110 research outputs found
Performance of the 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies in clinical practice
No full textWater for cities and rural areas in contexts of climate variability: assessing paths to shared prosperity – the example of Burkina Faso
Full text linkThe water management authorities in Burkina Faso are, at present, succeeding in responding to the ‘bulk’ water demand of the capital city, Ouagadougou – located in the semi-arid central region of Burkina – through a major ‘supply-side’ infrastructure project, the Ziga dam and Ziga-Ouagadougou pipelines. This article questions, however, the long-term viability of the current approach. Ouagadougou’s status as economic and administrative capital gives it great power to plan for and mobilise investment for its own water supplies, at the expense of water for rural development. In the context of climatic changes and forecasts of substantial continued growth of the city’s population, the author argues for development of an urban-rural water strategy with a different allocation model to support a pathway to future prosperity in this semi-arid economy
Water for cities and rural areas in contexts of climate variability: assessing paths to shared prosperity – the example of Burkina Faso
Full text linkThe water management authorities in Burkina Faso are, at present, succeeding in responding to the ‘bulk’ water demand of the capital city, Ouagadougou – located in the semi-arid central region of Burkina – through a major ‘supply-side’ infrastructure project, the Ziga dam and Ziga-Ouagadougou pipelines. This article questions, however, the long-term viability of the current approach. Ouagadougou’s status as economic and administrative capital gives it great power to plan for and mobilise investment for its own water supplies, at the expense of water for rural development. In the context of climatic changes and forecasts of substantial continued growth of the city’s population, the author argues for development of an urban-rural water strategy with a different allocation model to support a pathway to future prosperity in this semi-arid economy
SAT0238 SHORT TERM PROGNOSIS OF A PROSPECTIVELY FOLLOWED COHORT OF UNSELECTED ADULT IGA VASCULITIS PATIENTS – A SINGLE RHEUMATOLOGY CENTRE EXPERIENCE
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LIMITS OF INFORMTION TECHNOLOGY IN ENGINEERING
No full textABSTRACT: Excitement about possibilities of artificial intelligence has been shared in engineering professions as well. It has been predicted that because engineering designs (unlike architectural) are subject to "objective " evaluation, they could just as well be made by intelligent computer software. In this paper, the author claims that this is wrong. The optimistic predictions are founded on the beliefs that the strong AI and cognitive science community take for granted- that mentally engineers deal with models of objective reality, that together with others engineers they take part in various processes which result in building products, and that one of such processes is design which is in fact problem solving where a best solution is selected from a set of possible ones; and that these processes could be reproduced mechanically. There has been quite a lot of criticism of the strong AI approaches, particularly after extensive research in AI did not live up to its promise. The author's main line of work has not been AI, but he was surprised how many of the arguments of the AI critics can also be applied to some other research directions in engineering, particularly to that of product-model based integration. In this paper the author uses the theory of "hermeneutic constructivism " to explain the limitations of the "representation-centred " engineering software, warns against extrapolation from limited prototypes and suggests some alternate directions, such as weak AI, agents, groupware and workflow tools that could lead to useful engineering software as well
Tuberculosis among patients treated with TNF inhibitors for rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis in slovenia : a cohort study
Full text linkObjectives: This study aimed to assess the risk of tuberculosis (TB) in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with any of the commercially available tumour necrosis factor inhibitors (TNFis) in Slovenia. Design: This is a cohort, registry (biorx.si) cross-linked with the Slovenian National TB Registry. Setting: National, involving all Slovenian rheumatology centres (six secondary and two secondary/tertiary). Participants: 2429 patients with RA, AS or PsA exposed to at least one TNFi participated in the study. Primary and secondary outcome measures: The primary outcome measures were age-adjusted and sex-adjusted TB incidence rates (IRs) and the standardised incidence ratios (SIRs) compared with the general population exploring different TNFi exposure windows. The secondary outcome measures were a detailed characterisation of the national latent tuberculosis infection (LTBI) screening and TB chemoprophylaxis protocol implementation. Results: Among the 2429 patients exposed to at least one TNFi for a total of 10 445 (49% RA, 33% AS and 18% PsA) person-years (PY), 99% completed LTBI screening and 6% required TB chemoprophylaxis. Six RA (three adalimumab, three certolizumab), two PsA (two golimumab) and zero AS patients developed TB. Five out of eight had miliary TB, three out of eight had pulmonary TB and two patients died. The age-standardised and sex-standardised TB IR (95% CI) per 100 000 PYs/SIRs (95% CI) compared with the general Slovenian population for the current TNFi exposure were 52 (0 to 110)/6.7 (0.6 to 80), 47 (0 to 110)/6.1 (0.3 to 105), 45 (0 to 109)/5.8 (0.3 to 112) overall, in RA and PsA, respectively. Conclusions: The TB IR in the Slovenian patients with RA, AS and PsA treated with TNFi was comparable with TB IRs in TB non-endemic countries with less than a tenth of the patients requiring TB chemoprophylaxis
Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries
Full text linkObjective To compare the real-word effectiveness of subcutaneous tocilizumab (TCZ-SC) and intravenous tocilizumab (TCZ-IV) in rheumatoid arthritis (RA). Methods Patients with RA with TCZ from eight European registries were included. Drug retention was compared using unadjusted Kaplan-Meier and Cox models adjusted for baseline patient, disease and treatment characteristics, using a strata term for year of treatment initiation and country of registry. The proportions of patients achieving Clinical Disease Activity Index (CDAI) remission and low disease activity (LDA) at 1 year were compared using samples matched on the same covariates and corrected for attrition using LUNDEX. Results 3448 patients were retrieved, 2414 with TCZ-IV and 1034 with TCZ-SC. Crude median retention was 3.52 years (95% CI 3.22 to 3.85) for TCZ-IV and 2.12 years for TCZ-SC (95% CI 1.88 to 2.38). In a country-stratified and year of treatment initiation-stratified, covariate-Adjusted analysis, hazards of discontinuation were similar between TCZ-SC and TCZ-IV treated patients (HR 0.93, 95% CI 0.80 to 1.09). The average adjusted CDAI change at 1 year was similar in both groups (â '6.08). After matching, with 560 patients in each group, CDAI remission corrected for attrition at 1 year was also similar between TCZ-SC and TCZ-IV (10.4% in TCZ-IV vs 12.8% in TCZ-SC (difference: 2.4%, bootstrap 95% CI â '2.1% to 7.6%)), but CDAI LDA was lower in TCZ-IV patients: 41.0% in TCZ-IV versus 49.1% in TCZ-SC (difference: 8.0 %; bootstrap 95% CI 2.4% to 12.4%). Conclusion With similar retention and effectiveness, TCZ-SC is an adequate alternative to TCZ-IV for RA. When possible, considering the costs of the TCZ-IV route, TCZ-SC should be the preferred mode of administration
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