Original paper Cytokine profiles in axial spondyloarthritis

Directory of Open Access Journals (Sweden)

Marta Madej

2015-04-01

Full Text Available Objectives: Current studies concentrate on the cytokine network and its role in the pathogenesis of spondyloarthritis (SpA. In this study, we analyzed whether the serum cytokine profile (interleukins: IL-10, IL-11, IL-12, IL-15, IL-17, IL-23 and IL-33 correlates with demographic data, clinical manifestations, disease activity and treatment outcome in a group of patients with axial spondyloarthritis. Material and methods: Forty-nine patients with an established diagnosis of axial spondyloarthritis (aSpA and 19 healthy volunteers as controls were enrolled in the study. Clinical evaluation included patient’s medical history, 44 joint count, back pain intensity and global disease activity in the preceding week (VAS, the duration of morning stiffness and blood tests. Disease activity was assessed using BASDAI and ASDAS-CRP. Serum concentration of IL-10, IL-11, IL-12, IL-15, IL-17, IL-23 and IL-33 was determined. Results : In patients with aSpA, elevated serum concentration of IL-10, IL-15, IL-17 and IL-23 was detected. In the aSpA group we detected higher values of serum concentration of IL-23 and IL-33 in the subgroup with anterior uveitis (83.1 ±184.0 pg/ml vs. 14.0 ±17.1 pg/ml, p < 0.0001 and 45.5 ±71.9 pg/ml vs. 18.4 ±14.3 pg/ml, p < 0.0001, respectively. Additionally, in the subgroup with peripheral arthritis, elevation of serum concentration of IL-12 (249.3 ±246.9 pg/ml vs. 99.9 ±105.9 pg/ml, p = 0.0001 was detected. Patients with preradiological SpA had higher serum concentration of IL-17 than patients with established diagnosis of AS (6.37 ±8.50 pg/ml vs. 2.04 ±2.98 pg/ml, p = 0.0295. No differences in serum concentration of analyzed cytokines were found between the subgroup with low to moderate disease activity and the subgroup with high to very high disease activity. Conclusions : We report that in aSpA patients, compared to controls, elevated serum concentrations of IL-10, IL-15, IL-17 and IL-23 were observed. Some cytokines may

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

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

NARCIS (Netherlands)

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

2017-01-01

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

Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group

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...... of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. RESULTS: The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active...

The assessment of the spondyloarthritis international society concept and criteria for the classification of axial spondyloarthritis and peripheral spondyloarthritis: A critical appraisal for the pediatric rheumatologist

Directory of Open Access Journals (Sweden)

Burgos-Vargas Ruben

2012-05-01

Full Text Available Abstract This review refers to the origin and current state of the assessment of the SpondyloArthritis International Society (ASAS criteria for the classification of axial and peripheral spondyloarthritis (SpA and the possible implications in the pediatric population. The ASAS criteria evolved from the idea that the earlier the recognition of patients with ankylosing spondylitis, the better the efficacy of tumor necrosis factor blockers. Strategies included the development of new concepts, definitions, and techniques for the study of clinical signs and symptoms. Of relevance, the new definition of inflammatory back pain (IBP and the introduction of sacroiliitis by magnetic resonance imaging represented the most important advance in the early identification of AS in the “pre-radiographic stage” of the disease. AS is considered in this paper as a disease continuum with symptoms depending on age at onset. The application of those specific strategies in children and adolescents with SpA seems limited because the most important manifestation in the early stage of disease is not IBP, but peripheral arthritis and enthesitis. In this instance, the logical approach to juvenile onset SpA according to ASAS criteria should not be through the axial criteria but rather the peripheral set of criteria.

[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.

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...

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

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...

Predictive Factors of Clinical Response of Infliximab Therapy in Active Nonradiographic Axial Spondyloarthritis Patients

Directory of Open Access Journals (Sweden)

Zhiming Lin

2015-01-01

Full Text Available Objectives. To evaluate the efficiency and the predictive factors of clinical response of infliximab in active nonradiographic axial spondyloarthritis patients. Methods. Active nonradiographic patients fulfilling ESSG criteria for SpA but not fulfilling modified New York criteria were included. All patients received infliximab treatment for 24 weeks. The primary endpoint was ASAS20 response at weeks 12 and 24. The abilities of baseline parameters and response at week 2 to predict ASAS20 response at weeks 12 and 24 were assessed using ROC curve and logistic regression analysis, respectively. Results. Of 70 axial SpA patients included, the proportions of patients achieving an ASAS20 response at weeks 2, 6, 12, and 24 were 85.7%, 88.6%, 87.1%, and 84.3%, respectively. Baseline MRI sacroiliitis score (AUC = 0.791; P=0.005, CRP (AUC = 0.75; P=0.017, and ASDAS (AUC = 0.778, P=0.007 significantly predicted ASAS20 response at week 12. However, only ASDAS (AUC = 0.696, P=0.040 significantly predicted ASAS20 response at week 24. Achievement of ASAS20 response after the first infliximab infusion was a significant predictor of subsequent ASAS20 response at weeks 12 and 24 (wald χ2=6.87, P=0.009, and wald χ2=5.171, P=0.023. Conclusions. Infliximab shows efficiency in active nonradiographic axial spondyloarthritis patients. ASDAS score and first-dose response could help predicting clinical efficacy of infliximab therapy in these patients.

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

Recent Advances in Imaging of the Axial Skeleton in Spondyloarthritis for Diagnosis, Assessment of Treatment Effect, and Prognostication

DEFF Research Database (Denmark)

Pedersen, Susanne Juhl; Maksymowych, Walter P

2015-01-01

In the last few years, many studies have investigated the role of imaging for improved diagnosis, assessment of treatment effects, and determining prognosis in patients with axial spondyloarthritis (SpA). Recent research has primarily focused on the utility of magnetic resonance imaging (MRI...... developed and have provided insight into effects of treatment on structural progression and the interrelationships between different lesions visualized by MRI. This review gives an overview of the recent advances in imaging of the axial skeleton in axial SpA from a clinical perspective....

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. ...... for classification of axial SpA, reflecting the contextual information provided by T1SE and STIR sequences....

Efficacy and safety of biological and targeted-synthetic DMARDs: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

NARCIS (Netherlands)

Sepriano, Alexandre; Regel, Andrea; van der Heijde, Désirée; Braun, Jürgen; Baraliakos, Xenofon; Landewé, Robert; van den Bosch, Filip; Falzon, Louise; Ramiro, Sofia

2017-01-01

To update the evidence for the efficacy and safety of (b)biological and (ts)targeted-synthetic disease-modifying anti-rheumatic drugs (DMARDs) in patients with axial spondyloarthritis (axSpA) to inform the 2016 update of the Assessment of SpondyloArthritis international Society/European League

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.

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

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 and...... relevant for sacroiliitis have been defined by consensus by a group of rheumatologists and radiologists. These definitions should help in applying correctly the imaging feature "active sacroiliitis by MRI" in the new ASAS classification criteria for axial SpA.......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...

Efficacy and safety of etanercept in patients from Latin America, Central Europe and Asia with early non-radiographic axial spondyloarthritis.

Science.gov (United States)

Wei, James Cheng-Chung; Tsai, Wen-Chan; Citera, Gustavo; Kotak, Sameer; Llamado, Lyndon

2016-11-11

To evaluate etanercept in patients from Latin America, Central/Eastern Europe, and Asia with non-radiographic axial spondyloarthritis (nr-axSpA). A subset analysis was performed on nr-axSpA patients from Argentina, Colombia, the Czech Republic, Hungary, Russia and Taiwan who were enrolled in EMBARK (NCT01258738). Patients received either etanercept 50 mg or placebo once weekly. The primary endpoint was proportion of patients achieving 40% improvement from baseline based on Assessment of SpondyloArthritis International Society (ASAS) criteria. Secondary endpoints included other efficacy assessments, health-related quality of life (HRQoL) and safety. Of the 117 patients in this subset, 59 were treated with etanercept and 58 received placebo. At week 12, numerically greater improvements from baseline were observed for all efficacy endpoints in etanercept-treated patients compared with those receiving placebo. Statistically significant differences between the two treatment groups were observed for proportion of patients achieving ASAS40 (P = 0.0413, at week 8), ASAS5/6 (P = 0.0126), Ankylosing Spondylitis Disease Activity Score - C-reactive protein (CRP) inactive disease (P = 0.0093), Spondyloarthritis Research Consortium of Canada magnetic resonance imaging of sacroiliac joint scores (P = 0.0014), high-sensitivity CRP (P=0.032), and erythrocyte sedimentation rate (P = 0.0082). Statistically significant improvements in the etanercept-treated group compared with placebo group were observed for nocturnal back pain (P = 0.040), total back pain (P = 0.025), physician global assessment of disease (P = 0.023), and Work Productivity and Activity Impairment Questionnaire percent impairment while working (P = 0.047). Adverse events were similar between the two treatment groups. In this subset of patients with nr-axSpA from Latin America, Central/Eastern Europe, and Asia, treatment with etanercept, compared with placebo, resulted in improved disease symptoms and patient HRQo

Observed Incidence of Uveitis Following Certolizumab Pegol Treatment in Patients With Axial Spondyloarthritis.

Science.gov (United States)

Rudwaleit, M; Rosenbaum, J T; Landewé, R; Marzo-Ortega, H; Sieper, J; van der Heijde, D; Davies, O; Bartz, H; Hoepken, B; Nurminen, T; Deodhar, A

2016-06-01

Axial spondyloarthritis (axial SpA) is characterized by inflammation of the spine and sacroiliac joints and can also affect extraarticular sites, with the most common manifestation being uveitis. Here we report the incidence of uveitis flares in axial SpA patients from the RAPID-axSpA trial, including ankylosing spondylitis (AS) and nonradiographic (nr) axial SpA. The RAPID-axSpA (NCT01087762) trial is double-blind and placebo-controlled to week 24, dose-blind to week 48, and open-label to week 204. Patients were randomized to certolizumab pegol (CZP) or placebo. Placebo patients entering the dose-blind phase were re-randomized to CZP. Uveitis events were recorded on extraarticular manifestation or adverse event forms. Events were analyzed in patients with/without history of uveitis, and rates reported per 100 patient-years. At baseline, 38 of 218 CZP-randomized patients (17.4%) and 31 of 107 placebo-randomized patients (29.0%) had past uveitis history. During the 24-week double-blind phase, the rate of uveitis flares was lower in CZP (3.0 [95% confidence interval (95% CI) 0.6-8.8] per 100 patient-years) than in placebo (10.3 [95% CI 2.8-26.3] per 100 patient-years). All cases observed during the 24-week double-blind phase were in patients with a history of uveitis; in these patients, rates were similarly lower for CZP (17.1 [95% CI 3.5-50.1] per 100 patient-years) than placebo (38.5 [95% CI 10.5-98.5] per 100 patient-years). Rates of uveitis flares remained low up to week 96 (4.9 [95% CI 3.2-7.4] per 100 patient-years) and were similar between AS (4.4 [95% CI 2.3-7.7] per 100 patient-years) and nr-axial SpA (5.6 [95% CI 2.9-9.8] per 100 patient-years). The rate of uveitis flares was lower for axial SpA patients treated with CZP than placebo during the randomized controlled phase. Incidence of uveitis flares remained low to week 96 and was comparable to rates reported for AS patients receiving other anti-tumor necrosis factor antibodies. © 2016, American College

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

OBJECTIVE: To assess the incremental diagnostic value of spine MRI evaluated separately from and combined with sacroiliac joint (SIJ) MRI in non-radiographic axial spondyloarthritis (nr-axSpA) compared with SIJ MRI alone. METHODS: The study sample comprised two independent cohorts A/B of 130...

Efficacy, safety and cost per responder of biologics in the treatment of non-radiographic axial spondyloarthritis.

Science.gov (United States)

Olivieri, Ignazio; Fanizza, Caterina; Gilio, Michele; Ravasio, Roberto

2016-01-01

Anti-tumour necrosis factor (TNF) agents are recommended as second-line therapy for patients with axial spondyloarthropathies. This analysis reviewed data on studies investigating the efficacy and tolerability of anti-TNF agents in patients with non-radiographic axial spondyloarthritis (nr-axSpA) who had failed first-line non-steroidal anti-inflammatory (NSAID) treatment. Efficacy data from RCTs were used to calculate the number needed to treat (NNT) for individual anti-TNFs and then the cost per responder was determined to provide an indication of the value of each therapy. A systematic literature review and analysis of search results over the period January 2008 to September 2014 identified four randomised placebo-controlled trials that were included in the analysis. Adalimumab, etanercept and certolizumab pegol were all effective and well tolerated in patients with nr-axSpA. A patient was more likely to reach ASAS20 or ASAS40 when treated with etanercept or adalimumab, the NNT was lowest for adalimumab, and the risk of adverse events was higher with certolizumab pegol 200 mg every 2 weeks. The cost per responder (NNT) was lowest for adalimumab, followed closely by certolizumab 400 mg every 4 weeks, intermediate for certolizumab 200 mg every 2 weeks and highest for etanercept. Although all anti-TNF agents were associated with clinical improvement in patients with nr-axSpA, adalimumab presented a better cost per responder than etanercept and certolizumab pegol.

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

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...

The diagnostic utility of MRI in spondyloarthritis

DEFF Research Database (Denmark)

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

2012-01-01

The recently developed Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial and peripheral spondyloarthritis (SpA) are the first criteria ever to include findings on magnetic resonance imaging (MRI) of the sacroiliac joints. Features indicating sacroiliac...... 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....

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

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.

Bone mineral density in patients with early axial spondyloarthritis

Directory of Open Access Journals (Sweden)

E. E. Gubar

2015-01-01

Full Text Available Objective: to study bone mineral density (BMD of the lumbar spine (LS and femoral neck (FN in patients with early axial spondyloarthritis (SpA and to reveal its association with inflammatory disease activity.Subjects and methods. Seventy-three patients aged 18–45 years with inflammatory back pain lasting at least 3 months and not more than 5 years were examined. Axial SpA was diagnosed according to the 2009 ASAS criteria. BASDAI and ASDAS C-reactive protein (CRP values were used to estimate disease activity; BASFI was employed to evaluate functional status. The examination encompassed determination of HLA-B27, X-ray of the pelvis and LS, magnetic resonance imaging (MRI of sacroiliac joints, LS, and hip joints (in the presence of clinical signs of their injuries, densitometry of LS (LI-IV and FN. By taking into account the young age of patients, the Z-score was applied to measure BMD. The latter is considered lower if the Z-score is 1–2 standard deviations (SD in at least one of the segments under study.Results. The median Z-score was -0.7 (-1.3; -0.3 SD for FN and 0.9 (-1.6; -0.5 SD for LS. Reduced BMD in at least one of the segments under study was detected in 13 (17.8% patients: that in LS and FN in 11 (15.1% and 5 (6.8% patients, respectively. Lower BMD was observed in two segments in 3 (4.1% patients. No association was found between lower BMD and age, gender, disease activity (BASDAI, ASDAS, and laboratory inflammatory markers (erythrocyte sedimentation rate (ESR and CRP. A relationship was established between inflammatory changes according to the data of MRI of LS (MRI spondylitis and reduced BMD in the same segment. MRI spondylitis was detected in 8 patients. Five and 3 patients with spondylitis of LS were found to have lower and normal BMD in this segment, respectively. Six out of 65 patients without MRI spondylitis in LS had its reduced BMD and the remaining (n=59 patients had its normal BMD (p=0.0014.Conclusion. There was an

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

The oral microbiome of patients with axial spondyloarthritis compared to healthy individuals

Directory of Open Access Journals (Sweden)

Jordan E. Bisanz

2016-06-01

Full Text Available Background. A loss of mucosal tolerance to the resident microbiome has been postulated in the aetiopathogenesis of spondyloarthritis, thus the purpose of these studies was to investigate microbial communities that colonise the oral cavity of patients with axial spondyloarthritis (AxSpA and to compare these with microbial profiles of a matched healthy population. Methods. Thirty-nine participants, 17 patients with AxSpA and 22 age and gender-matched disease-free controls were recruited to the study. For patients with AxSpA, disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. All participants underwent a detailed dental examination to assess oral health, including the presence of periodontal disease assessed using probing pocket depth (PPD. Plaque samples were obtained and their bacterial populations were profiled using Ion Torrent sequencing of the V6 region of the 16S rRNA gene. Results.Patients with AxSpA had active disease (BASDAI 4.1 ± 2.1 [mean ± SD], and a significantly greater prevalence of periodontitis (PPD ≥ 4 mm at ≥4 sites than controls. Bacterial communities did not differ between the two groups with multiple metrics of α and β diversity considered. Analysis of operational taxonomic units (OTUs and higher levels of taxonomic assignment did not provide strong evidence of any single taxa associated with AxSpA in the subgingival plaque. Discussion. Although 16S rRNA gene sequencing did not identify specific bacterial profiles associated with AxSpA, there remains the potential for the microbiota to exert functional and metabolic influences in the oral cavity which could be involved in the pathogenesis of AxSpA.

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.

An Assessment in SpondyloArthritis International Society (ASAS)-endorsed definition of clinically important worsening in axial spondyloarthritis based on ASDAS.

Science.gov (United States)

Molto, Anna; Gossec, Laure; Meghnathi, Bhowmik; Landewé, Robert B M; van der Heijde, Désirée; Atagunduz, Pamir; Elzorkany, Bassel Kamal; Akkoc, Nurullah; Kiltz, Uta; Gu, Jieruo; Wei, James Cheng Chung; Dougados, Maxime

2018-01-01

In a previous phase, 12 draft definitions for clinically important worsening in axial spondyloarthritis (axSpA) were selected, of which 3 were based on absolute changes in Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP (ASDAS). The objective here was to select the best cut-off for ASDAS for clinically important worsening in axSpA for use in clinical trials and observational studies. An international longitudinal prospective study evaluating stable patients with axSpA was conducted. Data necessary to calculate ASDAS were collected at two consecutive visits (spaced 7 days to 6 months). Sensitivity and specificity of the three cut-offs for change in ASDAS were tested against the patient's subjective assessment of worsening as the external standard (ie, the patient reporting that he had worsened and felt a need for treatment intensification). Final selection was made by a consensus and voting procedure among Assessment of SpondyloArthritis International Society (ASAS) members. In total, 1169 patients with axSpA were analysed: 64.8% were male and had a mean age of 41.7 (SD 12.4) years. At the second visit, 127 (10.9%) patients judged their situation as worsened.Sensitivity and specificity for an increase of at least 0.6, 0.9 and 1.1 ASDAS points to detect patient-reported worsening were 0.55 (Se) and 0.91 (Sp), 0.38 (Se) and 0.96 (Sp), and 0.33 (Se) and 0.98 (Sp), respectively. The ASAS consensus was to define clinically important worsening as an increase in ASDAS of at least 0.9 points. This data-driven ASAS consensus process resulted in an ASDAS-based cut-off value defining clinically important worsening in axSpA for use in trials. © 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.

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...... capsular serotypes K2, K26, K36, and K50 were measured, and antibody seropositivity compared between groups and analysed for patient correlation in five different groups: (a) 96 patients fulfilling the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axSpA; (b) 38...... ankylosing spondylitis (AS) served as the negative and positive control groups. RESULTS: There was no difference in IgG and IgA seropositivity against all serotypes between the axSpA, non-axSpA, and LBP groups. No significant correlations were found between anti-Klebsiella antibodies and age, gender, HLA-B27...

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...... and clinical practice. The present article reviews key aspects of the status and recent important advances in MRI in spondyloarthritis, focussing on available MRI tools for assessing activity and damage in peripheral and, particularly, axial joints....

Gender Differences in Axial Spondyloarthritis: Women Are Not So Lucky.

Science.gov (United States)

Rusman, T; van Vollenhoven, R F; van der Horst-Bruinsma, I E

2018-05-12

Ankylosing spondylitis (AS) was historically seen as a predominantly male disease. However, more recent data showed a more homogenous sex prevalence. Unfortunately, in many studies in axial spondyloarthritis (axSpA), the number of women included is low and the analyses are often not stratified for gender distribution. The purpose of this review is to aggregate the existing data on gender differences in axSpA in order to increase the awareness that female axSpA patients are still under-recognized. Several studies considering gender differences revealed that female axSpA patients had different disease manifestations due to different immunological, hormonal, and genetic responses. For instance, allelic frequencies of the AHNK-gene and tissue non-specific alkaline phosphatase (TNAP) haplotypes differed between men and women with ankylosing spondylitis (AS). In addition, different levels of tumor necrosis factor (TNF), interleukins IL-6, IL-17, and IL-18, were found between the two sexes. Furthermore, female patients show a higher diagnostic delay compared to males. Several studies indicate a higher frequency of extra-articular manifestations (EAM) in female axSpA patients, such as enthesitis, psoriasis, and inflammatory bowel disease (IBD), whereas acute anterior uveitis is more prevalent in male patients. Male AS patients more frequently show a higher Bath Ankylosing Spondylitis Radiology Index (BASRI) scores and modified Stoke Ankylosing Spondylitis Spine Scores (mSASSS) than females, which indicates that males have higher radiological damage and radiographic progression. However, disease activity (BASDAI) and quality of life (AsQol) scores are significantly higher in women, and more importantly, they have significantly lower response rates to treatment with TNF inhibitors (TNFi) and a significantly lower drug adherence. Despite the fact that men with axial SpA have a worse radiologic prognosis, women have a high disease burden, in part because they have a longer

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.

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.)

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

International Nuclear Information System (INIS)

Larbi, Ahmed; Viala, Pierre; Baron, Marie Pierre; Taourel, Patrice; Cyteval, Catherine; Molinari, Nicolas; Lukas, Cedric

2014-01-01

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.)

Evaluation of the change in structural radiographic sacroiliac joint damage after 2 years of etanercept therapy (EMBARK trial) in comparison to a contemporary control cohort (DESIR cohort) in recent onset axial spondyloarthritis

NARCIS (Netherlands)

Dougados, Maxime; Maksymowych, Walter P.; Landewé, Robert B. M.; Moltó, Anna; Claudepierre, Pascal; de Hooge, Manouk; Lambert, Robert G.; Bonin, Randi; Bukowski, Jack F.; Jones, Heather E.; Logeart, Isabelle; Pedersen, Ron; Szumski, Annette; Vlahos, Bonnie; van der Heijde, Désirée

2018-01-01

To compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR). Endpoints were changes at week 104 per the modified

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

Sclerostin and Antisclerostin Antibody Serum Levels Predict the Presence of Axial Spondyloarthritis in Patients with Inflammatory Bowel Disease.

Science.gov (United States)

Luchetti, Michele Maria; Ciccia, Francesco; Avellini, Chiara; Benfaremo, Devis; Guggino, Giuliana; Farinelli, Alessia; Ciferri, Monia; Rossini, Matteo; Svegliati, Silvia; Spadoni, Tatiana; Bolognini, Laura; Fava, Giammarco; Mosca, Piergiorgio; Gesuita, Rosaria; Skrami, Edlira; Triolo, Giovanni; Gabrielli, Armando

2018-05-01

The early diagnosis of inflammatory bowel disease (IBD)-associated spondyloarthritis (SpA/IBD) in patients affected by IBD represents a major topic in clinical practice; in particular, to date there are no available serum biomarkers revealing the presence of joint inflammation in these patients. Sclerostin (SOST), an antagonist of the Wnt/β-catenin pathway, and antisclerostin-immunoglobulin G (anti-SOST-IgG) have been recently studied in patients with ankylosing spondylitis (AS) as a putative marker of disease activity. SOST and anti-SOST-IgG serum levels were assayed in 125 patients with IBD, 85 with axial or peripheral SpA, and in control groups (patients with AS and rheumatoid arthritis, and healthy individuals). The diagnostic performance in discriminating the presence of SpA/IBD was assessed for both candidate biomarkers. Patients affected by SpA/IBD with axial involvement displayed significantly lower levels of SOST and higher levels of anti-SOST-IgG compared to patients with only peripheral arthritis, IBD, and controls. Moreover, SOST and anti-SOST-IgG serum levels were inversely correlated and were associated with the duration of articular symptoms. Both biomarkers showed good accuracy in predicting the presence of axial SpA in patients with IBD. We demonstrated that in patients with IBD, SOST and anti-SOST-IgG might represent novel biomarkers to assess the presence of axial joint involvement. Moreover, the development of anti-SOST-IgG and the subsequent decrease of SOST serum levels could play a role in the pathogenesis of SpA/IBD.

Pharmacological therapy of spondyloarthritis.

Science.gov (United States)

Palazzi, Carlo; D'Angelo, Salvatore; Gilio, Michele; Leccese, Pietro; Padula, Angela; Olivieri, Ignazio

2015-01-01

The current pharmacological therapy of spondyloarthritis (SpA) includes several drugs: Non-steroidal anti-inflammatory drugs, corticosteroids, traditional disease-modifying antirheumatic drugs and biologic drugs. A systematic literature search was completed using the largest electronic databases (Medline, Embase and Cochrane), starting from 1995, with the aim to review data on traditional and biologic agents commercialised for SpA treatment. Randomised controlled trials and large observational studies were considered. In addition, studies performed in SpA patients treated with other, still unapproved, drugs (rituximab, anti-IL6 agents, apremilast, IL17 inhibitors and anakinra) were also taken into account. Biologic agents, especially anti-TNF drugs, have resulted in significant progress in improving clinical symptoms and signs, reducing inflammatory features in laboratory tests and imaging findings, and recovering all functional indexes. Anti-TNF drugs have radically changed the evolution of radiographic progression in peripheral joints; the first disappointing data concerning their efficacy on new bone formation of axial SpA has been recently challenged by studies enrolling patients who have been earlier diagnosed and treated. The opportunity to extend the interval of administration or to reduce the doses of anti-TNF agents can favourably influence the costs. Ustekinumab, the first non-anti-TNF biologic drug commercialised for psoriatic arthritis, offers new chances to patients that are unresponsive to anti-TNF.

Effect of certolizumab pegol over 96 weeks of treatment on inflammation of the spine and sacroiliac joints, as measured by MRI, and the association between clinical and MRI outcomes in patients with axial spondyloarthritis

NARCIS (Netherlands)

Braun, Jürgen; Baraliakos, Xenofon; Hermann, Kay-Geert; Landewé, Robert; Machado, Pedro M.; Maksymowych, Walter P.; Davies, Owen; Hoepken, Bengt; Nurminen, Tommi; Stach, Christian; van der Heijde, Désirée

2017-01-01

To report MRI outcomes and explore the relationship between clinical remission and MRI inflammation in patients with axial spondyloarthritis (axSpA) from the RAPID-axSpA trial, including radiographic (r-)axSpA and non-radiographic (nr-)axSpA. RAPID-axSpA (NCT01087762) was double-blind and

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...

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

Trabecular bone score as an assessment tool to identify the risk of osteoporosis in axial spondyloarthritis: a case-control study.

Science.gov (United States)

Kang, Kwi Young; Goo, Hye Yeon; Park, Sung-Hwan; Hong, Yeon Sik

2018-03-01

To compare the trabecular bone score (TBS) between patients with axial spondyloarthritis (axSpA) and matched normal controls and identify risk factors associated with a low TBS. TBS and BMD were assessed in the two groups (axSpA and control) using DXA. Osteoporosis risk factors and inflammatory markers were also assessed. Disease activity and radiographic progression in the sacroiliac joint and spine were evaluated in the axSpA group. Multivariate linear regression analysis was performed to identify risk factors associated with TBS. In the axSpA group, 248 subjects were enrolled; an equal number of age- and sex-matched subjects comprised the control group. The mean TBS was 1.43 (0.08) and 1.38 (0.12) in the control and axSpA groups, respectively (P tool to identify the risk of osteoporosis in patients with axSpA.

One year in review 2017: spondyloarthritis.

Science.gov (United States)

Terenzi, Riccardo; Monti, Sara; Tesei, Giulia; Carli, Linda

2018-01-01

The term spondyloarthritis (SpA) represents a condition characterised by a broad spectrum of clinical manifestations, laboratory abnormalities and imaging features; in particular, SpA is an inflammatory condition in which both peripheral and axial joints might be affected. The majority of people with this disease have either psoriatic arthritis or axial spondyloarthritis, which includes ankylosing spondylitis. Less common subgroups are enteropathic SpA, which is associated with inflammatory bowel diseases (Crohn's disease and ulcerative colitis), reactive arthritis, which can occur in people following gastrointestinal or genitourinary infections and undifferentiated SpA, that does not meet the diagnostic criteria of the other subgroups at onset, but that may evolve to do so later. Very interestingly, much of the emerging data show how SpA, during its course, tends to associate with the development of some comorbidities; in particular, with cardiovascular diseases, diabetes mellitus, osteoporosis and depressive disorders. Healthcare professionals in non-specialist settings do not always recognise the signs and symptoms of SpA, particularly spinal symptoms, which may be mistakenly attributed to other causes of low back pain, thus leading to significant delays in diagnosis and treatment of the disease itself and of its related comorbidities, with consequent disease progression and disability, compromising the health-related quality of life of patients. In this paper we reviewed the literature of the past year (Medline search of articles published from 1st March 2016 to 28th February 2017) with the aim of approaching the spectrum of SpA from some different points of view, to try to give the reader an insight into this clinically challenging group of rheumatic pathologies.

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...

Fat Metaplasia on Sacroiliac Joint Magnetic Resonance Imaging at Baseline Is Associated with Spinal Radiographic Progression in Patients with Axial Spondyloarthritis.

Directory of Open Access Journals (Sweden)

Kwi Young Kang

Full Text Available To study the relationship between inflammatory and structural lesions in the sacroiliac joints (SIJs on MRI and spinal progression observed on conventional radiographs in patients with axial spondyloarthritis (axSpA.One hundred and ten patients who fulfilled the ASAS axSpA criteria were enrolled. All underwent SIJ MRI at baseline and lumbar spine radiographs at baseline and after 2 years. Inflammatory and structural lesions on SIJ MRI were scored using the SPondyloArthritis Research Consortium of Canada (SPARCC method. Spinal radiographs were scored using the Stoke AS Spinal Score (SASSS. Multivariate logistic regression analysis was performed to identify predictors of spinal progression.Among the 110 patients, 25 (23% showed significant radiographic progression (change of SASSS≥2 over 2 years. There was no change in the SASSS over 2 years according to the type of inflammatory lesion. Patients with fat metaplasia or ankyloses on baseline MRI showed a significantly higher SASSS at 2 years than those without (p<0.001. According to univariate logistic regression analysis, age at diagnosis, HLA-B27 positivity, the presence of fat metaplasia, erosion, and ankyloses on SIJ MRI, increased baseline CRP levels, and the presence of syndesmophytes at baseline were associated with spinal progression over 2 years. Multivariate analysis identified syndesmophytes and severe fat metaplasia on baseline SIJ MRI as predictive of spinal radiographic progression (OR, 14.74 and 5.66, respectively.Inflammatory lesions in the SIJs on baseline MRI were not associated with spinal radiographic progression. However, fat metaplasia at baseline was significantly associated with spinal progression after 2 years.

ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNFα inhibitors

DEFF Research Database (Denmark)

Pedersen, Susanne Juhl; Sørensen, Inge Juul; Garnero, Patrick

2011-01-01

To investigate the relation between ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis disease activity index (BASDAI) and treatment response and biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), YKL-40), angiogenesis (vascular endothelial...... spondyloarthritis initiating tumour necrosis factor alpha (TNFa) inhibitor therapy....

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)....

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.

ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNF{alpha} inhibitors

DEFF Research Database (Denmark)

Pedersen, Susanne Juhl; Sørensen, Inge Juul; Garnero, Patrick

2011-01-01

To investigate the relation between ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis disease activity index (BASDAI) and treatment response and biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), YKL-40), angiogenesis (vascular endothelial...... spondyloarthritis initiating tumour necrosis factor alpha (TNFα) inhibitor therapy....

A novel diagnostic method (spectral computed tomography of sacroiliac joints) for axial spondyloarthritis.

Science.gov (United States)

Zhang, Ping; Yu, Kai Hu; Guo, Rui Min; Ran, Jun; Liu, Yao; Morelli, John; Runge, Val M; Li, Xiao Ming

2016-08-01

To evaluate the diagnostic value of spectral computed tomography (CT) of sacroiliac joints for axial spondyloarthritis (SpA). We retrospectively analyzed the records of 125 patients with low back pain (LBP) suspected of having SpA. Each patient underwent sacroiliac joint spectral CT examination. Water- and calcium-based material decomposition images were reconstructed. After 3-6 months of follow-up, 76 were diagnosed with SpA, and the remaining 49 patients were diagnosed with nonspecific LBP (nLBP). The slope of sacroiliac bone marrow HU (Hounsfield unit) curve (λHU), CT value, and bone marrow to normal muscle ratios of water and calcium concentrations in the ilium and sacrum were calculated and compared between nLBP and SpA patients. The iliac λHU was 8.26 ± 3.91 for nLBP and 9.81 ± 4.92 for SpA. The mean iliac ratios of water and calcium concentrations were 1.04 ± 0.03 and 21.67 ± 4.40, respectively, for nLBP, and 1.07 ± 0.04 and 111.5 ± 358.98, respectively, for SpA. The mean iliac CT values were 311.12 ± 86.52 HU for nLBP and 423.97 ± 127.51 HU for SpA. There were statistically significant differences in iliac ratios of water and calcium concentrations, CT value, and λHU between nLBP and SpA patients (p sacroiliac joints of SpA patients. Copyright © 2015. Published by Elsevier B.V.

Improving the Management of Psoriatic Arthritis and Axial Spondyloarthritis: Roundtable Discussions with Healthcare Professionals and Patients.

Science.gov (United States)

Garrido-Cumbrera, Marco; Hillmann, Ottfrid; Mahapatra, Raj; Trigos, David; Zajc, Petra; Weiss, Luisa; Bostynets, Galya; Gossec, Laure; Coates, Laura C

2017-12-01

Psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA) are both chronic, inflammatory conditions that result in a substantial burden of disease and reduced quality of life for patients. Patient involvement in developing optimal disease management strategies, including defining appropriate goals, therapies, and treatment options, as well as in setting policy priorities and agendas, is key. A working group of patient organization representatives and rheumatologists explored what patients consider to be unmet needs, important treatment gaps, and future priorities in PsA and AxSpA management. Reducing pain and fatigue, and improving physical and social functioning and work productivity were identified as important treatment goals for patients. Although the major treatment target for both PsA and AxSpA is remission, with low/minimal disease activity an alternative target for patients with established or long-standing disease, the meaning of remission from the patient's perspective needs to be explored further as it may differ considerably from the physician's perspective. Key recommendations from the working group to tackle unmet needs included reducing time to diagnosis, increasing patient and physician disease awareness, focusing on patients' priorities for treatment goals, and improving patient-physician communication. By addressing these key action points moving forward, the hope is that outcomes will continue to improve for patients with PsA and AxSpA.

Measurement properties of the ASAS Health Index: results of a global study in patients with axial and peripheral spondyloarthritis.

Science.gov (United States)

Kiltz, Uta; van der Heijde, Désirée; Boonen, Annelies; Akkoc, Nurullah; Bautista-Molano, Wilson; Burgos-Vargas, Ruben; Wei, James Cheng-Chung; Chiowchanwisawakit, Praveena; Dougados, Maxime; Duruoz, M Tuncay; Elzorkany, Bassel Kamal; Gaydukova, Inna; Gensler, Lianne S; Gilio, Michele; Grazio, Simeon; Gu, Jieruo; Inman, Robert D; Kim, Tae-Jong; Navarro-Compan, Victoria; Marzo-Ortega, Helena; Ozgocmen, Salih; Pimentel Dos Santos, Fernando; Schirmer, Michael; Stebbings, Simon; Van den Bosch, Filip E; van Tubergen, Astrid; Braun, Juergen

2018-06-01

To evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA). A representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4-7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2-24weeks using standardised response mean (SRM). Among the 1548 patients, 64.9% were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach's α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95% CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM=-0.44 for non-steroidal anti-inflammatory drugs, -0.69 for conventional synthetic disease-modifying antirheumatic drug and -0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health. The ASAS HI proved to be valid, reliable and responsive. It can be used to evaluate the impact of SpA and its treatment on functioning and health. Furthermore, comparison of disease impact between populations is possible. © Article author(s) (or their employer(s) unless otherwise

Spondyloarthritis

NARCIS (Netherlands)

Dougados, Maxime; Baeten, Dominique

2011-01-01

Spondyloarthritis is a group of several related but phenotypically distinct disorders: psoriatic arthritis, arthritis related to inflammatory bowel disease, reactive arthritis, a subgroup of juvenile idiopathic arthritis, and ankylosing spondylitis (the prototypic and best studied subtype). The past

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 ...... using two inception cohorts and comparing clinical and MRI-based classification supports the case for including both erosion and BME to define a positive SIJ MRI for the classification of axial SpA. © 2012 by the American College of Rheumatology.......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...

Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of SpondyloArthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain.

Science.gov (United States)

de Winter, Janneke; de Hooge, Manouk; van de Sande, Marleen; de Jong, Henriëtte; van Hoeven, Lonneke; de Koning, Anoek; Berg, Inger Jorid; Ramonda, Roberta; Baeten, Dominique; van der Heijde, Désirée; Weel, Angelique; Landewé, Robert

2018-03-07

To compare magnetic resonance images (MRIs) of the sacroiliac (SI) joints of healthy subjects and individuals with known mechanical strain acting upon the SI joints to those of patients with axial spondyloarthritis (SpA) and patients with chronic back pain. Three readers who had received standardized training and were blinded with regard to study group randomly scored MRIs of the SI joints of 172 subjects, including 47 healthy individuals without current or past back pain, 47 axial SpA patients from the Spondyloarthritis Caught Early (SPACE) cohort (with a previous MRI confirmed positive for sacroiliitis), 47 controls with chronic back pain (irrespective of MRI results) from the SPACE cohort, 7 women with postpartum back pain, and 24 frequent runners. MRIs were scored according to the Assessment of SpondyloArthritis international Society (ASAS) definition and Spondyloarthritis Research Consortium of Canada (SPARCC) index. Of the 47 healthy volunteers, 11 (23.4%) had an MRI positive for sacroiliitis, compared to 43 (91.5%) of 47 axial SpA patients and 3 (6.4%) of 47 patients with chronic back pain. Three (12.5%) of the 24 runners and 4 (57.1%) of the 7 women with postpartum back pain had a positive MRI. Using a SPARCC cutoff of ≥2 for positivity, 12 (25.5%) of 47 healthy volunteers, 46 (97.9%) of 47 positive axial SpA patients, 5 (10.6%) of 47 controls with chronic back pain, 4 (16.7%) of 24 runners, and 4 (57.1%) of 7 women with postpartum back pain had positive MRIs. Deep bone marrow edema (BME) lesions were not found in healthy volunteers, patients with chronic back pain, or runners, but were found in 42 (89.4%) of 47 positive axial SpA patients and in 1 (14.3%) of 7 women with postpartum back pain. A substantial proportion of healthy individuals without current or past back pain has an MRI positive for sacroiliitis according to the ASAS definition. Deep (extensive) BME lesions are almost exclusively found in axial SpA patients. © 2018 The Authors. Arthritis

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

Biomarkers, imaging and disease activity indices in patients with early axial spondyloarthritis: the Italian arm of the SpondyloArthritis-Caught-Early (SPACE Study

Directory of Open Access Journals (Sweden)

M. Lorenzin

2017-08-01

Full Text Available The study aimed to evaluate biomarkers facilitating early diagnosis of axial spondyloarthritis (axSpA and correlations between them and disease activity parameters and imaging indexes. Patients with low back pain (LBP (≥3 months, ≤2 years, onset ≤45 years participating in the Italian arm of the SpondyloArthritis-Caught-Early SPACE study underwent a physical examination, questionnaires, laboratory tests, X-rays and MRI of the spine and sacroiliac joints (SIJ. An expert rheumatologist formulated axSpA diagnosis in accordance with Assessment of SpondyloArthritis International Society (ASAS criteria. Disease activity and physical functioning were assessed using imaging, clinical and serological indices. Spine and SIJ MRI and X-rays were scored independently by 2 readers using the SPARCC, mSASSS and NY-criteria. Patients were classified as: subjects with signs of radiographic sacroiliitis (r-axSpA, subjects with signs of sacroiliitis on SIJ-MRI but not on X-rays (nr-axSpA MRI SIJ+ or subjects with no signs of sacroiliitis on MRI/X-rays but with >2 SpA features and signs of bone oedema on MRI spine (nr-axSpA MRI SIJ-/undifferentiated SpA. Significant differences were found in the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ scores. Biomarker levels were not significantly increased in any of the patient groups. The correlations between IL-17 and IL-23 and other indices were not significant; correlations were found between IL-22 and BASFI, BASG1, HAQ, VAS pain, between mSASSS and MMP3, and between the latter and hsCRP. Although not significantly higher in any of the three groups, IL-22, MMP3 and hsCRP values were correlated with some disease activity indexes and with mSASSS. Large observational studies are required to confirm these preliminary findings.

[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.

[The specificity and limitations of sacroiliac joint magnetic resonance imaging in the diagnosis of axial spondyloarthritis in patients with chronic low back pain].

Science.gov (United States)

Wang, Y Y; Zhao, Z; Luo, G; Li, Y; Zhang, J L; Huang, F

2016-11-01

Objective: To evaluate the specificity and limitations of sacroiliac joint magnetic resonance imaging (MRI) in the diagnosis of axial spondyloarthritis (SpA)in patients with chronic low back pain. Methods: We retrospectively analyzed clinical data of 390 patients with chronic low back pain in Department of Rheumatology, the PLA General Hospital from January 2013 to December 2015, including clinical manifestations, laboratory examinations and MRI data of sacroiliac joints. Results: There were 238 men and 152 women recruited. A total of 326 cases were diagnosed as axial SpA, including 216 men and 110 women with mean age (27.10±8.64) years and mean duration (7.64±3.50) months. Among these 326 patients, 243 (74.5%) were HLA-B 27 positive. The other 64 patients were considered as diagnoses rather than SpA (non-SpA), consisting of 22 men and 42 women with mean age (31.29±7.76) years and mean duration (5.75±2.90)months. Non-SpA group had 10 (15.6%) patients with HLA-B 27 positive. There were 68.1% and 65.0% SpA patients showing bone marrow edema and bone erosion of sacroiliac joint in MRI imaging respectively. Although there were 25.0% non-SpA patients with bone marrow edema and 7.8% with bone erosion in MRI of sacroiliac joint, the scores of bone marrow edema 0.00(0.00, 0.75) and bone erosion [0.00(0.00, 0.00)] were significantly lower compared with those in axial SpA group [bone marrow edema scores 2.00(0.00, 4.00), bone erosion scores 1.00(0.00, 3.00); P Sacroiliac joint MRI is a valuable method to diagnose axial SpA in patients with chronic low back pain. Yet it still has some limitations. Clinical presentations and spinal MRI would be helpful in some patients.

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.

'MRI-tis' in the early diagnosis of axial SpA: issues and limitations

NARCIS (Netherlands)

de Rycke, Leen; Maas, Mario; Tak, Paul P.; Baeten, Dominique

2010-01-01

Sacroiliitis on conventional radiography, a key diagnostic feature of axial spondyloarthritis (SpA), often appears only late in the disease course. With the introduction of potent biologic agents that may also be effective in early disease, diagnostic techniques that can identify SpA early in the

Clinical features of children with enthesitis-related juvenile idiopathic arthritis / juvenile spondyloarthritis followed in a French tertiary care pediatric rheumatology centre.

Science.gov (United States)

Goirand, Maxime; Breton, Sylvain; Chevallier, Frédéric; Duong, Ngoc-Phoi; Uettwiller, Florence; Melki, Isabelle; Mouy, Richard; Wouters, Carine; Bader-Meunier, Brigitte; Job-Deslandre, Chantal; Quartier, Pierre

2018-04-02

Childhood-onset spondyloarthropathies usually start with enthesitis and peripheral arthritis. However, axial disease may develop afterward. Patients are most often classified, following revised (Edmonton 2011) ILAR criteria, as enthesitis-related arthritis, psoriatic arthritis, or unclassified juvenile idiopathic arthritis, particularly in cases of psoriasis in the patient or a first-degree relative. In adults, peripheral spondyloarthritis is classified by ASAS criteria. We retrospectively studied patients with childhood-onset spondyloarthropathies followed for more than one year in our referral centre. We did not exclude patients with a personal or familial history of psoriasis. We included 114 patients followed between January 2008 and December 2015 for a median of 2.5 years (IQR = 2.3). Sixty-nine per-cent of patients fulfilled the revised ILAR classification criteria for enthesitis-related arthritis, and 92% the ASAS criteria for peripheral spondyolarthritis (p <  0.001). Axial disease and sacroiliitis were rare at disease onset. However, they appeared during follow-up in 63% and 47% of cases respectively, after a median disease duration of 2.6 (IC 95% [2.2-4.4]) and 5.3 years (IC 95% [4.1-7.7]), respectively. Multivariable analysis showed that familial history of spondyloarthritis was associated with the presence of sacroiliitis and active disease at the latest follow-up (OR = 3.61 [1.5-8.7], p <  0.01 and 2.98 [1.2-7.3], p = 0.02, respectively). Axial involvement developed in most patients within five years. Revised Edmonton criteria were less sensitive than ASAS criteria to classify patients as having childhood-onset spondyloarthropathies. The main risk factor for both sacroiliitis and persistent active disease was a familial history of spondyloarthritis.

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

OBJECTIVE: To establish the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) spondyloarthritis (SpA) classification criteria. METHODS: 22 centres (N=909 patients) from the initial 29 ASAS centres (N=975) participated in the ASAS-cohort follow-up study...... classification by the ASAS criteria was calculated using rheumatologist's diagnosis at follow-up as external standard. RESULTS: In total, 564 patients were assessed at follow-up (345 visits; 219 telephone) with a mean follow-up of 4.4 years (range: 1.9; 6.8) and 70.2% received a SpA diagnosis....... Patients 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...

New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS)

NARCIS (Netherlands)

Sieper, J.; Van der Heijde, D.M.; Landewe, RB; Brandt, J.; Burgos-Vagas, R.; Collantes-Estevez, E.; Dijkmans, B.A.C.; Dougados, M.; Khan, M.M.; Leirisalo-Repo, M; van der Linden, S.C.; Maksymowych, W.P.; Mielants, H.; Olivieri, I.; Rudwaleit, M.

2009-01-01

Objective: Inflammatory back pain (IBP) is an important clinical symptom in patients with axial spondyloarthritis (SpA), and relevant for classification and diagnosis. In the present report, a new approach for the development of IBP classification criteria is discussed. Methods: Rheumatologists (n =

MRI evidence of structural changes in the sacroiliac joints of patients with non-radiographic axial spondyloarthritis even in the absence of MRI inflammation.

Science.gov (United States)

Maksymowych, Walter P; Wichuk, Stephanie; Dougados, Maxime; Jones, Heather; Szumski, Annette; Bukowski, Jack F; Marshall, Lisa; Lambert, Robert G

2017-06-06

Studies have shown that structural lesions may be present in patients with non-radiographic axial spondyloarthritis (nr-axSpA). However, the relevance of structural lesions in these patients is unclear, particularly without signs of inflammation on magnetic resonance imaging (MRI). We assessed the presence of structural lesions at baseline on MRI in the sacroiliac joints (SIJ) of patients with nr-axSpA with and without SIJ inflammation on MRI. Bone marrow edema (BME) was assessed on short tau inversion recovery (STIR) scans from 185 patients with nr-axSpA, by two independent readers at baseline using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. Structural lesions were evaluated on T1 weighted spin echo scans, with readers blinded to STIR scans, using the SPARCC MRI SIJ structural score. Disease characteristics and structural lesions were compared in patients with SIJ BME (score ≥2) and without SIJ BME (score <2). Both SIJ BME and structural lesions scores were available for 183 patients; 128/183 (69.9%) patients had SIJ BME scores ≥2 and 55/183 (30.1%) had scores <2. Frequencies of MRI structural lesions in patients with vs without SIJ BME were: erosions (45.3% vs 10.9%, P < 0.001), backfill (20.3% vs 0%, P < 0.001), fat metaplasia (10.9% vs 1.8%, P = 0.04), and ankylosis (2.3% vs 1.8%, P = ns). Significantly more patients with both SIJ BME and structural lesions were male and/or HLA-B27 positive than patients with only SIJ BME. Mean (SD) spinal scores (23 discovertebral units) were significantly higher in patients with SIJ structural lesions than without: 6.5 (11.5) vs 3.3 (5.1), respectively, P = 0.01. In patients with nr-axSpA, SIJ structural lesions, particularly erosions, may be present on MRI when radiographs are normal or inconclusive, even in patients negative for MRI SIJ inflammation. They may reflect more severe disease with greater spinal inflammation. ClinicalTrials.gov, NCT01258738 . Registered on 9

New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS)

NARCIS (Netherlands)

Sieper, J.; van der Heijde, D.; Landewé, R.; Brandt, J.; Burgos-Vagas, R.; Collantes-Estevez, E.; Dijkmans, B.; Dougados, M.; Khan, M. A.; Leirisalo-Repo, M.; van der Linden, S.; Maksymowych, W. P.; Mielants, H.; Olivieri, I.; Rudwaleit, M.

2009-01-01

Inflammatory back pain (IBP) is an important clinical symptom in patients with axial spondyloarthritis (SpA), and relevant for classification and diagnosis. In the present report, a new approach for the development of IBP classification criteria is discussed. Rheumatologists (n = 13) who are experts

Does the reason for discontinuation of a first TNF inhibitor influence the effectiveness of a second TNF inhibitor in axial spondyloarthritis? Results from the Swiss Clinical Quality Management Cohort.

Science.gov (United States)

Ciurea, Adrian; Exer, Pascale; Weber, Ulrich; Tamborrini, Giorgio; Steininger, Beate; Kissling, Rudolf O; Bernhard, Jürg; Scherer, Almut

2016-03-22

With regard to switching tumor necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA), conflicting results have been reported as to whether the effectiveness of a second TNFi depends on the reason for discontinuation of the first TNFi. Patients with a clinical 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 of response was further divided into primary or secondary lack of response (PLR or SLR, respectively), depending on whether the first TNFi was stopped before or after 6 months of treatment. Among 632 patients with axSpA, median survival of a second TNFi was 1.1 years after PLR and 3.8 years after SLR (p = 0.003). At least moderate disease activity as defined by an Ankylosing Spondylitis Disease Activity Score using the erythrocyte sedimentation rate (ASDAS-ESR) reasons, respectively (p = 0.01). Only 4 % of patients achieved an ASDAS-ESR inactive disease state after PLR, in comparison to 22 % of those after SLR. Similar results were demonstrated in patients fulfilling the Assessment of SpondyloArthritis international Society classification criteria for axSpA (n = 488): ASDAS-ESR reasons, respectively (p = 0.01). The effectiveness of a second TNFi is significantly impaired in patients with axSpA after PLR to a first TNFi compared with SLR.

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.

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...

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...... 21-62)) treated with tumor-necrosis-factor-alpha (TNF-alpha) inhibitors (infliximab (n=41), etanercept (n=13), adalimumab (n=6)) responsiveness of ASDAS, conventional clinical measures of disease activity and treatment response, and the Berlin magnetic resonance imaging (MRI) sacroiliac joint (SIJ......) and lumbar spine inflammation scores were compared. RESULTS: After 22 weeks, 58.3% of the patients were clinical responders (50% or 20mm reduction in BASDAI). At baseline, clinical responders had significantly higher ASDAS (median 4.15 (range 1.98-6.04), p=0.008) compared with non-responders (2.99, 2...

Information needs of patients with spondyloarthritis about their disease.

Science.gov (United States)

Almodóvar, Raquel; Gratacós, Jordi; Zarco, Pedro

2017-06-02

1. To describe the information provided to, or inquired about, by patients with axial spondyloarthritis and psoriatic arthritis. 2. To analyze improvements. Analysis of the discourse of focus groups (with patients, some of them from patient associations, and rheumatologists). The discussion included the identification of elements that shape the reality being studied, describing the relationship among them and summarizing the results by: 1)thematic segmentation; 2)categorization according to situations, relationships, opinions, feelings or others; 3)coding of the various categories, and 4)interpretation of results. Representativeness was ensured by using a typological framework. Rheumatologists are the main source of information. Patient associations have a fundamental role and are well-regarded. Internet is used with caution due to its limited reliability. Patients are interested in: disease characteristics and treatments, the course and prognosis, and social, administrative and other kinds of support. More information is needed (objective and constructive, avoiding a catastrophic tone); it should be provided progressively, adjusted to patients features and needs. There are areas for improvement including: the standardization and updating of contents (based on scientific evidence), the optimization of informative materials (written, electronic), and other resources such as nursing and primary care. Rheumatologists are the main and most reliable source of information for patients with spondyloarthritis and psoriatic arthritis. Patient associations have an important role and are well-regarded. Changes in the content, format and sources of information are required. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set: translation and cross-cultural adaptation into 15 languages

Science.gov (United States)

Kiltz, U; van der Heijde, D; Boonen, A; Bautista-Molano, W; Burgos-Vargas, R; Chiowchanwisawakit, P; Duruoz, T; El-Zorkany, B; Essers, I; Gaydukova, I; Géher, P; Gossec, L; Grazio, S; Gu, J; Khan, M A; Kim, T J; Maksymowych, W P; Marzo-Ortega, H; Navarro-Compán, V; Olivieri, I; Patrikos, D; Pimentel-Santos, F M; Schirmer, M; van den Bosch, F; Weber, U; Zochling, J; Braun, J

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 version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages. Methods Translation and cross-cultural adaptation has been carried out following the forward–backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included. Results The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option ‘not applicable’ was added to two items of the ASAS HI to improve appropriateness. Discussion This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures. PMID:27752358

Cancer risk in patients with spondyloarthritis treated with TNF inhibitors

DEFF Research Database (Denmark)

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

2017-01-01

) patients with SpA initiating a first TNFi 2001-2011. From the Swedish National Patient and Population Registers we assembled a TNFi-naïve SpA cohort (n=28,164) and a Swedish age-matched and sex-matched general population comparator cohort (n=131 687). We identified incident cancers by linkage...... with the nationwide Swedish and Danish Cancer Registers 2001-2011, and calculated age-standardised and sex-standardised incidence ratios as measures of relative risk (RR). Results Based on 1188 cancers among the TNFi-naïve patients with SpA, RR of cancer overall was 1.1 (95% CI 1.0 to 1.2). Based on 147 cancers among......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...

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...

Imaging of juvenile spondyloarthritis. Part I: Classifications and radiographs

Directory of Open Access Journals (Sweden)

Iwona Sudoł-Szopińska

2017-09-01

Full Text Available Juvenile spondyloarthropathies are manifested mainly by symptoms of peripheral arthritis and enthesitis. By contrast with adults, children rarely present with sacroiliitis and spondylitis. Imaging and laboratory tests allow early diagnosis and treatment. Conventional radiographs visualize late inflammatory lesions and post-inflammatory complications. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presents classifications of juvenile spondyloarthropathies and discusses their radiographic presentation. Typical radiographic features of individual types of juvenile spondyloarthritis are listed (including ankylosing spondylitis, juvenile psoriatic arthritis, reactive arthritis and arthritis in the course of inflammatory bowel diseases. The second part will describe changes visible on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance imaging also visualizes early inflammatory changes in the axial skeleton and subchondral bone marrow edema, which is considered an early sign of inflammation.

Is undifferentiated spondyloarthritis a discrete entity? A debate.

Science.gov (United States)

Deodhar, Atul; Miossec, Pierre; Baraliakos, Xenofon

2018-01-01

The concept of undifferentiated spondyloarthritis has been introduced recently to describe a clinical setting where the classical features of spondyloarthritis (SpA) are not fully present. Whether this is a discrete entity was the basis of a debate during the 4th International Congress on Controversies in Rheumatology & Autoimmunity held in Bologna, Italy 9-11 March 2017. The pro and con aspects of the debate are presented. The implications of the debate are important ranging from diagnostic aspects to consequences for the society and the payers. Copyright © 2017 Elsevier B.V. All rights reserved.

Radionuclide Methods in the Diagnosis of Sacroiliitis in Patients with Spondyloarthritis: An Update

Directory of Open Access Journals (Sweden)

Karina Zilber

2016-10-01

Full Text Available Sacroiliitis, inflammation of the sacroiliac joint (SIJ, is the hallmark of ankylosing spondylitis and spondyloarthritis (SpA in general. The arsenal of recommended diagnostic modalities for imaging of the SIJ is scanty and, in practice, includes only conventional X-rays and magnetic resonance imaging (MRI. This review suggests that bone scintigraphy, particularly single-photon emission computed tomography (SPECT with calculation of indices, or SPECT in combination with low-dose computed tomography (CT can be a sensitive and specific tool for the diagnosis of sacroiliitis and can be used as part of the individualized approach to the diagnosis of axial SpA. In addition, [18F]fluoride positron emission tomography (PET/CT imaging and immunoscintigraphy, using labeled monoclonal anti-cytokine antibodies, are promising methods of current scientific interest in this field.

Unique transcriptome signatures and GM-CSF expression in lymphocytes from patients with spondyloarthritis.

Science.gov (United States)

Al-Mossawi, M H; Chen, L; Fang, H; Ridley, A; de Wit, J; Yager, N; Hammitzsch, A; Pulyakhina, I; Fairfax, B P; Simone, D; Yi, Yao; Bandyopadhyay, S; Doig, K; Gundle, R; Kendrick, B; Powrie, F; Knight, J C; Bowness, P

2017-11-15

Spondyloarthritis encompasses a group of common inflammatory diseases thought to be driven by IL-17A-secreting type-17 lymphocytes. Here we show increased numbers of GM-CSF-producing CD4 and CD8 lymphocytes in the blood and joints of patients with spondyloarthritis, and increased numbers of IL-17A + GM-CSF + double-producing CD4, CD8, γδ and NK cells. GM-CSF production in CD4 T cells occurs both independently and in combination with classical Th1 and Th17 cytokines. Type 3 innate lymphoid cells producing predominantly GM-CSF are expanded in synovial tissues from patients with spondyloarthritis. GM-CSF + CD4 + cells, isolated using a triple cytokine capture approach, have a specific transcriptional signature. Both GM-CSF + and IL-17A + GM-CSF + double-producing CD4 T cells express increased levels of GPR65, a proton-sensing receptor associated with spondyloarthritis in genome-wide association studies and pathogenicity in murine inflammatory disease models. Silencing GPR65 in primary CD4 T cells reduces GM-CSF production. GM-CSF and GPR65 may thus serve as targets for therapeutic intervention of spondyloarthritis.

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

(p = 0.003). At least moderate disease activity as defined by an Ankylosing Spondylitis Disease Activity Score using the erythrocyte sedimentation rate (ASDAS-ESR) ..., and other reasons, respectively (p = 0.01). Only 4 % of patients achieved an ASDAS-ESR inactive disease state after PLR, in comparison to 22 % of those after SLR. Similar results were demonstrated in patients fulfilling the Assessment of SpondyloArthritis international Society classification criteria for ax......SpA (n = 488): ASDAS-ESR

Craniectomy-associated Progressive Extra-Axial Collections with Treated Hydrocephalus (CAPECTH): redefining a common complication of decompressive craniectomy.

Science.gov (United States)

Nalbach, Stephen V; Ropper, Alexander E; Dunn, Ian F; Gormley, William B

2012-09-01

Extra-axial fluid collections following decompressive craniectomy have been observed in a variety of patient populations. These collections have traditionally been thought to represent extra-axial signs of hydrocephalus, but they often occur even in settings where hydrocephalus has been optimally treated. This study aims to elucidate the phenomenon of extra-axial fluid collections after decompressive craniectomy in patients with treated hydrocephalus, in order to improve identification, classification, prevention and treatment. We retrospectively reviewed all patients at a single institution undergoing decompressive craniectomy for refractory intracranial pressure elevations from June 2007 through December 2009. We identified 39 patients by reviewing clinical reports and imaging. Any patient who died on or prior to the third post-operative day (POD) was excluded. The analysis focused on patients with extra-axial collections and treated hydrocephalus. Twenty-one of 34 (62%) patients developed extra-axial collections and 18 of these developed collections despite ventricular drainage. Subgroup analysis revealed that seven of seven patients (100%) with subarachnoid hemorrhage, and 11 of 14 (79%) with traumatic brain injury developed collections. Extra-axial collections may develop after decompressive craniectomy despite aggressive treatment of communicating hydrocephalus. In these patients, the term "external hydrocephalus" does not appropriately capture the relevant pathophysiology. Instead, we define a new phenomenon, "Craniectomy-associated Progressive Extra-Axial Collections with Treated Hydrocephalus" (CAPECTH), as progressive collections despite aggressive cerebral spinal fluid (CSF) drainage. Our data indicate that early cranioplasty can help prevent the formation and worsening of this condition, presumably by returning normal CSF dynamics. Copyright © 2012 Elsevier Ltd. All rights reserved.

Comorbidities in Spondyloarthritis associate with poor function, work disability and quality of life: Results from the ASAS-COMOSPA study

NARCIS (Netherlands)

Nikiphorou, E.; Ramiro, S.; van der Heijde, D.; Norton, S.; Moltó, A.; Dougados, M.; van den Bosch, F.; Landewé, R.

2017-01-01

Comorbidities add to the burden of disease and its complexity, and may prevent the achievement of treat-to-target goals. The objective of this study was to study the relationship between comorbidities and key disease outcomes in Spondyloarthritis, namely function, work ability and quality of life.

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

Should over-treatment of axial spondyloarthritis with biologics remain a concern after the issue of the new ASAS criteria? Data from REGISPONSERBIO (Spanish Register of Biological Therapy in Spondyloarthritides).

Science.gov (United States)

Moreno, Mireia; Gratacós, Jordi; Navarro-Compán, Victoria; de Miguel, Eugenio; Font, Pilar; Clavaguera, Teresa; Linares, Luis Francisco; Joven, Beatriz; Juanola, Xavier

2018-05-08

To study whether disease status at treatment initiation has changed after the issue of the ASAS classification criteria. REGISPONSERBIO registers patients with axial spondyloarthritis (axSpA) on biological treatment since 2013. It includes patients starting biological treatment (incident) or already on biological therapies (prevalent). Patients in both groups were compared in terms of: age at disease onset and at treatment start, disease duration, gender, HLA-B27, body mass index (BMI), BASDAI, BASFI, C-reactive protein, ESR, metrological data, ASQoL, WAPAI, extra-articular manifestations, comorbidities, radiological study, type of biological treatment and concomitant treatments. 256 patients were included, of whom 174 (65%) were already on biologic therapy. Compared to incident patients, prevalent patients started treatment with longer disease duration (15 vs. 8.6 years; p<0.001), a higher proportion of them were men (83% vs. 67%; p=0.01), a smaller proportion of them showed non-radiographic axial spondylarthritis (nr-axSpA)(17% vs. 32%; p<0.01), and a higher proportion had HLAB27 (85% vs. 73%; p=0.02). There were no statistically significant differences in terms of disease activity, degree of disability, quality of life, or prevalence of extra-articular manifestations. Data suggest that, after the issue of the new classification criteria for SpA, biological therapy is being administered earlier than previously in SpA patients and in a higher proportion of patients with nr-axSpA. However, this change in prescribing profile, apparently, has not caused an over-treatment, as patients do not seem to have a lower disease burden than prior to the issue of the criteria.

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.

HLA B27 antigen in Middle Eastern and Arab countries: systematic review of the strength of association with axial spondyloarthritis and methodological gaps.

Science.gov (United States)

Ziade, Nelly Raymond

2017-06-29

Axial spondyloarthritis (AxSpA) is a relatively frequent and debilitating disease, with a prevalence ranging from 0.1 to 2% in the Caucasian population. Current Assessment of Spondyloarthritis International Society (ASAS) classification criteria of AxSpA rely either on sacroiliitis on imaging plus one SpA feature or positive HLAB27 antigen plus two SpA features, in a patient with chronic low back pain and age at onset of less than 45 years. Therefore, HLA-B27 is a central feature in SpA classification and plays a pivotal role in referral strategies and early diagnosis. The primary objective of the study is to review the prevalence of HLA-B27 in normal and AxSpA populations in Middle Eastern and Arab Countries and to assess the strength of association between HLA-B27 antigen and AxSpA. The secondary objective is to identify the gaps in the methodology of the studies and suggest a framework for future research. Studies were included in the analysis if they reported prevalence of HLA-B27 in AxSpA and/or general population and if they covered geographical location in the Middle East or Arab countries in the Mediterranean basin. Odds ratios (OR) were calculated for each country, as a measure of the strength of association between HLA-B27 and AxSpA, compared to the normal population, using the two-by-two frequency table. Available data from the literature were analyzed according to the following quality indicators: sample size, method of HLA-B27 testing, presence of control group and external validity. Twenty-seven studies were analyzed. HLAB27 prevalence in the normal population ranged from 0.3% (Oman) to 6.8% (Turkey). HLA-B27 prevalence in AxSpA ranged from 26.2% (Lebanon) to 91% (Turkey). HLA-B27 prevalence in all SpA ranged from 13.87% (Lebanon) to 69.43% (Kuwait). Peripheral SpA was less associated with HLA-B27 than AxSpA, indicating the need of differentiating between the two entities when calculating prevalence. When available (8 studies), the OR ranged from 21

Spectrum of Inflammatory Changes in the SIJs on Radiographs and MR Images in Patients with Suspected Axial Spondyloarthritis

International Nuclear Information System (INIS)

Sudoł-Szopińska, Iwona; Włodkowska-Korytkowska, Monika; Kwiatkowska, Brygida

2016-01-01

The aim of the paper was to compare radiographs and MRI in assessment of active and chronic inflammatory changes in the sacroiliac joints in patients with chronic back pain and suspected axial spondyloarthritis. Moreover, the aim was to determine which of the two methods is more accurate in diagnosing individual inflammatory changes in the sacroiliac joints and whether there is a correlation between radiographs and MRI in their identification. The analysis was conducted in a group of 101 patients, including 61 women and 40 men, referred to radiographs and MR examinations by rheumatologists due to chronic back pain. AP images of the lumbar region of the spine were performed in each patient in the supine position. The images included the sacroiliac joints. Changes in the SIJs were assessed based on the New York criteria of 1966. In MR examination, the SIJs were assessed in terms of the presence of active and chronic inflammatory changes described by the ASAS. The statistical analysis of the variables tested was conducted in the Excel and Statistica systems. In relation to the final clinical diagnosis of axSpA, MRI had higher sensitivity and specificity than radiography in diagnosing sacroiliitis (sensitivity: 71% vs. 22%, specificity: 90% vs. 94% on radiographs according to New York criteria. In relation to MRI, radiographs resulted in 40% of incorrect sacroiliitis diagnoses (both false positive and false negative results). In as many as 50% of cases (7/14), MRI failed to confirm the presence of inflammatory changes in the sacroiliac joints observed in radiography according to the modNY criteria (false positive results on radiographs). Both examinations are characterised by very low agreement, which is near to random, in assessing individual features of sacroiliitis, such as sclerosis, change in the joint space width, erosions and ankylosis. 1. Radiographs do not allow early inflammatory lesions indicating sacroiliitis to be diagnosed, which leads to diagnostic delay

Herpes simplex type 2 encephalitis and methotrexate medication: a fortuitous or causative association in a patient with spondyloarthritis?

Science.gov (United States)

Lupo, Julien; Dos Santos, Ophélie; Germi, Raphaele; Baccard-Longère, Monique; Stahl, Jean-Paul; Epaulard, Olivier; Morand, Patrice

2017-01-01

It is unclear whether immunosuppression is a risk factor for herpes encephalitis. Herein, we describe a rare case of herpes simplex virus type 2 encephalitis in a patient treated with low-dose methotrexate for HLA-B27-associated spondyloarthritis. The patient was successfully treated with acyclovir but presented sequelae of encephalitis. Here we discuss the possible role of low-dose methotrexate therapy as a risk factor of neurological herpes reactivation and severe disease. The host-related and viral risk factors are also addressed.

Tools for monitoring spondyloarthritis in clinical practice

NARCIS (Netherlands)

van Tubergen, Astrid M.; Landewé, Robert B. M.

2009-01-01

Spondyloarthritis (SpA) usually follows a chronic disease course that requires regular medical care and monitoring to control for increased disease activity and to maintain physical function. This Review describes the instruments and imaging techniques available for monitoring SpA in clinical

Evaluation of peripheral enthesitis in spondyloarthritis: Ultrasonography versus clinical examination

Directory of Open Access Journals (Sweden)

Anupam Wakhlu

2017-01-01

Full Text Available Background: Enthesitis is an important feature of spondyloarthritis but may often be subclinical. Data is sparse, especially from India, on the ultrasonography (USG detection of enthesitis in these patients. The present study aimed to find the prevalence and pattern of entheseal involvement assessed clinically and by USG. Methods: Fifty-two spondyloarthritis, 26 rheumatoid arthritis, and 26 healthy controls were evaluated for enthesitis by clinical examination and by USG using 2014 OMERACT consensus group definitions at bilateral Achilles insertion on the calcaneus, plantar fascia attachment on the calcaneus, quadriceps tendon insertion on the patella, patellar tendon origin from the inferior pole of the patella, and patellar tendon insertion on the tibial tuberosity. At least one ultrasonographic finding at any of the above sites was considered positive for enthesitis. Results: The number of entheseal sites screened in spondyloarthritis patients was 520 and 260 each in rheumatoid arthritis and healthy controls. USG (sensitivity - 94.2% was better in detecting enthesitis than clinical examination (sensitivity - 69.2%. Clinical examination was highly specific (100% compared to USG (55.7% in differentiating from rheumatoid arthritis and healthy controls. USG alone without clinical findings was positive at 23.8% of sites while clinical examination alone without USG findings was positive at 5.2% of sites. Frequency of enthesitis in rheumatoid arthritis was not more than healthy controls (6.1% vs. 8.1%, respectively and was much less than spondyloarthritis (34%. Conclusion: USG is a good screening tool for detection of enthesitis but cannot replace clinical examination completely.

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.

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

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.)

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.

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

with conventional MRI (convMRI). METHODS: WBMRI (3.0-T) of patients with peripheral PsA (n = 18) or axial SpA (n = 18) and of HS (n = 12) was examined for proportion of evaluable features (readability) and the presence and pattern of lesions in axial and peripheral joints. Furthermore, global WBMRI scores...... of inflammation and structural damage were constructed, and WBMRI findings were compared with clinical measures and convMRI (SpA/HS: spine and SI joints; PsA/HS: hand). RESULTS: The readability (92-100%) and reproducibility (intrareader intraclass correlation coefficient: 0.62-1.0) were high in spine/SI joint...

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.

Axial location of cladding failure during a slow transient overpower TREAT test

International Nuclear Information System (INIS)

Page, R.J.; Murphy, W.F.; Holland, J.W.

1983-01-01

The axial location of cladding failure following a transient overpower accident is of importance in fast reactor safety studies in that it is a determining factor in the relocation of fuel, and therefore in the possibility of inherent neutronic shutdown of the reactor. In-pile experimental data on the axial location of cladding failure of fuel in bundles of pins is sparse since, in general, the experimental fuel pin bundles are largely destroyed during the in-pile test. The post-test examination work has been completed for TREAT test J1. It was found that damage to the fuel elements during the irradiation was low enough for an accurate observation of the location of cladding failure to be made for each of the seven pins

Limited role of gadolinium to detect active sacroiliitis on MRI in juvenile spondyloarthritis

Energy Technology Data Exchange (ETDEWEB)

Herregods, N.; Leus, A.; Verstraete, K.; Jans, L. [Ghent University Hospital, Department of Radiology and Medical Imaging, Ghent (Belgium); Jaremko, J.L. [University of Alberta Hospital, Department of Radiology and Diagnostic Imaging, Edmonton, AB (Canada); Baraliakos, X. [Ruhr-University Bochum, Rheumazentrum Ruhrgebiet, Herne (Germany); Dehoorne, J. [Ghent University Hospital, Department of Pediatric Rheumatology, Ghent (Belgium)

2015-11-15

The aim of this study is to determine the added diagnostic value of contrast-enhanced (CE) magnetic resonance imaging (MRI) compared to routine non contrast-enhanced MRI to detect active sacroiliitis in clinically juvenile spondyloarthritis (JSpA). A total of 80 children clinically suspected for sacroiliitis prospectively underwent MRI of the sacroiliac (SI) joints. Axial and coronal T1-weighted (T1), Short-tau inversion recovery (STIR) and fat-saturated T1-weighted gadolinium-DTPA (Gd) contrast-enhanced (T1/Gd) sequences were obtained. The presence of bone marrow edema (BME), capsulitis, enthesitis, high intra-articular STIR signal, synovial enhancement and a global diagnostic impression of the MRI for diagnosis of sacroiliitis was recorded. STIR and T1/Gd sequences had 100 % agreement for depiction of BME, capsulitis and enthesitis. High intra-articular STIR signal was seen in 18/80 (22.5 %) patients, 15 (83 %) of whom also showed synovial enhancement in the T1/Gd sequence. Sensitivity (SN) and specificity (SP) for a clinical diagnosis of JSpA were similar for high STIR signal (SN = 33 %, SP = 85 %) and T1/Gd synovial enhancement (SN = 36 %, SP = 92 %). Positive likelihood ratio (LR+) for JSpA was twice as high for synovial enhancement than high STIR signal (4.5 compared to 2.2). Global diagnostic impression was similar (STIR: SN = 55 %, SP = 87 %, LR + =4.2; T1/Gd: SN = 55 %, SP = 92 %, LR + = 6.9). MRI without contrast administration is sufficient to identify bone marrow edema, capsulitis and retroarticular enthesitis as features of active sacroiliitis in juvenile spondyloarthritis. In selected cases when high STIR signal in the joint is the only finding, gadolinium-enhanced images may help to confirm the presence of synovitis. (orig.)

MRI of the sacroiliac joints in spondyloarthritis: the added value of intra-articular signal changes for a 'positive MRI'.

Science.gov (United States)

Laloo, Frederiek; Herregods, N; Jaremko, J L; Verstraete, K; Jans, L

2018-05-01

To determine if intra-articular signal changes at the sacroiliac joint space on MRI have added diagnostic value for spondyloarthritis, when compared to bone marrow edema (BME). A retrospective study was performed on the MRIs of sacroiliac joints of 363 patients, aged 16-45 years, clinically suspected of sacroiliitis. BME of the sacroiliac joints was correlated to intra-articular sacroiliac joint MR signal changes: high T1 signal, fluid signal, ankylosis and vacuum phenomenon (VP). These MRI findings were correlated with final clinical diagnosis. Sensitivity (SN), specificity (SP), likelihood ratios (LR), predictive values and post-test probabilities were calculated. BME had SN of 68.9%, SP of 74.0% and LR+ of 2.6 for diagnosis of spondyloarthritis. BME in absence of intra-articular signal changes had a lower SN and LR+ for spondyloarthritis (SN = 20.5%, LR+ 1.4). Concomitant BME and high T1 signal (SP = 97.2%, LR + = 10.5), BME and fluid signal (SP = 98.6%, LR + = 10.3) or BME and ankylosis (SP = 100%) had higher SP and LR+ for spondyloarthritis. Concomitant BME and VP had low LR+ for spondyloarthritis (SP = 91%, LR + =0.9). When BME was absent, intra-articular signal changes were less prevalent, but remained highly specific for spondyloarthritis. Our results suggest that both periarticular and intra-articular MR signal of the sacroiliac joint should be examined to determine whether an MRI is 'positive' or 'not positive' for sacroiliitis associated with spondyloarthritis.

Validation of ultrasound imaging for Achilles entheseal fibrocartilage in bovines and description of changes in humans with spondyloarthritis.

Science.gov (United States)

Aydin, Sibel Zehra; Bas, Emine; Basci, Onur; Filippucci, Emilio; Wakefield, Richard J; Celikel, Cigdem; Karahan, Mustafa; Atagunduz, Pamir; Benjamin, Mike; Direskeneli, Haner; McGonagle, Dennis

2010-12-01

Entheseal fibrocartilage (EF) derangement is hypothesised to be pivotal to the pathogenesis of spondyloarthritis. Ultrasound is useful for visualisation of the enthesis but its role in EF visualisation is uncertain. This work aimed to demonstrate face and content validity of ultrasound for EF visualisation both by bovine histological evaluation and EF imaging in spondyloarthritis. Achilles enthesis of 18 bovine hindfeet was visualised using a MyLab 70 ultrasound machine. The presence of tissue with EF characteristics was documented and histological confirmation was performed on five randomly selected sections using Masson trichrome staining. Ultrasound of the Achilles tendon (AT) was performed in 19 patients with spondyloarthritis and 21 healthy controls (HC). The bovine EF could be visualised in all cases and seen as a thin, uncompressible, well-defined, anechoic layer between the hyperechoic bone and the hyperechoic fibrils of the enthesis both in longitudinal and transverse scans. This region corresponded to EF on histological examination. The same pattern of low signal corresponding to EF location was seen in 17/19 patients and all HC. Discontinuities of the anechoic layer around the erosions and enthesophytes were observed in the spondyloarthritis group. The thickness of the anechoic layer was not significantly different in spondyloarthritis and HC (0.5 ± 0.1 vs 0.5 ± 0.2 mm, p=0.9) whereas the thickness of the EF was greater in men (0.6 ± 0.2 vs 0.5 ± 0.1 mm; p=0.009) compared with women. Ultrasound can visualise EF of the AT insertion, which can be abnormal in cases of spondyloarthritis. This has implications for a better understanding of enthesopathy.

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.

Autoimmune Arthritides, Rheumatoid Arthritis, Psoriatic Arthritis, or Peripheral Spondyloarthritis Following Lyme Disease.

Science.gov (United States)

Arvikar, Sheila L; Crowley, Jameson T; Sulka, Katherine B; Steere, Allen C

2017-01-01

To describe systemic autoimmune joint diseases that develop following Lyme disease, and to compare their clinical features with those of Lyme arthritis (LA). We reviewed records of all adult patients referred to our LA clinic over a 13-year period, in whom we had diagnosed a systemic autoimmune joint disease following Lyme disease. For comparison, records of patients enrolled in our LA cohort over the most recent 2-year period were analyzed. Levels of IgG antibodies to Borrelia burgdorferi and to 3 Lyme disease-associated autoantigens were measured. We identified 30 patients who had developed a new-onset systemic autoimmune joint disorder a median of 4 months after Lyme disease (usually manifested by erythema migrans [EM]). Fifteen had rheumatoid arthritis (RA), 13 had psoriatic arthritis (PsA), and 2 had peripheral spondyloarthritis (SpA). The 30 patients typically had polyarthritis, and those with PsA or SpA often had previous psoriasis, axial involvement, or enthesitis. In the comparison group of 43 patients with LA, the usual clinical picture was monoarticular knee arthritis, without prior EM. Most of the patients with systemic autoimmune joint disorders were positive for B burgdorferi IgG antibodies, as detected by enzyme-linked immunosorbent assay, but had significantly lower titers and lower frequencies of Lyme disease-associated autoantibodies than patients with LA. Prior to our evaluation, these patients had often received additional antibiotics for presumed LA, without benefit. We prescribed antiinflammatory agents, most commonly disease-modifying antirheumatic drugs, resulting in improvement. Systemic autoimmune joint diseases (i.e., RA, PsA, SpA) may follow Lyme disease. Development of polyarthritis after antibiotic-treated EM, previous psoriasis, or low-titer B burgdorferi antibodies may provide insight into the correct diagnosis. © 2016, American College of Rheumatology.

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...

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...

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.

Synovial Tissue Response to Treatment with TNF Blockers in Peripheral Spondyloarthritis

NARCIS (Netherlands)

Paramarta, Jacqueline E.; Baeten, Dominique; de Rycke, Leen

2011-01-01

This review describes the synovial response to treatment in peripheral spondyloarthritis (SpA). A series of recent studies demonstrates that the synovial histopathology is largely homogenous between different SpA subtypes and can be strongly modulated by effective treatment such as tumor necrosis

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

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...

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.)

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.)

Safety of treatment options for spondyloarthritis: a narrative review.

Science.gov (United States)

D'Angelo, Salvatore; Carriero, Antonio; Gilio, Michele; Ursini, Francesco; Leccese, Pietro; Palazzi, Carlo

2018-05-01

Spondyloarthritis (SpA) are chronic inflammatory diseases with overlapping pathogenic mechanisms and clinical features. Treatment armamentarium against SpA includes non-steroidal anti-inflammatory drugs, glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs, including sulfasalazine, methotrexate, leflunomide, cyclosporine), targeted synthetic DMARDs (apremilast) and biological DMARDs (TNF inhibitors, anti-IL 12/23 and anti-IL-17 agents). Areas covered: A narrative review of published literature on safety profile of available SpA treatment options was performed. Readers will be provided with a comprehensive overview on frequent and rare adverse events associated with each drug listed in current SpA treatment recommendations. Expert opinion: The overall safety profile of such molecules is good and serious adverse events are rare but need to be promptly recognized and treated. However, the monitoring of adverse events is a major challenge for clinicians because it is not adequately addressed by current treatment recommendations. A tailored treatment is crucial and rheumatologists must accurately select patients in order to identify those more susceptible to develop adverse events.

Diagnostic value of pelvic enthesitis on MRI of the sacroiliac joints in spondyloarthritis

Energy Technology Data Exchange (ETDEWEB)

Jans, L.; Langenhove, C. van; Lambrecht, V.; Verstraete, K. [Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium); Praet, L. van; Carron, P.; Elewaut, D.; Bosch, F.V. den [Ghent University Hospital, Department of Rheumatology, Gent (Belgium); Jaremko, J.L. [University of Alberta Hospital, Department of Radiology, Edmonton, Alberta (Canada)

2014-04-15

To determine the prevalence and diagnostic value of pelvic enthesitis on MRI of the sacroiliac (SI) joints in spondyloarthritis (SpA). A retrospective study in 444 patients aged 17-45 years old with MRI of the SI joints and with clinically suspected sacroiliitis was performed. Patients were classified as having SpA if they fulfilled the Assessment of Spondyloarthritis International Society (ASAS) criteria. Pelvic enthesitis on MRI was correlated with the final diagnosis. Sensitivity, specificity, positive and negative likelihood ratio (LR) and predictive values (PV) of pelvic enthesitis for the diagnosis of SpA were calculated. MRI showed pelvic enthesitis in 24.4 % of patients with SpA and in 7.1 % of patients without SpA. Presence of any enthesitis had sensitivity, specificity, LR+, LR-, PPV and NPV of 24.4 %, 92.9 %, 3.45, 0.81, 69.4 % and 65.2 % for the diagnosis of SpA, respectively. The most commonly affected entheses were the longitudinal ligament insertion (4.5 %), the retroarticular ligaments (4.1 %) and the pubic symphysis (4.1 %). The sites of enthesitis with the highest PPV for SpA were the iliac crest/wing (85.7 %) and the retroarticular ligaments (81.3 %). Nearly one fourth of SpA patients with suspected sacroiliitis showed pelvic enthesitis on MRI. Such pelvic enthesitis has a high specificity for the diagnosis of spondyloarthritis. (orig.)

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.

Association of human leukocyte A, B, and DR antigens in Colombian patients with diagnosis of spondyloarthritis.

Science.gov (United States)

Santos, Ana M; Peña, Paola; Avila, Mabel; Briceño, Ignacio; Jaramillo, Carlos; Vargas-Alarcon, Gilberto; Rueda, Juan C; Saldarriaga, Eugenia-Lucia; Angarita, Jose-Ignacio; Martinez-Rodriguez, Nancy; Londono, John

2017-04-01

There is substantial evidence that non-B27 major histocompatibility complex (MHC) genes are associated with spondyloarthritis (SpA). Studies in Mexican and Tunisian populations demonstrated the association of SpA and human leukocyte antigen (HLA) B15. The purpose of this study was to evaluate the association of HLA-A, B, and DR antigens in a group of Colombian patients with a diagnosis of SpA. A total of 189 patients and 100 healthy subjects were included in the present study. All subjects underwent a complete characterization of HLA alleles A, B, and DR. Of the 189 studied patients, 35 were reactive arthritis (ReA), 87 were ankylosing spondylitis (AS), and 67 undifferentiated SpA (uSpA). According to the Assessment of Spondyloarthritis International Society (ASAS) criteria, 167 were axial SpA (axSpA) and 171 were peripheral SpA (pSpA). 63.8% were men, with a mean age of 35.9 ± 12.7 years. 40.7% (77/189) of patients were HLA-B27 positive of which 52.9% had AS and 42.5% axSpA. 23.2% (44/189) of patients were HLA-B15 positive: 23.8% were uSpA, 12.57% were axSpA, and 11.7% were pSpA. In addition, HLA-DRB1*01 was associated with AS (58.6%) and axSpA (42.5%). Also, HLA-DRB1*04 was present in 62 patients with AS (71.2%) and in 26 with axSpA (15.5%). In this population, we found a strong association between the presence of HLA-B27 and the diagnosis of axSpA and AS, but the HLA-B15 is also significantly associated with all subtypes of the disease, predominantly with pSpA. Additionally, HLA-DR1 and DR4 were associated in a cohort of patients with SpA from Colombia.

Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases

DEFF Research Database (Denmark)

Sudoł-Szopińska, Iwona; Jurik, Anne Grethe; Eshed, Iris

2015-01-01

This article presents the recommendations of the European Society of Musculoskeletal Radiology Arthritis Subcommittee regarding the standards of the use of MRI in the diagnosis of musculoskeletal rheumatic diseases. The recommendations discuss (1) the role of MRI in current classification criteria...... of musculoskeletal rheumatic diseases (including early diagnosis of inflammation, disease follow-up, and identification of disease complications); (2) the impact of MRI on the diagnosis of axial and peripheral spondyloarthritis, rheumatoid arthritis, and juvenile spondyloarthritis; (3) MRI protocols for the axial...

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.

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...

Fever as an initial manifestation of spondyloarthritis: A retrospective study.

Directory of Open Access Journals (Sweden)

Se Jin Byun

Full Text Available We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS classification criteria.We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic. Clinical features and laboratory findings were compared in two patient groups.There were 26 patients who had fever as initial presentation of SpA (reactive arthritis 50%, undifferentiated SpA 26.9%, ankylosing spondylitis 15.4%, enteropathic arthritis 3.8%, psoriatic arthritis 3.8%. Peripheral SpA was more common in febrile SpA patients than in control SpA patients (65.4% vs 24.0%, p<0.001. Febrile SpA patients were less frequently HLA-B27 positive than control SpA patients (52.2% vs 77.0%, p<0.05. At baseline, systemic inflammatory markers were significantly higher in the febrile SpA patients (white blood cell count, 11.57 vs 7.81 cells/μL, p<0.001; erythrocyte sedimentation rate, 69.2 vs 41.0 mm/h, p<0.001; C-reactive protein, 109.6 vs 15.3 mg/L, p<0.001. The proportion of patients treated with systemic steroids was significantly higher in febrile SpA patients (57.7% vs. 11.0%, p<0.001. The proportion of patients who visited rheumatology specialty was significantly lower in febrile SpA patients than in control SpA patients (7.7% vs 59.0%, p<0.001.Various subgroups of SpA can be presented with fever as an initial manifestation. Febrile SpA patients demonstrated higher systemic inflammation and a lower chance to visit rheumatology in early stage. When evaluating febrile patients with any clinical features of SpA, clinicians are advised to consider performing SpA-focused evaluation including HLA-B27

Undifferentiated seronegative spondyloarthritis with inflammatory bowel disease and a family history of psoriasis. Sicca syndrome

Directory of Open Access Journals (Sweden)

Norma Marigliano

2013-04-01

Full Text Available Background: Seronegative spondyloarthritis is characterized by the presence of subcutaneous nodules, asymmetrical peripheral arthritis, sacroileitis with or without spondylitis, and rheumatoid-factor negativity. Other common clinical manifestations include oral ulcers, conjunctivitis, and cutaneous lesions such as psoriasis. Familial aggregation has also been described. According to the 1986 classification, corresponding clinical entities include ankylosing spondylitis, psoriatic arthritis, Reiter’s syndrome, arthritis associated with inflammatory bowel disease (IBD, and undifferentiated spondyloarthritis. The disease is also frequently associated with the HLA B27 antigen. From the clinical point of view, there are often incomplete forms of spondyloarthritis, such as reactive arthritis triggered by asymptomatic infections, psoriatic arthritis without psoriasis itself, initial phases of specific forms of spondyloarthritis or the phase of ankylosing spondylitis characterized by sacroiliac lesions, and all forms that remain undifferentiated for long periods of time. Moreover, there are close relations between arthropathy and IBDs, such as Crohn’s disease, ulcerative colitis, and Whipple’s syndrome. Recently, microscopic inflammatory bowel lesions and psoriatic arthritis have been described. Case report: A 30-year-old man (HLA B27-negative who had been vaccinated against TBC and HBV presented with a 6-year history of recurrent episodes of predominantly left-sided sciatica. The pain was worse at night and during rest. He was suffering from bilateral sacroileitis without spondylitis. Three to five times a day, usually after eating, he passed watery feces containing mucous and small amounts of bright red blood. Colonoscopy revealed pancolitis with histological evidence of chronic inflammation interspersed with areas of acute inflammation, edema, hyperemia, and glandular distortion. One year later, the clinical manifestations and histological

Efficacy and safety of adalimumab in ankylosing spondylitis

Directory of Open Access Journals (Sweden)

Mounach A

2014-08-01

Full Text Available Aziza Mounach, Abdellah El MaghraouiRheumatology Department, Military Hospital Mohammed V, Rabat, MoroccoAbstract: Ankylosing spondylitis (AS is the most common and most severe subtype of spondyloarthritis. It also may be an outcome of any of the other spondyloarthritis subtypes. AS preferentially affects the sacroiliac joints and the tip of the column, with a tendency to later ankylosis. Peripheral joints, enthesis, and other extra-articular involvement may be observed. Tumor necrosis factor (TNF inhibitors are now well-established, effective drugs in the treatment of AS symptoms. Adalimumab, which is a fully human monoclonal antibody that binds to and neutralizes TNF, has demonstrated efficacy in treating AS symptoms, including axial involvement, peripheral arthritis, enthesitis, uveitis, gut involvement, and psoriasis. Furthermore, adalimumab has showed an overall acceptable safety profile. In this paper, we review the efficacy and safety profile of adalimumab in the treatment of AS, and discuss its differences from the other anti-TNF drugs reported in the literature.Keywords: ankylosing spondylitis, spondyloarthritis, adalimumab, tumor necrosis factor-α

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.

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.

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

OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis...

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).

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...... activity at the enthesis (0.63). Conclusion: This is the first consensus based definition of US 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. Defining Enthesitis...

Enteropathic Spondyloarthritis: From Diagnosis to Treatment

Directory of Open Access Journals (Sweden)

Rosario Peluso

2013-01-01

Full Text Available Enteropathic arthritis (EA is a spondyloarthritis (SpA which occurs in patients with inflammatory bowel diseases (IBDs and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.

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

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

Economic evaluation of spondyloarthritis: economic impact of diagnostic delay in Italy.

Science.gov (United States)

Mennini, Francesco S; Viti, Raffaella; Marcellusi, Andrea; Sciattella, Paolo; Viapiana, Ombretta; Rossini, Maurizio

2018-01-01

Spondyloarthritis (SpA) is a disease that normally affects the axial skeleton. It progressively leads to overall stiffness up to severe postural deformity of rachis and functional impotence. The objective of the study was to quantify, through an economic model, the impact of specialized testing and pharmacological treatments carried out by the National Health Service (NHS) in normal clinical practice, before the patient is diagnosed with SpA in Italy. In line with the analysis objective, the chosen perspective is that of the NHS. The study was conducted by analyzing the Health Search Database - IMS Health Longitudinal Patient Database, from which newly diagnosed SpA patients were identified over the period 1 January 2007 to 31 December 2013. The use of specialist health care services and pharmacological treatments provided to the patients before the final SpA diagnosis were estimated. Through a retrospective analysis of the Health Search Database, 1,084 subjects (aged 25-45 years) were identified. These patients produced an expense of approximately €153,000 in the 3 years prior to a confirmed SpA diagnosis, in terms of specialist check-ups and drugs, presumably not appropriately used due to a lack of diagnosis. If we assume that the Health Search Database is a representative sample of the Italian population, it may be estimated that, in the 3 years prior to SpA diagnosis, over €5.4 million was largely unduly spent in Italy to examine and manage 38,232 newly diagnosed SpA patients, between 2010 and 2013. The costs due to the delay in SpA diagnosis were quantified for the first time in Italy. For this reason, this work represents a contribution for national and regional decision makers to understand the current clinical practice and the economic consequences of a diagnostic delay in the short and medium term.

The Danish nationwide clinical register for patients with rheumatoid arthritis: DANBIO

Directory of Open Access Journals (Sweden)

Ibfelt EH

2016-10-01

Full Text Available Else Helene Ibfelt,1 Dorte Vendelbo Jensen,2,3 Merete Lund Hetland2,4 1Registry Support Centre (East, Epidemiology and Biostatistics, Research Centre for Prevention and Health, Rigshospitalet, Glostrup University Hospital, 2DANBIO Registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup, 3Department of Rheumatology, Herlev and Gentofte University Hospital, Hellerup, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Introduction: DANBIO is a research register and a data source for rheumatologic diseases (rheumatoid arthritis [RA], axial spondyloarthritis, and psoriatic arthritis for monitoring clinical quality at the national, regional, and hospital levels. Study population: The register includes patients with rheumatologic diseases who are treated at a hospital or a private rheumatologic clinic. Registration is mandatory for all patients with RA regardless of treatment and also for patients with other diagnoses if treated with biological disease-modifying antirheumatic drugs. Since 2006, the registration has been done electronically, including patient-reported outcome measures registered electronically by the patients with the use of touch screens. Main variables: Core variables such as diagnosis, year of diagnosis, age, and sex are registered at the beginning. Data entered at later visits included the following: patient-reported outcomes for disease activity, pain, fatigue, functional status, and physician-reported objective measures of disease activity, treatment, C-reactive protein, and, when indicated, imaging. For subgroups of patients, the variables such as quality of life, sociodemographic factors, lifestyle, and comorbidity are also registered. Descriptive data: The DANBIO cohort comprised ~26,000 patients with RA, 3,200 patients with axial spondyloarthritis, and 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.)

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...... with tumor necrosis factor-alpha (TNFα) inhibitors and to compare with levels in healthy subjects. Biomarkers were measured in an observational cohort of 49 SpA patients (ankylosing spondylitis, n=32, and psoriatic arthritis, n=17) initiating TNFα inhibitor therapy (infliximab, n=38; etanercept, n=8...

Comorbidities in Spondyloarthritis

Directory of Open Access Journals (Sweden)

Anna Moltó

2018-03-01

Full Text Available Comorbidities in spondyloarthritis (SpA add to the burden of disease by contributing to disease activity, functional and work disability, and mortality. Thus, awareness of comorbidities in SpA is crucial to improve their screening and management and to ultimately improve outcomes in those affected. Osteoporosis has been reported to be the most prevalent comorbidity in SpA, and its risk is increased in these patients, compared with the general population; the risk of vertebral fractures requires further evaluation. Cardiovascular risk is also increased in this population, both due to an increase of the traditional cardiovascular risk factors in these patients, but also due to the presence of inflammation. The role of non-steroidal anti-inflammatory drugs in this increased risk needs further elucidation, but there is consensus on the need to encourage smoking cessation and to perform periodic evaluation of cardiovascular risk in these patients, particularly in the case of change in treatment course. Concerning the risk of cancer, no increased risk inherent to SpA seems to exist. However, an increased neoplastic risk can occur due to SpA treatments, e.g., P-UVA. Data are sparse on the risk of infections compared with rheumatoid arthritis, but there appears to be no risk in the absence of TNF-inhibitor exposure. Regardless of which comorbidity, a gap exists between recommendations for their management and actual implementation in clinical practice, suggesting that there is still a need for improvement in this area. Systematic screening for these comorbidities should improve both short- and long-term outcomes in SpA patients.

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.

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...... and ligamentous compartment. The incremental value of evaluating the ligamentous additionally to the cartilaginous compartment alone for diagnosis of SpA was graded qualitatively. We determined the lesion distribution between the two compartments, and the impact of the ligamentous compartment evaluation...... on diagnostic utility. RESULTS: MRI bone marrow lesions solely in the ligamentous compartment in the absence of lesions in the cartilaginous compartment were reported in just 0-2.0/0-4.0 % (BME/fat metaplasia) of all subjects. Additional assessment of the ligamentous compartment was regarded as essential...

Imaging of the Achilles tendon in spondyloarthritis: a comparison of ultrasound and conventional, short and ultrashort echo time MRI with and without intravenous contrast

International Nuclear Information System (INIS)

Hodgson, R.J.; Emery, P.; Grainger, A.J.; O'Connor, P.J.; Evans, R.; Coates, L.; Marzo-Ortega, H.; Helliwell, P.; McGonagle, D.; Robson, M.D.

2011-01-01

To compare conventional MRI, ultrashort echo time MRI and ultrasound for assessing the extent of tendon abnormalities in spondyloarthritis. 25 patients with spondyloarthritis and Achilles symptoms were studied with MRI and ultrasound. MR images of the Achilles tendon were acquired using T1-weighted spin echo, gradient echo and ultrashort echo time (UTE) sequences with echo times (TE) between 0.07 and 16 ms, before and after intravenous contrast medium. Greyscale and power Doppler ultrasound were also performed. The craniocaudal extent of imaging abnormalities measured by a consultant musculoskeletal radiologist was compared between the different techniques. Abnormalities were most extensive on spoiled gradient echo images with TE=2 ms. Contrast enhancement after intravenous gadolinium was greatest on the UTE images (TE=0.07 ms). Fewer abnormalities were demonstrated using unenhanced UTE. Abnormalities were more extensive on MRI than ultrasound. Contrast enhancement was more extensive than power Doppler signal. 3D spoiled gradient echo images with an echo time of 2 ms demonstrate more extensive tendon abnormalities than the other techniques in spondyloarthritis. Abnormalities of vascularity are best demonstrated on enhanced ultrashort echo time images. (orig.)

Enthesitis of lumbar spinal ligaments in clinically suspected spondyloarthritis: value of gadolinium-enhanced MR images in comparison to STIR

Energy Technology Data Exchange (ETDEWEB)

Agten, Christoph A.; Zubler, Veronika; Rosskopf, Andrea B.; Pfirrmann, Christian W.A. [Balgrist University Hospital, Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Weiss, Bettina [Balgrist University Hospital, Rheumatology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

2016-02-15

To compare detection of spinal ligament enthesitis between gadolinium-enhanced fat-saturated T1-weighted gadolinium-enhanced fat-saturated T1-weighted (T1+Gd) and STIR sequences in patients with suspected spondyloarthritis. Sixty-eight patients (37 males, 42 ± 14 years) with a sacroiliac-joint (SIJ) and lumbar spine MRI for suspected spondyloarthritis were prospectively included. Sagittal T1+Gd and STIR images of the lumbar spine were assessed by two readers for enthesitis of interspinous/supraspinous ligaments, and for capsulitis of facet-joints between T12-S1. Patients' MRI were grouped according to ASAS (Assessment of SpondyloArthritis international Society) criteria in positive (group A) or negative (group B) SIJs. Enthesitis/capsulitis were compared between groups. Interreader agreement was assessed. Enthesitis/capsulitis per patient was statistically significantly more frequent with T1+Gd compared to STIR (p ≤ 0.007), except for interspinous ligaments for reader 1 (p = 0.455). Interspinous enthesitis, supraspinous enthesitis, and capsulitis were present with T1+Gd(STIR) in 64.7 %(72.1 %), 60.3 %(17.7 %), and 61.8 %(29.4 %) for reader 1, and 51.5 %(41.2 %), 45.6 %(7.4 %), and 91.2 %(45.5 %) for reader 2. There were 76.5 %(52/68) patients in group A and 23.5 %(16/68) in group B. Total number of enthesitis/capsulitis on T1+Gd was statistically significantly higher in group A than B (4.96 vs. 2.94, p = 0.026; 8.12 vs. 5.25, p = 0.041 for reader 1 and 2, respectively). Interreader agreement showed mixed results for interspinous/supraspinous/capsulitis but was higher on T1+Gd (ICC = 0.838/0.783/0.367; p ≤ 0.001) compared to STIR (ICC = 0.652/0.298/0.224; p ≤ 0.032). In patients with suspected spondyloarthritis, enthesitis/capsulitis in the lumbar spine are common findings and more frequently/reliably detected with T1+Gd than STIR. In patients with positive SIJ-MRI, the total number of enthesitis/capsulitis in T1+Gd was higher compared to patients with

Treat to target in gout.

Science.gov (United States)

Perez-Ruiz, Fernando; Moreno-Lledó, Aitana; Urionagüena, Irati; Dickson, Alastair J

2018-01-01

The treat-to-target (T2T) approach has been successfully implemented in a number of diseases. T2T has been proposed for rheumatic diseases such as RA, spondyloarthritis, lupus, and recently for gout. The level of evidence for such approaches differs from one condition to the other (moderate to high for hyperlipidaemia, for example). Practice is based on the best available evidence at any time, and in absence of good evidence for T2T in gout, some suggest a conservative only-treat-symptoms approach. Evidence suggests that not treating gout to target in the long term is overall associated with worsening outcomes, such as flares, tophi and structural damage, which is associated to loss of quality of life and mortality. Different targets have been proposed for hyperuricaemia in gout; lower than 6 mg/dl (0.36 mmol/l) for all patients, at least gout. © The Author 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Danish nationwide clinical register for patients with rheumatoid arthritis: DANBIO.

Science.gov (United States)

Ibfelt, Else Helene; Jensen, Dorte Vendelbo; Hetland, Merete Lund

2016-01-01

DANBIO is a research register and a data source for rheumatologic diseases (rheumatoid arthritis [RA], axial spondyloarthritis, and psoriatic arthritis) for monitoring clinical quality at the national, regional, and hospital levels. The register includes patients with rheumatologic diseases who are treated at a hospital or a private rheumatologic clinic. Registration is mandatory for all patients with RA regardless of treatment and also for patients with other diagnoses if treated with biological disease-modifying antirheumatic drugs. Since 2006, the registration has been done electronically, including patient-reported outcome measures registered electronically by the patients with the use of touch screens. Core variables such as diagnosis, year of diagnosis, age, and sex are registered at the beginning. Data entered at later visits included the following: patient-reported outcomes for disease activity, pain, fatigue, functional status, and physician-reported objective measures of disease activity, treatment, C-reactive protein, and, when indicated, imaging. For subgroups of patients, the variables such as quality of life, sociodemographic factors, lifestyle, and comorbidity are also registered. The DANBIO cohort comprised ∼26,000 patients with RA, 3,200 patients with axial spondyloarthritis, and 6,200 patients with psoriatic arthritis in 2015. DANBIO has high nationwide coverage and completeness on key data variables. More than 60 original papers as well as annual reports of clinical quality (since 2005) have been published. DANBIO is a powerful register for research in rheumatologic diseases and furthermore serves as a Clinical Quality Register with the aim of monitoring treatment quality in patients with RA in Denmark.

Male smokers with HLA-B27 positivity, SI joints inflammation have more radiological damages and higher prevalence of AS while females have higher BASDAI scores: observations from cluster analyses of a group of SpA patients

Directory of Open Access Journals (Sweden)

Chan Shirley Chiu Wai

2016-12-01

Full Text Available To describe the clinical characteristics and the relations with disease activity, functional status, and syndesmophytes formation in patients with axial spondyloarthritis (AxSpA by categorizing them into different groups.

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

NARCIS (Netherlands)

van Tok, Melissa N.; Satumtira, Nimman; Dorris, Martha; Pots, Desirée; Slobodin, Gleb; van de Sande, Marleen G.; Taurog, Joel D.; Baeten, Dominique L.; van Duivenvoorde, Leonie M.

2017-01-01

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,

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

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

DEFF Research Database (Denmark)

Heftdal, Line Dam; Andersen, Thomas; Jæhger, 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...

Survey of Thai Physicians Regarding Recognition and Management of Inflammatory Back Pain and Spondyloarthritis.

Science.gov (United States)

Tangrungruengkit, Mintra; Srinonprasert, Varalak; Chiowchanwisawakit, Praveena

2016-01-01

To assess recognition and management of inflammatory back pain (IBP) and spondyloarthritis (SpA) among non-rheumatologists (NRs) and rheumatologists in Thailand. A cross-sectional survey was conducted among physicians in Thailand A questionnaire designed to evaluate knowledge regarding IBP and SpA was sent to 1,336 NRs. A different questionnaire regarding SpA management in practice was sent to 112 rheumatologists. Of 1,448 questionnaires distributed, 367 (25.3%) questionnaires were returned (NRs: 321 [24.0%] and included rheumatologists, 46 [41.1%]). Among NRs, 26.6%, 20.9%, and 9.4% recognized all features of IBP according to Calin, Assessment of SpondyloArthritis International Society, and Berlin criteria, respectively. In the presence of typical features of ankylosing spondylitis, 57.8% of NRs made the correct diagnosis. Regarding related clinical skills and involvement, 43.8%, 53.6%, and 37.3% of NRs lacked confidence in distinguishing IBP from mechanical back pain, performing musculoskeletal examination, and interpretation of plain radiography, respectively. Expensive biologic agents (31.2%) and advanced disease stage at diagnosis (27.1%) were the main problems reported by rheumatologists. Problems in diagnosis and management of SpA patients among NRs in Thailand included lack of knowledge and lack of associated clinical skills. Issues reported by rheumatologists centered on case management limitations. In order to improve overall quality of care for SpA patients, focused strategies should be implemented for both NRs and rheumatologists that consider the needs of patients, clinicians, and policy makers.

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.

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

Development and Validation of MRI Sacroiliac Joint Scoring Methods for the Semiaxial Scan Plane Corresponding to the Berlin and SPARCC MRI Scoring Methods, and of a New Global MRI Sacroiliac Joint Method

DEFF Research Database (Denmark)

Hededal, Pernille; Østergaard, Mikkel; Sørensen, Inge Juul

2018-01-01

OBJECTIVE: To develop semiaxial magnetic resonance imaging (MRI) scoring methods for assessment of sacroiliac joint (SIJ) bone marrow edema (BME) in patients with axial spondyloarthritis, and to compare the reliability with equivalent semicoronal scoring methods. METHODS: Two semiaxial SIJ MRI sc...

New immune cells in spondyloarthritis: Key players or innocent bystanders?

Science.gov (United States)

Venken, Koen; Elewaut, Dirk

2015-12-01

The central role of the inflammatory cytokines such as TNF-α, IL-23, and IL-17 in the disease pathogenesis of spondyloarthritis (SpA) is unquestionable, given the strong efficacy of anti-cytokine therapeutics used in the treatment of SpA patients. These cytokines are produced by a diverse range of immune cells, some extending beyond the typical spectrum of lineage-defined subsets. Recently, a number of specialized cells, such as innate-like T-cells, innate lymphoid cells (ILCs) and natural killer receptor (NKR)-expressing T cells, have been marked to be involved in SpA pathology. In this chapter, we will elaborate on the unique characteristics of these particular immune subsets and critically evaluate their potential contribution to SpA disease, taking into account their role in joint and gut pathology. Copyright © 2016 Elsevier Ltd. All rights reserved.

Occult spondyloarthritis in inflammatory bowel disease.

Science.gov (United States)

Bandinelli, Francesca; Manetti, Mirko; Ibba-Manneschi, Lidia

2016-02-01

Spondyloarthritis (SpA) is a frequent extra-intestinal manifestation in patients with inflammatory bowel disease (IBD), although its real diffusion is commonly considered underestimated. Abnormalities in the microbioma and genetic predisposition have been implicated in the link between bowel and joint inflammation. Otherwise, up to date, pathogenetic mechanisms are still largely unknown and the exact influence of the bowel activity on rheumatic manifestations is not clearly explained. Due to evidence-based results of clinical studies, the interest on clinically asymptomatic SpA in IBD patients increased in the last few years. Actually, occult enthesitis and sacroiliitis are discovered in high percentages of IBD patients by different imaging techniques, mainly enthesis ultrasound (US) and sacroiliac joint X-ray examinations. Several diagnostic approaches and biomarkers have been proposed in an attempt to correctly classify and diagnose clinically occult joint manifestations and to define clusters of risk for patient screening, although definitive results are still lacking. The correct recognition of occult SpA in IBD requires an integrated multidisciplinary approach in order to identify common diagnostic and therapeutic strategies. The use of inexpensive and rapid imaging techniques, such as US and X-ray, should be routinely included in daily clinical practice and trials to correctly evaluate occult SpA, thus preventing future disability and worsening of quality of life in IBD patients.

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.

A nationwide non-medical switch from originator infliximab to biosimilar CT-P13 in 802 patients with inflammatory arthritis

DEFF Research Database (Denmark)

Glintborg, Bente; Sørensen, Inge Juul; Loft, Anne Gitte

2017-01-01

Objectives According to guidelines, a nationwide non-medical switch from originator (INX, Remicade) to biosimilar infliximab (Remsima, CT-P13) was conducted in Danish patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA). We investigated disease...

Reference intervals of spinal mobility measures in normal individuals: the mobility study

NARCIS (Netherlands)

Ramiro, Sofia; van Tubergen, Astrid; Stolwijk, Carmen; van der Heijde, Desiree; Royston, Patrick; Landewe, Robert

2015-01-01

Objectives To establish reference intervals (RIs) for spinal mobility measures as recommended for patients with axial spondyloarthritis, and to determine the effect of age, height and gender on spinal mobility, in normal individuals. Methods A cross-sectional study (MOBILITY) was conducted among

Pannus inflammation in sacroiliitis following immune pathological injury and radiological structural damage: a study of 193 patients with spondyloarthritis.

Science.gov (United States)

Wang, Dan Min; Lin, Ling; Peng, Jian Hua; Gong, Yao; Hou, Zhi Duo; Chen, Su Biao; Xiao, Zheng Yu

2018-06-08

The pathogenesis of sacroiliitis is unclear; therefore, we aimed to systematically study the immunopathology of sacroiliitis in patients with axial spondyloarthritis (axSpA), and explore the relationship between pannus formation, inflammation, and the structural damage caused by sacroiliitis. Fine needle aspiration biopsy of the sacroiliac joint (SIJ) was performed in 193 patients with axSpA. Clinical, laboratory, and imaging data were collected at baseline and during the follow up. Immunohistochemistry analysis was performed to detect CD34+ microvessels, CD68+ osteoclasts/macrophages, vascular endothelial growth factor (VEGF), metalloproteinase-3 (MMP-3), tumor necrosis factor-α (TNF-α), and caspase-3. Autopsy subjects were used as controls. In early sacroiliitis (grade 0-1) all pathological features could be observed, with the most common being subchondral pannus formation. Among the 193 patients, 98 were followed up for 1-13 years (mean 3.6 years); 63.3% had radiological progression at the endpoint. Multiple regression analysis showed that cartilage pannus invasion (OR 2.99, P = 0.010) and endochondral ossification (OR 3.97, P = 0.049) at baseline were risk factors for radiological structural damage. Compared to SIJ controls, the subchondral microvessel density, number of CD68+ multinuclear osteoclasts, and the levels of VEGF, caspase-3, MMP-3, and TNF-α expressed at the interface of the bone and cartilage were significantly higher in patients with sacroiliitis. Subchondral fibrovascular tissue formation is the most important pathological feature in early sacroiliitis. The existence of cartilage pannus invasion or endochondral ossification at baseline can predict radiological structural damage during the follow up.

Rheumatoid Arthritis As a Risk Factor for Cardiovascular Events Following Hospitalized Pneumonia

DEFF Research Database (Denmark)

Holland-Fischer, Mette; Tarp, Ulrik; Thomsen, Reimar W

2015-01-01

Background/Purpose: AxSpA and PsA are core members of the spondyloarthritis complex. One cardinal characteristic shared by these two conditions is increased remodeling of bone and soft connective tissue in and around peripheral joints, axial skeleton and entheseal insertions leading to synovitis,...

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

One-loop calculations in QED in axial gauge

International Nuclear Information System (INIS)

Boos, E.E.; Kurannoy, S.S.

1983-01-01

The present paper pursued the aim to test at the simple example of the calculation of the anomalous magnetic moment in quantum electrodynamics the methods of calculating one-loop integrals in the axial gauge, using the dimensional regularization, and to investigate the independence of the results on the choice of the recipe of how to treat the poles in the denominators (k eta) -1 . It is shown that the techniques developed in another paper, as well as in the present paper, can be successfully applied in such calculations, in spite of the peculiarities of the axial gauge that have been discussed previously. The results of the two different ways of treating singularities (k eta) -1 (the principal value and 't Hooft's prescription) turn out to be equal. At the same time it was verified that the Green functions obtained by these calculations near the mass shell in the one-loop approximation satisfy the ward identity

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.

New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS).

Science.gov (United States)

Sieper, J; van der Heijde, D; Landewé, R; Brandt, J; Burgos-Vagas, R; Collantes-Estevez, E; Dijkmans, B; Dougados, M; Khan, M A; Leirisalo-Repo, M; van der Linden, S; Maksymowych, W P; Mielants, H; Olivieri, I; Rudwaleit, M

2009-06-01

Inflammatory back pain (IBP) is an important clinical symptom in patients with axial spondyloarthritis (SpA), and relevant for classification and diagnosis. In the present report, a new approach for the development of IBP classification criteria is discussed. Rheumatologists (n = 13) who are experts in SpA took part in a 2-day international workshop to investigate 20 patients with back pain and possible SpA. Each expert documented the presence/absence of clinical parameters typical for IBP, and judged whether IBP was considered present or absent based on the received information. This expert judgement was used as the dependent variable in a logistic regression analysis in order to identify those individual IBP parameters that contributed best to a diagnosis of IBP. The new set of IBP criteria was validated in a separate cohort of patients (n = 648). Five parameters best explained IBP according to the experts. These were: (1) improvement with exercise (odds ratio (OR) 23.1); (2) pain at night (OR 20.4); (3) insidious onset (OR 12.7); (4) age at onset validation cohort. This new approach with real patients defines a set of IBP definition criteria using overall expert judgement on IBP as the gold standard. The IBP experts' criteria are robust, easy to apply and have good face validity.

Using axial magnetized permanent rings to build axial gradient magnetic field

International Nuclear Information System (INIS)

Peng Quanling

2003-01-01

Axial field produced by an axially magnetized permanent ring was studied. For two permanent magnet rings, if they are magnetized in the same direction, a nearly uniform axial field can be produced; if they are magnetized in opposite direction, an axial gradient field can be produced in the region between the two permanent rings, with the field strength changing from -B 0 to B 0 . A high gradient axial magnetic field has been built by using two axially magnetized permanent rings, the measured field results agree with the PANDIRA calculation very well. It is desirable that the field gradient can be varied to match various requirements. A method to produce the variable gradient field is presented. Axial gradient field can also be used as a beam focusing facility for linear accelerator if axial periodic field can be produced. Its magnetic field is similar to that of a solenoid, in which, large stray field will leak to the outside environment. A method for shielding the outside stray field is discussed

Bone Single Photon Emission/Computed Tomography in the Detection of Sacroiliitis in Seronegative Spondyloarthritis: A Comparison with Magnetic Resonance Imaging

Directory of Open Access Journals (Sweden)

Theodoros Pipikos

2017-10-01

Full Text Available Objective: Seronegative spondyloarthritis (SpA is characterized by chronic inflammation affecting the axial skeleton, entheses and occasionally peripheral joints. The involvement of the sacroiliac joints, sacroiliitis, is considered as a pathognomonic radiographic finding. Magnetic resonance imaging (MRI is the method of choice for its early detection. Bone scintigraphy (BS is characterized by high sensitivity in the diagnosis of bone and articular diseases. Limited value of BS in the diagnosis of sacroiliitis may be attributed to the use of planar imaging. In the present study, we aimed to investigate the role of SPECT in SpA, compared to MRI. Methods: Forty-three patients suffering from inflammatory back pain underwent MRI evaluation of the sacroiliac joints and BS, combined with SPECT in the same region, for the assessment of sacroiliitis. Results: Bone SPECT revealed no findings of sacroiliitis in 11 patients, with total agreement with MRI. Findings of chronic lesions were demonstrated from both modalities in 2 patients. Bone SPECT and MRI findings were in concordance regarding the investigation of active sacroiliitis, with the exception of one patient with mild SPECT findings and negative MRI examination; the diagnosis of AS however, was established one year later, after a positive follow-up MRI. The evaluation of the planar imaging of the whole skeleton and SPECT imaging, revealed additional lesions. Conclusion: Bone SPECT is a reliable imaging method in the diagnosis of active sacroiliitis. Its application on planar BS, an economic and widely available diagnostic technique, appears to be a valuable aid for the clinician.

Impact of red and processed meat and fibre intake on treatment outcomes among patients with chronic inflammatory diseases

DEFF Research Database (Denmark)

Christensen, Robin; Heitmann, Berit L; Andersen, Karina Winther

2018-01-01

INTRODUCTION: Chronic inflammatory diseases (CIDs) are frequently treated with biological medications, specifically tumour necrosis factor inhibitors (TNFi)). These medications inhibit the pro-inflammatory molecule TNF alpha, which has been strongly implicated in the aetiology of these diseases. Up...... with inflammatory bowel disease (Crohn's disease and ulcerative colitis), rheumatic disorders (rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis), inflammatory skin diseases (psoriasis, hidradenitis suppurativa) and non-infectious uveitis. At baseline (pretreatment), patient characteristics...... will be assessed using patient-reported outcome measures, clinical assessments of disease activity, quality of life and lifestyle, in addition to registry data on comorbidity and concomitant medication(s). In accordance with current Danish standards, follow-up will be conducted 14-16 weeks after treatment...

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

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.

Axial holdup in pulsed perforated-plate column of pulser feeder type, (2)

International Nuclear Information System (INIS)

Ikeda, Hidematsu; Suzuki, Atsuyuki; Kiyose, Ryohei.

1987-01-01

In mathematical models for a pulsed perforated-plate column, the dispersed phase holdup has been considered to be uniform throughout the length of the column, but fairly recently it is treated as being nonuniform. In the previous paper, the axial holdup data were obtained in the dispersed aqueous and the dispersed organic modes. Experimental results showed that the axial holdup data become nonuniform throughout the column. It was also found that both of the plate type and the operation mode affected the axial holdup distribution. The present work is an attempt to formulate the axial holdup by means of a heuristic selforganization method that provides a nonlinear prediction model of complex system, since the holdup data did not directly show so significant trend as to formulate the axial holdup. The Group Method of Data Handling (GMDH) is used for this purpose. The GMDH can be used for selection and synthesis of input variables concerned with the axial holdup for the pulsed perforated-plate column. The axial holdup data have been successfully correlated and the identification models could be useful in discussing mathematical models. (author)

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

Science.gov (United States)

Dalto, Vitor Faeda; Assad, Rodrigo Luppino; Crema, Michel Daoud; Louzada-Junior, Paulo; Nogueira-Barbosa, Marcello Henrique

2017-09-01

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. • There are no studies evaluating which fat saturation technique should be used. • SPAIR T2w may be an alternative to STIR for sacroiliac joint evaluation. • The study will lead to changes in guidelines for spondyloarthritis.

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, ppatient 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/

BWR AXIAL PROFILE

International Nuclear Information System (INIS)

Huffer, J.

2004-01-01

The purpose of this calculation is to develop axial profiles for estimating the axial variation in burnup of a boiling water reactor (BWR) assembly spent nuclear fuel (SNF) given the average burnup of an assembly. A discharged fuel assembly typically exhibits higher burnup in the center and lower burnup at the ends of the assembly. Criticality safety analyses taking credit for SNF burnup must account for axially varying burnup relative to calculations based on uniformly distributed assembly average burnup due to the under-burned tips. Thus, accounting for axially varying burnup in criticality analyses is also referred to as accounting for the ''end effect'' reactivity. The magnitude of the reactivity change due to ''end effect'' is dependent on the initial assembly enrichment, the assembly average burnup, and the particular axial profile characterizing the burnup distribution. The set of bounding axial profiles should incorporate multiple BWR core designs and provide statistical confidence (95 percent confidence that 95 percent of the population is bound by the profile) that end nodes are conservatively represented. The profiles should also conserve the overall burnup of the fuel assembly. More background on BWR axial profiles is provided in Attachment I

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.)

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...

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.

Development and preliminary validation of the spondyloarthritis research consortium of Canada magnetic resonance imaging sacroiliac joint structural score

DEFF Research Database (Denmark)

Maksymowych, Walter P; Wichuk, Stephanie; Chiowchanwisawakit, Praveena

2015-01-01

on magnetic resonance imaging (MRI), the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ Structural Score (SSS). METHODS: The SSS method for assessment of structural lesions is based on T1-weighted spin echo MRI, validated lesion definitions, slice selection according to well-defined anatomical...... in scores, and was highest for fat metaplasia when both ICC and SDC values were compared. CONCLUSION: The new SPARCC MRI SSS method can detect structural changes in the SIJ with acceptable reliability over a 1-2-year timeframe, and should be further validated in patients with SpA....

Anti-TNFα agents and methotrexate in spondyloarthritis related uveitis in a Chinese population.

Science.gov (United States)

Lian, Fan; Zhou, Jun; Wei, Cui; Wang, Yu; Xu, Hanshi; Liang, Liuqin; Yang, Xiuyan

2015-11-01

This study seeks to evaluate the clinical characteristics of spondyloarthritis (SpA)-related uveitis in a cohort from South China and to assess the efficacy and safety of therapies based on TNF blockers. SpA patients with uveitis admitted to a south China hospital were enrolled. Demographic information, clinical characteristics, laboratory findings, intraocular inflammation, visual acuity, macular thickness, and treatments were documented. Of the 1,036 SpA patients reviewed, 182 had uveitis. Ankylosing spondylitis (AS) was the most common subtype. Unilateral uveitis was found in 51 cases (51/182, 28.0%), and unilateral alternating uveitis was found in 75 cases (75/182, 41.2%). Half of the cases were recurrent uveitis (52.2%), and acute onset was common (76.4%). The most serious complication was vision loss (0.5%). No significant difference in disease activity was found between the SpA patients with or without uveitis. Predominant improvements were found in cases treated with all three anti-TNFs (infliximab, adalimumab, and etanercept) and anti-TNFs plus methotrexate (MTX). Monotherapy of methotrexate was not adequate for inducing remission. Monotherapy of etanercept was not as effective as adalimumab and infliximab, mainly in the prevention of recurrence. No significant difference in effectiveness was found among the three anti-TNFs if MTX was added. Etanercept plus MTX were well tolerated. Infliximab and adalimumab were associated with more tuberculosis and/or hepatitis flares. Uveitis is common in SpA patients. Severe complications may develop in prolonged and intractable cases. Treatments based on anti-TNFs had good clinical response, and better safety documentation were observed in etanercept plus MTX compared to the other two anti-TNF monoclonal antibodies plus MTX.

Rheumatic diseases of the spine: imaging diagnosis.

Science.gov (United States)

Narváez, J A; Hernández-Gañán, J; Isern, J; Sánchez-Fernández, J J

2016-04-01

Spinal involvement is common both in the spondyloarthritides and in rheumatoid arthritis, in which the cervical segment is selectively affected. Rheumatoid involvement of the cervical spine has characteristic radiologic manifestations, fundamentally different patterns of atlantoaxial instability. Magnetic resonance imaging (MRI) is the technique of choice for evaluating the possible repercussions of atlantoaxial instability on the spinal cord and/or nerve roots in patients with rheumatoid arthritis as well as for evaluating parameters indicative of active inflammation, such as bone edema and synovitis. Axial involvement is characteristic in the spondyloarthritides and has distinctive manifestations on plain-film X-rays, which reflect destructive and reparative phenomena. The use of MRI has changed the conception of spondyloarthritis because it is able to directly detect the inflammatory changes that form part of the disease, making it possible to establish the diagnosis early in the disease process, when plain-film X-ray findings are normal (non-radiographic axial spondyloarthritis), to assess the prognosis of the disease, and to contribute to treatment planning. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Static axially symmetric gravitational fields with shell sources

International Nuclear Information System (INIS)

McCrea, J.D.

1976-01-01

Israel's (Israel, W., 1966, Nuovo Cim., vol.44, 1-14) method for treating surface layers in general relativity is applied to construct shell sources for exterior static axially symmetric gravitational fields. Consideration is restricted to cases in which the 3-cylinder representing the history of the shell is an equipotential surface of the exterior field and consequently the space-time inside this 3-cylinder is flat. (author)

Investigation of multipactor breakdown in communication satellite microwave co-axial systems

Science.gov (United States)

Nagesh, S. K.; Revannasiddiah, D.; Shastry, S. V. K.

2005-01-01

Multipactor breakdown or multipactor discharge is a form of high frequency discharge that may occur in microwave components operating at very low pressures. Some RF components of multi-channel communication satellites have co-axial geometry and handle high RF power under near-vacuum conditions. The breakdown occurs due to secondary electron resonance, wherein electrons move back and forth in synchronism with the RF voltage across the gap between the inner and outer conductors of the co-axial structure. If the yield of secondary electrons from the walls of the co-axial structure is greater than unity, then the electron density increases with time and eventually leads to the breakdown. In this paper, the current due to the oscillating electrons in the co-axial geometry has been treated as a radially oriented Hertzian dipole. The electric field, due to this dipole, at any point in the coaxial structure, may then be determined by employing the dyadic Green's function technique. This field has been compared with the field that would exist in the absence of multipactor.

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

Energy Technology Data Exchange (ETDEWEB)

Jevtic, V. [Inst. of Radiology, Univ. Medical Centre, Ljubljana (Slovenia); Watt, I. [Dept. of Clinical Radiology, Bristol Royal Infirmary (United Kingdom); Rozman, B. [Dept. of Rheumatology, Univ. Medical Centre, Ljubljana (Slovenia); Kos-Golja, M. [Dept. of Rheumatology, Univ. Medical Centre, Ljubljana (Slovenia); Demsar, F. [Inst. Jozef Stefan, Ljubljana (Slovenia); Jarh, O. [Inst. Jozef Stefan, Ljubljana (Slovenia)

1995-07-01

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.)

Patient-reported outcomes in European spondyloarthritis patients: a systematic review of the literature

Directory of Open Access Journals (Sweden)

Torre-Alonso JC

2018-05-01

Full Text Available Juan Carlos Torre-Alonso,1 Rubén Queiro,2 Marta Comellas,3 Luís Lizán,3,4 Carles Blanch5 1Rheumatology Department, Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Monte Naranco, Oviedo, Spain; 2Rheumatology Division, Hospital Universitario Central de Asturias (HUCA, Oviedo, Spain; 3Outcomes 10, Castellón de la Plana, Spain; 4Medicine Department, Jaime I University, Castellón de la Plana, Spain; 5Health Economics & Market Access, Novartis Pharmaceuticals, Barcelona, Spain Objective: This review aims to summarize the current literature on patient-reported outcomes (PROs in spondyloarthritis (SpA. Patients and methods: We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence in SpA patients published in the European Union through December 2016. International databases (Medline/PubMed, Cochrane Library, ISI Web of Knowledge, Scopus were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria. Results: A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients’ HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that

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

Relationship of HS CRP and Sacroiliac Joint Inflammation in Undifferentiated Spondyloarthritis.

Science.gov (United States)

Liu, Te-Jung; Chang, Cheng-Chiang; Chen, Liang-Cheng; Chu, Heng-Yi; Hsu, Chun-Sheng; Chang, Shin-Tsu

2018-01-01

Elevation of serum high sensitivity C-reactive protein (hs-CRP) level has been demonstrated as a risk factor for varying diseases, as well as a biomarker for predicting recovery after operation of lumber disc herniation. Our objective was to investigate the relationship between serum hs-CRP and sacroiliac (SI) joint inflammation in patients with undifferentiated spondyloarthritis (uSpA). In this retrospective study, we enrolled patients with uSpA who underwent hs-CRP testing between January 2007 and September 2013. Serum hs-CRP was analyzed at our central laboratory. All enrolled patients underwent skeletal scintigraphic scan with quantitative sacroiliac measurement. A total of 29 patients were enrolled with mean age 32.27 years and female:male ratio of 6:23. Pearson's correlation coefficient showed a significant difference between hs-CRP in serum and SI/S ratio in uSpA, particularly the middle part of the sacroiliac joint, either right side or left side. The significantly high concentration of serum hs-CRP might indicate a systemic inflammatory response to flare-up of the SI joint and might be an indicator of SI inflammation in uSpA.

Relationship of HS CRP and Sacroiliac Joint Inflammation in Undifferentiated Spondyloarthritis

Science.gov (United States)

Liu, Te-Jung; Chang, Cheng-Chiang; Chen, Liang-Cheng; Chu, Heng-Yi; Hsu, Chun-Sheng; Chang, Shin-Tsu

2018-01-01

Abstract Objective Elevation of serum high sensitivity C-reactive protein (hs-CRP) level has been demonstrated as a risk factor for varying diseases, as well as a biomarker for predicting recovery after operation of lumber disc herniation. Our objective was to investigate the relationship between serum hs-CRP and sacroiliac (SI) joint inflammation in patients with undifferentiated spondyloarthritis (uSpA). Methods In this retrospective study, we enrolled patients with uSpA who underwent hs-CRP testing between January 2007 and September 2013. Serum hs-CRP was analyzed at our central laboratory. All enrolled patients underwent skeletal scintigraphic scan with quantitative sacroiliac measurement. Results A total of 29 patients were enrolled with mean age 32.27 years and female:male ratio of 6:23. Pearson’s correlation coefficient showed a significant difference between hs-CRP in serum and SI/S ratio in uSpA, particularly the middle part of the sacroiliac joint, either right side or left side. The significantly high concentration of serum hs-CRP might indicate a systemic inflammatory response to flare-up of the SI joint and might be an indicator of SI inflammation in uSpA. PMID:29785410

Computerised Axial Tomography (CAT)

Science.gov (United States)

1990-06-01

Ministry of’ Defence, Defence Research Information Centre, UK. Computerised Axial Tomography ( CAT ) Report Secufty C"uMiauion tide Onadtiicadon (U. R, Cor S...DRIC T 8485 COMPUTERISED AXIAL TOMOGRAPHY ( CAT ) F.P. GENTILE, F. SABETTA, V. TRO1* ISS R 78/4.Rome, 1.5 Mlarch 1978 (from Italian) B Distribution(f...dello Radiazioni ISSN 0390--6477 F.P. GENTILE, F. SABETTA. V. TROI Computerised Axial Tomography ( CAT ) March 15, 1978). This paper is a review of

Increased levels of IgG antibodies against human HSP60 in patients with spondyloarthritis

DEFF Research Database (Denmark)

Hjelholt, Astrid; Carlsen, Thomas Gelsing; Deleuran, Bent Winding

2013-01-01

Introduction: Spondyloarthritis (SpA) comprises a heterogeneous group of inflammatory diseases, with strong association to human leukocyte antigen (HLA)-B27. SpA is suggested triggered by bacterial infection, and bacterial heat shock protein (HSP) seems to be a strong T cell antigen. Since...... against human HSP60, but not antibodies against bacterial HSP60, were elevated in the SpA group compared with the control group. Association between IgG3 antibodies against human HSP60 and BASMI was shown in HLA-B27+ patients. Only weak correlation between antibodies against bacterial and human HSP60...... was seen, and there was no indication of cross-reaction. Conclusion: These results suggest that antibodies against human HSP60 is associated with SpA, however, the theory that antibodies against human HSP60 is a specific part of the aetiology, through cross-reaction to bacterial HSP60, cannot be supported...

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.

Resolution of axial shear strain elastography

International Nuclear Information System (INIS)

Thitaikumar, Arun; Righetti, Raffaella; Krouskop, Thomas A; Ophir, Jonathan

2006-01-01

The technique of mapping the local axial component of the shear strain due to quasi-static axial compression is defined as axial shear strain elastography. In this paper, the spatial resolution of axial shear strain elastography is investigated through simulations, using an elastically stiff cylindrical lesion embedded in a homogeneously softer background. Resolution was defined as the smallest size of the inclusion for which the strain value at the inclusion/background interface was greater than the average of the axial shear strain values at the interface and inside the inclusion. The resolution was measured from the axial shear strain profile oriented at 45 0 to the axis of beam propagation, due to the absence of axial shear strain along the normal directions. The effects of the ultrasound system parameters such as bandwidth, beamwidth and transducer element pitch along with signal processing parameters such as correlation window length (W) and axial shift (ΔW) on the estimated resolution were investigated. The results show that the resolution (at 45 0 orientation) is determined by the bandwidth and the beamwidth. However, the upper bound on the resolution is limited by the larger of the beamwidth and the window length, which is scaled inversely to the bandwidth. The results also show that the resolution is proportional to the pitch and not significantly affected by the axial window shift

Signatures for axial chromodynamics

International Nuclear Information System (INIS)

Pati, J.C.

1978-07-01

Within the context of basic left-right symmetry and the hypothesis of unification of weak, electromagnetic and strong forces at a mass level approximately equal to 10 4 -10 6 GeV, relatively light ''mass'' axial gluons, confined or liberated, must be postulated. The authors remark that the existence of such ''light'' axial gluons supplementing the familiar vector octet preserves the successes of QCD, both for deep inelastic processes and charmonium physics. Through the characteristic spin-spin force, generated by their exchange, they may even help resolve some of the discrepancies between vector QCD predictions and charmonium physics. The main remark of this note is that if colour is liberated, not only vector but also axial-vector gluons are produced in high-energy e - e + experiments, e.g. at PETRA and PEP, with fairly large cross-section. Distinctive decay modes of such liberated axial gluons are noted

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.)

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

International Nuclear Information System (INIS)

Faeda Dalto, Vitor; Nogueira-Barbosa, Marcello Henrique; Assad, Rodrigo Luppino; Crema, Michel Daoud; Louzada-Junior, Paulo

2017-01-01

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.)

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.

A new strategy of axial power distribution control based on three axial offsets concept

International Nuclear Information System (INIS)

Shimazu, Yoichiro

2009-01-01

We have proposed a very simple control procedure for axial xenon oscillation control based on a characteristic trajectory. The trajectory is drawn by three offsets of power distributions, namely, AOp, AOi and AOx. They are defined as the offset of axial power distribution, the offset of the power distribution under which the current iodine distribution is obtained as the equilibrium and that for xenon distribution, respectively. When these offsets are plotted on X-Y plane for (AOp-AOx, AOi-AOx) the trajectory draws a quite characteristic ellipse (or an elliptic spiral). On the other hands, Constant Axial Offset Control (CAOC) procedure is adopted as axial power distribution control strategy during both base load and load following operations in domestic PWRs. In the previous paper, we have presented an innovative procedure of axial power distribution control during load following in PWRs based on this trajectory such that the AOp-AOx is to be controlled to zero when the value deviates the pre-determined limiting values. In this paper we propose a modified control strategy to get more stability of axial power distributions. In this strategy, we control the trajectory to be close to the major axis of the ellipse when the power distribution reaches the limiting values. In other words, the plot is not controlled only to reduce AOp-AOx but also AOi-AOx is taken into account at the same time. It is known that when the plot is controlled to the major axis, it means that the point gives the peak position of axial xenon oscillation. Therefore xenon oscillation will not increase its amplitude any more. Thus more stable axial power distribution control is attained. This kind of design concept is quite important especially for the future PWRs with elongated fuel length and longer core life. Because in a longer effective core and also the longer core life, it has been known that the stability of axial xenon oscillation becomes more unstable. In this paper, some simulation

Modernity: A new axial (era culture?

Directory of Open Access Journals (Sweden)

Wolfgang Schluchter

2017-10-01

Full Text Available The proposition of an axial age, lasting roughly from 800 to 200 B.C. and occurring in major civilizations (China, India, Near East independent of each other, first introduced by Alfred Weber and Karl Jaspers, then further developed by Robert Bellah and S. N. Eisenstadt among others, implied from the outset the question whether there has been a second axial age, leading to modernity, and if so, whether this second axial age consists in a secularization of the achievements of the first axial age. In this article it is argued that the notion of a second axial age is meaningful, but that the emergence of modernity can›t be accounted for in terms of secularization of the achievements of the first axial age. Rather, a new axial principle was institutionalized which separates the modern from the premodern world. This new principle is spelled out with reference to Hans Blumenberg, Charles Taylor and especially Max Weber. The emphasis is on the dialectics of disenchantment and the place of religion in a secular age

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

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.

Stall inception and warning in a single-stage transonic axial compressor with axial skewed slot casing treatment

International Nuclear Information System (INIS)

Lim, Byeung Jun; Kwon, Se Jin; Park, Tae Choon

2014-01-01

Characteristic changes in the stall inception in a single-stage transonic axial compressor with an axial skewed slot casing treatment were investigated experimentally. A rotating stall occurred intermittently in a compressor with an axial skewed slot, whereas spike-type rotating stalls occurred in the case of smooth casing. The axial skewed slot suppressed stall cell growth and increased the operating range. A mild surge, the frequency of which is the Helmholtz frequency of the compressor system, occurred with the rotating stall. The irregularity in the pressure signals at the slot bottom increased decreasing flow rate. An autocorrelation-based stall warning method was applied to the measured pressure signals. Results estimate and warn against the stall margin in a compressor with an axial skewed slot.

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

Magnetic resonance imaging of the sacroiliac joints in patients with suspected spondyloarthritis. Comparison of turbo spin-echo and gradient-echo sequences for the detection of structural alterations; MRT-Bildgebung der Sakroiliakalgelenke bei Verdacht auf Spondyloarthritis. Vergleich von Turbospinecho- und Gradientenechosequenzen zum Nachweis struktureller Veraenderungen

Energy Technology Data Exchange (ETDEWEB)

Dornia, C.; Hoffstetter, P. [Universitaetsklinikum Regensburg (Germany). Inst. fuer Roentgendiagnostik; Asklepios Klinikum, Bad Abbach (Germany). Inst. fuer Roentgendiagnostik; Fleck, M. [Universitaetsklinikum Regensburg (Germany). Klinik fuer Innere Medizin I; Asklepios Klinikum, Bad Abbach (Germany). Klinik fuer Rheumatologie und Klinische Immunologie; Hartung, W. [Asklepios Klinikum, Bad Abbach (Germany). Klinik fuer Rheumatologie und Klinische Immunologie; Niessen, C.; Stroszczynski, C. [Universitaetsklinikum Regensburg (Germany). Inst. fuer Roentgendiagnostik

2015-02-15

Magnetic resonance imaging (MRI) is the method of choice for the evaluation of spondyloarthritis (SpA). According to the guidelines of the Assessment of Spondyloarthritis International Society (ASAS) and Outcome Measures in Rheumatology (OMERACT), MRI findings in SpA of the spine and the sacroiliac joints (SIJ) are classified as inflammatory and structural alterations. Modern gradient-echo sequences (GRE) are recommended for optimized detection of structural alterations of the SIJ. We assess the benefit of GRE in the detection of structural alterations of the SIJ in comparison to conventional turbo spin-echo sequences (TSE). Retrospective study of 114 patients who received MRI of the SIJ for the evaluation of SpA. Structural alterations of the SIJ were assessed by two blinded readers separately for T1 TSE and T2{sup *} GRE. The findings were classified according to a previously published chronicity score separately for both sides and sequences. Interobserver reliability was calculated with Cohen's Kappa, and the significance of findings was assessed with the Wilcoxon test. P-values < 0.05 were required for statistical significance. 68 of 114 (60%) patients showed SpA-typical findings of the SIJ. The average chronicity score for GRE (score 3.3) was significantly higher than for TSE (score 2.6), p=0.001. The Kappa-values for the interobserver reliability were 0.86-0.90 without any statistically significant differences between both sides and sequences. Both T1 TSE and T2{sup *} GRE showed a high interobserver reliability in the detection of structural alterations in patients with SpA. However, T2{sup *} GRE detected significantly more structural alterations than T1 TSE and should be an integral part of a modern MRI protocol for the diagnostic workup of patients with suspected SpA.

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

. There is a need for biomarkers reflecting core disease pathways for diagnosis and disease mapping. Pro-C2 reflects mature cartilage collagen type IIB formation, while C-Col10 represents turnover of type X collagen, which is exclusively expressed by hypertrophic chondrocytes. The objectives of this study were......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....

Stability management of high speed axial flow compressor stage through axial extensions of bend skewed casing treatment

Directory of Open Access Journals (Sweden)

DilipkumarBhanudasji Alone

2016-09-01

Full Text Available This paper presents the experimental results to understand the performance of moderately loaded high speed single stage transonic axial flow compressor subjected to various configurations of axial extensions of bend skewed casing treatment with moderate porosity. The bend skewed casing treatment of 33% porosity was coupled with rectangular plenum chamber of depth equal to the slots depth. The five axial extensions of 20%, 40%, 60%, 80% and 100% were used for the experimental evaluations of compressor performance. The main objective was to identify the optimum extension of the casing treatment with reference to rotor leading edge which results in maximum stall margin improvements with minimum loss in the stage efficiency. At each axial extension the compressor performance is distinctive. The improvement in the stall margin was very significant at some axial extensions with 4%–5% penalty in the stage efficiency. The compressors stage shows recovery in terms of efficiency at lower axial extensions of 20% and 40% with increase in the peak stage efficiency. Measurements of flow parameters showed the typical behaviors at near stall flow conditions. Hot wire sensor was placed at the rotor upstream in the tip region to capture the oscillations in the inlet axial and tangential velocities at stall conditions. In the absence of casing treatment the compressor exhibit abrupt stall with very high oscillations in the inlet axial and tangential velocity of the flow. The extents of oscillations reduce with bend skewed casing treatment. Few measurements were also performed in the plenum chamber and salient results are presented in this paper.

On renormalization of axial anomaly

International Nuclear Information System (INIS)

Efremov, A.V.; Teryaev, O.V.

1989-01-01

It is shown that multiplicative renormalization of the axial singlet current results in renormalization of the axial anomaly in all orders of perturbation theory. It is a necessary condition for the Adler - Bardeen theorem being valid. 10 refs.; 2 figs

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.

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.

Origin of axial current in scyllac

International Nuclear Information System (INIS)

Sugisaki, K.

1975-12-01

The origin of the axial current observed in Scyllac (a high beta stellarator experiment) is discussed. A shaped coil and/or helical winding produce rotational transform which links magnetic lines of force to the plasma column and the axial current is induced electromagnetically. This phenomenon is inherent in a pulsed high-beta stellarator. The rotational transform produced by the induced axial current is much smaller than that associated with the l = 1, 0 equilibrium fields. The effect of the axial current on the equilibrium and stability of the plasma column is thus small. It is also shown that the magnetic field shear near a plasma surface is very strong

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.)

Frequency and Anatomic Distribution of Magnetic Resonance Imaging Features in the Sacroiliac Joints of Young Athletes: Exploring "Background Noise" Toward 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

2018-05-01

Low-grade bone marrow edema (BME) has been reported in the sacroiliac (SI) joints of 25% of healthy individuals and patients with nonspecific mechanical back pain, thus challenging the specificity and predictive value of magnetic resonance imaging (MRI) for the discrimination of early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may trigger BME. This study sought to explore the frequency and anatomic distribution of SI joint MRI lesions in recreational and elite athletes. After pretest calibration, semicoronal MRI scans of the SI joints of 20 recreational runners before and after running and 22 elite ice hockey players were assessed for BME and structural lesions. Three readers assessed the MRI scans in a blinded manner, using an SI joint quadrant-based module; scans from tumor necrosis factor inhibitor-treated patients with SpA served for masking. The readers recorded subjects who met the Assessment of SpondyloArthritis international Society (ASAS) definition of active sacroiliitis. For descriptive analysis, the frequency of SI joint quadrants exhibiting BME and structural lesions, as concordantly recorded by ≥2 of 3 readers, and their distribution in 8 anatomic SI joint regions (the upper and lower ilium and sacrum, subdivided in anterior and posterior slices) were determined. The proportions of recreational runners and elite ice hockey players fulfilling the ASAS definition of active sacroiliitis, as recorded concordantly by ≥2 of 3 readers, were 30-35% and 41%, respectively. In recreational runners before and after running, the mean ± SD number of SI joint quadrants showing BME was 3.1 ± 4.2 and 3.1 ± 4.5, respectively, while in elite ice hockey players, it was 3.6 ± 3.0. The posterior lower ilium was the single most affected SI joint region, followed by the anterior upper sacrum. Erosion was virtually absent. In recreational and elite athletes, MRI revealed BME in an average of 3-4 SI joint quadrants, meeting the

Magnetic resonance imaging of the sacroiliac joints in patients with suspected spondyloarthritis. Comparison of turbo spin-echo and gradient-echo sequences for the detection of structural alterations

International Nuclear Information System (INIS)

Dornia, C.; Hoffstetter, P.; Asklepios Klinikum, Bad Abbach; Fleck, M.; Asklepios Klinikum, Bad Abbach; Hartung, W.; Niessen, C.; Stroszczynski, C.

2015-01-01

Magnetic resonance imaging (MRI) is the method of choice for the evaluation of spondyloarthritis (SpA). According to the guidelines of the Assessment of Spondyloarthritis International Society (ASAS) and Outcome Measures in Rheumatology (OMERACT), MRI findings in SpA of the spine and the sacroiliac joints (SIJ) are classified as inflammatory and structural alterations. Modern gradient-echo sequences (GRE) are recommended for optimized detection of structural alterations of the SIJ. We assess the benefit of GRE in the detection of structural alterations of the SIJ in comparison to conventional turbo spin-echo sequences (TSE). Retrospective study of 114 patients who received MRI of the SIJ for the evaluation of SpA. Structural alterations of the SIJ were assessed by two blinded readers separately for T1 TSE and T2 * GRE. The findings were classified according to a previously published chronicity score separately for both sides and sequences. Interobserver reliability was calculated with Cohen's Kappa, and the significance of findings was assessed with the Wilcoxon test. P-values * GRE showed a high interobserver reliability in the detection of structural alterations in patients with SpA. However, T2 * GRE detected significantly more structural alterations than T1 TSE and should be an integral part of a modern MRI protocol for the diagnostic workup of patients with suspected SpA.

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

Axial gap rotating electrical machine

Science.gov (United States)

None

2016-02-23

Direct drive rotating electrical machines with axial air gaps are disclosed. In these machines, a rotor ring and stator ring define an axial air gap between them. Sets of gap-maintaining rolling supports bear between the rotor ring and the stator ring at their peripheries to maintain the axial air gap. Also disclosed are wind turbines using these generators, and structures and methods for mounting direct drive rotating electrical generators to the hubs of wind turbines. In particular, the rotor ring of the generator may be carried directly by the hub of a wind turbine to rotate relative to a shaft without being mounted directly to the shaft.

Study of axial magnetic effect

Energy Technology Data Exchange (ETDEWEB)

Braguta, Victor [IHEP, Protvino, Moscow region, 142284 Russia ITEP, B. Cheremushkinskaya street 25, Moscow, 117218 (Russian Federation); School of Biomedicine, Far Eastern Federal University, Ajax 10 Building 25, Russian island, Vladivostok, 690922 (Russian Federation); Chernodub, M. N. [CNRS, Laboratoire de Mathématiques et Physique Théorique, Université François-Rabelais Tours, Fédération Denis Poisson, Parc de Grandmont, 37200 Tours, France Department of Physics and Astronomy, University of Gent, Krijgslaan 281, S9, B-9000 Gent (Belgium); School of Biomedicine, Far Eastern Federal University, Ajax 10 Building 25, Russian island, Vladivostok, 690922 (Russian Federation); Goy, V. A. [School of Natural Sciences, Far Eastern Federal University, Sukhanova street 8, Vladivostok, 690950 (Russian Federation); Landsteiner, K. [Instituto de Física Teórica UAM/CSIC, C/ Nicolás Cabrera 13-15, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid (Spain); Molochkov, A. V. [School of Biomedicine, Far Eastern Federal University, Ajax 10 Building 25, Russian island, Vladivostok, 690922 (Russian Federation); Ulybyshev, M. [ITEP, B. Cheremushkinskaya street 25, Moscow, 117218 Russia Institute for Theoretical Problems of Microphysics, Moscow State University, Moscow, 119899 (Russian Federation)

2016-01-22

The Axial Magnetic Effect manifests itself as an equilibrium energy flow of massless fermions induced by the axial (chiral) magnetic field. Here we study the Axial Magnetic Effect in the quenched SU(2) lattice gauge theory with massless overlap fermions at finite temperature. We numerically observe that in the low-temperature hadron phase the effect is absent due to the quark confinement. In the high-temperature deconfinement phase the energy flow is an increasing function of the temperature which reaches the predicted asymptotic T{sup 2} behavior at high temperatures. We find, however, that energy flow is about one order of magnitude lower compared to a theoretical prediction.

Giant Cell Tumors of the Axial Skeleton

Directory of Open Access Journals (Sweden)

Maurice Balke

2012-01-01

Full Text Available Background. We report on 19 cases of giant cell tumor of bone (GCT affecting the spine or sacrum and evaluate the outcome of different treatment modalities. Methods. Nineteen patients with GCT of the spine (=6 or sacrum (=13 have been included in this study. The mean followup was 51.6 months. Ten sacral GCT were treated by intralesional procedures of which 4 also received embolization, and 3 with irradiation only. All spinal GCT were surgically treated. Results. Two (15.4% patients with sacral and 4 (66.7% with spinal tumors had a local recurrence, two of the letter developed pulmonary metastases. One local recurrence of the spine was successfully treated by serial arterial embolization, a procedure previously described only for sacral tumors. At last followup, 9 patients had no evidence of disease, 8 had stable disease, 1 had progressive disease, 1 died due to disease. Six patients had neurological deficits. Conclusions. GCT of the axial skeleton have a high local recurrence rate. Neurological deficits are common. En-bloc spondylectomy combined with embolization is the treatment of choice. In case of inoperability, serial arterial embolization seems to be an alternative not only for sacral but also for spinal tumors.

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.

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.)

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)

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.

EULAR RECOMMENDATIONS FOR THE USE OF IMAGING IN SPONDYLOARTHRITIS IN CLINICAL PRACTICE

DEFF Research Database (Denmark)

Mandl, P; Navarro-Compán, V; Terslev, L

2014-01-01

, tenosynovitis, bursitis and particularly peripheral enthesitis, which may support the diagnosis of SpA. MRI of the SIJ and/or spine may be used to assess and monitor disease activity, while CR of the SIJ and/or spine may be used for long-term monitoring of structural damage, particularly new bone formation...... of the included studies was performed using the QUADAS-2 tool. Results: A total of 7550 references were identified in the search process, from which 157 studies were included in the systematic review. Ten recommendations were produced encompassing the role of imaging in making a diagnosis of axial Sp...... in axial SpA. In patients with AS (not nonradiographic axial SpA), initial CRs of the lumbar and cervical spine are recommended to detect syndesmophytes, which are predictive of development of new syndesmophytes. MRI (vertebral corner inflammatory lesion) may also be used to predict development of new...

Temporal and Spatial Variability in the Geochemistry of Axial and CoAxial Segment Lavas and their Mantle Sources

Science.gov (United States)

Smith, M. C.; Perfit, M. R.; Davis, C.; Kamenov, G. D.

2011-12-01

Three spatially related volcanic eruptions along the CoAxial Segment of the Juan de Fuca Ridge (JdFR) have documented emplacements between 1981 and 1993. Two of the historic flows outcrop at the "Flow Site" and were emplaced within less than 12 years and 500 m from one another. The third was emplaced at the "Floc Site" to the south in the 1980s. Previous studies have documented that CoAxial lavas are among the most incompatible element and isotopically depleted lavas along the entire JdFR, whereas the Axial Seamount segment immediately south of CoAxial has erupted the most chemically enriched lavas south of the Endeavor Segment. Geochemical studies have shown little temporal change in the chemistry of recent Axial Seamount eruptives, whereas CoAxial lavas exhibit distinct chemical differences over short time periods. Significant chemical differences observed among depleted CoAxial lavas emplaced close to one another in space and time are in marked contrast to the relatively constant chemical characteristics of enriched lavas erupted at the magmatically more robust Axial segment only 10's of kilometers to the south and west. New trace element and isotopic (Sr, Nd, Pb) geochemical analyses of historic and older CoAxial lavas have resulted in better documentation of interflow and intraflow chemical variation providing an improved understanding of spatial/temporal chemical variability in lavas, and further insight into JdFR magmatic processes. Modeling of major and trace element abundances suggest that the observed intraflow chemical variation within CoAxial lavas is largely due to shallow-level fractional crystallization but that a single fractional crystallization model cannot account for all interflow chemical variation. In fact, elemental and isotopic data require different parental magmas for each of the three recent CoAxial Segment lava flows suggesting very short-term differences or changes in the chemical character of the mantle source region. In particular

EBQ code: Transport of space-charge beams in axially symmetric devices

Science.gov (United States)

Paul, A. C.

1982-11-01

Such general-purpose space charge codes as EGUN, BATES, WODF, 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.

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

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease.

Science.gov (United States)

Rizzello, Fernando; Olivieri, Ignazio; Armuzzi, Alessandro; Ayala, Fabio; Bettoli, Vincenzo; Bianchi, Luca; Cimino, Luca; Costanzo, Antonio; Cristaudo, Antonio; D'Angelo, Salvatore; Daperno, Marco; Fostini, Anna Chiara; Galeazzi, Mauro; Gilio, Michele; Gionchetti, Paolo; Gisondi, Paolo; Lubrano, Ennio; Marchesoni, Antonio; Offidani, Annamaria; Orlando, Ambrogio; Pugliese, Daniela; Salvarani, Carlo; Scarpa, Raffaele; Vecchi, Maurizio; Girolomoni, Giampiero

2018-04-01

Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis and uveitis. A Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements. Consensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important. The present Delphi consensus identified a set of

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.)

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.

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.)

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.

Inverse axial mounting stiffness design for lithographic projection lenses.

Science.gov (United States)

Wen-quan, Yuan; Hong-bo, Shang; Wei, Zhang

2014-09-01

In order to balance axial mounting stiffness of lithographic projection lenses and the image quality under dynamic working conditions, an easy inverse axial mounting stiffness design method is developed in this article. Imaging quality deterioration at the wafer under different axial vibration levels is analyzed. The desired image quality can be determined according to practical requirements, and axial vibrational tolerance of each lens is solved with the damped least-squares method. Based on adaptive interval adjustment, a binary search algorithm, and the finite element method, the axial mounting stiffness of each lens can be traveled in a large interval, and converges to a moderate numerical solution which makes the axial vibrational amplitude of the lens converge to its axial vibrational tolerance. Model simulation is carried out to validate the effectiveness of the method.

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

the PDQ and other phenotypical patient characteristics are prognostically important for response to biological therapy according to established response criteria like 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (50%) and Ankylosing Spondylitis Disease Activity Score. ETHICS......-radiographic axSpA (nr-axSpA). Tumour necrosis factor-α inhibitors have revolutionised the treatment of patients with axSpA who failed to respond to non-steroidal anti-inflammatory drugs and physical therapy. Chronic pain is common in patients with SpA and may still persist despite the lack of signs...... 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...

EXPERIENCE OF ADALIMUMAB ADMINISTRATION TO A PATIENT WITH JUVENILE ANKYLOSING SPONDYLOARTHRITIS AND CHRONIC VIRUS HEPATITIS B

Directory of Open Access Journals (Sweden)

E. A. Legostaeva

2014-01-01

Full Text Available The article presents a clinical case of high effectiveness of adalimumab — human monoclonal antibodies to tumor necrosis factor — in a patient with juvenile ankylosing spondyloarthritis refractory to therapy with classic immunosuppressive drugs and secondary to virus hepatitis B in the integrative phase. Joint pains and intensity of exudative alterations in interphalangeal and wrist joints attenuated as early as after as the first adalimumab injection; the authors achieved a 50% improvement in indices BASDAI (2.4 and ASDAI (1.1. Acute inflammatory alterations terminated, motion range of the affected joints completely recovered, general laboratory parameters of disease activity (erythrocyte sedimentation rate, C-reactive protein and white blood cell count normalized and inactive disease stage was registered after 6 months. Adverse events or virus hepatitis B exacerbations in the setting of adalimumab therapy were not observed. No osteochondral destruction progression was observed at computed and magnetic resonance imaging of joints 6 months after the therapy beginning. Emotional condition and quality of life of the child and his family improved considerably. 

Energy Dissipation in Sandwich Structures During Axial Compression

DEFF Research Database (Denmark)

Urban, Jesper

2002-01-01

The purpose of this paper is to investigate the energy dissipation in sandwich structures during axial crushing. Axial crushing tests on six sandwich elements are described. The sandwich elements consist of a polyurethane core and E-glass/Polyester skin. The elements compare to full-scale structu......The purpose of this paper is to investigate the energy dissipation in sandwich structures during axial crushing. Axial crushing tests on six sandwich elements are described. The sandwich elements consist of a polyurethane core and E-glass/Polyester skin. The elements compare to full...

Improved axial position detection in optical tweezers measurements

DEFF Research Database (Denmark)

Dreyer, Jakob Kisbye; Berg-Sørensen, Kirstine; Oddershede, Lene

2004-01-01

We investigate the axial position detection of a trapped microsphere in an optical trap by using a quadrant photodiode. By replacing the photodiode with a CCD camera, we obtain detailed information on the light scattered by the microsphere. The correlation of the interference pattern with the axial...... position displays complex behavior with regions of positive and negative interference. By analyzing the scattered light intensity as a function of the axial position of the trapped sphere, we propose a simple method to increase the sensitivity and control the linear range of axial position detection....

Comparison of femoropopliteal artery stents under axial and radial compression, axial tension, bending, and torsion deformations.

Science.gov (United States)

Maleckis, Kaspars; Deegan, Paul; Poulson, William; Sievers, Cole; Desyatova, Anastasia; MacTaggart, Jason; Kamenskiy, Alexey

2017-11-01

High failure rates of Peripheral Arterial Disease (PAD) stenting appear to be associated with the inability of certain stent designs to accommodate severe biomechanical environment of the femoropopliteal artery (FPA) that bends, twists, and axially compresses during limb flexion. Twelve Nitinol stents (Absolute Pro, Supera, Lifestent, Innova, Zilver, Smart Control, Smart Flex, EverFlex, Viabahn, Tigris, Misago, and Complete SE) were quasi-statically tested under bench-top axial and radial compression, axial tension, bending, and torsional deformations. Stents were compared in terms of force-strain behavior, stiffness, and geometrical shape under each deformation mode. Tigris was the least stiff stent under axial compression (6.6N/m axial stiffness) and bending (0.1N/m) deformations, while Smart Control was the stiffest (575.3N/m and 105.4N/m, respectively). Under radial compression Complete SE was the stiffest (892.8N/m), while Smart Control had the lowest radial stiffness (211.0N/m). Viabahn and Supera had the lowest and highest torsional stiffness (2.2μNm/° and 959.2μNm/°), respectively. None of the 12 PAD stents demonstrated superior characteristics under all deformation modes and many experienced global buckling and diameter pinching. Though it is yet to be determined which of these deformation modes might have greater clinical impact, results of the current analysis may help guide development of new stents with improved mechanical characteristics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Safety of Resuming Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis Patients Concomitant with the Treatment of Active Tuberculosis: A Retrospective Nationwide Registry of the Korean Society of Spondyloarthritis Research

Science.gov (United States)

Kim, Hye Won; Kwon, Seong Ryul; Jung, Kyong-Hee; Kim, Seong-Kyu; Baek, Han Joo; Seo, Mi Ryung; Bang, So-Young; Lee, Hye-Soon; Suh, Chang-Hee; Jung, Ju Yang; Son, Chang-Nam; Shim, Seung Cheol; Lee, Sang-Hoon; Lee, Seung-Geun; Lee, Yeon-Ah; Lee, Eun Young; Kim, Tae-Hwan

2016-01-01

Backgrounds Patients who develop an active tuberculosis infection during tumor necrosis factor (TNF) inhibitor treatment typically discontinue TNF inhibitor and receive standard anti-tuberculosis treatment. However, there is currently insufficient information on patient outcomes following resumption of TNF inhibitor treatment during ongoing anti- tuberculosis treatment. Our study was designed to investigate the safety of resuming TNF inhibitors in ankylosing spondylitis (AS) patients who developed tuberculosis as a complication of the use of TNF inhibitors. Methods Through the nationwide registry of the Korean Society of Spondyloarthritis Research, 3929 AS patients who were prescribed TNF inhibitors were recruited between June 2003 and June 2014 at fourteen referral hospitals. Clinical information was analyzed about the patients who experienced tuberculosis after exposure to TNF inhibitors. The clinical features of resumers and non-resumers of TNF inhibitors were compared and the outcomes of tuberculosis were surveyed individually. Findings Fifty-six AS patients were treated for tuberculosis associated with TNF inhibitors. Among them, 23 patients resumed TNF inhibitors, and these patients were found to be exposed to TNF inhibitors for a longer period of time and experienced more frequent disease flare-up after discontinuation of TNF inhibitors compared with those who did not resume. Fifteen patients resumed TNF inhibitors during anti-tuberculosis treatment (early resumers) and 8 after completion of anti-tuberculosis treatment (late resumers). Median time to resuming TNF inhibitor from tuberculosis was 3.3 and 9.0 months in the early and late resumers, respectively. Tuberculosis was treated successfully in all resumers and did not relapse in any of them during follow-up (median 33.8 [IQR; 20.8–66.7] months). Conclusions Instances of tuberculosis were treated successfully in our AS patients, even when given concomitantly with TNF inhibitors. We suggest that early

Axial anomaly at finite temperature and finite density

International Nuclear Information System (INIS)

Qian Zhixin; Su Rukeng; Yu, P.K.N.

1994-01-01

The U(1) axial anomaly in a hot fermion medium is investigated by using the real time Green's function method. After calculating the lowest order triangle diagrams, we find that finite temperature as well as finite fermion density does not affect the axial anomaly. The higher order corrections for the axial anomaly are discussed. (orig.)

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

CAMDYN: a new model to describe the axial motion of molten fuel inside the pin of a fast breeder reactor during accident conditions

International Nuclear Information System (INIS)

Peter, G.

1991-01-01

The new in-pin fuel motion model CAMDYN (Cavity Material Dynamics) describes the axial motion of both partially and fully molten fuel inside the pin of a fast breeder reactor during accident conditions. The motion of the two types of molten fuel and the imbedded fission gas bubbles is treated both before and after cladding failure. The basic modelling approach consists of the treatment of two one-dimensional flows which are coupled by interaction terms. Each of these flows is treated compressively and with axially variable flow cross sections. The mass and energy equations of both fields are solved explicitly using upwind differencing on a fixed Eulerian grid. The two momentum equations are solved simultaneously, using the convective momentum fluxes of the previous timestep. Both partially and fully molten fuel can move axially into a central hole extending to the plenum in the case of certain hollow pellet designs. The fuel temperature calculation includes the determination of a radial temperature profile. A simple conduction freezing model is included. After cladding failure, ejection into the coolant channel is modeled

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.

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

2015-12-01

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 response to TENS in older adults compared with younger adults is untested. In a dose-response study stratified by age, 60 participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high-frequency high-intensity TENS over a 2- to 3-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold) and central pain excitability (phasic heat temporal summation and heat aftersensations) 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 reports across sessions. Independent of age, individuals experienced episodic increase in the pressure pain detection threshold and reduction in aftersensation after 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 4 sessions. However, older adults received higher TENS amplitude across all sessions to achieve TENS responses similar to those in younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief to that of younger individuals after high-frequency, high-intensity TENS when higher dose parameters are used. This study examined age group differences in experimental and axial CLBP response to TENS, delivered under the current recommended parameters of strong, but tolerable amplitude. Older adults had comparable TENS response although at higher TENS

Diagnostic value of axial CT scan

International Nuclear Information System (INIS)

Kiuchi, Sousuke

1983-01-01

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. (author)

Improving the lattice axial vector current

International Nuclear Information System (INIS)

Horsley, R.; Perlt, H.; Schiller, A.; Zanotti, J.M.

2015-11-01

For Wilson and clover fermions traditional formulations of the axial vector current do not respect the continuum Ward identity which relates the divergence of that current to the pseudoscalar density. Here we propose to use a point-split or one-link axial vector current whose divergence exactly satisfies a lattice Ward identity, involving the pseudoscalar density and a number of irrelevant operators. We check in one-loop lattice perturbation theory with SLiNC fermion and gauge plaquette action that this is indeed the case including order O(a) effects. Including these operators the axial Ward identity remains renormalisation invariant. First preliminary results of a nonperturbative check of the Ward identity are also presented.

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

Δ(1232) Axial Charge and Form Factors from Lattice QCD

International Nuclear Information System (INIS)

Alexandrou, Constantia; Gregory, Eric B.; Korzec, Tomasz; Koutsou, Giannis; Negele, John W.; Sato, Toru; Tsapalis, Antonios

2011-01-01

We present the first calculation on the Δ axial vector and pseudoscalar form factors using lattice QCD. Two Goldberger-Treiman relations are derived and examined. A combined chiral fit is performed to the nucleon axial charge, N to Δ axial transition coupling constant and Δ axial charge.

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...... force transducers over in-vivo strain gauges of various sizes to electrical impedance based measurements. The amplitude and duration of the axial force has been shown to be as reliable as manometry. Normal, as well as abnormal, manometric recordings occur with normal bolus transit, which have been...... 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...

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)

Stochastic quantization for the axial model

International Nuclear Information System (INIS)

Farina, C.; Montani, H.; Albuquerque, L.C.

1991-01-01

We use bosonization ideas to solve the axial model in the stochastic quantization framework. We obtain the fermion propagator of the theory decoupling directly the Langevin equation, instead of the Fokker-Planck equation. In the Appendix we calculate explicitly the anomalous divergence of the axial-vector current by using a regularization that does not break the Markovian character of the stochastic process

Nonperturbative Aspects of Axial Vector Vertex

Institute of Scientific and Technical Information of China (English)

ZONG Hong-Shi; CHEN Xiang-Song; WANG Fan; CHANG Chao-Hsi; ZHAO En-Guang

2002-01-01

It is shown how the axial vector current of current quarks is related to that of constituent quarks within the framework of the global color symmetry model.Gluon dressing of the axial vector vertex and the quark self-energy functions are described by the inhomogeneous Bethe-Salpeter equation in the ladder approximation and the Schwinger Dyson equation in the rainbow approximation,respectively.

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

Development of submersible axial pump for wastewater

Energy Technology Data Exchange (ETDEWEB)

Yun, Jeong Eui [Kangwon Nat' l Univ., Chuncheon (Korea, Republic of)

2013-02-15

This study was performed to develop a high efficiency submersible axial pump for concentration wastewater treatment. To do this, we simulated the effect of some parameters such as the axial twist angle of a blade({beta}), the radial twist angle of a blade({alpha}) and the length of a blade ({iota}) on pump efficiency using commercial code, ANSYS CFX and BladeGen. The results showed that the axial twist angle of a blade({beta}) was the most sensible parameter on the pump efficiency. And the pump efficiency had a maximum at {beta}=20.deg, {alpha}=110.deg and {iota}=240mm.

Axial displacements in external and internal implant-abutment connection.

Science.gov (United States)

Lee, Ji-Hye; Kim, Dae-Gon; Park, Chan-Jin; Cho, Lee-Ra

2014-02-01

The purpose of this study was to evaluate the axial displacement of the abutments during clinical procedures by the tightening torque and cyclic loading. Two different implant-abutment connection systems were used (external butt joint connection [EXT]; internal tapered conical connection [INT]). The master casts with two implant replicas, angulated 10° from each other, were fabricated for each implant connection system. Four types of impression copings were assembled and tightened with the corresponding implants (hex transfer impression coping, non-hex transfer impression coping, hex pick-up impression coping, non-hex pick-up impression coping). Resin splinted abutments and final prosthesis were assembled. The axial displacement was measured from the length of each assembly, which was evaluated repeatedly, after 30 Ncm torque tightening. After 250 N cyclic loading of final prosthesis for 1,000,000 cycles, additional axial displacement was recorded. The mean axial displacement was statistically analyzed (repeated measured ANOVA). There was more axial displacement in the INT group than that of the EXT group in impression copings, resin splinted abutments, and final prosthesis. Less axial displacement was found at 1-piece non-hex transfer type impression coping than other type of impression copings in the INT group. There was more axial displacement at the final prosthesis than resin splinted abutments in the INT and the EXT groups. After 250 N cyclic loading of final prosthesis, the INT group showed more axial displacement than that of the EXT group. Internal tapered conical connection demonstrated a varying amount of axial displacement with tightening torque and cyclic loading. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

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.

MRI grading method for active and chronic spinal changes in spondyloarthritis

International Nuclear Information System (INIS)

Madsen, K.B.; Jurik, A.G.

2010-01-01

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.

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.

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).

Dual-detection confocal fluorescence microscopy: fluorescence axial imaging without axial scanning.

Science.gov (United States)

Lee, Dong-Ryoung; Kim, Young-Duk; Gweon, Dae-Gab; Yoo, Hongki

2013-07-29

We propose a new method for high-speed, three-dimensional (3-D) fluorescence imaging, which we refer to as dual-detection confocal fluorescence microscopy (DDCFM). In contrast to conventional beam-scanning confocal fluorescence microscopy, where the focal spot must be scanned either optically or mechanically over a sample volume to reconstruct a 3-D image, DDCFM can obtain the depth of a fluorescent emitter without depth scanning. DDCFM comprises two photodetectors, each with a pinhole of different size, in the confocal detection system. Axial information on fluorescent emitters can be measured by the axial response curve through the ratio of intensity signals. DDCFM can rapidly acquire a 3-D fluorescent image from a single two-dimensional scan with less phototoxicity and photobleaching than confocal fluorescence microscopy because no mechanical depth scans are needed. We demonstrated the feasibility of the proposed method by phantom studies.

sizing of wind powered axial flux permanent magnet alternator using

African Journals Online (AJOL)

user

2016-10-04

Oct 4, 2016 ... Keywords: Wind-Power, Axial flux, Axial Flux Permanent Machines (AFPM), Axial Flux Permanent Magnet ... energy for power generation, a high constraint is the .... arrangements as Single-Rotor Single-Stator Structure.

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

are assessed at each vertebral endplate at all 23 spinal levels from C2/3 to L5/S1, whereas facet joint lesions are to be assessed by segmental level (cervical, thoracic, and lumbar). CONCLUSION: An anatomy-based set of definitions and an assessment system for structural lesions in the spine of patients......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...... 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...

Buoyant Helical Twin-Axial Wire Antenna

Science.gov (United States)

2016-11-15

February 2017 The below identified patent application is available for licensing. Requests for information should be addressed to...300169 1 of 9 BUOYANT HELICAL TWIN-AXIAL WIRE ANTENNA CROSS REFERENCE TO OTHER PATENT APPLICATIONS [0001] This application is a divisional...application and claims the benefit of the filing date of United States Patent Application No. 14/280,889; filed on May 19, 2014; and entitled “Twin-Axial

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.

Chiral filter, axial charges and Gamow-Teller strengths

International Nuclear Information System (INIS)

Rho, M.

1983-09-01

The different ways that nuclear matter responds to the weak axial-vector current are interpreted in terms of modification of the ''vacuum'' in baryon-rich environments. The notion of ''chiral filter'' is introduced. Use of a ward identity is suggested. The Gamow-Teller quenching and the enhanced axial charge in O + O - transitions follow from this. I also discuss briefly possible relevance of the nucleon as a topological soliton configuration to the global property of nuclear axial response functions

Fuel rod with axial regions of annular and standard fuel pellets

International Nuclear Information System (INIS)

Freeman, T.R.

1991-01-01

This patent describes a fuel rod for use in a nuclear reactor fuel assembly. It comprises: an elongated hollow cladding tube; a pair of end plugs connected to and sealing the cladding tube at opposite ends of thereof; and an axial stack of fuel pellets contained in and extending between the end plugs at the opposite ends of the tube, all of the fuel pellets contained in the tube being composed of fissile material being enriched above the level of natural enrichment; the fuel pellets in the stack thereof being provided in an arrangement of axial regions. The arrangement of axial regions including a pair of first axial regions defined respectively at the opposite ends of the pellet stack adjacent to the respective end plugs. The pellets in the first axial regions being identical in number and having annular configurations with an annulus of a first void size. The arrangement of axial regions also including another axial region defined between the first axial regions, some of the pellets in the another axial region having solid configurations

Chiral lattice fermions, minimal doubling, and the axial anomaly

International Nuclear Information System (INIS)

Tiburzi, B. C.

2010-01-01

Exact chiral symmetry at finite lattice spacing would preclude the axial anomaly. In order to describe a continuum quantum field theory of Dirac fermions, lattice actions with purported exact chiral symmetry must break the flavor-singlet axial symmetry. We demonstrate that this is indeed the case by using a minimally doubled fermion action. For simplicity, we consider the Abelian axial anomaly in two dimensions. At finite lattice spacing and with gauge interactions, the axial anomaly arises from nonconservation of the flavor-singlet current. Similar nonconservation also leads to the axial anomaly in the case of the naieve lattice action. For minimally doubled actions, however, fine-tuning of the action and axial current is necessary to arrive at the anomaly. Conservation of the flavor nonsinglet vector current additionally requires the current to be fine-tuned. Finally, we determine that the chiral projection of a minimally doubled fermion action can be used to arrive at a lattice theory with an undoubled Dirac fermion possessing the correct anomaly in the continuum limit.

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

OpenAIRE

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 perio...

Imaging in ankylosing spondylitis

DEFF Research Database (Denmark)

Østergaard, Mikkel; Lambert, Robert G W

2012-01-01

Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography...... in the spine and sacroiliac joints, but its clinical utility is limited due to its use of ionizing radiation and lack of ability to assess the soft tissues. It is exciting that with continued dedicated research and the rapid technical development it is likely that even larger improvements in the use of imaging...

Axial Myopia and its Influence on Diabetic Retinopathy

International Nuclear Information System (INIS)

Tayyab, H.; Haider, M. A.; Bukhari, S. A. H.

2014-01-01

Objective: To evaluate the correlation between axial myopia and diabetic retinopathy. Study Design: Cross-sectional study. Place and Duration of Study: Eye Department of Postgraduate Medical Institute, Lahore General Hospital, from August 2012 to February 2013. Methodology: A total of 258 participants suffering from type-2 diabetic retinopathy were included. Axial length was measured by two optometrists using contact type ultrasound biometer. Colored retinal photographs, red free retinal photographs and Fundus Fluorescein Angiography (FFA) were performed on all patients using standard fundus camera. All fundus photographs and angiograms were independently reviewed and graded by two qualified vitreoretinal fellows. Results: Out of 258 patients, 163 were males (63.2%) and 95 (36.8%) were females. Average age of patients was 56.30 +- 7.57 years. Average axial length of right and left eyes were 23.16 mm and 23.15 mm respectively. There was statistically significant negative correlation between axial length and severity of diabetic retinopathy in the right eye, (Spearman correlation = -0.511, p = 0.0001) as well as the left eye (Spearman correlation = -0.522, p = 0.0001). Conclusion: There is a protective influence of longer axial length of globe on the stage and severity of diabetic retinopathy. This study may help in modifying the screening protocol for diabetic retinopathy amongst patients of differing axial lengths. (author)

Transitions in axial morphology along the Southeast Indian Ridge

Science.gov (United States)

Ma, Ying; Cochran, James R.

1996-07-01

Shipboard bathymetric and magnetic profiles across the Southeast Indian Ridge (SEIR) were analyzed in order to examine the nature of along-axis variations in axial morphology at this intermediate spreading rate ridge. Three types of axial morphology are observed along the SEIR: an axial high, a shallow (200-700 m deep) axial valley and a deep (>1000 m deep) axial valley. An axial high is found to the east of the Australian-Antarctic Discordance (AAD) (east of 128°E) and between 82°E and 104°E. A shallow rift valley is found from 104°E to 114°E and from 82°E westward past the Amerstdam/St. Paul hotspot (ASP) to about 30°S, 75°E. Deep rift valleys are found from 114°E to 128°E in the vicinity of the AAD and from the Indian Ocean Triple Junction (IOTJ) at 25°S, 70°E to about 30°S, 75°E. The transition near 30°S occurs in an area of constant zero-age depth and does not appear to result from an increase in mantle temperature. It could be the result of the rapid increase in spreading rate along that portion of the SEIR. The most likely cause of the other transitions in axial morphology is variations in mantle temperature. The transitions between the different types of axial morphology are well defined and occur over a limited distance. Transitions in axial morphology are accompanied by significant changes in ridge flank topographic roughness. The transitions from axial valleys to axial highs are also accompanied by changes in the amplitude of the seafloor magnetic anomalies. Our observations suggest that there are distinct modes rather than a continuum of axial morphology on the SEIR and that there appears to be a "threshold" mechanism for a rapid change between different states of axial morphology. The ASP has only a limited influence on the SEIR. The ridge axis is marked by an axial valley for the entire distance from the IOTJ up to and past the ASP. The ridge axis becomes shallower as the ASP is approached from the northwest but only by about 300 m over

The Axially Symmetric One-Monopole

International Nuclear Information System (INIS)

Wong, K.-M.; Teh, Rosy

2009-01-01

We present new classical generalized one-monopole solution of the SU(2) Yang-Mills-Higgs theory with the Higgs field in the adjoint representation. We show that this solution with θ-winding number m = 1 and φ-winding number n = 1 is an axially symmetric generalization of the 't Hooft-Polyakov one-monopole. We construct this axially symmetric one-monopole solution by generalizing the large distance asymptotic solutions of the 't Hooft-Polyakov one-monopole to the Jacobi elliptic functions and solving the second order equations of motion numerically when the Higgs potential is vanishing. This solution is a non-BPS solution.

Behavior of metallic fuel in treat transient overpower tests

International Nuclear Information System (INIS)

Bauer, T.H.; Wright, A.E.; Robinson, W.R.; Klickman, A.E.

1988-01-01

Results and analyses are reported for TREAT in-pile transient overpower tests of margin to cladding failure and pre-failure axial expansion of metallic fuel. In all cases the power rise was exponential on an 8 s period until either incipient or actual cladding failure was achieved. Test fuel included EBR-II driver fuel and ternary alloy, the reference fuel of the Intergral Fast Reactor concept. Test pin burnup spanned the widest range available. The nature of the observed cladding failure and resultant fuel dispersals is described. Simple models are presented which describe observed cladding failures and pre-failure axial expansions yet are general enough to apply to all metal fuel types

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)

On the mechanism of zircaloy cladding axial splits

International Nuclear Information System (INIS)

Grigoriev, V.; Josefsson, B.

1998-01-01

The macroscopically brittle axial splitting is treated as a process entirely accomplished by a plastic mechanism operating on a microscopic scale and is discussed in terms of the degree of plasticity and localisation of plasticity. The suggested mechanism involves hydrogen assisted localised shear (HALS) as a main factor of material deterioration. The reason and the driving force for the HALS is an in-plane shear (as for mode II loading) existing at the tip of a crack loaded in mode I (Opening). The HALS mechanism does not require brittle fracture of the hydrides and is only operable under certain combination of material strength, applied stresses, and temperature, needed for the local yielding at the crack tip. If the combination of those parameters results in the bulk yielding, the in-plane shear component is diminished and the delayed cracking is suppressed. (orig.)

Magmatic controls on axial relief and faulting at mid-ocean ridges

Science.gov (United States)

Liu, Zhonglan; Buck, W. Roger

2018-06-01

Previous models do not simultaneously reproduce the observed range of axial relief and fault patterns at plate spreading centers. We suggest that this failure is due to the approximation that magmatic dikes open continuously rather than in discrete events. During short - lived events, dikes open not only in the strong axial lithosphere but also some distance into the underlying weaker asthenosphere. Axial valley relief affects the partitioning of magma between the lithosphere and asthenosphere during diking events. The deeper the valley, the more magma goes into lithospheric dikes in each event and so the greater the average opening rate of those dikes. The long-term rate of lithospheric dike opening controls faulting rate and axial depth. The feedback between axial valley depth D and lithospheric dike opening rate allows us to analytically relate steady-state values of D to lithospheric thickness HL and crustal thickness HC. A two-dimensional model numerical model with a fixed axial lithospheric structure illustrates the analytic model implications for axial faulting. The predictions of this new model are broadly consistent with global and segment-scale trends of axial depth and fault patterns with HL and HC.

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

The effects of initial rise and axial loads on MEMS arches

KAUST Repository

Tella, Sherif Adekunle

2017-04-07

Arch microbeams have been utilized and proposed for many uses over the past few years due to their large tunability and bistability. However, recent experimental data have shown different mechanical behavior of arches when subjected to axial loads. This paper aims to investigate in depth the influence of the competing effects of initial rise and axial loads on the mechanical behavior of micromachined arches; mainly their static deflection and resonant frequencies. Based on analytical solutions, the static response and eigenvalue problems are analyzed for various values of initial rises and axial loads. Universal curves showing the variation of the first three resonance frequencies of the arch are generated for various values of initial rise under both tensile and compressive axial loads. This study shows that increasing the tensile or compressive axial loads for different values of initial rise may lead to either increase in the stiffness of the beam or initial decrease in the stiffness, which later increases as the axial load is increased depending on the dominant effect of the initial rise of the arch and the axial load. The obtained universal curves represent useful design tools to predict the tunability of arches under axial loads for various values of initial rises. The use of the universal curves is demonstrated with an experimental case study. Analytical formulation is developed to predict the point of minimum where the trend of the resonance frequency versus axial loads changes qualitatively due to the competing effects of axial loads and initial curvature.

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.

Quasi-renormalization of the axial vector model

International Nuclear Information System (INIS)

Schweda, M.

1979-01-01

Using the regulator-free BPHZL renormalization scheme the problem of anomalies in a massive axial vector meson model is reinvestigated. The Adler-Bardeen-Bell-Jackiw anomaly introduces some impressive modifications: the nontrivial self-energy and the counterterm of the longitudinal part of the axial vector field depend on the anomaly via the anomalous Ward identity. The investigations are based on a Fermi-type gauge. (author)

Effect of axial heat flux distribution on CHF

Energy Technology Data Exchange (ETDEWEB)

Park, Cheol

2000-10-01

Previous investigations for the effect of axial heat flux distributions on CHF and the prediction methods are reviewed and summarized. A total of 856 CHF data in a tube with a non-uniform axial heat flux distribution has been compiled from the articles and analyzed using the 1995 Groeneveld look-up table. The results showed that two representative correction factors, K5 of the look-up table and Tongs F factor, can be applied to describe the axial heat flux distribution effect on CHF. However, they overpredict slightly the measured CHF, depending on the quality and flux peak shape. Hence, a corrected K5 factor, which accounts for the axial heat flux distribution effect is suggested to correct these trends. It predicted the CHF power for the compiled data with an average error of 1.5% and a standard deviation of 10.3%, and also provides a reasonable prediction of CHF locations.

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.

Theoretical analysis of the axial growth of nanowires starting with a binary eutectic droplet via vapor-liquid-solid mechanism

Science.gov (United States)

Liu, Qing; Li, Hejun; Zhang, Yulei; Zhao, Zhigang

2018-06-01

A series of theoretical analysis is carried out for the axial vapor-liquid-solid (VLS) growth of nanowires starting with a binary eutectic droplet. The growth model considering the entire process of axial VLS growth is a development of the approaches already developed by previous studies. In this model, the steady and unsteady state growth are considered both. The amount of solute species in a variable liquid droplet, the nanowire length, radius, growth rate and all other parameters during the entire axial growth process are treated as functions of growth time. The model provides theoretical predictions for the formation of nanowire shape, the length-radius and growth rate-radius dependences. It is also suggested by the model that the initial growth of single nanowire is significantly affected by Gibbs-Thompson effect due to the shape change. The model was applied on predictions of available experimental data of Si and Ge nanowires grown from Au-Si and Au-Ge systems respectively reported by other works. The calculations with the proposed model are in satisfactory agreement with the experimental results of the previous works.

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

Singlet axial constant from QCD sum rules

International Nuclear Information System (INIS)

Belitskij, A.V.; Teryaev, O.V.

1995-01-01

We analyze the singlet axial form factor of the proton for small momentum transferred in the framework of QCD sum rules using the interpolating nucleon current which explicitly accounts for the gluonic degrees of freedom. As the result we come to the quantitative prediction of the singlet axial constant. It is shown that the bilocal power corrections play the most important role in the analysis. 21 refs., 3 figs

Meson exchange corrections to nuclear weak axial charge density in hard pion model and O+ reversible O- transition in A = 16 nuclei

International Nuclear Information System (INIS)

Jager, H.U.; Kirchbach, M.; Truhlik, E.

1982-01-01

Starting with the hard pion model based on a minimal chiral invariant phenomenological Lagrangian, the two-particle part of the time component of the weak axial-vector current is constructed in the tree-approximation. Pion, rho- and A 1 -meson exchanges are considered. The mesonic exchange operator obtained is applied to describe the purely weak axial 0 + reversible 0 - , ΔT=1 transition in the nuclear A=16 system the muon reaction μ - + 16 O(0 1 + ; T=0) → 16 N(0 1 - ; T=1) + γsub(μ) and beta decay 16 N(0 1 - ; T=1) → 16 O(0 1 + ; T=0) + e - + anti νsub(e). In order to treat nufar structure correlation efects explicit use of shell model wave functions with configuration mixing is made. The large enhancement of the nuclear weak axial charge density with respect to impulse approximation is established

Axial clamp for nuclear reactor head penetration conoseal joints

International Nuclear Information System (INIS)

Hackley, T.A.

1986-01-01

A method for forming a sealed coupling between two bodies each body presenting an abutment surface, the bodies being arranged so that their respective abutment surfaces are axially adjacent one another and define a space therebetween in which a deformable gasket is disposed. An axial external force is applied to the bodies for compressing the abutment surfaces together against the gasket to form a seal between the bodies and the bodies are immobilized relative to one another while the external force is being applied to the bodies so that sufficient compression will be maintained by the abutment surfaces to preserve the integrity of the seal when the external axial force is withdrawn. The external axial force is then withdrawn, leaving the two bodies coupled together via the seal. (author)

Diffusion-weighted Imaging Is a Sensitive and Specific Magnetic Resonance Sequence in the Diagnosis of Ankylosing Spondylitis.

Science.gov (United States)

Bradbury, Linda A; Hollis, Kelly A; Gautier, Benoît; Shankaranarayana, Sateesh; Robinson, Philip C; Saad, Nivene; Lê Cao, Kim-Anh; Brown, Matthew A

2018-06-01

We tested the discriminatory capacity of diffusion-weighted magnetic resonance imaging (DWI) and its potential as an objective measure of treatment response to tumor necrosis factor inhibition in ankylosing spondylitis (AS). Three cohorts were studied prospectively: (1) 18 AS patients with Bath Ankylosing Spondylitis Disease Activity Index > 4, and erythrocyte sedimentation rate > 25 and/or C-reactive protein > 10 meeting the modified New York criteria for AS; (2) 20 cases of nonradiographic axial spondyloarthritis (nr-axSpA) as defined by the Assessment of Spondyloarthritis international Society (ASAS) criteria; and (3) 20 non-AS patients with chronic low back pain, aged between 18 and 45 years, who did not meet the imaging arm of the ASAS criteria for axSpA. Group 1 patients were studied prior to and following adalimumab treatment. Patients were assessed by DWI and conventional magnetic resonance imaging (MRI), and standard nonimaging measures. At baseline, in contrast to standard nonimaging measures, DWI apparent diffusion coefficient (ADC) values showed good discriminatory performance [area under the curve (AUC) > 80% for Group 1 or 2 compared with Group 3]. DWI ADC values were significantly lower posttreatment (0.45 ± 0.433 before, 0.154 ± 0.23 after, p = 0.0017), but had modest discriminating capacity comparing pre- and posttreatment measures (AUC = 68%). This performance was similar to the manual Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system. DWI is informative for diagnosis of AS and nr-axSpA, and has moderate utility in assessment of disease activity or treatment response, with performance similar to that of the SPARCC MRI score.

Axial Dispersion during Hanford Saltcake Washing

International Nuclear Information System (INIS)

Josephson, Gary B.; Geeting, John GH; Lessor, Delbert L.; Barton, William B.

2006-01-01

Clean up of Hanford salt cake wastes begins with dissolution retrieval of the sodium rich salts that make up the dominant majority of mass in the tanks. Water moving through the porous salt cake dissolves the soluble components and also displaces the soluble radionuclides (e.g. 137Cs and 99TcO4- ). The separation that occurs from this displacement, known as Selective dissolution, is an important component in Hanford?s pretreatment of low activity wastes for subsequent Supplemental treatment. This paper describes lab scale testing conducted to evaluate Selective dissolution of cesium from non-radioactive Hanford tank 241-S-112 salt cake simulant containing the primary chemicals found the actual tank. An modified axial dispersion model with increasing axial dispersion was developed to predict cesium removal. The model recognizes that water dissolves the salt cake during washing, which causes an increase in the axial dispersion during the wash. This model was subsequently compared with on-line cesium measurements from the retrieval of tank 241-S-112. The model had remarkably good agreement with both the lab scale and full scale data

[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).

Investigation of angular and axial smoothing of PET data

International Nuclear Information System (INIS)

Daube-Witherspoon, M.E.; Carson, R.E.

1996-01-01

Radial filtering of emission and transmission data is routinely performed in PET during reconstruction in order to reduce image noise. Angular smoothing is not typically done, due to the introduction of a non-uniform resolution loss; axial filtering is also not usually performed on data acquired in 2D mode. The goal of this paper was to assess the effects of angular and axial smoothing on noise and resolution. Angular and axial smoothing was incorporated into the reconstruction process on the Scanditronix PC2048-15B brain PET scanner. In-plane spatial resolution and noise reduction were measured for different amounts of radial and angular smoothing. For radial positions away from the center of the scanner, noise reduction and degraded tangential resolution with no loss of radial resolution were seen. Near the center, no resolution loss was observed, but there was also no reduction in noise for angular filters up to a 7 degrees FWHM. These results can be understood by considering the combined effects of smoothing projections across rows (angles) and then summing (backprojecting). Thus, angular smoothing is not optimal due to its anisotropic noise reduction and resolution degradation properties. However, uniform noise reduction comparable to that seen with radial filtering can be achieved with axial smoothing of transmission data. The axial results suggest that combined radial and axial transmission smoothing could lead to improved noise characteristics with more isotropic resolution degradation

Axial clamp for nuclear reactor head penetration conoseal joints

International Nuclear Information System (INIS)

Hackley, T.A.

1987-01-01

A method is described for forming a sealed coupling between two bodies, each body presenting an annular abutment surface. The respective bodies are arranged so that their respective annular abutment surfaces are axially adjacent one another, defining a space therebetween, wherein a deformable gasket is disposed within the space. The method comprises: providing one of the bodies with an annular projection; providing the other body with threads for receiving an annular locknut which can be tightened to bear against the annular projection of the one body; applying an external axial forced to the bodies for compressing the abutment surfaces together against the gasket to form a seal between the bodies; immobilizing the bodies relative to one another while the external force is being applied to the bodies by hand-tightening an annular locknut via the threads of the other body until the locknut abuts the annular projection of the one body, substantially preventing relative axial movement between the bodies when the external axial force is withdrawn; and withdrawing the external axial force applied to the bodies, leaving the two bodies coupled together via the seal

Three-dimensional magnetotelluric axial anisotropic forward modeling and inversion

Science.gov (United States)

Cao, Hui; Wang, Kunpeng; Wang, Tao; Hua, Boguang

2018-06-01

Magnetotelluric (MT) data has been widely used to image underground electrical structural. However, when the significant axial resistivity anisotropy presents, how this influences three-dimensional MT data has not been resolved clearly yet. We here propose a scheme for three-dimensional modeling of MT data in presence of axial anisotropic resistivity, where the electromagnetic fields are decomposed into primary and secondary components. A 3D staggered-grid finite difference method is then used to resolve the resulting 3D governing equations. Numerical tests have completed to validate the correctness and accuracy of the present algorithm. A limited-memory Broyden-Fletcher-Goldfarb-Shanno method is then utilized to realize the 3D MT axial anisotropic inversion. The testing results show that, compared to the results of isotropic resistivity inversion, taking account the axial anisotropy can much improve the inverted results.

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.

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.

Generalized dynamic model and control of ambiguous mono axial vehicle robot

Directory of Open Access Journals (Sweden)

Frantisek Duchon

2016-09-01

Full Text Available This article deals with the novel concept of ambiguous mono axial vehicle robot. Such robot is a combination of Segway and dicycle, which utilizes the advantages of each chassis. The advantage of dicycle is lower energy consumption during the movement and the higher safety of carried payload. The movable platform inside the ambiguous mono axial vehicle allows using the various sensors or devices. This will change the ambiguous mono axial vehicle to the Segway type robot. Both these modes are necessary to control in the stable mode to ensure the safety of the ambiguous mono axial vehicle’s movement. The main contents of the article contain description of generalized dynamic model of ambiguous mono axial vehicle and related control of ambiguous mono axial vehicle. The proposal is unique in that the same controller is used for both modes. Several simulations verify proposed control schemes and identified parameters. Moreover, the dicycle type of platform has never been used in robotics and that is another novelty.

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%

The spin of the proton and the axial anomaly

International Nuclear Information System (INIS)

Hatsuda, T.; Zahed, I.

1989-01-01

We show that a consistent treatment of the abelian axial anomaly in a two-phase model of the proton yields a flavor singlet axial current that is saturated by the anomaly at Q 2 =0 in the chiral limit. This result suggests that at Q 2 =0 the matrix element of the flavor singlet axial current in a polarized proton state is small while the proton spin is still one-half. Modulo the QCD evolution equation, this result is in fair agreement with the recent EMC data. (orig.)

Axial to transverse energy mixing dynamics in octupole-based magnetostatic antihydrogen traps

Science.gov (United States)

Zhong, M.; Fajans, J.; Zukor, A. F.

2018-05-01

The nature of the trajectories of antihydrogen atoms confined in an octupole minimum-B trap is of great importance for upcoming spectroscopy, cooling, and gravity experiments. Of particular interest is the mixing time between the axial and transverse energies for the antiatoms. Here, using computer simulations, we establish that almost all trajectories are chaotic, and then quantify the characteristic mixing time between the axial and transverse energies. We find that there are two classes of trajectories: for trajectories whose axial energy is higher than about 20% of the total energy, the axial energy substantially mixes within about 10 s, whereas for trajectories whose axial energy is lower than about 10% of the total energy, the axial energy remains nearly constant for 1000 s or longer.

Test Setup for Axially Loaded Piles in Sand

DEFF Research Database (Denmark)

Thomassen, Kristina

The test setup for testing axially static and cyclic loaded piles in sand is described in the following. The purpose for the tests is to examine the tensile capacity of axially loaded piles in dense fully saturated sand. The pile dimensions are chosen to resemble full scale dimension of piles used...... in offshore pile foundations today....

An axial calculation method for accurate two-dimensional PWR core simulation

International Nuclear Information System (INIS)

Grimm, P.

1985-02-01

An axial calculation method, which improves the agreement of the multiplication factors determined by two- and three-dimensional PWR neutronic calculations, is presented. The axial buckling is determined at each time point so as to reproduce the increase of the leakage due to the flattening of the axial power distribution and the effect of the axial variation of the group constants of the fuel on the reactivity is taken into account. The results of a test example show that the differences of k-eff and cycle length between two- and three-dimensional calculations, which are unsatisfactorily large if a constant buckling is used, become negligible if the results of the axial calculation are used in the two-dimensional core simulation. (Auth.)

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.

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.

Rehabilitation of patients with chlamydial spondyloarthritis at the health resortv

Directory of Open Access Journals (Sweden)

V.M. Sokrut

2017-02-01

Full Text Available Background. Rehabilitation of patients with chlamy­dial spondyloarthritis (CSA under the conditions of the health resort remains undeveloped, there are not enough data to elucidate the mechanism of natural and preformed physical factors in such category of patients, the criteria for the effectiveness of rehabilitation measures not yet defined. The objective of the study: to evaluate the results of treatment in patients with CSA in a Slaviansk balneological health resort. Materials and methods. The research included 117 patients, who were treated at the rheumatological clinic, and then underwent rehabilitation in health resort, which has continental sulfide lake muds and brines with highly minerali­zed chloride-sodium composition. Among the patients under the study, there were 61 % of males and 39 % of females with an average age of 35 years. Both genders did not differ in the duration of illness (median of 7 years and the degree of activity of the pathological process. Seropositivity for rheumatoid factor is detected in 2 % of patients, and by the presence of antibodies to cyclic citrulline peptide — in 70 %. During the resort stage, in 91 % of cases of СSA, Chlamydia trachomatis was found in prostatic secretions, scrapings from the urethra, cervix, vaginal walls, 83 % reported positive serological tests for chlamydial infection. Results. Analysis of the results showed that in 3 % of cases the effect was absent, in 14 % there was a slight improvement, in 50 % — an improvement and in 33 % — a significant improvement. The effectiveness of sanatorium stage of rehabilitation for women was higher, and due to increasing degree of disease activity, the positive results were getting worse. A significant adverse effect on the efficiency of sanatorium and health resort treatment activity has the presence of sacroiliitis and cardiac pathology in patients. Differences in the effectiveness of rehabilitation of patients depends on the types of the

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

Development of vortex model with realistic axial velocity distribution

International Nuclear Information System (INIS)

Ito, Kei; Ezure, Toshiki; Ohshima, Hiroyuki

2014-01-01

A vortex is considered as one of significant phenomena which may cause gas entrainment (GE) and/or vortex cavitation in sodium-cooled fast reactors. In our past studies, the vortex is assumed to be approximated by the well-known Burgers vortex model. However, the Burgers vortex model has a simple but unreal assumption that the axial velocity component is horizontally constant, while in real the free surface vortex has the axial velocity distribution which shows large gradient in radial direction near the vortex center. In this study, a new vortex model with realistic axial velocity distribution is proposed. This model is derived from the steady axisymmetric Navier-Stokes equation as well as the Burgers vortex model, but the realistic axial velocity distribution in radial direction is considered, which is defined to be zero at the vortex center and to approach asymptotically to zero at infinity. As the verification, the new vortex model is applied to the evaluation of a simple vortex experiment, and shows good agreements with the experimental data in terms of the circumferential velocity distribution and the free surface shape. In addition, it is confirmed that the Burgers vortex model fails to calculate accurate velocity distribution with the assumption of uniform axial velocity. However, the calculation accuracy of the Burgers vortex model can be enhanced close to that of the new vortex model in consideration of the effective axial velocity which is calculated as the average value only in the vicinity of the vortex center. (author)

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.

Anisotropic yield surfaces in bi-axial cyclic plasticity

International Nuclear Information System (INIS)

Rider, R.J.; Harvey, S.J.; Breckell, T.H.

1985-01-01

Some aspects of the behaviour of yield surfaces and work-hardening surfaces occurring in biaxial cyclic plasticity have been studied experimentally and theoretically. The experimental work consisted of subjecting thin-walled tubular steel specimens to cyclic plastic torsion in the presence of sustained axial loads of various magnitudes. The experimental results show that considerable anisotropy is induced when the cyclic shear strains are dominant. Although the true shapes of yield and work-hardening surfaces can be very complex, a mathematical model is presented which includes both anisotropy and Bauschinger effects. The model is able to qualitatively predict the deformation patterns during a cycle of applied plastic shear strain for a range of sustained axial stresses and also indicate the material response to changes in axial stress. (orig.)

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

Gravitational waves from the axial perturbations of hyperon stars

International Nuclear Information System (INIS)

Wen De-Hua; Yan Jing; Liu Xue-Mei

2012-01-01

The eigen-frequencies of the axial w-mode oscillations of hyperon stars are examined. It is shown that as the appearance of hyperons softens the equation of state of the super-density matter, the frequency of gravitational waves from the axial w-mode of hyperon star becomes smaller than that of a traditional neutron star at the same stellar mass. Moreover, the eigenfrequencies of hyperon stars also have scaling universality. It is shown that the EURO third-generation gravitational-wave detector has the potential to detect the gravitational-wave signal emitted from the axial w-mode oscillations of a hyperon star. (general)

Axial injection in Orsay superconducting cyclotron

International Nuclear Information System (INIS)

Depauw, J.; Kugler, M.F.; Legoff, A.; Potier, J.C.; Richomme, A.; Skowron, R.; Mandrillon, P.; Schapira, J.P.

1983-01-01

The compact superconducting cyclotron currently planned at IPN at Orsay is designed for light ion acceleration together with heavy ion acceleration. From the beginning, for this reason, a central geometry able to receive an inflector (to 90deg C) allowing the axial injection of low energy ion beams given by an outer source. The present study is aimed at showing the technical feasibility of theoretical results obtained on axial injection. First experimental study has been made of spatial repartition in three dimensions of electric potential developed by a central geometry of 3 electrodes. Then, the electric study of an electrostatic mirror has been made [fr

Bessel beam CARS of axially structured samples

Science.gov (United States)

Heuke, Sandro; Zheng, Juanjuan; Akimov, Denis; Heintzmann, Rainer; Schmitt, Michael; Popp, Jürgen

2015-06-01

We report about a Bessel beam CARS approach for axial profiling of multi-layer structures. This study presents an experimental implementation for the generation of CARS by Bessel beam excitation using only passive optical elements. Furthermore, an analytical expression is provided describing the generated anti-Stokes field by a homogeneous sample. Based on the concept of coherent transfer functions, the underling resolving power of axially structured geometries is investigated. It is found that through the non-linearity of the CARS process in combination with the folded illumination geometry continuous phase-matching is achieved starting from homogeneous samples up to spatial sample frequencies at twice of the pumping electric field wave. The experimental and analytical findings are modeled by the implementation of the Debye Integral and scalar Green function approach. Finally, the goal of reconstructing an axially layered sample is demonstrated on the basis of the numerically simulated modulus and phase of the anti-Stokes far-field radiation pattern.

Uniform Decay for Solutions of an Axially Moving Viscoelastic Beam

Energy Technology Data Exchange (ETDEWEB)

Kelleche, Abdelkarim, E-mail: kellecheabdelkarim@gmail.com [Université des Sciences et de la Technologie Houari Boumediene, Faculté des Mathématiques (Algeria); Tatar, Nasser-eddine, E-mail: tatarn@Kfupm.edu.sa [King Fahd University of Petroleum and Minerals, Department of Mathematics and Statistics (Saudi Arabia)

2017-06-15

The paper deals with an axially moving viscoelastic structure modeled as an Euler–Bernoulli beam. The aim is to suppress the transversal displacement (transversal vibrations) that occur during the axial motion of the beam. It is assumed that the beam is moving with a constant axial speed and it is subject to a nonlinear force at the right boundary. We prove that when the axial speed of the beam is smaller than a critical value, the dissipation produced by the viscoelastic material is sufficient to suppress the transversal vibrations. It is shown that the rate of decay of the energy depends on the kernel which arise in the viscoelastic term. We consider a general kernel and notice that solutions cannot decay faster than the kernel.

Atlanto-axial Subluxation in rheumatoid arthritis: description of a case

International Nuclear Information System (INIS)

Medina, Yimy F; Martinez V, Jose B; Restrepo, Jose Felix; Rondon H, Federico; Iglesias G, Antonio

2004-01-01

The damage of the spine by rheumatoid arthritis is multiple and a variety of affectations have been described at cervical level, being the anterior atlanto-axial subluxation and vertical subluxation the more common. However the posterior atlanto-axial subluxation has been rarely described. In this paper, we describe the case of a patient with posterior atlanto-axial subluxaction in addition to its infrequent manifestation of alteration of the lower cranial nerves as a manifestation of myelopathy

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

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.

SCLERAL AND CHOROIDAL THICKNESS IN SECONDARY HIGH AXIAL MYOPIA.

Science.gov (United States)

Shen, Ling; You, Qi Sheng; Xu, Xiaolin; Gao, Fei; Zhang, Zhibao; Li, Bin; Jonas, Jost B

2016-08-01

To assess differences in scleral and choroidal thickness between eyes with secondary high axial myopia caused by congenital glaucoma, eyes with primary high axial myopia, and nonhighly myopic eyes. The study consisted of 301 Chinese individuals with a mean age of 23.9 ± 22.6 years and mean axial length of 24.8 ± 4.2 mm. It included the "secondary highly myopic group" (SHMG) because of congenital glaucoma (n = 20 eyes; axial length >26.0 mm), the "primary highly myopic group" (PHMG) (n = 73; axial length >26.0 mm), and the remaining nonhighly myopic group (NHMG). The secondary highly myopic group versus the primary highly myopic group had significantly thinner sclera in the pars plana region (343 ± 71 μm versus 398 ± 83 μm; P = 0.006), whereas scleral thickness in other regions did not differ significantly between both highly myopic groups and was significantly thinner in both highly myopic groups than in the NHMG. Mean total scleral volume did not differ significantly (P > 0.20) between any group (SHMG: 659 ± 106 μm; PHMG: 667 ± 128 μm; NHMG: 626 ± 135 μm). Choroidal thickness was significantly thinner in both highly myopic groups than in the NHMG, with no significant differences between both highly myopic groups. Choroidal volume did not differ significantly (P > 0.40) between any of the groups (SHMG: 43 ± 12 μm; PHMG: 43 ± 13 μm; NHMG: 46 ± 17 μm). In secondary high axial myopia, the sclera gets thinner anterior and posterior to the equator; whereas in primary high axial myopia, scleral thinning is predominantly found posterior to the equator. Because volume of sclera and choroid did not differ between any group, scleral and choroidal thinning in myopia may be due to a rearrangement of tissue and not due to the new formation of tissue.

Plasma sheath axial phase dynamics in coaxial device

Energy Technology Data Exchange (ETDEWEB)

Soliman, H.M. (Plasma Physics Dept., NRC, Atomic Energy Authority, Cairo (Egypt)); Masoud, M.M. (Plasma Physics Dept., NRC, Atomic Energy Authority, Cairo (Egypt))

1994-10-01

The study of the plasma sheath dynamics in the axial phase has been carried out in a 3 kJ coaxial system of Mather type for two different inner electrode (IE) lengths, 20 cm and 31.5 cm. For both lengths, measurements showed that the plasma sheath is splitted into two layers at the breech, which is referred to as a shock front and its magnetic piston. It has been found that the two layers of the plasma current sheath rotate around the inner electrode. At the muzzle the back layer reverse its rotation direction due to the magnetic field structure of the system. Results showed that the axial velocity of the first layer is greater than the second one all over the axial phase within the range between 1.4 and 1.7. (orig.).

Plasma sheath axial phase dynamics in coaxial device

International Nuclear Information System (INIS)

Soliman, H.M.; Masoud, M.M.

1994-01-01

The study of the plasma sheath dynamics in the axial phase has been carried out in a 3 kJ coaxial system of Mather type for two different inner electrode (IE) lengths, 20 cm and 31.5 cm. For both lengths, measurements showed that the plasma sheath is splitted into two layers at the breech, which is referred to as a shock front and its magnetic piston. It has been found that the two layers of the plasma current sheath rotate around the inner electrode. At the muzzle the back layer reverse its rotation direction due to the magnetic field structure of the system. Results showed that the axial velocity of the first layer is greater than the second one all over the axial phase within the range between 1.4 and 1.7. (orig.)

Generation of parasitic axial flow by drift wave turbulence with broken symmetry: Theory and experiment

Science.gov (United States)

Hong, R.; Li, J. C.; Hajjar, R.; Chakraborty Thakur, S.; Diamond, P. H.; Tynan, G. R.

2018-05-01

Detailed measurements of intrinsic axial flow generation parallel to the magnetic field in the controlled shear decorrelation experiment linear plasma device with no axial momentum input are presented and compared to theory. The results show a causal link from the density gradient to drift-wave turbulence with broken spectral symmetry and development of the axial mean parallel flow. As the density gradient steepens, the axial and azimuthal Reynolds stresses increase and radially sheared azimuthal and axial mean flows develop. A turbulent axial momentum balance analysis shows that the axial Reynolds stress drives the radially sheared axial mean flow. The turbulent drive (Reynolds power) for the azimuthal flow is an order of magnitude greater than that for axial flow, suggesting that the turbulence fluctuation levels are set by azimuthal flow shear regulation. The direct energy exchange between axial and azimuthal mean flows is shown to be insignificant. Therefore, the axial flow is parasitic to the turbulence-zonal flow system and is driven primarily by the axial turbulent stress generated by that system. The non-diffusive, residual part of the axial Reynolds stress is found to be proportional to the density gradient and is formed due to dynamical asymmetry in the drift-wave turbulence.

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

Axial nucleon form factors from lattice QCD

International Nuclear Information System (INIS)

Alexandrou, C.; Brinet, M.; Carbonell, J.; Harraud, P. A.; Papinutto, M.; Constantinou, M.; Guichon, P.; Jansen, K.; Korzec, T.

2011-01-01

We present results on the nucleon axial form factors within lattice QCD using two flavors of degenerate twisted mass fermions. Volume effects are examined using simulations at two volumes of spatial length L=2.1 fm and L=2.8 fm. Cut-off effects are investigated using three different values of the lattice spacings, namely a=0.089 fm, a=0.070 fm and a=0.056 fm. The nucleon axial charge is obtained in the continuum limit and chirally extrapolated to the physical pion mass enabling comparison with experiment.

Topological invariants and the dynamics of an axial vector torsion field

International Nuclear Information System (INIS)

Drechsler, W.

1983-01-01

A generalized throry of gravitation is discussed which is based on a Riemann-Cartan space-time, U 4 , with an axial vector torsion field. Besides Einstein's equations determining the metric of the U 4 a system of nonlinear field equations is established coupling an axial vector source current to the axial vector torsion field. The properties of the solutions of these equations are discussed assuming a London-type condition relating the axial current and torsion field. To characterize the solutions use is made of the Euler and Pontrjagin forms and the associated quadratic curvature invariants for the U 4 space-time. It is found that there exists for a Riemann-Cartan space-time a relation between the zeros of the axial vector torsion field and the singularities of the Pontrjagin invariant, which is analogous to the well-known Hopf relation between the zeros of vector fields and the Euler characteristic. (author)

Evaluation of efficiency of axial profiling in WWER-440 fuel assemblies

International Nuclear Information System (INIS)

Ananjev, Yu. A.; Kurakin, K. Yu.; Artemov, V.G.; Ivanov, A.S.

2005-01-01

The present report deals with consideration of fuel enrichment axial profiling in WWER-440 assemblies. The study is performed on improving the effectiveness of fuel utilization using the example of implementing the axial profiling in the assemblies of the second generation. For simulation of fuel loadings the computer code package SAPFIR 9 5 and RC is used that allows for correct consideration of specific features of assemblies design changes. The methodical approach to assessment of effectiveness of implementing the axial profiling is considered with the use of capabilities of the mentioned code package. In conclusion the recommendations are given on using the fuel enrichment axial profiling in WWER-440 assemblies (Authors)

Precautions against axial fan stall in reactor building to Tianwan NPP

International Nuclear Information System (INIS)

Liu Chunlong; Pei Junmin

2011-01-01

The paper introduces the mechanism and harm of rotating stall of axial fans, analyzes the necessity for prevention against axial fan stall in reactor building of Tianwan NPP, introduces the precautions, and then makes an assessment on anti-stall effect of flow separators. It can provide reference for model-selection or reconstruction of similar fans in power stations, and for operation and maintenance of axial fans. (authors)

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.

Analysis of the axial filaments of Treponema hyodysenteriae by SDS-PAGE and immunoblotting.

Science.gov (United States)

Kent, K A; Sellwood, R; Lemcke, R M; Burrows, M R; Lysons, R J

1989-06-01

Purified axial filaments from eight serotypes of Treponema hyodysenteriae and two non-pathogenic intestinal spirochaetes were characterized by SDS-PAGE and Western blotting. Axial filaments of all ten strains had similar SDS-PAGE profiles; five major axial filament polypeptides were identified, with molecular masses of 43.8, 38, 34.8, 32.8 and 29.4 kDa. Hyperimmune gnotobiotic pig serum raised against purified axial filaments of strain P18A (serotype 4) cross-reacted with all other serotypes and with the non-pathogens, and convalescent serum taken from a pig with persistent swine dysentery also showed a strong response to the axial filament polypeptides. Hyperimmune gnotobiotic pig serum raised against axial filaments failed to agglutinate viable organisms and did not inhibit growth in vitro. Hence, the axial filaments of T. hyodysenteriae have been identified as major immunodominant antigens, although the role that antibodies to these antigens play in protection has yet to be established.

Investigation of axial power gradients near a control rod tip

Energy Technology Data Exchange (ETDEWEB)

Loberg, John, E-mail: John.Loberg@fysast.uu.se [Uppsala University, Department of Physics and Astronomy, Division of Applied Nuclear Physics, Box 525, SE-75120 Uppsala (Sweden); Osterlund, Michael, E-mail: Michael.Osterlund@fysast.uu.se [Uppsala University, Department of Physics and Astronomy, Division of Applied Nuclear Physics, Box 525, SE-75120 Uppsala (Sweden); Bejmer, Klaes-Hakan, E-mail: Klaes-Hakan.Bejmer@vattenfall.com [Vattenfall Nuclear Fuel AB, Jaemtlandsgatan 99, 162 60 Vaellingby, Stockholm (Sweden); Blomgren, Jan, E-mail: Jan.Blomgren@vattenfall.com [Vattenfall Nuclear Fuel AB, Jaemtlandsgatan 99, 162 60 Vaellingby, Stockholm (Sweden); Kierkegaard, Jesper, E-mail: Jesper.Kierkegaar@vattenfall.com [Vattenfall Nuclear Fuel AB, Jaemtlandsgatan 99, 162 60 Vaellingby, Stockholm (Sweden)

2011-07-15

Highlights: > Pin power gradients near BWR control rod tips have been investigated. > A control rod tip is modeled in MCNP and compared to simplified 2D/3D geometry. > Small nodes increases pin power gradients; standard nodes underestimates gradients. > The MCNP results are validated against axial gamma scan of a controlled fuel pin. - Abstract: Control rod withdrawal in BWRs induces large power steps in the adjacent fuel assemblies. This paper investigates how well a 2D/3D method, e.g., CASMO5/SIMULATE5 computes axial pin power gradients adjacent to an asymmetrical control-rod tip in a BWR. The ability to predict pin power gradients accurately is important for safety considerations whereas large powers steps induced by control rod withdrawal can cause Pellet Cladding Interaction. The computation of axial pin power gradients axially around a control rod tip is a challenging task for any nodal code. On top of that, asymmetrical control rod handles are present in some BWR designs. The lattice code CASMO requires diagonal symmetry of all control rod parts. This introduces an error in computed pin power gradients that has been evaluated by Monte Carlo calculations. The results show that CASMO5/SIMULATE5, despite the asymmetrical control rod handle, is able to predict the axial pin power gradient within 1%/cm for axial nodal sizes of 15-3.68 cm. However, a nodal size of 3.68 cm still causes underestimations of pin power gradients compared with 1 cm nodes. Furthermore, if conventional node sizes are used, {approx}15 cm, pin power gradients can be underestimated by over 50% compared with 1 cm nodes. The detailed axial pin power profiles from MCNP are corroborated by measured gamma scan data on fuel rods irradiated adjacent to control rods.

Bruch´s membrane thickness in relationship to axial length.

Directory of Open Access Journals (Sweden)

Hai Xia Bai

Full Text Available To assess a potential role of Bruch´s membrane (BM in the biomechanics of the eye, we measured its thickness and the density of retinal pigment epithelium (RPE cells in various ocular regions in eyes of varying axial length.Human globes, enucleated because of an ocular tumor or end-stage glaucoma were prepared for histological examination. Using light microscopy, the histological slides were histomorphometrically examined applying a digitized image analysis system.The study included 104 eyes with a mean axial length of 27.9±3.2 mm (range:22.6mm-36.5mm. In eyes without congenital glaucoma, BM was significantly thickest (P<0.001 at the ora serrata, followed by the posterior pole, the midpoint between equator and posterior pole (MBEPP, and finally the equator. BM thickness was not significantly correlated with axial length (ora serrata: P = 0.93; equator:P = 0.31; MBEPP:P = 0.15; posterior pole:P = 0.35. RPE cell density in the pre-equatorial region (P = 0.02; regression coefficient r = -0.24 and in the retro-equatorial region (P = 0.03; r = -0.22 decreased with longer axial length, while RPE cell density at the ora serrata (P = 0.35, the MBEPP (P = 0.06; r = -0.19 and the posterior pole (P = 0.38 was not significantly correlated with axial length. Highly myopic eyes with congenital glaucoma showed a tendency towards lower BM thickness and lower RPE cell density at all locations.BM thickness, in contrast to scleral and choroidal thickness, was independent of axial length in eyes without congenital glaucoma. In association with an axial elongation associated decrease in the RPE cell density in the midperiphery, the findings support the notion of a biomechanical role BM may play in the process of emmetropization/myopization.

Investigation of axial power gradients near a control rod tip

International Nuclear Information System (INIS)

Loberg, John; Osterlund, Michael; Bejmer, Klaes-Hakan; Blomgren, Jan; Kierkegaard, Jesper

2011-01-01

Highlights: → Pin power gradients near BWR control rod tips have been investigated. → A control rod tip is modeled in MCNP and compared to simplified 2D/3D geometry. → Small nodes increases pin power gradients; standard nodes underestimates gradients. → The MCNP results are validated against axial gamma scan of a controlled fuel pin. - Abstract: Control rod withdrawal in BWRs induces large power steps in the adjacent fuel assemblies. This paper investigates how well a 2D/3D method, e.g., CASMO5/SIMULATE5 computes axial pin power gradients adjacent to an asymmetrical control-rod tip in a BWR. The ability to predict pin power gradients accurately is important for safety considerations whereas large powers steps induced by control rod withdrawal can cause Pellet Cladding Interaction. The computation of axial pin power gradients axially around a control rod tip is a challenging task for any nodal code. On top of that, asymmetrical control rod handles are present in some BWR designs. The lattice code CASMO requires diagonal symmetry of all control rod parts. This introduces an error in computed pin power gradients that has been evaluated by Monte Carlo calculations. The results show that CASMO5/SIMULATE5, despite the asymmetrical control rod handle, is able to predict the axial pin power gradient within 1%/cm for axial nodal sizes of 15-3.68 cm. However, a nodal size of 3.68 cm still causes underestimations of pin power gradients compared with 1 cm nodes. Furthermore, if conventional node sizes are used, ∼15 cm, pin power gradients can be underestimated by over 50% compared with 1 cm nodes. The detailed axial pin power profiles from MCNP are corroborated by measured gamma scan data on fuel rods irradiated adjacent to control rods.

Nuclear chiral axial currents and applications to few-nucleon systems

Energy Technology Data Exchange (ETDEWEB)

Baroni, Alessandro [Old Dominion Univ., Norfolk, VA (United States)

2017-08-01

This Thesis is divided into three main parts. The first part discusses basic aspects of chiral effective field theory and the formalism, based on time ordered perturbation theory, used to to derive the nuclear potentials and currents from the chiral Lagrangians. The second part deals with the actual derivation, up to one loop, of the two-nucleon potential and one- and two-nucleon weak axial charge and current. In both derivations ultraviolet divergences generated by loop corrections are isolated using dimensional regularization. The resulting axial current is finite and conserved in the chiral limit, while the axial charge requires renormalization. A complete set of contact terms for the axial charge up to the relevant order in the power counting is constructed. The third part of this Thesis discusses two applications: (i) the calculation of the Gamow-Teller matrix element of tritium, used to constrain the single low-energy constant entering the axial current; (ii) the calculation of neutrino-deuteron inclusive cross sections at low energies. These results have confirmed previous predictions obtained in phenomenological approaches. These latter studies have played an important role in the analysis and interpretation of experiments at the Sudbury Neutrino Observatory.

Reconstruction of core axial power shapes using the alternating conditional expectation algorithm

International Nuclear Information System (INIS)

Lee, Eun Ki; Kim, Yong Hee; Cha, Kune Ho; Park, Moon Ghu

1999-01-01

We have introduced the alternating conditional expectation (ACE) algorithm in reconstructing 20-node axial core power shapes from five-level in-core detector powers. The core design code, Reactor Operation and Control Simulation (ROCS), calculates 3-dimensional power distributions for various core states, and the reference core-averaged axial power shapes and corresponding simulated detector powers are utilized to synthesize the axial power shape. By using the ACE algorithm, the optimal relationship between a dependent variable, the plane power, and independent variables, five detector powers, is determined without any preprocessing. A total of ∼3490 data sets per each cycle of YongGwang Nuclear (YGN) power plant units 3 and 4 is used for the regression. Continuous analytic function corresponding to each optimal transformation is calculated by simple regression model. The reconstructed axial power shapes of ∼21,200 cases are compared to the original ROCS axial power shapes. Also, to test the validity and accuracy of the new method, its performance is compared with that of the Fourier fitting method (FFM), a typical method of the deterministic approach. For a total of 21,204 data cases, the averages of root mean square (rms) error, axial peak error (ΔF z ), and axial shape index error (ΔASI) of new method are calculated as 0.81%, 0.51% and 0.00204, while those of FFM are 2.29%, 2.37% and 0.00264, respectively. We also evaluated the wide range of axial power profiles from the xenon-oscillation. The results show that the newly developed method is far superior to FFM; average rms and axial peak error are just ∼35 and ∼20% of those of FFM, respectively

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 

What changed during the axial age: Cognitive styles or reward systems?

Science.gov (United States)

Baumard, Nicolas; Hyafil, Alexandre; Boyer, Pascal

2015-01-01

The ‘Axial Age’ (500–300 BCE) refers to the period during which most of the main religious and spiritual traditions emerged in Eurasian societies. Although the Axial Age has recently been the focus of increasing interest,1-5 its existence is still very much in dispute. The main reason for questioning the existence of the Axial Age is that its nature, as well as its spatial and temporal boundaries, remain very much unclear. The standard approach to the Axial Age defines it as a change of cognitive style, from a narrative and analogical style to a more analytical and reflective style, probably due to the increasing use of external memory tools. Our recent research suggests an alternative hypothesis, namely a change in reward orientation, from a short-term materialistic orientation to a long-term spiritual one.6 Here, we briefly discuss these 2 alternative definitions of the Axial Age. PMID:27066164

Axial gravity, massless fermions and trace anomalies

International Nuclear Information System (INIS)

Bonora, L.; Cvitan, M.; Giaccari, S.; Stemberga, T.; Prester, P.D.; Pereira, A.D.; UFF-Univ. Federal Fluminense, Niteroi

2017-01-01

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.)

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.)

On the problem of axial anomaly in supersymmetric gauge theories

International Nuclear Information System (INIS)

Kazakov, D.I.

1984-01-01

The explicit relation is found between the axial current obeying the Adler-Bardeen theorem and the supersymmetric one belonging to a supermultiplet. It is shown that the axial and superconformal anomalies are consistent in all orders of perturbation theory

Metamorphosis of helical magnetorotational instability in the presence axial electric current

OpenAIRE

Priede, Jānis

2014-01-01

This paper presents numerical linear stability analysis of a cylindrical Taylor-Couette flow of liquid metal carrying axial electric current in a generally helical external magnetic field. Axially symmetric disturbances are considered in the inductionless approximation corresponding to zero magnetic Prandtl number. Axial symmetry allows us to reveal an entirely new electromagnetic instability. First, we show that the electric current passing through the liquid can extend the range of helical ...

Progressive atlanto-axial subluxation in Behcet's disease

Energy Technology Data Exchange (ETDEWEB)

Kim, Sang-hyuk [Chonbuk National University Hospital, Department of Neurosurgery, Jeonju City, Jeonbuk (Korea); Eoh, Whan [Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Neurosurgery, Seoul (Korea)

2010-03-15

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.)

Introducing New Biosimilars Into Current Treatment Algorithms

Directory of Open Access Journals (Sweden)

John D. Isaacs

2016-07-01

Full Text Available Three biosimilar products are now licensed for the treatment of rheumatic diseases in Europe. The European Medicines Agency (EMA requires that similarity between a biosimilar and its reference product is demonstrated using a rigorous, stepwise process that includes extensive physicochemical and biological analytical testing, non-clinical pharmacology, clinical evaluations, and pharmacovigilance plans. Each step is highly sensitive to any differences between products and progressively reduces any uncertainty over similarity; all steps must be satisfied to demonstrate biosimilarity. The US Food and Drug Administration (FDA requires a similar stringent biosimilar development process. The etanercept biosimilar SB4 (Benepali®, recently approved for the treatment of rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis (ankylosing spondylitis, non-radiographic axial spondyloarthritis, and plaque psoriasis, is herein used to demonstrate the detailed analytical characterisation and clinical testing that are required by the EMA before biosimilars are approved for use. A comprehensive characterisation study involving >55 physiochemical and >25 biological assays demonstrated that SB4 has highly similar structural, physicochemical, and biological quality attributes to reference etanercept. A Phase I study demonstrated pharmacokinetic equivalence between SB4 and reference etanercept in healthy male subjects. Furthermore, a Phase III, randomised, controlled trial performed in patients with moderate-to-severe rheumatoid arthritis despite treatment with methotrexate (MTX showed that SB4 was equivalent to etanercept in terms of efficacy, safety, and immunogenicity. In conclusion, the biosimilar development process performed according to EMA or FDA guidelines is highly rigorous and comprehensive. Biosimilars such as SB4 are now available in clinical practice and are likely to improve access, reduce costs, and ultimately, improve health outcomes.

The transverse force experienced by the radial head during axial loading of the forearm: A cadaveric study.

Science.gov (United States)

Orbay, Jorge L; Mijares, Michael R; Berriz, Cecilia G

2016-01-01

When designing a radial head replacement, the magnitude and direction of forces applied across the proximal radio-ulnar joint (PRUJ) and the radiocapitellar joint must be included. These designs often focus on axial loads transmitted to the radial head by the capitellum; however, the radial head also bears a significant transverse force at the PRUJ. Load transmission by the central band of the interosseous ligament induces a force component in a lateral direction perpendicular to the axis of the limb, which is borne by the articular surfaces of the proximal and distal radio-ulnar joints. The objective of this study is to establish the relationship between distally applied axial forces and proximal transverse reaction forces. Five cadaveric, human forearms with intact interosseous membranes were used to measure the magnitude of transversely-directed forces experienced by the radial head during axial loading of the forearm at the lunate fossa. A Mark-10 test stand applied a gradual and continuous axial load on the articular surface of the distal radius. A Mark-10 force gauge measured the resultant transverse force experienced by the radial head in the proximal radioulnar joint. Classical mechanics and static force analysis were applied in order to predict lateral force values that would occur when the interosseous ligament is treated as the major load transmitter between the radius and ulna. Acquired data show that the radial head bears a force in the transverse direction that averages 18% (SD 3.89%) in magnitude of the axial force applied at the wrist. This figure is in close accordance with the predicted value of 22% that was calculated by way of free-body plotting. Physiologic forearm loading results in a clinically significant transverse force component transmitted through the interosseous ligament complex. The existence of transverse forces in the human forearm may explain clinical problems seen after radial head resection and suggest that radial head implants

Development of axial tomography technique for the study of steam explosion

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Young; Seo, S. W.; You, S. [Handong Golbal Univ., Pohang (Korea, Republic of)

2006-05-15

In this report, axial tomography applying to steam explosion is implemented. When steam explosion experiment is performed, we have seen the difficulty with physical modeling due to the complex phenomena of generated steam, propagation of shock wave and bubble breakup and coalescence. Hence, the uncertainty due to these phenomena is occurred. The fast and global measurement of the steam distribution is imperative to understand the complex phenomena performed during the steam explosion, KAERI have developed the fast and global measuring instrument to monitor such phenomena of axial steam distribution. Generally, X-ray is used as measuring method, but this method is very expensive and has limited measurement area. So we need new method that can substitute X-ray method and in this research, ECT method is replaced. The research is performed dividing within two parts: Software and Hardware. In the software part, the electric field analysis code and algorithm for inverse projection were developed. And, in the hardware part, capacitance measurement circuit is developed to measure up to fF level. Operable axial tomography was analyzed with concept design of axial tomography appropriate to steam explosion accident and analysis code for axial electric field analysis and inverse algorithm were developed, moreover, designing signal analysis system for axial tomography was performed.

Axial sidelobe reduction in single-photon 4Pi microscopy by Toraldo filters

International Nuclear Information System (INIS)

Martinex-Corral, M.; Pons, A.; Caballero, M.T.

2002-01-01

Full text: The 4Pi-confocal fluorescence microscope is a recently developed 3D imaging technique in which two opposing high-NA objectives are used for coherently illuminating and/or detecting the same point of the fluorescent sample. The interference process yields an intensity point spread function (PSF) with an extremely narrow axial core, but with very large axial sidelobes, which compromise the actual improvement in axial resolution. To overcome this problem we propose the use, in the illumination arm of the 4Pi-confocal microscope, of multiple-zones phase filters whose design is based on the Toraldo-design principle. Note that the Toraldo procedure allows to select at will the positions of the zeros of the PSF of an optical system. Then, what we propose here if to design a phase pupil filter such that the position of the first zero of the illumination axial PSF is close to the position of the maximum of the first axial sidelobe of the detection PSF. In the design procedure it is taken into account that: 1. The value of the parameter ε = λ exc /λ det which, in a single-photon fluorescent process, is the responsible for the different scales of the illumination and detection PSFs. 2. The Toraldo procedure was originally designed to control the position of zeros of the transverse PSF. In this case the procedure is adapted to the aim of controlling the position of zeros of the axial PSF. 3. Since 4Pi-confocal microscopes are only useful when built with high-NA objectives, the Toraldo principle is reformulated in terms of the nonparaxial diffraction theory. We show that by using Toraldo filters in the illumination part of a 4Pi-confocal microscope it is possible to obtain up to a 60% reduction of height of the axial sidelobe of the whole-system axial PSF. This fact permits to fully benefit the axial resolution from the strong narrowness of the central peak of the axial PSF, inherent to the 4Pi principle. Copyright (2002) Australian Society for Electron Microscopy

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.

Method to Measure Tone of Axial and Proximal Muscle

Science.gov (United States)

Gurfinkel, Victor S.; Cacciatore, Timothy W.; Cordo, Paul J.; Horak, Fay B.

2011-01-01

The control of tonic muscular activity remains poorly understood. While abnormal tone is commonly assessed clinically by measuring the passive resistance of relaxed limbs1, no systems are available to study tonic muscle control in a natural, active state of antigravity support. We have developed a device (Twister) to study tonic regulation of axial and proximal muscles during active postural maintenance (i.e. postural tone). Twister rotates axial body regions relative to each other about the vertical axis during stance, so as to twist the neck, trunk or hip regions. This twisting imposes length changes on axial muscles without changing the body's relationship to gravity. Because Twister does not provide postural support, tone must be regulated to counteract gravitational torques. We quantify this tonic regulation by the restive torque to twisting, which reflects the state of all muscles undergoing length changes, as well as by electromyography of relevant muscles. Because tone is characterized by long-lasting low-level muscle activity, tonic control is studied with slow movements that produce "tonic" changes in muscle length, without evoking fast "phasic" responses. Twister can be reconfigured to study various aspects of muscle tone, such as co-contraction, tonic modulation to postural changes, tonic interactions across body segments, as well as perceptual thresholds to slow axial rotation. Twister can also be used to provide a quantitative measurement of the effects of disease on axial and proximal postural tone and assess the efficacy of intervention. PMID:22214974

Modelling larval transport in a axial convergence front

Science.gov (United States)

Robins, P.

2010-12-01

Marine larvae exhibit different vertical swimming behaviours, synchronised by factors such as tidal currents and daylight, in order to aid retention near the parent populations and hence promote production, avoid predation, or to stimulate digestion. This paper explores two types of larval migration in an estuarine axial convergent front which is an important circulatory mechanism in many coastal regions where larvae are concentrated. A parallelised, three-dimensional, ocean model was applied to an idealised estuarine channel which was parameterised from observations of an axial convergent front which occurs in the Conwy Estuary, U.K. (Nunes and Simpson, 1985). The model successfully simulates the bilateral cross-sectional recirculation of an axial convergent front, which has been attributed to lateral density gradients established by the interaction of the lateral shear of the longitudinal currents with the axial salinity gradients. On the flood tide, there is surface axial convergence whereas on the ebb tide, there is (weaker) surface divergence. Further simulations with increased/decreased tidal velocities and with stronger/weaker axial salinity gradients are planned so that the effects of a changing climate on the secondary flow can be understood. Three-dimensional Lagrangian Particle Tracking Models (PTMs) have been developed which use the simulated velocity fields to track larvae in the estuarine channel. The PTMs take into account the vertical migrations of two shellfish species that are commonly found in the Conwy Estuary: (i) tidal migration of the common shore crab (Carcinus maenas) and (ii), diel (daily) migration of the Great scallop (Pecten maximus). These migration behaviours are perhaps the most widespread amongst shellfish larvae and have been compared with passive (drifting) particles in order to assess their relative importance in terms of larval transport. Preliminary results suggest that the net along-estuary dispersal over a typical larval

Axial loaded MRI of the lumbar spine

Energy Technology Data Exchange (ETDEWEB)

Saifuddin, A. E-mail: asaifuddin@aol.com; Blease, S.; MacSweeney, E

2003-09-01

Magnetic resonance imaging is established as the technique of choice for assessment of degenerative disorders of the lumbar spine. However, it is routinely performed with the patient supine and the hips and knees flexed. The absence of axial loading and lumbar extension results in a maximization of spinal canal dimensions, which may in some cases, result in failure to demonstrate nerve root compression. Attempts have been made to image the lumbar spine in a more physiological state, either by imaging with flexion-extension, in the erect position or by using axial loading. This article reviews the literature relating to the above techniques.

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

Case report: Physical therapy management of axial dystonia.

Science.gov (United States)

Voos, Mariana Callil; Oliveira, Tatiana de Paula; Piemonte, Maria Elisa Pimentel; Barbosa, Egberto Reis

2014-01-01

Few studies have described physical therapy approaches to provide functional independence and reduce pain in individuals with dystonia. This report describes the physical therapy treatment of a 46-year-old woman diagnosed with idiopathic segmental axial dystonia. For two years, the patient was treated with kinesiotherapy (active and resisted movements and stretching of neck and trunk muscles), abdominal taping (kinesiotaping techniques), functional training, and sensory tricks. She was assessed with parts I, II and III of Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-I, TWSTRS-II and TWSTRS-III), Berg Balance Scale (BBS), Six-Minute Walk Test (6-MWT), and the motor domain of Functional Independence Measure (FIM-motor) before and after the two-year treatment and after the one year follow-up. Postural control and symmetry improved (TWSTRS-I: from 30 to 18), functional independence increased (TWSTRS-II: from 27 to 15; BBS: from 36 to 46; 6-MWT: from 0 to 480 meters (m); FIM-motor: from 59 to 81), and the pain diminished (TWSTRS-III: from 12 to 5). The functional improvement was retained after one year (TWSTRS-I: 14/35; TWRTRS-II: 12/30; TWRTRS-III: 5/20; BBS: 48/56; 6-MWT: 450 m; FIM-motor: 81/91). This program showed efficacy on providing a better control of the dystonic muscles and thus the doses of botulinum toxin needed to treat them could be reduced. Outcomes support the therapeutic strategies used to deal with this type of dystonia.

Development of Performance Analysis Program for an Axial Compressor with Meanline Analysis

International Nuclear Information System (INIS)

Park, Jun Young; Park, Moo Ryong; Choi, Bum Suk; Song, Je Wook

2009-01-01

Axial-flow compressor is one of the most important parts of gas turbine units with axial turbine and combustor. Therefore, precise prediction of performance is very important for development of new compressor or modification of existing one. Meanline analysis is a simple, fast and powerful method for performance prediction of axial-flow compressors with different geometries. So, Meanline analysis is frequently used in preliminary design stage and performance analysis for given geometry data. Much correlations for meanline analysis have been developed theoretically and experimentally for estimating various types of losses and flow deviation angle for long time. In present study, meanline analysis program was developed to estimate compressor losses, incidence angles, deviation angles, stall and surge conditions with many correlations. Performance prediction of one stage axial compressors is conducted with this meanline analysis program. The comparison between experimental and numerical results show a good agreement. This meanline analysis program can be used for various types of single stage axial-flow compressors with different geometries, as well as multistage axial-flow compressors

Xenon-induced axial power oscillations in the 400 MW PBMR

International Nuclear Information System (INIS)

Strydom, Gerhard

2008-01-01

The redistribution of the spatial xenon concentration in the 400 MW Pebble Bed Modular Reactor (PBMR) core has a non-linear, time-dependent feedback effect on the spatial power density during several types of operational transient events. Due to the inherent weak coupling that exists between the iodine and xenon formation and destruction rates, as well as the complicating effect of spatial variance in the thermal flux field, reactor cores have been analyzed for a number of decades for the occurrence and severity of xenon-induced axial power oscillations. Of specific importance is the degree of oscillation damping exhibited by the core during transients, which involves axial variations in the local power density. In this paper the TINTE reactor dynamics code is used to assess the stability of the current 400 MW PBMR core design with regard to axial xenon oscillations. The focus is mainly on the determination of the inherent xenon and power oscillation damping properties by utilizing a set of hypothetical control rod insertion transients at various power levels. The oscillation damping properties of two 100%-50%-100% load-follow transients, one of which includes the de-stabilizing axial effects of moving control rods, are also discussed in some detail. The study shows that, although first axial mode oscillations do occur in the 400 MW PBMR core, the inherent damping of these oscillations is high, and that none of the investigated load-follow transients resulted in diverging oscillations. It is also shown that the PBMR core exhibits no radial oscillation components for these xenon-induced axial power oscillations

Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor α inhibitors

DEFF Research Database (Denmark)

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

2011-01-01

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...... 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....

Axial displacement of abutments into implants and implant replicas, with the tapered cone-screw internal connection, as a function of tightening torque.

Science.gov (United States)

Dailey, Bruno; Jordan, Laurence; Blind, Olivier; Tavernier, Bruno

2009-01-01

The passive fit of a superstructure on implant abutments is essential to success. One source of error when using a tapered cone-screw internal connection may be the difference between the tightening torque level applied to the abutments by the laboratory technician compared to that applied by the treating clinician. The purpose of this study was to measure the axial displacement of tapered cone-screw abutments into implants and their replicas as a function of the tightening torque level. Twenty tapered cone-screw abutments were selected. Two groups were created: 10 abutments were secured into 10 implants, and 10 abutments were secured into 10 corresponding implant replicas. Each abutment was tightened in increasing increments of 5 Ncm, from 0 Ncm to 45 Ncm, with a torque controller. The length of each sample was measured repeatedly with an Electronic Digital Micrometer. The mean axial displacement for the implant group and the replica group was calculated. The data were analyzed by the Mann-Whitney and Spearman tests. For both groups, there was always an axial displacement of the abutment upon each incremental application of torque. The mean axial displacement values varied between 7 and 12 microm for the implant group and between 6 and 21 microm for the replica group at each 5-Ncm increment. From 0 to 45 Ncm, the total mean axial displacement values were 89 microm for the implant group and 122 microm for the replica group. There was a continuous axial displacement of the abutments into implants and implant replicas when the applied torque was raised from 0 to 45 Ncm. Torque applied above the level recommended by the manufacturer increased the difference in displacement between the two groups.

A study on multi-axial fatigue model based on structural stress

International Nuclear Information System (INIS)

Kim, Cheol; Kim, Jong Sung; Jin, Tae Eun; Dong, P.

2004-01-01

In nuclear components, cyclic loadings that cause complex states of stress are common. Through a reference review, four sources of the multi-axial fatigue data were collected from LBF, University of Illinois, EPRI, and TWI. All these tests were conducted using tube to flange specimens with a circumferential fillet welds. The loading conditions were mostly bending/ torsion combinations, except that TWI used tension/ torsion combinations. None of fatigue correlation parameters have been demonstrated to be satisfactory in correlating the multi-axial fatigue data outside of their own. In this paper, we proposed the characterizing multi-axial fatigue behavior in terms of the structural stress methods by using some of the well-known multi-axial fatigue data available in the references

Precision axial translator with high stability.

Science.gov (United States)

Bösch, M A

1979-08-01

We describe a new type of translator which is inherently stable against torsion and twisting. This concentric translator is also ideally suited for precise axial motion with clearance of the center line.

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.

The relative axial expansions under irradiation of stacks of UO{sub 2} pellets in zircaloy sheaths

Energy Technology Data Exchange (ETDEWEB)

Notley, M. J.F.

1962-08-15

An experiment was performed to measure the relative axial movement of UO{sub 2} fuel pellets inside a Zircaloy sheath. Although the results must be treated with some reservation, the inferences are that there is very little relative movement between the fuel and the sheath when the two are in firm pressure contact. Relative movement was in the range 0.075 {+-} 0.03 cm for a 30 cm fuel length, and was not greatly affected by the power output, profile of the pellet end-faces or the diametral clearance left between the fuel and the sheath on assembly. However in two elements that had thick sheaths to withstand the coolant pressure and that were assembled with large diametral clearances (2% of the diameter) the available axial clearance for relative fuel/ sheath movement (1%) was fully taken up. The thin sheathed elements showed residual axial expansions of up to 0.17 cm, indicating that the pellets move relative to the sheath only until frictional forces are sufficient for the sheath to grip the fuel; thereafter the sheath is extended. The measurements also indicate that sheath elongation is governed by the temperature at the contact points between adjacent pellets, eg. at the inner edge of a pellet shoulder, as long as that temperature is below approximately 1000{sup o}C. At higher temperatures, the UO{sub 2} is too plastic to exert sufficient force to strain the sheath. (author)

The joint in psoriatic arthritis.

Science.gov (United States)

Mortezavi, Mahta; Thiele, Ralph; Ritchlin, Christopher

2015-01-01

Psoriatic arthritis (PsA), a chronic inflammatory joint disease associated with psoriasis, is notable for diversity in disease presentation, course and response to treatment. Equally varied are the types of musculoskeletal involvement which include peripheral and axial joint disease, dactylitis and enthesitis. In this review, we focus on the psoriatic joint and discuss pathways that underlie synovial, cartilage and bone inflammation and highlight key histopathologic features. The pivotal inflammatory mechanisms and pathobiology of PsA parallel findings in other forms of spondyloarthritis but are distinct from disease pathways described in rheumatoid synovitis and bone disease. The diagnosis of PsA from both a clinical and imaging perspective is also discussed.

Efficacy of golimumab in treating uveitis in patients with ankylosing spondylitis

Directory of Open Access Journals (Sweden)

T. V. Dubinina

2016-01-01

Full Text Available The paper presents the results of recent studies of the efficacy of golimumab (GLM in the treatment of uveitis in patients with ankylosing spondylitis (AS. The data obtained in these studies suggest that GLM is highly effective in relieving and preventing uveitis attacks. However, all the given studies have a number of disadvantages; primarily they have included a limited number of patients. Further prospective randomized clinical trials with large sample sizes are required to evaluate the efficacy and safety of GLM for the treatment of uveitis in patients with spondyloarthritis.

Investigation on a procedure for optimal axial depth of cut accuracy in micromilling

DEFF Research Database (Denmark)

Bissacco, Giuliano; Hansen, Hans Nørgaard; De Chiffre, Leonardo

2005-01-01

On the basis of a previously developed procedure for control of axial depth of cut in high accuracy micromilling operations, this paper presents an investigation on the estimation of the uncertainty of the set axial depth of cut.......On the basis of a previously developed procedure for control of axial depth of cut in high accuracy micromilling operations, this paper presents an investigation on the estimation of the uncertainty of the set axial depth of cut....

Asymptotic freedom in the axial and Coulomb gauges

International Nuclear Information System (INIS)

Frenkel, J.; Taylor, J.C.

1976-01-01

The sources of the negative contribution to the charge renormalization factor gsup(B)/g-1 in Yang-Mills theories are investigated in the axial and Coulomb gauges. In the axial gauge, a Kaellen dispersion relation exists but the spectral function is not positive definite because of the prescription that is used to integrate the singular polarization vectors. In the Coulomb gauge, the negative contributions are (to the lowest order) isolated in the Coulomb self-energy corrections to the Coulomb field. (Auth.)

Effects of axial coordination on immobilized Mn(salen) catalysts.

Science.gov (United States)

Teixeira, Filipe; Mosquera, Ricardo A; Melo, André; Freire, Cristina; Cordeiro, M Natália D S

2014-11-13

The consequences of anchoring Mn(salen) catalysts onto a supporting material using one of the vacant positions of the metal center are tackled by studying several Mn(salen) complexes with different axial ligands attached. This is accomplished using Density Functional Theory at the X3LYP/Triple-ζ level of theory and the Atom In Molecules formalism. The results suggest that both Mn(salen) complexes and their oxo derivatives should lie in a triplet ground state. Also, the choice of the axial ligand bears a moderate effect on the energy involved in the oxidation of the former to oxo-Mn(salen) complexes, as well as in the stability of such complexes toward ligand removal by HCl. AIM analysis further suggests that the salen ligand acts as a "charge reservoir" for the metal center, with strong correlations being obtained between the charge of salen and the electron population donated by the axial ligand to the metal center. Moreover, the results suggest that the Mn atom in Mn(salen) complexes holds different hybridization of its valence orbitals depending on the type of axial ligand present in the system.

Axial magnetic field restriction of plasma sheath in a coaxial discharge

International Nuclear Information System (INIS)

Masoud, M. M.; Soliman, H. M.; Ibrahim, F. A.

1999-01-01

The study deals with the effect of an applied axial magnetic field on the dynamics and parameters of the plasma sheath and the expanded plasma in a coaxial discharge. Experimental investigations were carried out with a 3 kJ coaxial discharge device of a Mather geometry. The discharge takes place in Hydrogen gas with base pressure of 1 torr. The experiments were conducted with a 10 kV bank voltage, which corresponds to 100 kA discharge currents. The investigations have shown that the maximum axial plasma sheath velocity is decreased by 20% when applying the external axial magnetic field along the coaxial electrodes of intensity 2.6 kG. The experimental results of axial magnetic field intensity B z along the coaxial electrodes indicated that the application of external axial magnetic field causes an increases of B z ∼ 40% at a mid-distance between the breech and the muzzle and a decrease by 75% at the muzzle. The experimental results of expanded plasma electron temperature T e and density n e cleared that when the axial magnetic field is applied the maximum T e is decreased by 2.6 and 3 times, while the maximum n e is increased by 2.8 and 2 times for the first and second half cycles respectively. (author)

Efficient Propulsion Structure with an Axial Flux Rotary Converter for HEV Drive Unit

Directory of Open Access Journals (Sweden)

Ales Havel

2011-01-01

Full Text Available This paper describes an efficient axial flux arrangement of the four quadrant rotary converter for hybrid electric vehicles. The design of the axial flux wound stator and both axial flux squirrel cage rotors is based on the arrangement of radial air gap induction motor and permanent magnet synchronous motor. The method of constant magnetic circuit volume is utilized for dimensions conversion, which results into basic dimensions of stator and rotor discs in axial flux conception. This allows the creation of real 3D models in the CAD application. Finally, the finite element simulations of electromagnetic induction in the axial flux stator pack are presented in the concluding part of this paper.

Axial and radial velocities in the creeping flow in a pipe

Directory of Open Access Journals (Sweden)

Zuykov Andrey L'vovich

2014-05-01

Full Text Available The article is devoted to analytical study of transformation fields of axial and radial velocities in uneven steady creeping flow of a Newtonian fluid in the initial portion of the cylindrical channel. It is shown that the velocity field of the flow is two-dimensional and determined by the stream function. The article is a continuation of a series of papers, where normalized analytic functions of radial axial distributions in uneven steady creeping flow in a cylindrical tube with azimuthal vorticity and stream function were obtained. There is Poiseuille profile for the axial velocity in the uniform motion of a fluid at an infinite distance from the entrance of the pipe (at x = ∞, here taken equal to zero radial velocity. There is uniform distribution of the axial velocity in the cross section at the tube inlet at x = 0, at which the axial velocity is constant along the current radius. Due to the axial symmetry of the flow on the axis of the pipe (at r = 0, the radial velocities and the partial derivative of the axial velocity along the radius, corresponding to the condition of the soft function extremum, are equal to zero. The authors stated vanishing of the velocity of the fluid on the walls of the pipe (at r = R , where R - radius of the tube due to its viscous sticking and tightness of the walls. The condition of conservation of volume flow along the tube was also accepted. All the solutions are obtained in the form of the Fourier - Bessel. It is shown that the hydraulic losses at uniform creeping flow of a Newtonian fluid correspond to Poiseuille - Hagen formula.

Axial length elongation in adults with long-standing unilateral traumatic cataract

Directory of Open Access Journals (Sweden)

Jonel Steffen

2016-09-01

Full Text Available Background: Unilateral eye elongation with resultant axial myopia has been reported to occur secondary to visual deprivation from birth or early childhood. Acquired axial length elongation secondary to visual deprivation in adults has rarely been reported. Aim: To report acquired axial myopia in adults with visual deprivation due to long-standing unilateral traumatic cataract. Methods: Eleven consecutive adult patients who presented for cataract surgery with unilateral, long-standing, mature, traumatic cataracts and an interocular axial length difference of more than 1 mm were studied. Patients with a post-operative best corrected visual acuity (BCVA of < 6/12 were excluded to rule out possible pre-existing anisometropic amblyopia. Results: Of the 11 patients with significant interocular axial length difference, 5 patients were excluded on the basis of possible pre-existing amblyopia. The remaining 6 patients had final BCVA of 6/12 or better. The median length of the cataractous eyes was 2.83 mm longer than the fellow eyes (range 1.12 mm – 3.52 mm. The intraocular lens power required for emmetropia was 6.8 dioptres (range 3.5 dioptres – 11.5 dioptres less in the cataractous eyes. A refractive outcome within 1 dioptre of the target refraction was achieved in all patients. The median delay between ocular trauma and cataract surgery was 20 years (range 8–24 years. Conclusion: Significant unilateral axial length elongation may occur in adults with longstanding traumatic cataracts and visual deprivation. A potential correlation may exist between delay to surgery and degree of axial length difference. This rare phenomenon must be considered when determining intraocular lens power to avoid post-operative refractive surprises.

Computational analysis of a multistage axial compressor

Science.gov (United States)

Mamidoju, Chaithanya

Turbomachines are used extensively in Aerospace, Power Generation, and Oil & Gas Industries. Efficiency of these machines is often an important factor and has led to the continuous effort to improve the design to achieve better efficiency. The axial flow compressor is a major component in a gas turbine with the turbine's overall performance depending strongly on compressor performance. Traditional analysis of axial compressors involves throughflow calculations, isolated blade passage analysis, Quasi-3D blade-to-blade analysis, single-stage (rotor-stator) analysis, and multi-stage analysis involving larger design cycles. In the current study, the detailed flow through a 15 stage axial compressor is analyzed using a 3-D Navier Stokes CFD solver in a parallel computing environment. Methodology is described for steady state (frozen rotor stator) analysis of one blade passage per component. Various effects such as mesh type and density, boundary conditions, tip clearance and numerical issues such as turbulence model choice, advection model choice, and parallel processing performance are analyzed. A high sensitivity of the predictions to the above was found. Physical explanation to the flow features observed in the computational study are given. The total pressure rise verses mass flow rate was computed.

High-resolution axial MR imaging of tibial stress injuries

Directory of Open Access Journals (Sweden)

Mammoto Takeo

2012-05-01

Full Text Available Abstract Purpose To evaluate the relative involvement of tibial stress injuries using high-resolution axial MR imaging and the correlation with MR and radiographic images. Methods A total of 33 patients with exercise-induced tibial pain were evaluated. All patients underwent radiograph and high-resolution axial MR imaging. Radiographs were taken at initial presentation and 4 weeks later. High-resolution MR axial images were obtained using a microscopy surface coil with 60 × 60 mm field of view on a 1.5T MR unit. All images were evaluated for abnormal signals of the periosteum, cortex and bone marrow. Results Nineteen patients showed no periosteal reaction at initial and follow-up radiographs. MR imaging showed abnormal signals in the periosteal tissue and partially abnormal signals in the bone marrow. In 7 patients, periosteal reaction was not seen at initial radiograph, but was detected at follow-up radiograph. MR imaging showed abnormal signals in the periosteal tissue and entire bone marrow. Abnormal signals in the cortex were found in 6 patients. The remaining 7 showed periosteal reactions at initial radiograph. MR imaging showed abnormal signals in the periosteal tissue in 6 patients. Abnormal signals were seen in the partial and entire bone marrow in 4 and 3 patients, respectively. Conclusions Bone marrow abnormalities in high-resolution axial MR imaging were related to periosteal reactions at follow-up radiograph. Bone marrow abnormalities might predict later periosteal reactions, suggesting shin splints or stress fractures. High-resolution axial MR imaging is useful in early discrimination of tibial stress injuries.

High-resolution axial MR imaging of tibial stress injuries

Science.gov (United States)

2012-01-01

Purpose To evaluate the relative involvement of tibial stress injuries using high-resolution axial MR imaging and the correlation with MR and radiographic images. Methods A total of 33 patients with exercise-induced tibial pain were evaluated. All patients underwent radiograph and high-resolution axial MR imaging. Radiographs were taken at initial presentation and 4 weeks later. High-resolution MR axial images were obtained using a microscopy surface coil with 60 × 60 mm field of view on a 1.5T MR unit. All images were evaluated for abnormal signals of the periosteum, cortex and bone marrow. Results Nineteen patients showed no periosteal reaction at initial and follow-up radiographs. MR imaging showed abnormal signals in the periosteal tissue and partially abnormal signals in the bone marrow. In 7 patients, periosteal reaction was not seen at initial radiograph, but was detected at follow-up radiograph. MR imaging showed abnormal signals in the periosteal tissue and entire bone marrow. Abnormal signals in the cortex were found in 6 patients. The remaining 7 showed periosteal reactions at initial radiograph. MR imaging showed abnormal signals in the periosteal tissue in 6 patients. Abnormal signals were seen in the partial and entire bone marrow in 4 and 3 patients, respectively. Conclusions Bone marrow abnormalities in high-resolution axial MR imaging were related to periosteal reactions at follow-up radiograph. Bone marrow abnormalities might predict later periosteal reactions, suggesting shin splints or stress fractures. High-resolution axial MR imaging is useful in early discrimination of tibial stress injuries. PMID:22574840

Imaging features suggestive of a conjoined nerve root on routine axial MRI

Energy Technology Data Exchange (ETDEWEB)

Song, Su Jin; Lee, Joon Woo; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Gyeongi-do (Korea); Choi, Ja-Young; Hong, Sung Hwan; Kim, Na Ra [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Ki-Jeong; Chung, Sang-Ki; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeongi-Do (Korea)

2008-02-15

The purpose of our study is to evaluate imaging features suggestive of a conjoined nerve root on routine axial MRI. Two radiologists and two surgeons retrospectively reviewed the MRI of three cases in which a conjoined nerve root was discovered during operation and found three suggestive signs on routine axial MR images: ''corner'' (asymmetric morphology of the anterolateral corner of the dural sac), ''fat crescent'' (intervening extradural fat between the asymmetric dura and the nerve root), and ''parallel'' signs (visualization of the entire parallel course of the nerve root at the disc level). Two radiologists prospectively found these signs during routine MRI interpretation sessions over a period of 6 months. If one or a combination of signs were noted on axial MR images, contiguous axial scans were additionally obtained. Three cases that were previously found during operations were also included. Prevalence and confidence scores for each sign were assessed on axial T1- and T2-weighted images. Twelve patients showed one or a combination of the three signs, 9 had contiguous axial MR scans. Five cases were confirmed by operation. The prevalence of the corner, fat crescent, and parallel signs were 12 out of 12 (100%), 6 out of 12 (50%), and 8 out of 12 (67.7%) on axial T1-weighted images. The overall diagnostic confidence was higher on T1- than on T2-weighted images (P < 0.05). On routine axial L-spine MRI, corner, fat crescent, and parallel signs are suggestive of and assist in the recognition of a conjoined nerve root. (orig.)

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

Work participation in spondyloarthritis across countries: analysis from the ASAS-COMOSPA study.

Science.gov (United States)

Rodrigues Manica, Santiago; Sepriano, Alexandre; Ramiro, Sofia; Pimentel Santos, Fernando; Putrik, Polina; Nikiphorou, Elena; Norton, Sam; Molto, Anna; Dougados, Maxime; van der Heijde, Désirée; Landewé, Robert B M; van den Bosch, Filip E; Boonen, Annelies

2018-06-02

To explore the role of individual and country level socioeconomic (SE) factors on employment, absenteeism and presenteeism in patients with spondyloarthritis (SpA) across 22 countries worldwide. Patients with a clinical diagnosis of SpA fulfilling the ASAS classification criteria and in working age (≤65 years) from COMOSPA were included. Outcomes of interest were employment status, absenteeism and presenteeism, assessed by the Work Productivity and Activity Impairment Specific General Health questionnaire. Three multivariable models were built (one per outcome) using mixed-effects binomial (for work status) or ordinal regressions (for absenteeism and presenteeism), with country as random effect. The contribution of SE factors at the individual-level (eg, gender, education, marital status) and country-level (healthcare expenditure (HCE) per capita, Human Development Index (HDI) and gross domestic product per capita) SE factors, independent of clinical factors, was assessed. In total, 3114 patients with SpA were included of which 1943 (62%) were employed. Physical function and comorbidities were related to all work outcomes in expected directions and disease activity also with absenteeism and presenteeism. Higher education (OR 4.2 (95% CI 3.1 to 5.6)) or living in a country with higher HCE (OR 2.3 (1.5 to 3.6)) or HDI (OR 1.9 (1.2 to 3.3)) was positively associated with being employed. Higher disease activity was associated with higher odds for absenteeism (OR 1.5 (1.3 to 1.7)) and presenteeism (OR 2.1 (1.8 to 2.4)). No significant association between individual-level and country-level SE factors and absenteeism or presenteeism was found. Higher education level and higher country SE welfare are associated with a higher likelihood of keeping patients with SpA employed. Absenteeism and presenteeism are only associated with clinical but not with individual-level or country-level SE factors. © Article author(s) (or their employer(s) unless otherwise stated in the text

Pion Photo- and Electroproduction and the Partially Conserved Axial Current

International Nuclear Information System (INIS)

Haberzettl, Helmut

2000-01-01

The relevance of the axial current for pion production processes off the nucleon with real or virtual photons is revisited. Employing the hypothesis of a partially conserved axial current (PCAC), it is shown that, when all of the relevant contributions are taken into account, PCAC does not provide any additional constraint for threshold production processes that goes beyond the Goldberger-Treiman relation. In particular, it is shown that pion electroproduction processes at threshold cannot be used to extract any information regarding the weak axial form factor. The relationships found in previous investigations are seen to be an accident of the approximations usually made in this context

Research on axial thrust of the waterjet pump based on CFD under cavitation conditions

International Nuclear Information System (INIS)

Shen, Z H; Pan, Z Y

2015-01-01

Based on RANS equations, performance of a contra-rotating axial-flow waterjet pump without hydrodynamic cavitation state had been obtained combined with shear stress transport turbulence model. Its cavitation hydrodynamic performance was calculated and analysed with mixture homogeneous flow cavitation model based on Rayleigh-Plesset equations. The results shows that the cavitation causes axial thrust of waterjet pump to drop. Furthermore, axial thrust and head cavitation characteristic curve is similar. However, the drop point of the axial thrust is postponed by 5.1% comparing with one of head, and the critical point of the axial thrust is postponed by 2.6%

Research on axial thrust of the waterjet pump based on CFD under cavitation conditions

Science.gov (United States)

Shen, Z. H.; Pan, Z. Y.

2015-01-01

Based on RANS equations, performance of a contra-rotating axial-flow waterjet pump without hydrodynamic cavitation state had been obtained combined with shear stress transport turbulence model. Its cavitation hydrodynamic performance was calculated and analysed with mixture homogeneous flow cavitation model based on Rayleigh-Plesset equations. The results shows that the cavitation causes axial thrust of waterjet pump to drop. Furthermore, axial thrust and head cavitation characteristic curve is similar. However, the drop point of the axial thrust is postponed by 5.1% comparing with one of head, and the critical point of the axial thrust is postponed by 2.6%.

New Sodium Cooled Long-Life Cores with Axially Multi-Driver Regions

International Nuclear Information System (INIS)

Hyun, Hae Ri; Hong, Ser Gi

2014-01-01

In this concept of long-life core (they are sometimes called B-B (Breed and Burn)), tall blanket is placed above the relatively short driver fuel. In the initial stage of burning, the power by fission is mostly generated in the driver region and it moves into the blanket region. The power and flux distributions that are highly peaked in the axial direction propagates slowly from the driver into the blanket region. This concept of long-life core fully utilizes the breeding of blanket in the fast spectra and it can achieve very high burnup of fuel. In this work, we introduce new sodium cooled longlife cores rating 600MWe (1800MWt). In these cores, the driver regions are heterogeneously placed into blanket region so as to achieve stabilized and less peaked axial power distribution as depletion proceeds. At present, our study is focused on only two axial driver regions but this concept can be easily extended onto the multi-driver region concept. The cores designed in this paper have two axial driver regions so as to have stabilized and less peaked axial power distributions as depletion proceeds. The results of the core design and analyses show that the cores have very long-lives longer than -49EFPYs and high discharge burnup higher than 200GWD/kg. Additionally, we considered a long-life core having no blanket. As expected, it was shown that these cores have stabilized and less peaked axial power distribution as the fuel depletes. However, the study shows that the cores having two driver regions still show high initial peaking of the axial power distributions and the core can be optimized by changing the driver fuel height

Thermal characterization of phacoemulsification probes operated in axial and torsional modes.

Science.gov (United States)

Zacharias, Jaime

2015-01-01

To analyze temperature increases and identify potential sources of heat generated when sleeved and sleeveless phacoemulsification probes were operated in axial and torsional modes using the Infiniti Vision System with the Ozil torsional handpiece. Phacodynamics Laboratory, Pasteur Ophthalmic Clinic, Santiago, Chile. Experimental study. Two computer-controlled thermal transfer systems were developed to evaluate the contribution of internal metal stress and tip-to-sleeve friction on heat generation during phacoemulsification using axial and torsional ultrasound modalities. Both systems incorporated infrared thermal imaging and used a black-body film to accurately capture temperature measurements. Axial mode was consistently associated with greater temperature increases than torsional mode whether tips were operated with or without sleeves. In tests involving bare tips, axial mode and torsional mode peaked at 51.7°C and 34.2°C, respectively. In an example using sleeved tips in which a 30.0 g load was applied for 1 second, temperatures for axial mode reached 45°C and for torsional mode, 38°C. Friction between the sleeved probe and the incisional wall contributed more significantly to the temperature increase than internal metal stress regardless of the mode used. In all experiments, the temperature increase observed with axial mode was greater than that observed with torsional mode, even when conditions such as power or amplitude and flow rate were varied. Tip-to-sleeve friction was a more dominant source of phaco probe heating than internal metal stress. The temperature increase due to internal metal stress was greater with axial mode than with torsional mode. Dr. Zacharias received research funding from Alcon Laboratories, Inc., to conduct this study. He has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

The accuracy of axial length measurements in cases of macula-off retinal detachment.

Science.gov (United States)

Abou-Shousha, Mohsen; Helaly, Hany Ahmed; Osman, Ihab Mohamed

2016-04-01

To assess the accuracy of axial length measurements in cases of macula-off retinal detachment using different methods (optical biometry, A-scan ultrasound, and combined applanation vector-A/B-scan biometry). This prospective clinical study included 100 eyes of 100 patients who underwent vitrectomy alone or phacovitrectomy for macula-off retinal detachment. All patients included signed an informed consent. Preoperative examination of the patients included recording the axial length measurements using optical biometry, A-scan ultrasound, and combined applanation vector-A/B-scan biometry. The mean postoperative IOLMaster axial length after macular reattachment was 26.11 ± 2.91 mm. The mean preoperative IOLMaster axial length with macula-off was 25.32 ± 2.72 mm. The mean preoperative A-scan axial length with macula-off was 25.29 ± 2.80 mm. The mean preoperative vector-A/B-scan axial length with macula-off was 26.03 ± 2.90 mm. The preoperative vector-A/B-scan mean absolute error was 0.59 ± 0.48 D (range, 0.10-2.25 D). Regular methods (optical biometry and A-scan biometry) of measuring the axial length in cases with a detached macula proved to be variable and less accurate. The vector-A/B-scan offered good measurements of the actual axial length in the patients. This was reflected on more accurate postoperative refractive outcome. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Calculation of core axial power shapes using alternating conditional expectation algorithm

International Nuclear Information System (INIS)

Lee, Eun Ki; Kim, Yong Hee; Cha, Kune Ho; Park, Moon Kyu

1998-01-01

We have introduced the alternating conditional expectation (ACE) algorithm in the method of reconstructing 20 node axial power shapes from five level detector powers. The ACE algorithm was used to find the optimal relationships between each plane power and normalized five detector powers. The obtained all optimal transformations had simple forms to be represented with polynomials. The reference axial power shapes and simulated detector powers were drawn out of the 3-dimensional results of Reactor Operation and Control Simulation (ROCS) code for various core states. By the ACE algorithm, we obtained the optimal relationship between dependent variable plane power, y, and independent variable detector powers, {Di, i=1,...,5 without any preprocessing, where a total of ≅3490 data sets per each cycle of YongGwang Nuclear (YGN) Power Plant units 3 and 4 are used. To test the validity and accuracy of the new method, about 21,200 cases of reconstructed axial power shapes are compared to original ROCS axial power shapes, and they are also contrasted with those obtained by Fourier fitting method (FFM). The average error of root mean square (rms), axial peak (DFZ), and axial shape index (DASI) of our new method for total 21204 data cases are 0.81%, 0.51% and 0.00204, while FFM 2.29%, 2.37% and 0.00264, respectively. The evaluation results for the data sets not used in the ACE transformations also show that the accuracy of new method is much better than that of FFM

Optimización de Estatores para Motores Superconductores de Flujo Axial Optimización de Estatores para Motores Superconductores de Flujo Axial

Directory of Open Access Journals (Sweden)

Oscar Gerardo Ibarra-Manzano

2012-02-01

Full Text Available The development of superconducting electrical machines has been designed primarily to design and build engines with the superconducting magnetic field in radial configuration, as traditional engines, so the design and construction of rotating electrical machines in axial flow configuration has become an alternative for the design and construction of such engines. In this paper we present preliminary calculations for the optimization of the stator of a superconducting motor in axial flow confi guration, based on the equations of general power of the rotary axial flow configuration. It performs the construction, optimization and evaluation of models of stators in geometries of 4, 6 and 8 poles with high-temperature superconducting tapes of Bismuth. The results show the feasibility of the design implemented, which is verified by a significant decrease in the current of superconducting motor operation.El desarrollo de máquinas eléctricas superconductoras ha estado encaminado principalmentea diseñar y construir motores superconductores con el campo magnético en configuración radial, como los motores tradicionales, por lo que el diseño y construcción demáquinas eléctricas rotativas en configuración de flujo axial ha venido a ser una alternativa para el diseño y construcción de este tipo de motores. En el presente trabajo se presentan los cálculos preliminares para la optimización del estator de un motor superconductor en configuración de flujo axial, basados en las ecuaciones generales de potencia de las máquinas eléctricas rotativas en configuración flujo axial ha venido a ser una alternativa para el diseño y construcción, optimización y evaluación de modelos de estatores en geometrías de 4, 6 y 8 polos, con cintas superconductoras de alta temperatura de Bismuto. Los resultados obtenidos muestran la viabilidaddel diseño implementado, lo cual se comprueba por medio de una disminución significativa de la corriente de operaci

CONTRIBUTION OF AXIAL MOTOR IMPAIRMENT TO PHYSICAL INACTIVITY IN PARKINSON'S DISEASE

Science.gov (United States)

Bryant, Mon S; Hou, Jyhgong Gabriel; Collins, Robert L; Protas, Elizabeth J

2015-01-01

Objective To investigate the relationships between motor symptoms of Parkinson’s disease (PD) and activity limitations in persons with PD. Design/Methods Cross-sectional study of persons with mild to moderate PD (N=90). Associations among axial motor features, limb motor signs, the Physical Activity Scale for Elders (PASE), the ability to perform Activities of Daily Living (ADL) and level of ADL dependency were studied. A composite score of axial motor features included the following UPDRS items: speech, rigidity of the neck, arising from chair, posture, gait and postural stability. A composite score of limb motor signs included the following UPDRS items: tremor at rest of all extremities, action tremor, rigidity of all extremities, finger taps, hand movement, rapid alternating hand movements and foot tapping. Results Axial motor features of PD were significantly correlated with physical inactivity (pphysical inactivity. After controlling for age, gender, disease duration and comorbidity, axial motor features contributed significantly to physical inactivity, decreased ADL and increase in ADL dependency, whereas the limb motor signs did not. Conclusions Axial motor impairment contributed to physical inactivity and decreased ability to perform ADLs in persons with PD. PMID:26368837

Visualization of bonding at an inclusion boundary using axial-shear strain elastography: a feasibility study

International Nuclear Information System (INIS)

Thitaikumar, Arun; Krouskop, Thomas A; Garra, Brian S; Ophir, Jonathan

2007-01-01

Ultrasound elastography produces strain images of compliant tissues under quasi-static compression. In axial-shear strain elastography, the local axial-shear strain resulting from application of quasi-static axial compression to an inhomogeneous material is imaged. The overall hypothesis of this work is that the pattern of axial-shear strain distribution around the inclusion/background interface is completely determined by the bonding at the interface after normalization for inclusion size and applied strain levels, and that it is feasible to extract certain features from the axial-shear strain elastograms to quantify this pattern. The mechanical model used in this study consisted of a single stiff circular inclusion embedded in a homogeneous softer background. First, we performed a parametric study using finite-element analysis (FEA) (no ultrasound involved) to identify possible features that quantify the pattern of axial-shear strain distribution around an inclusion/background interface. Next, the ability to extract these features from axial-shear strain elastograms, estimated from simulated pre- and post-compression noisy RF data, was investigated. Further, the feasibility of extracting these features from in vivo breast data of benign and malignant tumors was also investigated. It is shown using the FEA study that the pattern of axial-shear strain distribution is determined by the degree of bonding at the inclusion/background interface. The results suggest the feasibility of using normalized features that capture the region of positive and negative axial-shear strain area to quantify the pattern of the axial-shear strain distribution. The simulation results showed that it was feasible to extract the features, as identified in the FEA study, from axial-shear strain elastograms. However, an effort must be made to obtain axial-shear strain elastograms with the highest signal-to-noise ratio (SNR asse ) possible, without compromising the resolution. The in vivo

Organo-axial volvulus of the small intestine: radiological case report and consideration for its mechanism.

Science.gov (United States)

Ishiguro, Toshitaka; Hiyama, Takashi; Nasu, Katsuhiro; Akashi, Yoshimasa; Minami, Manabu

2017-07-01

Gastrointestinal volvulus is mainly classified into two subtypes, mesentero-axial volvulus and organo-axial volvulus. The detailed imaging findings of organo-axial volvulus of the small intestine have never been reported as far as we know. In this article, we report a case of organo-axial volvulus of the small intestine, focusing on the computed tomography (CT) findings. An 80-year-old man was radiologically diagnosed as having organo-axial volvulus of the terminal ileum and it was confirmed by open surgery without adhesion or any other anatomical abnormalities. CT showed two specific findings, split-bowel sign and rotating-C sign, which we think reflect pathophysiologic features of organo-axial volvulus. We think the pathogenic mechanism of organo-axial volvulus can be explained by the convergence of the reversed-rotational twist following the formation of a twisted but non-obstructive circular loop, even if there is no adhesion. Radiologists should be aware that organo-axial volvulus can occur even in the small intestine, and in the case of small bowel obstruction with single transition point, the two pathophysiologic signs mentioned above must be looked for to diagnose the possibility of organo-axial volvulus.

Beyond axial symmetry: An improved class of models for global data

KAUST Repository

Castruccio, Stefano

2014-03-01

An important class of models for data on a spherical domain, called axially symmetric, assumes stationarity across longitudes but not across latitudes. The main aim of this work is to introduce a new and more flexible class of models by relaxing the assumption of longitudinal stationarity in the context of regularly gridded climate model output. In this investigation, two other related topics are discussed: the lack of fit of an axially symmetric parametric model compared with a non-parametric model and to longitudinally reversible processes, an important subclass of axially symmetric models.

Beyond axial symmetry: An improved class of models for global data

KAUST Repository

Castruccio, Stefano; Genton, Marc G.

2014-01-01

An important class of models for data on a spherical domain, called axially symmetric, assumes stationarity across longitudes but not across latitudes. The main aim of this work is to introduce a new and more flexible class of models by relaxing the assumption of longitudinal stationarity in the context of regularly gridded climate model output. In this investigation, two other related topics are discussed: the lack of fit of an axially symmetric parametric model compared with a non-parametric model and to longitudinally reversible processes, an important subclass of axially symmetric models.

Differential diagnosis of extra-axial intracranial tumours by dynamic spin-echo MRI

International Nuclear Information System (INIS)

Joo, Y.G.; Korogi, Y.; Hirai, T.; Sakamoto, Y.; Sumi, M.; Takahashi, M.; Ushio, Y.

1995-01-01

Dynamic MRI was performed on 22 patients with extra-axial intracranial tumours. Serial images were obtained every 30 s for 3 min using a spin-echo sequence (TR 200, TE 15 ms) after rapid injection of Gd-DTPA, 0.1 mmol/kg body weight. The contrast medium enhancement ratio (CER) was correlated with the histology of the tumours. Meningiomas and extra-axial metastases showed a sharp rise, then a gradual decline. Although both had a definite early peak of CER, metastases showed a more rapid decline. Neuromas and extra-axial lymphoma showed a slow, steady increase with no peak within 180 s. This study indicates that the CER is helpful in the differentiation of extra-axial tumours. (orig.)

Characterisation of plasmas produced by the "Torche a Injection Axiale"

NARCIS (Netherlands)

Jonkers, J.; Selen, L.J.M.; Mullen, van der J.J.A.M.; Regt, de J.M.; Timmermans, E.A.H.; Schram, D.C.

1996-01-01

Summary form only given. The Torche a Injection Axiale (TIA), i.e. torch with axial gas injection, was developed by the group of Moisan in 1993. We report on the investigations on two different kind of plasmas created by the TIA: one with helium and the other with argon as main gas. Using absolute

Axial blanket enrichment optimization of the NPP Krsko fuel

International Nuclear Information System (INIS)

Kromar, M.; Kurincic, B.

2001-01-01

In this paper optimal axial blanket enrichment of the NPP Krsko fuel is investigated. Since the optimization is dictated by economic categories that can significantly vary in time, two step approach is applied. In the first step simple relationship between the equivalent change in enrichment of axial blankets and central fuel region is established. The relationship is afterwards processed with economic criteria and constraints to obtain optimal axial blanket enrichment. In the analysis realistic NPP Krsko conditions are considered. Except for the fuel enrichment all other fuel characteristics are the same as in the fuel used in the few most recent cycles. A typical reload cycle after the plant power uprate is examined. Analysis has shown that the current blanket enrichment is close to the optimal. Blanket enrichment reduction results in an approximately 100 000 US$ savings per fuel cycle.(author)

Computerized axial tomography in traumatic cervical lesions

International Nuclear Information System (INIS)

Koyama, Tsunemaro

1982-01-01

Although plain computerized axial tomography cannot routinely demonstrate the spinal cord, it does provide excellent visualization of the bony outline of the spinal canal and vertebral column. So it should be reasonable to use this technique in cases of cervical traumatic disorders. In this paper we presented 10 cases of cervical traumatic lesions; 3 atlanto-axial dislocation, 2 cervical canal stenosis, 3 OPLL, 1 intramedullary hematoma and 1 C 2 -neurinoma. In some patients neurologic deficits were induced by cervical trauma. Bony lesions appeared more adequately deliniated than intraspinal lesions, however, in some cases intramedullary changes could also be demonstrated. The use of metrizamide with high resolution CT-scanner could improve the usefullness of this technique. (author)

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.

Passive axial magnetic bearing with Halbach magnetized array in magnetically suspended control moment gyro application

International Nuclear Information System (INIS)

Sun Jinji; Ren Yuan; Fang Jiancheng

2011-01-01

The paper presents a special configuration of passive axial magnetic bearing with segmented Halbach magnetized array in magnetically suspended control moment gyro (MSCMG). Peculiarity of presented passive axial magnetic bearing is its ability to provide angular stiffness so that it can produce gyro moment when it is used in MSCMG. The MSCMG with this passive axial magnetic bearing can efficiently reduce the power loss when it supplies gyro moment compared with the five degrees of freedom (5-DOF) MSCMG. The characteristics of the suspension force and stiffness of the passive axial magnetic bearing are studied using finite element method (FEM). The performance of the presented passive axial magnetic bearing with Halbach magnetized array is verified by a prototyped MSCMG. - Research highlights: → Passive axial magnetic bearing is used to provide angular stiffness. → Passive axial magnetic bearing is based on repulsion. → Layers Halbach magnetized array realizes higher stiffness per bearing volume. → Passive axial magnetic bearing can provide gyro moment in CMG. → Power loss of MSCMG with PMB does not increase when it provides gyro moment.

Guided wave propagation as a measure of axial loads in rails

CSIR Research Space (South Africa)

Loveday, PW

2010-03-01

Full Text Available Guided wave propagation has been proposed as a means to monitor the axial loads in continuously welded railway rails although no practical system has been developed. In this paper, the influence of axial load on the guided wave propagation...

Posterior atlanto-occipital and atlanto-axial area and its surgical interest

Directory of Open Access Journals (Sweden)

Newton José Godoy Pimenta

2014-10-01

Full Text Available Classic anatomical studies describe two membranes – atlanto-occipital and atlanto-axial in the posterior aspect of the craniocervical region. During many surgical procedures in this area, however, we have not found such membranes. Objective To clarify the anatomical aspects and structures taking part of the posterior atlanto-occipital and atlanto-axial area. Method Analysis of histological cuts of three human fetuses and anatomical studies of 8 adult human cadavers. Results In both atlanto-occipital and atlanto-axial areas, we have observed attachment between suboccipital deep muscles and the spinal cervical dura. However, anatomical description of such attachments could not be found in textbooks of anatomy. Conclusion Our study shows the absence of the classical atlanto-occipital and atlanto-axial membranes; the occipito-C1 and C1-C2 posterior intervals are an open area, allowing aponeurotic attachment among cervical dura mater and posterior cervical muscles.

A quantitative analysis of two-dimensional manually segmented transrectal ultrasound axial images in planning high dose rate brachytherapy for prostate cancer

Directory of Open Access Journals (Sweden)

Dabić-Stanković Kata

2017-01-01

Full Text Available Background/Aim. Prostate delineation, pre-planning and catheter implantation procedures, in high-dose rate brachytherapy (HDR-BT, are commonly based on the prostate manually segmented transrectal ultrasound (TRUS images. The aim of this study was to quantitatively analyze the consistency of prostate capsule delineation, done by a single therapist, prior to each HDR-BT fraction and the changes in the shape of the prostate capsule during HDR-BT, using two dimensional (2D TRUS axial image. Methods. A group of 16 patients were treated at the Medical System Belgrade Brachytherapy Department with definitive HDRBT. The total applied median dose of 52 Gy was divided into four individual fractions, each fraction being delivered 2– 3 weeks apart. Real time prostate axial visualization and the manual segmentation prior to each fraction were performed using B-K Medical ultrasound. Quantitative analyses, analysis of an area and shape were applied on 2D-TRUS axial images of the prostate. Area analyses were used to calculate the average value of the cross-sectional area of the prostate image. The parameters of the prostate shape, the fractal dimension and the circularity ratio of the prostate capsule contour were estimated at the maximum axial cross section of the prostate image. Results. The sample group consisted of four phases, each phase being performed prior to the first, second, third and fourth HDR-BT fraction, respectively. Statistical analysis showed that during HDR-BT fractions there were no significant differences in the average value of area, as well as in the maximum shape of prostate capsule. Conclusions. Quantitative analysis of TRUS axial prostate segmented images shows a successful capsule delineation in the series of manually segmented TRUS images, and the prostate maximum shape remaining unchanged during HDR-BT fractions.

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.

A note on axial symmetries

International Nuclear Information System (INIS)

Beetle, Christopher; Wilder, Shawn

2015-01-01

This note describes how to characterize and normalize an axial Killing field on a general Riemannian geometry or four-dimensional Lorentzian geometry. No global assumptions are necessary, such as that the orbits of the Killing field all have period 2π. Rather, any Killing field that vanishes at at least one point necessarily has the expected global properties. (note)

[Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation].

Science.gov (United States)

Ge, Qihang; Wan, Chunyou; Liu, Yabei; Ji, Xu; Ma, Jihai; Cao, Haikun; Yong, Wei; Liu, Zhao; Zhang, Ningning

2017-08-01

To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation. The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups ( P >0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures. There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group ( P good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups ( Z =-2.146, P =0

Point-splitting in a curved space-time background. 1 -gravitational contribution to the axial anomaly

International Nuclear Information System (INIS)

Liggatt, P.A.J.; Macfarlane, A.J.

1978-01-01

A prescription is given for point-splitting in a curved space-time background which is a natural generalization of that familiar in quantum electrodynamics and Yang-Mills theory. It is applied (to establish its validity) to the verification of the gravitational anomaly in the divergence of a fermion axial current. Notable features of the prescription are that it defines a point-split current which can be differentiated straightforwardly, and that it involves a natural way of averaging (four dimensionally) over the directions of point splitting. The method can extend directly from the spin-1/2 fermion case treated to other cases, e.g. to spin -3/2 Rarita-Schwinger fermions. (author)

Axial power deviation control strategy and computer simulation for Daya Bay Nuclear Power Station

International Nuclear Information System (INIS)

Liao Yehong; Zhou Xiaoling, Xiao Min

2004-01-01

Daya Bay Nuclear Power Station has very tight operation diagram especially at its right side. Therefore the successful control of axial power deviation for PWR is crucial to nuclear safety. After analyzing various core characters' effect on axial power distribution, several axial power deviation control strategies has been proposed to comply with different power varying operation scenario. Application and computer simulation of the strategies has shown that our prediction of axial power deviation evolution are comparable to the measurement values, and that our control strategies are effective. Engineering experience shows that the application of our methodology can predict accurately the transient of axial power deviation, and therefore has become a useful tool for reactor operation and safety control. This paper presents the axial power control characteristics, reactor operation strategy research, computer simulation, and comparison to measurement results in Daya Bay Nuclear Power Station. (author)

Theorem on axially symmetric gravitational vacuum configurations

Energy Technology Data Exchange (ETDEWEB)

Papadopoulos, A; Le Denmat, G [Paris-6 Univ., 75 (France). Inst. Henri Poincare

1977-01-24

A theorem is proved which asserts the non-existence of axially symmetric gravitational vacuum configurations with non-stationary rotation only. The eventual consequences in black-hole physics are suggested.

Tunable axial gauge fields in engineered Weyl semimetals: semiclassical analysis and optical lattice implementations

Science.gov (United States)

Roy, Sthitadhi; Kolodrubetz, Michael; Goldman, Nathan; Grushin, Adolfo G.

2018-04-01

In this work, we describe a toolbox to realize and probe synthetic axial gauge fields in engineered Weyl semimetals. These synthetic electromagnetic fields, which are sensitive to the chirality associated with Weyl nodes, emerge due to spatially and temporally dependent shifts of the corresponding Weyl momenta. First, we introduce two realistic models, inspired by recent cold-atom developments, which are particularly suitable for the exploration of these synthetic axial gauge fields. Second, we describe how to realize and measure the effects of such axial fields through center-of-mass observables, based on semiclassical equations of motion and exact numerical simulations. In particular, we suggest realistic protocols to reveal an axial Hall response due to the axial electric field \

Patient-reported impact of spondyloarthritis on work disability and working life: the ATLANTIS survey.

Science.gov (United States)

Ramonda, Roberta; Marchesoni, Antonio; Carletto, Antonio; Bianchi, Gerolamo; Cutolo, Maurizio; Ferraccioli, Gianfranco; Fusaro, Enrico; De Vita, Salvatore; Galeazzi, Mauro; Gerli, Roberto; Matucci-Cerinic, Marco; Minisola, Giovanni; Montecucco, Carlomaurizio; Pellerito, Raffaele; Salaffi, Fausto; Paolazzi, Giuseppe; Sarzi-Puttini, Piercarlo; Scarpa, Raffaele; Bagnato, Gianfilippo; Triolo, Giovanni; Valesini, Guido; Punzi, Leonardo; Olivieri, Ignazio

2016-04-01

The aim was to establish how patients experience the impact of spondyloarthritis (SpA) on work disability and working life. The survey was performed in 17/20 regions in Italy (1 January to 31 March 2013). A multiple-choice questionnaire was published on the official website of the sponsor - the National Association of Rheumatic Patients (ANMAR) - and hard-copies were distributed at outpatient clinics for rheumatic patients. Respondents (n = 770) were of both sexes (56 % men), educated (62 % at high school or more), of working age (75 % aged ≤60 years), and affected by SpA. The most common types diagnosed were ankylosing spondylitis (AS) (39 %) and psoriatic arthritis (PsA) (36 %). Respondents were working full-time (45 %), part-time (8 %) or had retired (22 %); 15 % were unemployed (for reasons linked to the disease or for other reasons, students or housewives). Patients reported disability (39 %), were receiving disability benefits (34 %), were experiencing important limitations that were hindering their professional development/career (36 %) and some had to change/leave their job or lost it because of SpA (21 %). Employed respondents (n = 383) had worked on average 32.2 h in the last 7 days. More hours of work were lost over the last 7 days due to SpA (2.39 h vs 1.67 h). The indirect costs of the disease amounted to €106/week for patients reporting well-being/good physical conditions/improvement and €216/week for those reporting permanent impairment. Most patients were in the midst of their productive years and were experiencing considerable difficulties in carrying out their job because of the disease: half of them reported disability and one third were experiencing important limitations in their career perspective.

Factors associated with accelerated subclinical atherosclerosis in patients with spondyloarthritis without overt cardiovascular disease.

Science.gov (United States)

Giollo, Alessandro; Dalbeni, Andrea; Cioffi, Giovanni; Ognibeni, Federica; Gatti, Davide; Idolazzi, Luca; Orsolini, Giovanni; Minuz, Pietro; Rossini, Maurizio; Fava, Cristiano; Viapiana, Ombretta

2017-11-01

Data on the progression of atherosclerosis in spondyloarthritis (SpA) are scarce, despite a high burden of cardiovascular diseases (CVD). The aim of this study was to identify the predictors of an accelerated subclinical atherosclerosis in patients with SpA. Study participants were 66 patients free of CVD classified according to ASAS criteria. The patients were evaluated at baseline and after 13.5 ± 3.6 months. Ultrasound measurements of carotid intima-media thickness (cIMT) and distensibility coefficient (cDC) were used to assess the extent of subclinical atherosclerosis. cIMT progression rate was calculated dividing the cIMT change by the time between the scans. Accelerated atherosclerosis was defined as the top cIMT progression rate quartile. At baseline, the mean Framingham Risk Score was 14 ± 11%. At follow-up, cIMT increased in 39 patients (59%; mean difference 0.01 ± 0.10; p = 0.334). Mean cIMT progression rate was 0.01 mm/year (95% CI - 0.02 to 0.03). cDC was unchanged at follow-up. Patients with accelerated atherosclerosis (n = 16) had significantly higher serum creatinine and lower glomerular filtration rate (eGFR) at baseline. In multiple logistic regression, only eGFR and the presence of syndesmophytes were associated with an accelerated atherosclerosis, independent of traditional cardiovascular risk factors. In patients with SpA without overt CV disease, a decrease in renal function and radiographic damage are conditions associated with the development of subclinical accelerated atherosclerosis. Longitudinal assessment of cIMT could be useful to better evaluate the individual CV risk of these patients improving their prognostic stratification.

Axial-Centrifugal Compressor Program

Science.gov (United States)

1975-10-01

Assembly . .. . .... ..... 33 5 Tie Bolt...... .. .. .. .. . *.. .. .. .. .. .. ... 34 6 Axial Compressor Rotor Assembly Runouts . . .. . 34 7 CCV Blow...1.796 Impeller Slip Factor ’Ce2/U 2 ) .91 Impeller Wheel Speed ft/sec 1992.2 Impellet ’.ip Radius in. 3.780 Blade Tip Metal Angle- deg 0 Numbec of Blades...test item to the next Phase V component test. The test vehicle final balance levels and rotor runouts were normal at teardown, and no rubsI were

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

Constitutive relations describing creep deformation for multi-axial time-dependent stress states

Science.gov (United States)

McCartney, L. N.

1981-02-01

A THEORY of primary and secondary creep deformation in metals is presented, which is based upon the concept of tensor internal state variables and the principles of continuum mechanics and thermodynamics. The theory is able to account for both multi-axial and time-dependent stress and strain states. The wellknown concepts of elastic, anelastic and plastic strains follow naturally from the theory. Homogeneous stress states are considered in detail and a simplified theory is derived by linearizing with respect to the internal state variables. It is demonstrated that the model can be developed in such a way that multi-axial constant-stress creep data can be presented as a single relationship between an equivalent stress and an equivalent strain. It is shown how the theory may be used to describe the multi-axial deformation of metals which are subjected to constant stress states. The multi-axial strain response to a general cyclic stress state is calculated. For uni-axial stress states, square-wave loading and a thermal fatigue stress cycle are analysed.

Design, Test, and Evaluation of a Transonic Axial Compressor Rotor with Splitter Blades

Science.gov (United States)

2013-09-01

INTRODUCTION A. MOTIVATION Over the course of turbomachinery history splitter vanes have been used extensively in centrifugal compressors . Axial...TEST, AND EVALUATION OF A TRANSONIC AXIAL COMPRESSOR ROTOR WITH SPLITTER BLADES by Scott Drayton September 2013 Dissertation Co...AXIAL COMPRESSOR ROTOR WITH SPLITTER BLADES 5. FUNDING NUMBERS 6. AUTHOR(S) Scott Drayton 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES

Spectral analysis in thin tubes with axial heterogeneities

KAUST Repository

Ferreira, Rita; Mascarenhas, M. Luí sa; Piatnitski, Andrey

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]).

Rotating stall simulation for axial and centrifugal compressors

Science.gov (United States)

Halawa, Taher; Gadala, Mohamed S.

2017-05-01

This study presents a numerical simulation of the rotating stall phenomenon in axial and centrifugal compressors with detailed descriptions of stall precursors and its development with time. Results showed that the vaneless region of the centrifugal compressor is the most critical location affected by stall. It was found that the tip leakage flow and the back flow impingement are the main cause of the stall development at the impeller exit area for centrifugal compressors. The results of the axial compressor simulations indicated that the early separated flow combined with the tip leakage flow can block the impeller passages during stall.

Interconnection between several eye biomechanical and biometric parameters in children with axial and refractive mild myopia

Directory of Open Access Journals (Sweden)

T. Ye. Tsybulskaya

2016-08-01

Full Text Available Aim – to study the relationship of biometric and biomechanical indicators of corneoscleral capsule of the eye in children with axial and refractive mild myopia. Materials and methods. Axial myopia was diagnosed in 32 children (64 eyes, refractive myopia – 18 (36 eyes. The control group – 16 children without ophthalmic diseases (32 eyes. Eye examination: visometry, automated refractometry, biomicroscopy, ophthalmoscopy, determination of the axial length of the eyeball and corneal hysteresis. Results. Significant differences were determined in the indicators of dioptric power of the cornea: 42.2 dpt in patients with axial and 44.7 dpt with refractive myopia (p<0.05, and also difference between patients with refractive myopia and the control group, in which the diopter power of cornea was 42.6 (p<0.05. There are also significant differences in the indicators of the axial length of eyes between axial and refractive myopia – 24.5±0.64 mm and 23.1±0.43 mm (p<0.05. Significant difference with the control group in the axial length marked only in eyes with axial myopia 22.7±0.33 mm and 24.5±0.64 mm, respectively (p<0.05. Corneal hysteresis determined significantly reduced on eyes with both the axial and refractive myopia, which was significantly lower than in the indicators of emmetropic eyes of the control group 13.7 (p<0.05. Corneal hysteresis is inversely related to the axial length of the eyeball: in patients with axial myopia r -0.32, p<0.05; with refractive myopia r -0.36, p<0.05. Сorrelation between diopter power of cornea and axial length of the eyeball: r -0.53, р<0.05 in eyes with axial myopia and r -0.42, p<0.05 refractive myopia. Comparative analysis showed no significant differences between the corneal hysteresis, the axial length of the eye and the spherical component of myopia. Conclusions. In patients with axial and refractive mild myopia corneal hysteresis is reduced on average in 1.2 and 1.1 times, in comparison with

Breast tumor classification using axial shear strain elastography: a feasibility study

International Nuclear Information System (INIS)

Thitaikumar, Arun; Ophir, Jonathan; Mobbs, Louise M; Kraemer-Chant, Christina M; Garra, Brian S

2008-01-01

Recently, the feasibility of visualizing the characteristics of bonding at an inclusion-background boundary using axial-shear strain elastography was demonstrated. In this paper, we report a feasibility study on the utility of the axial-shear strain elastograms in the classification of in vivo breast tumor as being benign or malignant. The study was performed using data sets obtained from 15 benign and 15 malignant cases that were biopsy proven. A total of three independent observers were trained, and their services were utilized for the study. A total of 9 cases were used as training set and the remaining cases were used as testing set. The feature from the axial-shear strain elastogram, namely, the area of the axial-shear region, was extracted by the observers. The observers also outlined the tumor area on the corresponding sonogram, which was used to normalize the area of the axial-shear strain region. There are several observations that can be drawn from the results. First, the result indicates that the observers consistently (∼82% of the cases) noticed the characteristic pattern of the axial-shear strain distribution data as predicted in the previous simulation studies, i.e. alternating regions of positive and negative axial-shear strain values around the tumor-background interface. Second, the analysis of the result suggests that in approximately 57% of the cases in which the observers did not visualize tumor in the sonogram, the elastograms helped them to locate the tumor. Finally, the analysis of the result suggests that for the discriminant feature value of 0.46, the number of unnecessary biopsies could be reduced by 56.3% without compromising on sensitivity and on negative predictive value (NPV). Based on the results in this study, feature values greater than 0.75 appear to be indicative of malignancy, while values less than 0.46 to be indicative of benignity. Feature values between 0.46 and 0.75 may result in an overlap between benign and malignant

Utility of axial images in an early Alzheimer disease diagnosis support system (VSRAD)

International Nuclear Information System (INIS)

Goto, Masami; Aoki, Shigeki; Abe, Osamu

2006-01-01

In recent years, voxel-based morphometry (VBM) has become a popular tool for the early diagnosis of Alzheimer disease. The Voxel-Based Specific Regional Analysis System for Alzheimer's Disease (VSRAD), a VBM system that uses MRI, has been reported to be clinically useful. The able-bodied person database (DB) of VSRAD, which employs sagittal plane imaging, is not suitable for analysis by axial plane imaging. However, axial plane imaging is useful for avoiding motion artifacts from the eyeball. Therefore, we created an able-bodied person DB by axial plane imaging and examined its utility. We also analyzed groups of able-bodied persons and persons with dementia by axial plane imaging and reviewed the validity. After using the DB of axial plane imaging, the Z-score of the intrahippocampal region improved by 8 in 13 instances. In all brains, the Z-score improved by 13 in all instances. (author)

[Utility of axial images in an early Alzheimer disease diagnosis support system (VSRAD)].

Science.gov (United States)

Goto, Masami; Aoki, Shigeki; Abe, Osamu; Masumoto, Tomohiko; Watanabe, Yasushi; Satake, Yoshiroh; Nishida, Katsuji; Ino, Kenji; Yano, Keiichi; Iida, Kyohhito; Mima, Kazuo; Ohtomo, Kuni

2006-09-20

In recent years, voxel-based morphometry (VBM) has become a popular tool for the early diagnosis of Alzheimer disease. The Voxel-Based Specific Regional Analysis System for Alzheimer's Disease (VSRAD), a VBM system that uses MRI, has been reported to be clinically useful. The able-bodied person database (DB) of VSRAD, which employs sagittal plane imaging, is not suitable for analysis by axial plane imaging. However, axial plane imaging is useful for avoiding motion artifacts from the eyeball. Therefore, we created an able-bodied person DB by axial plane imaging and examined its utility. We also analyzed groups of able-bodied persons and persons with dementia by axial plane imaging and reviewed the validity. After using the DB of axial plane imaging, the Z-score of the intrahippocampal region improved by 8 in 13 instances. In all brains, the Z-score improved by 13 in all instances.

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:

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

Assessment of the impact of modeling axial compression on PET image reconstruction.

Science.gov (United States)

Belzunce, Martin A; Reader, Andrew J

2017-10-01

To comprehensively evaluate both the acceleration and image-quality impacts of axial compression and its degree of modeling in fully 3D PET image reconstruction. Despite being used since the very dawn of 3D PET reconstruction, there are still no extensive studies on the impact of axial compression and its degree of modeling during reconstruction on the end-point reconstructed image quality. In this work, an evaluation of the impact of axial compression on the image quality is performed by extensively simulating data with span values from 1 to 121. In addition, two methods for modeling the axial compression in the reconstruction were evaluated. The first method models the axial compression in the system matrix, while the second method uses an unmatched projector/backprojector, where the axial compression is modeled only in the forward projector. The different system matrices were analyzed by computing their singular values and the point response functions for small subregions of the FOV. The two methods were evaluated with simulated and real data for the Biograph mMR scanner. For the simulated data, the axial compression with span values lower than 7 did not show a decrease in the contrast of the reconstructed images. For span 11, the standard sinogram size of the mMR scanner, losses of contrast in the range of 5-10 percentage points were observed when measured for a hot lesion. For higher span values, the spatial resolution was degraded considerably. However, impressively, for all span values of 21 and lower, modeling the axial compression in the system matrix compensated for the spatial resolution degradation and obtained similar contrast values as the span 1 reconstructions. Such approaches have the same processing times as span 1 reconstructions, but they permit significant reduction in storage requirements for the fully 3D sinograms. For higher span values, the system has a large condition number and it is therefore difficult to recover accurately the higher

Production of low axial energy spread ion beams with multicusp sources

Energy Technology Data Exchange (ETDEWEB)

Lee, Yung -Hee Y. [Univ. of California, Berkeley, CA (United States)

1998-05-01

Multicusp ion sources are capable of producing ions with low axial energy spread which are necessary in applications such as: ion projection lithography (IPL) and focused ion beams for the next generation lithographic tools and nuclear science experiments such as radioactive ion beam production. The axial ion energy spread for multicusp source is approximately 6 eV which is too large for IPL and radioactive ion beam applications. The addition of a magnetic filter which consists of a pair of permanent magnets to the multicusp source reduces the energy spread considerably. The reduction is due to the improvement in the uniformity of the axial plasma potential distribution in the discharge region. Axial ion energy spread of the filament driven ion source has been measured using three different techniques. In all cases, it was found to be less than 2 eV. Energy spread of the radio frequency (RF) driven source has also been explored, and it was found to be less than 3 eV with the proper RF-shielding. A new multicusp source configuration has been designed and constructed to further reduce the energy spread. To achieve a more uniform axial plasma potential distribution, a cylindrical magnetic filter has been designed and constructed for a 2-cm-diameter source. This new source configuration, the co-axial source, is new in its kind. The energy spread in this source has been measured to be a record low of 0.6 eV. Because of the novelty of this device, some plasma parameters inside the source have been studied. Langmuir probe has been used to measure the plasma potential, the electron temperature and the density distribution.

Production of low axial energy spread ion beams with multicusp sources

International Nuclear Information System (INIS)

Lee, Y.H.Y.

1998-05-01

Multicusp ion sources are capable of producing ions with low axial energy spread which are necessary in applications such as: ion projection lithography (IPL) and focused ion beams for the next generation lithographic tools and nuclear science experiments such as radioactive ion beam production. The axial ion energy spread for multicusp source is approximately 6 eV which is too large for IPL and radioactive ion beam applications. The addition of a magnetic filter which consists of a pair of permanent magnets to the multicusp source reduces the energy spread considerably. The reduction is due to the improvement in the uniformity of the axial plasma potential distribution in the discharge region. Axial ion energy spread of the filament driven ion source has been measured using three different techniques. In all cases, it was found to be less than 2 eV. Energy spread of the radio frequency (RF) driven source has also been explored, and it was found to be less than 3 eV with the proper RF-shielding. A new multicusp source configuration has been designed and constructed to further reduce the energy spread. To achieve a more uniform axial plasma potential distribution, a cylindrical magnetic filter has been designed and constructed for a 2-cm-diameter source. This new source configuration, the co-axial source, is new in its kind. The energy spread in this source has been measured to be a record low of 0.6 eV. Because of the novelty of this device, some plasma parameters inside the source have been studied. Langmuir probe has been used to measure the plasma potential, the electron temperature and the density distribution

Bifunctional organocatalysts for the asymmetric synthesis of axially chiral benzamides

Directory of Open Access Journals (Sweden)

Ryota Miyaji

2017-08-01

Full Text Available Bifunctional organocatalysts bearing amino and urea functional groups in a chiral molecular skeleton were applied to the enantioselective synthesis of axially chiral benzamides via aromatic electrophilic bromination. The results demonstrate the versatility of bifunctional organocatalysts for the enantioselective construction of axially chiral compounds. Moderate to good enantioselectivities were afforded with a range of benzamide substrates. Mechanistic investigations were also carried out.

Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views

International Nuclear Information System (INIS)

Schmidt, Sabine; Chalaron, Marc; Schnyder, Pierre; Denys, Alban; Chevallier, Patrick; Bessoud, Bertrand; Verdun, Francis R.; Frascarolo, Philippe

2005-01-01

The purpose of this study was to compare the diagnostic performance of axial and coronal views in multidetector CT enteroclysis (MDCTE). We retrospectively evaluated 48 patients with pathological correlation investigated by MDCTE for small bowel disorders. After nasojejunal administration of 2 l of 5% methylcellulose axial arterial and venous acquisition of MDCTE was followed by coronal reconstructions using equal slice thicknesses of 2.5 mm with 2 mm increments. Spatial resolution of both planes was evaluated by phantom. Three radiologists independently read axial and coronal images concerning 12 pathological features. The interobserver agreement and time of reading was calculated. Sensitivity and specificity resulted from comparison with histopathology (n=39) or follow-up (n=9). Phantom study revealed higher spatial resolution for axial than coronal views, whatever reconstruction interval was used. However, spatial frequency always remained high. Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and intraperitoneal fluid (IPF), showed better interobserver agreement on axial than coronal views (BWT: 0.61 vs. 0.44; BWE: 0.56 vs. 0.5; IPF:0.53 vs. 0.43). The Wilcoxon signed-rank test revealed significantly higher sensitivity for axial than coronal views (P=0.0453); the time of reading was significantly shorter for the latter (P=0.0146). The diagnostic value of axial slices is superior to coronal reconstructions despite the reduced data volume and display of the physiological course of bowel loops on the coronal plane. (orig.)

Applying the sequential neural-network approximation and orthogonal array algorithm to optimize the axial-flow cooling system for rapid thermal processes

International Nuclear Information System (INIS)

Hung, Shih-Yu; Shen, Ming-Ho; Chang, Ying-Pin

2009-01-01

The sequential neural-network approximation and orthogonal array (SNAOA) were used to shorten the cooling time for the rapid cooling process such that the normalized maximum resolved stress in silicon wafer was always below one in this study. An orthogonal array was first conducted to obtain the initial solution set. The initial solution set was treated as the initial training sample. Next, a back-propagation sequential neural network was trained to simulate the feasible domain to obtain the optimal parameter setting. The size of the training sample was greatly reduced due to the use of the orthogonal array. In addition, a restart strategy was also incorporated into the SNAOA so that the searching process may have a better opportunity to reach a near global optimum. In this work, we considered three different cooling control schemes during the rapid thermal process: (1) downward axial gas flow cooling scheme; (2) upward axial gas flow cooling scheme; (3) dual axial gas flow cooling scheme. Based on the maximum shear stress failure criterion, the other control factors such as flow rate, inlet diameter, outlet width, chamber height and chamber diameter were also examined with respect to cooling time. The results showed that the cooling time could be significantly reduced using the SNAOA approach

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...

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

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.

Axial shuffling fuel-management schemes for 1.2% SEU in CANDU

International Nuclear Information System (INIS)

Younis, M.H.; Boczar, P.G.

1989-11-01

The use of slightly enriched uranium (SEU) in CANDU (CANada Deuterium Uranium) requires a different fuel-management strategy than that usually employed with natural uranium fuel. Axial shuffling is a fuel-management strategy in which some or all of the fuel bundles are removed from the channel, rearranged, and reinserted into the same channel, along with fresh fuel. An axial shuffling scheme has been devised for 1.2% SEU which results in excellent power profiles, from the perspectives of both good axial flattening and power histories. With the CANFLEX (CANdu FLEXible fuelling) advanced fuel bundle, fuel rating can be reduced to below 40kW/m, with consequent safety benefits

Critical Axial Load

Directory of Open Access Journals (Sweden)

Walt Wells

2008-01-01

Full Text Available Our objective in this paper is to solve a second order differential equation for a long, simply supported column member subjected to a lateral axial load using Heun's numerical method. We will use the solution to find the critical load at which the column member will fail due to buckling. We will calculate this load using Euler's derived analytical approach for an exact solution, as well as Euler's Numerical Method. We will then compare the three calculated values to see how much they deviate from one another. During the critical load calculation, it will be necessary to calculate the moment of inertia for the column member.

Helical axial injection concept for cyclotrons

Energy Technology Data Exchange (ETDEWEB)

Hudson, E.D.

1981-01-01

A concept for an external beam injection system using a helical beam path centered on the cyclotron axis is described. This system could be used to couple two accelerator stages, with or without intermediate stripping, in cases where conventional axial injection or radial injection are not practical.

Helical axial injection concept for cyclotrons

International Nuclear Information System (INIS)

Hudson, E.D.

1981-01-01

A concept for an external beam injection system using a helical beam path centered on the cyclotron axis is described. This system could be used to couple two accelerator stages, with or without intermediate stripping, in cases where conventional axial injection or radial injection are not practical

BPHZL-subtraction scheme and axial gauges

Energy Technology Data Exchange (ETDEWEB)

Kreuzer, M.; Rebhan, A.; Schweda, M.; Piguet, O.

1986-03-27

The application of the BPHZL subtraction scheme to Yang-Mills theories in axial gauges is presented. In the auxillary mass formulation we show the validity of the convergence theorems for subtracted momentum space integrals, and we give the integral formulae necessary for one-loop calculations. (orig.).

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

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:

Discriminant validity study of Achilles enthesis ultrasound.

Science.gov (United States)

Expósito Molinero, María Rosa; de Miguel Mendieta, Eugenio

2016-01-01

We want to know if the ultrasound examination of the Achilles tendon in spondyloarthritis is different compared to other rheumatic diseases. We studied 97 patients divided into five groups: rheumatoid arthritis, spondyloarthritis, gout, chondrocalcinosis and osteoarthritis, exploring six elementary lesions in 194 Achilles entheses examined. In our study the total index ultrasonographic Achilles is higher in spondyloarthritis with significant differences. The worst elementary spondyloarthritis lesions for discriminations against other pathologies were calcification. This study aims to demonstrate the discriminant validity of Achilles enthesitis observed by ultrasound in spondyloarthritis compared with other rheumatic diseases that may also have ultrasound abnormalities such enthesis level. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Axial Hall effect and universality of holographic Weyl semi-metals

Energy Technology Data Exchange (ETDEWEB)

Copetti, Christian; Fernández-Pendás, Jorge; Landsteiner, Karl [Instituto de Física Teórica UAM/CSIC,c/ Nicolás Cabrera 13-15, Cantoblanco, 28049 Madrid (Spain)

2017-02-28

The holographic Weyl semimetal is a model of a strongly coupled topological semi-metal. A topological quantum phase transition separates a topological phase with non-vanishing anomalous Hall conductivity from a trivial state. We investigate how this phase transition depends on the parameters of the scalar potential (mass and quartic self coupling) finding that the quantum phase transition persists for a large region in parameter space. We then compute the axial Hall conductivity. The algebraic structure of the axial anomaly predicts it to be 1/3 of the electric Hall conductivity. We find that this holds once a non-trivial renormalization effect on the external axial gauge fields is taken into account. Finally we show that the phase transition also occurs in a top-down model based on a consistent truncation of type IIB supergravity.

Linear optical response of carbon nanotubes under axial magnetic field

Science.gov (United States)

Moradian, Rostam; Chegel, Raad; Behzad, Somayeh

2010-04-01

We considered single walled carbon naotubes (SWCNTs) as real three dimensional (3D) systems in a cylindrical coordinate. The optical matrix elements and linear susceptibility, χ(ω), in the tight binding approximation in terms of one-dimensional wave vector, kz and subband index, l are calculated. In an external axial magnetic field optical frequency dependence of linear susceptibility are investigated. We found that axial magnetic field has two effects on the imaginary part of the linear susceptibility spectrum, in agreement with experimental results. The first effect is broadening and the second, splitting. Also we found that for all metallic zigzag and armchair SWCNTs, the axial magnetic field leads to the creation of a peak with energy less than 1.5 eV, contrary to what is observed in the absence of a magnetic field.

Axially symmetrical stresses measurement in the cylindrical tube using DIC with hole-drilling

Science.gov (United States)

Ma, Yinji; Yao, Xuefeng; Zhang, Danwen

2015-03-01

In this paper, a new method combining the digital image correlation (DIC) with the hole-drilling technology to characterize the axially symmetrical stresses of the cylindrical tube is developed. First, the theoretical expressions of the axially symmetrical stresses in the cylindrical tube are derived based on the displacement or strain fields before and after hole-drilling. Second, the release of the axially symmetrical stresses for the cylindrical tube caused by hole-drilling is simulated by the finite element method (FEM), which indicates that the axially symmetrical stresses of the cylindrical tube calculated by the cylindrical solution is more accuracy than that for traditionally planar solution. Finally, both the speckle image information and the displacement field of the cylindrical tube before and after hole-drilling are extracted by combining the DIC with the hole-drilling technology, then the axially symmetrical loading induced stresses of the cylindrical tube are obtained, which agree well with the results from the strain gauge method.

Axially alignable nuclear fuel pellets

International Nuclear Information System (INIS)

Johansson, E.B.; Klahn, D.H.; Marlowe, M.O.

1978-01-01

An axially alignable nuclear fuel pellet of the type stacked in end-to-end relationship within a tubular cladding is described. Fuel cladding failures can occur at pellet interface locations due to mechanical interaction between misaligned fuel pellets and the cladding. Mechanical interaction between the cladding and the fuel pellets loads the cladding and causes increased cladding stresses. Nuclear fuel pellets are provided with an end structure that increases plastic deformation of the pellets at the interface between pellets so that lower alignment forces are required to straighten axially misaligned pellets. Plastic deformation of the pellet ends results in less interactions beween the cladding and the fuel pellets and significantly lowers cladding stresses. The geometry of pellets constructed according to the invention also reduces alignment forces required to straighten fuel pellets that are tilted within the cladding. Plastic deformation of the pellets at the pellet interfaces is increased by providing pellets with at least one end face having a centrally-disposed raised area of convex shape so that the mean temperature and shear stress of the contact area is higher than that of prior art pellets

Exact axially symmetric galactic dynamos

Science.gov (United States)

Henriksen, R. N.; Woodfinden, A.; Irwin, J. A.

2018-05-01

We give a selection of exact dynamos in axial symmetry on a galactic scale. These include some steady examples, at least one of which is wholly analytic in terms of simple functions and has been discussed elsewhere. Most solutions are found in terms of special functions, such as associated Lagrange or hypergeometric functions. They may be considered exact in the sense that they are known to any desired accuracy in principle. The new aspect developed here is to present scale-invariant solutions with zero resistivity that are self-similar in time. The time dependence is either a power law or an exponential factor, but since the geometry of the solution is self-similar in time we do not need to fix a time to study it. Several examples are discussed. Our results demonstrate (without the need to invoke any other mechanisms) X-shaped magnetic fields and (axially symmetric) magnetic spiral arms (both of which are well observed and documented) and predict reversing rotation measures in galaxy haloes (now observed in the CHANG-ES sample) as well as the fact that planar magnetic spirals are lifted into the galactic halo.

Resolution of extra-axial collections after decompressive craniectomy for ischemic stroke.

Science.gov (United States)

Ropper, Alexander E; Nalbach, Stephen V; Lin, Ning; Dunn, Ian F; Gormley, William B

2012-02-01

Extra-axial fluid collections are known consequences of decompressive hemicraniectomy. Studies have examined these collections and their management. We retrospectively reviewed 12 consecutive patients who underwent decompressive hemicraniectomy for the treatment of malignant cerebral edema after infarction and evaluated the evolution, resolution and treatment of post-operative extra-axial fluid collections. All patients underwent standard-sized frontotemporoparietal hemicraniectomy with duraplasty as treatment for medically intractable malignant cerebral edema at an average of 3 days after the stroke (median 2 days). Their 30-day mortality was 25%. Three patients developed some extra-axial fluid collections after craniectomy: two patients developed the collections early in their post-operative course, 3 days and 5 days after the craniectomy. Both experienced spontaneous resolution of the collections without corrective cranioplasty or shunt placement at 34 days and 58 days after surgery. The third patient developed a collection 55 days after the operation related to a subgaleal bacterial infection. In the final analysis, 18% of patients developed extra-axial collections and all resolved spontaneously. The incidence of extra-axial collections after decompressive hemicraniectomy following ischemic stroke was lower in our retrospective series than has been reported by others. The collections resolved spontaneously, suggesting that early anticipatory, corrective treatment with cerebrospinal fluid diversion or cranioplasty may not be warranted. Copyright © 2011 Elsevier Ltd. All rights reserved.

Axial oblique MR imaging of the intrinsic ligaments of the wrist: initial experience

International Nuclear Information System (INIS)

Robinson, G.; Chung, T.; Finlay, K.; Friedman, L.

2006-01-01

To evaluate two separate MR sequences acquired in the axial oblique plane, parallel to the long axis of the scapholunate (SL) and lunotriquetral (LT) ligaments, to determine whether the addition of these sequences to the standard MR wrist examination improves visualization of the intrinsic ligaments, and the evaluation of their integrity. To our knowledge, this plane has not been described in the literature previously. In total we evaluated 26 patients with chronic wrist pain or instability, referred for MR imaging following assessment by an orthopedic surgeon or physiatrist. All patients underwent initial conventional tri-compartment wrist arthrography, which served as the reference standard. This was immediately followed by MR arthrography, in the standard coronal and true axial planes, as well as in the axial oblique plane. The SL and LT ligaments were initially assessed for the presence or absence of tear, using the standard coronal and true axial sequences, and subsequently re-evaluated with the addition of the axial oblique planes. A total of ten intrinsic ligament tears were identified with conventional arthrography: six SL and four LT tears. Five of the six SL tears were identified on the standard sequences. All six were diagnosed with the addition of the oblique sequences. There were three false-positive SL tears identified using standard MR imaging, and two false-positives with the addition of the oblique sequences. No LT tear was identified on standard sequences, whereas all four were confidently seen with the addition of oblique images. No false-positives of the LT ligament were recorded with either standard or axial oblique sequences. The study suggests that the addition of axial oblique MR sequences helps identify tears to the intrinsic ligaments of the wrist, particularly the LT ligament. In addition, the axial oblique images assist in localization of the tear. (orig.)

Automatic measurement of axial length of human eye using three-dimensional magnetic resonance imaging

International Nuclear Information System (INIS)

Watanabe, Masaki; Kiryu, Tohru

2011-01-01

The measurement of axial length and the evaluation of three dimensional (3D) form of an eye are essential to evaluate the mechanism of myopia progression. We propose a method of automatic measurement of axial length including adjustment of the pulse sequence of short-term scan which could suppress influence of eyeblink, using a magnetic resonance imaging (MRI) which acquires 3D images noninvasively. Acquiring T 2 -weighted images with 3.0 tesla MRI device and eight-channel phased-array head coil, we extracted left and right eye ball images, and then reconstructed 3D volume. The surface coordinates were calculated from 3D volume, fitting the ellipsoid model coordinates with the surface coordinates, and measured the axial length automatically. Measuring twenty one subjects, we compared the automatically measured values of axial length with the manually measured ones, then confirmed significant elongation in the axial length of myopia compared with that of emmetropia. Furthermore, there were no significant differences (P<0.05) between the means of automatic measurements and the manual ones. Accordingly, the automatic measurement process of axial length could be a tool for the elucidation of the mechanism of myopia progression, which would be suitable for evaluating the axial length easily and noninvasively. (author)

Numerical investigation of the performances of axial separation helical baffle heat exchangers

International Nuclear Information System (INIS)

Tang, Hongling; Chen, Yaping; Wu, Jiafeng; Yang, Shifan

2016-01-01

Highlights: • Seriation incline angles of axial separation reduce helical baffle manufacture cost. • Adjacent helical baffles are separated by sleeve tubes to form a greater pitch helix. • Flow and thermal performances of normal and axial separation schemes were simulated. • Deviation of h.t.c. or pressure drop of 21(15)° and 21° schemes is −1.21% or 4.96%. • Seriation step of baffle incline angles can be extended to 8° by axial separation. - Abstract: Axial separation is a novel baffle connection configuration of circumferential overlap helical baffle heat exchangers which makes baffle incline angle seriation possible. The adjacent baffle plates are separated by sleeve tubes to form a greater pitched helix for enhancing heat transfer under required pressure drop with the least number of molds for reducing baffle manufacture cost. Numerical simulations of flow and heat transfer performances were conducted and the calculation results were verified by the experimental ones. Performance investigation was conducted on eight normal trisection helical baffle schemes with baffle incline angles from 15° to 23° and five axial separation schemes of equivalent 17–22° angles using 15° baffles. In the calculation scope the average deviations of heat transfer coefficients and pressure drops of the normal helical schemes are respectively about −1.97% and −8.11% per 1° deviation of incline angle. The axial separation schemes using 15° baffles with equivalent 21° and 22° incline angles have deviation values of heat transfer coefficient 1.21% and 1.33% lower and pressure drop 4.96% and 5.55% higher respectively than those of the normal 21° and 22° incline angle schemes. By adopting axial separation approach the seriation step of baffle incline angles can be extended to 8°.

Electron–Cyclotron Laser Using Free-Electron Two-Quantum Stark Radiation in a Strong Uniform Axial Magnetic Field and an Alternating Axial Electric Field in a Voltage-Supplied Pill-Box Cavity

International Nuclear Information System (INIS)

Kim, S. H.

2016-01-01

We consider the radiation from the beam electrons traveling in a strong uniform axial magnetic field and an axial alternating electric field of wavelength λ_w generated by a voltage-supplied pill-box cavity. The beam electrons emit genuine laser radiation that propagates only in the axial direction through free-electron two-quantum Stark radiation. We find that laser radiation takes place only at the expense of the axial kinetic energy when λ_w ≪ c/(ω_c/γ), where ω_c/γ is the relativistic electron–cyclotron frequency. We formulate the laser power based on quantum-wiggler electrodynamics, and envision a laser of length 10 m with estimated power 0.1 GW/(kA) in the 10"−"4 cm wavelength range. (paper)

Five-year follow-up of 23 asymmetrical Parkinson's disease patients treated with unilateral subthalamic nucleus stimulation

Institute of Scientific and Technical Information of China (English)

Jinchuan Liang; Xiaowu Hu; Xiaoping Zhou; Xiufeng Jiang; Yiqun Cao; Laixing Wang; Aiguo Jin; Jianmin Liu

2012-01-01

In this study, 23 asymmetrical Parkinson's disease patients were treated with unilateral deep brain stimulation of the subthalamic nucleus and followed up for 5 years. At 5 years after stimulation treatment, Unified Parkinson's Disease Rating Scale II, III and axial symptom scores in the off-drug condition were significantly increased compared those at baseline. However, total Unified Parkinson's Disease Rating Scale II, III and axial symptom scores were significantly lower with stimulation-on compared with the synchronous stimulation-off state in off-drug condition, and the motor symptoms of contralateral side limbs were effectively controlled. Only low Hoehn-Yahr stage was correlated with good long-term postoperative improvement in motor symptoms. The mean levodopa-equivalent daily dose after stimulation treatment was significantly lower than that before treatment, but dyskinesias became worse. Our experimental findings indicate that unilateral deep brain stimulation of the subthalamic nucleus is an effective treatment for improving motor symptoms in well selected asymmetrical Parkinson's disease patients presenting no severe axial symptoms and dyskinesias.

Multi-axial mechanical stimulation of tissue engineered cartilage: Review

Directory of Open Access Journals (Sweden)

S D Waldman

2007-04-01

Full Text Available The development of tissue engineered cartilage is a promising new approach for the repair of damaged or diseased tissue. Since it has proven difficult to generate cartilaginous tissue with properties similar to that of native articular cartilage, several studies have used mechanical stimuli as a means to improve the quantity and quality of the developed tissue. In this study, we have investigated the effect of multi-axial loading applied during in vitro tissue formation to better reflect the physiological forces that chondrocytes are subjected to in vivo. Dynamic combined compression-shear stimulation (5% compression and 5% shear strain amplitudes increased both collagen and proteoglycan synthesis (76 ± 8% and 73 ± 5%, respectively over the static (unstimulated controls. When this multi-axial loading condition was applied to the chondrocyte cultures over a four week period, there were significant improvements in both extracellular matrix (ECM accumulation and the mechanical properties of the in vitro-formed tissue (3-fold increase in compressive modulus and 1.75-fold increase in shear modulus. Stimulated tissues were also significantly thinner than the static controls (19% reduction suggesting that there was a degree of ECM consolidation as a result of long-term multi-axial loading. This study demonstrated that stimulation by multi-axial forces can improve the quality of the in vitro-formed tissue, but additional studies are required to further optimize the conditions to favour improved biochemical and mechanical properties of the developed tissue.

The Co-axial Flow of Injectable Solid Hydrogels with Encapsulated Cells

Science.gov (United States)

Stewart, Brandon; Pochan, Darrin; Sathaye, Sameer

2013-03-01

Hydrogels are quickly becoming an important biomaterial that can be used for the safe, localized injection of cancer drugs, the injection of stem cells into areas of interest or other biological applications. Our peptides can be self-assembled in a syringe where they form a gel, sheared by injection and, once in the body, immediately reform a localized pocket of stiff gel. My project has been designed around looking at the possibility of having a co-axial strand, in which one gel can surround another. This co-axial flow can be used to change the physical properties of our gel during injection, such as stiffening our gel using hyaluronic acid or encapsulating cells in the gel and surrounding the gel with growth medium or other biological factors. Rheology on hyaluron stiffened gels and cells encapsulated in gels was performed for comparison to the results from co-axial flow. Confocal microscopy was used to examine the coaxial gels after flow and to determine how the co-axial nature of the gels is affected by the concentration of peptide.

Tomografía axial computarizada en pacientes con enfermedades cerebrovasculares hemorrágicas Computerized axial tomography in patients with hemorrhagic cerebrovascular diseases

Directory of Open Access Journals (Sweden)

Solángel Bolaños Vaillant

2009-10-01

Full Text Available Se efectuó un estudio descriptivo y transversal de 196 pacientes con enfermedad cerebrovascular hemorrágica, que abarcó desde enero del 2004 hasta igual mes del 2005 en el Hospital Provincial Docente “Saturnino Lora” de Santiago de Cuba, a los cuales se indicó una tomografía axial computarizada. Al relacionar las imágenes tomográficas con los síntomas y signos presentados por los enfermos, se halló lenguaje tropeloso en todos ellos; predominio de hematomas intraparenquimatosos, generalmente en ganglios basales y región temporal, así como primacía de la hipertensión arterial entre los antecedentes patológicos más importantes. Se concluyó que la tomografía axial computarizada es un medio para diagnóstico certero en las urgencias médicas por esa grave afección.A descriptive and cross sectional study of 196 patients with cerebrovascular hemorrhagic disease was carried out from January, 2004 to the same month of 2005 in "Saturnino Lora" Teaching Provincial Hospital from Santiago de Cuba, to whom a computerized axial tomography was indicated. When relating the tomographic images with the symptoms and signs which they presented, trouble speaking was detected in all of them; prevalence of intraparenchymatous hematomas, generally in basal ganglia and temporal region, as well as prevalence of hypertension among the most important pathological history. It was concluded that computarized axial tomography is a mean for precise diagnosis in medical emergencies due to that serious disorder.

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.

Second harmonic generation of off axial vortex beam in the case of walk-off effect

Science.gov (United States)

Chen, Shunyi; Ding, Panfeng; Pu, Jixiong

2016-07-01

Process of off axial vortex beam propagating in negative uniaxial crystal is investigated in this work. Firstly, we get the formulae of the normalized electric field and calculate the location of vortices for second harmonic beam in two type of phase matching. Then, numerical analysis verifies that the intensity distribution and location of vortices of the first order original vortex beam depend on the walk-off angle and off axial magnitude. It is shown that, in type I phase matching, the distribution of vortices is symmetrical about the horizontal axis, the separation distance increases as the off axial magnitude increases or the off axial magnitude deceases. However, in type II phase matching, the vortices are symmetrical along with some vertical axis, and increase of the walk-off angle or off axial magnitude leads to larger separation distance. Finally, the case of high order original off axial vortex beam is also investigated.

Launch Lock Assemblies Including Axial Gap Amplification Devices and Spacecraft Isolation Systems Including the Same

Science.gov (United States)

Barber, Tim Daniel (Inventor); Hindle, Timothy (Inventor); Young, Ken (Inventor); Davis, Torey (Inventor)

2014-01-01

Embodiments of a launch lock assembly are provided, as are embodiments of a spacecraft isolation system including one or more launch lock assemblies. In one embodiment, the launch lock assembly includes first and second mount pieces, a releasable clamp device, and an axial gap amplification device. The releasable clamp device normally maintains the first and second mount pieces in clamped engagement; and, when actuated, releases the first and second mount pieces from clamped engagement to allow relative axial motion there between. The axial gap amplification device normally residing in a blocking position wherein the gap amplification device obstructs relative axial motion between the first and second mount pieces. The axial gap amplification device moves into a non-blocking position when the first and second mount pieces are released from clamped engagement to increase the range of axial motion between the first and second mount pieces.

A tubular hybrid Halbach/axially-magnetized permanent-magnet linear machine

Directory of Open Access Journals (Sweden)

Yi Sui

2017-05-01

Full Text Available A single-phase tubular permanent-magnet linear machine (PMLM with hybrid Halbach/axially-magnetized PM arrays is proposed for free-piston Stirling power generation system. Machine topology and operating principle are elaborately illustrated. With the sinusoidal speed characteristic of the free-piston Stirling engine considered, the proposed machine is designed and calculated by finite-element analysis (FEA. The main structural parameters, such as outer radius of the mover, radial length of both the axially-magnetized PMs and ferromagnetic poles, axial length of both the middle and end radially-magnetized PMs, etc., are optimized to improve both the force capability and power density. Compared with the conventional PMLMs, the proposed machine features high mass and volume power density, and has the advantages of simple control and low converter cost. The proposed machine topology is applicable to tubular PMLMs with any phases.

A tubular hybrid Halbach/axially-magnetized permanent-magnet linear machine

Science.gov (United States)

Sui, Yi; Liu, Yong; Cheng, Luming; Liu, Jiaqi; Zheng, Ping

2017-05-01

A single-phase tubular permanent-magnet linear machine (PMLM) with hybrid Halbach/axially-magnetized PM arrays is proposed for free-piston Stirling power generation system. Machine topology and operating principle are elaborately illustrated. With the sinusoidal speed characteristic of the free-piston Stirling engine considered, the proposed machine is designed and calculated by finite-element analysis (FEA). The main structural parameters, such as outer radius of the mover, radial length of both the axially-magnetized PMs and ferromagnetic poles, axial length of both the middle and end radially-magnetized PMs, etc., are optimized to improve both the force capability and power density. Compared with the conventional PMLMs, the proposed machine features high mass and volume power density, and has the advantages of simple control and low converter cost. The proposed machine topology is applicable to tubular PMLMs with any phases.

Cdx and Hox genes differentially regulate posterior axial growth in mammalian embryos

NARCIS (Netherlands)

Young, Teddy; Rowland, Jennifer Elizabeth; van de Ven, Cesca; Bialecka, Monika; Novoa, Ana; Carapuco, Marta; van Nes, Johan; de Graaff, Wim; Duluc, Isabelle; Freund, Jean-Noël; Beck, Felix; Mallo, Moises; Deschamps, Jacqueline

2009-01-01

Hox and Cdx transcription factors regulate embryonic positional identities. Cdx mutant mice display posterior body truncations of the axial skeleton, neuraxis, and caudal urorectal structures. We show that trunk Hox genes stimulate axial extension, as they can largely rescue these Cdx mutant

[The clinical characteristics of 26 cases of hypophosphatemia osteomalacia misdiagnosed as spondyloarthritis].

Science.gov (United States)

Jin, Jingyu; Sun, Fei; Wang, Gang; Yang, Jinshui; Luo, Gui; Ma, Hua; Zhao, Zheng; Feng, Lixia; Wang, Yanyan; Zhao, Wei; Zhang, Jianglin; Zhu, Jian; Huang, Feng

2014-11-01

To study and summarize the clinical features of hypophosphatemia osteomalacia (HO) misdiagnosed as spondyloarthritis (SpA), aiming to analyze the reasons of misdiagnosis and improve the prognosis of such patients. A total of 26 cases of HO misdiagnosed as SpA were selected. Clinical features, laboratory tests, and image presentations were analyzed. Related literatures were reviewed. (1) Clinical characters: 26 patients were included (12 males and 14 females) with a median age of 38 years (range 20-60). The mean disease duration was 3.2 years (range 0.75 to 10 years). Of all the patients, 15 were diagnosed as tumor-induced HO, 4 were long-term oral adefovir dipivoxil-related HO, 3 were associated with Fanconi syndrome, 2 were related to hyperparathyroidism, while 2 were Sjogren's syndrome complicated with renal tubular acidosis. All of the 26 patients presented with low back pain including 15 with night pain. The time of morning stiffness was about 30 minutes. Non-steroidal anti-inflammatory drugs were given to each patient whereas with poor efficacy, neither did other agents work well, such as glucocorticoids, disease modifying anti-rheumatic drugs and biologics. (2) LABORATORY FINDINGS: the platelet count and inflammatory markers such as erythrocyte sedimentation rate, C-reactive protein (CRP) were usually normal. The level of serum calcium was normal or slightly lower, nevertheless, all patients had hypophosphatemia and increased level of alkaline phosphatase (ALP). Patients with adefovir dipivoxil-related HO, Fanconi syndrome or Sjogren's syndrome complicated with renal tubular acidosis were characterized by hypokalemia, hyperchloremia and alkaline urine. Patients with hyperparathyroidism had elevated parathyroid hormone (PTH). Positive antinuclear antibodies (ANA) (titer ≥ 1: 320), anti-SSA/SSB antibodies were found in patients with Sjogren's syndrome. (3) Radiographic features: sacroiliac joint lesions were found in X-ray, CT, positron emission tomography

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

Numerical investigations on axial and radial blade rubs in turbo-machinery

Science.gov (United States)

Abdelrhman, Ahmed M.; Tang, Eric Sang Sung; Salman Leong, M.; Al-Qrimli, Haidar F.; Rajamohan, G.

2017-07-01

In the recent years, the clearance between the rotor blades and stator/casing had been getting smaller and smaller prior improving the aerodynamic efficiency of the turbomachines as demand in the engineering field. Due to the clearance reduction between the blade tip and the rotor casing and between rotor blades and stator blades, axial and radial blade rubbing could be occurred, especially at high speed resulting into complex nonlinear vibrations. The primary aim of this study is to address the blade axial rubbing phenomenon using numerical analysis of rotor system. A comparison between rubbing caused impacts of axial and radial blade rubbing and rubbing forces are also aims of this study. Tow rotor models (rotor-stator and rotor casing models) has been designed and sketched using SOILDSWORKS software. ANSYS software has been used for the simulation and the numerical analysis. The rubbing conditions were simulated at speed range of 1000rpm, 1500rpm and 2000rpm. Analysis results for axial blade rubbing showed the appearance of blade passing frequency and its multiple frequencies (lx, 2x 3x etc.) and these frequencies will more excited with increasing the rotational speed. Also, it has been observed that when the rotating speed increased, the rubbing force and the harmonics frequencies in x, y and z-direction become higher and severe. The comparison study showed that axial blade rub is more dangerous and would generate a higher vibration impacts and higher blade rubbing force than radial blade rub.

Studies of axial-leakage simulations for homogeneous and heterogeneous EBR-II core configurations

International Nuclear Information System (INIS)

Grimm, K.N.; Meneghetti, D.

1985-08-01

When calculations of flux are done in less than three dimensions, leakage-absorption cross sections are normally used to model leakages (flows) in the dimensions for which the flux is not calculated. Since the neutron flux is axially dependent, the leakages, and hence the leakage-absorption cross sections, are also axially dependent. Therefore, to obtain axial flux profiles (or reaction rates) for individual subassemblies, an XY-geometry calculation delineating each subassembly has to be done at several axial heights with space- and energy-dependent leakage-absorption cross sections that are appropriate for each height. This report discusses homogeneous and heterogeneous XY-geometry calculations at various axial locations and using several differing assumptions for the calculation of the leakage-absorption cross section. The positive (outward) leakage-absorption cross sections are modeled as actual leakage absorptions, but the negative (inward) leakage-absorption cross sections are modeled as either negative leakage absorptions (+-B 2 method) or positive downscatter cross sections [the Σ/sub s/(1 → g) method]. 3 refs., 52 figs., 10 tabs

Particle flow of ceramic breeder pebble beds in bi-axial compression experiments

International Nuclear Information System (INIS)

Hermsmeyer, S.; Reimann, J.

2002-01-01

Pebble beds of ceramic material are investigated within the framework of developing solid breeder blankets for future fusion power plants. A thermo-mechanical characterisation of such pebble beds is mandatory for understanding the behaviour of pebble beds, and thus the overall blanket, under fusion environment conditions. The mechanical behaviour of pebble beds is typically explored with uni-axial, bi-axial and tri-axial compression experiments. The latter two types of experiment are particularly revealing since they contain explicitly, beyond a compression behaviour of the bed, information on the conditions for pebble flow, i.e. macroscopic relocation, in the pebble bed. (orig.)

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 ... order as that of the screw-thread motor can be obtained. LIST OF .... The n stator have equal non- magnetic spacers .... induction motor. An.

A double-superconducting axial bearing system for an energy storage flywheel model

Science.gov (United States)

Deng, Z.; Lin, Q.; Ma, G.; Zheng, J.; Zhang, Y.; Wang, S.; Wang, J.

2008-02-01

The bulk high temperature superconductors (HTSCs) with unique flux-pinning property have been applied to fabricate two superconducting axial bearings for an energy storage flywheel model. The two superconducting axial bearings are respectively fixed at two ends of the vertical rotational shaft, whose stator is composed of seven melt-textured YBa2Cu3O7-x (YBCO) bulks with diameter of 30 mm, height of 18 mm and rotor is made of three cylindrical axial-magnetized NdFeB permanent magnets (PM) by superposition with diameter of 63 mm, height of 27 mm. The experimental results show the total levitation and lateral force produced by the two superconducting bearings are enough to levitate and stabilize the 2.4 kg rotational shaft. When the two YBCO stators were both field cooled to the liquid nitrogen temperature at respective axial distances above or below the PM rotor, the shaft could be automatically levitated between the two stators without any contact. In the case of a driving motor, it can be stably rotated along the central axis besides the resonance frequency. This double-superconducting axial bearing system can be used to demonstrate the flux-pinning property of bulk HTSC for stable levitation and suspension and the principle of superconducting flywheel energy storage system to visitors.

Axial force in a superconductor magnet journal bearing

Science.gov (United States)

Postrekhin, E.; Chong, Wang; Ki Bui, Ma; Chen, Quark; Chu, Wei-Kan

Using superconductors and magnets, a journal bearing could be made from a permanent magnet cylinder in a superconductor ring. We have assembled a prototype superconductor magnet journal bearing of this configuration, and investigated the behavior of the axial force that it can provide. We have put together a numerical model of the interaction between the permanent magnet and the superconductor that is capable of describing these experimental results semi-quantitatively. Combining direct experimental measurements and using the numerical models proposed, we have achieved a qualitative understanding of the behavior of the axial force and its relationship of to the dimensions of the magnet and material quality such as the homogeneity of the superconductor that constitute the bearing.

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.

Bifurcation of cubic nonlinear parallel plate-type structure in axial flow

International Nuclear Information System (INIS)

Lu Li; Yang Yiren

2005-01-01

The Hopf bifurcation of plate-type beams with cubic nonlinear stiffness in axial flow was studied. By assuming that all the plates have the same deflections at any instant, the nonlinear model of plate-type beam in axial flow was established. The partial differential equation was turned into an ordinary differential equation by using Galerkin method. A new algebraic criterion of Hopf bifurcation was utilized to in our analysis. The results show that there's no Hopf bifurcation for simply supported plate-type beams while the cantilevered plate-type beams has. At last, the analytic expression of critical flow velocity of cantilevered plate-type beams in axial flow and the purely imaginary eigenvalues of the corresponding linear system were gotten. (authors)

ABOUT MODELING COMPLEX ASSEMBLIES IN SOLIDWORKS – LARGE AXIAL BEARING

Directory of Open Access Journals (Sweden)

Cătălin IANCU

2017-12-01

Full Text Available In this paperwork is presented the modeling strategy used in SOLIDWORKS for modeling special items as large axial bearing and the steps to be taken in order to obtain a better design. In the paper are presented the features that are used for modeling parts, and then the steps that must be taken in order to obtain the 3D model of a large axial bearing used for bucket-wheel equipment for charcoal moving.

The research on flow pulsation characteristics of axial piston pump

Science.gov (United States)

Wang, Bingchao; Wang, Yulin

2017-01-01

The flow pulsation is an important factor influencing the axial piston pump performance. In this paper we implement modeling and simulation of the axial piston pump with AMESim software to explore the flow pulsation characteristics under various factors . Theory analysis shows the loading pressure, angular speed, piston numbers and the accumulator impose evident influence on the flow pulsation characteristics. This simulation and analysis can be used for reducing the flow pulsation rate via properly setting the related factors.

A review of creep analysis and design under multi-axial stress states

International Nuclear Information System (INIS)

Yao, H.-T.; Xuan Fuzhen; Wang Zhengdong; Tu Shantung

2007-01-01

The existence of multi-axial states of stress cannot be avoided in elevated temperature components. It is essential to understand the associated failure mechanisms and to predict the lifetime in practice. Although metal creep has been studied for about 100 years, many problems are still unsolved, in particular for those involving multi-axial stresses. In this work, a state-of-the-art review of creep analysis and engineering design is carried out, with particular emphasis on the effect of multi-axial stresses. The existing theories and creep design approaches are grouped into three categories, i.e., the classical plastic theory (CPT) based approach, the cavity growth mechanism (CGM) based approach and the continuum damage mechanics (CDM) based approach. Following above arrangements, the constitutive equations and design criteria are addressed. In the end, challenges on the precise description of the multi-axial creep behavior and then improving the strength criteria in engineering design are presented

Axial Force Analysis and Roll Contour Configuration of Four-High CVC Mill

Directory of Open Access Journals (Sweden)

Guang-ming Liu

2018-01-01

Full Text Available In order to analyze the influence of technical parameters on work roll axial force of four-high continuous variable crown (CVC mill, the deformation analyzing model with top roll system and strip was established based on influence function method. Then a CVC work roll curve designing scheme was proposed and it was carried out on some cold rolling mill considering the requirement of comprehensive work roll axial force minimization. The status of comprehensive work roll axial force is improved considering the rolling schedule that is beneficial to the roller bearing. Corresponding to the newly designed work roll contour, the backup roll end chamfer was designed considering comprehensive performance of interroll stress concentration, comprehensive work roll axial force, and strip shape control ability. The distribution of roll wear with newly designed backup roll contour is more even according to the field application data. The newly established roll configuration scheme is beneficial to four-high CVC mill.

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.)

The Influence of the Axial Magnetic Field Upon-the Coaxial Plasma Gun Parameters

International Nuclear Information System (INIS)

El-Aragi, G.M.; EL-Demrdash, A.

2001-01-01

This study concerns with the influence of an applied axial magnetic field upon the electrical parameters of a coaxial plasma gun device. The experimental results are investigated with 0.5 KJ plasma gun device operated with argon gas at a pressure of 3.5 Torr. An axial time independent magnetic field with intensity of 550 G is introduced along the plasma current sheath axial region, within the annular space between the two coaxial electrodes. From the measurements of the discharge current I(t) and the voltage V(t), the electrical discharge parameters of the plasma gun device and the plasma current sheath implosion velocity are estimated, in normal mode of plasma gun operation and in the mode of presence external axial magnetic field. A comparison between these two modes is studied

Axial power difference control strategy and computer simulation for GNPS during stretch-out and power decrease

International Nuclear Information System (INIS)

Liao Yehong; Xiao Min; Li Xianfeng; Zhu Minhong

2004-01-01

Successful control of the axial power difference for PWR is crucial to nuclear safety. After analyzing various elements' effect on the axial power distribution, different axial power deviation control strategies have been proposed to comply with different power decrease scenarios. Application of the strategy to computer simulation shows that our prediction of axial power deviation evolution is comparable to the measurement value, and that our control strategy is effective

THE EFFECT OF VARIATION CONCRETE CUBE OF AXIAL LOAD ON ULTRASONIC PULSE VELOCITY TRANSMITTER

Directory of Open Access Journals (Sweden)

Faqih Ma’arif

2015-05-01

The test result showed that the increase of ultrasonic pulse velocity effect on cube II due to axial load variation was optimum at 0,35P0 and was minimum at 0,7P0, if compared to the one without axial load, the results were 4,17% and 11,60 respectively. The decrease of pulse velocity on cube III due to axial load variation was at 0,25P0 and 0,7P0; if compared to the one without axial load the result were 0,47% and 20,87% respectively. And the increase of ultrasonic pulse velocity effect on cube IV due to axial load variation was optimum at 0,35P0 and was minimum at 0,7P0; if compared to the one without axial load the result were 0,52% and 21,63% respectively. The maximum limit of effective load step at structure experiencing compressive load ranged from 0,35P0 up to 0,4P0. At high stress level, the crack that occurred was spread evenly to the concrete cubic components and was giving an exponential equation y = y= 5,11e0,0467x. The result of analysis of cubes II, III and IV showed that on paired sample t-test 0,00<0,025, the significant value (2-tailed (0,00<(0,025; meaning there was a difference of pulse velocity due to axial load variation on concrete cube.

Dispersive approach to the axial anomaly and nonrenormalization theorem

International Nuclear Information System (INIS)

Pasechnik, R.S.; Teryaev, O.V.

2006-01-01

Anomalous triangle graphs for the divergence of the axial-vector current are studied using the dispersive approach generalized for the case of higher orders of perturbation theory. The validity of this procedure is proved up to the two-loop level. By direct calculation in the framework of dispersive approach we have obtained that the two-loop axial-vector-vector (AVV) amplitude is equal to zero. According to the Vainshtein's theorem, the transversal part of the anomalous triangle is not renormalized in the chiral limit. We generalize this theorem for the case of finite fermion mass in the triangle loop

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

Multiaxial ratcheting behavior of zirconium alloy tubes under combined cyclic axial load and internal pressure

Energy Technology Data Exchange (ETDEWEB)

Chen, G.; Zhang, X. [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Xu, D.K. [Environmental Corrosion Center, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016 (China); Li, D.H. [Hunan Taohuajiang Nuclear Power Co., Ltd, Yiyang, 413000 (China); Chen, X. [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Zhang, Z., E-mail: zhe.zhang@tju.edu.cn [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China)

2017-06-15

In this study, a series of uniaxial and multiaxial ratcheting tests were conducted at room temperature on zirconium alloy tubes. The experimental results showed that for uniaxial symmetrical cyclic test, the axial ratcheting strain ɛ{sub x} did not accumulate obviously in initial stage, but gradually increased up to 1% with increasing stress amplitude σ{sub xa}. For multiaxial ratcheting tests, the zirconium alloy tube was highly sensitive to both the axial stress amplitude σ{sub xa} and the internal pressure p{sub i}. The hoop ratcheting strain ɛ{sub θ} increased continuously with the increase of axial stress amplitude, whereas the evolution of axial ratcheting strain ɛ{sub x} was related to the axial stress amplitude. The internal pressure restricted the ratcheting accumulation in the axial direction, but promoted the hoop ratcheting strain on the contrary. The prior loading history greatly restrained the ratcheting behavior of subsequent cycling with a small internal pressure. - Highlights: •Uniaxial and multiaxial ratcheting behavior of the zirconium alloy tubes are investigated at room temperature. •The ratcheting depends greatly on the stress amplitude or internal pressure. •The interaction between the axial and hoop ratcheting mechanisms is greatly dependent on the internal pressure level. •The ratcheting is influenced significantly by the loading history of internal pressure.

Multiaxial ratcheting behavior of zirconium alloy tubes under combined cyclic axial load and internal pressure

International Nuclear Information System (INIS)

Chen, G.; Zhang, X.; Xu, D.K.; Li, D.H.; Chen, X.; Zhang, Z.

2017-01-01

In this study, a series of uniaxial and multiaxial ratcheting tests were conducted at room temperature on zirconium alloy tubes. The experimental results showed that for uniaxial symmetrical cyclic test, the axial ratcheting strain ɛ x did not accumulate obviously in initial stage, but gradually increased up to 1% with increasing stress amplitude σ xa . For multiaxial ratcheting tests, the zirconium alloy tube was highly sensitive to both the axial stress amplitude σ xa and the internal pressure p i . The hoop ratcheting strain ɛ θ increased continuously with the increase of axial stress amplitude, whereas the evolution of axial ratcheting strain ɛ x was related to the axial stress amplitude. The internal pressure restricted the ratcheting accumulation in the axial direction, but promoted the hoop ratcheting strain on the contrary. The prior loading history greatly restrained the ratcheting behavior of subsequent cycling with a small internal pressure. - Highlights: •Uniaxial and multiaxial ratcheting behavior of the zirconium alloy tubes are investigated at room temperature. •The ratcheting depends greatly on the stress amplitude or internal pressure. •The interaction between the axial and hoop ratcheting mechanisms is greatly dependent on the internal pressure level. •The ratcheting is influenced significantly by the loading history of internal pressure.

Anisotropic Material Behavior of Uni-axially Compacted Graphite Matrix for HTGR Fuel Compact Fabrication

Energy Technology Data Exchange (ETDEWEB)

Lee, Young-Woo; Yeo, Seunghwan; Yoon, Ji-Hae; Cho, Moon Sung [KAERI, Daejeon (Korea, Republic of)

2016-05-15

In developing the fuel compact fabrication technology, and fuel graphite material to meet the required material properties, it is essential to investigate the relationship among the process parameters of the matrix graphite powder preparation, the fabrication parameters of fuel element green compact and the heat treatments conditions and the material properties of fuel element. It was observed, during this development, that the pressing technique employed for the compaction fabrication prior to the two successive heat treatments (carbonization and final high temperature heat treatment) was of extreme importance in determining the material properties of the final compact product. In this work, the material behavior of the uni-axially pressed graphite matrix during the carbonization and final heat treatment are evaluated and summarized along the different directions, viz., perpendicular and parallel directions to pressing direction. In this work, the dimensional variations and variations in thermal expansion, thermal conductivity and Vickers hardness of the graphite matrix compact samples in the axial and radial directions prepared by uni-axial pressing are evaluated, and compared with those of samples prepared by cold isostatic pressing with the available data. From this work, the followings are observed. 1) Dimensional changes of matrix graphite green compacts during carbonization show that the difference in radial and axial variations shows a large anisotropic behavior in shrinkage. The radial variation is very small while the axial variation is large. During carbonization, the stresses caused by the force would be released in to the axial direction together with the phenolic resin vapor. 2) Dimensional variation of compact samples in perpendicular and parallel directions during carbonization shows a large difference in behavior when compact sample is prepared by uni-axial pressing. However, when compact sample is prepared by cold isostatic pressing, there is

Anisotropic Material Behavior of Uni-axially Compacted Graphite Matrix for HTGR Fuel Compact Fabrication

International Nuclear Information System (INIS)

Lee, Young-Woo; Yeo, Seunghwan; Yoon, Ji-Hae; Cho, Moon Sung

2016-01-01

In developing the fuel compact fabrication technology, and fuel graphite material to meet the required material properties, it is essential to investigate the relationship among the process parameters of the matrix graphite powder preparation, the fabrication parameters of fuel element green compact and the heat treatments conditions and the material properties of fuel element. It was observed, during this development, that the pressing technique employed for the compaction fabrication prior to the two successive heat treatments (carbonization and final high temperature heat treatment) was of extreme importance in determining the material properties of the final compact product. In this work, the material behavior of the uni-axially pressed graphite matrix during the carbonization and final heat treatment are evaluated and summarized along the different directions, viz., perpendicular and parallel directions to pressing direction. In this work, the dimensional variations and variations in thermal expansion, thermal conductivity and Vickers hardness of the graphite matrix compact samples in the axial and radial directions prepared by uni-axial pressing are evaluated, and compared with those of samples prepared by cold isostatic pressing with the available data. From this work, the followings are observed. 1) Dimensional changes of matrix graphite green compacts during carbonization show that the difference in radial and axial variations shows a large anisotropic behavior in shrinkage. The radial variation is very small while the axial variation is large. During carbonization, the stresses caused by the force would be released in to the axial direction together with the phenolic resin vapor. 2) Dimensional variation of compact samples in perpendicular and parallel directions during carbonization shows a large difference in behavior when compact sample is prepared by uni-axial pressing. However, when compact sample is prepared by cold isostatic pressing, there is

Axially substituted silicon (IV) tetrapyrazinoporphyrazines: Synthesis, characterization and investigation of photophysicochemical properties

Energy Technology Data Exchange (ETDEWEB)

Jung, Chang Young; Park, Jong Min; Song, Cheol Jun; Jaung, Jae Yun, E-mail: jjy1004@hanyang.ac.kr

2016-02-15

A series of silicon tetrapyrazinoporphyrazine (SiPz) complexes, conjugated with various substituents at their axial positions, were synthesized into non-aggregated structures in organic solvents. The UV–vis spectra of the SiPz complexes maintained a strong and sharp Q-band, which is an archetypal characteristic of non-aggregated phthalocyanines (Pcs), in various organic solvents under high concentrations. In addition, the SiPz complexes with axial alkyl groups had high fluorescence quantum yields and singlet oxygen quantum yields. However, the SiPz complexes with axial aniline groups had very low fluorescence quantum yields and singlet oxygen quantum yields due to the quenching ability of the aniline group.

Constraining vectors and axial-vectors in walking technicolour by a holographic principle

DEFF Research Database (Denmark)

D. Dietrich, Dennis; Kouvaris, Christoforos

2008-01-01

We use a holographic principle to study the low-energy spectrum of walking technicolour models. In particular, we predict the masses of the axial vectors as well as the decay constants of vectors and axial vectors as functions of the mass of the techni-rho. Given that there are very few...

Axial offset anomalies and local pH

International Nuclear Information System (INIS)

Tarin, F.; Montes, M.; Izquierdo, J.; Garcia-Sanchez, J.

2001-01-01

Small radial and axial offset anomalies (AOA) in some Spanish PWR-type NPP's, in addition to the knowledge of the existence of similar anomalies in U.S. PWR's, led us in 1993 to study this problem. Important parameters were correlated for a database of plant operating data consisting of six cycles of five different PWR plants (all of them of the Westinghouse 3-loop, 12 ft., 17 x 17 fuel design). One of these cycles (the oldest one) followed the standard constant pH 308 = 7.0, and the remaining ones followed a modified elevated pH control strategy (the pH at EOC is typically 7.4). Only for the oldest cycle that used the standard pH control was the in-core and ex-core axial offset values found to be in good agreement with the predictions, and an anomalous soluble boron curve behavior not observed. (author)

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.

Elastin Cables Define the Axial Connective Tissue System in the Murine Lung.

Science.gov (United States)

Wagner, Willi; Bennett, Robert D; Ackermann, Maximilian; Ysasi, Alexandra B; Belle, Janeil; Valenzuela, Cristian D; Pabst, Andreas; Tsuda, Akira; Konerding, Moritz A; Mentzer, Steven J

2015-11-01

The axial connective tissue system is a fiber continuum of the lung that maintains alveolar surface area during changes in lung volume. Although the molecular anatomy of the axial system remains undefined, the fiber continuum of the lung is central to contemporary models of lung micromechanics and alveolar regeneration. To provide a detailed molecular structure of the axial connective tissue system, we examined the extracellular matrix of murine lungs. The lungs were decellularized using a 24 hr detergent treatment protocol. Systematic evaluation of the decellularized lungs demonstrated no residual cellular debris; morphometry demonstrated a mean 39 ± 7% reduction in lung dimensions. Scanning electron microscopy (SEM) demonstrated an intact structural hierarchy within the decellularized lung. Light, fluorescence, and SEM of precision-cut lung slices demonstrated that alveolar duct structure was defined by a cable line element encased in basement membrane. The cable line element arose in the distal airways, passed through septal tips and inserted into neighboring blood vessels and visceral pleura. The ropelike appearance, collagenase resistance and anti-elastin immunostaining indicated that the cable was an elastin macromolecule. Our results indicate that the helical line element of the axial connective tissue system is composed of an elastin cable that not only defines the structure of the alveolar duct, but also integrates the axial connective tissue system into visceral pleura and peripheral blood vessels. © 2015 Wiley Periodicals, Inc.

Effect of bone-soft tissue friction on ultrasound axial shear strain elastography.

Science.gov (United States)

Tang, Songyuan; Chaudhry, Anuj; Kim, Namhee; Reddy, J N; Righetti, Raffaella

2017-07-12

Bone-soft tissue friction is an important factor affecting several musculoskeletal disorders, frictional syndromes and the ability of a bone fracture to heal. However, this parameter is difficult to determine using non-invasive imaging modalities, especially in clinical settings. Ultrasound axial shear strain elastography is a non-invasive imaging modality that has been used in the recent past to estimate the bonding between different tissue layers. As most elastography methods, axial shear strain elastography is primarily used in soft tissues. More recently, this technique has been proposed to assess the bone-soft tissue interface. In this paper, we investigate the effect of a variation in bone-soft tissue friction coefficient in the resulting axial shear strain elastograms. Finite element poroelastic models of bone specimens exhibiting different bone-soft tissue friction coefficients were created and mechanically analyzed. These models were then imported to an ultrasound elastography simulation module to assess the presence of axial shear strain patterns. In vitro experiments were performed to corroborate selected simulation results. The results of this study show that the normalized axial shear strain estimated at the bone-soft tissue interface is statistically correlated to the bone-soft tissue coefficient of friction. This information may prove useful to better interpret ultrasound elastography results obtained in bone-related applications and, possibly, monitor bone healing.

Deformation and collapse of zircaloy fuel rod cladding into plenum axial gaps

International Nuclear Information System (INIS)

Pfennigwerth, P.L.; Gorscak, D.A.; Selsley, I.A.

1983-01-01

To minimize support structure, blanket and reflector fuel rods of the thoria urania-fueled Light Water Breeder Reactor (LWBR) were designed with non-freestanding Zircaloy-4 cladding. An analytical model was developed to predict deformation of unirradiated cladding into axial gaps of fuel rod plenum regions where it is unsupported. This model uses the ACCEPT finite element computer program to calculate elastic-plastic deformation of cladding due to external pressure. The finite element is 20-node, triquadratic, isoparametric, and 3-dimensional. Its curved surface permits accurate modeling of the tube geometry, including geometric nonuniformities such as circumferential wall thickness variation and initial tube out-of-roundness. Progressive increases in axial gap length due to cladding elongation and fuel stack shrinkage are modeled, as are deformations of fuel pellets and stainless steel support sleeves which bound plenum axial gaps in LWBR type blanket fuel rods. Zircaloy-4 primary and secondary thermal creep representations were developed from uniaxial creep testing of fuel rod tubing. Creep response to multi-axial loading is modeled with a variation of Hill's formulation for anisotropic materials. Coefficients accounting for anisotropic thermal creep in Zircaloy-4 tubes were developed from creep testing of externally pressurized tubes having fixed axial gaps in the range 2.5 cm to 5.7 cm and radial clearances over simulated fuel pellets ranging from zero to 0.089 mm. (orig./RW)

Axial transport of fission gas in LWR fuel rods

International Nuclear Information System (INIS)

Kinoshita, M.

1983-01-01

With regard to fission gas transportation inside the fuel rod, the following three mechanisms are important: (1) a localized and time dependent fission gas release from UO 2 fuel to pellet/clad gap, (2) the consequent gas pressure difference between the gap and the plenum, and (3) the inter-diffusion of initially filled Helium and released fission gas such as Xenon. Among these three mechanisms, the 2nd mechanism would result in the one dimensional flow through P/C gap in the axial direction, while the 3rd would average the local fission gas concentration difference. In this paper, an attempt was made to develop a computerized model, LINUS (LINear flow and diffusion under Un-Steady condition) describing the above two mechanisms, items (2) and (3). The item (1) is treated as an input. The code was applied to analyse short length experimental fuel rods and long length commercial fuel rods. The calculated time evolution of Xe concentration along the fuel column shows that the dilution rate of Xe in commercial fuel rods is much slower than that in short experimental fuel rods. Some other sensitivity studies, such as the effect of pre-pressurization, are also presented. (author)

Tunable Clamped–Guided Arch Resonators Using Electrostatically Induced Axial Loads

KAUST Repository

Alcheikh, Nouha; Ramini, Abdallah; Hafiz, Md Abdullah Al; Younis, Mohammad I.

2017-01-01

We present a simulation and experimental investigation of bi-directional tunable in-plane clamped-guided arch microbeam resonators. Tensile and compressive axial forces are generated from a bi-directional electrostatic actuator, which modulates the microbeam stiffness, and hence changes its natural frequency to lower or higher values from its as-fabricated value. Several devices of various anchor designs and geometries are fabricated. We found that for the fabricated shallow arches, the effect of the curvature of the arch is less important compared to the induced axial stress from the axial load. We have shown that the first mode resonance frequency can be increased up to twice its initial value. Additionally, the third mode resonance frequency can be increased up to 30% of its initial value. These results can be promising as a proof-of-concept for the realization of wide-range tunable microresonators. The experimental results have been compared to finite-element simulations, showing good agreement among them.

Axial temperatures and fuel management models for a HTR system

Energy Technology Data Exchange (ETDEWEB)

Hansen, U

1971-11-12

In the HTR system, there is a large difference in temperature between different parts of the reactor core. The softer neutron spectrum in the upper colder core regions tends to shift the power productions in the fresh fuel upwards. As uranium 235 depletes and plutonium with its higher cross sections in the lower hot regions is built-up, an axial power flattening takes place. These effects have been studied in detail for a single column in an equilibrium environment. The aim of this paper is to relate these findings to a whole reactor core and to investigate the influence of axial temperatures on the overall performance and in particular, the fuel management scheme chosen for the reference design. A further objective has been to calculate the reactivity requirements for different part load conditions and for various daily and weekly load diagrams. As the xenon cross section changes significantly with temperature these investigations are performed for an equilibrium core with due representation of axial temperature zones.

Tunable Clamped–Guided Arch Resonators Using Electrostatically Induced Axial Loads

KAUST Repository

Alcheikh, Nouha

2017-01-04

We present a simulation and experimental investigation of bi-directional tunable in-plane clamped-guided arch microbeam resonators. Tensile and compressive axial forces are generated from a bi-directional electrostatic actuator, which modulates the microbeam stiffness, and hence changes its natural frequency to lower or higher values from its as-fabricated value. Several devices of various anchor designs and geometries are fabricated. We found that for the fabricated shallow arches, the effect of the curvature of the arch is less important compared to the induced axial stress from the axial load. We have shown that the first mode resonance frequency can be increased up to twice its initial value. Additionally, the third mode resonance frequency can be increased up to 30% of its initial value. These results can be promising as a proof-of-concept for the realization of wide-range tunable microresonators. The experimental results have been compared to finite-element simulations, showing good agreement among them.

Axial sesamoiditis in the horse: A review

Directory of Open Access Journals (Sweden)

Christelle Le Roux

2018-03-01

Full Text Available Axial sesamoiditis or osteitis of the proximal sesamoid bones (PSBs in the horse is described as a rare condition. The cause remains unknown and speculative, with vascular, infectious, and traumatic aetiologies implicated. It is specifically associated with injury of the palmar or plantar ligament (PL, also known as the intersesamoidean ligament. Imaging findings are generally rewarding and radiological changes are typical, if not pathognomonic, for the condition. Lesions consist of bone lysis at the apical to mid-body axial margins of the PSBs, with variable degrees of joint effusion. Radiographic technique warrants careful attention to make a diagnosis, and exposure factors may need to be adjusted. Perineural, intra-articular and intra-thecal anaesthesia does not seem to provide consistent improvement of lameness in these cases, with literature reporting inconsistent findings. Ultrasonographic findings include digital flexor sheath effusion, loss of the normal fibre structure of the PL at its attachment to the PSBs, abnormal echogenicity or change in thickness of the PL, and irregular hyperechoic cortical margins of the axial margins of the PSBs. Scintigraphy, computed tomography and magnetic resonance imaging, although not necessary to make a diagnosis, may add valuable information regarding the location and extent of lesions. The prognosis remains guarded to poor for return to athletic function. The focus of this paper is a comprehensive review of the proposed aetiopathogenesis of the condition, the prognosis, and a summary of the literature findings with focus on the notable diagnostic imaging features, including radiography, ultrasonography, scintigraphy, computed tomography and magnetic resonance imaging.

Behaviour of a neutral particle with spin in an axial magnetic field

International Nuclear Information System (INIS)

Sorokin, S.V.; Ehpp, V.Ya.

1982-01-01

Proceeding from the Tamm-Good equation taking into account the spin influence on motion trajectory, the neutral particle motion tracjectory and vector turn of spin polarizition in axial magnetic field have been found. The behaviour of a neutral particle possessing its own magnetic moment in an axially-symmetric stationary magnetic field is considered

Prevalence of Peri-Implant Mucositis and Peri-Implantitis in Patients Treated with a Combination of Axial and Tilted Implants Supporting a Complete Fixed Denture

Directory of Open Access Journals (Sweden)

Nicolò Cavalli

2015-01-01

Full Text Available Objectives. The aim of this retrospective study was to assess the incidence and prevalence of peri-implant mucositis and peri-implantitis in patients with a fixed full-arch prosthesis supported by two axial and two tilted implants. Materials and Methods. Sixty-nine patients were included in the study. Each patient received a fixed full-arch prosthesis supported by two mesial axial and two distal tilted implants to rehabilitate the upper arch, the lower arch, or both. Three hundred thirty-six implants for 84 restorations were delivered. Patients were scheduled for follow-up visits every 6 months in the first 2 years and yearly after. At each follow-up visit peri-implant mucositis and peri-implantitis were diagnosed if present. Results. The overall follow-up range was from 12 to 130 months (mean 63,2 months. Three patients presented peri-implantitis. The prevalence of peri-implant mucositis ranged between 0 and 7,14% of patients (5,06% of implants while the prevalence of peri-implantitis varied from 0 to 4,55% of patients (3,81% of implants. Conclusions. The prevalence and incidence of peri-implant mucositis and peri-implantitis are lower than most of the studies in literature. Therefore this kind of rehabilitation could be considered a feasible option, on the condition of adopting a systematic hygienic protocol.

Axial-Current Matrix Elements in Light Nuclei from Lattice QCD

Energy Technology Data Exchange (ETDEWEB)

Savage, Martin [Univ. of Washington, Seattle, WA (United States); Shanahan, Phiala E. [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Tiburzi, Brian C. [Univ. of Maryland, College Park, MD (United States); Wagman, Michael L. [Univ. of Washington, Seattle, WA (United States); Winter, Frank T. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Beane, Silas [Univ. of New Hampshire, Durham, NH (United States); Chang, Emmanuel [Univ. of Washington, Seattle, WA (United States); Davoudi, Zohreh; Detmold, William [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Orginos, Konstantinos [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); College of William and Mary, Williamsburg, VA (United States)

2016-12-01

I present results from the first lattice QCD calculations of axial-current matrix elements in light nuclei, performed by the NPLQCD collaboration. Precision calculations of these matrix elements, and the subsequent extraction of multi-nucleon axial-current operators, are essential in refining theoretical predictions of the proton-proton fusion cross section, neutrino-nucleus cross sections and $\\beta\\beta$-decay rates of nuclei. In addition, they are expected to shed light on the phenomenological quenching of $g_A$ that is required in nuclear many-body calculations.