasma IL-6, VEGF, YKL-40, MMP-3, and total aggrecan and a potential value for monitoring disease activity and treatment response in SpA patients. Larger prospective studies are required to clarify clinical utility of these biomarkers....

  2. Predictive validity of the ASAS classification criteria for axial and peripheral spondyloarthritis after follow-up in the ASAS cohort

    DEFF Research Database (Denmark)

    Sepriano, Alexandre; Landewé, Robert; van der Heijde, Désirée

    2016-01-01

    had either chronic (>3 months) back pain of unknown origin and age of onset below 45 years (N=658) or peripheral arthritis and/or enthesitis and/or dactylitis (N=251). At follow-up, information was obtained at a clinic visit or by telephone. The positive predictive value (PPV) of the baseline...... years is excellent. The 'imaging arm' and 'clinical arm' of the axSpA criteria have similar predictive validity and are truly complementary....

  3. Axial tomographic scanner

    International Nuclear Information System (INIS)

    1976-01-01

    An axial tomographic system is described comprising axial tomographic means for collecting sets of data corresponding to the transmission or absorption of a number of beams of penetrating radiation through a planar slice of an object. It includes means to locate an object to be analyzed, a source and detector for directing one or more beams of penetrating radiation through the object from the source to the detector, and means to rotate (and optionally translate) the source as well as means to process the collected sets of data. Data collection, data processing, and data display can each be conducted independently of each other. An additional advantage of the system described is that the raw data (i.e., the originally collected data) are not destroyed by the data processing but instead are retained intact for further reference or use, if needed

  4. Synovial cell production of IL-26 induces bone mineralization in spondyloarthritis

    DEFF Research Database (Denmark)

    Heftdal, Line Dam; Andersen, Thomas; Jaehger, Ditte

    2017-01-01

    expression in SpA patients, and examine the in vitro production of IL-26 by synovial cells and the effects of IL-26 on human osteoblasts. IL-26 was measured by ELISA in plasma and synovial fluid (SF) of 15 SpA patients and in plasma samples from 12 healthy controls. Facet joints from axial SpA patients were...... and the myofibroblast marker α-smooth-muscle-actin (αSMA) and analyzed by flow cytometry. Human osteoblasts were cultured in the presence of IL-26, and the degree of mineralization was quantified. We found that IL-26 levels in SF were increased compared with plasma (P ... in facet joints of axial SpA patients within the bone marrow. IL-26 secretion was primarily found in αSMA+ myofibroblasts. In contrast, Th17 cells did not produce detectable amounts of IL-26. Human osteoblasts treated with IL-26 showed increased mineralization compared with untreated osteoblasts (P = 0...

  5. Cardiovascular and selected comorbidities in early arthritis and early spondyloarthritis, a comparative study: results from the ESPOIR and DESIR cohorts.

    Science.gov (United States)

    Gherghe, Ana Maria; Dougados, Maxime; Combe, Bernard; Landewé, Robert; Mihai, Carina; Berenbaum, Francis; Mariette, Xavier; Wolterbeek, Ron; van der Heijde, Désirée

    2015-01-01

    To investigate the prevalence of comorbidities in early rheumatoid arthritis (ERA) and early axial spondyloarthritis (ESpA) versus the general population. Baseline data of 689 patients with ERA from the Etude et Suivi des Polyarthrites Indifférenciées Récentes (ESPOIR) cohort (age 48.2±12.1 years, symptoms duration 14.2±14.5 weeks) and 645 patients with ESpA from Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; age 32.8±8.4 years, axial symptoms duration 79.0±45.7 weeks) were analysed. Metabolic and cardiovascular diseases (CVD), infections and neoplasia were determined in each cohort. The prevalence (95% CI) of several comorbidities was compared with that in the French general population. For patients without CVD, the 10-year risk of developing CVD was calculated using the Framingham and SCORE equations. The heart age was calculated using the 2008 Framingham points system. 42% of patients with ERA and 20.3% of patients with ESpA had at least 1 comorbidity; the most common were arterial hypertension (AHT) and dyslipidaemia. AHT prevalence (95% CI) in ERA (18.2% (15.5% to 21.3%)), but not in ESpA (5.08% (3.57% to 7.14%)), was significantly increased (p<0.05) compared with the general population (7.58%). Prevalence of tuberculosis history was higher in ERA (4.7% (3.3% to 6.6%)), and ESpA (0.99% (0.4% to 2.3%)) than in the general population (0.02%; both p<0.05). No differences were observed in malignancies, coronary heart disease or diabetes. In ERA, among patients without a history of CVD, an intermediate to high CVD risk was found. The heart age exceeded the real age by 4.1±9.6 years in ERA and by 2.1±7.0 years in ESpA (p<0.001). We found an increased prevalence of AHT and tuberculosis history in ERA and ESpA, and an increased CVD risk. These results should prompt rheumatologists to check these comorbidities early in the disease.

  6. 2014 Update of the Canadian Rheumatology Association/spondyloarthritis research consortium of Canada treatment recommendations for the management of spondyloarthritis. Part I: principles of the management of spondyloarthritis in Canada.

    Science.gov (United States)

    Rohekar, Sherry; Chan, Jon; Tse, Shirley M L; Haroon, Nigil; Chandran, Vinod; Bessette, Louis; Mosher, Dianne; Flanagan, Cathy; Keen, Kevin J; Adams, Karen; Mallinson, Michael; Thorne, Carter; Rahman, Proton; Gladman, Dafna D; Inman, Robert D

    2015-04-01

    The Canadian Rheumatology Association (CRA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) have collaborated to update the recommendations for the management of spondyloarthritis (SpA). A working group was assembled and consisted of the SPARCC executive committee, rheumatologist leaders from SPARCC collaborating sites, Canadian rheumatologists from across the country with an interest in SpA (both academic and community), a rheumatology trainee with an interest in SpA, an epidemiologist/health services researcher, a member of the CRA executive, a member of the CRA therapeutics committee, and a patient representative from the Canadian Spondylitis Association. An extensive review was conducted of literature published from 2007 to 2014 involving the management of SpA. The working group created draft recommendations using multiple rounds of Web-based surveys and an in-person conference. A survey was sent to the membership of the CRA to obtain an extended review that was used to finalize the recommendations. Guidelines for the management of SpA were created. Part I focuses on the principles of management of SpA in Canada and includes 6 general management principles, 5 ethical considerations, target groups for treatment recommendations, 2 wait time recommendations, and recommendations for disease monitoring. Also included are 6 modifications for application to juvenile SpA. These recommendations were developed based on current literature and applied to a Canadian healthcare context. It is hoped that the implementation of these recommendations will promote best practices in the treatment of SpA.

  7. Safety of Etoricoxib, Celecoxib, and Nonselective Nonsteroidal Antiinflammatory Drugs in Ankylosing Spondylitis and Other Spondyloarthritis Patients

    DEFF Research Database (Denmark)

    Kristensen, L E; Jakobsen, A K; Askling, J

    2015-01-01

    OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular, and cardio......OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular...... exposure was assessed time dependently based on the prescription drug register from 2006-2009, adjusting for sociodemographics and comorbidities derived from national population-based registers. RESULTS: Exposure to etoricoxib, celecoxib, and nonselective NSAIDs was 7.6%, 3.9%, and 71.2%, respectively...

  8. Educational needs in patients with spondyloarthritis in Sweden ? a mixed-methods study

    OpenAIRE

    Haglund, Emma; Bremander, Ann; Bergman, Stefan; Larsson, Ingrid

    2017-01-01

    Background There is a demand for a flexible and individually tailored patient education to meet patients? specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and priorities in patient education in patients with SpA. A second aim was to investigate patients? experiences and preferences of receiving patient education. Methods Data collection ...

  9. Spondylodiscitis as the only clinical manifestation of the onset of psoriatic spondyloarthritis

    Directory of Open Access Journals (Sweden)

    V. Bruzzese

    2011-06-01

    Full Text Available Psoriatic arthritis falls within the family of seronegative spondyloarthritis given that the involvement of the spine, whether in combination with peripheral arthritis or not, is one of the most common clinical fi ndings of the disease. Symptomatological polymorphism of the disease, however, still includes several clinical subsets ranging from peripheral arthritis, mono-, oligo- and polyarticular, to enthesitis and dactylitis, all the way to crippling arthritis. Despite the frequent

  10. Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register

    DEFF Research Database (Denmark)

    Lindström, U; Exarchou, S; Sigurdardottir, V

    2015-01-01

    (AS) and undifferentiated SpA (uSpA) in the NPR against the established classification criteria [modified New York (mNY), Assessment of SpondyloArthritis international Society (ASAS), Amor, and European Spondyloarthropathy Study Group (ESSG) criteria]. METHOD: All patients with an ICD-8/9/10 code...... for AS or uSpA had high PPVs, suggesting that our case identification in the Swedish NPR can be used for nationwide, population-based, epidemiological studies of these diseases....

  11. [Patient education in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis].

    Science.gov (United States)

    Ehlebracht-König, Inge; Bönisch, Angelika

    2008-01-01

    Patients with early spondyloarthritis often suffer from uncertainty regarding to their disease and the future development, sometimes fear of the future is to the fore. Patients with rheumatic diseases need a comprehensive and interdisciplinary treatment. In this connection patient education takes the part to lead patients to a better self-management. The goals of patient education are: to increase knowledge and interoception, to influence attitudes and self-efficacy and in addition to improve the disease or health behaviour. The study group "patient education" of the German Society of Rheumatology (DGRh) developed several education programmes, which methods and topics are based on behavioural science. The program for patients with spondyloarthritis is topic entered and close to patients needs. It is an interdisciplinary course, carried out by a qualified education team. The course contains 6 modules each lasting 90 minutes. The efficacy has been proved in different levels as well as return to work, economic advantages have been shown. Particularly patients with early spondyloarthritis and noticeable scores in the self-assessments (BASDAI, FFbH-R, AHI) profited from the education course.

  12. Rate and Predisposing Factors for Sacroiliac Joint Radiographic Progression After a Two-Year Follow-up Period in Recent-Onset Spondyloarthritis.

    Science.gov (United States)

    Dougados, Maxime; Demattei, Christophe; van den Berg, Rosaline; Vo Hoang, Viet; Thevenin, Fabrice; Reijnierse, Monique; Loeuille, Damien; Feydy, Antoine; Claudepierre, Pascal; van der Heijde, Désirée

    2016-08-01

    To evaluate the rate of radiographic structural progression in the sacroiliac (SI) joints in patients with radiographic or nonradiographic axial spondyloarthritis (SpA), and to determine factors predisposing to such progression, over 2 years. Patients with recent-onset axial SpA (from the Devenir des Spondyloarthropathies Indifferérenciées Récentes cohort) were assigned a radiographic SI joint score according to the modified New York criteria. Demographic characteristics, smoking status, HLA-B27 positivity, inflammation on magnetic resonance imaging (MRI) of the SI joints, disease activity, and treatment were investigated as potential predisposing factors. The main analysis consisted of the evaluation of the switch from nonradiographic to radiographic axial SpA, but other definitions of radiographic progression were also evaluated. Of the 708 patients enrolled, 449 had baseline and 2-year pelvic radiographs. Of these patients, 47% were men. Their mean ± SD age was 34 ± 9 years, 61% were B27 positive, and 37% had inflammation of the SI joints on MRI. The percentages of patients who switched from nonradiographic to radiographic axial SpA (4.9% [16 of 326]) and from radiographic to nonradiographic axial SpA (5.7% [7 of 123]) were low. The mean ± SD change in the total SI joint score (range 0-8) was small (0.1 ± 0.8) but highly significant (P < 0.001). The potential baseline predisposing factors for meeting the modified New York criteria in the multivariate analysis were current smoking, HLA-B27 positivity, and inflammation of the SI joints on MRI, with odds ratios of 3.3 (95% confidence interval [95% CI] 1.0-11.5], 12.6 (95% CI 2.3-274), and 48.8 (95% CI 9.3-904), respectively. Our findings suggest that structural progression does exist in early SpA, but it is quite small and observed in a small number of patients, and that environmental (smoking status), genetic (HLA-B27 positivity), and inflammation (inflammation of the SI joints on MRI

  13. Rate and Predisposing Factors for Sacroiliac Joint Radiographic Progression After a Two‐Year Follow‐up Period in Recent‐Onset Spondyloarthritis

    Science.gov (United States)

    Demattei, Christophe; van den Berg, Rosaline; Vo Hoang, Viet; Thevenin, Fabrice; Reijnierse, Monique; Loeuille, Damien; Feydy, Antoine; Claudepierre, Pascal; van der Heijde, Désirée

    2016-01-01

    Objective To evaluate the rate of radiographic structural progression in the sacroiliac (SI) joints in patients with radiographic or nonradiographic axial spondyloarthritis (SpA), and to determine factors predisposing to such progression, over 2 years. Methods Patients with recent‐onset axial SpA (from the Devenir des Spondyloarthropathies Indifferérenciées Récentes cohort) were assigned a radiographic SI joint score according to the modified New York criteria. Demographic characteristics, smoking status, HLA–B27 positivity, inflammation on magnetic resonance imaging (MRI) of the SI joints, disease activity, and treatment were investigated as potential predisposing factors. The main analysis consisted of the evaluation of the switch from nonradiographic to radiographic axial SpA, but other definitions of radiographic progression were also evaluated. Results Of the 708 patients enrolled, 449 had baseline and 2‐year pelvic radiographs. Of these patients, 47% were men. Their mean ± SD age was 34 ± 9 years, 61% were B27 positive, and 37% had inflammation of the SI joints on MRI. The percentages of patients who switched from nonradiographic to radiographic axial SpA (4.9% [16 of 326]) and from radiographic to nonradiographic axial SpA (5.7% [7 of 123]) were low. The mean ± SD change in the total SI joint score (range 0–8) was small (0.1 ± 0.8) but highly significant (P < 0.001). The potential baseline predisposing factors for meeting the modified New York criteria in the multivariate analysis were current smoking, HLA–B27 positivity, and inflammation of the SI joints on MRI, with odds ratios of 3.3 (95% confidence interval [95% CI] 1.0–11.5], 12.6 (95% CI 2.3–274), and 48.8 (95% CI 9.3–904), respectively. Conclusion Our findings suggest that structural progression does exist in early SpA, but it is quite small and observed in a small number of patients, and that environmental (smoking status), genetic (HLA–B27 positivity

  14. Progression rate of ankylosing spondylitis in patients with undifferentiated spondyloarthritis

    Science.gov (United States)

    Xia, Qing; Fan, Dazhi; Yang, Xiao; Li, Xiaona; Zhang, Xu; Wang, Mengmeng; Xu, Shengqian; Pan, Faming

    2017-01-01

    Abstract Background: The idea that undifferentiated spondyloarthritis (uSpA) represents the early undifferentiated stage of ankylosing spondylitis (AS) and other well-defined SpA subtypes is well known. The gist of this study is to assess the rate estimate of patients with uSpA evolved to AS during long-term follow-up. Methods: A systematic search was implemented to identify pertinent articles. The primary outcome was the rate estimate that patients with uSpA fulfilling the diagnosis of AS according to the modified New York criteria during follow-up. The rate estimate and corresponding 95% confidence interval (95%CI) were pooled by the random-effects model in STATA 11.0 software. Meta-regression analyses were adopted to explore the sources of heterogeneity. The quality assessment was conducted by the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Begg test and the Egger test were applied to assess publication bias. Results: Sixteen papers were finally included in this study after screening 1299 citations. The pooled rate of patients with uSpA progression to AS synthesized from the 16 papers was 0.323 (95%CI 0.257–0.389). Subgroup analysis based on the length of follow-up showed that the rate at the time-point of 5, 8, and 10 years follow-up was 0.220 (95%CI 0.110–0.330), 0.291 (95%CI 0.257–0.325), and 0.399 (95%CI 0.190–0.608), respectively; while the rate in Asia, Europe, and Latin America was 0.367 (95%CI 0.282–0.452), 0.228 (95%CI 0.066–0.390), and 0.269 (95%CI 0.209–0.329), respectively. Meta-regression analysis indicated that the length of follow-up alone accounts for 45.23% of the total heterogeneity. Nearly half of the papers scored fair quality and none publication bias was identified based on the Begg test and the Egger test. Further, line chart describes an obviously increased trend for the patients with uSpA fulfilling the diagnosis of AS over time. Conclusion: The

  15. Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor a inhibitors: a study of radiographic progression, inflammation on magnetic resonance imaging, and circulating biomarkers of inflammation

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Lambert, Robert G. W.

    2011-01-01

    metalloproteinase 3 [MMP-3], and cartilage oligomeric matrix protein [COMP]), and bone turnover (CTX-I and osteocalcin) to inflammation on magnetic resonance imaging (MRI) and radiographic progression in patients with axial spondylarthritis (SpA) beginning tumor necrosis factor α (TNFα) inhibitor therapy.......To investigate the relationship of circulating biomarkers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and YKL-40), angiogenesis (vascular endothelial growth factor), cartilage turnover (C-terminal crosslinking telopeptide of type II collagen [CTX-II], total aggrecan, matrix...

  16. Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor α inhibitors: A study of radiographic progression, inflammation on magnetic resonance imaging, and circulating biomarkers of inflammation

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Lambert, Robert G W

    2011-01-01

    metalloproteinase 3 [MMP-3], and cartilage oligomeric matrix protein [COMP]), and bone turnover (CTX-I and osteocalcin) to inflammation on magnetic resonance imaging (MRI) and radiographic progression in patients with axial spondylarthritis (SpA) beginning tumor necrosis factor a (TNFa) inhibitor therapy.......To investigate the relationship of circulating biomarkers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and YKL-40), angiogenesis (vascular endothelial growth factor), cartilage turnover (C-terminal crosslinking telopeptide of type II collagen [CTX-II], total aggrecan, matrix...

  17. Compton backscattering axial spectrometer

    International Nuclear Information System (INIS)

    Rad'ko, V.E.; Mokrushin, A.D.; Razumovskaya, I.V.

    1981-01-01

    Compton gamma backscattering axial spectrometer of new design with the 200 time larger aperture as compared with the known spectrometers at the equal angular resolution (at E=159 keV) is described. Collimator unit, radiation source and gamma detector are located in the central part of the spectrometer. The investigated specimen (of cylindrical form) and the so called ''black body'' used for absorption of photons, passed through the specimen are placed in the peripheric part. Both these parts have an imaginary symmetry axis that is why the spectrometer is called axial. 57 Co is used as the gamma source. The 122 keV spectral line which corresponds to the 83 keV backscattered photon serves as working line. Germanium disk detector of 10 mm diameter and 4 mm height has energy resolution not worse than 900 eV. The analysis of results of test measurements of compton water profile and their comparison with data obtained earlier show that only finity of detector resolution can essentially affect the form of Compton profile. It is concluded that the suggested variant of the spectrometer would be useful for determination of Compton profiles of chemical compounds of heavy elements [ru

  18. Axial skeletal CT densitometry

    International Nuclear Information System (INIS)

    Lampmann, L.E.H.

    1982-01-01

    Since the discovery of the Roentgen ray a precise and accurate assessment of bone mineral content has been a challenge to many investigators. A number of methods have been developed but no one satisfied. Considering its technical possibilities computed tomography is very promising in determination of bone mineral content (BMC). The new modality enables BMC estimations in the axial skeletal trabecular bone. CT densitometry can be performed on a normal commercially available third generation whole body CT scanner. No dedicated device in a special clinical set-up is necessary. In this study 106 patients, most of them clinically suspected of osteoporosis, were examined. The new method CT densitometry has been evaluated. The results have been correlated to alternative BMC determination methods. (Auth.)

  19. Patient-physician discordance in global assessment in early spondyloarthritis and its change over time: the DESIR cohort.

    Science.gov (United States)

    Desthieux, Carole; Molto, Anna; Granger, Benjamin; Saraux, Alain; Fautrel, Bruno; Gossec, Laure

    2016-09-01

    To assess patient-physician discordance in global assessment of disease activity in early axial spondyloarthritis (axSpA) over time and determinants of discordance. DESIR (Devenir des Spondyloarthropathies Indifférenciées Récentes) is a French, multicentre, longitudinal cohort of patients with early inflammatory back pain suggestive of axSpA. Patient global assessment (PGA) and physician global assessment (PhGA) were rated with a 0-10 numerical rating scale, every 6 months during 2 years then at 3 years. Discordance was defined by the absolute difference |PGA-PhGA|≥3 (range 0-10) and was analysed at each visit. Determinants of (PGA-PhGA) were assessed at the visit level by a generalised linear mixed model. A total of 702 patients were analysed at baseline (401 with complete data over 3 years): mean age 33.8±8.6 years, 379 (54.0%) female, mean symptom duration 18.1±10.5 months. Mean PGA values were always higher than mean PhGA values with a mean absolute difference of 1.8 points. At baseline, 202 (28.8%) patients had discordance mainly by PGA>PhGA; over 3 years the frequency of discordance was stable (range 25.5-28.8%). Discordance was not stable at the patient level, 118 (29.4%) patients were discordant once and 88 (22.0%) twice, and only 92 (22.9%) more than twice. Determinants of (PGA-PhGA) were spine pain (β=0.24, p<0.001) and fatigue (β=0.13, p<0.001). Discordance concerned a quarter of patients with early axSpA. Over 3 years of follow-up, discordance did not decrease (no 'reference shift'). Discordance was not a stable trait, indicating discordance is not a patient characteristic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Evaluation of dose reduction versus standard dosing for maintenance of remission in patients with spondyloarthritis and clinical remission with anti-TNF (REDES-TNF): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Pontes, Caridad; Gratacós, Jordi; Torres, Ferran; Avendaño, Cristina; Sanz, Jesús; Vallano, Antoni; Juanola, Xavier; de Miguel, Eugenio; Sanmartí, Raimon; Calvo, Gonzalo

    2015-08-20

    Dose reduction schedules of tumor necrosis factor antagonists (anti-TNF) as maintenance therapy in patients with spondyloarthritis are used empirically in clinical practice, despite the lack of clinical trials providing evidence for this practice. To address this issue the Spanish Society of Rheumatology (SER) and Spanish Society of Clinical Pharmacology (SEFC) designed a 3-year multicenter, randomized, open-label, controlled clinical trial (2 years for inclusion and 1 year of follow-up). The study is expected to include 190 patients with axial spondyloarthritis on stable maintenance treatment (≥4 months) with any anti-TNF agent at doses recommended in the summary of product characteristics. Patients will be randomized to either a dose reduction arm or maintenance of the dosing regimen as per the official labelling recommendations. Randomization will be stratified according to the anti-TNF agent received before study inclusion. Patient follow-up, visit schedule, and examinations will be maintained as per normal clinical practice recommendations according to SER guidelines. The study aims to test the hypothesis of noninferiority of the dose reduction strategy compared with standard treatment. The first patients were recruited in July 2012, and study completion is scheduled for the end of April 2015. The REDES-TNF study is a pragmatic clinical trial that aims to provide evidence to support a medical decision now made empirically. The study results may help inform clinical decisions relevant to both patients and healthcare decision makers. EudraCT 2011-005871-18 (21 December 2011).

  1. Dissipative Axial Inflation

    CERN Document Server

    Notari, Alessio

    2016-12-22

    We analyze in detail the background cosmological evolution of a scalar field coupled to a massless abelian gauge field through an axial term $\\frac{\\phi}{f_\\gamma} F \\tilde{F}$, such as in the case of an axion. Gauge fields in this case are known to experience tachyonic growth and therefore can backreact on the background as an effective dissipation into radiation energy density $\\rho_R$, which which can lead to inflation without the need of a flat potential. We analyze the system, for momenta $k$ smaller than the cutoff $f_\\gamma$, including numerically the backreaction. We consider the evolution from a given static initial condition and explicitly show that, if $f_\\gamma$ is smaller than the field excursion $\\phi_0$ by about a factor of at least ${\\cal O} (20)$, there is a friction effect which turns on before that the field can fall down and which can then lead to a very long stage of inflation with a generic potential. In addition we find superimposed oscillations, which would get imprinted on any kind of...

  2. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis....... Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided...... Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists Udgivelsesdato: 2008/12/1...

  3. Nefropatia por IgA nas espondiloartrites IgA nephropathy in spondyloarthritis

    Directory of Open Access Journals (Sweden)

    Daniela Castelo Azevedo

    2011-02-01

    Full Text Available Pacientes com espondiloartrites poderiam ser mais acometidos pela nefropatia por IgA do que a população geral, havendo, possivelmente, um mecanismo etiopatogênico comum. O seguinte artigo relaciona quatro casos que exemplificam essa possível associaçãoSpondyloarthritis patients can be more frequently affected by IgA nephropathy than the general population, and a common etiopathogenic mechanism can be involved. We report four cases that may exemplify that association

  4. Relationship between fecal calprotectin, anti-Saccharomyces cerevisiae antibodies and other markers of disease activity in patients with spondyloarthritis.

    Science.gov (United States)

    Moreno Martínez, María José; Moreno Ramos, Manuel José; Linares Ferrando, Luis Francisco

    2018-02-01

    To assess the relationship between the increase of fecal calprotectin, anti-Saccharomyces cerevisiae antibodies (ASCA) and disease markers in a group of patients with spondyloarthritis. We evaluated patients who were at least 18-years-old and met the Assessment in Spondyloarthritis International Society (ASAS) criteria for spondyloarthritis or the New York modified criteria. We analyzed activity criteria, physical function, analytical criteria (human leukocyte antigen [HLA] B27, fecal calprotectin, presence of ASCA, among others) and demographic data. We included 33 patients. All but one patient had normal ASCA values. We found statistical significance in the correlation of calprotectin with C-reactive protein (CRP) but not with other parameters. We also found a relationship between calprotectin levels and nonsteroidal anti-inflammatory drug (NSAID) intake (P=.001). We found no relationship between CRP levels and NSAID use. After discontinuation of NSAIDs for one month, we found no significant differences in calprotectin levels (P=.9). Fecal calprotectin is elevated in patients with spondyloarthritis and correlates positively with CRP. Level of fecal calprotectin is not altered by NSAID use. The amount of ASCA present does not change and does not correlate with any clinical parameters in the study population. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  5. Report from the Latin American Spondyloarthritis Society for Education and Research in Immunology and Medicine organization 2012 workshop.

    Science.gov (United States)

    Bautista-Molano, Wilson; Toloza, Sergio; Gutiérrez, Marwin; Uribe, Carlos Vinicio Caballero; Pineda, Carlos; Londoño, John; Santos, Pedro; Jaimes, Diego; Diaz, Mario; Chalem, Phillipe; Villota, Orlando; Sierra, Rita; Puche, William; Salas, José; Yara, José; Hamilton, Gordon; Pardo, Carlos; Mercado, Beatriz; Valle-Oñate, Rafael

    2013-09-01

    The first annual meeting of the Latin American Spondyloarthritis Society for Education and Research in Immunology and Medicine (LASSERIM) was held in Bogotá, Colombia, in September 2012 and was attended by key opinion leaders, researchers, and rheumatologists. The meeting included presentations and discussions from renowned speakers during 2 days and a coaching leadership exercise led by an expert in the field followed by an open forum. Two groups defined a priori discussed the establishment of a professional network and organization to be involved in the identification, assessment, and effective resolution of health care issues in Latin America.A broad spectrum of topics were discussed but focused on the following: pharmacoeconomics in general rheumatology, spondyloarthritis and chronic back pain, therapeutic interventions in rheumatoid arthritis, ultrasonography in spondyloarthritis, impact of social media in medicine and global trends in leadership, quality of life, and innovation. A special workshop on coaching in health care and coaching as a tool to implement LASSERIM goals was part of the 2-day conference.LASSERIM will be working in the future on education, research, and innovation in the field of rheumatology and immunology. A special focus will be on spondyloarthritis, by promoting research, open discussions, and by conducting carefully planned research studies to impact on the quality of life of patients and doctors from Latin American countries.

  6. Colon mucosa of patients both with spondyloarthritis and Crohn's disease is enriched with macrophages expressing the scavenger receptor CD163

    NARCIS (Netherlands)

    Demetter, P.; de Vos, M.; van Huysse, J. A.; Baeten, D.; Ferdinande, L.; Peeters, H.; Mielants, H.; Veys, E. M.; de Keyser, F.; Cuvelier, C. A.

    2005-01-01

    BACKGROUND: Crohn's disease is associated with an increased number of macrophages in ileal and colonic mucosa. Data on macrophages in gut mucosa of patients with spondyloarthritis (SpA) are scarce. OBJECTIVE: To investigate macrophages and other antigen presenting cells in gut mucosa from patients

  7. Conservative axial burnup distributions for actinide-only burnup credit

    International Nuclear Information System (INIS)

    Kang, C.; Lancaster, D.

    1997-11-01

    Unlike the fresh fuel approach, which assumes the initial isotopic compositions for criticality analyses, any burnup credit methodology must address the proper treatment of axial burnup distributions. A straightforward way of treating a given axial burnup distribution is to segment the fuel assembly into multiple meshes and to model each burnup mesh with the corresponding isotopic compositions. Although this approach represents a significant increase in modeling efforts compared to the uniform average burnup approach, it can adequately determine the reactivity effect of the axial burnup distribution. A major consideration is what axial burnup distributions are appropriate for use in light of many possible distributions depending on core operating conditions and histories. This paper summarizes criticality analyses performed to determine conservative axial burnup distributions. The conservative axial burnup distributions presented in this paper are included in the Topical Report on Actinide-Only Burnup Credit for Pressurized Water Reactor Spent Nuclear Fuel Packages, Revision 1 submitted in May 1997 by the US Department of Energy (DOE) to the US Nuclear Regulatory Commission (NRC). When approved by NRC, the conservative axial burnup distributions may be used to model PWR spent nuclear fuel for the purpose of gaining actinide only burnup credit

  8. Characterization of Multiflux Axial Compressors

    International Nuclear Information System (INIS)

    Brasnarof, Daniel; Kyung Kyu-Hyung; Rivarola, Martin; Gonzalez Jose; Florido, Pablo; Orellano, Pablo; Bergallo, Juan

    2003-01-01

    In the present work the results of analytical models of performance are compared with experimental data acquired in the multi flux axial compressor test facility, built in The Pilcaniyeu Technological Complex for the SIGMA project.We describe the experimental circuit and the data of the dispersion inside the axial compressor obtained using a tracer gas through one of the annular inlets.The attained results can be used to validate the design code for the multi flux axial compressors and SIGMA industrial plant

  9. Janus kinase/signal transducer and activator of transcription pathways in spondyloarthritis.

    Science.gov (United States)

    Raychaudhuri, Smriti K; Raychaudhuri, Siba P

    2017-07-01

    Cytokines are major drivers of autoimmunity, and biologic agents targeting cytokines have revolutionized the treatment of immune-mediated diseases. Janus kinase/signal transducer and activator of transcription (JAK-STAT) pathway represents a group of several intracellular molecules with a key role in signal pathways activated by growth factors and cytokines. These kinase proteins are associated with the signaling process of multiple key cytokines, which regulates various T-cell subpopulations and their effector cytokines. Development of novel drugs to inhibit this kinase cascade is an emerging field in clinical immunology. Thus, it is essential to have insights about the regulatory role of the JAK-STAT cytokine signaling in relation to autoimmune diseases and its applications in spondyloarthritis. JAK-STAT kinase signaling proteins have been extensively studied in rheumatoid arthritis. Initial observations suggest that JAK-STAT kinase signaling cascade regulates activation and proliferation of the IL17 effector memory T cells and thus has a potential role in the pathogenesis of psoriasis, psoriatic arthritis and ankylosing spondylitis. Here, we provide an overview of the clinical rheumatologists about the significance of JAK-STAT signaling system in rheumatic diseases and introduce the potential application of JAK and STAT inhibitors in spondyloarthritis.

  10. Fluorescence axial nanotomography with plasmonics.

    Science.gov (United States)

    Cade, Nicholas I; Fruhwirth, Gilbert O; Krasavin, Alexey V; Ng, Tony; Richards, David

    2015-01-01

    We present a novel imaging technique with super-resolution axial sensitivity, exploiting the changes in fluorescence lifetime above a plasmonic substrate. Using conventional confocal fluorescence lifetime imaging, we show that it is possible to deliver down to 6 nm axial position sensitivity of fluorophores in whole biological cell imaging. We employ this technique to map the topography of the cellular membrane, and demonstrate its application in an investigation of receptor-mediated endocytosis in carcinoma cells.

  11. Perceptions of patients with rheumatic diseases treated with subcutaneous biologicals on their level of information: RHEU-LIFE Survey.

    Science.gov (United States)

    de Toro, Javier; Cea-Calvo, Luis; Battle, Enrique; Carmona, Loreto; Arteaga, María J; Fernández, Sabela; González, Carlos M

    2017-12-22

    To investigate, in Spanish patients with rheumatic diseases treated with subcutaneous biological drugs, their sources of information, which sources they consider most relevant, and their satisfaction with the information received in the hospital. Rheumatologists from 50 hospitals handed out an anonymous survey to 20 consecutive patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis treated with subcutaneous biologicals. The survey was developed ad hoc by 4 rheumatologists and 3 patients, and included questions with closed-ended responses on sources of information and satisfaction. The survey was handed-out to 1,000 patients, 592 of whom completed it (response rate: 59.2%). The rheumatologist was mentioned as the most important source of information (75%), followed by the primary care physician, nurses, and electronic resources; 45.2% received oral and written information about the biological, 46.1% oral only, and 6.0% written only; 8.7% stated that they had not been taught to inject the biological. The percentage of patients satisfied with the information received was high (87.2%), although the satisfaction was lower in relation to safety. If the information came from the rheumatologist, the satisfaction was higher (89.6%) than when coming from other sources (59.6%; P<.001). Satisfaction was also higher if the information was provided orally and written (92.8%) than if provided only orally (86.1%; P=.013); 45.2% reported having sought information from sources outside the hospital. The rheumatologist is key in transmitting satisfactory information on biological treatment to patients. He or she must also act as a guide, since a high percentage of patients seeks information in other different sources. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  12. Selected issues in diagnostic imaging of spondyloarthritides: psoriatic arthritis and juvenile spondyloarthritis.

    Science.gov (United States)

    Sudoł-Szopińska, Iwona; Płaza, Mateusz; Pracoń, Grzegorz

    2016-01-01

    Spondyloarthritides (also known as spondyloarthropathies) are a group of rheumatic diseases that consists of diversified entities, i.e. ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis in the course of Crohn's disease and ulcerative colitis, and juvenile spondyloarthropathies. In the diagnostics of spondyloarthritides, plain radiography has played a crucial role for years due to its undisputed ability to show distinctive bony changes. Yet as those diseases often manifest themselves by soft tissue pathology and bone marrow inflammation, ultrasonography and magnetic resonance imaging are currently a subject of numerous studies in the quest for setting up diagnostic criteria, especially at early stages of inflammatory processes. In our review, we present an up-to-date insight into classifications, etiopathogenesis and imaging of psoriatic arthritis and juvenile spondyloarthritis.

  13. Mesenchimal stem cells: a possible role in the pathogenesis and treatment of spondyloarthritis.

    Science.gov (United States)

    Perrotta, F M; Guerra, G; De Socio, A; Scriffignano, S; Lubrano, E

    2017-05-22

    Spondyloarthritis (SpAs) are a group of chronic inflammatory diseases that affect joints and enthesis with a possible involvement of other districts such as skin, eye and bowel. In SpAs, the inflammatory process could lead to both erosive damage (as in peripheral joint involvement of psoriatic arthritis), or bone formation (as in ankylosing spondylitis) with a reduction in function and quality of life. Recently, Mesenchimal stem cells (MSCs) transplant was used in different diseases, including autoimmune and inflammatory diseases, with the aim of repairing tissue damage, exploiting their regenerative capacity. However, MSCs also proved to have an immune-modulatory capacity due to their interaction with the cells of the immune system. The aim of this brief paper was to review the possible pathogenic role and the new perspective of MSCs use in SpAs.

  14. A Case of Spondyloarthritis in Patient Affected by Unicentric Castleman’s Disease Effectively Managed with Surgery Resection and Tocilizumab Treatment

    Directory of Open Access Journals (Sweden)

    M. Filippini

    2018-01-01

    Full Text Available A 38-year-old woman was referred to our hospital for rheumatologic manifestations (migrant arthritis and tenosynovitis, without psoriasis or family history of psoriasis, gastroenteric manifestations, or recent genitourinary infections. The instrumental and laboratory tests have suggested a diagnosis of undifferentiated seronegative HLA-B27-positive spondyloarthritis with predominantly peripheral involvement. The symptoms were very severe and resistant to anti-inflammatory drugs and steroids. She had a history of hyaline-vascular unicentric Castleman’s disease (HBV, HIV, and HHV-8 negative treated with surgery resection. After a first pharmacological attempt with sulfasalazine (suspended for urticarial rash, we managed the patient with monotherapy tocilizumab 8 mg/kg, with full response of rheumatologic manifestations. The efficacy of tocilizumab was confirmed even after a follow-up of three years. Our experience seems to describe a new late-onset autoimmune disease (only 21 cases described in literature potentially related to Castleman’s disease. The patient experienced marked improvement from IL-6-based therapy (tocilizumab.

  15. Axial structure of the nucleon

    Energy Technology Data Exchange (ETDEWEB)

    Veronique Bernard; Latifa Elouadrhiri; Ulf-G Meissner

    2002-01-01

    We review the current status of experimental and theoretical understanding of the axial nucleon structure at low and moderate energies. Topics considered include (quasi)elastic (anti)neutrino-nucleon scattering, charged pion electroproduction off nucleons and ordinary as well as radiative muon capture on the proton.

  16. Axial stability of Taylor bubbles

    NARCIS (Netherlands)

    Lu, X.; Prosperetti, Andrea

    2006-01-01

    Long gas bubbles rising in a vertical tube are observed to lose axial symmetry and become unstable in a downward liquid flow. In this paper an approximate linear stability analysis of this phenomenon is presented. It is found that, under the combined effect of gravity and the pressure gradient which

  17. Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

    Science.gov (United States)

    Gheorghe, Andrada; Zahiu, Denise Carmen Mihaela; Voiosu, Theodor Alexandru; Mateescu, Bogdan Radu; Voiosu, Mihail Radu; Rimbaş, Mihai

    2017-06-01

    As already known, spondyloarthritis patients present a striking resemblance in intestinal inflammation with early Crohn's disease. Moreover, the frequent use of nonsteroidal anti-inflammatory drugs is an important part of their treatment. Both conditions could lead to intestinal stenoses. Therefore we proposed to investigate the usefulness of the patency capsule test in patients with spondyloarthritis. 64 consecutive patients (33 males; mean age 38 ± 11 years) that fulfilled the AMOR criteria for seronegative spondyloarthropathy (59.4% ankylosing spondylitis) lacking symptoms or signs of intestinal stenosis were enrolled and submitted to an AGILE™ capsule patency test followed by a video capsule endoscopy (PillCam SB2™), as part of a protocol investigating the presence of intestinal inflammatory lesions. After reviewing the VCE recordings, the Lewis score (of small bowel inflammatory involvement) was computed. In only 5 patients (7.8%) of the study group, the luminal patency test was negative. However, there was no retention of the videocapsule in any of the patients. From the 59 patients with a positive patency test, 3 patients presented single small bowel stenoses (two with ulcerated overlying inflamed mucosa, one cicatricial), all being traversed by the videocapsule along the length of the recording. None of the patients with a negative test had bowel stenoses. There was no correlation between the patency test and the Lewis score, the C reactive protein value, diagnosis of inflammatory bowel disease, or the family history of spondyloarthritis, psoriasis or inflammatory bowel disease. The AGILE patency capsule does not seem to be a useful tool for all patients with spondyloarthritis prior to small bowel videocapsule endoscopy (ClinicalTrial.gov ID NCT 00768950).

  18. Axial magnetic field produced by axially and radially magnetized permanent rings

    International Nuclear Information System (INIS)

    Peng, Q.L.; McMurry, S.M.; Coey, J.M.D.

    2004-01-01

    Axial magnetic fields produced by axially and radially magnetized permanent magnet rings were studied. First, the axial magnetic field produced by a current loop is introduced, from which the axial field generated by an infinitely thin solenoid and by an infinitely thin current disk can be derived. Then the axial fields produced by axially and by radially magnetized permanent magnet rings can be obtained. An analytic formula for the axial fields produced by two axially magnetized rings is given. A permanent magnet with a high axial gradient field is fabricated, the measured results agree with the theoretical calculation very well. As an example, the axial periodic field produced by an arrangement of alternating axially and radially magnetized rings has been discussed

  19. View of the Axial Field Spectrometer

    CERN Multimedia

    1980-01-01

    The Axial Field Spectrometer, with the vertical uranium/scintillator calorimeter and the central drift chamber retracted for service. One coil of the Open Axial Field Magnet is just visible to the right.

  20. Coherent and incoherent radiation from free-electron lasers with an axial guide field

    OpenAIRE

    Freund, Henry P.; Sprangle, P.; Dillenburg, Darcy; Jornada, Eda Homrich da; Liberman, Bernardo; Schneider, Ruth de Souza

    1981-01-01

    The spontaneous and induced emission from a free-electron laser is treated for the case in which an axial magnetic field is imposed in addition to the helical, axially periodic wiggler magnetic field. The classes of possible single-particle trajectories in this configuration are discussed, and the results are applied to a calculation of the incoherent radiation from a beam of relativistic electrons in the system. The coherent radiation is treated by solving the Vlasov-Maxwell equations for th...

  1. THE CONCEPT OF BARRIER ORGAN DISEASE IN THE PATHOGENESIS OF SPONDYLOARTHRITIS

    Directory of Open Access Journals (Sweden)

    E. A. Galushko

    2016-01-01

    Full Text Available There have been now prerequisites for changing the scientific view of the etiology and pathogenesis of spondyloarthritis (SpA. An important role is assigned to the dysfunction and disintegration of the so-called barrier organs that make protection of man between his internal milieu and the environment. An update on cellular and molecular mechanisms in the pathogenesis of SpA permits rheumatologists to offer a hypothesis of the concept of barrier organ disease as a preclinical stage of the diseases included in the SpA group. There is reason to think that this process involves individual genetic and immune factors leading to damage of the superficial epithelium of the mucosal membranes and epidermis that serves as the first protective barrier for innate immunity and is in contact with huge numbers of microorganisms (a microbiome and with the pathogen-associated molecular patterns. The microbiome may affect the preclinical phase of the disease in several ways, including those to change the composition of the microflora (dysbiosis and to act as targets for immunological dysregulation. 

  2. Fibromyalgia, a missed comorbidity in spondyloarthritis: prevalence and impact on assessment and treatment.

    Science.gov (United States)

    Mease, Philip J

    2017-07-01

    Fibromyalgia is a clinical representation of the neurobiological phenomenon of central sensitization, characterized by chronic widespread pain, fatigue, sleep disturbance, and other symptoms. Fibromyalgia may occur in conjunction with chronic rheumatic diseases, driven by the effects of chronic pain and inflammation and likely influenced by the patient's genetic and psychoemotional background. This article reviews the data on prevalence of concomitant fibromyalgia and its impact on disease assessment in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA). Fibromyalgia occurs in 2-8% of the general population. In AxSpA cohorts the prevalence has been reported in 4-25%, and in PsA, 16-22%, the majority being female. Measures of disease activity which are comprised partly or wholly of patient-reported outcomes such as pain and patient global are significantly higher in patients with concomitant fibromyalgia and do not improve as much with treatment as more objective measures, a finding which has been observed in other diseases such as rheumatoid arthritis and lupus. Fibromyalgia occurs in a significant proportion of patients with SpA and PsA. Disease activity measures with subjective elements are conflated in patients with fibromyalgia and do not reliably assess true inflammatory disease. This needs to be taken into account when evaluating the impact of immunomodulatory therapy.

  3. MR signal in the sacroiliac joint space in spondyloarthritis: a new sign

    Energy Technology Data Exchange (ETDEWEB)

    Laloo, Frederiek; Herregods, N.; Verstraete, K.; Jans, L. [Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium); Varkas, G.; Elewaut, D.; Bosch, F. van den [Ghent University Hospital, Department of Rheumatology, Gent (Belgium); Jaremko, J.L. [University of Alberta Hospital, Department of Radiology and Diagnostic Imaging, Edmonton, Alberta (Canada); Baraliakos, X. [Ruhr-University Bochum, Rheumazentrum Ruhrgebiet, Herne (Germany)

    2017-05-15

    To determine the diagnostic value of MR signal within the sacroiliac (SI) joint space in spondyloarthritis (SpA). A retrospective analysis of MRIs of SI joints was performed in 363 patients, aged 16-45 years, clinically suspected of sacroiliitis. Intra-articular SI joint MR signals were categorized as normal, high T1 signal, fluid signal, ankylosis or vacuum phenomenon (VP). These MRI findings were correlated with the final diagnosis, according to the ASAS criteria. Sensitivity, specificity, and positive and negative likelihood ratios (LR) and predictive values were calculated. Presence of intra-articular high T1 signal, fluid signal and ankylosis had a specificity of 95.8 %, 95.3 % and 99.5 % for SpA. High T1 signal, fluid signal and ankylosis were present in 38.4 %, 19.2 % and 17.9 % of SpA patients and in 4.2 %, 4.7 % and 0.5 % of patients without SpA, resulting in LR+ of 9.0, 4.1 and 37.9, respectively. VP was present in 13.2 % of SpA patients and in 20.8 % of patients without SpA, resulting in an LR+ of 0.6. Presence of high T1 signal, fluid signal and ankylosis within the SI joint on MRI have high specificity for SpA. High T1 signal is the most sensitive MRI feature within the SI joint for SpA. (orig.)

  4. Spondyloarthritis: Matrix Metalloproteinasesas Biomarkers of Pathogenesis and Response to Tumor Necrosis Factor (TNF) Inhibitors.

    Science.gov (United States)

    Moz, Stefania; Aita, Ada; Basso, Daniela; Ramonda, Roberta; Plebani, Mario; Punzi, Leonardo

    2017-04-14

    The term spondyloarthritis (SpA) is used to describe a group of multifactorial chronic inflammatory diseases characterized by a predisposing genetic background and clinical manifestations typically involving the sacroiliac joint. The absence of pathognomonic clinical and/or laboratory findings generally results in a delay in diagnosis and, consequently, in treatment. In addition, 20-40% of SpA patients are non-responders to tumor necrosis factor (TNF) inhibitor therapies. Given these considerations, it is important to identify biomarkers that can facilitate the diagnosis and assessment of disease activity. As inflammation plays a key role in the pathogenesis of SpA, inflammatory mediators have been investigated as potential biomarkers for diagnosing the disease and predicting response to therapy. Some investigators have focused their attention on the role of matrix metalloproteinases (MMPs), which are known to be markers of synovial inflammation that is generated in the joint in reaction to inflammatory stimuli. Several studies have been carried out to verify if serum MMPs levels could be useful to diagnose SpA, to assess disease severity, and to predict response to TNF inhibitor therapy. The current review focuses on MMPs' role in SpA pathogenesis, diagnosis and therapeutic implications.

  5. Prevalence of spondyloarthritis symptom in inflammatory bowel disease patients: A questionnaire survey.

    Science.gov (United States)

    Kamo, Kenta; Shuto, Toshihide; Haraguchi, Akihisa

    2015-05-01

    We clarified the prevalence of spondyloarthritis (SpA) symptom in inflammatory bowel disease (IBD). We performed the questionnaire survey of SpA symptom in IBD patients on their office visit. One hundred and thirty seven patients were evaluated. The SpA features group included 46 (33.6%) patients (32 Men). Among them there were 22 Crohn's disease (CD) patients and 24 ulcerative colitis (UC) patients. The patients had a mean age of 48.3 years with a mean disease duration of 12.3 years. Non-SpA group (66.4%) included 91 patients (49 Men). Among them there were 27 CD patients and 64 UC patients. The patients had a mean age of 43.3 years with a mean disease duration of 9.2 years. In univariate analysis, the SpA group (33.6%) had longer disease duration than non-SpA group (p disease duration was independently associated with SpA symptom (OR, 1.05; 95% CI, 1-1.09; p = 0.036). The prevalence of SpA symptom was relatively higher than what we had expected. Physicians should consider SpA when they observe IBD patients with arthralgia, and refer them to an appropriate department if needed.

  6. Axial diagnostic package for Z

    International Nuclear Information System (INIS)

    Nash, T.J.; Derzon, M.S.; Chandler, G.

    1998-06-01

    The authors have developed and fielded an axial diagnostic package for the 20 MA, 100 ns, z-pinch driver Z. The package is used to diagnose dynamic hohlraum experiments which require an axial line of sight. The heart of the package is a reentrant cone originally used to diagnose ion-beam-driven hohlraums on PBFA-H. It has one diagnostic line of sight at 0 degrees, 4 at 6 degrees, and 4 at 9 degrees. In addition it has a number of viewing, alignment, and vacuum feedthrough ports. The front of the package sits approximately 5 feet from the pinch. This allows much closer proximity to the pinch, with inherently better resolution and signal, than is presently possible in viewing the pinch from the side. Debris that is preferentially directed along the axis is mitigated by two apertures for each line of sight, and by fast valves and imaging pinholes or cross slits for each diagnostic. In the initial run with this package they fielded a time resolved pinhole camera, a five-channel pinhole-apertured x-ray diode array, a bolometer, a spatially resolved time-integrated crystal spectrometer, and a spatially and temporally resolved crystal spectrometer. They present data obtained from these diagnostics in the dynamic hohlraum research conducted on Z

  7. Role of HLA-B Alleles and Clinical Presentation of B27 Negative Spondyloarthritis Patients from Mumbai, Western India

    Directory of Open Access Journals (Sweden)

    Devaraj J. Parasannanavar

    2014-01-01

    Full Text Available Seronegative spondyloarthritis (SpA are variably associated with HLA-B*27 antigen. HLA-B*27 negative SpA has also been reported from different parts of the world. There is paucity of data on this entity from Indian subcontinent. We studied 100 consecutively diagnosed HLA-B27 negative spondyloarthritis patients from a tertiary care center in India. Modified New York Criteria for ankylosing spondylitis (AS and ESSG criteria for SpA were used for diagnosing patients. HLA-B*27 typing was done by an in-house PCR-SSP technique in SpA patients to exclude B*27 positive patients and PCR-SSOP technique was used to type 100 B*27 negative SpA patients and 100 controls from the same ethnicity. Frequency of B*07 was significantly increased (B*07: % PF 54 versus 18; OR 5.348; 95% CI 2.808–10.186; P value 1.14E − 07, whereas frequency of B*40 was significantly decreased (B*40: % PF 17 versus 32; OR 0.435; 95% CI 0.222–0.850; P value 0.013 when compared with B*27 negative controls. Among 100 SpA patients, 47 were undifferentiated spondyloarthritis and 33 patients were reactive arthritis patients. 40% of the patients were suffering from polyarticular arthritis, 35% had pauciarticular arthritis with knee joint, hip joint, ankle joint, and SI joint involvement. We conclude that B*07 was significantly associated with B27 negative spondyloarthropathy from Western India and majority of B*27 negative patients were uSpA.

  8. Does spinal MRI add incremental diagnostic value to MRI of the sacroiliac joints alone in patients with non-radiographic axial spondyloarthritis?

    DEFF Research Database (Denmark)

    Weber, Ulrich; Zubler, Veronika; Zhao, Zheng

    2015-01-01

    assessed SIJ and spine MRI separately 6 months apart, and 1-12 months later both scans simultaneously using standardised modules. Readers recorded presence/absence of SpA and their level of confidence in this conclusion on a 0-10 scale (0=definitely not; 10=definite). We analysed differences between SIJ...

  9. Does the reason for discontinuation of a first TNF inhibitor influence the effectiveness of a second TNF inhibitor in axial spondyloarthritis?

    DEFF Research Database (Denmark)

    Ciurea, Adrian; Exer, Pascale; Weber, Ulrich

    2016-01-01

    diagnosis of axSpA starting a second TNFi in the Swiss Clinical Quality Management cohort were included. Effectiveness of treatment at 1 year, as well as drug survival, was compared between subgroups having discontinued the first TNFi because of lack of response, adverse events (AEs), or other reasons. Lack...

  10. Electric machines with axial magnetic flux

    Science.gov (United States)

    Nuca, I.; Ambros, T.; Burduniuc, M.; Deaconu, S. I.; Turcanu, A.

    2018-01-01

    The paper contains information on the performance of axial machines compared to cylindrical ones. At the same time, various constructive schemes of synchronous electromechanical converters with permanent magnets and asynchronous with short-circuited rotor are presented. In the developed constructions, the aim is to maximize the usage of the material of the stator windings. The design elements of the axial machine magnetic system are presented. The FEMM application depicted the array of the magnetic field of an axial machine.

  11. Axial vector mass spectrum and mixing angles

    International Nuclear Information System (INIS)

    Caffarelli, R.V.; Kang, K.

    1976-01-01

    Spectral sum rules of the axial-vector current and axial-vector current-pseudoscalar field are used to study the axial-vector mass spectrum and mixing angles, as well as the decay constants and mixing angles of the pseudoscalar mesons. In general, the result is quite persuasive for the existence of the Jsup(PC) = 1 ++ multiplet in which one has a canonical D-E mixing. (Auth.)

  12. Centrifugal and axial compressor control

    CERN Document Server

    McMillan, Gregory K

    2009-01-01

    Control engineers, mechanical engineers and mechanical technicians will learn how to select the proper control systems for axial and centrifugal compressors for proper throughput and surge control, with a particular emphasis on surge control. Readers will learn to understand the importance of transmitter speed, digital controller sample time, and control valve stroking time in helping to prevent surge. Engineers and technicians will find this book to be a highly valuable guide on compressor control schemes and the importance of mitigating costly and sometimes catastrophic surge problems. It can be used as a self-tutorial guide or in the classroom with the book's helpful end-of-chapter questions and exercises and sections for keeping notes.

  13. Axial channeling of uttrarelativistic electrons

    Energy Technology Data Exchange (ETDEWEB)

    Telegin, V.I.; Khokonov, M.Kh. (Moskovskij Gosudarstvennyj Univ. (USSR). Nauchno-Issledovatel' skij Inst. Yadernoj Fiziki)

    1982-07-01

    The dynamics of motion of ultrarelativistic electrons under axial channeling conditions is investigated. The analysis is based on the solution of the kinetic equation obtained recently by Beloshitsky and Kumakhov. The particle dechanneling function is investigated as depending on the type of a crystal, particle energy and angle of entrance into the single crystal. It is found that for most of the beam the major diffusion mechanism is scattering by electrons. It is shown that an optimal depth range exists for which the fraction of channeled particles sharply increases at the expense of the quasi-channeled particles. In a number of cases the dechanneling length for crystals with high atomic numbers may be greater than that of light elements.

  14. Axial channeling of uttrarelativistic electrons

    International Nuclear Information System (INIS)

    Telegin, V.I.; Khokonov, M.Kh.

    1982-01-01

    The dynamics of motion of ultrarelativistic electrons under axial channeling conditions is investigated. The analysis is based on the solution of the kinetic equation obtained recently by Beloshitsky and Kumakhov. The particle dechanneling function is investigated as depending on the type of a crystal, particle energy and angle of entrance into the single crystal. It is found that for most of the beam the major diffusion mechanism is scattering by electrons. It is shown that an optimal depth range exists for which the fraction of channeled particles sharply increases at the expense of the quasi-channeled particles. In a number of cases the dechanneling length for crystals with high atomic numbers may be greater than that of light elements

  15. Radial and axial compression of pure electron

    International Nuclear Information System (INIS)

    Park, Y.; Soga, Y.; Mihara, Y.; Takeda, M.; Kamada, K.

    2013-01-01

    Experimental studies are carried out on compression of the density distribution of a pure electron plasma confined in a Malmberg-Penning Trap in Kanazawa University. More than six times increase of the on-axis density is observed under application of an external rotating electric field that couples to low-order Trivelpiece-Gould modes. Axial compression of the density distribution with the axial length of a factor of two is achieved by controlling the confining potential at both ends of the plasma. Substantial increase of the axial kinetic energy is observed during the axial compression. (author)

  16. Axial and Radial Oxylipin Transport.

    Science.gov (United States)

    Gasperini, Debora; Chauvin, Adeline; Acosta, Ivan F; Kurenda, Andrzej; Stolz, Stéphanie; Chételat, Aurore; Wolfender, Jean-Luc; Farmer, Edward E

    2015-11-01

    Jasmonates are oxygenated lipids (oxylipins) that control defense gene expression in response to cell damage in plants. How mobile are these potent mediators within tissues? Exploiting a series of 13-lipoxygenase (13-lox) mutants in Arabidopsis (Arabidopsis thaliana) that displays impaired jasmonic acid (JA) synthesis in specific cell types and using JA-inducible reporters, we mapped the extent of the transport of endogenous jasmonates across the plant vegetative growth phase. In seedlings, we found that jasmonate (or JA precursors) could translocate axially from wounded shoots to unwounded roots in a LOX2-dependent manner. Grafting experiments with the wild type and JA-deficient mutants confirmed shoot-to-root oxylipin transport. Next, we used rosettes to investigate radial cell-to-cell transport of jasmonates. After finding that the LOX6 protein localized to xylem contact cells was not wound inducible, we used the lox234 triple mutant to genetically isolate LOX6 as the only JA precursor-producing LOX in the plant. When a leaf of this mutant was wounded, the JA reporter gene was expressed in distal leaves. Leaf sectioning showed that JA reporter expression extended from contact cells throughout the vascular bundle and into extravascular cells, revealing a radial movement of jasmonates. Our results add a crucial element to a growing picture of how the distal wound response is regulated in rosettes, showing that both axial (shoot-to-root) and radial (cell-to-cell) transport of oxylipins plays a major role in the wound response. The strategies developed herein provide unique tools with which to identify intercellular jasmonate transport routes. © 2015 American Society of Plant Biologists. All Rights Reserved.

  17. [Progress on atlanto-axial pedicle screw fixation through posterior approach].

    Science.gov (United States)

    Li, Guo-Qing; Ma, Wei-Hu; Liu, Guan-Yi

    2014-06-01

    The present of atlanto-axial pedicle screw fixation through posterior approach provide a new remedy for treating instability of pillow and cervical. A lot of researches have reported feasibility of atlanto-axial pedicle screw fixation, the results showed that it had advantages of easily exposure, less blood loss, shorter operative time, especially in treating as remedy fixation for atlanto-axial joint screw, atlas lateral mass screws and pedicle screw caused by injuries of tumor,inflammation and trauma. If not done properly, it can cause serious complications, such as iatrogenic fracture,injuries of vertebral artery and cervical spinal cord. Therefore,the safty and effectiveness of atlanto-axial pedicle screw fixation may be focus of research.

  18. Axial current matrix elements of the nucleon based on an exact diagonalization of the SU(3) Skyrme model hamiltonian

    International Nuclear Information System (INIS)

    Park, N.W.; Schechter, J.; Weigel, H.

    1989-01-01

    The vanishing of the form factor of the SU(3) single axial current is shown to be stable under the addition of derivative type symmetry breaking terms in the SU(3) Skyrme model. We find that treating the collective hamiltonian exactly dramatically lowers the predicted form factor for the strange quark axial current. Nevertheless, agreement with the EMC experiment is maintained. (orig.)

  19. Educational needs in patients with spondyloarthritis in Sweden - a mixed-methods study.

    Science.gov (United States)

    Haglund, Emma; Bremander, Ann; Bergman, Stefan; Larsson, Ingrid

    2017-08-02

    There is a demand for a flexible and individually tailored patient education to meet patients' specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and priorities in patient education in patients with SpA. A second aim was to investigate patients' experiences and preferences of receiving patient education. Data collection included a questionnaire survey with the Educational Needs Assessment Tool (ENAT) and interviews, using a mixed-methods design. Patients were identified through a specialist clinic register. Descriptive data are presented as mean with standard deviation, or frequencies. Chi-square test and independent-samples t-test were used for group comparisons. A manifest qualitative conventional content analysis was conducted to explore patients' experiences and needs in patient education, based on two focus groups (n = 6) and five individual interviews. Almost half (43%) of the 183 SpA patients had educational needs, particularly regarding aspects of self-help, feelings, and the disease process. More educational needs were reported by women and in patients with higher disease activity, while duration of disease did not affect the needs. The qualitative analysis highlighted the importance of obtaining a guiding, reliable, and easily available patient education for management of SpA. Individual contacts with healthcare professionals were of importance, but newer media were also requested. There are considerable educational needs in patients with SpA, and education concerning self-help, feelings, and the diseases process were raised as important issues. Healthcare professionals need to consider the importance of presenting varied formats of education based on the experiences and preferences of patients with SpA.

  20. Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review.

    Science.gov (United States)

    Png, Kelly; Kwan, Yu Heng; Leung, Ying Ying; Phang, Jie Kie; Lau, Jia Qi; Lim, Ka Keat; Chew, Eng Hui; Low, Lian Leng; Tan, Chuen Seng; Thumboo, Julian; Fong, Warren; Østbye, Truls

    2018-03-21

    This systematic review aimed to identify studies investigating measurement properties of patient reported outcome measures (PROMs) for spondyloarthritis (SpA), and to evaluate their methodological quality and level of evidence relating to the measurement properties of PROMs. This systematic review was guided by the preferred reporting items for systematic review and meta-analysis (PRISMA). Articles published before 30 June 2017 were retrieved from PubMed ® , Embase ® , and PsychINFO ® (Ovid). Methodological quality and level of evidence were evaluated according to recommendations from the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). We identified 60 unique PROMs from 125 studies in 39 countries. Twenty-one PROMs were validated for two or more SpA subtypes. The literature examined hypothesis testing (82.4%) most frequently followed by reliability (60.0%). A percentage of 77.7% and 42.7% of studies that assessed PROMs for hypothesis testing and reliability, respectively had "fair" or better methodological quality. Among the PROMs identified, 41.7% were studied in ankylosing spondylitis (AS) only and 23.3% were studied in psoriatic arthritis (PsA) only. The more extensively assessed PROMs included the ankylosing spondylitis quality of life (ASQoL) and bath ankylosing spondylitis functional index (BASFI) for ankylosing spondylitis, and the psoriatic arthritis quality of life questionnaire (VITACORA-19) for psoriatic arthritis. This study identified 60 unique PROMs through a systematic review and synthesized evidence of the measurement properties of the PROMs. There is a lack of validation of PROMs for use across SpA subtypes. Future studies may consider validating PROMs for use across different SpA subtypes. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. MRI grading method for active and chronic spinal changes in spondyloarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Madsen, K.B. [Department of Radiology, Aarhus University Hospital, Aarhus Sygehus (Denmark); Jurik, A.G., E-mail: anne.jurik@aarhus.rm.d [Department of Radiology, Aarhus University Hospital, Aarhus Sygehus (Denmark)

    2010-01-15

    Aim: To describe a magnetic resonance imaging (MRI) grading method for both active and chronic spondyloarthritis (SpA) changes in the spine, to test its validity, and compare chronic MRI scores with findings obtained by radiography. Material and methods: A total of 91 patients (41 males; 50 females) with back pain fulfilling the European Spondylarthropathy Study Group (ESSG) criteria for SpA were examined using MRI and radiography of the spine. The mean age was 36.7 years (range 16-51 years) and symptom duration was between 3 and 27 years. The MRI images were assessed for signs of disease activity (bone marrow oedema at the vertebral plates and costo-vertebral joints) and chronic structural changes [syndesmophytes/vertebral fusion, erosion, and fatty marrow deposition (FMD)]. The interobserver agreement was analysed based on 37 examinations. Radiographs were assessed for the presence of shiny corners, vertebral squaring, syndesmophytes/fusion, and erosion. Results: The interobserver agreement for the assessed MRI abnormalities was acceptable, with kappa values between 0.62 and 0.77. A total of 56 patients had SpA-related spinal abnormalities as depicted using MRI. The total chronic MRI score was not significantly related to the radiographic score, mainly because syndesmophytes were difficult to detect by MRI and FMD was only visualized by MRI. However, FMD was significantly related to the total radiographic score and vertebral squaring. Conclusion: The described MRI grading method was reliable for assessing both disease activity and chronic changes. MRI is promising for estimating chronic changes, but cervical radiography may still be needed. FMD seems to be an important sign of chronicity.

  2. Aryabhata and Axial Rotation of Earth

    Indian Academy of Sciences (India)

    GENERAL I ARTICLE. Aryabhata and Axial Rotation of Earth. 3. A Brief History. Amartya Kumar Datta is in the Stat-Math Unit of. Indian Statistic.llnstiutte,. Kolkata. His research ... historical account of some of Aryabha~a's views on axial rotation of Earth, ..... and stress on periodic observations and updating of the parameters.

  3. Coexistence of spondyloarthritis and joint hypermobility syndrome: rare or unknown association?

    Directory of Open Access Journals (Sweden)

    J.B. Pinto Carneiro

    2017-09-01

    Full Text Available We report two cases of siblings presenting coexisting non-radiographic axial spondyloartrhritis and joint hypermobility syndrome, complaining of back pain with morning stiffness, enthesitis, peripheral arthralgia, high erythrocyte sedimentation rate and C-reactive protein level and positive HLA-B27. The association of these two conditions is rare, but especially interesting in view of their contrasting features, one causing axial skeleton stiffness, the other a wider range of peripheral joint movements. Coexistence of these two opposite disorders causes confusion in diagnosis and management, resulting in lower quality of life for patients, as they are in pain from the early stages. Therefore, this association is suspected in young individuals with back pain and physical exam findings of peripheral joint hypermobility and axial skeleton loss of mobility.

  4. Axial anomalies of Lifshitz fermions

    CERN Document Server

    Bakas, Ioannis

    2011-01-01

    We compute the axial anomaly of a Lifshitz fermion theory with anisotropic scaling z=3 which is minimally coupled to geometry in 3+1 space-time dimensions. We find that the result is identical to the relativistic case using path integral methods. An independent verification is provided by showing with spectral methods that the eta-invariant of the Dirac and Lifshitz fermion operators in three dimensions are equal. Thus, by the integrated form of the anomaly, the index of the Dirac operator still accounts for the possible breakdown of chiral symmetry in non-relativistic theories of gravity. We apply this framework to the recently constructed gravitational instanton backgrounds of Horava-Lifshitz theory and find that the index is non-zero provided that the space-time foliation admits leaves with harmonic spinors. Using Hitchin's construction of harmonic spinors on Berger spheres, we obtain explicit results for the index of the fermion operator on all such gravitational instanton backgrounds with SU(2)xU(1) isom...

  5. Diagnostic value of axial CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Kiuchi, Sousuke (Tsukuba Univ., Sakura, Ibaraki (Japan))

    1983-03-01

    Axial CT scan was used to investigate the radiological details of the temporal bone of 33 patients with chronic otitis media, secondary cholesteatoma, sensorineural hearing loss, Meniere disease, vertigo, facial spasm, and neoplasma. The axial scans showed anatomic details of the temporal bone, and at the same time clearly demonstrated the extent of the soft-tissue masses in the middle ears, as well as the destructions of the ossicles. Bone changes of the anterior walls of the epitympanum and external auditory meatus were more clearly demonstrated than by coronary CT scan. However, the axial scan had the disadvantages in demonstrating the stapes, crista transversa, and the mastoid portion of the facial canal.

  6. Axial force measurement for esophageal function testing

    DEFF Research Database (Denmark)

    Gravesen, Flemming Holbæk; Funch-Jensen, Peter; Gregersen, Hans

    2009-01-01

    force (force in radial direction) whereas the bolus moves along the length of esophagus in a distal direction. Force measurements in the longitudinal (axial) direction provide a more direct measure of esophageal transport function. The technique used to record axial force has developed from external...... documented using imaging modalities such as radiography and scintigraphy. This inconsistency using manometry has also been documented by axial force recordings. This underlines the lack of information when diagnostics are based on manometry alone. Increasing the volume of a bag mounted on a probe...

  7. The educational needs of patients with undifferentiated spondyloarthritis: Validation of the ENAT questionnaire and needs assessment.

    Science.gov (United States)

    Bremander, A; Haglund, E; Bergman, S; Ndosi, M

    2018-02-07

    The aim of the present study was to validate the Swedish version of the educational needs assessment tool (SwENAT) in undifferentiated spondyloarthritis (USpA) and use it to study the educational needs of patients with USpA. This was a cross-sectional study, recruiting a random sample of patients with USpA from a hospital register in Sweden. Educational needs data were collected, together with disease activity and function indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Bath Ankylosing Spondylitis Functional Index [BASFI]). Rasch analysis was utilized to evaluate the construct validity, internal consistency and unidimensionality of the SwENAT before studying differences in educational needs between patient subgroups (gender, age and disease severity). Complete responses were obtained from 77 patients (48 women), with a mean age (standard deviation [SD]) of 50 (12) years, a disease duration of 16 (11) years, a BASDAI score of 4.9 (1.9) and a BASFI score of 3.1 (2.3). The SwENAT satisfied the requirements of the Rasch model (χ 2 = 11.488; p = 0.119), including strict unidimensionality. Overall, the mean (SD) SwENAT score was 86 (32). Women reported higher needs than men in the domains of pain (mean [SD] 13.1 [6.8] versus 10.1 [6.0]; p = 0.05); movement (mean [SD] 13.0 [5.5] versus 9.9 [5.7]; p = 0.02) and self-help (mean [SD] 17.0 [5.8] versus 14.1 [5.0]; p = 0.03). Higher disease activity (BASDAI >4) was associated with higher educational needs (mean [SD] 92.6 [31.9] versus 73.7 [29.4]; p = 0.02). These data suggest that the SwENAT is valid in USpA. Women and patients with higher disease activity are more likely to have high levels of educational needs, so special attention and strategies to target patient education are warranted. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Melt Motion Due to Peltier Marking During Bridgman Crystal Growth with an Axial Magnetic Field

    Science.gov (United States)

    Sellers, C. C.; Walker, John S.; Szofran, Frank R.; Motakef, Shariar

    2000-01-01

    This paper treats a liquid-metal flow inside an electrically insulating cylinder with electrically conducting solids above and below the liquid region. There is a uniform axial magnetic field, and there is an electric current through the liquid and both solids. Since the lower liquid-solid interface is concave into the solid and since the liquid is a better electrical conductor than the adjacent solid, the electric current is locally concentrated near the centerline. The return to a uniform current distribution involves a radial electric current which interacts with the axial magnetic field to drive an azimuthal flow. The axial variation of the centrifugal force due to the azimuthal velocity drives a meridional circulation with radial and axial velocities. This problem models the effects of Peltier marking during the vertical Bridgman growth of semiconductor crystals with an externally applied magnetic field, where the meridional circulation due to the Peltier Current may produce important mixing in the molten semiconductor.

  9. Capacitive axial position and speed transduction system

    International Nuclear Information System (INIS)

    Jimenez D, H.; Flores Ll, H.; Cabral P, A.; Ramirez J, F.J.; Galindo, S.

    1984-01-01

    A new and inexpensive circuit arrangement of a capacitive axial position and speed transduction system is described. Design details and the theory of operation of the device are briefly outlined together with performance results. (author)

  10. Two pad axially grooved hydrostatic bearing

    Science.gov (United States)

    San Andres, Luis A. (Inventor)

    1995-01-01

    A hydrostatic bearing having two axial grooves on opposite sides of the bearing for breaking the rotational symmetry in the dynamic force coefficients thus reducing the whirl frequency ratio and increasing the damping and stiffness of the hydrostatic bearing.

  11. High temperature co-axial winding transformers

    Science.gov (United States)

    Divan, Deepakraj M.; Novotny, Donald W.

    1993-01-01

    The analysis and design of co-axial winding transformers is presented. The design equations are derived and the different design approaches are discussed. One of the most important features of co-axial winding transformers is the fact that the leakage inductance is well controlled and can be made low. This is not the case in conventional winding transformers. In addition, the power density of co-axial winding transformers is higher than conventional ones. Hence, using co-axial winding transformers in a certain converter topology improves the power density of the converter. The design methodology used in meeting the proposed specifications of the co-axial winding transformer specifications are presented and discussed. The final transformer design was constructed in the lab. Co-axial winding transformers proved to be a good choice for high power density and high frequency applications. They have a more predictable performance compared with conventional transformers. In addition, the leakage inductance of the transformer can be controlled easily to suit a specific application. For space applications, one major concern is the extraction of heat from power apparatus to prevent excessive heating and hence damaging of these units. Because of the vacuum environment, the only way to extract heat is by using a cold plate. One advantage of co-axial winding transformers is that the surface area available to extract heat from is very large compared to conventional transformers. This stems from the unique structure of the co-axial transformer where the whole core surface area is exposed and can be utilized for cooling effectively. This is a crucial issue here since most of the losses are core losses.

  12. Axial model in curved space-time

    Energy Technology Data Exchange (ETDEWEB)

    Barcelos-Neto, J.; Farina, C.; Vaidya, A.N.

    1986-12-11

    We study the axial model in a background gravitational field. Using the zeta-function regularization, we obtain explicitly the anomalous divergence of the axial-vector current and the exact generating functional of the theory. We show that, as a consequence of a space-time-dependent metric, all differential equations involved in the theory generalize to their covariantized forms. We also comment on the finite-mass renormalization exhibited by the pseudoscalar field and the form of the fermion propagator.

  13. Dechanneling function for relativistic axially channeled electrons

    International Nuclear Information System (INIS)

    Muralev, V.A.; Telegin, V.I.

    1981-01-01

    Behaviour of the x(t) dechanneling function depending on the depth is theoretically studied. Theoretical consideration of x(t) for axial channeled relativistic electrons in anisotropic medium results in two-dimensional kinetic equation with mixed derivatives of the parabolic type. The kinetic equation in the approximation of the continuous Lindchard model for relativistic axial channeled electrons is numerically solved. The depth dependence of the x(t) dechanneling function is obtained [ru

  14. Axial forces in centrifugal compressor couplings

    Science.gov (United States)

    Ivanov, A. N.; Ivanov, N. M.; Yun, V. K.

    2017-08-01

    The article presents the results of the theoretical and experimental investigation of axial forces arising in the toothed and plate couplings of centrifugal compressor shaft lines. Additional loads on the thrust bearing are considered that can develop in the toothed couplings as a result of coupled rotors misalignment. Design relationships to evaluate the level of axial forces and recommendations for their reduction in the operating conditions are given.

  15. High harmonic generation from axial chiral molecules.

    Science.gov (United States)

    Wang, Dian; Zhu, Xiaosong; Liu, Xi; Li, Liang; Zhang, Xiaofan; Lan, Pengfei; Lu, Peixiang

    2017-09-18

    Axial chiral molecules, whose stereogenic element is an axis rather than a chiral center, have attracted widespread interest due to their important application, such as asymmetric synthesis and chirality transfer. We investigate high harmonic generation from axial chiral molecules with bichromatic counterrotating circularly polarized laser fields. High harmonic generation from three typical molecules: (Sa)-3-chloropropa-1,2-dien-1-ol, propadiene, and (Ra)-2,3-pentadiene is simulated with time-dependent density-functional theory and strong field approximation. We found that harmonic spectra for 3D oriented axial chiral molecules exhibit obvious circular dichroism. However, the circular dichroism of High harmonic generation from an achiral molecule is much trivial. Moreover, the dichroism of high harmonic generation still exists when axial chiral molecules are 1D oriented,such as (Sa) -3-chloropropa-1,2-dien-1-ol. For a special form of axial chiral molecules with the formula abC=C=Cab (a, b are different substituents), like (Ra)-2,3-pentadiene, the dichroism discriminations disappear when the molecules are only in 1D orientation. The circular dichroism of high harmonic generation from axial chiral molecules is well explained by the trajectory analysis based on the semiclassical three-step mechanism.

  16. Cytokines and integrins related to inflammation of joint and gut in patients with spondyloarthritis and inflammatory bowel disease.

    Science.gov (United States)

    Kontny, Ewa; Dmowska-Chalaba, Joanna; Kwiatkowska, Brygida; Maśliński, Włodzimierz

    2017-01-01

    Inflammatory bowel disease (IBD) and spondyloarthritis (SpA) have some overlapping clinical features, i.e. gut and joint inflammation. Cytokines of interleukin 17(IL-17)/IL-23 axis play a pathogenic role in both diseases. Integrins (ITGs) regulate migration of immune cells to inflamed tissues (ITGβ7 into gut, ITGβ2 into gut and also to other tissues). In this study, we search for differences in the serum concentrations of these cytokines and integrins between patients suffering from SpA or IBD with and without overlapping symptoms. Patients with SpA ( n = 30), IBD ( n = 68), and healthy volunteers ( n = 28) were included in the study. Fourteen SpA patients reported symptoms characteristic for IBD. Spondyloarthritis symptoms were diagnosed in 50% of IBD patients, while other patients of this group reported arthralgia only. Serum concentrations of IL-17, IL-22, IL-23, ITGβ2, and ITGβ7 were measured by specific enzyme-linked immunosorbent assay using commercially available sets. The Mann-Whitney and Spearman's rank tests were used for intergroup comparison and correlation assessment, respectively. Comparison of patient groups showed significantly higher serum concentrations of IL-17, IL-22, and ITGβ7 in SpA, and up-regulated levels of IL-23 in IBD patients. Similar differences were observed between patient subgroups, both with and without overlapping symptoms. In SpA but not in IBD patients, serum concentrations of ITGβ7 inversely correlated ( r = -0.552) with C-reactive protein. Patients with SpA and IBD differ in the circulating concentrations of IL-17/IL-23 axis cytokines and ITGβ7, irrespectively of the presence or absence of overlapping symptoms. Therefore, we conclude that observed differences are attributed rather to underlying than concurrent disease.

  17. [Epidemiologic profile of juvenile-onset compared to adult-onset spondyloarthritis in a large Brazilian cohort].

    Science.gov (United States)

    Duarte, Angela P; Marques, Cláudia D L; Bortoluzzo, Adriana B; Gonçalves, Célio R; da Silva, José Antonio Braga; Ximenes, Antonio Carlos; Bértolo, Manoel B; Ribeiro, Sandra Lúcia E; Keiserman, Mauro; Skare, Thelma L; Carneiro, Sueli; Menin, Rita; Azevedo, Valderilio F; Vieira, Walber P; Albuquerque, Elisa N; Bianchi, Washington A; Bonfiglioli, Rubens; Campanholo, Cristiano; Carvalho, Hellen M S; Costa, Izaias P; Kohem, Charles L; Leite, Nocy; Lima, Sonia A L; Meirelles, Eduardo S; Pereira, Ivânio A; Pinheiro, Marcelo M; Polito, Elizandra; Resende, Gustavo G; Rocha, Francisco Airton C; Santiago, Mittermayer B; Sauma, Maria de Fátima L C; Valim, Valéria; Sampaio-Barros, Percival D; Barros, Percival D Sampaio

    2014-01-01

    To analyze the clinical and epidemiologic characteristics of juvenile-onset spondyloarthritis (SpA) (< 16 years) and compare them with a group of adult-onset (≥ 16 years) SpA patients. Prospective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE - Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset<16 years (JOSpA group) and age at onset ≥ 16 years (AOSpA group). Among the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p<0.001), lower limb arthritis (p=0.001), enthesitis (p=0.008), anterior uveitis (p=0.041) and positive HLA-B27 (p=0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI; p=0.007) and functionality (Bath Ankylosing Spondylitis Functional Index - BASFI; p=0.036). Cutaneous psoriasis (p<0.001), inflammatory bowel disease (p=0.023), dactylitis (p=0.024) and nail involvement (p=0.004) were more frequent in patients with adult-onset SpA. Patients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA-B27 and lower disease scores. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  18. Treating Infertility

    Science.gov (United States)

    ... Patients Search FAQs Treating Infertility Page Navigation ▼ ACOG Pregnancy Book Treating Infertility Patient Education FAQs Treating Infertility Patient Education Pamphlets - Spanish Treating ...

  19. Intestinal Metabolites Are Profoundly Altered in the Context of HLA-B27 Expression and Functionally Modulate Disease in a Rat Model of Spondyloarthritis.

    Science.gov (United States)

    Asquith, Mark; Davin, Sean; Stauffer, Patrick; Michell, Claire; Janowitz, Cathleen; Lin, Phoebe; Ensign-Lewis, Joe; Kinchen, Jason M; Koop, Dennis R; Rosenbaum, James T

    2017-10-01

    HLA-B27-associated spondyloarthritides are associated with an altered intestinal microbiota and bowel inflammation. We undertook this study to identify HLA-B27-dependent changes in both host and microbial metabolites in the HLA-B27/β 2 -microglobulin (β 2 m)-transgenic rat and to determine whether microbiota-derived metabolites could impact disease in this major model of spondyloarthritis. Cecal contents were collected from Fischer 344 33-3 HLA-B27/β 2 m-transgenic rats and wild-type controls at 6 weeks (before disease) and 16 weeks (with active bowel inflammation). Metabolomic profiling was performed by high-throughput gas and liquid chromatography-based mass spectrometry. HLA-B27/β 2 m-transgenic rats were treated with the microbial metabolites propionate or butyrate in drinking water for 10 weeks, and disease activity was subsequently assessed. Our screen identified 582 metabolites, of which more than half were significantly altered by HLA-B27 expression at 16 weeks. Both microbial and host metabolites were altered, with multiple pathways affected, including those for amino acid, carbohydrate, xenobiotic, and medium-chain fatty acid metabolism. Differences were even observed at 6 weeks, with up-regulation of histidine, tyrosine, spermidine, N-acetylmuramate, and glycerate in HLA-B27/β 2 m-transgenic rats. Administration of the short-chain fatty acid propionate significantly attenuated HLA-B27-associated inflammatory disease, although this was not associated with increased FoxP3+ T cell induction or with altered expression of the immunomodulatory cytokines interleukin-10 (IL-10) or IL-33 or of the tight junction protein zonula occludens 1. HLA-B27 expression was also associated with altered host expression of messenger RNA for the microbial metabolite receptors free fatty acid receptor 2 (FFAR2), FFAR3, and niacin receptor 1. HLA-B27 expression profoundly impacts the intestinal metabolome, with changes evident in rats even at age 6 weeks. Critically, we

  20. Vector and axial constants of the baryon decuplet

    International Nuclear Information System (INIS)

    Belyaev, V.M.; Blok, B.Y.; Kogan, Y.I.

    1985-01-01

    On the basis of the QCD sum rules for the polarization operator in external axial and vector fields we determine the vector and axial transition constants in the 3/2 + baryon decuplet. We show that the renormalization of the axial constant is due to the interaction of the external axial field with the quark condensate

  1. Nucleon axial form factor from lattice QCD

    International Nuclear Information System (INIS)

    Liu, K.F.; Dong, S.J.; Draper, T.; Wu, J.M.; Wilcox, W.

    1994-01-01

    Results for the isovector axial form factors of the proton from a lattice QCD calculation are presented for both the point-split and local currents. They are obtained on a quenched 16 3 x24 lattice at β=6.0 with Wilson fermions for a range of quark masses from strange to twice the charm mass. For each quark mass, we find that the axial form factor falls off slower than the corresponding proton electric form factor. Results extrapolated to the chiral limit show that the q 2 dependence of the axial form factor agrees quite well with experiment. The axial vector coupling constant g A calculated for the point-split and local currents is 1.20±0.11 and 1.18±0.11. The central values are 4% and 6% smaller than the experimental value of 1.254, respectively. We also consider the large ma correction and renormalization for the axial vector current of heavy quarks

  2. Optimization of residual heat removal pump axial thrust and axial bearing

    International Nuclear Information System (INIS)

    Schubert, F.

    1996-01-01

    The residual heat removal (RHR) pumps of German 1300 megawatt pressurized-water reactor (PWR) power plants are of the single stage end suction type with volute casing or with diffuser and forged circular casing. Due to the service conditions the pumps have to cover the full capacity range as well as a big variation in suction static pressure. This results in a big difference in the axial thrust that has to be borne by the axial bearing. Because these pumps are designed to operate without auxiliary systems (things that do not exist can not fail), they are equipped with antifriction bearings and sump oil lubrication. To minimize the heat production within the bearing casing, a number of PWR plants have pumps with combined axial/radial bearings of the ball type. Due to the fact that the maximum axial thrust caused by static pressure and hydrodynamic forces on the impeller is too big to be borne by that type of axial bearing, the impellers were designed to produce a hydrodynamic axial force that counteracts the static axial force. Thus, the resulting axial thrust may change direction when the static pressure varies

  3. Optimization of residual heat removal pump axial thrust and axial bearing

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, F.

    1996-12-01

    The residual heat removal (RHR) pumps of German 1300 megawatt pressurized-water reactor (PWR) power plants are of the single stage end suction type with volute casing or with diffuser and forged circular casing. Due to the service conditions the pumps have to cover the full capacity range as well as a big variation in suction static pressure. This results in a big difference in the axial thrust that has to be borne by the axial bearing. Because these pumps are designed to operate without auxiliary systems (things that do not exist can not fail), they are equipped with antifriction bearings and sump oil lubrication. To minimize the heat production within the bearing casing, a number of PWR plants have pumps with combined axial/radial bearings of the ball type. Due to the fact that the maximum axial thrust caused by static pressure and hydrodynamic forces on the impeller is too big to be borne by that type of axial bearing, the impellers were designed to produce a hydrodynamic axial force that counteracts the static axial force. Thus, the resulting axial thrust may change direction when the static pressure varies.

  4. Wave propagation in axially moving periodic strings

    DEFF Research Database (Denmark)

    Sorokin, Vladislav S.; Thomsen, Jon Juel

    2017-01-01

    The paper deals with analytically studying transverse waves propagation in an axially moving string with periodically modulated cross section. The structure effectively models various relevant technological systems, e.g. belts, thread lines, band saws, etc., and, in particular, roller chain drives...... for diesel engines by capturing both their spatial periodicity and axial motion. The Method of Varying Amplitudes is employed in the analysis. It is shown that the compound wave traveling in the axially moving periodic string comprises many components with different frequencies and wavenumbers....... This is in contrast to non-moving periodic structures, for which all components of the corresponding compound wave feature the same frequency. Due to this "multi-frequency" character of the wave motion, the conventional notion of frequency band-gaps appears to be not applicable for the moving periodic strings. Thus...

  5. Growth-induced axial buckling of a slender elastic filament embedded in an isotropic elastic matrix

    KAUST Repository

    O'Keeffe, Stephen G.

    2013-11-01

    We investigate the problem of an axially loaded, isotropic, slender cylinder embedded in a soft, isotropic, outer elastic matrix. The cylinder undergoes uniform axial growth, whilst both the cylinder and the surrounding elastic matrix are confined between two rigid plates, so that this growth results in axial compression of the cylinder. We use two different modelling approaches to estimate the critical axial growth (that is, the amount of axial growth the cylinder is able to sustain before it buckles) and buckling wavelength of the cylinder. The first approach treats the filament and surrounding matrix as a single 3-dimensional elastic body undergoing large deformations, whilst the second approach treats the filament as a planar, elastic rod embedded in an infinite elastic foundation. By comparing the results of these two approaches, we obtain an estimate of the foundation modulus parameter, which characterises the strength of the foundation, in terms of the geometric and material properties of the system. © 2013 Elsevier Ltd. All rights reserved.

  6. Axial pico turbine - construction and experimental research

    Science.gov (United States)

    Peczkis, G.; Goryca, Z.; Korczak, A.

    2017-08-01

    The paper concerns axial water turbine of power equal to 1 kW. The example of axial water turbine constructional calculations was provided, as well as turbine rotor construction with NACA profile blades. The laboratory test rig designed and built to perform measurements on pico turbine was described. The turbine drove three-phase electrical generator. On the basis of highest efficiency parameters, pico turbine basic characteristics were elaborated. The experimental research results indicated that pico turbine can achieve maximum efficiency close to the values of larger water turbines.

  7. Axial Vircator for Electronic Warfare Applications

    Directory of Open Access Journals (Sweden)

    L. Drazan

    2009-12-01

    Full Text Available This paper deals with a high power microwave generator with virtual cathode – vircator in axial release for electronic warfare applications. The classification of directed energy weapons microwave (DEWM is introduced together with basic block diagrams of a particular class of DEWM. In the paper, methods for designing vircator pulsed power supply, axial vircator structure, measurement methods and experimental results are presented. The vircator in electromagnetic ammunition is powered by magneto-cumulative generator and in weapons for defense of objects (WDO, it is powered by Marx generator. The possible applications of a vircator in the DEWM area are discussed.

  8. Axial crystals macroscopic symmetry and tensor properties

    Czech Academy of Sciences Publication Activity Database

    Janovec, Václav

    2017-01-01

    Roč. 90, č. 1 (2017), s. 1-10 ISSN 0141-1594 Institutional support: RVO:68378271 Keywords : axial * polar * pseudopolar * chiral * enantiomorphism * optical activity Subject RIV: BM - Solid Matter Physics ; Magnetism OBOR OECD: Condensed matter physics (including formerly solid state physics, supercond.) Impact factor: 1.060, year: 2016

  9. Optimisation of efficiency of axial fans

    NARCIS (Netherlands)

    Kruyt, Nicolaas P.; Pennings, P.C.; Faasen, R.

    2014-01-01

    A three-stage research project has been executed to develop ducted axial-fans with increased efficiency. In the first stage a design method has been developed in which various conflicting design criteria can be incorporated. Based on this design method, an optimised design has been determined

  10. The design of axial shaftless pump

    Science.gov (United States)

    Schmirler, Michal; Netrebska, Hana

    The axial shaftless pump with a rotary casing has been proposed. The pump is unique in its small space requirements and the ability to draw a liquid with a high content of impurities and fibers. Modern motor with an external commutation was used to propel the pump rotor. The pump can be used for both pumping of liquids and marine propulsion.

  11. VERY SLOW SPEED AXIAL MOTION RELUCTANCE MOTOR

    African Journals Online (AJOL)

    Dr Obe

    1984-09-01

    Sep 1, 1984 ... VERY SLOW SPEED AXIAL MOTION RELUCTANCE MOTOR by. L. A. Agu. Electrical Engineering Department. University of Nigeria, Nsukka. ABSTRACT. This paper presents the scheme for a very slow speed linear machine which uses conventional laminations and with which speeds of the same low.

  12. Aryabha~ and Axial Rotation of Earth

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 4. Aryabhata and Axial Rotation of Earth - Naksatra Dina (the Sidereal Day). Amartya Kumar Dutta. General Article Volume 11 Issue 4 April 2006 pp 56-74. Fulltext. Click here to view fulltext PDF. Permanent link:

  13. Aryabhala and Axial Rotation of Earth

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 3. Aryabhata and Axial Rotation of Earth - Khagola (The Celestial Sphere). Amartya Kumar Dutta. General Article Volume 11 Issue 3 March 2006 pp 51-68. Fulltext. Click here to view fulltext PDF. Permanent link:

  14. The axial polarizability of nucleons and nuclei

    International Nuclear Information System (INIS)

    Ericson, M.; Figureau, A.

    1981-02-01

    The part of the static nuclear axial polarizability arising from the nucleonic excitations is derived from the low energy expansion of the πN amplitude. It is shown that the contribution of the Δ intermediate state, though dominant, does not saturate the nucleonic response. A similar effect, though more pronounced, is known to occur for the magnetic susceptibility

  15. Excitation modes in non-axial nuclei

    International Nuclear Information System (INIS)

    Leviatan, A.; Ginnochio, J.N.

    1990-01-01

    Excitation modes of non-axial quadrupole shapes are investigated in the framework of interacting boson models. Both γ-unstable and γ-rigid nuclear shapes are considered for systems with one type of boson as well as with proton-neutron bosons. 6 refs

  16. Excitation modes in non-axial nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Leviatan, A.; Ginnochio, J.N.

    1990-01-01

    Excitation modes of non-axial quadrupole shapes are investigated in the framework of interacting boson models. Both {gamma}-unstable and {gamma}-rigid nuclear shapes are considered for systems with one type of boson as well as with proton-neutron bosons. 6 refs.

  17. AERODYNAMIC DESIGN OF HIGH PRESSRE AXIAL FAN

    Directory of Open Access Journals (Sweden)

    Y. A. Ryzhov

    2014-01-01

    Full Text Available The paper presents the results of numerical studies of flow in a high axial fan of H-2, the geometric parameters are carefully designed by the author. The coefficients of performance, the total pressure, efficiency and capacity. Shows the benefits of fan of H-2 on several other fans, expressed in increased efficiency with equal dimensions and angles of blade setting.

  18. Co-axial, high energy gamma generator

    Science.gov (United States)

    Reijonen, Jani Petteri [Princeton, NJ; Gicquel, Frederic [Pennington, NJ

    2011-08-16

    A gamma ray generator includes an ion source in a first chamber. A second chamber is configured co-axially around the first chamber at a lower second pressure. Co-axially arranged plasma apertures separate the two chambers and provide for restricted passage of ions and gas from the first to the second chamber. The second chamber is formed by a puller electrode having at least one long channel aperture to draw ions from the first chamber when the puller electrode is subject to an appropriate applied potential. A plurality of electrodes rings in the third chamber in third pressure co-axially surround the puller electrode and have at least one channel corresponding to the at least one puller electrode aperture and plasma aperture. The electrode rings increase the energy of the ions to a selected energy in stages in passing between successive pairs of the electrodes by application of an accelerating voltage to the successive pairs of accelerator electrodes. A target disposed co-axially around the plurality of electrodes receives the beam of accelerated ions, producing gamma rays.

  19. Carotid intima-media thickness in spondyloarthritis patients Espessamento da camada média-íntima da carótida em pacientes com espondiloartrite

    Directory of Open Access Journals (Sweden)

    Thelma Larocca Skare

    2013-04-01

    Full Text Available CONTEXT AND OBJECTIVE Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT in spondyloarthritis (SpA patients and correlate this with clinical parameters and inflammatory markers. DESIGN AND SETTING Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba. METHODS IMTs (measured using Doppler ultrasonography of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR, C-reactive protein (CRP and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI and lipid profile. RESULTS The mean IMT in SpA patients was 0.72 ± 0.21 mm; in controls, 0.57 ± 0.13 mm (P = 0.0007. There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65; higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64; and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72. CONCLUSION SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients. CONTEXTO E OBJETIVO A aterogênese acelerada tem se tornado um grande problema nas doenças reumáticas inflamatórias. O objetivo foi analisar a espessura da camada íntima-média (ECIM da carótida em pacientes com espondiloartrite (ES e relacioná-la com parâmetros clínicos e marcadores inflamatórios. TIPO DE ESTUDO E LOCAL Estudo transversal analítico no Ambulatório de Reumatologia do Hospital Universitário Evangélico de

  20. Defining enthesitis in spondyloarthritis by ultrasound: results of a Delphi process and of a reliability reading exercise.

    Science.gov (United States)

    Terslev, L; Naredo, E; Iagnocco, A; Balint, P V; Wakefield, R J; Aegerter, P; Aydin, S Z; Bachta, A; Hammer, H B; Bruyn, G A W; Filippucci, E; Gandjbakhch, F; Mandl, P; Pineda, C; Schmidt, W A; D'Agostino, M A

    2014-05-01

    To standardize ultrasound (US) in enthesitis. An initial Delphi exercise was undertaken to define US-detected enthesitis and its core components. These definitions were subsequently tested on static images taken from spondyloarthritis patients in order to evaluate their reliability. Excellent agreement (>80%) was obtained for including hypoechogenicity, increased thickness of the tendon insertion, calcifications, enthesophytes, erosions, and Doppler activity as core elementary lesions of US-detected enthesitis. US definitions were subsequently obtained for each elementary component. On static images, the intraobserver reliability showed a high degree of variability for the detection of elementary lesions, with kappa coefficients ranging from 0.13-1. The interobserver kappa values were variable, with the lowest kappa coefficient for enthesophytes (0.24) and the highest coefficient for Doppler activity at the enthesis (0.63). This is the first consensus-based US definition of enthesitis and its elementary components and the first step performed to ensure a higher degree of homogeneity and comparability of results between studies and in daily clinical work. Copyright © 2014 by the American College of Rheumatology.

  1. Review of Axial Burnup Distribution Considerations for Burnup Credit Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, J.C.; DeHart, M.D.

    2000-03-01

    This report attempts to summarize and consolidate the existing knowledge on axial burnup distribution issues that are important to burnup credit criticality safety calculations. Recently released Nuclear Regulatory Commission (NRC) staff guidance permits limited burnup credit, and thus, has prompted resolution of the axial burnup distribution issue. The reactivity difference between the neutron multiplication factor (keff) calculated with explicit representation of the axial burnup distribution and keff calculated assuming a uniform axial burnup is referred to as the ``end effect.'' This end effect is shown to be dependent on many factors, including the axial-burnup profile, total accumulated burnup, cooling time, initial enrichment, assembly design, and the isotopics considered (i.e., actinide-only or actinides plus fission products). Axial modeling studies, efforts related to the development of axial-profile databases, and the determination of bounding axial profiles are also discussed. Finally, areas that could benefit from further efforts are identified.

  2. Review of Axial Burnup Distribution Considerations for Burnup Credit Calculations

    International Nuclear Information System (INIS)

    Wagner, J.C.; DeHart, M.D.

    2000-01-01

    This report attempts to summarize and consolidate the existing knowledge on axial burnup distribution issues that are important to burnup credit criticality safety calculations. Recently released Nuclear Regulatory Commission (NRC) staff guidance permits limited burnup credit, and thus, has prompted resolution of the axial burnup distribution issue. The reactivity difference between the neutron multiplication factor (keff) calculated with explicit representation of the axial burnup distribution and keff calculated assuming a uniform axial burnup is referred to as the ''end effect.'' This end effect is shown to be dependent on many factors, including the axial-burnup profile, total accumulated burnup, cooling time, initial enrichment, assembly design, and the isotopics considered (i.e., actinide-only or actinides plus fission products). Axial modeling studies, efforts related to the development of axial-profile databases, and the determination of bounding axial profiles are also discussed. Finally, areas that could benefit from further efforts are identified

  3. Piping inspection carriage having axially displaceable sensor

    Science.gov (United States)

    Zollinger, W.T.; Treanor, R.C.

    1994-12-06

    A pipe inspection instrument carriage is described for use with a pipe crawler for performing internal inspections of piping surfaces. The carriage has a front leg assembly, a rear leg assembly and a central support connecting the two assemblies and for mounting an instrument arm having inspection instruments. The instrument arm has a Y-arm mounted distally thereon for axially aligning the inspection instrumentation and a mounting block, a linear actuator and axial movement arm for extending the inspection instruments radially outward to operably position the inspection instruments on the piping interior. Also, the carriage has a rotation motor and gear assembly for rotating the central support and the front leg assembly with respect to the rear leg assembly so that the inspection instruments azimuthally scan the piping interior. The instrument carriage allows performance of all piping inspection operations with a minimum of moving parts, thus decreasing the likelihood of performance failure. 4 figures.

  4. Ventajas de los motores de flujo axial

    Directory of Open Access Journals (Sweden)

    Alberto M Basanta Otero

    2011-03-01

    Full Text Available Es importante conocer sobre una familia de motores que a diferencia de los convencionales o tradicionales no presentanun flujo rotatorio radial, denominados motores de flujo axial. Dichos motores presentan altos valores de par motriz abajas velocidades, una alta eficiencia y alta densidad de potencia. Este trabajo constituye un breve análisis dealgunos motores de la referencia bibliográfica.  Is important to know about a family of motors that at difference whit the traditional, don't have a rotator radial flux,called, axial flux motors. These motors have high torque for low speed, high efficiency and high power density. Thiswork is a brief analysis of several motors of the bibliographic references.

  5. Cross-flow filtration and axial filtration

    International Nuclear Information System (INIS)

    Kraus, K.A.

    1974-01-01

    Two relatively novel alternative solid-liquid-separation techniques of filtration are discussed. In cross-flow filtration, the feed is pumped past the filtering surface. While in axial filtration the filter, mounted on a rotor, is moved with respect to the feed. While large-scale application of the axial filter is still in doubt, it permits with little expenditure of time and money, duplication of many hydrodynamic aspects of cross-flow filtration for fine-particle handling problems. The technique has been applied to municipal wastes, low-level radioactive waste treatment plant, lead removal from industrial wastes, removal of pulp-mill contaminants, textile-mill wastes, and pretreatment of saline waters by lime-soda process in preparation for hyperfiltration. Economics and energy requirements are also discussed

  6. Axial pattern skin flaps in cats.

    Science.gov (United States)

    Remedios, A M; Bauer, M S; Bowen, C V; Fowler, J D

    1991-01-01

    The major direct cutaneous vessels identified in the cat include the omocervical, thoracodorsal, deep circumflex iliac, and caudal superficial epigastric arteries. Axial pattern skin flaps based on the thoracodorsal and caudal superficial epigastric arteries have been developed in cats. Rotation of these flaps as islands allows skin coverage to the carpus and metatarsus, respectively. The thoracodorsal and caudal superficial epigastric flaps provide a practical, one-step option in the reconstruction of large skin defects involving the distal extremities of cats.

  7. Atlanto-axial subluxation: a case report

    OpenAIRE

    Thurlow, Robert D

    1988-01-01

    One of the causes of death in rheumatoid patients is cord compression following atlanto-axial subluxation. Dislocations in the cervical spine are common with patients who have rheumatoid arthritis. Anterior subluxation occurs in up to 35%, followed by vertical subluxation in 22.2%, lateral subluxation in 20.6% and rarely posterior subluxation. A case report is presented to illustrate such a complication.

  8. Axial flux permanent magnet brushless machines

    CERN Document Server

    Gieras, Jacek F; Kamper, Maarten J

    2008-01-01

    Axial Flux Permanent Magnet (AFPM) brushless machines are modern electrical machines with a lot of advantages over their conventional counterparts. They are being increasingly used in consumer electronics, public life, instrumentation and automation system, clinical engineering, industrial electromechanical drives, automobile manufacturing industry, electric and hybrid electric vehicles, marine vessels and toys. They are also used in more electric aircrafts and many other applications on larger scale. New applications have also emerged in distributed generation systems (wind turbine generators

  9. Cervical Spine Axial Rotation Goniometer Design

    OpenAIRE

    Emin Ulaş Erdem; Filiz Can

    2012-01-01

    To evaluate the cervical spine rotation movement is quiet harder than other joints. Configuration and arrangement of current goniometers and devices is not always practic in clinics and some methods are quiet expensive. The cervical axial rotation goniometer designed by the authors is consists of five pieces (head apparatus, chair, goniometric platform, eye pads and camera). With this goniometer design a detailed evaluation of cervical spine range of motion can be obtained. Besides, measureme...

  10. Axial gravity, massless fermions and trace anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Bonora, L. [International School for Advanced Studies (SISSA), Trieste (Italy); KEK, Tsukuba (Japan). KEK Theory Center; INFN, Sezione di Trieste (Italy); Cvitan, M.; Giaccari, S.; Stemberga, T. [Zagreb Univ. (Croatia). Dept. of Physics; Prester, P.D. [Rijeka Univ. (Croatia). Dept. of Physics; Pereira, A.D. [UERJ-Univ. Estadual do Rio de Janeiro (Brazil). Dept. de Fisica Teorica; UFF-Univ. Federal Fluminense, Niteroi (Brazil). Inst. de Fisica

    2017-08-15

    This article deals with two main topics. One is odd parity trace anomalies in Weyl fermion theories in a 4d curved background, the second is the introduction of axial gravity. The motivation for reconsidering the former is to clarify the theoretical background underlying the approach and complete the calculation of the anomaly. The reference is in particular to the difference between Weyl and massless Majorana fermions and to the possible contributions from tadpole and seagull terms in the Feynman diagram approach. A first, basic, result of this paper is that a more thorough treatment, taking account of such additional terms and using dimensional regularization, confirms the earlier result. The introduction of an axial symmetric tensor besides the usual gravitational metric is instrumental to a different derivation of the same result using Dirac fermions, which are coupled not only to the usual metric but also to the additional axial tensor. The action of Majorana and Weyl fermions can be obtained in two different limits of such a general configuration. The results obtained in this way confirm the previously obtained ones. (orig.)

  11. Axial polarizability and weak currents in nuclei

    International Nuclear Information System (INIS)

    Ericson, M.

    1977-01-01

    The weak interaction nucleonic coupling constants in nuclei are modified by the presence of the neighbouring nucleons. One type of modification is due to the virtual excitation of the isobars through meson exchange. The influence of the isobars is described by means of the nuclear axial polarizability coefficient. This polarizability is known; it is linked to the p-wave πN scattering volume. A relation is derived between the axial nuclear current and the pion field which incorporates the polarizability effects. This relation has an electromagnetic analogue. It is then possible to derive the axial and pseudoscalar coupling constants from a knowledge of the pion field. This field in turn obeys a Klein-Gordon equation which has to include the isobaric excitations. The propagation of the pion field is similar to that of an electromagnetic wave in a dielectric medium. The strong interaction coupling constant is shown to be renormalized in nuclei by the effect of the various types of correlations. (author)

  12. Dynamic control of knee axial deformities

    Directory of Open Access Journals (Sweden)

    E. E. Malyshev

    2013-01-01

    Full Text Available The authors have evaluated the clinical examination of the patients with axial malalignments in the knee by the original method and device which was named varovalgometer. The measurements were conducted by tension of the cord through the spina iliaca anterior superior and the middle of the lower pole of patella. The deviation of the center of the ankle estimated by metal ruler which was positioned perpendicular to the lower leg axis on the level of the ankle joint line. The results of comparison of our method and computer navigation in 53 patients during the TKA show no statistically significant varieties but they differ by average 5° of valgus in clinical examination in comparison with mechanical axis which was identified by computer navigation. The dynamic control of axial malalignment can be used in clinical practice for estimation of the results of treatment of pathology with axial deformities in the knee; for the control of reduction and secondary displacement of the fractures around the knee; for assessment of instability; in planning of correctional osteotomies and intraoperative control of deformity correction; for estimation of Q angle in subluxation and recurrent dislocation of patella; in planning of TKA; during the growth of child it allows to assess the progression of deformity.

  13. Respiratory effects of transient axial acceleration.

    Science.gov (United States)

    Loring, S H; Lee, H T; Butler, J P

    2001-06-01

    Whereas gravity has an inspiratory effect in upright subjects, transient upward acceleration is reported to have an expiratory effect. To explore the respiratory effects of transient axial accelerations, we measured axial acceleration at the head and transrespiratory pressure or airflow in five subjects as they were dropped or lifted on a platform. For the first 100 ms, upward acceleration caused a decrease in mouth pressure and inspiratory flow, and downward acceleration caused the opposite. We also simulated these experimental observations by using a computational model of a passive respiratory system based on anatomical data and normal respiratory characteristics. After 100 ms, respiratory airflow in our subjects became highly variable, no longer varying with acceleration. Electromyograms of thoracic and abdominal respiratory muscles showed bursts of activity beginning 40-125 ms after acceleration, suggesting reflex responses responsible for subsequent flow variability. We conclude that, in relaxed subjects, transient upward axial acceleration causes inspiratory airflow and downward acceleration causes expiratory airflow, but that after ~100 ms, reflex activation of respiratory musculature largely determines airflow.

  14. Atlanto-Axial Subluxation After Adenoidectomy.

    Science.gov (United States)

    Gross, Isabel Theresia; Bahar-Posey, Laleh

    2017-06-01

    Atlanto-axial subluxation is a rare but potentially serious complication after otolaryngological procedures. We are describing a case of a 4-year-old child who developed atlanto-axial subluxation of the cervical spine after adenoidectomy. Our patient underwent adenoidectomy and, 18 days later, presented to the emergency department with her neck tilted to the left in a cock-robin position and complaining of neck pain persisting since the surgery. A multiplanar 3-dimensional computed tomography was obtained and confirmed the diagnosis of an atlanto-axial subluxation (Fielding type 3). She was managed conservatively with the application of a cervical collar, anti-inflammatory medication, and manual reduction under anesthesia later in the course because of persistence of her symptoms. It is important to consider this diagnosis in any child who undergoes ENT surgical procedures complaining of neck pain subsequent to surgery or holding the head in a fixed position persistently after surgery. Early diagnosis is important to reduce the time between the onset of symptoms and reduction to reduce the risk or need for surgical intervention.

  15. Structural lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis - definitions, assessment system, and reference image set

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Maksymowych, Walter P; Pedersen, Susanne J

    2009-01-01

    in the spine of patients with SpA. METHODS: MRI definitions of different structural ("chronic") lesions at various anatomical locations in the spine, and an accompanying assessment system, were agreed by consensus within the Canada-Denmark MRI working group. Subsequently, a reference image set......OBJECTIVE: There is no reliable and sensitive magnetic resonance imaging (MRI) assessment system for structural lesions in patients with spondyloarthritis (SpA). We sought to develop and illustrate a detailed anatomy-based set of MRI definitions and an assessment system for structural lesions...

  16. Frequency and anatomical distribution of magnetic resonance imaging features in sacroiliac joints of young athletes: Exploring "background noise" towards a data-driven definition of sacroiliitis in early spondyloarthritis.

    Science.gov (United States)

    Weber, Ulrich; Jurik, Anne Grethe; Zejden, Anna; Larsen, Ejnar; Jørgensen, Steen Hylgaard; Rufibach, Kaspar; Schioldan, Christian; Schmidt-Olsen, Søren

    2018-02-12

    Low grade bone marrow edema (BME) was reported in the sacroiliac joints (SIJ) of 25% of healthy individuals and mechanical back pain patients, challenging the imaging discrimination from early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may trigger BME. We explored frequency and anatomical distribution of SIJ MRI lesions in recreational and elite athletes. After pre-test calibration, semicoronal SIJ MRI scans of 20 recreational runners (RR) before/after running and 22 elite ice-hockey players (IP) were assessed by 3 blinded readers for BME and structural lesions using an SIJ quadrant-based module. Scans of TNF-treated SpA patients served to mask readers. Readers recorded subjects meeting the ASAS definition for active sacroiliitis. Descriptive analysis comprised frequency of SIJ quadrants with BME/structural lesions and their distribution in 8 anatomical SIJ regions: upper/lower ilium and sacrum, subdivided in anterior/posterior slices, as concordantly recorded by ≥2/3 readers. The proportions in RR/IP fulfilling the ASAS definition concordantly by ≥2/3 readers were 30-35%/41%. The mean number (SD) of SIJ quadrants showing BME was 3.1 (4.2)/3.1 (4.5) in RR before/after running, and 3.6 (3.0) in IP. The posterior lower ilium was the single most affected SIJ region, followed by the anterior upper sacrum. Erosion was virtually absent. In recreational and elite athletes, BME showed on average in 3-4 SIJ quadrants, meeting the ASAS definition in 30%-41%. The posterior lower ilium was the single most affected SIJ region. These findings in athletes help refine data-driven thresholds for defining sacroiliitis in early SpA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Impact of axial velocity and transmembrane pressure (TMP) on ARP filter performance

    Energy Technology Data Exchange (ETDEWEB)

    Poirier, M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Burket, P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-02-29

    The Savannah River Site (SRS) is currently treating radioactive liquid waste with the Actinide Removal Process (ARP) and the Modular Caustic Side Solvent Extraction Unit (MCU). Recently, the low filter flux through the ARP of approximately 5 gallons per minute has limited the rate at which radioactive liquid waste can be treated. Salt Batch 6 had a lower processing rate and required frequent filter cleaning. Savannah River Remediation (SRR) has a desire to understand the causes of the low filter flux and to increase ARP/MCU throughput. One potential method for increasing filter flux is to adjust the axial velocity and transmembrane pressure (TMP). SRR requested SRNL to conduct bench-scale filter tests to evaluate the effects of axial velocity and transmembrane pressure on crossflow filter flux. The objective of the testing was to determine whether increasing the axial velocity at the ARP could produce a significant increase in filter flux. The authors conducted the tests by preparing slurries containing 6.6 M sodium Salt Batch 6 supernate and 2.5 g MST/L, processing the slurry through a bench-scale crossflow filter unit at varying axial velocity and TMP, and measuring filter flux as a function of time.

  18. The deep structure of Axial Volcano

    Science.gov (United States)

    West, Michael Edwin

    The subsurface structure of Axial Volcano, near the intersection of the Juan de Fuca Ridge and the Cobb-Eickelberg seamount chain in the northeast Pacific, is imaged from an active source seismic experiment. At a depth of 2.25 to 3.5 km beneath Axial lies an 8 km x 12 km region of very low seismic velocities that can only be explained by the presence of magma. In the center of this magma storage chamber at 2--3.5 km below sea floor, the crust is at least 10--20% melt. At depths of 4--5 km there is evidence of additional low concentrations of magma (a few percent) over a larger area. In total, 5--11 km3 of magma are stored in the mid-crust beneath Axial. This is more melt than has been positively identified under any basaltic volcano on Earth. It is also far more than the 0.1--0.2 km3 emplaced during the 1998 eruption. The implied residence time in the magma reservoir of a few hundred to a few thousand years agrees with geochemical trends which suggest prolonged storage and mixing of magmas. The large volume of melt bolsters previous observations that Axial provides much of the material to create crust along its 50 km rift zones. A high velocity ring-shaped feature sits above the magma chamber just outside the caldera walls. This feature is believed to be the result of repeated dike injections from the magma body to the surface during the construction of the volcanic edifice. A rapid change in crustal thickness from 8 to 11 km within 15 km of the caldera implies focused delivery of melt from the mantle. The high flux of magma suggests that melting occurs deeper in the mantle than along the nearby ridge. Melt supply to the volcano is not connected to any plumbing system associated with the adjacent segments of the Juan de Fuca Ridge. This suggests that, despite Axial's proximity to the ridge, the Cobb hot spot currently drives the supply of melt to the volcano.

  19. Intrinsic carpal ligaments on MR and multidetector CT arthrography: comparison of axial and axial oblique planes

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ryan K.L.; Griffith, James F.; Ng, Alex W.H.; Law, Eric K.C. [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince Of Wales Hospital, Hong Kong (China); Tse, W.L.; Wong, Clara W.Y.; Ho, P.C. [The Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince Of Wales Hospital, Hong Kong (China)

    2017-03-15

    To compare axial and oblique axial planes on MR arthrography (MRA) and multidetector CT arthrography (CTA) to evaluate dorsal and volar parts of scapholunate (SLIL) and lunotriquetral interosseous (LTIL) ligaments. Nine cadaveric wrists of five male subjects were studied. The visibility of dorsal and volar parts of the SLIL and LTIL was graded semi-quantitatively (good, intermediate, poor) on MRA and CTA. The presence of a ligament tear was determined on arthrosocopy and sensitivity, specificity and accuracy of tear detection were calculated. Oblique axial imaging was particularly useful for delineating dorsal and volar parts of the LTIL on MRA with overall 'good' visibility increased from 11 % to 78 %. The accuracy of MRA and CTA in revealing SLIL and LTIL tear was higher using the oblique axial plane. The overall accuracy for detecting SLIL tear on CTA improved from 94 % to 100 % and from 89 % to 94 % on MRA; the overall accuracy of detecting LTIL tear on CTA improved from 89 % to 100 % and from 72 % to 89 % on MRA Oblique axial imaging during CT and MR arthrography improves detection of tears in the dorsal and volar parts of both SLIL and LTIL. (orig.)

  20. Prevalence of Comorbidities and Risk Factors for Comorbidities in Patients with Spondyloarthritis in Latin America: A Comparative Study with the General Population and Data from the ASAS-COMOSPA Study

    NARCIS (Netherlands)

    Bautista-Molano, Wilson; Landewé, Robert; Burgos-Vargas, Rubén; Maldonado-Cocco, José; Moltó, Anna; van den Bosch, Filip; Valle-Oñate, Rafael; Dougados, Maxime; van der Heijde, Désirée

    2018-01-01

    Increased risk of comorbidities has been reported in spondyloarthritis (SpA). The objective of this study was to determine the prevalence and risk of developing comorbidities in patients with SpA in 3 Latin American (LA) countries, and to compare that prevalence with the general population. Data

  1. Axial flow heat exchanger devices and methods for heat transfer using axial flow devices

    Science.gov (United States)

    Koplow, Jeffrey P.

    2016-02-16

    Systems and methods described herein are directed to rotary heat exchangers configured to transfer heat to a heat transfer medium flowing in substantially axial direction within the heat exchangers. Exemplary heat exchangers include a heat conducting structure which is configured to be in thermal contact with a thermal load or a thermal sink, and a heat transfer structure rotatably coupled to the heat conducting structure to form a gap region between the heat conducting structure and the heat transfer structure, the heat transfer structure being configured to rotate during operation of the device. In example devices heat may be transferred across the gap region from a heated axial flow of the heat transfer medium to a cool stationary heat conducting structure, or from a heated stationary conducting structure to a cool axial flow of the heat transfer medium.

  2. Are Upper-Body Axial Symptoms a Feature of Early Parkinson’s Disease?

    Science.gov (United States)

    Moreau, Caroline; Baille, Guillaume; Delval, Arnaud; Tard, Céline; Perez, Thierry; Danel-Buhl, Nicolas; Seguy, David; Labreuche, Julien; Duhamel, Alain; Delliaux, Marie; Dujardin, Kathy; Defebvre, Luc

    2016-01-01

    Background Axial disorders are considered to appear late in the course of Parkinson’s disease (PD). The associated impact on quality of life (QoL) and survival and the lack of an effective treatment mean that understanding and treating axial disorders is a key challenge. However, upper-body axial disorders (namely dysarthria, swallowing and breathing disorders) have never been prospectively assessed in early-stage PD patients. Objectives To characterize upper-body axial symptoms and QoL in consecutive patients with early-stage PD. Methods We prospectively enrolled 66 consecutive patients with early-stage PD (less than 3 years of disease progression) and assessed dysarthria, dysphagia and respiratory function (relative to 36 controls) using both objective and patient-reported outcomes. Results The mean disease duration was 1.26 years and the mean UPDRS motor score was 19.4 out of 108. 74% of the patients presented slight dysarthria (primarily dysprosodia). Men appeared to be more severely affected (i.e. dysphonia). This dysfunction was strongly correlated with low swallowing speed (despite the absence of complaints about dysphagia), respiratory insufficiency and poor QoL. Videofluorography showed that oral-phase swallowing disorders affected 60% of the 31 tested patients and that pharyngeal-phase disorders affected 21%. 24% of the patients reported occasional dyspnea, which was correlated with anxiety in women but not in men. Marked diaphragmatic dysfunction was suspected in 42% of the patients (predominantly in men). Conclusion Upper body axial symptoms were frequent in men with early-stage PD, whereas women presented worst non-motor impairments. New assessment methods are required because currently available tools do not reliably detect these upper-body axial disorders. PMID:27654040

  3. Are Upper-Body Axial Symptoms a Feature of Early Parkinson's Disease?

    Directory of Open Access Journals (Sweden)

    Caroline Moreau

    Full Text Available Axial disorders are considered to appear late in the course of Parkinson's disease (PD. The associated impact on quality of life (QoL and survival and the lack of an effective treatment mean that understanding and treating axial disorders is a key challenge. However, upper-body axial disorders (namely dysarthria, swallowing and breathing disorders have never been prospectively assessed in early-stage PD patients.To characterize upper-body axial symptoms and QoL in consecutive patients with early-stage PD.We prospectively enrolled 66 consecutive patients with early-stage PD (less than 3 years of disease progression and assessed dysarthria, dysphagia and respiratory function (relative to 36 controls using both objective and patient-reported outcomes.The mean disease duration was 1.26 years and the mean UPDRS motor score was 19.4 out of 108. 74% of the patients presented slight dysarthria (primarily dysprosodia. Men appeared to be more severely affected (i.e. dysphonia. This dysfunction was strongly correlated with low swallowing speed (despite the absence of complaints about dysphagia, respiratory insufficiency and poor QoL. Videofluorography showed that oral-phase swallowing disorders affected 60% of the 31 tested patients and that pharyngeal-phase disorders affected 21%. 24% of the patients reported occasional dyspnea, which was correlated with anxiety in women but not in men. Marked diaphragmatic dysfunction was suspected in 42% of the patients (predominantly in men.Upper body axial symptoms were frequent in men with early-stage PD, whereas women presented worst non-motor impairments. New assessment methods are required because currently available tools do not reliably detect these upper-body axial disorders.

  4. Innate Immune Activation Can Trigger Experimental Spondyloarthritis in HLA-B27/Huβ2m Transgenic Rats

    Directory of Open Access Journals (Sweden)

    Melissa N. van Tok

    2017-08-01

    Full Text Available Spondyloarthritis (SpA does not display the typical features of auto-immune disease. Despite the strong association with MHC class I, CD8+ T cells are not required for disease induction in the HLA-B27/Huβ2m transgenic rats. We used Lewis HLA-B27/Huβ2m transgenic rats [21-3 × 283-2]F1, HLA-B7/Huβ2m transgenic rats [120-4 × 283-2]F1, and wild-type rats to test our hypothesis that SpA may be primarily driven by the innate immune response. In vitro, splenocytes were stimulated with heat-inactivated Mycobacterium tuberculosis and cytokine expression and production was measured. In vivo, male and female rats were immunized with 30, 60, or 90 µg of heat-inactivated M. tuberculosis and clinically monitored for spondylitis and arthritis development. After validation of the model, we tested whether prophylactic and therapeutic TNF targeting affected spondylitis and arthritis. In vitro stimulation with heat-inactivated M. tuberculosis strongly induced gene expression of pro-inflammatory cytokines such as TNF, IL-6, IL-1α, and IL-1β, in the HLA-B27 transgenic rats compared with controls. In vivo immunization induced an increased spondylitis and arthritis incidence and an accelerated and synchronized onset of spondylitis and arthritis in HLA-B27 transgenic males and females. Moreover, immunization overcame the protective effect of orchiectomy. Prophylactic TNF targeting resulted in delayed spondylitis and arthritis development and reduced arthritis severity, whereas therapeutic TNF blockade did not affect spondylitis and arthritis severity. Collectively, these data indicate that innate immune activation plays a role in the initiation of HLA-B27-associated disease and allowed to establish a useful in vivo model to study the cellular and molecular mechanisms of disease initiation and progression.

  5. Assessing physician and patient acceptance of infliximab biosimilars in rheumatoid arthritis, ankylosing spondyloarthritis and psoriatic arthritis across Germany

    Directory of Open Access Journals (Sweden)

    Waller J

    2017-03-01

    Full Text Available John Waller,1 Emma Sullivan,1 James Piercy,1 Christopher M Black,2 Sumesh Kachroo2 1Adelphi Real World, Manchester, UK; 2Center for Observational and Real-World Evidence (CORE, Merck & Co., Inc., Kenilworth, NJ, USA Objectives: We examined rheumatologists’ motivation for prescribing biosimilars, assessed their treatment preferences in relation to prescribing behavior and explored patient attitudes to biosimilars. Methods: Data were taken from the Adelphi Real World Biosimilars Programme, a real-world, cross-sectional study undertaken with German rheumatologists and patients with rheumatoid arthritis, ankylosing spondyloarthritis or psoriatic arthritis in 2015–2016. Rheumatologists provided data on their prescribing behavior and attitudes toward biosimilars and invited the next eight eligible consecutive consulting patients to complete a questionnaire. Rheumatologists were split into “investigative”, “conservative” and “other” groups. Results: Overall, 50 rheumatologists and 261 patients participated. Biosimilars accounted for <10% of all biologic therapy prescriptions, and >95% of rheumatologists would prescribe a biooriginator rather than biosimilar as the first- or second-line therapy if unrestricted. Patients showed some reluctance to accept biosimilars, and a small proportion of patients were unhappy when switched from a biooriginator to a biosimilar. Satisfaction with treatment was highest in patients who started treatment with a biooriginator prior to biosimilar availability. Patient concerns when starting treatment with a biooriginator or a biosimilar included not knowing enough about the drug (25%–41%, potential side effects (26%–32% and potential long-term problems (19%–30%. Conclusion: Study results demonstrate that there is some reluctance from patients to accept biosimilars and the need to educate patients who are unsure to allow them to be involved in decision making, highlighting the importance of patient and

  6. QCD plasma parameters in axial gauge

    Energy Technology Data Exchange (ETDEWEB)

    Nachbagauer, H. (Technische Univ., Vienna (Austria). Inst. fuer Theoretische Physik)

    1992-11-01

    Within the framework of imaginary time formalism we investigate the structure of the gluon polarization tensor and relate its structure functions to the dispersion relation of plasma eigenmodes. To one loop order, we calculate the transversal structure function to leading order in the high temperature expansion as well as the first subleading order contribution in the long wavelength limit. The result is used to express the dynamical mass and the damping constant for transversal plasma eigenmodes. The aim of our present paper is a systematic discussion of the gauge fixing vector dependence of the damping constant. In the limit of temporal axial gauge we encounter a negative damping constant contradicting previous results. (orig.).

  7. QCD plasma parameters in axial gauge

    Science.gov (United States)

    Nachbagauer, Herbert

    1992-09-01

    Within the framework of imaginary time formalism we investigate the structure of the gluon polarization tensor and relate its structure functions to the dispersion relation of plasma eigenmodes. To one loop order, we calculate the transversal structure function to leading order in the high temperature expansion as well as the first subleading order contribution in the long wavelength limit. The result is used to express the dynamical mass and the damping constant for transversal plasma eigenmodes. The aim of our present paper is a systematic discussion of the gauge fixing vector dependence of the damping constant. In the limit of temporal axial gauge we encounter a negative damping constant contradicting previous results.

  8. Disordered axial movement in Parkinson's disease.

    OpenAIRE

    Steiger, M J; Thompson, P D; Marsden, C D

    1996-01-01

    Axial motor impairments are a common cause of disability in patients with Parkinson's disease, become more prominent with longer disease duration, and have been said to be less responsive to levodopa replacement therapy. The ability to turn in bed while lying supine before and after dopaminergic stimulation was studied in a group of 36 patients with Parkinson's disease; 23 were in Hoehn and Yahr stages 3-5 when "off", and 13 were in stages 1-2. Turning was also compared with postural stabilit...

  9. Water ingestion into jet engine axial compressors

    Science.gov (United States)

    Tsuchiya, T.; Murthy, S. N. B.

    1982-01-01

    An axial flow compressor has been tested with water droplet ingestion under a variety of conditions. The results illustrate the manner in which the compressor pressure ratio, efficiency and surging characteristics are affected. A model for estimating the performance of a compressor during water ingestion has been developed and the predictions obtained compare favorably with the test results. It is then shown that with respect to five droplet-associated nonlinearly-interacting processes (namely, droplet-blade interactions, blade performance changes, centrifugal action, heat and mass transfer processes and droplet break-up), the initial water content and centrifugal action play the most dominant roles.

  10. Cervical Spine Axial Rotation Goniometer Design

    Directory of Open Access Journals (Sweden)

    Emin Ulaş Erdem

    2012-06-01

    Full Text Available To evaluate the cervical spine rotation movement is quiet harder than other joints. Configuration and arrangement of current goniometers and devices is not always practic in clinics and some methods are quiet expensive. The cervical axial rotation goniometer designed by the authors is consists of five pieces (head apparatus, chair, goniometric platform, eye pads and camera. With this goniometer design a detailed evaluation of cervical spine range of motion can be obtained. Besides, measurement of "joint position sense" which is recently has rising interest in researches can be made practically with this goniometer.

  11. MRI assessment of bone marrow oedema in the sacroiliac joints of patients with spondyloarthritis: is the SPAIR T2w technique comparable to STIR?

    Energy Technology Data Exchange (ETDEWEB)

    Faeda Dalto, Vitor; Nogueira-Barbosa, Marcello Henrique [University of Sao Paulo, Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, Ribeirao Preto, SP (Brazil); Assad, Rodrigo Luppino [University of Sao Paulo, Division of Clinical Imunology, Department of Internal Medicine, Ribeirao Preto Medical School, Ribeirao Preto, SP (Brazil); Crema, Michel Daoud [Hopital Saint-Antoine, Universite Paris VI, Service de Radiologie, Paris (France); Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Hospital do Coracao (HCor) e Teleimagem, Departamento de Radiologia, Sao Paulo, SP (Brazil); Louzada-Junior, Paulo [University of Sao Paulo, Department of Internal Medicine, Ribeirao Preto Medical School, Ribeirao Preto, SP (Brazil)

    2017-09-15

    To compare short tau inversion-recovery (STIR) with another fat saturation method in the assessment of sacroiliac joint inflammation. This prospective cross-sectional study comprised 76 spondyloarthritis (SpA) patients who underwent magnetic resonance imaging of the sacroiliac joints in a 1.5-T scanner, using STIR, spectral attenuated inversion recovery (SPAIR) T2w and spectral presaturation with inversion recovery (SPIR) T1w post-contrast sequences. Two independent readers (R1 and R2) assessed the images using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. We assessed agreement of the SPARCC scores for SPAIR T2w and STIR with that for T1 SPIR post-contrast (reference standard) using the St. Laurent coefficient. We evaluated each sequence using the concordance correlation coefficient (CCC). We observed a strong agreement between STIR and SPAIR T2w sequences. Lin's CCC was 0.94 for R1 and 0.84 for R2 for STIR and 0.94 for R1 and 0.84 for R2 for SPAIR. The interobserver evaluation revealed a good CCC of 0.79 for SPAIR and 0.78 for STIR. STIR technique and SPAIR T2w sequence showed high agreement in the evaluation of sacroiliac joint subchondral bone marrow oedema in patients with SpA. SPAIR T2w may be an alternative to the STIR sequence for this purpose. (orig.)

  12. Distinctive radiological features of small hand joints in rheumatoid arthritis and seronegative spondyloarthritis demonstrated by contrast-enhanced (Gd-DTPA) magnetic resnance imaging

    International Nuclear Information System (INIS)

    Jevtic, V.; Watt, I.; Rozman, B.; Kos-Golja, M.; Demsar, F.; Jarh, O.

    1995-01-01

    A series of patients with clinically early inflammatory joint disease due to rheumatoid arthritis, psoriatic arthritis and Reiter's syndrome were examined by plain film radiography and magnetic resonance imaging (MRI). The spin echo T1-weighted precontrast, T2-weighted, and, especially, T1-weighted postcontrast images demonstrated distinct differences in the distribution of inflamatory changes, both within and adjacent to involved small hand joints. Two major subtypes of inflammatory arthritis were shown, thus providing a specific differential diagnosis between rheumatoid arthritis and some patients with seronegative spondyloarthritis. In particular, all the patients with Reiter's syndrome who were studied, and half of those with psoriatic arthritis, had a distinctive pattern of extra-articular desease involvement. The need for a new classification of clinical subsets in psoriatic arthritis has been recently suggested. The present findings suggest that magnetic resonance imaging could be useful in such a reclassification of seronegative spondyloarthritis, as well as offering considerable potential for a reappraisal of pathogenesis and therapy. In this series, it was also noted that juxta-articular osteoporosis on plain film did not correlate with bone marrow oedema on MRI. Hence the aetiology of this common radiographic finding also merits further consideration. (orig.)

  13. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system.

    Science.gov (United States)

    Azevedo, Valderilio Feijó; Rossetto, Chayanne N; Lorencetti, Pedro G; Tramontin, Mariana Y; Fornazari, Bruna; Araújo, Denizar V

    2016-01-01

    Patients with ankylosing spondylitis require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. 70 patients (75.28%) were male and 23 (24.72%) female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32); 63.44% were using anti-tumour necrotic factor drugs. Comparing male and female patients the mean Bath Ankylosing Spondylitis Disease Activity Index was 4.64 and 5.49 while the mean Bath Ankylosing Spondylitis Functional Index was 5.03 and 6.35 respectively. The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-tumour necrotic factor therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  14. Medullary sponge kidney on axial computed tomography

    International Nuclear Information System (INIS)

    Ginalski, J.-M.; Schnyder, Pierre; Portmann, Luc; Jaeger, Philippe

    1991-01-01

    To evaluate features of medullary sponge kidney (MSK) on computed tomography (CT), 4-mm-thick axial slices without intravenous contrast material were 1st made in 13 patients through 24 kidneys which showed images of MSK on excretory urograms. On CT, papillary calcifications were found in 11 kidneys. In 5 of these, the calcifications were not detectable on plain films. Some hyperdense papillae (attenuation value 55-70 Hounsfield units) without calcification were found in 4 other kidneys. 9 kidneys appeared normal. 10 of the 14 kidneys were reexamined by a 2nd series of 4-mm-thick axial slices, 5 min after intravenous injection of 50 ml of Urografin. Images suggesting possible ectasia of precaliceal tubules were found in only 4 kidneys. These images appear much less obvious and characteristic on CT than on excretory urogram and do nothing more than suggest the possibility of MSK. In conclusion, the sensitivity of CT in the detection of MSK is markedly lower than that of excretory urography. In the most florid cases of the disease, CT can only show images suggesting the possibility of MSK. On the other hand, CT appears much more sensitive than plain films and tomograms of excretory in the detection of papillary calcifications, the most frequent complication of MSK. (author). 13 refs.; 3 figs

  15. Axial tomography in live cell laser microscopy

    Science.gov (United States)

    Richter, Verena; Bruns, Sarah; Bruns, Thomas; Weber, Petra; Wagner, Michael; Cremer, Christoph; Schneckenburger, Herbert

    2017-09-01

    Single cell microscopy in a three-dimensional (3-D) environment is reported. Cells are grown in an agarose culture gel, located within microcapillaries and observed from different sides after adaptation of an innovative device for sample rotation. Thus, z-stacks can be recorded by confocal microscopy in different directions and used for illustration in 3-D. This gives additional information, since cells or organelles that appear superimposed in one direction, may be well resolved in another one. The method is tested and validated with single cells expressing a membrane or a mitochondrially associated green fluorescent protein, or cells accumulating fluorescent quantum dots. In addition, axial tomography supports measurements of cellular uptake and distribution of the anticancer drug doxorubicin in the nucleus (2 to 6 h after incubation) or the cytoplasm (24 h). This paper discusses that upon cell rotation an enhanced optical resolution in lateral direction compared to axial direction can be utilized to obtain an improved effective 3-D resolution, which represents an important step toward super-resolution microscopy of living cells.

  16. Axial vessel widening in arborescent monocots.

    Science.gov (United States)

    Petit, Giai; DeClerck, Fabrice A J; Carrer, Marco; Anfodillo, Tommaso

    2014-02-01

    Dicotyledons have evolved a strategy to compensate for the increase in hydraulic resistance to water transport with height growth by widening xylem conduits downwards. In monocots, the accumulation of hydraulic resistance with height should be similar, but the absence of secondary growth represents a strong limitation for the maintenance of xylem hydraulic efficiency during ontogeny. The hydraulic architecture of monocots has been studied but it is unclear how monocots arrange their axial vascular structure during ontogeny to compensate for increases in height. We measured the vessel lumina and estimated the hydraulic diameter (Dh) at different heights along the stem of two arborescent monocots, Bactris gasipaes (Kunth) and Guadua angustifolia (Kunth). For the former, we also estimated the variation in Dh along the leaf rachis. Hydraulic diameter increased basally from the stem apex to the base with a scaling exponent (b) in the range of those reported for dicot trees (b = 0.22 in B. gasipaes; b = 0.31 and 0.23 in G. angustifolia). In B. gasipaes, vessels decrease in Dh from the stem's centre towards the periphery, an opposite pattern compared with dicot trees. Along the leaf rachis, a pattern of increasing Dh basally was also found (b = 0.13). The hydraulic design of the monocots studied revealed an axial pattern of xylem conduits similar to those evolved by dicots to compensate and minimize the negative effect of root-to-leaf length on hydrodynamic resistance to water flow.

  17. Modeling the axial offset anomaly in PWRs

    Energy Technology Data Exchange (ETDEWEB)

    Blok, J.; Chauffriat, S.; Frattini, P. [EPRI, Palo Alto, CA (United States)

    2002-07-01

    Axially un-symmetrical flux depression is defined as axial offset anomaly (AOA) in PWRs. The effect has only been observed in PWR reactor cores operated at high power duty. The threat of AOA limits the aggressiveness of core design, and in extreme form, the effect can decrease shutdown margin near end of cycle (EOC) sufficiently to mandate power reduction. AOA is ultimately the result of boron hideout on fuel. Studies have confirmed that sufficient boron hideout to produce measurable AOA requires relatively large amounts of corrosion products to deposit on the fuel. Because corrosion product deposition is favored in the boiling upper regions of the (high duty) core, the amount of boron uptake in these regions is large in proportion, and core reactivity is affected disproportionately in the upper region of the core. This paper explores possible mechanisms for deposition of corrosion products on fuel and the consequent incorporation of boron compounds. The proposed mechanisms are viewed in the context of corrosion product samples from the Callaway Cycle 9, one of the PWR fuel cycles that exhibited the most severe AOA to date. (author)

  18. Axial dispersion in a Kureha Crystal Purifier (KCP)

    Science.gov (United States)

    Otawara, K.; Matsuoka, T.

    2002-04-01

    It is widely accepted that the degree of axial back-mixing in the equipment affects the performance of a column crystallizer. Specifically, small such mixing is inevitable for obtaining highly pure crystal. In fact, it is believed that scale-up of some column crystallizers has been terminated due to the large axial back-mixing or maldistribution. Thus, experiments have been performed for estimating axial dispersion coefficients of liquid phase representing axial back-mixing in the column of a Kureha Crystal Purifier (KCP). The effect of the column diameter on such coefficients has been investigated and it has become evident that the axial back-mixing in the column is more significant in the larger column. Nevertheless, the results have also indicated that the axial back-mixing in KCPs of industrial sizes can be substantially smaller than those in other types of column crystallizers.

  19. Axial stress corrosion cracking forming method to metal tube

    International Nuclear Information System (INIS)

    Araki, Kumiko

    1998-01-01

    Generally, it is more difficult in a metal tube, to intentionally cause a stress corrosion cracking in axial direction than in circumferential direction. In the present invention, a bevel is formed on a metal tube and welding is conducted in circumferential direction along the bevel, and welding is conducted in axial direction partially to the portion welded in circumferential direction. Namely, a bevel is formed in circumferential direction to an abutting portion of thick-walled metal tubes with each other, welding is conducted in circumferential direction along the bevel, and welding is conducted in axial direction partially to a portion welded in circumferential direction. With such procedures, since tensile stress in the circumferential direction is increased partially at a portion welded in axial direction, stress corrosion cracking is caused in axial direction at the portion. Then, stress corrosion cracking in axial direction can thus be formed on the thick-walled metal tube. (N.H.)

  20. Revisiting the vector and axial-vector vacuum susceptibilities

    International Nuclear Information System (INIS)

    Chang Lei; Liu Yuxin; Sun Weimin; Zong Hongshi

    2008-01-01

    We re-investigate the vector and axial-vector vacuum susceptibilities by taking advantage of the vector and axial-vector Ward-Takahashi identities. We show analytically that, in the chiral limit, the vector vacuum susceptibility is zero and the axial-vector vacuum susceptibility equals three fourths of the square of the pion decay constant. Besides, our analysis reproduces the Weinberg sum rule

  1. Aerodynamic Modelling and Optimization of Axial Fans

    DEFF Research Database (Denmark)

    Sørensen, Dan Nørtoft

    A numerically efficient mathematical model for the aerodynamics oflow speed axial fans of the arbitrary vortex flow type has been developed.The model is based on a blade-element principle, whereby therotor is divided into a number of annular streamtubes.For each of these streamtubes relations...... and integrated propertiesshow that the computed results agree well with the measurements.Integrating a rotor-only version of the aerodynamic modelwith an algorithm for numerical designoptimization, enables the finding of an optimum fan rotor.The angular velocity of the rotor, the hub radius and the spanwise...... of fan efficiency in a design interval of flow rates,thus designinga fan which operates well over a range of different flow conditions.The optimization scheme was used to investigate the dependence ofmaximum efficiency on1: the number of blades,2: the width of the design interval and3: the hub radius...

  2. Geometric inequalities for axially symmetric black holes

    International Nuclear Information System (INIS)

    Dain, Sergio

    2012-01-01

    A geometric inequality in general relativity relates quantities that have both a physical interpretation and a geometrical definition. It is well known that the parameters that characterize the Kerr-Newman black hole satisfy several important geometric inequalities. Remarkably enough, some of these inequalities also hold for dynamical black holes. This kind of inequalities play an important role in the characterization of the gravitational collapse; they are closely related with the cosmic censorship conjecture. Axially symmetric black holes are the natural candidates to study these inequalities because the quasi-local angular momentum is well defined for them. We review recent results in this subject and we also describe the main ideas behind the proofs. Finally, a list of relevant open problems is presented. (topical review)

  3. Collimated trans-axial tomographic scintillation camera

    International Nuclear Information System (INIS)

    1980-01-01

    The objects of this invention are first to reduce the time required to obtain statistically significant data in trans-axial tomographic radioisotope scanning using a scintillation camera. Secondly, to provide a scintillation camera system to increase the rate of acceptance of radioactive events to contribute to the positional information obtainable from a known radiation source without sacrificing spatial resolution. Thirdly to reduce the scanning time without loss of image clarity. The system described comprises a scintillation camera detector, means for moving this in orbit about a cranial-caudal axis relative to a patient and a collimator having septa defining apertures such that gamma rays perpendicular to the axis are admitted with high spatial resolution, parallel to the axis with low resolution. The septa may be made of strips of lead. Detailed descriptions are given. (U.K.)

  4. Collimated trans-axial tomographic scintillation camera

    International Nuclear Information System (INIS)

    1980-01-01

    The principal problem in trans-axial tomographic radioisotope scanning is the length of time required to obtain meaningful data. Patient movement and radioisotope migration during the scanning period can cause distortion of the image. The object of this invention is to reduce the scanning time without degrading the images obtained. A system is described in which a scintillation camera detector is moved to an orbit about the cranial-caudal axis relative to the patient. A collimator is used in which lead septa are arranged so as to admit gamma rays travelling perpendicular to this axis with high spatial resolution and those travelling in the direction of the axis with low spatial resolution, thus increasing the rate of acceptance of radioactive events to contribute to the positional information obtainable without sacrificing spatial resolution. (author)

  5. Axial flux data for fuel measurement

    Energy Technology Data Exchange (ETDEWEB)

    Popovich, R.P.

    1964-02-11

    A survey of the PITA-18 nonpoisonous spline program was conducted in conjunction with a study to determine the best method of eliminating the variability of axial flux on the fuel performance parameter, q. The results of this survey and the conclusions reached in the rupture coefficient study were found to be inter-dependent such that both are presented in this report. The data from the PITA-18 nonpoisonous spline program, as received, is the output of the NOLA-2 computer program. One quantity of interest is the rupture potential relative to a cosine, commonly referred to as the relative rupture potential. As programmed, the relative rupture potential, which was derived by applying the rupture model to individual fuel elements, might be expected to vary linearly with the rupture rate. The use of the relative rupture potential was studied over the period of July 1962 through December 1963. The results of this study are presented.

  6. Composite Axial Flow Propulsor for Small Aircraft

    Directory of Open Access Journals (Sweden)

    R. Poul

    2005-01-01

    Full Text Available This work focuses on the design of an axial flow ducted fan driven by a reciprocating engine. The solution minimizes the turbulization of the flow around the aircraft. The fan has a rotor - stator configuration. Due to the need for low weight of the fan, a carbon/epoxy composite material was chosen for the blades and the driving shaft.The fan is designed for optimal isentropic efficiency and free vortex flow. A stress analysis of the rotor blade was performed using the Finite Element  Method. The skin of the blade is calculated as a laminate and the foam core as a solid. A static and dynamic analysis were made. The RTM technology is compared with other technologies and is described in detail. 

  7. Clinical investigation on axial versus tilted implants for immediate fixed rehabilitation of edentulous arches: preliminary results of a single cohort study.

    Science.gov (United States)

    Agnini, Alessandro; Agnini, Andrea Mastrorosa; Romeo, Davide; Chiesi, Manuele; Pariente, Leon; Stappert, Christian F J

    2014-08-01

    The purpose of this clinical investigation was to evaluate full-arch fixed-dental restorations supported by immediate loaded axial and tilted implants in a single-cohort study. Survival rate of axial and tilted implants was compared. From 2006 to 2010, 30 patients were recruited and treated with dental implants. Provisional fixed-dental prostheses were screw-retained over axial or axial and tilted implants within 24 hours after surgery. Follow-ups at 6, 12, and 24 months and annually up to 5 years were scheduled, and radiographic evaluation of peri-implant bone level changes was conducted. Thirty patients (20 females and 10 males) were followed up for an average of 44 months (range 18-67 months). Six patients received both upper and lower implant rehabilitations, resulting in 36 restorations. A total of two hundred two implants were placed (maxilla = 118; mandible = 84) and 46% of the fixtures were evaluated at the 4-year recall. Four axial implants were lost in three patients, leading to 98.02% implant (97.56% axial implants and 100% tilted implants) and 100% prosthetic cumulative survival rate, respectively. No significant difference in marginal bone loss was found between tilted and axial implants in both jaws at 1-year evaluation. Midterm results confirmed that immediate loading of axial and tilted implants provides a viable treatment modality for the rehabilitation of edentulous arches. © 2012 Wiley Periodicals, Inc.

  8. Estimation of ocular volume from axial length.

    Science.gov (United States)

    Nagra, Manbir; Gilmartin, Bernard; Logan, Nicola S

    2014-12-01

    To determine which biometric parameters provide optimum predictive power for ocular volume. Sixty-seven adult subjects were scanned with a Siemens 3-T MRI scanner. Mean spherical error (MSE) (D) was measured with a Shin-Nippon autorefractor and a Zeiss IOLMaster used to measure (mm) axial length (AL), anterior chamber depth (ACD) and corneal radius (CR). Total ocular volume (TOV) was calculated from T2-weighted MRIs (voxel size 1.0 mm(3)) using an automatic voxel counting and shading algorithm. Each MR slice was subsequently edited manually in the axial, sagittal and coronal plane, the latter enabling location of the posterior pole of the crystalline lens and partitioning of TOV into anterior (AV) and posterior volume (PV) regions. Mean values (±SD) for MSE (D), AL (mm), ACD (mm) and CR (mm) were -2.62±3.83, 24.51±1.47, 3.55±0.34 and 7.75±0.28, respectively. Mean values (±SD) for TOV, AV and PV (mm(3)) were 8168.21±1141.86, 1099.40±139.24 and 7068.82±1134.05, respectively. TOV showed significant correlation with MSE, AL, PV (all p<0.001), CR (p=0.043) and ACD (p=0.024). Bar CR, the correlations were shown to be wholly attributable to variation in PV. Multiple linear regression indicated that the combination of AL and CR provided optimum R(2) values of 79.4% for TOV. Clinically useful estimations of ocular volume can be obtained from measurement of AL and CR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Axial and coronal orientation of subaxial cervical zygapophysial joints and their effect on axial rotation and lateral bending.

    Science.gov (United States)

    Hsu, Wen-Hsing; Benzel, Edward C; Chen, Tzu-Yung; Chen, Yao-Liang

    2008-10-15

    Computerized tomography and image processing methodologies were used to analyze the axial and coronal orientation of cervical zygapophysial joints in asymptomatic adults. Surface motions of axial rotation and lateral bending were simulated. The study was designed to obtain the normal distribution and variation of facet orientation (FO) in axial and coronal planes to investigate factors affecting FO and to study the effects of FO on axial rotation and lateral bending. The FO of the subaxial cervical spine is usually evaluated in the sagittal plane. Cervical spine axial and coronal FO is usually considered to be horizontal. The literature reveals no statistical data for axial or coronal FO. Serial thin-sliced computed tomography scans of the cervical spine in asymptomatic adults were input into Image J, National Institutes of Health, image processing software. Bilateral zygapophysial joint angles from C2-C3 to C6-C7 were measured in the axial and coronal planes and collected from 100 subjects. The effect of gender, age, and correlation was analyzed. The surface motions of axial rotation and lateral bending were simulated in Abaqus CAE 6.5. Mathematical facet contact and range of motion were computed. The FO was widely distributed at each level. Gender had no significant association with FO. Age affected FO at most levels. Axial and coronal FO were significantly correlated. The zygapophysial joint of internally rotated/inverted FO contacted more perpendicularly to each other, and mathematical range of motion was smaller. The axial or coronal FO of the subaxial cervical spine was found with more variability. Age was significantly related to FO. Geometrically, internally rotated/inverted FO of axial rotation/lateral bending was morerestricted. The extent of axial rotation and lateral bending was correlated with each other.

  10. Comprehensive linkage and association analyses identify haplotype, near to the TNFSF15 gene, significantly associated with spondyloarthritis.

    Directory of Open Access Journals (Sweden)

    Elena Zinovieva

    2009-06-01

    Full Text Available Spondyloarthritis (SpA is a chronic inflammatory disorder with a strong genetic predisposition dominated by the role of HLA-B27. However, the contribution of other genes to the disease susceptibility has been clearly demonstrated. We previously reported significant evidence of linkage of SpA to chromosome 9q31-34. The current study aimed to characterize this locus, named SPA2. First, we performed a fine linkage mapping of SPA2 (24 cM with 28 microsatellite markers in 149 multiplex families, which allowed us to reduce the area of investigation to an 18 cM (13 Mb locus delimited by the markers D9S279 and D9S112. Second, we constructed a linkage disequilibrium (LD map of this region with 1,536 tag single-nucleotide polymorphisms (SNPs in 136 families (263 patients. The association was assessed using a transmission disequilibrium test. One tag SNP, rs4979459, yielded a significant P-value (4.9 x 10(-5. Third, we performed an extension association study with rs4979459 and 30 surrounding SNPs in LD with it, in 287 families (668 patients, and in a sample of 139 cases and 163 controls. Strong association was observed in both familial and case/control datasets for several SNPs. In the replication study, carried with 8 SNPs in an independent sample of 232 cases and 149 controls, one SNP, rs6478105, yielded a nominal P-value<3 x 10(-2. Pooled case/control study (371 cases and 312 controls as well as combined analysis of extension and replication data showed very significant association (P<5 x 10(-4 for 6 of the 8 latter markers (rs7849556, rs10817669, rs10759734, rs6478105, rs10982396, and rs10733612. Finally, haplotype association investigations identified a strongly associated haplotype (P<8.8 x 10(-5 consisting of these 6 SNPs and located in the direct vicinity of the TNFSF15 gene. In conclusion, we have identified within the SPA2 locus a haplotype strongly associated with predisposition to SpA which is located near to TNFSF15, one of the major

  11. Age Group Comparisons of TENS Response among Individuals with Chronic Axial Low Back Pain

    Science.gov (United States)

    Simon, Corey B.; Riley, Joseph L.; Fillingim, Roger B.; Bishop, Mark D.; George, Steven Z.

    2015-01-01

    Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however, TENS response for older adults compared to younger adults is untested. In a dose-response study stratified by age, sixty participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high frequency, high intensity TENS over a two to three-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold, PPT) and central pain excitability (phasic heat temporal summation, TS; heat aftersensations, AS) were assessed before and after TENS. Episodic or immediate axial CLBP relief was assessed after TENS via measures of resting pain, movement-evoked-pain, and self-reported disability. Cumulative or prolonged axial CLBP relief was assessed by comparing daily pain report across sessions. Independent of age, individuals experienced episodic increase in PPT and reduction in AS following TENS application. Similarly, all groups, on average, experienced episodic axial CLBP relief via improved resting pain, movement-evoked pain, and disability report. Under this design, no cumulative effect was observed as daily pain did not improve for any age group across the four sessions. However, older adults received higher TENS amplitude across all sessions in achieving similar TENS responses to younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief as younger individuals following high frequency, high intensity TENS when higher dosage parameters are used. PMID:26342650

  12. Nonlinear vibration analysis of axially moving strings based on gyroscopic modes decoupling

    Science.gov (United States)

    Yang, Xiao-Dong; Wu, Hang; Qian, Ying-Jing; Zhang, Wei; Lim, C. W.

    2017-04-01

    A novel idea that applies the multiple scale analysis to a discretized decoupled system of gyroscopic continua is introduced and an axial moving string is treated as an example. First, the invariant manifold method is applied to the discretized ordinary differential equations of the axially moving string. Complex gyroscopic mode functions that agree well with true analytical results are obtained. The gyroscopic modes are subsequently used for the discretized ordinary differential equations with gyroscopic and nonlinear coupling terms that yield a gyroscopically decoupled system. Further the method of multiple scales is used to obtain the equations at a slow scale. This novel procedure is compared to solutions obtained by directly applying the classical multiple scale analysis to the gyroscopically coupled system without decoupling. The modal decoupled system analysis yields better frequency with comparing to the classic method. The proposed methodology provides a novel alternative for nonlinear dynamic analysis of gyroscopic continua.

  13. Equation of motion for the axial gravitational superfield

    International Nuclear Information System (INIS)

    Ogievetsky, V.; Sokatchev, E.

    1980-01-01

    Transformation properties of the axial supergravitational field variants are investigated. The equation of motion for the axial gravitational superfield is derived by direct variation of the N = 1 supergravity action. The left-hand side of this equation is a component of the torsion tensor, and the right-hand side is the supercurrent. The question about the cosmological term in supergravity is discussed

  14. The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis

    DEFF Research Database (Denmark)

    Lie, Elisabeth; Kristensen, Lars Erik; Forsblad-d'Elia, Helena

    2015-01-01

    OBJECTIVE: To assess the effect of comedication with conventional synthetic disease modifying antirheumatic drugs (csDMARDs) on retention to tumour necrosis factor inhibitor (TNFi) therapy in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA). METHODS: Data...... on patients with a clinical diagnosis of AS or uSpA starting treatment with adalimumab, etanercept or infliximab as their first TNFi during 2003-2010 were retrieved from the Swedish national biologics register and linked to national population based registers. Five-year drug survival was analysed by Cox...... regression with age, sex, baseline csDMARD comedication, TNFi type, prescription year and covariates representing frailty and socioeconomic status. AS and uSpA were analysed separately. Sensitivity analyses included models with csDMARD as a time-dependent covariate and adjustments for additional potential...

  15. Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products

    Directory of Open Access Journals (Sweden)

    González CM

    2017-07-01

    Full Text Available Carlos M González,1 Loreto Carmona,2 Javier de Toro,3 Enrique Batlle-Gualda,4 Antonio I Torralba,5 María J Arteaga,6 Luis Cea-Calvo6 1Department of Rheumatology, Gregorio Marañón Hospital, 2Instituto de Salud Musculoesquelética, Madrid, 3Department of Rheumatology, Hospital Universitario A Coruña, A Coruña, 4Department of Rheumatology, Hospital Universitario de Sant Joan d’Alacant, Alicante, 5Coordinadora Nacional de Artritis, 6Medical Affairs Department, Merck Sharp & Dohme, Madrid, Spain Objective: The aim of this study was to explore perceptions of patients with rheumatic diseases treated with subcutaneous (SC biological drugs on the impact on daily life and satisfaction with current therapy, including preferred attributes. Methods: A survey was developed ad hoc by four rheumatologists and three patients, including Likert questions on the impact of disease and treatment on daily life and preferred attributes of treatment. Rheumatologists from 50 participating centers were instructed to handout the survey to 20 consecutive patients with rheumatoid arthritis (RA, axial spondyloarthritis (ax-SpA, or psoriatic arthritis (PsA receiving SC biological drugs. Patients responded to the survey at home and sent it to a central facility by prepaid mail. Results: A total of 592 patients returned the survey (response rate: 59.2%, 51.4% of whom had RA, 23.8% had ax-SpA, and 19.6% had PsA. Patients reported moderate-to-severe impact of their disease on their quality of life (QoL (51.9%, work/daily activities (49.2%, emotional well-being (41.0%, personal relationships (26.0%, and close relatives’ life (32.3%; 30%–50% patients reported seldom/never being inquired about these aspects by their rheumatologists. Treatment attributes ranked as most important were the normalization of QoL (43.6% and the relief from symptoms (35.2%. The satisfaction with their current antirheumatic therapy was high (>80% were “satisfied” or “very satisfied

  16. Bi-axial quartz as a stress indicator

    Science.gov (United States)

    Starkey, John

    2000-03-01

    Experiments confirm that stress causes quartz to become biaxial with the optical axial plane parallel to the direction of maximum applied stress. Five tectonites were studied for which published data indicate strong patterns of preferred orientation of quartz. Conoscopic investigation, using an optical universal stage, reveals that the quartz in these rocks is biaxial with the 2V as large as 22°. The optic axial planes display strong patterns of preferred orientation. In the natural tectonites the maximum stress directions deduced from the orientations of the optical axial planes cannot be correlated with the supposed tectonic framework responsible for the quartz orientation fabric. The ease with which quartz can be made biaxial experimentally suggests that the orientation of the optic axial planes may be sensitive to tectonic events which affected the rocks subsequent to the development of the quartz orientation fabrics. The analysis of the orientation of optic axial planes in biaxial quartz may provide a tool for the investigation of neotectonics.

  17. Diagnostic utility of magnetic resonance imaging and radiography in juvenile spondyloarthritis: evaluation of the sacroiliac joints in controls and affected subjects.

    Science.gov (United States)

    Jaremko, Jacob L; Liu, Lei; Winn, Naomi J; Ellsworth, Janet E; Lambert, Robert G W

    2014-05-01

    To compare the utility of radiography and magnetic resonance imaging (MRI) for the diagnosis of juvenile-onset spondyloarthritis in pediatric patients presenting with low back and/or sacroiliac (SI) pain of potentially inflammatory etiology. Radiographs and MRI studies of the SI joints in 26 patients with juvenile spondyloarthritis (JSpA) and 35 controls were assessed independently by 2 radiologists, with discrepancies arbitrated by a third. Radiographs and MRI were blinded and read in separate batches in random order. Erosion was common and was the most useful diagnostic feature on radiography [positive likelihood ratio (LR) = 3.5] and was especially diagnostic of SpA on MRI (LR = 6.7). Subchondral sclerosis was common but was the least specific feature for both modalities. Joint space narrowing had some utility on radiography (LR = 2.0) and MRI (LR = 2.7) but was uncommon and had poor reader reliability. Bone marrow edema (LR = 3.1) and subarticular fat infiltration (LR = 4.5), detectable only on MRI, were both useful features. Global diagnostic impression of MRI (LR = 9.4) had very high utility for the diagnosis of JSpA, exceeding radiography (LR = 4.4) because of superior specificity. In addition, global diagnosis of SpA is much more reliably made on MRI (κ = 0.80) compared to radiography (κ = 0.30). Specificity and reliability of MRI of the SI joints are superior to radiography for the diagnosis of juvenile-onset SpA and, where available, MRI should replace radiography as the first line of investigation.

  18. Relation between axial length and ocular parameters

    Directory of Open Access Journals (Sweden)

    Xue-Qiu Yang

    2013-09-01

    Full Text Available AIM: To investigatethe relation between axial length(AL, age and ocular parameters.METHODS: A total of 360 subjects(360 eyeswith emmetropia or myopia were recruited. Refraction, center corneal thickness(CCT, AL, intraocular pressure(IOPwere measured by automatic-refractor, Pachymeter, A-mode ultrasound and non-contact tonometer, respectively. Corneal curvature(CC, anterior chamber depth(ACDand white-to-white distance(WWDwere measured by Orbscan II. Three dimensional frequency domain coherent optical tomography(3D-OCTwas used to examine the retinal nerve fiber layer thickness(RNFLT. The Pearson correlation coefficient(rand multiple regression analysis were performed to evaluate the relationship between AL, age and ocular parameters.RESULTS: The average AL was 24.15±1.26mm. With elongation of the AL, spherical equivalent(SE(r=-0.742,Pr=-0.395, Pr=-0.374, Pr=0.411, Pr=0.099, P=0.060and WWD(r=0.061, P=0.252. There was also a significant correlation between AL and age(P=0.001, SE(PPPCONCLUSION: In longer eyes, there is a tendency toward myopia, a flatter cornea, a deeper ACD and a thinner RNFLT. Age is an influencing factor for the AL as well.

  19. Nucleon axial coupling from Lattice QCD

    Science.gov (United States)

    Cheng Chang, Chia; Nicholson, Amy; Rinaldi, Enrico; Berkowitz, Evan; Garron, Nicolas; Brantley, David; Monge-Camacho, Henry; Monahan, Chris; Bouchard, Chris; Clark, M. A.; Joó, Bálint; Kurth, Thorsten; Orginos, Kostas; Vranas, Pavlos; Walker-Loud, André

    2018-03-01

    We present state-of-the-art results from a lattice QCD calculation of the nucleon axial coupling, gA, using Möbius Domain-Wall fermions solved on the dynamical Nf = 2 + 1 + 1 HISQ ensembles after they are smeared using the gradient-flow algorithm. Relevant three-point correlation functions are calculated using a method inspired by the Feynman-Hellmann theorem, and demonstrate significant improvement in signal for fixed stochastic samples. The calculation is performed at five pion masses of mπ {400, 350, 310, 220, 130} MeV, three lattice spacings of a {0.15, 0.12, 0.09} fm, and we do a dedicated volume study with mπL {3.22, 4.29, 5.36}. Control over all relevant sources of systematic uncertainty are demonstrated and quantified. We achieve a preliminary value of gA = 1.285(17), with a relative uncertainty of 1.33%.

  20. Axial sheath dynamics in a plasma focus

    International Nuclear Information System (INIS)

    Soliman, H.M.; El-Khalafawy, T.A.; Masoud, M.M.

    1990-01-01

    This paper presents the result of investigation with a 10 kJ Mather type plasma focus. It is operated in hydrogen gas at ambient pressure of 0.15--1 torr and charging voltage of 8--11 kV. Radial distribution of the current sheath density with axial distance has been estimated. Plasma rotation in the expansion chamber in the absence of external magnetic field has been detected. A plasma flare from the plasma focus region propagating in the radial direction has been observed. Streak photography shows two plasma streams flowing simultaneously out of the muzzle. The mean energy of the electron beam ejected from the pinch region of the focused plasma, was measured by retarding field analyzer to be 0.32 keV. The electron temperature of the plasma focus at peak compression was determined by measuring the X-ray intensity as a function of absorber thickness at a distance of 62 cm from the focus. The electron temperature has been found to 3 keV

  1. Nitinol stent design - understanding axial buckling.

    Science.gov (United States)

    McGrath, D J; O Brien, B; Bruzzi, M; McHugh, P E

    2014-12-01

    Nitinol׳s superelastic properties permit self-expanding stents to be crimped without plastic deformation, but its nonlinear properties can contribute towards stent buckling. This study investigates the axial buckling of a prototype tracheobronchial nitinol stent design during crimping, with the objective of eliminating buckling from the design. To capture the stent buckling mechanism a computational model of a radial force test is simulated, where small geometric defects are introduced to remove symmetry and allow buckling to occur. With the buckling mechanism ascertained, a sensitivity study is carried out to examine the effect that the transitional plateau region of the nitinol loading curve has on stent stability. Results of this analysis are then used to redesign the stent and remove buckling. It is found that the transitional plateau region can have a significant effect on the stability of a stent during crimping, and by reducing the amount of transitional material within the stent hinges during loading the stability of a nitinol stent can be increased. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Axial elongation following prolonged near work in myopes and emmetropes.

    Science.gov (United States)

    Woodman, Emily C; Read, Scott A; Collins, Michael J; Hegarty, Katherine J; Priddle, Scott B; Smith, Josephine M; Perro, Judd V

    2011-05-01

    To investigate the influence of a period of sustained near work upon axial length in groups of emmetropes (EMM) and myopes. Forty young adult subjects (20 myopes and 20 emmetropes) were recruited for the study. Myopes were further classified as early onset (EOM), late onset (LOM), stable (SM) or progressing (PM) subgroups. Axial length was measured with the IOLMaster instrument before, immediately after and then again 10 min after a continuous 30 min near task of 5 D accommodation demand. Measures of distance objective refraction were also collected. Significant changes in axial length were observed immediately following the near task. EOM axial length elongated on average by 0.027±0.021 mm, LOM by 0.014±0.020 mm, EMM by 0.010±0.015 mm, PM by 0.031±0.022 mm and SM by 0.014±0.018 mm. At the conclusion of the 10 min regression period, axial length measures were not significantly different from baseline values. Axial elongation was observed following a prolonged near task. Both EOM and PM groups showed increases in axial length that were significantly greater than emmetropes.

  3. Dispositivos de asistencia ventricular de tipo axial

    Directory of Open Access Journals (Sweden)

    Albert Miralles Cassina

    2009-04-01

    Full Text Available El uso de dispositivos de asistencia ventricular se ha ido extendiendo en las últimas décadas. La mejora de los resultados ha ido acompañada del diseño de nuevos aparatos más pequeños y eficientes como son las bombas de flujo axial. las características técnicas básicas de estos dispositivos se hallan en la generación de un flujo continuo unidireccional conseguido mediante sistemas de turbina que obtienen su alimentación de una fuente eléctrica. Las ventajas principales de estos dispositivos son: su facilidad de implantación por su tamaño reducido, su prolongada durabilidad gracias a su sencillo diseño y su eficiencia energética al utilizar energía eléctrica. Su utilidad se ha podido demostrar en diferentes indicaciones de asistencia circulatoria mecánica, como en el caso de puente al trasplante o dispositivo de recuperación miocárdica, si bien donde radica más interés es en su uso como sistemas de asistencia circulatoria mecánica definitiva. Existe una variedad de modelos de diversos diseños. Son dispositivos que permiten soporte normalmente univentricular izquierdo, que se implantan en el tórax con cánula de entrada a nivel ventricular y cánula de salida a nivel aórtico. En este artículo se efectúa una descripción de los principales sistemas disponibles en la actualidad, comentando las características técnicas, ventajas e inconvenientes y un resumen de la experiencia existente.

  4. Radial loads and axial thrusts on centrifugal pumps

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    The proceedings of a seminar organised by the Power Industries Division of the IMechE are presented in this text. Complete contents: Review of parameters influencing hydraulic forces on centrifugal impellers; The effect of fluid forces at various operation conditions on the vibrations of vertical turbine pumps; A review of the pump rotor axial equilibrium problem - some case studies; Dynamic hydraulic loading on a centrifugal pump impeller; Experimental research on axial thrust loads of double suction centrifugal pumps; A comparison of pressure distribution and radial loads on centrifugal pumps; A theoretical and experimental investigation of axial thrusts within a multi-stage centrifugal pump

  5. Measurement for cobalt target activity and its axial distribution

    International Nuclear Information System (INIS)

    Li Xingyuan; Chen Zigen.

    1985-01-01

    Cobalt target activity and its axial distribution are measured in process of producing radioactive isotopes 60 Co by irradiation in HFETR. Cobalt target activity is obtained with measured data at 3.60 m and 4.60 m, relative axial distribution of cobalt target activity is obtained with one at 30 cm, and axial distribution of cobalt target activity(or specific activity) is obtained with both of data. The difference between this specific activity and measured result for 60 Co teletherapy sources in the end is less than +- 5%

  6. Axial weak currents in the Wess-Zumino term

    International Nuclear Information System (INIS)

    Fujikawa, Kazuo.

    1985-03-01

    The conventional axial gauging of the Wess-Zumino term leads to the results which do not necessarily agree with the expectations on the basis of quark level Ward-Takahashi identities. This discrepancy arises from the fact that the quark level anomalous identities reflect the short distance structure of QCD, whereas the gauging of the Wess-Zumino term reflects the axial symmetry in the spontaneously broken chiral phase. The low energy theorem for axial weak fields is not sharply defined, in contrast to the case of vector fields where no such complications arise. (author)

  7. Osteolytic extra-axial sacral myxopapillary ependymoma

    International Nuclear Information System (INIS)

    Biagini, R.; Demitri, S.; Orsini, U.; Bibiloni, J.; Briccoli, A.; Bertoni, F.

    1999-01-01

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed. (orig.)

  8. Osteolytic extra-axial sacral myxopapillary ependymoma.

    Science.gov (United States)

    Biagini, R; Demitri, S; Orsini, U; Bibiloni, J; Briccoli, A; Bertoni, F

    1999-10-01

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed.

  9. Osteolytic extra-axial sacral myxopapillary ependymoma

    Energy Technology Data Exchange (ETDEWEB)

    Biagini, R.; Demitri, S.; Orsini, U. [Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna (Italy); Bibiloni, J. [Medical Sciences Campus San Juan, University of Puerto Rico (Puerto Rico); Briccoli, A. [Istituto di Patologia Chirurgica, University of Modena (Italy); Bertoni, F. [Servizio di Anatomia Patologica, Istituto Ortopedico Rizzoli Bologna (Italy)

    1999-10-01

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed. (orig.)

  10. The Design Method of Axial Flow Runners Focusing on Axial Flow Velocity Uniformization and Its Application to an Ultra-Small Axial Flow Hydraulic Turbine

    Directory of Open Access Journals (Sweden)

    Yasuyuki Nishi

    2016-01-01

    Full Text Available We proposed a portable and ultra-small axial flow hydraulic turbine that can generate electric power comparatively easily using the low head of open channels such as existing pipe conduits or small rivers. In addition, we proposed a simple design method for axial flow runners in combination with the conventional one-dimensional design method and the design method of axial flow velocity uniformization, with the support of three-dimensional flow analysis. Applying our design method to the runner of an ultra-small axial flow hydraulic turbine, the performance and internal flow of the designed runner were investigated using CFD analysis and experiment (performance test and PIV measurement. As a result, the runners designed with our design method were significantly improved in turbine efficiency compared to the original runner. Specifically, in the experiment, a new design of the runner achieved a turbine efficiency of 0.768. This reason was that the axial component of absolute velocity of the new design of the runner was relatively uniform at the runner outlet in comparison with that of the original runner, and as a result, the negative rotational flow was improved. Thus, the validity of our design method has been verified.

  11. A thermal model for czochralski silicon crystal growth with an axial magnetic field

    Science.gov (United States)

    Hjellming, L. N.

    1990-07-01

    This paper presents a thermal model for molten silicon in a Czochralski crystal puller system with an applied uniform axial magnetic field. The melt depth is treated as continually decreasing, which affects the thermal environment of the melt and crystal. The radiative heat loss and the input heat flux are treated as functions of time, with a constraint placed on the heat lost to the crystal from the melt. As the melt motion reaches a steady state rapidly, the temperature and flow fields are treated as instantaneously steady at each melt depth. The heat transport is a mixture of conduction and convection, and by considering the crystal and crucible to be rotating with the same angular velocity, the flows driven by buoyancy and thermocapillarity are isolated and provide the convective heat transport in the melt for the range of magnetic field strengths 0.2 ≤ B ≤ 1.0T.

  12. Tricky Treats

    Centers for Disease Control (CDC) Podcasts

    2008-08-04

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

  13. Case Study of CPT-based Design Methods for Axial Capacity of Driven Piles in Sand

    DEFF Research Database (Denmark)

    Thomassen, Kristina; Ibsen, Lars Bo; Andersen, Lars Vabbersgaard

    2012-01-01

    . Thus, several CPT-based methods have been proposed for the design of offshore driven piles in cohesionless soil such as the UWA-05, ICP-05, and NGI-99 methods. This article treats a case study where the API-method as well as the UWA-05 and NGI-99 methods are compared using CPT-data from an offshore...... loaded offshore driven piles in cohesionless soil has until now been the β-method given in API. The API-method is based on the effective overburden pressure at the depth in question. Previous studies show deviations between full-scale load test measurements of the axial pile capacity and the predictions...

  14. Case report 344: Tuberculous spondyilitis resulting in atlanto-axial dislocation

    International Nuclear Information System (INIS)

    Dowd, C.F.; Sartoris, D.J.; Resnick, D.; Haghighi, P.

    1986-01-01

    In summary, this case exhibits many of the typical features of atlanto-axial tuberculous spondylitis, including its presenting symptomatology and radiological manifestations. No other sites of tuberculous involvement were discovered on subsequent work-up in this patient. He was treated with traction and transoral debridement of soft tissues and bone, followed by anti-tuberculous chemotherapy for eight weeks and a posterior spinal fusion. The patient subsequently recovered full motor and sensory function and is currently undergoing rehabilitation therapy several months following surgery. (orig.)

  15. Ocular axial length changes in a pediatric patient with aphakia and pseudophakia.

    Science.gov (United States)

    Sinskey, R M; Stoppel, J O; Amin, P A

    1993-11-01

    Excessive eye elongation can be induced in experimental animals by visual deprivation. A tendency toward myopic refraction or shift in pediatric aphakia has been recorded in some children. In this report, we present the case of an 18-year-old patient who had developmental cataracts treated at seven years of age with bilateral cataract extraction and implantation of an intraocular lens in one eye only. Axial length of the eye with a contact lens increased compared with the eye with the intraocular lens.

  16. Cladding axial elongation models for FRAP-T6

    International Nuclear Information System (INIS)

    Shah, V.N.; Carlson, E.R.; Berna, G.A.

    1983-01-01

    This paper presents a description of the cladding axial elongation models developed at the Idaho National Engineering Laboratory (INEL) for use by the FRAP-T6 computer code in analyzing the response of fuel rods during reactor transients in light water reactors (LWR). The FRAP-T6 code contains models (FRACAS-II subcode) that analyze the structural response of a fuel rod including pellet-cladding-mechanical-interaction (PCMI). Recently, four models were incorporated into FRACAS-II to calculate cladding axial deformation: (a) axial PCMI, (b) trapped fuel stack, (c) fuel relocation, and (d) effective fuel thermal expansion. Comparisons of cladding axial elongation measurements from two experiments with the corresponding FRAP-T6 calculations are presented

  17. The relation between anomalous magnetic moment and axial anomaly

    International Nuclear Information System (INIS)

    Teryaev, O.V.

    1990-12-01

    The conservation of total angular momentum of spinor particle leads to a simple relation between the famous Schwinger and Adler coefficients determining axial anomaly and anomalous magnetic moment, respectively. (author). 8 refs, 1 fig

  18. The geometrical theory of diffraction for axially symmetric reflectors

    DEFF Research Database (Denmark)

    Rusch, W.; Sørensen, O.

    1975-01-01

    The geometrical theory of diffraction (GTD) (cf. [1], for example) may be applied advantageously to many axially symmetric reflector antenna geometries. The material in this communication presents analytical, computational, and experimental results for commonly encountered reflector geometries...

  19. Time Domain Terahertz Axial Computed Tomography Non Destructive Evaluation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to demonstrate key elements of feasibility for a high speed automated time domain terahertz computed axial tomography (TD-THz CT) non destructive...

  20. Basilar impression in osteogenesis imperfecta: can it be treated with halo traction and posterior fusion?

    NARCIS (Netherlands)

    Noske, D. P.; van Royen, B. J.; Bron, J. L.; Vandertop, W. P.

    2006-01-01

    Basilar impression (BI) and hydrocephalus complicating osteogenesis imperfecta (OI) is usually treated by anterior transoral decompression and posterior fixation. Nevertheless, it may be questioned if posterior fusion following axial halo traction is adequate in patients with symptomatic BI

  1. A new mucosal propeller flap (deep lingual artery axial propeller): the renaissance of lingual flaps.

    Science.gov (United States)

    Cordova, Adriana; Toia, Francesca; D'Arpa, Salvatore; Giunta, Gabriele; Moschella, Francesco

    2015-03-01

    Lingual flaps provide ideal mucosal coverage for intraoral defects but traditionally require two surgical stages. The authors present an axial mucosal propeller flap for single-stage intraoral reconstruction. The flap includes the mucosa of the lateral side of the tongue, islanded on the deep lingual vessels. Between 2011 and 2013, 23 patients underwent intraoral mucosal reconstruction with a deep lingual artery axial propeller flap after cancer resection in the cheek (n = 16), floor of the mouth (n = 2), retromolar trigone (n = 2), hard palate (n = 2), and soft palate (n = 1). Mean defect size was 19.5 cm. Preoperative and postoperative intraoral function was evaluated with the Functional Intraoral Glasgow Scale. The authors always achieved one-stage reconstruction with primary donor-site closure. The only complications were an infection treated conservatively and a late oronasal fistula caused by radiotherapy. All patients resumed an oral diet after 1 week and none required surgical revision. Mean 12-month postoperative Functional Intraoral Glasgow Scale score was better than the preoperative score (13.5 versus 12.8). The deep lingual artery axial propeller flap combines the advantages of the traditional lingual flap (i.e., reliable axial vascularization and like-with-like reconstruction) with those of a propeller flap (i.e., one-stage transfer of like tissue and extreme mobility) and has wider indications than a conventional lingual flap. The technique is fast and has low morbidity and good functional results, and the authors recommend it as a first-choice technique to reconstruct moderate to large intraoral defects. Therapeutic, IV.

  2. Pole prescription in axial gauge at finite temperature

    Science.gov (United States)

    Kreuzer, Maximilian; Nachbagauer, Herbert

    1991-11-01

    We establish Yang-Mills theory at finite temperature in axial gauge. We encounter the breakdown of the Hata-Kugo expression for the partition function in the special choice of temporal axial gauge. For n ≠ 0 the finite temperature propagator is calculated in both the imaginary time formalism and the real time formalism. In the latter we recover the Leibbrandt-Mandelstam prescription in the lijit T→0. As a check we calculate the mean energy to lowest order.

  3. Pole prescription in axial gauge at finite temperature

    Energy Technology Data Exchange (ETDEWEB)

    Kreuzer, M.; Nachbagauer, H. (Technische Univ., Vienna (Austria). Inst. fuer Theoretische Physik)

    1991-11-14

    We establish Yang-Mills theory at finite temperature in axial gauge. We encounter the breakdown of the Hata-Kugo expression for the partition function in the special choice of temporal axial gauge. For n {ne} 0 the finite temperature propagator is calculated in both the imaginary time formalism and the real time formalism. In the latter we recover the Leibbrandt-Mandelstam prescription in the limit T {yields} 0. As a check we calculate the mean energy to lowest order. (orig.).

  4. Axial myopia in computed and magnetic resonance tomography

    Energy Technology Data Exchange (ETDEWEB)

    Beyer-Enke, S.A.; Goerich, J.; Gamroth, A.

    1987-08-01

    The case of a 44-year old woman suffering from amblyopia on the left eye with unilateral proptosis caused by axial (progressive) myopia is presented. The clinical and radiological findings were discussed in reference to the literature. The diagnosis was established by ruling out neoplastic, inflammatory or endocrine causes for the exophtalmos. CT and MR scans revealed an enlarged left globe without evidence of orbital masses. The findings were regarded as typical for the diagnosis at axial myopia.

  5. Flutter of a fan blade in supersonic axial flow

    Science.gov (United States)

    Kielb, Robert E.; Ramsey, John K.

    1988-01-01

    An application of a simple aeroelastic model to an advanced supersonic axial flow fan is presented. Lane's cascade theory is used to determine the unsteady aerodynamic loads. Parametric studies are performed to determine the effects of mode coupling, Mach number, damping, pitching axis location, solidity, stagger angle, and mistuning. The results show that supersonic axial flow fan and compressor blades are susceptible to a strong torsional mode flutter having critical reduced velocities which can be less than one.

  6. Axial loading cross screw fixation for the Austin bunionectomy.

    Science.gov (United States)

    Rigby, Ryan B; Fallat, Lawrence M; Kish, John P

    2011-01-01

    The Austin procedure has become a common method of osteotomy for the correction of hallux abductovalgus when indicated. The V-type configuration is intrinsically stable but not without complications. One complication encountered is rotation and/or displacement of the capital fragment. We present the use of an axial loading screw in conjunction with a dorsally placed compression screw. The benefit to this technique lies in the orientation of the axial loading screw, because it is directed to resist the ground reactive forces while also providing a second point of fixation in a crossing screw design. In a head-to-head biomechanical comparison, we tested single dorsal screw fixation versus double screw fixation, including both the dorsal and the axial loading screws in 10 metatarsal Sawbones(®) (Pacific Research Laboratories Inc, Vashon, WA). Five metatarsals received single dorsal screw fixation and five received the dorsal screw and the additional axial loading screw. The metatarsals were analyzed on an Instron compression device for comparison; 100% of the single screw fixation osteotomies failed with compression at an average peak load of 205 N. Four of five axial loading double screw fixation osteotomies did not fail. This finding suggests that the addition of an axial loading screw providing cross screw orientation significantly increases the stability of the Austin osteotomy, ultimately decreasing the likelihood of displacement encountered in the surgical repair of hallux abductovalgus. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Reactive control of subsonic axial fan noise in a duct.

    Science.gov (United States)

    Liu, Y; Choy, Y S; Huang, L; Cheng, L

    2014-10-01

    Suppressing the ducted fan noise at low frequencies without varying the flow capacity is still a technical challenge. This study examines a conceived device consisting of two tensioned membranes backed with cavities housing the axial fan for suppression of the sound radiation from the axial fan directly. The noise suppression is achieved by destructive interference between the sound fields from the axial fan of a dipole nature and sound radiation from the membrane via vibroacoustics coupling. A two-dimensional model with the flow effect is presented which allows the performance of the device to be explored analytically. The air flow influences the symmetrical behavior and excites the odd in vacuo mode response of the membrane due to kinematic coupling. Such an asymmetrical effect can be compromised with off-center alignment of the axial fan. Tension plays an important role to sustain the performance to revoke the deformation of the membrane during the axial fan operation. With the design of four appropriately tensioned membranes covered by a cylindrical cavity, the first and second blade passage frequencies of the axial fan can be reduced by at least 20 dB. The satisfactory agreement between experiment and theory demonstrates that its feasibility is practical.

  8. Axial design of nuclear fuel using path relinking; Diseno axial de combustible nuclear utilizando path relinking

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, A.; Torres, M.; Ortiz, J. J.; Perusquia, R.; Hernandez, J. L.; Montes, J. L. [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)]. e-mail: jacm@nuclear.inin.mx

    2008-07-01

    In the present work the preliminary results were obtained with the zoctli system whose purpose is the axial design of assembly of nuclear fuel under certain considerations. For the mentioned design well-know cells were already used and that they have been proven in diverse cycles of operation in the nuclear power plant of Laguna Verde. The design contemplates fuels assemblies of 10x10 and with 2 water channels. The assembly was distributed in 6 axial zones according to its structure. In order to take to end the optimization is was used the well-known technique like Path relinking and to find the group of previous solutions required by this technique uses the technical Taboo search. In order to work with Path relinking, 5 trajectories was taken in to account from a set of 5 previous solutions generated with theTaboo search, the update of the group of solutions is carried out in dynamic form. In the case of the Taboo search it was used a list of variable size, it was implement an aspiration approach, it was used the vector of frequencies and due to the cost of the evaluation of the objective function, only it was review 5% of the vicinity. For the objective function was considered the limit thermal, the axial profile of power, the effective multiplication factor and the margin of having turned off in cold. In order to prove the design system, it was used a balance cycle with a value of reference of 0.9928 for the effective multiplication factor that is equivalent to a produced energy of 10896 MWd/TU at the end of operation to full power. The designed assemblies were placed both in one of lots different from fresh assemblies on which it counts the referred cycle. At the end one a comparison with the results obtained with other techniques and under similar conditions is made. The results obtained until the moment show an appropriate performance of the system. It is possible to indicate that a small inconvenient is the amount of consumed resources of calculation during

  9. High Precision Axial Coordinate Readout for an Axial 3-D PET Detector Module using a Wave Length Shifter Strip Matrix

    CERN Document Server

    Braem, André; Joram, C; Séguinot, Jacques; Weilhammer, P; De Leo, R; Nappi, E; Lustermann, W; Schinzel, D; Johnson, I; Renker, D; Albrecht, S

    2007-01-01

    We describe a novel method to extract the axial coordinate from a matrix of long axially oriented crystals, which is based on wavelength shifting plastic strips. The method allows building compact 3-D axial gamma detector modules for PET scanners with excellent 3-dimensional spatial, timing and energy resolution while keeping the number of readout channels reasonably low. A voxel resolution of about 10 mm3 is expected. We assess the performance of the method in two independent ways, using classical PMTs and G-APDs to read out the LYSO (LSO) scintillation crystals and the wavelength shifting strips. We observe yields in excess of 35 photoelectrons from the strips for a 511 keV gamma and reconstruct the axial coordinate with a precision of about 2.5 mm (FWHM).

  10. Juvenile Spondyloarthritis: An Overview

    Science.gov (United States)

    ... Primary Care Physicians For First Responders For Chiropractors Research Article Archive About SAA Major Accomplishments Awards & Honors Where ... Research Funded By SAA Early Career Investigators Award Research Article Archive Advocacy Key Messages Meet The People Meet ...

  11. Axial Lengths in Children with Recessive Cornea Plana.

    Science.gov (United States)

    Al Hazimi, Amro; Khan, Arif O

    2015-06-01

    While flat keratometry contributes to the hyperopia and associated refractive accommodative esotropia that is part of recessive cornea plana, whether or not axial lengths are abnormally short in the disease is unclear. In this study we assess this possibility. Prospective (2010-2012) axial length measurement (IOLmaster; Carl Zeiss, Oberkochen, Germany) of affected right eyes and comparison to right eyes with refractive accommodative esotropia only. Keratometry and refraction were also performed. For eight affected right eyes (age 10-12 years; seven families) axial length ranged from 21.46-24.80 mm (mean 23.34). Best corrected visual acuity ranged from 20/25 to 20/50, keratometry from 25.33-39.80 diopters (D) [mean 31.80], and refraction from +2.00 to +14.00 D (mean +7.22). For 50 control right eyes (age 4-12 years), axial length ranged from 19.87-23.66 mm (mean 21.6). Best-corrected visual acuity was 20/25 or better, keratometry ranged from 39.81-46.25 D (mean 42.42), and refraction from +2.25 to +8.00 D (mean 4.71). Axial lengths were longer in the affected group (2-tailed unpaired t-test p value 0.000005) despite greater hyperopia (2-tailed unpaired t-test p value 0.001). Despite greater hyperopia, axial lengths were longer in eyes with recessive cornea plana, evidence that axial lengths are not shortened by the disease. Keratometry in children with cornea plana was below the range of controls and was the major factor underlying the phenotype's hyperopia.

  12. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

    DEFF Research Database (Denmark)

    Mandl, P; Navarro-Compán, V; Terslev, L

    2015-01-01

    of imaging in SpA were generated using a process of discussion and consensus. Imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed tomography (CT), positron emission tomography, single photon emission CT, dual-emission x-ray absorptiometry and scintigraphy...... process, from which 158 studies were included in the systematic review. Ten recommendations were produced using research-based evidence and expert opinion encompassing the role of imaging in making a diagnosis of axial SpA or peripheral SpA, monitoring inflammation and damage, predicting outcome, response...... to treatment, and detecting spinal fractures and osteoporosis. The SOR for each recommendation was generally very high (range 8.9-9.5). These are the first recommendations which encompass the entire spectrum of SpA and evaluate the full role of all commonly used imaging modalities. We aimed to produce...

  13. Continuous millennial decrease of the Earth's magnetic axial dipole

    Science.gov (United States)

    Poletti, Wilbor; Biggin, Andrew J.; Trindade, Ricardo I. F.; Hartmann, Gelvam A.; Terra-Nova, Filipe

    2018-01-01

    Since the establishment of direct estimations of the Earth's magnetic field intensity in the first half of the nineteenth century, a continuous decay of the axial dipole component has been observed and variously speculated to be linked to an imminent reversal of the geomagnetic field. Furthermore, indirect estimations from anthropologically made materials and volcanic derivatives suggest that this decrease began significantly earlier than direct measurements have been available. Here, we carefully reassess the available archaeointensity dataset for the last two millennia, and show a good correspondence between direct (observatory/satellite) and indirect (archaeomagnetic) estimates of the axial dipole moment creating, in effect, a proxy to expand our analysis back in time. Our results suggest a continuous linear decay as the most parsimonious long-term description of the axial dipole variation for the last millennium. We thus suggest that a break in the symmetry of axial dipole moment advective sources occurred approximately 1100 years earlier than previously described. In addition, based on the observed dipole secular variation timescale, we speculate that the weakening of the axial dipole may end soon.

  14. Amphiregulin Antibody and Reduction of Axial Elongation in Experimental Myopia

    Directory of Open Access Journals (Sweden)

    Wen Jun Jiang

    2017-03-01

    Full Text Available To examine the mechanism of ocular axial elongation in myopia, guinea pigs (age: 2–3 weeks which either underwent unilateral or bilateral lens-induced myopization (group 1 or which were primarily myopic at baseline (group 2 received unilateral intraocular injections of amphiregulin antibody (doses: 5, 10, or 15 μg three times in intervals of 9 days. A third group of emmetropic guinea pigs got intraocular unilateral injections of amphiregulin (doses: 0.25, 0.50 or 1.00 ng, respectively. In each group, the contralateral eyes received intraocular injections of Ringer's solution. In intra-animal inter-eye comparison and intra-eye follow-up comparison in groups 1 and 2, the study eyes as compared to the contralateral eyes showed a dose-dependent reduction in axial elongation. In group 3, study eyes and control eyes did not differ significantly in axial elongation. Immunohistochemistry revealed amphiregulin labelling at the retinal pigment epithelium in eyes with lens-induced myopization and Ringer's solution injection, but not in eyes with amphiregulin antibody injection. Intraocular injections of amphiregulin-antibody led to a reduction of lens-induced axial myopic elongation and of the physiological eye enlargement in young guinea pigs. In contrast, intraocularly injected amphiregulin in a dose of ≤1 ng did not show a significant effect. Amphiregulin may be one of several essential molecular factors for axial elongation.

  15. Analysis of axial compressive loaded beam under random support excitations

    Science.gov (United States)

    Xiao, Wensheng; Wang, Fengde; Liu, Jian

    2017-12-01

    An analytical procedure to investigate the response spectrum of a uniform Bernoulli-Euler beam with axial compressive load subjected to random support excitations is implemented based on the Mindlin-Goodman method and the mode superposition method in the frequency domain. The random response spectrum of the simply supported beam subjected to white noise excitation and to Pierson-Moskowitz spectrum excitation is investigated, and the characteristics of the response spectrum are further explored. Moreover, the effect of axial compressive load is studied and a method to determine the axial load is proposed. The research results show that the response spectrum mainly consists of the beam's additional displacement response spectrum when the excitation is white noise; however, the quasi-static displacement response spectrum is the main component when the excitation is the Pierson-Moskowitz spectrum. Under white noise excitation, the amplitude of the power spectral density function decreased as the axial compressive load increased, while the frequency band of the vibration response spectrum increased with the increase of axial compressive load.

  16. Development and Testing of an Axial Halbach Magnetic Bearing

    Science.gov (United States)

    Eichenberg, Dennis J.; Gallo, Christopher A.; Thompson, William K.

    2006-01-01

    The NASA Glenn Research Center has developed and tested a revolutionary Axial Halbach Magnetic Bearing. The objective of this work is to develop a viable non-contact magnetic thrust bearing utilizing Halbach arrays for all-electric flight, and many other applications. This concept will help to reduce harmful emissions, reduce the Nation s dependence on fossil fuels and mitigate many of the concerns and limitations encountered in conventional axial bearings such as bearing wear, leaks, seals and friction loss. The Axial Halbach Magnetic Bearing is inherently stable and requires no active feedback control system or superconductivity as required in many magnetic bearing designs. The Axial Halbach Magnetic Bearing is useful for very high speed applications including turbines, instrumentation, medical systems, computer memory systems, and space power systems such as flywheels. Magnetic fields suspend and support a rotor assembly within a stator. Advanced technologies developed for particle accelerators, and currently under development for maglev trains and rocket launchers, served as the basis for this application. Experimental hardware was successfully designed and developed to validate the basic principles and analyses. The report concludes that the implementation of Axial Halbach Magnetic Bearings can provide significant improvements in rotational system performance and reliability.

  17. Modeling Effects of Axial Extension on Arterial Growth and Remodeling

    Science.gov (United States)

    Valentín, A.; Humphrey, J.D.

    2013-01-01

    Diverse mechanical perturbations elicit arterial growth and remodeling responses that appear to optimize structure and function so as to achieve mechanical homeostasis. For example, it is well known that functional adaptations to sustained changes in transmural pressure and blood flow primarily affect wall thickness and caliber to restore circumferential and wall shear stresses toward normal. More recently, however, it has been shown that changes in axial extension similarly prompt dramatic cell and matrix reorganization and turnover, resulting in marked changes in unloaded geometry and mechanical behavior that presumably restore axial stress toward normal. Because of the inability to infer axial stress from in vivo measurements, simulations are needed to examine this hypothesis and to guide the design of future experiments. In this paper, we show that a constrained mixture model predicts salient features of observed responses to step increases in axial extension, including marked increases in fibrous constituent production, leading to a compensatory lengthening that restores original mechanical behavior. Because axial extension can be modified via diverse surgical procedures, including bypass operations and exploited in tissue regeneration research, there is a need for increased attention to this important aspect of arterial biomechanics and mechanobiology. PMID:19649667

  18. Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Arnbak, Bodil; Jensen, Tue S.; Manniche, Claus [Hospital Lillebaelt, Research Department, Spine Centre of Southern Denmark, Middelfart (Denmark); University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); Egund, Niels; Zejden, Anna [Aarhus University Hospital, Department of Radiology, Aarhus C (Denmark); Hoerslev-Petersen, Kim [University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); King Christian 10th Hospital for Rheumatic Diseases, Graasten, Graasten (Denmark); Jurik, Anne G. [Hospital Lillebaelt, Research Department, Spine Centre of Southern Denmark, Middelfart (Denmark); University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); Aarhus University Hospital, Department of Radiology, Aarhus C (Denmark)

    2016-04-15

    To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. (orig.)

  19. Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

    International Nuclear Information System (INIS)

    Arnbak, Bodil; Jensen, Tue S.; Manniche, Claus; Egund, Niels; Zejden, Anna; Hoerslev-Petersen, Kim; Jurik, Anne G.

    2016-01-01

    To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. (orig.)

  20. Thermocapillary Convection in Floating Zone with Axial Magnetic Fields

    Science.gov (United States)

    Liang, Ruquan; Yang, Shuo; Li, Jizhao

    2014-02-01

    Numerical simulations on the effects of axial magnetic fields on the thermocapillary convection in a liquid bridge of silicone-oil-based ferrofluid under zero gravity have been conducted. The Navier-Stokes equations coupled with the energy conservation equation are solved on a staggered grid, and the mass conserving level set approach is used to capture the free surface deformation of the liquid bridge. The obvious effects of the magnetic fields on the flow pattern as well as the velocity and temperature distributions in the liquid bridge can be detected. The axial magnetic fields suppress the thermocapillary convection and a stagnant flow zone is formed between the circulating flow and the symmetric axis as the magnetic fields increase. The axial magnetic fields affect not only the velocity level inside the liquid bridge but also the velocity level on the free surface. The temperature contours near the free surface illustrates conduction-type temperature profiles at moderate strength fields.

  1. Ball Screw Actuator Including an Axial Soft Stop

    Science.gov (United States)

    Wingett, Paul T. (Inventor); Forrest, Steven Talbert (Inventor); Abel, Steve (Inventor); Woessner, George (Inventor); Hanlon, Casey (Inventor)

    2016-01-01

    An actuator includes an actuator housing, a ball screw, and an axial soft stop assembly. The ball screw extends through the actuator housing and has a first end and a second end. The ball screw is coupled to receive a drive force and is configured, upon receipt of the drive force, to selectively move in a retract direction and an extend direction. The axial soft stop assembly is disposed within the actuator housing. The axial soft stop assembly is configured to be selectively engaged by the ball screw and, upon being engaged thereby, to translate, with compliance, a predetermined distance in the extend direction, and to prevent further movement of the ball screw upon translating the predetermined distance.

  2. Improvement of axial power distribution synthesis methodology in CPC

    International Nuclear Information System (INIS)

    Kim, H. H.; Gee, S. G.;; Kim, Y. B.; In, W. K.

    2003-01-01

    The capability of axial power distribution synthesis in CPC plays an important role in determining the DNBR and LPD trip caused by CPC. The axial power distribution is synthesized using the cubic spline function based on the three excore detector signals. The axial power distributions are categorized into 8 function sets and each sets are stored as pre-calculated values in CPC to save the calculation time. In this study, the additional function sets, the real break-point function sets and the polynomial function are suggested to evaluate the possibility of improving the synthesis capability in CPC. In addition, RMS errors are compared and evaluated for each synthesis method. As a result, it was confirmed that the function sets stored in CPC were not optimal. The analysis result showed that RMS error could be reduced by selecting the proper function sets suggested in this study

  3. Axially modulated arch resonator for logic and memory applications

    KAUST Repository

    Hafiz, Md Abdullah Al

    2018-01-17

    We demonstrate reconfigurable logic and random access memory devices based on an axially modulated clamped-guided arch resonator. The device is electrostatically actuated and the motional signal is capacitively sensed, while the resonance frequency is modulated through an axial electrostatic force from the guided side of the microbeam. A multi-physics finite element model is used to verify the effectiveness of the axial modulation. We present two case studies: first, a reconfigurable two-input logic gate based on the linear resonance frequency modulation, and second, a memory element based on the hysteretic frequency response of the resonator working in the nonlinear regime. The energy consumptions of the device for both logic and memory operations are in the range of picojoules, promising for energy efficient alternative computing paradigm.

  4. Program for beam optical computation of axial symmetrical electrostatic systems

    International Nuclear Information System (INIS)

    Ke Jianlin; Wu Chunlei; Zhou Changgeng

    2012-01-01

    The beam optical computation of axial symmetrical electrostatic systems is very important in the design and test of low-energy accelerators such as Cock-Croft and Van de Graaf accelerators. In this paper, a program for the beam optical computation of these structures has been developed using transfer matrix method. The electrostatic field region is divided into several small intervals in the program, and then the beam envelope is calculated interval-to-interval from the axial potential distribution, which is calculated by other electromagnetic field simulation software such as Maxwell SV. Space charge effect is included so that the program can be used in the computation of intense beam, while nonlinear effect is beyond its ability. The program can be used in the calculation of beam optics in most complicated axial symmetrical electrostatic fields, and the computing time required is very short. (authors)

  5. Progressive atlanto-axial subluxation in Behcet's disease

    International Nuclear Information System (INIS)

    Kim, Sang-hyuk; Eoh, Whan

    2010-01-01

    Behcet's disease is a chronic inflammatory condition involving several organs, such as the skin, mucous membranes, eyes, joints, intestines, lungs and central nervous system. It rarely affects the spinal column. We describe a case of progressive atlanto-axial subluxation in a 44-year-old woman with Behcet's disease. The patient started complaining of posterior neck pain 10 years after the diagnosis of her Behcet's disease. Initial radiographs showed no abnormal finding, but follow-up radiographs 6 month later demonstrated atlanto-axial subluxation. To the best of our knowledge, this is the second reported case in the worldwide literature of an atlanto-axial instability in a patient with Behcet's disease. (orig.)

  6. Bifurcation and chaos of an axially accelerating viscoelastic beam

    International Nuclear Information System (INIS)

    Yang Xiaodong; Chen Liqun

    2005-01-01

    This paper investigates bifurcation and chaos of an axially accelerating viscoelastic beam. The Kelvin-Voigt model is adopted to constitute the material of the beam. Lagrangian strain is used to account for the beam's geometric nonlinearity. The nonlinear partial-differential equation governing transverse motion of the beam is derived from the Newton second law. The Galerkin method is applied to truncate the governing equation into a set of ordinary differential equations. By use of the Poincare map, the dynamical behavior is identified based on the numerical solutions of the ordinary differential equations. The bifurcation diagrams are presented in the case that the mean axial speed, the amplitude of speed fluctuation and the dynamic viscoelasticity is respectively varied while other parameters are fixed. The Lyapunov exponent is calculated to identify chaos. From numerical simulations, it is indicated that the periodic, quasi-periodic and chaotic motions occur in the transverse vibrations of the axially accelerating viscoelastic beam

  7. Reducing gait speed affects axial coordination of walking turns.

    Science.gov (United States)

    Forsell, Caroline; Conradsson, David; Paquette, Caroline; Franzén, Erika

    2017-05-01

    Turning is a common feature of daily life and dynamic coordination of the axial body segments is a cornerstone for safe and efficient turning. Although slow walking speed is a common trait of old age and neurological disorders, little is known about the effect of walking speed on axial coordination during walking turns. The aim of this study was to investigate the influence of walking speed on axial coordination during walking turns in healthy elderly adults. Seventeen healthy elderly adults randomly performed 180° left and right turns while walking in their self-selected comfortable pace and in a slow pace speed. Turning velocity, spatiotemporal gait parameters (step length and step time), angular rotations and angular velocity of the head and pelvis, head-pelvis separation (i.e. the angular difference in degrees between the rotation of the head and pelvis) and head-pelvis velocity were analyzed using Wilcoxon signed-rank tests. During slow walking, turning velocity was 15% lower accompanied by shorter step length and longer step time compared to comfortable walking. Reducing walking speed also led to a decrease in the amplitude and velocity of the axial rotation of the head and pelvis as well as a reduced head-pelvis separation and angular velocity. This study demonstrates that axial coordination during turning is speed dependent as evidenced by a more 'en bloc' movement pattern (i.e. less separation between axial segments) at reduced speeds in healthy older adults. This emphasizes the need for matching speed when comparing groups with diverse walking speeds to differentiate changes due to speed from changes due to disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. [Myopia: frequency of lattice degeneration and axial length].

    Science.gov (United States)

    Martín Sánchez, M D; Roldán Pallarés, M

    2001-05-01

    To evaluate the relationship between lattice retinal degeneration and axial length of the eye in different grades of myopia. A sample of 200 eyes from 124 myopic patients was collected by chance. The average age was 34.8 years (20-50 years) and the myopia was between 0.5 and 20 diopters (D). The eyes were grouped according to the degree of refraction defect, the mean axial length of each group (Scan A) and the frequency of lattice retinal degeneration and the relationship between these variables was studied. The possible influence of age on our results was also considered. For the statistical analysis, the SAS 6.07 program with the variance analysis for quantitative variables, and chi(2) test for qualitative variables with a 5% significance were used. A multivariable linear regression model was also adjusted. The highest frequency of lattice retinal degeneration occurred in those myopia patients having more than 15 D, and also in the group of myopia patients between 3 and 6 D, but this did not show statistical significance when compared with the other myopic groups. If the axial length is assessed, a greater frequency of lattice retinal degeneration is also found when the axial length is 25-27 mm and 29-30 mm, which correspond, respectively, to myopias between 3-10 D and more than 15 D. When the multivariable linear regression model was adjusted, the axial length showed the existence of lattice retinal degeneration (beta 0.41 mm; p=0.08) adjusted by the number of diopters (beta 0.38 mm; plattice retinal degeneration was found for myopias with axial eye length between 29-30 mm (more than 15 D), and 25-27 mm (between 3-10 D).

  9. Axial Permanent Magnet Generator for Wearable Energy Harvesting

    DEFF Research Database (Denmark)

    Högberg, Stig; Sødahl, Jakob Wagner; Mijatovic, Nenad

    2016-01-01

    An increasing demand for battery-free electronics is evident by the rapid increase of wearable devices, and the design of wearable energy harvesters follows accordingly. An axial permanent magnet generator was designed to harvest energy from human body motion and supplying it to a wearable...... application. The design was approached from an lectromagnetic point of view in this article. Two types of axial flux permanent magnet generators were designed: one with an iron yoke, which is commonly used to reduce the machine volume and demand of permanent magnets, and a second without the iron yoke...

  10. Manufacture of axially insulated large-area diodes

    International Nuclear Information System (INIS)

    Ma Weiyi; Zhou Kungang; Wang Youtian; Zhang Dong; Shan Yusheng; Wang Naiyan

    1999-01-01

    The author describes the design and construction of the axially insulated large-area diodes used in the 'Heaven-1'. The four axially insulated large-area diodes are connected to the 10 ohm pulse transmission lines via the vacuum feed through tubes. The experimental results with the diodes are given. The diodes can steadily work at the voltage of 650 kV, and the diode current density is about 80 A per cm 2 with a pulse width of 220 ns. The electron beams with a total energy of 25 kJ are obtained

  11. Periodicity effects of axial waves in elastic compound rods

    DEFF Research Database (Denmark)

    Nielsen, R. B.; Sorokin, S. V.

    2015-01-01

    Floquet analysis is applied to the Bernoulli-Euler model for axial waves in a periodic rod. Explicit asymptotic formulae for the stop band borders are given and the topology of the stop band pattern is explained. Eigenfrequencies of the symmetric unit cell are determined by the Phase-closure Prin......Floquet analysis is applied to the Bernoulli-Euler model for axial waves in a periodic rod. Explicit asymptotic formulae for the stop band borders are given and the topology of the stop band pattern is explained. Eigenfrequencies of the symmetric unit cell are determined by the Phase...

  12. Buckling localization in a cylindrical panel under axial compression

    DEFF Research Database (Denmark)

    Tvergaard, Viggo; Needleman, A.

    2000-01-01

    Localization of an initially periodic buckling pattern is investigated for an axially compressed elastic-plastic cylindrical panel of the type occurring between axial stiffeners on cylindrical shells. The phenomenon of buckling localization and its analogy with plastic flow localization in tensile...... test specimens is discussed in general. For the cylindrical panel, it is shown that buckling localization develops shortly after a maximum load has been attained, and this occurs for a purely elastic panel as well as for elastic-plastic panels. In a case where localization occurs after a load maximum...

  13. Spectral analysis in thin tubes with axial heterogeneities

    KAUST Repository

    Ferreira, Rita

    2015-01-01

    In this paper, we present the 3D-1D asymptotic analysis of the Dirichlet spectral problem associated with an elliptic operator with axial periodic heterogeneities. We extend to the 3D-1D case previous 3D-2D results (see [10]) and we analyze the special case where the scale of thickness is much smaller than the scale of the heterogeneities and the planar coefficient has a unique global minimum in the periodic cell. These results are of great relevance in the comprehension of the wave propagation in nanowires showing axial heterogeneities (see [17]).

  14. A simple approach to the ABJ axial anomaly

    International Nuclear Information System (INIS)

    Horejsi, J.

    1985-01-01

    A very simple semi-quantitative derivation of the Adler-Bell-Jackiw (ABJ) axial anomaly is given, based on an investigation of the absorptive part of the VVA triangle graph and dispersion relations. Essential ingredients of our discussion are: normal Ward identities for the absorptive part of the relevant diagram, dimensional analysis, unitarity, and energy-momentum conservation. An explanation of the physical origin of axial anomaly, proposed in some earlier treatments within such a dispersive framework, is critically examined. In particular, the interpretation of the ABJ anomaly as an analogy of the Lee-Nauenberg effect occurring in the massless limit of spinor electrodynamics is shown to be fallacious

  15. Light-front view of the axial anomaly

    International Nuclear Information System (INIS)

    Ji, C.; Rey, S.

    1996-01-01

    Motivated by an apparent puzzle of the light-front vacua incompatible with the axial anomaly, we have considered the two-dimensional massless Schwinger model for an arbitrary interpolating angle of Hornbostel close-quote s interpolating quantization surface. By examining spectral deformation of the Dirac sea under an external electric field semiclassically, we have found that the axial anomaly is quantization angle independent. This indicates an intricate nontrivial vacuum structure present even in the light-front limit. copyright 1996 The American Physical Society

  16. Study on Predicting Axial Load Capacity of CFST Columns

    Science.gov (United States)

    Ravi Kumar, H.; Muthu, K. U.; Kumar, N. S.

    2017-11-01

    This work presents an analytical study and experimental study on the behaviour and ultimate load carrying capacity of axially compressed self-compacting concrete-filled steel tubular columns. Results of tests conducted by various researchers on 213 samples concrete-filled steel tubular columns are reported and present authors experimental data are reported. Two theoretical equations were derived for the prediction of the ultimate axial load strength of concrete-filled steel tubular columns. The results from prediction were compared with the experimental data. Validation to the experimental results was made.

  17. Computed tomographic myelography (CTM) in atlanto-axial rheumatoid arthritis

    International Nuclear Information System (INIS)

    Laasonen, E.M.; Servo, A.; Kankaanpaeae, U.; Paukku, P.; Sandelin, J.; Slaetis, P.

    1985-01-01

    Thirty-two patients with severe cervical rheumatoid arthritis were investigated preoperatively with cervical myelography (CeM) and computed tomographic myelography (CTM). The severity of their clinical symptoms correlated excellently with a combination of the deformation of the spinal cord at the atlanto-axial level, the lateral dislocation of the cord at the same level, and the deformation of the cord at some lower cervical level. Obstructing softtissue excrescences seemed to have little value. No correlation was found in this study between the deformation of the cord and the main findings of the plain films: the atlanto-axial subluxation (AAS), the vertical subluxation (VS), or their combination. (orig.)

  18. Redesigning axial-axial (biaxial) cruciform specimens for very high cycle fatigue ultrasonic testing machines.

    Science.gov (United States)

    Montalvão, Diogo; Wren, Andrew

    2017-11-01

    The necessity to increase performances in terms of lifetime and security in mechanical components or structures is the motivation for intense research in fatigue. Applications range from aeronautics to medical devices. With the development of new materials, there is no longer a fatigue limit in the classical sense, where it was accepted that the fatigue limit is the stress level such that there is no fracture up to 1E7 cycles. The recent development of ultrasonic testing machines where frequencies can go as high as 20 kHz or over enabled tests to be extended to ranges larger than 1E9 in just a few days. This area of studies is now known as Very High Cycle Fatigue (VHCF). On the other hand, most of the existing test equipment in the market for both classical and VHCF are uniaxial test machines. However, critical components used in Engineering applications are usually subjected to complex multi-axial loading conditions. In this paper, it is presented the methodology to redesigning existing cruciform test specimens that can be used to create an in-plane biaxial state of stress when used in 'uniaxial' VHCF ultrasonic testing machines (in this case, the term 'uniaxial' is used not because of the state of stress created at the centre of the specimen, but because of the direction at which the load is applied). The methodology is explained in such a way that it can be expanded to other existing designs, namely cruciform designs, that are not yet used in VHCF. Also, although the approach is presented in simple and logical terms, it may not be that obvious for those who have a more focused approach on fatigue rather than on modal analysis. It is expected that by contributing to bridging the gap between the sciences of modal analysis and fatigue, this research will help and encourage others exploiting new capabilities in VHCF.

  19. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series

    Directory of Open Access Journals (Sweden)

    Miller Larry E

    2011-09-01

    Full Text Available Abstract Introduction Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and is associated with significant complications. The advent of minimally invasive surgical techniques offers patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion offers an alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. Case presentation Three patients who had L5-S1 grade 2 spondylolisthesis and who presented with axial pain and lumbar radiculopathy were treated with a minimally invasive surgical technique. The patients-a 51-year-old woman and two men (ages 46 and 50-were Caucasian. Under fluoroscopic guidance, spondylolisthesis was reduced with a percutaneous pedicle screw system, resulting in interspace distraction. Then, an axial presacral approach with the AxiaLIF System (TranS1, Inc., Wilmington, NC, USA was used to perform the discectomy and anterior fixation. Once the axial rod was engaged in the L5 vertebral body, further distraction of the spinal interspace was made possible by partially loosening the pedicle screw caps, advancing the AxiaLIF rod to its final position in the vertebrae, and retightening the screw caps. The operative time ranged from 173 to 323 minutes, and blood loss was minimal (50 mL. Indirect foraminal decompression and adequate fixation were achieved in all cases. All patients were ambulatory after surgery and reported relief from pain and resolution of radicular symptoms. No perioperative complications were reported, and patients were discharged in two to three days. Fusion was demonstrated radiographically in all patients at one-year follow-up. Conclusions Percutaneous pedicle screw reduction combined with axial presacral lumbar interbody fusion offers a promising and minimally invasive alternative for the management

  20. Compression, heating and fusion in dynamic pinches stabilized by an axial magnetic field

    International Nuclear Information System (INIS)

    Libermann, M.A.; Golberg, S.M.; Velikovich, A.L.

    1990-01-01

    The inertial confinement Z-pinch fusion systems have at least one advantage: there is no limitation on I like I PB , the current can be as high as the pulsed power driver is capable to deliver. When a dynamic Z-pinch is treated as an ICF system, its most important characteristic is stability of compression. The idea of combining the advantages of inertial and magnetic approaches to controlled fusion in some hybrid scheme has been discussed for a long time. It was shown that a sufficiently strong magnetic field in the ICF systems can localize the ignition by suppressing the electron thermal conductivity and diffusion of the α-particles, and also provide an initial preheating of the compressed plasma. It was also pointed out that perhaps the most important is the possibility to inhibit the development of hydrodynamic instabilities in the course of compression with the aid of the magnetic field, thus increasing the degree of stable radial compression. It was shown, that a relatively small axial magnetic field can significantly improve the uniform radial compression by suppressing the most dangerous sausage and kink modes of RT instability associated with inward acceleration of an annular plasma by the azimuthal magnetic field. This allows one to obtain higher degrees of stable radial compression up to 22-fold compression achieved instead of convetnional -8. The stabilizing effect of axial magnetic field on pinch implosions can be explained with the aid of an ideal MHD model. Stability of an implosion can be expected if the final number of e-folding of the dominating perturbation modes n ef is shown to be small or, at least, limited in comparison with the case when no axial magnetic field is present. (author) 9 refs., 1 fig

  1. Supersymmetric axial anomalies and the Wess-Zumino action

    International Nuclear Information System (INIS)

    Harada, K.; Shizuya, K.

    1988-01-01

    We derive, by an algebraic method, a manifestly supersymmetric extension of Bardeen's minimal form of axial anomalies, which obeys the Wess-Zumino consistency condition. The left-right symmetric form of the anomalies is also obtained by a reduction procedure. We construct the supersymmetric Wess-Zumino effective action and study its low-energy features. (orig.)

  2. Dynamic Response of Axially Loaded Euler-Bernoulli Beams

    DEFF Research Database (Denmark)

    Bayat, M.; Barari, Amin; Shahidi, M.

    2011-01-01

    The current research deals with application of a new analytical technique called Energy Balance Method (EBM) for a nonlinear problem. Energy Balance Method is used to obtain the analytical solution for nonlinear vibration behavior of Euler-Bernoulli beams subjected to axial loads. Analytical...

  3. Axial Torsion of Gangrenous Meckel's Diverticulum Causing Small ...

    African Journals Online (AJOL)

    dividing the band. Resection and anastomosis of the small bowel including the MD was performed. We hereby report a rare and unusual complication of a MD. Although treatment outcome is generally good, pre-operative diagnosis is often difficult. Key words: Axial torsion, Meckel's diverticulum, small bowel obstruction.

  4. A cylindrical drift chamber with azimuthal and axial position readout

    Energy Technology Data Exchange (ETDEWEB)

    Bar-Yam, Z.; Cummings, J.P.; Dowd, J.P.; Eugenio, P.; Hayek, M.; Kern, W.; King, E.; Shenhav, N.; Chung, S.U.; Hackenburg, R.W.; Olchanski, C.; Weygand, D.P.; Willutzki, H.J.; Brabson, B.B.; Crittenden, R.R.; Dzierba, A.R.; Gunter, J.; Lindenbusch, R.; Rust, D.R.; Scott, E.; Smith, P.T.; Sulanke, T.; Teige, S.; Denisov, S.; Dushkin, A.; Kochetkov, V.; Lipaev, V.; Popov, A.; Shein, I.; Soldatov, A.; Anoshina, E.V.; Bodyagin, V.A.; Demianov, A.I.; Gribushin, A.M.; Kodolova, O.L.; Korotkikh, V.L.; Kostin, M.A.; Ostrovidov, A.I.; Sarycheva, L.I.; Sinev, N.B.; Vardanyan, I.N.; Yershov, A.A.; Adams, T.; Bishop, J.M.; Cason, N.M.; Sanjari, A.H.; LoSecco, J.M.; Manak, J.J.; Shephard, W.D.; Stienike, D.L.; Taegar, S.A.; Thompson, D.R.; Brown, D.S.; Pedlar, T.; Seth, K.K.; Wise, J.; Zhao, D.; Adams, G.S.; Napolitano, J.; Nozar, M.; Smith, J.A.; Witkowski, M. [Massachusetts Univ., North Dartmouth, MA (United States)]|[Brookhaven National Laboratory, Upton, L.I., NY 11973 (United States)]|[Indiana University, Bloomington, IN 47405 (United States)]|[Institute for High Energy Physics, Protvino (Russian Federation)]|[Institute of Nuclear Physics, Moscow State University, Moscow (Russian Federation)]|[University of Notre Dame, Notre Dame, IN 46556 (United States)]|[Northwestern University, Evanston, IL 60208 (United States)]|[Rensselaer Polytechnic Institute, Troy, NY 12180 (United States)

    1997-02-21

    A cylindrical multiwire drift chamber with axial charge-division has been constructed and used in experiment E852 at Brookhaven National Laboratory. It serves as a trigger element and as a tracking device for recoil protons in {pi}{sup -}p interactions. We describe the chamber`s design considerations, details of its construction, electronics, and performance characteristics. (orig.).

  5. Studi Regangan Axial dan Lateral pada Tanah Ekspansif

    Directory of Open Access Journals (Sweden)

    Lisa Fitriyana

    2017-07-01

    Full Text Available Swelling and shrinkage abilities of soils are dangerous for buildings. According to Hardiyatmo (2014 There are two types of swelling in expansive soils that are the movement of lateral (horizontal and axial (vertical. Oftentimes the deformation of soils cannot be supported by building stiffness. This damage can be seen in retaining walls, tunnel walls, and etc. With the aims to identify an expansive soil and to know its lateral and axial strains, an experimental study was performed. Swelling tests were conducted in a specimen having diameter (d of 4,5 cm and height (h0 of 2 cm with the variations in : 1 water content wopt = 31% and 18%; 2 vertical pressure (pv 1 kPa, 3.5 kPa and 6.9 kPa; and 3 membrane thickness (t 0.7 mm and 0.5 mm. The strain in the axial direction was measured with a dial gauge that was set vertically parallel whereas the lateral strain is by measuring changes in diameter of the specimen with a digital caliper measurement tools. Based on the analysis on the identification results, the observed soil is classified as expansive soil with the expansion potential is high average. The test results show the same potential for the occurrence of lateral and lateral strain if the lateral retention (e.g. retaining wall is weak. The largest lateral and axial soil development occurred at water content w0 = 18% are 15.7% and 15.8% respectively.

  6. Axial-Gap Induction Motor For Levitated Specimens

    Science.gov (United States)

    Sridharan, Govind; Rhim, Won-Kyu; Barber, Dan; Chung, Sang

    1992-01-01

    Motor does not obscure view of specimen. Axial-gap induction motor applies torque to rotate electrostatically or electromagnetically levitated specimen of metal. Possible applications include turning specimens for uniform heating under focused laser beams and obtaining indirect measurements of resistivities or of surface tensions in molten specimens.

  7. On aspects of vibration of axially moving continua

    NARCIS (Netherlands)

    Hageraats-Ponomareva, S.

    2009-01-01

    In axially moving structures like conveyor belt systems, magnetic tapes, and so on, vibrations occur due to the presence of different kinds of imperfections in the systems. For these structures internal resonances can lead to severe vibrations. Resonance free conveyor belt systems can be constructed

  8. Axial Length/Corneal Radius of Curvature Ratio and Refractive ...

    African Journals Online (AJOL)

    2017-12-05

    Dec 5, 2017 ... variously described as determined by the ocular biometric variables. There have been many studies on the relationship between refractive error and ocular axial length (AL), anterior chamber depth, corneal radius of curvature (CR), keratometric readings as well as other ocular biometric variables such as ...

  9. Solution of the gauge identities in the axial gauge

    International Nuclear Information System (INIS)

    Delbourgo, R.

    1981-01-01

    Starting from the spectral representation of the two-point functions in the axial gauge, the gauge identities are solved so as to express the higher-point Green functions linearly in terms of the two-point spectral function. The four-point functions are an important input for investigations of scalar electrodynamics and vector chromodynamics based on the gauge technique. (author)

  10. 3-D Simulation of Vertical-Axial Tidal Current Turbine

    Directory of Open Access Journals (Sweden)

    Zhiyang Zhang

    2016-12-01

    Full Text Available Vertical-axial tidal current turbine is the key for the energy converter, which has the advantages of simple structure, adaptability to flow and uncomplex convection device. It has become the hot point for research and application recently. At present, the study on the hydrodynamic performance of vertical-axial tidal current turbine is almost on 2-D numerical simulation, without the consideration of 3-D effect. CFD (Computational Fluid Dynamics method and blade optimal control technique are used to improve accuracy in the prediction of tidal current turbine hydrodynamic performance. Numerical simulation of vertical-axial tidal current turbine is validated. Fixed and variable deflection angle turbine are comparatively studied to analysis the influence of 3-D effect and the character of fluid field and pressure field. The method, put the plate on the end of blade, of reduce the energy loss caused by 3-D effect is proposed. The 3-D CFD numerical model of vertical-axial tidal current turbine hydrodynamic performance in this study may provide theoretical, methodical and technical reference for the optimal design of turbine.

  11. View of the Axial Field Spectrometer (R807)

    CERN Multimedia

    1980-01-01

    In this view of the Axial Field Spectrometer at I8, the vertical uranium/scintillator hadron calorimeter (just left of centre) is retracted to give access to the cylindrical central drift chamber. The yellow iron structure served as a filter to identify muons, with MWPCs and the array of Cherenkov counters to the right.

  12. Landforms along transverse faults parallel to axial zone of folded ...

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Earth System Science; Volume 126; Issue 1. Landforms along transverse faults parallel to axial zone of folded mountain front, north-eastern Kumaun Sub-Himalaya, India. Khayingshing ... Keywords. Himalayan Frontal Thrust; outer Kumaun Himalaya; transverse structure; folded mountain front.

  13. sizing of wind powered axial flux permanent magnet alternator using

    African Journals Online (AJOL)

    user

    2016-10-04

    Oct 4, 2016 ... Using analytical calculations, the design parameters of the alternator's main dimensions were obtained in a ... SIZING OF WIND POWERED AXIAL FLUX PERMANENT MAGNET ALTERNATOR USING ANALYTICAL APPROACH,. A. O. Otuoze, et al .... then be expressed as. Equation (7) can be re-written as.

  14. Evaluation of electromagnetic shielding effectiveness of multi-axial ...

    Indian Academy of Sciences (India)

    Abstract. The usage of electrical and electronic equipments has been increasing in daily life, which has a potential hazardous impact on humans and other living organisms. In this paper, multi-axial fabrics containing steel yarns and carbon filaments, and their polyester (PES) resin-reinforced composites have been ...

  15. Ocular Axial Length and Keratometry Readings of Normal Eyes in ...

    African Journals Online (AJOL)

    Aim: To provide average axial length and keratometry readings in healthy eyes of people in Rivers and surrounding states in southern Nigeria. This may guide the purchase of intraocular lens in the study area. Materials and methods: Four hundred consecutive patients with 800 non-cataractous eyes attending the eye clinic ...

  16. Axial drive to nonlinear flow between rotating cylinders

    Science.gov (United States)

    Ashrafi, Nariman; Hazbavi, Abbas

    2014-02-01

    Stability of pseudoplastic rotational flow between cylinders in presence of an independent axial component is investigated. The fluid is assumed to follow the Carreau model and mixed boundary conditions are imposed. The conservation of mass and momentum equations give rise to a four-dimensional low-order dynamical system, including additional nonlinear terms in the velocity components originated from the shear-dependent viscosity. In absence of the axial flow, as the pseudoplasticity effects increases, the purely-azimuthal base flow loses its stability to the vortex structure at a lower critical Taylor number. Emergence of the vortices corresponds to the onset of a supercritical bifurcation also present in the flow of a linear fluid. However, unlike the Newtonian case, pseudoplastic Taylor vortices lose their stability as the Taylor number reaches a second critical number corresponding to the onset of a Hopf bifurcation. Existence of an axial flow induced by a pressure gradient appears to further advance each critical point on the bifurcation diagram. In continuation, complete flow field together with viscosity maps is analyzed for different flow scenarios. Through evaluation of the Lyapunov exponent, flow stability and temporal behavior of the system for cases with and without axial flow are brought to attention.

  17. Employing a tri-axial accelerometer for estimating energy ...

    African Journals Online (AJOL)

    The Tritrac-R3D, a portable tri-axial accelerometer, was assessed for its ability to estimate energy expenditure during simulated load carrying activities. The Tritrac data were compared to metabolic data collected simultaneously by a MetaMax ergospirometry system while ten, healthy male subjects (aged 20.7 ±1.4 years) ...

  18. Numerical simulation of breakup and detachment of an axially ...

    Indian Academy of Sciences (India)

    Kishore Singh Patel

    Abstract. The extensional, breakup and detachment dynamics of an axially stretching Newtonian liquid bridge are investigated numerically with a dynamic domain multiphase incompressible flow solver. The mul- tiphase flow solver employs a Cahn–Hilliard phase field model to describe the evolution of the diffuse interface.

  19. Computation of the lateral and axial point spread functions in ...

    Indian Academy of Sciences (India)

    ... confocal scanning microscopes for the above-mentioned amplitude filters. These results of axial and lateral irradiances are graphically represented by constructing a computer program using MATLAB. The obtained results are compared with that obtained in case of circular, annular, and Martinez-Corral apodized aperture ...

  20. Axial Length/Corneal Radius of Curvature Ratio and Refractive ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... Aim/Background: Associations between axial length (AL) to corneal radius of curvature (CR) ratio and refractive status in a healthy Nigerian adult population were studied. Materials and Methods: Healthy students and members of staff of Obafemi Awolowo Teaching Hospitals Complex, Ile-Ife, South West ...

  1. Axial heterogeneous core concept applied for super phoenix reactor

    International Nuclear Information System (INIS)

    Batista, J.L.; Renke, C.A.C.; Waintraub, M.; Santos Bastos, W. dos; Brito Aghina, L.O. de.

    1991-11-01

    Always maintaining the current design rules, this paper presents a parametric study on the type of axial heterogeneous core concept (CHA), utilizing a core of fast reactor Super Phenix type, reaching a maximum thermal burnup rate of 150000 M W d/t and being managed in single batch. (author)

  2. Fission gas retention and axial expansion of irradiated metallic fuel

    International Nuclear Information System (INIS)

    Fenske, G.R.; Emerson, J.E.; Savoie, F.E.; Johanson, E.W.

    1986-05-01

    Out-of-reactor experiments utilizing direct electrical heating and infrared heating techniques were performed on irradiated metallic fuel. The results indicate accelerated expansion can occur during thermal transients and that the accelerated expansion is driven by retained fission gases. The results also demonstrate gas retention and, hence, expansion behavior is a function of axial position within the pin

  3. Evaluation of electromagnetic shielding effectiveness of multi-axial ...

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... ... Lecture Workshops · Refresher Courses · Symposia. Home; Journals; Bulletin of Materials Science; Volume 39; Issue 4. Evaluation of electromagnetic shielding effectiveness of multi-axial fabrics and their reinforced PES composites. RAMAZAN ERDEM. Volume 39 Issue 4 August 2016 pp 963-970 ...

  4. Evaluation of electromagnetic shielding effectiveness of multi-axial ...

    Indian Academy of Sciences (India)

    The usage of electrical and electronic equipments has been increasing in daily life, which has a potential hazardous impact on humans and other living organisms. In this paper, multi-axial fabrics containing steel yarns and carbon filaments, and their polyester (PES) resin-reinforced composites have been prepared for ...

  5. Elevated temperature axial and torsional fatigue behavior of Haynes 188

    Science.gov (United States)

    Bonacuse, Peter J.; Kalluri, Sreeramesh

    1995-01-01

    The results are reported for high-temperature axial and torsional low-cycle fatigue experiments performed at 760 C in air on thin-walled tubular specimens of Haynes 188, a wrought cobalt-based superalloy. Data are also presented for mean coefficient of thermal expansion, elastic modulus, and shear modulus at various temperatures from room to 1000 C, and monotonic and cyclic stress-strain curves in tension and in shear at 760 C. This data set is used to evaluate several multiaxial fatigue life models (most were originally developed for room temperature multiaxial life prediction) including von Mises equivalent strain range (ASME Boiler and Pressure Code), Manson-Halford, modified multiaxiality factor (proposed in this paper), modified Smith-Watson-Topper, and Fatemi-Socie-Kurath. At von Mises equivalent strain ranges (the torsional strain range divided by the square root of 3, taking the Poisson's ratio to be 0.5), torsionally strained specimens lasted, on average, factors of 2 to 3 times longer than axially strained specimens. The modified multiaxiality factor approach shows promise as a useful method of estimating torsional fatigue life from axial fatigue data at high temperatures. Several difficulties arose with the specimen geometry and extensometry used in these experiments. Cracking at extensometer probe indentations was a problem at smaller strain ranges. Also, as the largest axial and torsional strain range fatigue tests neared completion, a small amount of specimen buckling was observed.

  6. first principles derivation of a stress function for axially symmetric

    African Journals Online (AJOL)

    HOD

    found to be identical with the Love stress function. The stress function was then applied to solve the axially symmetric problem of finding the stress fields, strain fields and displacement fields in the semi-infinite linear elastic, isotropic homogeneous medium subject to a point load P acting at the origin of coordinates also ...

  7. Kinetics and equilibria for the axial ligation of bromomethyl (aqua ...

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Chemical Sciences; Volume 121; Issue 6. Kinetics and equilibria for the axial ligation of bromomethyl (aqua)cobaloxime with pyridines - Isolation characterization and DNA binding. Kotha Laxma Reddy K Ashwini Kumar N Ravi Kumar Reddy Penumaka Nagababu A Panasa Reddy S ...

  8. Axial anomaly and magnetism of nuclear and quark matter

    Science.gov (United States)

    Son, D. T.; Stephanov, M. A.

    2008-01-01

    We consider the response of the QCD ground state at finite baryon density to a strong magnetic field B. We point out the dominant role played by the coupling of neutral Goldstone bosons, such as π0, to the magnetic field via the axial triangle anomaly. We show that, in vacuum, above a value of B˜mπ2/e, a metastable object appears—the π0 domain wall. Because of the axial anomaly, the wall carries a baryon number surface density proportional to B. As a result, for B≳1019G a stack of parallel π0 domain walls is energetically more favorable than nuclear matter at the same density. Similarly, at higher densities, somewhat weaker magnetic fields of order B≳1017 1018G transform the color-superconducting ground state of QCD into new phases containing stacks of axial isoscalar (η or η') domain walls. We also show that a quark-matter state known as “Goldstone current state,” in which a gradient of a Goldstone field is spontaneously generated, is ferromagnetic due to the axial anomaly. We estimate the size of the fields created by such a state in a typical neutron star to be of order 1014 1015G.

  9. Modelling the cardiac transverse-axial tubular system

    Czech Academy of Sciences Publication Activity Database

    Pásek, Michal; Šimurda, J.; Christé, G.; Orchard, C.

    2008-01-01

    Roč. 96, - (2008), s. 226-246 ISSN 0079-6107 Institutional research plan: CEZ:AV0Z20760514 Keywords : cardiac cell * transverse-axial tubular system * quantitative modelling Subject RIV: BO - Biophysics Impact factor: 6.388, year: 2008

  10. Comparison of design methods for axially loaded buckets in sand

    DEFF Research Database (Denmark)

    Vaitkunaite, Evelina; Nielsen, Benjaminn Nordahl; Ibsen, Lars Bo

    2015-01-01

    A study of the present knowledge about the bucket resistance for axial loading was performed considering analytical and numerical design methods as well as physical models. A case study was performed with two bucket foundations of equal diameter, but different skirt lengths installed in dense san...

  11. Axial and focal-plane diffraction catastrophe integrals

    International Nuclear Information System (INIS)

    Berry, M V; Howls, C J

    2010-01-01

    Exact expressions in terms of Bessel functions are found for some of the diffraction catastrophe integrals that decorate caustics in optics and mechanics. These are the axial and focal-plane sections of the elliptic and hyperbolic umbilic diffraction catastrophes, and symmetric elliptic and hyperbolic unfoldings of the X 9 diffraction catastrophes. These representations reveal unexpected relations between the integrals.

  12. Atlanto-axial instability in rheumatoid arthritis: a review | Omar ...

    African Journals Online (AJOL)

    Objectives: The purpose of this literature review is to identify common lesions present in the rheumatoid neck with specific emphasis to atlanto-axial instability, review its clinical presentation, imaging findings and management. Study design: A review of the English medical literature was done with focus on recent studies ...

  13. Axial Length/Corneal Radius of Curvature Ratio and Refractive ...

    African Journals Online (AJOL)

    Aim/Background: Associations between axial length (AL) to corneal radius of curvature (CR) ratio and refractive status in a healthy Nigerian adult population were studied. Materials and Methods: Healthy students and members of staff of Obafemi Awolowo Teaching Hospitals Complex, Ile‑Ife, South West Nigeria, free of ...

  14. Ocular Axial Length Measurement Among Normal Adults Using ...

    African Journals Online (AJOL)

    2017-07-26

    Jul 26, 2017 ... Background/Introduction: Macrophthalmia and microphthalmia are cardinal signs of many orbito-ocular and systemic diseases which are seen in northern Nigeria. Some cases of refractive error may also be directly related to the ocular axial length (AL). The need for an imaging parameter that will aid their ...

  15. Axial Torsion of Gangrenous Meckel's Diverticulum Causing Small ...

    African Journals Online (AJOL)

    Meckel's diverticulum (MD) is a commonly encountered congenital anomaly of the small intestine. We report an extremely unusual case of an axially torted, gangrenous MD presenting as acute intestinal obstruction. A 26-year-old male patient presented to our emergency department with 3 days history of abdominal pain, ...

  16. Computation of the lateral and axial point spread functions in ...

    Indian Academy of Sciences (India)

    scanning microscopes for the above-mentioned amplitude filters. These results of axial and lateral irradiances are graphically represented by constructing a computer program using MATLAB. The obtained results are compared with that obtained in case of circular, annular, and Martinez-Corral apodized aperture. Keywords ...

  17. Fatigue Limit of Axially Compressed Concrete | Levchich | Nigerian ...

    African Journals Online (AJOL)

    An attempt to evaluate analytically the fatigue limit of axially loaded concrete depending upon the load parameters, number of load cycles and static short-term strength is presented. The conventional limit of concrete microcracking statical sustained strength of concrete, curvelinear relationship between fatigue limit and load ...

  18. Severe vertical atlanto-axial subluxation in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sílvia Fernandes

    2015-01-01

    Full Text Available The authors present the imaging study of a case of severe vertical atlanto-axial subluxation in a 60-year-old male with long-term rheumatoid arthritis with severe polyarticular involvement (Class IV of Steinbrocker functional classification.

  19. Report on the Dynamical Evolution of an Axially Symmetric Quasar ...

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... The role of the angular momentum in the regular or chaotic character of motion in an axially symmetric quasar model is examined. It is found that, for a given value of the critical angular momentum , there are two values of the mass of the nucleus for which transition from regular to chaotic motion ...

  20. Report on the Dynamical Evolution of an Axially Symmetric Quasar ...

    Indian Academy of Sciences (India)

    Abstract. The role of the angular momentum in the regular or chaotic character of motion in an axially symmetric quasar model is examined. It is found that, for a given value of the critical angular momentum Lzc, there are two values of the mass of the nucleus Mn for which transition from regular to chaotic motion occurs.

  1. Axial-flow fan with eccentric rotor | Blaho | Zede Journal

    African Journals Online (AJOL)

    Axial-flow fan with eccentric rotor. M Blaho. Abstract. No Abstract. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES... for Researchers · for Journals ...

  2. The Nucleon Axial Form Factor and Staggered Lattice QCD

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Aaron Scott [Chicago U.

    2017-01-01

    The study of neutrino oscillation physics is a major research goal of the worldwide particle physics program over the upcoming decade. Many new experiments are being built to study the properties of neutrinos and to answer questions about the phenomenon of neutrino oscillation. These experiments need precise theoretical cross sections in order to access fundamental neutrino properties. Neutrino oscillation experiments often use large atomic nuclei as scattering targets, which are challenging for theorists to model. Nuclear models rely on free-nucleon amplitudes as inputs. These amplitudes are constrained by scattering experiments with large nuclear targets that rely on the very same nuclear models. The work in this dissertation is the rst step of a new initiative to isolate and compute elementary amplitudes with theoretical calculations to support the neutrino oscillation experimental program. Here, the eort focuses on computing the axial form factor, which is the largest contributor of systematic error in the primary signal measurement process for neutrino oscillation studies, quasielastic scattering. Two approaches are taken. First, neutrino scattering data on a deuterium target are reanalyzed with a model-independent parametrization of the axial form factor to quantify the present uncertainty in the free-nucleon amplitudes. The uncertainties on the free-nucleon cross section are found to be underestimated by about an order of magnitude compared to the ubiquitous dipole model parametrization. The second approach uses lattice QCD to perform a rst-principles computation of the nucleon axial form factor. The Highly Improved Staggered Quark (HISQ) action is employed for both valence and sea quarks. The results presented in this dissertation are computed at physical pion mass for one lattice spacing. This work presents a computation of the axial form factor at zero momentum transfer, and forms the basis for a computation of the axial form factor momentum dependence

  3. Axial SPN and radial MOC coupled whole core transport calculation

    International Nuclear Information System (INIS)

    Cho, Jin-Young; Kim, Kang-Seog; Lee, Chung-Chan; Zee, Sung-Quun; Joo, Han-Gyu

    2007-01-01

    The Simplified P N (SP N ) method is applied to the axial solution of the two-dimensional (2-D) method of characteristics (MOC) solution based whole core transport calculation. A sub-plane scheme and the nodal expansion method (NEM) are employed for the solution of the one-dimensional (1-D) SP N equations involving a radial transverse leakage. The SP N solver replaces the axial diffusion solver of the DeCART direct whole core transport code to provide more accurate, transport theory based axial solutions. In the sub-plane scheme, the radial equivalent homogenization parameters generated by the local MOC for a thick plane are assigned to the multiple finer planes in the subsequent global three-dimensional (3-D) coarse mesh finite difference (CMFD) calculation in which the NEM is employed for the axial solution. The sub-plane scheme induces a much less nodal error while having little impact on the axial leakage representation of the radial MOC calculation. The performance of the sub-plane scheme and SP N nodal transport solver is examined by solving a set of demonstrative problems and the C5G7MOX 3-D extension benchmark problems. It is shown in the demonstrative problems that the nodal error reaching upto 1,400 pcm in a rodded case is reduced to 10 pcm by introducing 10 sub-planes per MOC plane and the transport error is reduced from about 150 pcm to 10 pcm by using SP 3 . Also it is observed, in the C5G7MOX rodded configuration B problem, that the eigenvalues and pin power errors of 180 pcm and 2.2% of the 10 sub-planes diffusion case are reduced to 40 pcm and 1.4%, respectively, for SP 3 with only about a 15% increase in the computing time. It is shown that the SP 5 case gives very similar results to the SP 3 case. (author)

  4. EBQ code: transport of space-charge beams in axially symmetric devices

    International Nuclear Information System (INIS)

    Paul, A.C.

    1982-11-01

    Such general-purpose space charge codes as EGUN, BATES, WOLF, and TRANSPORT do not gracefully accommodate the simulation of relativistic space-charged beams propagating a long distance in axially symmetric devices where a high degree of cancellation has occurred between the self-magnetic and self-electric forces of the beam. The EBQ code was written specifically to follow high current beam particles where space charge is important in long distance flight in axially symmetric machines possessing external electric and magnetic field. EBQ simultaneously tracks all trajectories so as to allow procedures for charge deposition based on inter-ray separations. The orbits are treated in Cartesian geometry (position and momentum) with z as the independent variable. Poisson's equation is solved in cylindrical geometry on an orthogonal rectangular mesh. EBQ can also handle problems involving multiple ion species where the space charge from each must be included. Such problems arise in the design of ion sources where different charge and mass states are present

  5. Two-dimensional nonlinear dynamics of an axially moving viscoelastic beam with time-dependent axial speed

    International Nuclear Information System (INIS)

    Ghayesh, Mergen H.; Amabili, Marco; Farokhi, Hamed

    2013-01-01

    In the present study, the coupled nonlinear dynamics of an axially moving viscoelastic beam with time-dependent axial speed is investigated employing a numerical technique. The equations of motion for both the transverse and longitudinal motions are obtained using Newton’s second law of motion and the constitutive relations. A two-parameter rheological model of the Kelvin–Voigt energy dissipation mechanism is employed in the modelling of the viscoelastic beam material, in which the material time derivative is used in the viscoelastic constitutive relation. The Galerkin method is then applied to the coupled nonlinear equations, which are in the form of partial differential equations, resulting in a set of nonlinear ordinary differential equations (ODEs) with time-dependent coefficients due to the axial acceleration. A change of variables is then introduced to this set of ODEs to transform them into a set of first-order ordinary differential equations. A variable step-size modified Rosenbrock method is used to conduct direct time integration upon this new set of first-order nonlinear ODEs. The mean axial speed and the amplitude of the speed variations, which are taken as bifurcation parameters, are varied, resulting in the bifurcation diagrams of Poincaré maps of the system. The dynamical characteristics of the system are examined more precisely via plotting time histories, phase-plane portraits, Poincaré sections, and fast Fourier transforms (FFTs)

  6. A Retrospective Analysis of Subaxial Subluxation After Atlanto-axial Arthrodesis in Patients With Rheumatoid Arthritis Based on Annual Radiographs Obtained for 5 Years.

    Science.gov (United States)

    Iizuka, Haku; Iizuka, Yoichi; Mieda, Tokue; Kobayashi, Ryoichi; Nishinome, Masahiro; Ara, Tsuyoshi; Sorimachi, Yasunori; Nakajima, Takashi; Takagishi, Kenji

    2017-06-01

    Retrospective study. The purpose of this study was to investigate the incidence of subaxial subluxation (SAS) after atlanto-axial arthrodesis in rheumatoid arthritis (RA) patients using annual radiographs obtained for 5 years and clarify the characteristics of SAS after surgery. Rheumatoid SAS has been reported to occur after atlanto-axial arthrodesis. Many authors have noted that excessive correction of the atlanto-axial angle (AAA) results in a decrease in subaxial lordosis, thereby inducing SAS; therefore, we paid special attention to acquiring a suitable AAA in patients with atlanto-axial arthrodesis. Twenty-five patients with AAS treated with surgery were reviewed. In all patients, lateral cervical radiographs were obtained in neutral, maximal flexion, and maximal extension positions every year for 5 years after surgery. We investigated the occurrence and progression of SAS using these annual radiographs. There were no significant differences between preoperative and postoperative value in AAA and subaxial angle (SAA), respectively. Before surgery, SAS was found in 10 patients. The occurrence and progression of SAS after surgery was found in 12 cases (SAS P+ group). There were no significant differences in age, sex, or the duration of RA between the SAS P+ group and the remaining 13 cases. We also found no differences in the preoperative and postoperative AAA and SAA between the 2 groups. Although SAA was maintained after atlanto-axial arthrodesis in RA-AAS patients, 12 of 25 patients (48%) with AAS developed SAS after atlanto-axial fusion. Further surgery was not needed for SAS up to 5 years after the initial surgery. We did not find any relationship between the occurrence of SAS and the AAA and SAA before and after surgery. Therefore, our findings suggest that proper reduction of AAA in patients with atlanto-axial arthrodesis does not affect the occurrence of SAS at 5 years after surgery.

  7. Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index in Turkish patients with ankylosing spondylitis: relationship with disease activity and quality of life.

    Science.gov (United States)

    Zahiroglu, Yeliz; Ulus, Yasemin; Akyol, Yesim; Tander, Berna; Durmus, Dilek; Bilgici, Ayhan; Kuru, Omer

    2014-02-01

    The aim of this study was to investigate the relationship between Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index and disease activity and health-related quality of life in patients with ankylosing spondylitis (AS). Eighty-six AS patients not receiving antitumour necrosis factor (TNF) therapy were included in the study. Spinal pain by visual analogue scale (pain VAS rest and activity), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional capacity by Bath Ankylosing Spondylitis Functional Index (BASFI), enthesitis severity by SPARCC index, quality of life by Short Form-36 (SF-36), and Bath Ankylosing Spondylitis Metrology Index (BASMI) were assessed in patients. In the laboratory evaluations, the erythrocyte sedimentation rates and serum C-reactive protein levels of the patients were determined. All participants were aged between 18 and 65 years, with a mean age of 36.9 ± 11.13 years. The most frequent region of enthesitis was Achilles tendon insertion into calcaneum (55.8%). Pain VAS rest and activity, BASFI and all parameters of SF-36 were significantly different in AS patients with and without enthesitis. SPARCC index was significantly correlated with pain VAS activity (P  0.05). The clinical assessment of enthesitis in AS is an important outcome measure, and enthesitis indexes such as SPARCC enthesitis index can be valuable tools in the evaluation of disease activity in AS patients not receiving anti-TNF therapy. © 2013 The Authors International Journal of Rheumatic Diseases © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  8. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort.

    Science.gov (United States)

    Landi, Margarita; Maldonado-Ficco, Hernán; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A; Citera, Gustavo; Arturi, Pablo; Sampaio-Barros, Percival D; Flores Alvarado, Diana E; Burgos-Vargas, Rubén; Santos, Elena; Palleiro, Daniel; Gutiérrez, Miguel A; Vieira-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O; Berman, Alberto; Barrezueta, Claudia Vera; Vazquez-Mellado, Janitzia; Collantes-Estevez, Eduardo

    2016-12-01

    The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P spondylitis according to the gender.Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.

  9. Altano-axial subluxation with torticollis secondary to Langerhans cell histocytosis

    Directory of Open Access Journals (Sweden)

    Joshua Y. Chua, MD

    2017-12-01

    Full Text Available Langerhans Cell Histiocytosis is a rare disease featuring aberrant proliferation of dendritic cells that can infiltrate the bony skeleton. The authors report a case of six-year-old female presenting with torticollis. She was found to have extensive lytic LCH lesions in the cranio-cervical junction, causing atlanto-axial rotatory subluxation. Decision was made for a non-surgical approach to treat the patient. She was placed in a Halo brace, and given concomitant chemotherapy. Post-treatment imaging demonstrated near-complete reconstitution of the skeleton affected by LCH. This case highlights the feasibility of non-surgical treatment in selected LCH patients at high-risk of spinal instability.

  10. Axial segregation in spherical and cylindrical rotating tumblers

    Directory of Open Access Journals (Sweden)

    D’Ortona Umberto

    2017-01-01

    Full Text Available Monodisperse and bidisperse granular flows are studied in rotating tumblers using DEM. In spherical tumblers, flowing particles’ trajectories do not follow straight lines but are curved. At the same time particles near the surface drift toward the pole, inducing two global recirculation cells. Combined with radial segregation, drift and curvature compete to impose the axial segregation pattern: Small-Large-Small (SLS or Large-Small-Large (LSL. Fill level, rotation speed and wall roughness influence drift and curvature, and modify the resulting segregation pattern. In cylindrical tumblers, equivalent recirculation cells occur next to the end walls. A second pair of recirculation cells with a weak drift in the opposite direction appears at the center for long enough tumblers. Unlike the sphere case, curvature and drift in the primary cells combine to push large particles toward the end walls, explaining why large particle bands appear at the end walls for axial segregation in cylinder.

  11. Classical theory of the Kumakhov radiation in axial channeling

    International Nuclear Information System (INIS)

    Khokonov, M.K.; Komarov, F.F.; Telegin, V.I.

    1984-01-01

    The paper considers radiation of ultrarelativistic electrons in axial channeling initially predicted by Kumakhov. The consideration is based on the results of solution of the Fokker-Planck equation. The spectral-angular characteristics of the Kumakhov radiation in thick single crystals are calculated. It is shown that in heavy single crystals the energy losses on radiation can amount to a considerable portion of the initial beam energy. The possibility of a sharp increase of radiation due to a decrease of crystal temperature is discussed. It is shown that radiation intensity in axial channeling is weakly dependent on the initial angle of the electron entrance into the channel if this angle changes within the limits of a critical one. (author)

  12. Impaired bed mobility: quantitative torque analysis with axial inertial sensors.

    Science.gov (United States)

    Bhidayasiri, Roongroj; Sringean, Jirada; Thanawattano, Chusak

    2017-08-01

    Difficulty in turning in bed is rated as the most troublesome night-time symptom among Parkinson's disease (PD) patients. To develop a practical objective method for home assessment of a patient's ability to turn in bed. Nocturnal parameters and torque of self-turning in bed from 17 PD couples were assessed and compared using a wearable axial sensor for two nights in their homes. The torque of axial rotation which indicates the ability of PD patients to turn in bed was significantly less than their spouses (p turning in bed and total unified Parkinson's Disease Rating Scale score (r = 0.71; p = 0.001), and total Nocturnal Akinesia Dystonia and Cramp score (r = 0.634; p = 0.006). Our study confirms a decreased ability in turning in PD.

  13. Vector and axial nucleon form factors: A duality constrained parameterization

    International Nuclear Information System (INIS)

    Bodek, A.; Avvakumov, S.; Bradford, R.; Budd, H.

    2008-01-01

    We present new parameterizations of vector and axial nucleon form factors. We maintain an excellent descriptions of the form factors at low momentum transfers, where the spatial structure of the nucleon is important, and use the Nachtman scaling variable ξ to relate elastic and inelastic form factors and impose quark-hadron duality constraints at high momentum transfers where the quark structure dominates. We use the new vector form factors to re-extract updated values of the axial form factor from neutrino experiments on deuterium. We obtain an updated world average value from ν μ d and pion electroproduction experiments of M A =1.014±0.014 GeV/c 2 . Our parameterizations are useful in modeling neutrino interactions at low energies (e.g. for neutrino oscillations experiments). The predictions for high momentum transfers can be tested in the next generation electron and neutrino scattering experiments. (orig.)

  14. Computerized axial tomography : the tool in osseointegrated dental implants

    International Nuclear Information System (INIS)

    Fernandez-Lopez, Otton

    2002-01-01

    Failure rates in rehabilitations with osseointegrated implants are handled through appropriate radiographic preoperative planning. The appropriate length of the implant without running the risk of a perforation of vital structures, has been determined by a radiographic diagnosis. Computerized and conventional axial tomography have proved to be invaluable elements for pre-surgical evaluation. A radiologic guidance is elaborated to perform a computerized axial tomography (CT) of maxillary bones in totally edentulous patients. Surgical guides are constructed from a wax-up emanated from the information of the CT. The CT has proven to be an radiographic indispensable element to achieve the surgical-prosthetic success in osseointegrated dental implants. The CT has allowed the realization of a precise wax-up for making of surgical guide and a precise temporary prostheses in positioning of osseointegrated implants, with the consequent saving time and money for the rehabilitator and patient [es

  15. Organocatalyzed Asymmetric Synthesis of Axially, Planar, and Helical Chiral Compounds.

    Science.gov (United States)

    Shirakawa, Seiji; Liu, Shiyao; Kaneko, Shiho

    2016-02-04

    Axially, planar, and helical chiral compounds are indispensable building blocks in modern organic synthesis. A wide variety of chiral ligands and catalysts were designed based on these chiral scaffolds, and these chiral ligands and catalysts were used for various catalytic asymmetric transformations to produce important chiral compounds in an optically enriched form. Furthermore, these chiral skeletons are found in the structure of biologically active natural products. Thus, the development of efficient enantioselective methods for the synthesis of these chiral compounds is an important task in the field of organic chemistry. In the last few years, organocatalyzed approaches, which are one of the most reliable catalytic asymmetric methods, became a hot topic. This Focus Review summarizes asymmetric organocatalytic methods for the synthesis of axially, planar, and helical chiral compounds as useful chiral building blocks. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. An Axial Sliding Test for machine elements surfaces

    DEFF Research Database (Denmark)

    Godi, Alessandro; Grønbæk, J.; Mohaghegh, Kamran

    2012-01-01

    are necessary: a press to provide the normal pressure and a tensile machine to perform the axial movements. The test is calibrated so that the correspondence between the normal pressure and the container advancement is found. Finally, preliminary tests are carried out involving a multifunctional and a fine......Throughout the years, it has become more and more important to find new methods for reducing friction and wear occurrence in machine elements. A possible solution is found in texturing the surfaces under tribological contact, hence the development and spread of plateau-honed surface for cylinder...... liners. To prove the efficacy of a particular textured surface, it is paramount to perform experimental tests under controlled laboratory conditions. In this paper a new test rig simulating pure sliding conditions is presented, dubbed Axial Sliding Test. It presents four major components: a rod, a sleeve...

  17. Axial positrons emission tomography: from mouse to human brain imaging

    International Nuclear Information System (INIS)

    Brard, Emmanuel

    2013-01-01

    Positrons emission tomography is a nuclear imaging technics using nuclear decays. It is used both in clinical and preclinical studies. The later requires the use of small animals such as the mouse. The objective is to obtain the best signal with the best spatial resolution. Yet, a weight ratio between humans and mice indicates the need of a sub-millimeter resolution. A conventional scanner is based on detection modules surrounding the object to image and arranged perpendicularly. This implies a strong relationship between efficiency and spatial resolution. This work focuses on the axial geometry in which detection modules are arranged parallel to the object. This limits the relationship between the figures of merit, leading to both high spatial resolution and efficiency. The simulations of prototypes showed great perspectives in term of sub-millimeter resolution with efficiencies of 15 or 40% according to the scanner's axial extension. These results indicate great perspectives for both clinical and preclinical imaging. (author)

  18. Buckling Imperfection Sensitivity of Axially Compressed Orthotropic Cylinders

    Science.gov (United States)

    Schultz, Marc R.; Nemeth, Michael P.

    2010-01-01

    Structural stability is a major consideration in the design of lightweight shell structures. However, the theoretical predictions of geometrically perfect structures often considerably over predict the buckling loads of inherently imperfect real structures. It is reasonably well understood how the shell geometry affects the imperfection sensitivity of axially compressed cylindrical shells; however, the effects of shell anisotropy on the imperfection sensitivity is less well understood. In the present paper, the development of an analytical model for assessing the imperfection sensitivity of axially compressed orthotropic cylinders is discussed. Results from the analytical model for four shell designs are compared with those from a general-purpose finite-element code, and good qualitative agreement is found. Reasons for discrepancies are discussed, and potential design implications of this line of research are discussed.

  19. Involvement of the axial skeleton in psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    E. E. Gubar

    2017-01-01

    Full Text Available The involvement of the spine in psoriatic arthritis (PsA is observed in a large number of cases; however, a unified approach to solving this problem has not yet been formed. Criteria for the diagnosis of psoriatic spondylitis have not been clearly defined; internationally accepted definitions for this concept are absent; criteria for a PsA exacerbation and remission have not been formulated with regard to spondylitis. The specialists of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis have no their own recommendations for the treatment of axial involvement in PsA now. The therapeutic tactics used in the treatment of axial spondylitis and ankylosing spondylitis is borrowed in this area. The involvement of the spine calls for further investigation.

  20. Axial Ge/Si nanowire heterostructure tunnel FETs

    Energy Technology Data Exchange (ETDEWEB)

    Picraux, Sanuel T [Los Alamos National Laboratory; Daych, Shadi A [Los Alamos National Laboratory

    2010-01-01

    The vapor-liquid-solid (VLS) growth of semiconductor nanowires allows doping and composition modulation along their axis and the realization of axial 1 D heterostructures. This provides additional flexibility in energy band-edge engineering along the transport direction which is difficult to attain by planar materials growth and processing techniques. We report here on the design, growth, fabrication, and characterization of asymmetric heterostructure tunnel field-effect transistors (HTFETs) based on 100% compositionally modulated Si/Ge axial NWs for high on-current operation and low ambipolar transport behavior. We discuss the optimization of band-offsets and Schottky barrier heights for high performance HTFETs and issues surrounding their experimental realization. Our HTFET devices with 10 nm PECVD SiN{sub x} gate dielectric resulted in a measured current drive exceeding 100 {mu}A/{mu}m (I/{pi}D) and 10{sup 5} I{sub on}/I{sub off} ratios.

  1. Buckling localization in a cylindrical panel under axial compression

    DEFF Research Database (Denmark)

    Tvergaard, Viggo; Needleman, A.

    2000-01-01

    Localization of an initially periodic buckling pattern is investigated for an axially compressed elastic-plastic cylindrical panel of the type occurring between axial stiffeners on cylindrical shells. The phenomenon of buckling localization and its analogy with plastic flow localization in tensile...... test specimens is discussed in general. For the cylindrical panel, it is shown that buckling localization develops shortly after a maximum load has been attained, and this occurs for a purely elastic panel as well as for elastic-plastic panels. In a case where localization occurs after a load maximum......, but where subsequently the load starts to increase again, it is found that near the local load minimum, the buckling pattern switches back to a periodic type of pattern. The inelastic material behavior of the panel is described in terms of J(2) corner theory, which avoids the sometimes unrealistically high...

  2. Accuracy Improvement of Axial Power Shape Reconstruction Using GMDH Algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Yum, Seongpil; Kim, Jaemin; Park, Minyong; Choe, Jiwon; Zhang, Peng; Lee, Deokjung [UNIST, Ulsan (Korea, Republic of); Shin, Ho Cheol [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    This paper applies Group Method of Data Handling (GMDH) algorithm to improve the reconstruction accuracy. Reference three-dimensional power distributions are generated for Shinkori Unit 1 Cycle 3 by simulating Xe transients in BOC, MOC, and EOC, which include saddle, top- and bottom-skewed shapes. Using these power distributions, the axial power distributions were reconstructed by GMDH and the 5th order Fourier series method. It was shown that GMDH algorithm reduced the average Root-Mean-Square-Error (RMSE) from 1.01% of Fourier series method, down to 0.17%. This paper presents the accuracy improvement of axial power reconstruction using GMDH algorithm with the first order polynomial basis function compared to the COLSS Fourier series expansion algorithm.

  3. Axial weak currents in the Wess-Zumino term

    International Nuclear Information System (INIS)

    Fujikawa, Kazuo

    1986-01-01

    In a simplified model lagrangian of 3 quarks with an SU(2)sub(L) gauging of chiral SU(3)sub(L)xSU(3)sub(R) to introduce W-boson, we analyse certain complications associated with the low-energy theorem including axial weak fields. We first show that the low-energy amplitude is independent of the form of the quark-level anomalous identity, whether in the covariant form or the consistent form. However, the interplay of the short-distance dynamics (anomalous identity) and the long-distance dynamics (low-energy theorem) becomes involved in the presence of axial fields. We then discuss what kinds of conditions single out the gauged Wess-Zumino term as a low-energy effective action. The connection of the low-energy theorem with the 't Hooft anomaly matching condition is also discussed. (orig.)

  4. Dynamics of tubular cylindrical structures in axial flow.

    OpenAIRE

    Paidoussis, Michael P.

    2017-01-01

    The dynamics of slender cylinders in axial flow subject to conventional boundary conditions is recalled first. This is followed by brief reviews and discussion of new developments in (i) the dynamics of unconventionally supported cylinders, e.g. cylinders free at the upstream end and supported at the downstream one, (ii) the dynamics of cylinders subject to both internal and external flow for applications in oil and gas drilling and production, as well as hydrocarbon storage in salt-mined cav...

  5. Experimental investigations on an axial grooved cryogenic heat pipe

    Directory of Open Access Journals (Sweden)

    Senthil Kumar Muniappan

    2012-01-01

    Full Text Available This paper deals with development and studies of a trapezoidal axial grooved nitrogen heat pipe. A special liquid nitrogen cryostat has been designed and developed for evaluating the performance of heat pipe where the condenser portion is connected to the cold sink externally. Experiments have been performed on the heat pipe as well as on an equivalent diameter copper rod at different heat loads. The steady state performance of the heat pipe is compared with that of copper rod.

  6. Axially symmetric domain wall in 2+1-dimensions

    International Nuclear Information System (INIS)

    Soda, Jiro; Yamanaka, Yuki.

    1991-04-01

    An axially symmetric domain wall (string) in 2+1-dimensions is investigated in the synchronous gauge. This problem is also regarded as a cylindrical symmetric domain wall (membrane) in 3+1-dimensions. Using Israel's method, we present a general solution. As a special case, a static solution is obtained which agrees with the previous result of Deser and Jackiw obtained by another method. (author)

  7. Axially symmetric, stationary gravitational field equations and pseudospherical surfaces

    International Nuclear Information System (INIS)

    Tomimatsu, Akira.

    1981-04-01

    For axially symmetric, stationary gravitational field equations, a new Lax pair of the inverse scattering method is presented from a geometrical point of view. The metric coefficient e sup(2γ) (= -g sub(rho rho)g sub(tt)sup(-1)) is taken as the basic field variable, which satisfies an equation describing pseudospherical surfaces, i.e., surfaces of constant negative Gaussian curvature. The equations for other metric coefficients are also discussed. (author)

  8. Overview of the Axial Field Spectrometer in the ISR tunnel

    CERN Multimedia

    1980-01-01

    A view of the Axial Field Spectrometer – the last large experiment at the ISR. The horizontal top and vertical outer arrays of the uranium-scintillator hadron calorimeter are clear to be seen, with the blue cylindrical pole piece of the magnet just visible. The pipes that are visible in front of the pole piece are cryogenic feed pipes for the superconducting low-beta quadrupoles.

  9. Channel of Axial Injection of DC-60 Cyclotron

    CERN Document Server

    Gikal, B N; Bogomolov, S L; Borisenko, A N; Borisov, O N; Gulbekyan, G G; Ivanenko, I A; Kalagin, I V; Kazacha, V I; Kazarinov, N Yu; Khabarov, M V; Lysukhin, S N; Melnikov, V N; Paschenko, S V; Tikhomirov, A V

    2006-01-01

    The design study and realization of the axial injection beam line of DC-60 cyclotron constructed at the Flerov Laboratory of Nuclear Reactions of the Joint Institute for Nuclear Research are given. The channel allows one to transport and to inject into the cyclotron ions with mass-to-charge ratio $A/Z$ being within interval A/Z=6-12 and kinetic energy up to 17 $Z/A$ keV/m.u.

  10. Colonic surveillance by CT colonography using axial images only

    International Nuclear Information System (INIS)

    Bruzzi, John F.; Brennan, Darren D.; Fenlon, Helen M.; Moss, Alan C.; MacMathuna, Padraic

    2004-01-01

    Patients at increased risk of colon cancer require strict colon surveillance. Our objective was to establish the efficacy of 2D axial CT colonography as a surveillance test when performed in routine clinical practice. Eighty-two patients at increased risk of colon cancer underwent CT colonography followed by conventional colonoscopy on the same morning. CT colonography studies were performed on a four-ring multidetector CT scanner (100 mAs, 120 kVp, 4 x 2.5 collimation) and were interpreted by two radiologists using 2D axial images only. Results were correlated with findings at colonoscopy. Note was made of subsequent histology reports from polypectomy specimens. A total of 52 polyps were detected at colonoscopy. Using 2D axial images alone, with no recourse to 2D multiplanar or 3D views, the sensitivity of CT colonography was 100, 33 and 19% for polyps larger than 9, 6-9 and smaller than 6 mm, respectively. Per-patient specificities were 98.8, 96 and 81.5%, respectively. Twenty-nine percent of polyps smaller than 1 cm were adenomatous and there were no histological features of severe dysplasia. CT colonography is a useful colon surveillance tool for patients at increased risk of colon cancer. It has a high specificity for identifying patients who should proceed to colonoscopy and polypectomy, while allowing further colon examination to be deferred in patients with normal studies. Using 2D axial images only, CT colonography can be performed as part of the daily CT workload, with a very low rate of referral for unnecessary colonoscopy. (orig.)

  11. Numerical analysis of a microwave torch with axial gas injection

    Energy Technology Data Exchange (ETDEWEB)

    Gritsinin, S. I.; Davydov, A. M.; Kossyi, I. A., E-mail: kossyi@fpl.gpi.ru [Russian Academy of Sciences, Prokhorov General Physics Institute (Russian Federation); Kulumbaev, E. B. [National Research University Belgorod State University (Russian Federation); Lelevkin, V. M. [Kyrgyz-Russian Slavic University (Kyrgyzstan)

    2013-07-15

    The characteristics of a microwave discharge in an argon jet injected axially into a coaxial channel with a shortened inner electrode are numerically analyzed using a self-consistent equilibrium gas-dynamic model. The specific features of the excitation and maintenance of the microwave discharge are determined, and the dependences of the discharge characteristics on the supplied electromagnetic power and gas flow rate are obtained. The calculated results are compared with experimental data.

  12. One-loop corrections to the baryon axial vector current

    Indian Academy of Sciences (India)

    2012-10-06

    Oct 6, 2012 ... 917–920. One-loop corrections to the baryon axial vector current. M A HERNÁNDEZ-RUÍZ1,2. 1Instituto de Física, Universidad Autónoma de San Luis Potosí,. Av. Manuel Nava 6 Zona Universitaria 78290, San Luis Potosí SLP, México. 2Facultad de Ciencias Químicas, Universidad Autónoma de Zacatecas,.

  13. Taming axial dispersion in hydrodynamic chromatography columns through wall patterning

    Science.gov (United States)

    Adrover, Alessandra; Cerbelli, Stefano; Giona, Massimiliano

    2018-04-01

    A well-known limitation of hydrodynamic chromatography arises from the synergistic interaction between transverse diffusion and streamwise convection, which enhances axial dispersion through the Taylor-Aris mechanism. We show that a periodic sequence of slip/no-slip conditions at the channel walls (e.g., representing wall indentations hosting stable air pockets) can significantly reduce axial dispersion, thus enhancing separation performance. The theoretical/numerical analysis is based on a generalization of Brenner's macrotransport approach to solute transport, here modified to account for the finite-size of the suspended particles. The most effective dispersion-taming outcome is observed when the alternating sequence of slip/no-slip conditions yields non-vanishing cross-sectional flow components. The combination of these components with the hindering interaction between the channel boundaries and the finite-sized particles gives rise to a non-trivial solution of Brenner's problem on the unit periodic cell, where the cross-sectional particle number density departs from the spatially homogeneous condition. In turn, this effect impacts upon the solution of the so-called b-field defining the large-scale dispersion tensor, with an overall decremental effect on the axial dispersion coefficient and on the Height Equivalent of a Theoretical Plate.

  14. Fundamental metallurgical aspects of axial splitting in zircaloy cladding

    International Nuclear Information System (INIS)

    Chung, H. M.

    2000-01-01

    Fundamental metallurgical aspects of axial splitting in irradiated Zircaloy cladding have been investigated by microstructural characterization and analytical modeling, with emphasis on application of the results to understand high-burnup fuel failure under RIA situations. Optical microscopy, SEM, and TEM were conducted on BWR and PWR fuel cladding tubes that were irradiated to fluence levels of 3.3 x 10 21 n cm -2 to 5.9 x 10 21 n cm -2 (E > 1 MeV) and tested in hot cell at 292--325 C in Ar. The morphology, distribution, and habit planes of macroscopic and microscopic hydrides in as-irradiated and posttest cladding were determined by stereo-TEM. The type and magnitude of the residual stress produced in association with oxide-layer growth and dense hydride precipitation, and several synergistic factors that strongly influence axial-splitting behavior were analyzed. The results of the microstructural characterization and stress analyses were then correlated with axial-splitting behavior of high-burnup PWR cladding reported for simulated-RIA conditions. The effects of key test procedures and their implications for the interpretation of RIA test results are discussed

  15. Imaging results and TOF studies with axial PET detectors

    CERN Document Server

    Joram, Christian

    2013-01-01

    We have developed a fully operational PET demonstrator setup which allows true 3D reconstruction of the 511 keV photons and therefore leads to practically parallax free images. The AX-PET concept is based on thin 100 mm long scintillation crystals (LYSO), axially oriented and arranged in layers around the held of view. Layers of wavelength shifting plastic strips mounted in between the crystal layers give the axial coordinate. Both crystals and WLS strips are individually read out by G-APD (SiPM) photodetectors. The Fully scalable concept overcomes the dilemma of sensitivity versus spatial resolution which is inherent to classical PET designs. A demonstrator set-up based on two axial modules was exhaustively characterized using point-like sources, phantoms filled with radiotracer and finally rats and a mouse. The results entirely meet the performance expectations ( <2 mm FWHM in all three coordinates over the complete held of view) and also demonstrated the ability to include Compton interactions (inter-cr...

  16. Imaging results and TOF studies with axial PET detectors

    Science.gov (United States)

    Joram, Christian

    2013-12-01

    We have developed a fully operational PET demonstrator setup which allows true 3D reconstruction of the 511 keV photons and therefore leads to practically parallax free images. The AX-PET concept is based on thin 100 mm long scintillation crystals (LYSO), axially oriented and arranged in layers around the field of view. Layers of wavelength shifting plastic strips mounted in between the crystal layers give the axial coordinate. Both crystals and WLS strips are individually read out by G-APD (SiPM) photodetectors. The fully scalable concept overcomes the dilemma of sensitivity versus spatial resolution which is inherent to classical PET designs. A demonstrator set-up based on two axial modules was exhaustively characterized using point-like sources, phantoms filled with radiotracer and finally rats and a mouse. The results entirely meet the performance expectations (PET concept making use of the novel digital SiPM detectors by Philips. After reproducing comparable energy and spatial resolution on a small digital AX-PET set-up with 100 mm long crystals, we demonstrated a coincidence resolving time of about 210 ps FWHM.

  17. The New Performance Calculation Method of Fouled Axial Flow Compressor

    Directory of Open Access Journals (Sweden)

    Huadong Yang

    2014-01-01

    Full Text Available Fouling is the most important performance degradation factor, so it is necessary to accurately predict the effect of fouling on engine performance. In the previous research, it is very difficult to accurately model the fouled axial flow compressor. This paper develops a new performance calculation method of fouled multistage axial flow compressor based on experiment result and operating data. For multistage compressor, the whole compressor is decomposed into two sections. The first section includes the first 50% stages which reflect the fouling level, and the second section includes the last 50% stages which are viewed as the clean stage because of less deposits. In this model, the performance of the first section is obtained by combining scaling law method and linear progression model with traditional stage stacking method; simultaneously ambient conditions and engine configurations are considered. On the other hand, the performance of the second section is calculated by averaged infinitesimal stage method which is based on Reynolds’ law of similarity. Finally, the model is successfully applied to predict the 8-stage axial flow compressor and 16-stage LM2500-30 compressor. The change of thermodynamic parameters such as pressure ratio, efficiency with the operating time, and stage number is analyzed in detail.

  18. Multi technical analysis of wear mechanisms in axial piston pumps

    Science.gov (United States)

    Schuhler, G.; Jourani, A.; Bouvier, S.; Perrochat, J.-M.

    2017-05-01

    Axial piston pumps convert a motor rotation motion into hydraulic or pneumatic power. Their compactness and efficiency of approximately 0.9 make them suitable for actuation applications especially in aeronautics. However, they suffer a limited life due to the wear of their components. In the literature, studies of axial piston pumps deal with contact between its different elements under lubrication conditions. Nevertheless, they are more focused on analytic or numerical approaches. This study consists in an experimental analysis of worn pump components to highlight and understand wear mechanisms. Piston shoes are central components in the axial piston pump since they are involved in three tribological contacts. These three contacts are thereby studied: piston shoes/swashplate, piston shoes/pistons and piston shoes/shoes hold down plate (SHDP). To perform this analysis, helicopter hydraulic pumps after different operating times have been studied. The wear damage mechanisms and wear debris are analysed using SEM observations. 3D surface roughness measurements are then used to characterize worn surfaces. The observations reveal that in the contact between shoes and swashplate, the main wear mechanism is three-body abrasive wear due to coarse carbides removal. Between shoes and pistons, wear occurs in a less severe way and is mainly due to the debris generated in the first contact and conveyed by the lubricating fluid. In the third contact, the debris are also the prime cause of the abrasive wear and the generation of deep craters in the piston shoes.

  19. Simultaneous Rotational and Axial Flow of Nonlinear Fluids

    Science.gov (United States)

    Ashrafi, Nariman; Yektapour, Mehdi; Shafahi, Mehdi

    2017-11-01

    An axial flow is introduced to the rotational flow of pseudoplastic fluids in the gap between concentric cylinders. The outer cylinder is fixed while the inner one has simultaneous and independent rotational and translational motions. The fluid follows the Carreau-Bird model and mixed boundary conditions are imposed. The four-dimensional low-order equations resulted from Galerkin projection of the conservation of mass and momentum equations, includes highly non-linear terms in the velocity components. Without axial flow, stability of the base radial flow is lost to the vortex structure at a lower critical Taylor number, with increase of the fluid pseudoplasticity. The vortices imply onset of a supercritical bifurcation which occurs in the rotational flow of linear fluids as well. In contrast to the Newtonian case, pseudoplastic Taylor vortices lose their stability at a second critical Taylor number is reached a second critical number that corresponds to the onset of a Hopf bifurcation. The axial flow, caused by the translational motion of the inner cylinder advance each critical point on the bifurcation diagram. The flow field and viscosity maps are provided for major stability regions.

  20. Behavior of unbonded flexible risers subject to axial tension

    Science.gov (United States)

    Ren, Shao-fei; Tang, Wen-yong; Guo, Jin-ting

    2014-04-01

    Owing to nonlinear contact problems with slip and friction, a lot of limiting assumptions are made when developing analytical models to simulate the behavior of an unbonded flexible riser. Meanwhile, in order to avoid convergence problems and excessive calculating time associated with running the detailed finite element (FE) model of an unbonded flexible riser, interlocked carcass and zeta layers with complicated cross section shapes are replaced by simple geometrical shapes (e.g. hollow cylindrical shell) with equivalent orthotropic materials. But the simplified model does not imply the stresses equivalence of these two layers. To solve these problems, based on ABAQUS/Explicit, a numerical method that is suitable for the detailed FE model is proposed. In consideration of interaction among all component layers, the axial stiffness of an eight-layer unbonded flexible riser subjected to axial tension is predicted. Compared with analytical and experimental results, it is shown that the proposed numerical method not only has high accuracy but also can substantially reduce the calculating time. In addition, the impact of the lay angle of helical tendons on axial stiffness is discussed.

  1. HTS axial flux induction motor with analytic and FEA modeling

    International Nuclear Information System (INIS)

    Li, S.; Fan, Y.; Fang, J.; Qin, W.; Lv, G.; Li, J.H.

    2013-01-01

    Highlights: •A high temperature superconductor axial flux induction motor and a novel maglev scheme are presented. •Analytic method and finite element method have been adopted to model the motor and to calculate the force. •Magnetic field distribution in HTS coil is calculated by analytic method. •An effective method to improve the critical current of HTS coil is presented. •AC losses of HTS coils in the HTS axial flux induction motor are estimated and tested. -- Abstract: This paper presents a high-temperature superconductor (HTS) axial-flux induction motor, which can output levitation force and torque simultaneously. In order to analyze the character of the force, analytic method and finite element method are adopted to model the motor. To make sure the HTS can carry sufficiently large current and work well, the magnetic field distribution in HTS coil is calculated. An effective method to improve the critical current of HTS coil is presented. Then, AC losses in HTS windings in the motor are estimated and tested

  2. Axial power monitoring uncertainty in the Savannah River Reactors

    International Nuclear Information System (INIS)

    Losey, D.C.; Revolinski, S.M.

    1990-01-01

    The results of this analysis quantified the uncertainty associated with monitoring the Axial Power Shape (APS) in the Savannah River Reactors. Thermocouples at each assembly flow exit map the radial power distribution and are the primary means of monitoring power in these reactors. The remaining uncertainty in power monitoring is associated with the relative axial power distribution. The APS is monitored by seven sensors that respond to power on each of nine vertical Axial Power Monitor (APM) rods. Computation of the APS uncertainty, for the reactor power limits analysis, started with a large database of APM rod measurements spanning several years of reactor operation. A computer algorithm was used to randomly select a sample of APSs which were input to a code. This code modeled the thermal-hydraulic performance of a single fuel assembly during a design basis Loss-of Coolant Accident. The assembly power limit at Onset of Significant Voiding was computed for each APS. The output was a distribution of expected assembly power limits that was adjusted to account for the biases caused by instrumentation error and by measuring 7 points rather than a continuous APS. Statistical analysis of the final assembly power limit distribution showed that reducing reactor power by approximately 3% was sufficient to account for APS variation. This data confirmed expectations that the assembly exit thermocouples provide all information needed for monitoring core power. The computational analysis results also quantified the contribution to power limits of the various uncertainties such as instrumentation error

  3. Numerical Analysis of Erosion Caused by Biomimetic Axial Fan Blade

    Directory of Open Access Journals (Sweden)

    Jun-Qiu Zhang

    2013-01-01

    Full Text Available Damage caused by erosion has been reported in several industries for a wide range of situations. In the present work, a new method is presented to improve the erosion resistance of machine components by biomimetic method. A numerical investigation of solid particle erosion in the standard and biomimetic configuration blade of axial fan is presented. The analysis consists in the application of the discrete phase model, for modeling the solid particles flow, and the Eulerian conservation equations to the continuous phase. The numerical study employs computational fluid dynamics (CFD software, based on a finite volume method. User-defined function was used to define wear equation. Gas/solid flow axial fan was simulated to calculate the erosion rate of the particles on the fan blades and comparatively analyzed the erosive wear of the smooth surface, the groove-shaped, and convex hull-shaped biomimetic surface axial flow fan blade. The results show that the groove-shaped biomimetic blade antierosion ability is better than that of the other two fan blades. Thoroughly analyze of antierosion mechanism of the biomimetic blade from many factors including the flow velocity contours and flow path lines, impact velocity, impact angle, particle trajectories, and the number of collisions.

  4. Characteristics of tip-leakage flow in an axial fan

    Science.gov (United States)

    Park, Keuntae; Choi, Haecheon; Choi, Seokho; Sa, Yongcheol

    2014-11-01

    An axial fan with a shroud generates complicated vortical structures by the interaction of the axial flow with the fan blades and shroud near the blade tips. Large eddy simulation (LES) is performed for flow through a forward-swept axial fan, operating at the design condition of Re = 547,000 based on the radius of blade tip and the tip velocity. A dynamic global model (Lee et al. 2010) is used for a subgrid-scale model, and an immersed boundary method in a non-inertial reference frame (Kim & Choi 2006) is adopted for the present simulation. It is found that two vortical structures are formed near the blade tip: the main tip leakage vortex (TLV) and the auxiliary TLV. The main TLV is initiated near the leading edge, develops downstream, and impinges on the pressure surface of the next blade, where the pressure fluctuations and turbulence intensity become high. On the other hand, the auxiliary TLV is initiated at the aft part of the blade but is relatively weak such that it merges with the main TLV. Supported by the KISTI Supercomputing Center (KSC-2014-C2-014).

  5. Axial resolution of confocal Raman microscopes : Gaussian beam theory and practice

    NARCIS (Netherlands)

    Grauw, C J De; Sijtsema, N M; Otto, C; Greve, J

    1997-01-01

    A straightforward and transparent model, based on Gaussian beam optics, for the axial ro resolution of a confocal microscope is presented, A confocal Raman microscope was used to determine the axial confocality in practice. The axial response of a thin planar object was measured for three different

  6. Axial Resolution of Confocal Raman Microscopes: Gaussian Beam Theory and Practice

    NARCIS (Netherlands)

    de Grauw, C.J.; de Grauw, C.J.; Sijtsema, N.M.; Otto, Cornelis; Greve, Jan

    1997-01-01

    A straightforward and transparent model, based on Gaussian beam optics, for the axial r0 resolution of a confocal microscope is presented. A confocal Raman microscope was used to determine the axial confocality in practice. The axial response of a thin planar object was measured for three different

  7. Experimental Study of Axially Tension Cold Formed Steel Channel Members

    Science.gov (United States)

    Apriani, Widya; Lubis, Fadrizal; Angraini, Muthia

    2017-12-01

    Experimental testing is commonly used as one of the steps to determine the cause of the collapse of a building structure. The collapse of structures can be due to low quality materials. Although material samples have passed laboratory tests and the existing technical specifications have been met but there may be undetected defects and known material after failure. In this paper will be presented Experimental Testing of Axially Tension Cold Formed Steel Channel Members to determine the cause of the collapse of a building roof truss x in Pekanbaru. Test of tensile strength material cold formed channel sections was performed to obtain the main characteristics of Cold Formed steel material, namely ultimate tensile strength loads that can be held by members and the yield stress possessed by channel sections used in construction. Analysis of axially tension cold formed steel channel section presents in this paper was conducted through experimental study based on specificationsAnnualBook of ASTM Standards: Metal Test methods and Analitical Procedures, Section 3 (1991). The result of capacity loads experimental test was compared with design based on SNI 03-7971-2013standard of Indonesia for the design of cold formed steel structural members. The results of the yield stress of the material will be seen against the minimum allowable allowable stress range. After the test, the percentace of ultimate axial tension capacity theory has a result that is 16.46% larger than the ultimate axial tension capacity experimental. When compared with the load that must be borne 5.673 kN/m it can be concluded that 2 specimens do not meet. Yield stress of member has fulfilled requirement that wass bigger than 550 MPa. Based on the curve obtained ultimate axial tension capacity theory, results greater than experimental. The greatest voltage value (fu) is achieved under the same conditions as its yield stress. For this specimen with a melting voltage value fy = 571.5068 MPa has fulfilled the

  8. Design and axial optimization of nuclear fuel for BWR reactors

    International Nuclear Information System (INIS)

    Garcia V, M.A.

    2006-01-01

    In the present thesis, the modifications made to the axial optimization system based on Tabu Search (BT) for the axial design of BWR fuel type are presented, developed previously in the Nuclear Engineering Group of the UNAM Engineering Faculty. With the modifications what is mainly looked is to consider the particular characteristics of the mechanical design of the GE12 fuel type, used at the moment in the Laguna Verde Nucleo electric Central (CNLV) and that it considers the fuel bars of partial longitude. The information obtained in this thesis will allow to plan nuclear fuel reloads with the best conditions to operate in a certain cycle guaranteeing a better yield and use in the fuel burnt, additionally people in charge in the reload planning will be favored with the changes carried out to the system for the design and axial optimization of nuclear fuel, which facilitate their handling and it reduces their execution time. This thesis this developed in five chapters that are understood in the following way in general: Chapter 1: It approaches the basic concepts of the nuclear energy, it describes the physical and chemical composition of the atoms as well as that of the uranium isotopes, the handling of the uranium isotope by means of the nuclear fission until arriving to the operation of the nuclear reactors. Chapter 2: The nuclear fuel cycle is described, the methods for its extraction, its conversion and its enrichment to arrive to the stages of the nuclear fuel management used in the reactors are described. Beginning by the radial design, the axial design and the core design of the nuclear reactor related with the fuel assemblies design. Chapter 3: the optimization methods of nuclear fuel previously used are exposed among those that are: the genetic algorithms method, the search methods based on heuristic rules and the application of the tabu search method, which was used for the development of this thesis. Chapter 4: In this part the used methodology to the

  9. Experimental Studies on Strength Behaviour of Notched Glass/Epoxy Laminated Composites under Uni-axial and Bi-axial Loading

    Science.gov (United States)

    Guptha, V. L. Jagannatha; Sharma, Ramesh S.

    2017-11-01

    The use of FRP composite materials in aerospace, aviation, marine, automotive and civil engineering industry has increased rapidly in recent years due to their high specific strength and stiffness properties. The structural members contrived from such composite materials are generally subjected to complex loading conditions and leads to multi-axial stress conditions at critical surface localities. Presence of notches, much required for joining process of composites, makes it further significant. The current practice of using uni-axial test data alone to validate proposed material models is inadequate leading to evaluation and consideration of bi-axial test data. In order to correlate the bi-axial strengths with the uni-axial strengths of GFRP composite laminates in the presence of a circular notch, bi-axial tests using four servo-hydraulic actuators with four load cells were carried out. To determine the in-plane strength parameters, bi-axial cruciform test specimen model was considered. Three different fibre orientations, namely, 0°, 45°, and 90° are considered with a central circular notch of 10 mm diameter in the present investigation. From the results obtained, it is observed that there is a reduction in strength of 5.36, 2.41 and 13.92% in 0°, 45°, and 90° fibre orientation, respectively, under bi-axial loading condition as compared to that of uni-axial loading in laminated composite.

  10. A new method for the regularization of a class of divergent Feynman integrals in covariant and axial gauges

    International Nuclear Information System (INIS)

    Lee, H.C.; Milgram, M.S.

    1984-07-01

    A hybrid of dimensional and analytic regularization is used to regulate and uncover a Meijer's G-function representation for a class of massless, divergent Feynman integrals in an axial gauge. Integrals in the covariant gauge belong to a subclass and those in the light-cone gauge are reached by analytic continuation. The method decouples the physical ultraviolet and infrared singularities from the spurious axial gauge singularity but regulates all three simultaneously. For the axial gauge singularity, the new analytic method is more powerful and elegant than the old principal value prescription, but the two methods yield identical infinite as well as regular parts. It is shown that dimensional and analytic regularization can be made equivalent, implying that the former method is free from spurious γ5-anomalies and the latter preserves gauge invariance. The hybrid method permits the evaluation of integrals containing arbritrary integer powers of logarithms in the integrand by differentiation with respect to exponents. Such 'exponent derivatives' generate the same set of 'polylogs' as that generated in multi-loop integrals in perturbation theories and may be useful for solving equations in nonperturbation theories. The close relation between the method of exponent derivatives and the prescription of 't Hooft and Veltman for treating overlapping divergencies is pointed out. It is demonstrated that both methods generate functions that are free from unrecognizable logarithmic infinite parts. Nonperturbation theories expressed in terms of exponent derivatives are thus renormalizable. Some intriguing connections between nonperturbation theories and nonintegral exponents are pointed out

  11. Homocysteine causes disruptions in spinal cord morphology and changes the expression of Pax 1/9 and Sox 9 gene products in the axial mesenchyme.

    Science.gov (United States)

    Kobus, Karoline; Ammar, Dib; Nazari, Evelise Maria; Müller, Yara Maria Rauh

    2013-06-01

    Neural tube defects (NTD) involve disruptions in the axial mesenchyme, and are related to an imbalance between folic acid (FA) and homocysteine (Hcy). This study evaluated the effects of FA/Hcy imbalance on cell proliferation and expression of the Pax 1/9 and Sox 9 gene products in the axial mesenchyme of chickens. Embryos were incubated (38°C) and pretreated at 24 h and treated at 46 h of incubation. The experimental groups were: FA-pretreated with saline and treated with 0.5 μg FA/saline; Hcy-pretreated with 50 μl saline and treated with 20 μmol D,L-Hcy/50 μl saline; FA+Hcy-pretreated with 0.5 μg FA/50 μl saline and treated with 20 μmol D,L-Hcy/50 μl saline; and the control embryos were pretreated and treated with saline. Embryos were analyzed at E4 and E6. Immunohistochemistry was performed to identify proliferating cells and the expression of the gene products of Pax 1/9 and Sox 9. Total RNA of the E4 embryos was extracted and a RT-qPCR assay was performed to quantify Pax 1/9 mRNA expression. Hcy treatment caused spinal NTD and abnormalities in axial mesenchyme development, affecting the distribution of sclerotomal cells and chondrification. Hcy also reduced cell proliferation and changed the expression of Pax 1/9 and Sox 9 in the mesenchyme. Our data clarified the relationship between spinal NTD genesis and disruptions of Pax 1/9 and Sox 9 gene products in the axial mesenchyme caused by the FA/Hcy imbalance. Copyright © 2013 Wiley Periodicals, Inc.

  12. Design and axial optimization of nuclear fuel for BWR reactors; Diseno y optimizacion axial de combustible nuclear para reactores BWR

    Energy Technology Data Exchange (ETDEWEB)

    Garcia V, M.A

    2006-07-01

    In the present thesis, the modifications made to the axial optimization system based on Tabu Search (BT) for the axial design of BWR fuel type are presented, developed previously in the Nuclear Engineering Group of the UNAM Engineering Faculty. With the modifications what is mainly looked is to consider the particular characteristics of the mechanical design of the GE12 fuel type, used at the moment in the Laguna Verde Nucleo electric Central (CNLV) and that it considers the fuel bars of partial longitude. The information obtained in this thesis will allow to plan nuclear fuel reloads with the best conditions to operate in a certain cycle guaranteeing a better yield and use in the fuel burnt, additionally people in charge in the reload planning will be favored with the changes carried out to the system for the design and axial optimization of nuclear fuel, which facilitate their handling and it reduces their execution time. This thesis this developed in five chapters that are understood in the following way in general: Chapter 1: It approaches the basic concepts of the nuclear energy, it describes the physical and chemical composition of the atoms as well as that of the uranium isotopes, the handling of the uranium isotope by means of the nuclear fission until arriving to the operation of the nuclear reactors. Chapter 2: The nuclear fuel cycle is described, the methods for its extraction, its conversion and its enrichment to arrive to the stages of the nuclear fuel management used in the reactors are described. Beginning by the radial design, the axial design and the core design of the nuclear reactor related with the fuel assemblies design. Chapter 3: the optimization methods of nuclear fuel previously used are exposed among those that are: the genetic algorithms method, the search methods based on heuristic rules and the application of the tabu search method, which was used for the development of this thesis. Chapter 4: In this part the used methodology to the

  13. Renormalization of the axial-vector current in QCD

    International Nuclear Information System (INIS)

    Chiu, C.B.; Pasupathy, J.; Wilson, S.L.

    1985-01-01

    Following the method of Ioffe and Smilga, the propagation of the baryon current in an external constant axial-vector field is considered. The close similarity of the operator-product expansion with and without an external field is shown to arise from the chiral invariance of gauge interactions in perturbation theory. Several sum rules corresponding to various invariants both for the nucleon and the hyperons are derived. The analysis of the sum rules is carried out by two independent methods, one called the ratio method and the other called the continuum method, paying special attention to the nondiagonal transitions induced by the external field between the ground state and excited states. Up to operators of dimension six, two new external-field-induced vacuum expectation values enter the calculations. Previous work determining these expectation values from PCAC (partial conservation of axial-vector current) are utilized. Our determination from the sum rules of the nucleon axial-vector renormalization constant G/sub A/, as well as the Cabibbo coupling constants in the SU 3 -symmetric limit (m/sub s/ = 0), is in reasonable accord with the experimental values. Uncertainties in the analysis are pointed out. The case of broken flavor SU 3 symmetry is also considered. While in the ratio method, the results are stable for variation of the fiducial interval of the Borel mass parameter over which the left-hand side and the right-hand side of the sum rules are matched, in the continuum method the results are less stable. Another set of sum rules determines the value of the linear combination 7F-5D to be roughly-equal0, or D/(F+D)roughly-equal(7/12). .AE

  14. Axial dispersion via shear-enhanced diffusion in colloidal suspensions

    KAUST Repository

    Griffiths, I. M.

    2012-03-01

    The familiar example of Taylor dispersion of molecular solutes is extended to describe colloidal suspensions, where the fluctuations that contribute to dispersion arise from hydrodynamic interactions. The generic scheme is illustrated for a suspension of particles in a pressure-driven pipe flow, with a concentration-dependent diffusivity that captures both the shear-induced and Brownian contributions. The effect of the cross-stream migration via shear-induced diffusion is shown to dramatically reduce the axial dispersion predicted by classical Taylor dispersion for a molecular solute. Analytic and numerical solutions are presented that illustrate the effect of the concentration dependence of this nonlinear hydrodynamic mechanism. Copyright © EPLA, 2012.

  15. Axial gas flow in irradiated PWR fuel rods

    International Nuclear Information System (INIS)

    Dagbjartsson, S.J.; Murdock, B.A.; Owen, D.E.; MacDonald, P.E.

    1977-09-01

    Transient and steady state axial gas flow experiments were performed on six irradiated, commercial pressurized water reactor fuel rods at ambient temperature and 533 K. Laminar flow equations, as used in the FRAP-T2 and SSYST fuel behavior codes, were used with the gas flow results to calculate effective fuel rod radial gaps. The results of these analyses were compared with measured gap sizes obtained from metallographic examination of one fuel rod. Using measured gap sizes as input, the SSYST code was used to calculate pressure drops and mass fluxes and the results were compared with the experimental gas flow data

  16. Test Procedure for Axially Loaded Piles in Sand

    DEFF Research Database (Denmark)

    Thomassen, Kristina

    The test procedure described in the following is used when examining the effects of static or cyclic loading on the skin friction of an axially loaded pile in dense sand. The pile specimen is only loaded in tension to avoid any contribution from the base resistance. The pile dimensions are chosen...... to resemble full scale dimension of piles used in offshore pile foundations today. In this report is given a detailed description of the soil preparation and pile installation procedures as well data acquisition methods....

  17. Renormalisation group flows for gauge theories in axial gauges

    CERN Document Server

    Litim, Daniel F; Litim, Daniel F.; Pawlowski, Jan M.

    2002-01-01

    Gauge theories in axial gauges are studied using Exact Renormalisation Group flows. We introduce a background field in the infrared regulator, but not in the gauge fixing, in contrast to the usual background field gauge. It is shown how heat-kernel methods can be used to obtain approximate solutions to the flow and the corresponding Ward identities. Expansion schemes are discussed, which are not applicable in covariant gauges. As an application, we derive the one-loop effective action for covariantly constant field strength, and the one-loop beta-function for arbitrary regulator.

  18. Axial and Radial Gas Holdup in Bubble Column Reactor

    International Nuclear Information System (INIS)

    Wagh, Sameer M.; Ansari, Mohashin E Alan; Kene, Pragati T.

    2014-01-01

    Bubble column reactors are considered the reactor of choice for numerous applications including oxidation, hydrogenation, waste water treatment, and Fischer-Tropsch (FT) synthesis. They are widely used in a variety of industrial applications for carrying out gas-liquid and gas-liquid-solid reactions. In this paper, the computational fluid dynamics (CFD) model is used for predicting the gas holdup and its distribution along radial and axial direction are presented. Gas holdup increases linearly with increase in gas velocity. Gas bubbles tends to concentrate more towards the center of the column and follows a wavy path

  19. Time Dependent and Steady Uni-axial Elongational Viscosity

    DEFF Research Database (Denmark)

    Nielsen, Jens K.; Rasmussen, Henrik Koblitz; Hassager, Ole

    2005-01-01

    Here we present measurements of transient and steady uni-axial elongational viscosity, using the Filament Stretching Rheometer1 or FSR1 (see Fig. 1) of the following melts: Four narrow MMD polystyrene (PS) samples with weight-average molar mass Mw in the range of 50k to 390k. Three different bi......-disperse samples, mixed from the narrow MMD PS. Two low-density polyethylene (LDPE) melts (Lupolen 1840D and 3020D). A steady-state viscosity was kept for 1-2.5 Hencky strain units in all measurements....

  20. Plasticity around an Axial Surface Crack in a Cylindrical Shell

    DEFF Research Database (Denmark)

    Krenk, Steen

    1979-01-01

    field in an axially cracked cylindrical shell arising from use of classical eighth order shallow shell theory is removed when use is made of a tenth order shell theory which accounts for transverse shear deformations. Although the membrane stresses are only moderately affected, the influence...... and Ratwani,3–5 it generalises Dugdale's assumption of a concentrated yield zone in the plane of the crack but, contrary to that model, transverse shear effects are included and a continuous stress distribution is assumed in the yield zone. The inherent difficulties arising from the use of shell theory...

  1. Axial gravitational waves in FLRW cosmology and memory effects

    Science.gov (United States)

    Kulczycki, Wojciech; Malec, Edward

    2017-09-01

    We show initial data for gravitational axial waves that are twice differentiable but that are not C2. They generate wave pulses that interact with matter in the radiation cosmological era. This forces the radiation matter to rotate. This rotation is permanent—it persists after the passage of the gravitational pulse. The observed inhomogeneities of the cosmic microwave background radiation put a bound onto discontinuities of superhorizon metric perturbations. We explicitly show that a class of smooth initial metrics that are at least C2 gives rise to gravitational wave pulses that do not interact with the background during the radiation epoch.

  2. Static Tension Tests on Axially Loaded Pile Segments in Sand

    DEFF Research Database (Denmark)

    Thomassen, Kristina; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo

    This paper provides laboratory test results of static axially loaded piles in sand. With a newly developed test setup, the pile-soil interface friction was investigated by using an open-ended steel pile segment with a diameter of 0.5 m. Use of a pile length of 1 m enabled the pile-soil interface...... friction to be analyzed at a given soil horizon while increasing the vertical effective stress in the sand. Test results obtained by this approach can be analyzed as single t-z curves and compared to predictions of unit shaft friction from current design methods for offshore foundations. The test results...

  3. Parametric design of tri-axial nested Helmholtz coils.

    Science.gov (United States)

    Abbott, Jake J

    2015-05-01

    This paper provides an optimal parametric design for tri-axial nested Helmholtz coils, which are used to generate a uniform magnetic field with controllable magnitude and direction. Circular and square coils, both with square cross section, are considered. Practical considerations such as wire selection, wire-wrapping efficiency, wire bending radius, choice of power supply, and inductance and time response are included. Using the equations provided, a designer can quickly create an optimal set of custom coils to generate a specified field magnitude in the uniform-field region while maintaining specified accessibility to the central workspace. An example case study is included.

  4. Nonlinear vibration of an axially loaded beam carrying rigid bodies

    Directory of Open Access Journals (Sweden)

    O. Barry

    2016-12-01

    Full Text Available This paper investigates the nonlinear vibration due to mid-plane stretching of an axially loaded simply supported beam carrying multiple rigid masses. Explicit expressions and closed form solutions of both linear and nonlinear analysis of the present vibration problem are presented for the first time. The validity of the analytical model is demonstrated using finite element analysis and via comparison with the result in the literature. Parametric studies are conducted to examine how the nonlinear frequency and frequency response curve are affected by tension, rotational inertia, and number of intermediate rigid bodies.

  5. Research on a novel axial-flux magnetic-field-modulated brushless double-rotor machine with low axial force and high efficiency

    Directory of Open Access Journals (Sweden)

    Chengde Tong

    2017-05-01

    Full Text Available The axial-flux magnetic-field-modulated brushless double-rotor machine (MFM-BDRM is a possible alternative as a power-split device for hybrid electric vehicles (HEVs. However, the existence of large axial force may lead to assembly problems and rich inner air-gap harmonics could result in high PM loss and low efficiency. This paper proposes a novel axial-flux MFM-BDRM with improved PM rotor structure. 2-D analytical method to predict the magnetic-field distribution of the proposed MFM-BDRM is developed and the design procedure of the proposed machine is illustrated. The impact of key geometrical parameters on axial force and torque is investigated. To evaluate the advantage of the proposed machine, a comparison is made with a conventional one with respect to electromagnetic performances. Results show that the proposed machine is effective in reducing PM eddy loss and axial force by 60% and 35%, respectively.

  6. Factors That Influence Perforator Thrombosis and Predict Healing Perforator Sclerotherapy for Venous Ulceration Without Axial Reflux

    Science.gov (United States)

    Kiguchi, Misaki M.; Hager, Eric S.; Winger, Daniel G.; Hirsch, Stanley A.; Chaer, Rabih A.; Dillavou, Ellen D.

    2014-01-01

    OBJECTIVES Refluxing perforators contribute to venous ulceration. We sought to describe patient characteristics and procedural factors that (1) impact rates of incompetent perforator vein (IPV) thrombosis with ultrasound-guided sclerotherapy (UGS) and (2) impact the healing of venous ulcers (CEAP 6) without axial reflux. METHODS Retrospective review of UGS of IPV injections from 1/2010–11/2012 identified 73 treated venous ulcers in 62 patients. Patients had no other superficial/axial reflux and were treated with standard wound care and compression. Ultrasound was used to screen for refluxing perforators near ulcer(s), and these were injected with sodium tetradecyl sulfate or polidocanol foam and assessed for thrombosis at 2 weeks. Demographic data, comorbidities, treatment details and outcomes were analyzed. Univariate and multivariable modeling was performed to determine covariates predicting IPV thrombosis and ulcer healing. RESULTS 62 patients with active ulcers for an average of 28 months with compression therapy prior to perforator treatment had an average age of 57.1 years, were 55% male, 36% had a history of DVT and 30% had deep venous reflux. 32 patients (52%) healed ulcers, while 30 patients (48%) had non-healed ulcer(s) in mean follow-up of 30.2 months. Ulcers were treated with 189 injections, with average thrombosis rate of 54%. Of 73 ulcers, 43 ulcers healed (59%), and 30 ulcers did not heal (41%). Patients that healed ulcers had an IPV thrombosis rate of 69 % vs. 38% in patients who did not heal (Pulcer healing found complete IPV thrombosis was a positive predictor (P=.02), while large initial ulcer area was a negative predictor (P=.08). Increased age was associated with fewer ulcer recurrences (P=.05). Hypertension and increased follow-up time predicted increased ulcer recurrences (P=.04, P=.02). Calf vein thrombosis occurred after 3% (6/189) of injections. CONCLUSIONS Thrombosis of IPVs with UGS increases venous ulcer healing in a difficult patient

  7. Optimized tracking strategies for step MOC calculations in extruded 3D axial geometries

    International Nuclear Information System (INIS)

    Sciannandrone, Daniele; Santandrea, Simone; Sanchez, Richard

    2016-01-01

    Highlights: • We apply the Method of Characteristics to 3D axial geometries. • We apply tracking strategies for reducing memory and time requirements of the solver. • Performances are tested through numerical tests. • Results show good improvement of performances of the solver. - Abstract: Specialized tracking techniques have been developed for a step-characteristics transport solver. These techniques strongly exploit the regularities of extruded 3D axial geometries to reduce the number of operations and the memory requirements of the transport solver. The method of compound trajectories has been applied to exactly treat geometrical boundary conditions with a minimum number of trajectories. The chord classification method consists in identifying recognized types of chords that share the same length. It allows a consistent reduction of the number of chords that have to be stored and also an important speed up of the transport iterations thanks to the pre-computed values of escape coefficients. An alternative storage method has also been implemented: in this method one trajectory is represented by a partial record which is used to reconstruct the trajectories on-the-fly. Numerical tests show good improvements for both memory and computational time. Optimized methods have also been developed for horizontal and vertical directions, which are particularly advantageous in terms of computational costs. In the same contest, a modified version of the Minimized-Bickley quadrature (Sanchez et al., 2002) containing these directions is proposed. The new methods have been tested by comparison with standard quadrature sets. Results show that for some cases the special directions improve the efficiency of the solver, while for some others the opposite effect is obtained.

  8. Lateral and axial cutting efficiency of instruments manufactured with conventional nickel-titanium and novel gold metallurgy.

    Science.gov (United States)

    Vasconcelos, R A; Arias, A; Peters, O A

    2017-07-26

    To isolate the effect of metallurgy in lateral and axial cutting efficacy against plastic and bovine dentine substrates by comparing two rotary systems with identical design but manufactured with either conventional nickel-titanium or heat-treated gold alloy. A total of 258 ProTaper Universal (PTU) and ProTaper Gold (PTG) Shaping instruments were used. Bending behaviour was assessed to determine the appropriate displacement associated with a 2 N force in lateral cutting. Ten instruments of each type were used in lateral action for 60 s against bovine dentine or plastic substrates four consecutive times producing four notches in each specimen. Ten further instruments of each type were used in on axial action in four standardized simulated root canals fabricated from 4-mm thick plastic or dentine discs. Both tests were performed at 300 rpm in a computer-controlled testing platform. Notch area and torsional load were compared with Student's t-tests. Repeated measures ANOVA was used to compare cutting efficiency across the four different time-points. Pearson correlation coefficients between substrates were also determined. For lateral action, all three PTG instruments cut significantly more effectively (P < 0.05) than PTU on the plastic substrate. S1 and S2 PTG cut significantly more after 120 and 180 s (P < 0.05) on bovine dentine substrate. For axial action, S1 and S2 PTG were significantly more efficient in cutting at 180 s on plastic and 120 s on bovine dentine (P < 0.05). Instruments made from heat-treated nickel-titanium gold alloy had equal or greater cutting efficiency when compared to those made from conventional nickel-titanium. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  9. Mandibular condylar fractures and acute atlanto-axial subluxation. Part 1 - A new clinical and nosographic evidence.

    Science.gov (United States)

    Cutilli, T; Corbacelli, A

    2009-05-01

    The aim of this study was to analyze the acute repercussions of condylar mandibular fractures on occipital-atlanto-axial joint. Twenty-five non-consecutive cases (16 males and 9 females, mean age: 22.96/range 14-36 years), observed and treated in the Maxillofacial Surgery Department of the University of L'Aquila have been considered. Types of fractures examined included: unilateral: 19 cases (solitary: 12; associated with other mandibular fractures: 7; homolateral: 2); bilateral: 6 cases (equivalent: 2; not equivalent: 4). A control group was constituted of 10 patients, 5 males and 5 females, aged from 19 to 24 years (mean-range: 21.6) suffering from acute isolated cervical distorsion (whiplash). The study has been performed by means of the analysis of X-ray and computed tomography (CT)-CT/3D of the mandibular condylar regions, the occipital-atlanto-axial structures and the cervical region. In all the cases of fractures of the mandibular condyle an acute alteration of the junctional atlanto-axial structures was present. In case of unilateral solitary condylar fractures the authors have observed an atlas rotation, homolateral to the side of the condylar fracture, independent from the level of the fracture (intra- or extracapsular). The rotation seems to be proportional to the entity of the condylar fragments dislocation on the horizontal plane and it causes a modification of the articular relations between atlas and axis (atlanto-axial subluxation) and between the atlas and the occipital bone. The authors have observed a constant derangement of the cranio-axial joint on the three planes of the space. In particular, on the vertical plane the CT reconstructions show on the right and left side a different height between the atlanto-axial articular spaces. The largest one is homolateral to the side of the condylar fracture. In case of unilateral condylar fractures associated with other mandibular fracture (homolateral or not) the authors have observed the same

  10. Stress analysis of fuel claddings with axial fins including creep effects

    International Nuclear Information System (INIS)

    Krieg, R.

    1977-01-01

    For LMFBR fuel claddings with axial fins the stress and strain fields are calculated which may be caused by internal pressure, differential thermal expansion and irradiation induced differential swelling. To provide an appropriate description of the cladding material it is assumed that the total strain is the sum of a linear elastic and a creep term, where the latter one includes the thermal as well as the irradiation induced creep. First the linear elastic problem is treated by a semi-analytical method leading to a bipotential equation for Airys' stress function. Solving this equation analytically means that the field equations valid within the cladding are satisfied exactly. By applying a combined point matching- least square-method the boundary conditions could be satisfied approximately such that in most cases the remaining error is within the uncertainty range of the loading conditions. Then the nonlinear problem which includes creep is approximated by a sequence of linear elastic solutions with time as parameter. The accumulated creep strain is treated here as an imposed strain field. To study the influence of different effects such as fin shape, temperature region, irradiation induced creep and swelling or internal pressure, a total of eleven cases with various parameter variations are investigated. The results are presented graphically in the following forms: stress and strain distributions over the cladding cross section for end of life conditions and boundary stresses and strains versus time. (Auth.)

  11. Competition between modes with different axial structures in gyrotrons

    International Nuclear Information System (INIS)

    Khutoryan, Eduard M.; Nusinovich, Gregory S.; Sinitsyn, Oleksandr V.

    2014-01-01

    This study was motivated by some experiments in which it was found that during the voltage rise, instead of expected excitation of a high-frequency parasitic mode, the excitation of a lower-frequency parasitic mode takes place in a certain range of voltages. For explaining this fact, the dependence of start currents of possible competing modes on the beam voltage was carried out in the cold-cavity approximation and by using the self-consistent approach. It was found that in the case of cavities, which consist of the combination of a section of constant radius waveguide and a slightly uptapered waveguide, these two approaches yield completely different results. Thus, experimentally observed excitation of the low-frequency parasitic mode can be explained by the self-consistent modification of the axial profile of the excited field, which has strong influence on the diffractive quality factor of competing modes. This modification is especially pronounced in the case of excitation of modes with many axial variations which can be excited in the region of beam interaction with the backward-wave component of such modes

  12. Spine labeling in axial magnetic resonance imaging via integral kernels.

    Science.gov (United States)

    Miles, Brandon; Ben Ayed, Ismail; Hojjat, Seyed-Parsa; Wang, Michael H; Li, Shuo; Fenster, Aaron; Garvin, Gregory J

    2016-12-01

    This study investigates a fast integral-kernel algorithm for classifying (labeling) the vertebra and disc structures in axial magnetic resonance images (MRI). The method is based on a hierarchy of feature levels, where pixel classifications via non-linear probability product kernels (PPKs) are followed by classifications of 2D slices, individual 3D structures and groups of 3D structures. The algorithm further embeds geometric priors based on anatomical measurements of the spine. Our classifier requires evaluations of computationally expensive integrals at each pixel, and direct evaluations of such integrals would be prohibitively time consuming. We propose an efficient computation of kernel density estimates and PPK evaluations for large images and arbitrary local window sizes via integral kernels. Our method requires a single user click for a whole 3D MRI volume, runs nearly in real-time, and does not require an intensive external training. Comprehensive evaluations over T1-weighted axial lumbar spine data sets from 32 patients demonstrate a competitive structure classification accuracy of 99%, along with a 2D slice classification accuracy of 88%. To the best of our knowledge, such a structure classification accuracy has not been reached by the existing spine labeling algorithms. Furthermore, we believe our work is the first to use integral kernels in the context of medical images. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Axial length of atomic bomb survivors in Nagasaki

    International Nuclear Information System (INIS)

    Wakiyama, Harumi; Kishikawa, Yasuhiro; Imamura, Naoki; Amemiya, Tsugio

    2002-01-01

    We reviewed a series of 778 patients who had cataract surgery during the past 4 years at the Nagasaki Atomic Bomb Memorial Hospital. We evaluated the history of exposure to radiation by atomic bomb in 1945, axial length and state of refraction. All were born before 1945. The series comprised 263 males and 515 females. Their ages averaged 76.5±8.6 years. History of exposure to radiation was present in 356 patients. The remaining 422 patients served as control. There was no difference in the type of cataract between the two groups. High myopia was present in 11 irradiated patients (3.2%) and in 24 patients in the control group (6.0%). The difference was not significant (p=0.083). There was no high myopia among 24 patients who were aged 18 years or less at the time of radiation and who were within 2 km from the epicenter. No difference was present regarding the axial length between the two groups or between both sexes. The present result is not definitive because ''irradiated group'' would include those with little or no exposure and because precise data has not been available about the dosis of radiation. (author)

  14. Axial anomaly and index theorem for Dirac-Kaehler fermions

    International Nuclear Information System (INIS)

    Fonseca Junior, C.A.L. da.

    1985-02-01

    Some aspects of topological influence on gauge field theory are analysed, considering the geometry and differential topology methods. A review of concepts of differential forms, fibered spaces, connection and curvature, showing an interpretation of gauge theory in this context, is presented. The question of fermions, analysing in details the Dirac-Kaehler which fermionic particle is considered a general differential form, is studied. It is shown how the explicit expressions in function of the Dirac spinor components vary with the Dirac matrix representation. The Dirac-Kahler equation contains 4 times (in 4 dimensions) the Dirac equation, each particle being associated an ideal at left of the algebra of general differential forms. These ideals and the SU(4) symmetry among them are also studied on the point of view of spinors and, the group of reduction to one of the ideals is identified as the Cartan subalgebra of this SU(4). Finally, the axial anomaly is calculated through the functional determinant given by the Dirac-Kaehler operator. The regularization method is the Seeley's coefficients. From that results a comparison of the index theorems for the twisted complexes of signature and spin, which proportionality is given by the number of the algebra ideals contained in the Dirac-Kaehler equation and which also manifests in the respective axial anomaly equations. (L.C.) [pt

  15. Axial and parity anomalies and vacuum charge: A direct approach

    International Nuclear Information System (INIS)

    Boyanovsky, D.; Blankenbecler, R.

    1985-01-01

    We study the axial and parity anomalies in Abelian gauge theories using the direct yet intuitive approach of counting the relative number of states of one chirality with respect to the other. A fundamental gauge-invariant quantity, the determinantal ratio, is introduced for this purpose. We find that the number of states is conserved and that the gauge fields differentially phase shift states of opposite chirality at infinite energies. This implies a relative flow of states at very large energies which must be compensated by a rearrangement of the density of states at finite energies. We then derive a sum rule which yields two alternative formulas for the index of a Dirac operator. One expresses the index in terms of its high-energy behavior, and the other in terms of the low-energy properties; these are the ''zero modes'' of definite chirality. Two examples are worked out in detail to clarify our general result. The physics of the axial anomaly is shown to translate into that of the parity anomaly in 2+1 dimensions, in which parity and chirality have interchanged roles. We also analyze the vacuum charge in regard to its high- and low-energy origin. The possibility of spectral flow is formulated and briefly discussed. In short, we provide a physical interpretation of certain mathematical indices, relate them to an extended version of Levinson's theorem of potential scattering, and simplify their evaluation

  16. Axial U(1) current in Grabowska and Kaplan's formulation

    Science.gov (United States)

    Hamada, Yu; Kawai, Hikaru

    2017-06-01

    Recently, Grabowska and Kaplan [Phys. Rev. Lett. 116, 211602 (2016); Phys. Rev. D 94, 114504 (2016)] suggested a nonperturbative formulation of a chiral gauge theory, which consists of the conventional domain-wall fermion and a gauge field that evolves by gradient flow from one domain wall to the other. We introduce two sets of domain-wall fermions belonging to complex conjugate representations so that the effective theory is a 4D vector-like gauge theory. Then, as a natural definition of the axial-vector current, we consider a current that generates simultaneous phase transformations for the massless modes in 4 dimensions. However, this current is exactly conserved and does not reproduce the correct anomaly. In order to investigate this point precisely, we consider the mechanism of the conservation. We find that this current includes not only the axial current on the domain wall but also a contribution from the bulk, which is nonlocal in the sense of 4D fields. Therefore, the local current is obtained by subtracting the bulk contribution from it.

  17. Nanowelding configuration between carbon nanotubes in axial direction

    International Nuclear Information System (INIS)

    Cui Jianlei; Yang Lijun; Wang Yang

    2013-01-01

    Highlights: ► Nanowelding process could be accomplished at a lower temperature than the melting point of the bulk solder. ► CNTs are connected with solder joints of nodule shape. ► Some silver atoms are captured and dragged into carbon nanotube to form the core filling structures of nanowires. ► Some silver atoms diffuse along the outer walls of SWNTs with the dominant mechanism of capillary wetting. - Abstract: Interconnect technology of carbon nanotubes (CNTs) is essential for functional devices. However, difficulty in the fabrication of the interface between carbon nanotube (CNT) and CNT in axial direction, hindered the quality of connection and practical applications of electrical devices. Also, investigation of dynamic evolution of connection configuration about nanowelding is still lacking. In order to analyze the nanowelding configuration between CNTs in axial direction, the different connection cases are investigated using molecular dynamics simulation. Simulation results show that the nanowelding process could be accomplished at a lower temperature than the melting point of the bulk solder and the CNTs are connected with solder joints of nodule shape. It is also found that metal atoms are captured and dragged into nanotube to form the core filling structures of nanowires during nanowelding. Also, the connection configuration shows that Ag atoms diffuse along the outer walls of SWNTs with the dominant mechanism of capillary wetting, which would increase the contact length to improve the mechanical strength.

  18. Axial Ge/Si nanowire heterostructure tunnel FETs.

    Energy Technology Data Exchange (ETDEWEB)

    Dayeh, Shadi A. (Los Alamos National Laboratory); Gin, Aaron V.; Huang, Jian Yu; Picraux, Samuel Thomas (Los Alamos National Laboratory)

    2010-03-01

    Axial Ge/Si heterostructure nanowires (NWs) allow energy band-edge engineering along the axis of the NW, which is the charge transport direction, and the realization of asymmetric devices for novel device architectures. This work reports on two significant advances in the area of heterostructure NWs and tunnel FETs: (i) the realization of 100% compositionally modulated Si/Ge axial heterostructure NWs with lengths suitable for device fabrication and (ii) the design and implementation of Schottky barrier tunnel FETs on these NWs for high-on currents and suppressed ambipolar behavior. Initial prototype devices with 10 nm PECVD SiN{sub x} gate dielectric resulted in a very high current drive in excess of 100 {micro}A/{micro}m (I/{pi}D) and 10{sup 5} I{sub on}/I{sub off} ratios. Prior work on the synthesis of Ge/Si axial NW heterostructures through the VLS mechanism have resulted in axial Si/Si{sub 1-x}Ge{sub x} NW heterostructures with x{sub max} {approx} 0.3, and more recently 100% composition modulation was achieved with a solid growth catalyst. In this latter case, the thickness of the heterostructure cannot exceed few atomic layers due to the slow axial growth rate and concurrent radial deposition on the NW sidewalls leading to a mixture of axial and radial deposition, which imposes a big challenge for fabricating useful devices form these NWs in the near future. Here, we report the VLS growth of 100% doping and composition modulated axial Ge/Si heterostructure NWs with lengths appropriate for device fabrication by devising a growth procedure that eliminates Au diffusion on the NW sidewalls and minimizes random kinking in the heterostructure NWs as deduced from detailed microscopy analysis. Fig. 1 a shows a cross-sectional SEM image of epitaxial Ge/Si axial NW heterostructures grown on a Ge(111) surface. The interface abruptness in these Ge/Si heterostructure NWs is of the order of the NW diameter. Some of these NWs develop a crystallographic kink that is {approx

  19. Factors influencing surgical complications of intra-axial brain tumours.

    Science.gov (United States)

    Brell, M; Ibáñez, J; Caral, L; Ferrer, E

    2000-01-01

    Extensive surgical resection remains nowadays the best treatment available for most intra-axial brain tumours. However, postoperative sequelae can outweigh the potential benefits of surgery. The goal of this study has been to review the results of this treatment in our Department in order to quantify morbidity and mortality and determine predictive risk factors for each patient. We report a retrospective study of 200 patients submitted to a craniotomy for intra-axial brain tumours including gliomas and metastases. Postoperative major complications are analysed and related to different variables. An exhaustive review of the literature concerning the main controversial points about primary and metastatic brain tumours surgery is done. The overall major complication rate was 27.5%, with neurological complications being the most frequently encountered. We did not find a statistically significant relation between them and the grade of eloquence of the tumoural area. Infratentorial tumour location, previous radiotherapy and reoperations were factors strongly related to the incidence of regional complications. Age over 60 and severe concomitant disease were risk factors for systemic complications. The results from published series concerning surgical complications after craniotomies for brain tumours are not comparable because of the lack of homogeneity between them. The knowledge of the complications rate in each particular neurosurgical department turns out essentially to provide the patient with tailored information about risks before surgery.

  20. Estimation of axial curvature of anterior sclera: correlation between axial length and anterior scleral curvature as affected by angle kappa.

    Science.gov (United States)

    Lee, Sang-Mok; Choi, Hyuk Jin; Choi, Heejin; Kim, Mee Kum; Wee, Won Ryang

    2016-10-07

    BACKGROUND: Though the development and fitting of scleral contact lenses are expanding steadily, there is no simple method to provide scleral metrics for scleral contact lens fitting yet. The aim of this study was to establish formulae for estimation of the axial radius of curvature (ARC) of the anterior sclera using ocular biometric parameters that can be easily obtained with conventional devices. A semi-automated stitching method and a computational analysis tool for calculating ARC were developed by using the ImageJ and MATLAB software. The ARC of all the ocular surface points were analyzed from the composite horizontal cross-sectional images of the right eyes of 24 volunteers; these measurements were obtained using anterior segment optical coherence tomography for a previous study (AS-OCT; Visante). Ocular biometric parameters were obtained from the same volunteers with slit-scanning topography and partial coherence interferometry. Correlation analysis was performed between the ARC at 8 mm to the axis line (ARC[8]) and other ocular parameters (including age). With ARC obtained on several nasal and temporal points (7.0, 7.5, 8.0, 8.5, and 9.0 mm from the axis line), univariate and multivariate linear regression analyses were performed to develop a model for estimating ARC with the help of ocular biometric parameters. Axial length, spherical equivalent, and angle kappa showed correlations with temporal ARC[8] (tARC[8]; Pearson's r = 0.653, -0.579, and -0.341; P = 0.001, 0.015, and 0.015, respectively). White-to-white corneal diameter (WTW) and anterior chamber depth (ACD) showed correlation with nasal ARC[8] (nARC[8]; Pearson's r = -0.492 and -0.461; P = 0.015 and 0.023, respectively). The formulae for estimating scleral curvatures (tARC, nARC, and average ARC) were developed as a function of axial length, ACD, WTW, and distance from the axis line, with good determinant power (72 - 80 %; SPSS ver. 22.0). Angle kappa showed strong