121 research outputs found
The association between disease activity and NT-proBNP in 238 patients with rheumatoid arthritis: a 10-year longitudinal study
No full textIntroduction
Disease activity in patients with rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, of which N-terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor. Our objective was to examine the cross-sectional and longitudinal associations between markers of inflammation, measures of RA disease activity, medication used in the treatment of RA, and NT-proBNP levels (dependent variable).
Methods
Two hundred thirty-eight patients with RA of less than 4 years in duration were followed longitudinally with three comprehensive assessments of clinical and radiographic data over a 10-year period. Serum samples were frozen and later batch-analyzed for NT-proBNP levels and other biomarkers. Bivariate, multivariate, and repeated analyses were performed.
Results
C-reactive protein (CRP) levels at baseline were cross-sectionally associated with NT-proBNP levels after adjustment for age and gender (r
2 adjusted = 0.23; P < 0.05). At the 10-year follow-up, risk factors for cardiovascular disease were recorded. Duration of RA and CRP levels were independently associated with NT-proBNP in the final model that was adjusted for gender, age, and creatinine levels (r
2 adjusted = 0.38; P < 0.001). In the longitudinal analyses, which adjusted for age, gender, and time of follow-up, we found that repeated measures of CRP predicted NT-proBNP levels (P < 0.001).
Conclusion
CRP levels are linearly associated with levels of NT-proBNP in cross-sectional and longitudinal analyses of patients with RA. The independent associations of NT-proBNP levels and markers of disease activity with clinical cardiovascular endpoints need to be further investigated
Interplay between network configurations and network governance mechanisms in supply networks a systematic literature review
No full textPurpose: This work systematically reviews the extant academic management literature on supply networks. It specifically examines how network configurations and network governance mechanisms influence each other in supply networks.
Design: 125 analytical and empirical studies were identified using an evidence-based approach to review the literature mainly published between 1985 and 2012.
Synthesis: Drawing on a multi-disciplinary theoretical foundation, this work develops an integrative framework to identify three distinct yet interdependent themes that characterize the study of supply networks: a) Network Configurations (structures and relationships); b) Network Governance Mechanisms (formal and informal); and c) The Interplay between Network Configurations and Network Governance Mechanisms.
Findings: Network configurations and network governance mechanisms mutually influence each other and cannot be considered in isolation. Formal and informal governance mechanisms provide better control when used as complements rather than as substitutes. The choice of governance mechanism depends on the nature of exchange; role of management; desired level of control; level of flexibility in formal contracts; and complementary role of formal and informal governance mechanism.
Research implications: This nascent field has thematic and methodological research opportunities for academics. Comparative network analysis using longitudinal case studies offers a rich area for further study.
Practical Implications: The complexity surrounding the conflicting roles of managers at the organisation and network levels poses a significant challenge during the development and implementation stage of strategic network policies.
Originality/value: This review reveals that formal and informal governance mechanisms provide better control when used as complements rather than as substitutes
Text-to-Comic Generative Adversarial Network
No full textDrawing and annotating comic illustrations is a complex and difficult process. No existing machine learning algorithms have been developed to create comic illustrations based on descriptions of illustrations, or the dialogue in comics. Moreover, it is not known if a generative adversarial network (GAN) can generate original comics that correspond to the dialogue and/or descriptions. GANs are successful in producing photo-realistic images, but this technology does not necessarily translate to generation of flawless comics. What is more, comic evaluation is a prominent challenge as common metrics such as Inception Score will not perform comparably, as they are designed to work on photos. In this paper, we: 1. Extend state of the art GANs to enable a comics-focused GAN architecture; 2) We implement DescriptionGAN, a novel text-to-comic pipeline based on a text-to-image GAN that synthesizes comics according to text descriptions. 3. We describe an in-depth empirical study of the technical difficulties of comic generation using GAN’s. DescriptionGAN has two novel features: (i) text description creation from labels via permutation and augmentation, and (ii) custom image encoding with Convolutional Neural Networks. We extensively evaluate the proposed DescriptionGAN in twoscenarios, namely image generation from descriptions, and image generation from dialogue. Our results on 1000 Dilbert comic panels and 6000 descriptions show synthetic comic panels from text inputs resemble original Dilbert panels. Novel methods for text description creation and custom image encoding brought improvements to Frechet Inception Distance, detail, and overall image quality over baseline algorithms. Generating illustrations from descriptions provided clear comics including characters and colours that were specified in the descriptions.Comics Illustration Synthesizer using Generative Adversarial NetworksCSE3000 Research ProjectComputer Science and Engineerin
Effects of a mindfulness-based and acceptance-based group programme followed by physical activity for patients with fibromyalgia: a randomised controlled trial
No full textIntroduction: Non-pharmacological approaches are recommended as first-line treatment for patients with fibromyalgia. This randomised controlled trial investigated the effects of a multicomponent rehabilitation programme for patients with recently diagnosed fibromyalgia in primary and secondary healthcare.
Methods: Patients with widespread pain ≥3 months were referred to rheumatologists for diagnostic clarification and assessment of study eligibility. Inclusion criteria were age 20–50 years, engaged in work or studies at present or during the past 2 years, and fibromyalgia diagnosed according to the American College of Rheumatology 2010 criteria. All eligible patients participated in a short patient education programme before inclusion and randomisation. The multicomponent programme, a 10-session mindfulness-based and acceptance-based group programme followed by 12 weeks of physical activity counselling was evaluated in comparison with treatment as usual, that is, no treatment or any other treatment of their choice. The primary outcome was the Patient Global Impression of Change (PGIC). Secondary outcomes were self-reported pain, fatigue, sleep quality, psychological distress, physical activity, health-related quality of life and work ability at 12-month follow-up.
Results: In total, 170 patients were randomised, 1:1, intervention:control. Overall, the multicomponent rehabilitation programme was not more effective than treatment as usual; 13% in the intervention group and 8% in the control group reported clinically relevant improvement in PGIC (p=0.28). No statistically significant between-group differences were found in any diseaserelated secondary outcomes. There were significant between-group differences in patient’s tendency to be mindful (p=0.016) and perceived benefits of exercise (p=0.033) in favour of the intervention group.
Conclusions: A multicomponent rehabilitation programme combining patient education with a mindfulness-based and acceptance-based group programme followed by physical activity counselling was not more effective than patient education and treatment as usual for patients with recently diagnosed fibromyalgia at 12-month follow-u
Incidence of overall and site-specific cancers in tnf inhibitor treated patients with psoriatic arthritis:a population-based cohort study from 4 nordic countries
No full textBackground Tumour necrosis factor inhibitors (TNFi) effectively reduce inflammation in Psoriatic arthritis (PsA). However, a possible association between treatment with TNFi and an increased cancer risk has previously been suggested.Objectives To investigate the risk of cancer in TNFi treated PsA patients compared with standardized rates from the general population in Denmark, Finland, Iceland and Sweden.Methods TNFi-treated PsA patients were followed from first registration with TNFi-treatment in ARTIS (Sweden), DANBIO (Denmark), ICEBIO (Iceland) or ROB-FIN (Finland) and linked to the national Cancer Registry in each country. Patients with a cancer history prior to start of follow-up were excluded. We investigated the risk of primary cancer among TNFi-treated PsA patients compared with general population cancer rates standardized to age, sex and calendar period within each country. Standardized incidence ratios (SIRs) were estimated for each country and pooled SIRs were subsequently calculated for both any cancer and site-specific cancers of interest.Results A total of 5218, 2039, 270 and 526 patients were registered as ever TNFi-treated in ARTIS, DANBIO, ICEBIO and ROB-FIN, respectively, contributing a total of 44 041 patient years of follow-up across all 4 countries.For all cancers, the SIRs of TNFi-treated patients from ARTIS, DANBIO, ICEBIO and ROB-FIN were 0.94 (0.80 to 1.10), 0.99 (0.77 to 1.26), 1.71 (0.88 to 2.99) and 1.28 (0.82 to 1.90), respectively. The number of observed and expected cancers and the SIRs of any and selected site-specific cancers are listed in table 1.View this table:Table 1 Standardized incidence ratios (SIR) of TNFi-treated patients from 4 Nordic countries compared with the general population.Conclusion Our results suggest that the overall cancer risk for TNFi-treated PsA patients is not increased compared to the general population. Further analysis of the risk of malignant lymphomas will inform on whether the increased risk we observed is attributed to the PsA disease or treatment with TNFi.Acknowledgement This study is funded by FOREUM and NordForsk.Disclosure of Interests Christine Ballegaard Speakers bureau: Janssen Pharmaceuticals., Karin Hellgren: None declared, René Cordtz: None declared, Bénédicte Delcoigne: None declared, Björn Gudbjornsson: None declared, Thorvardur Jon Love Consultant for: Received reimbursment from Celgene for speaking about guidelines for the treatment of psoriatic arthritis, Kalle Aaltonen: None declared, Dan Nordström Grant/research support from: MSD, Pfizer, Consultant for: AbbVie, BMS, MSD, Novartis, Roche, Pfizer, UCB, Speakers bureau: Novartis, UCB, Sella Aarrestad Provan Consultant for: Novartis, Speakers bureau: Lilly, Johan Askling Grant/research support from: Karolinska Institutet (JA) has or has had research agreements with the following pharmaceutical companies, mainly in the context of the ATRIS national safety monitoring programme for rheumatology biologicals: Abbvie, BMS, MSD, Eli Lilly, Pfizer, Roche, Samsung Bioepis, and UCB., Consultant for: Karolinska Institutet has received remuneration for JA participating in ad boards arranged by Lilly, Novartis, and Pfizer., Kristian Zobbe: None declared, Lars Erik Kristensen Grant/research support from: UCB, Biogen, Janssen Pharmaceuticals, and Novartis, Consultant for: Consultant for AbbVie, Amgen, Biogen, BMS, Celgene, Eli Lilly, Janssen Pharmaceuticals, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB Pharma., Speakers bureau: Pfizer, AbbVie, Amgen, UCB, BMS, Biogen, MSD, Novartis, Eli Lilly and Company, and Janssen Pharmaceuticals, Lene Dreyer Consultant for: MSD, UCB and Janssen Pharmaceuticals, Speakers bureau: MSD, UCB and Janssen Pharmaceuticals, Speakers bureau: UCB, MSD, Eli Lilly and Janssen Pharmaceuticals
Advances in ITP - therapy and quality of life - a patient survey.
No full textCurrent guidelines recommend glucocorticoids and splenectomy as standard 1(st) and 2(nd) line treatments for chronic immune thrombocytopenia (ITP). We sought to find out how German ITP-patients are treated with respect to these guidelines. Members of a patient support association ≥18 years with a self-reported history of chronic ITP>12 months were surveyed with a web-based questionnaire. 122 questionnaires were evaluated. 70% of patients had chronic ITP for more than 5 years and 20% an average platelet count of ≤30·10(9)/L. 41% of the patients reported haematomas or petechiae more than once or twice and up to 12 times or more per year and 17% oropharyngeal and nasal bleeds. 11% had been admitted to hospital during the last 12 months. 88% had received or currently receive glucocorticoids, 27% were splenectomised. IVIG had been given to 55%, rituximab to 22%, anti-D to 12%, ciclosporin to 7%, while complementary and alternative medical treatments had been used by 36%. 50 women responded to questions concerning pregnancy. 14 (28%) had been advised not to become pregnant. 23 reported pregnancies and 10 (44%) required treatment for their ITP during pregnancy. Glucocorticoids are the most common therapy for chronic ITP but complementary and alternative treatments already come second and less than ⅓ of patients are splenectomised. This and the frequent use of complementary medicines suggests patients' dissatisfaction with conventional approaches. Many patients receive off-label therapies. There is a major need for adequate counselling and care for pregnant ITP-patients
The changing states of fibromyalgia in patients with axial spondyloarthritis : results from the British Society of Rheumatology Biologics Register for Ankylosing Spondylitis
No full textWe are grateful to the staff of the BSRBR-AS register, Claudia Zabke, Elizabeth Ferguson-Jones, Maureen Heddle, Nafeesa Nazlee and Barry Morris, and to the recruiting staff at the clinical centres, details of which are available at: https://www.abdn.ac.uk/iahs/research/epidemiology/spondyloarthritis.php#panel1011. The BSRBR-AS is funded by the British Society for Rheumatology, who have received funding for this from Pfizer, AbbVie and UCB. These companies receive advance copies of manuscripts for comments but made none in relation to this manuscript. They have no input in determining the topics for analysis or work involved in undertaking it. SP received a travel grant from the South Eastern Health Authority of Norway. SP had the idea for the study and with GJM planned the analysis. SP undertook the analysis and drafted the manuscript. The results were discussed by all authors, who also commented on the draft manuscript. Funding: No specific funding was received from any funding agency in the public, commercial or not-for-profit sectors to carry out the work described in this article.Peer reviewe
Discovering Genesis content, interpretation, reception
No full textComprehensive, up-to-date and student-friendly introduction to Genesis: its structure, content, theological concerns, key interpretative debates and historical reception. Encourages students to engage with Genesis for themselves, by alerting them to key issues and questions raised by the text Explores and explains the approaches of a wide range of interpreters - both ancient and modern Special sections on the reception of Genesis and its distinctive influence on Christian history and culture This introduction to the interpretation of Genesis encourages in-depth study of the text, and genuine grappling with the theological and historical questions raised, by providing a critical assessment of key interpreters and interpretative debates. It draws on a range of methodological approaches (author-, text- and reader-centred), as complementary rather than mutually exclusive ways of understanding the text. It also reflects the growing scholarly attention to the reception history of biblical texts, increasingly viewed as a vital aspect of interpretation rather than an optional extr
Evidence of reduced parasympathetic autonomic regulation in inflammatory joint disease: A meta-analyses study
No full textHow does current disease activity in rheumatoid arthritis affect the short-term risk of acute coronary syndrome? : A clinical register based study from Sweden and Norway
No full textObjectives: To estimate short-term risks of acute coronary syndrome (ACS) in patients with rheumatoid arthritis (RA) as a function of current RA disease activity including remission. Methods: Data from clinical visits of RA patients in Sweden (SE) and Norway (NO) between January 1st 2012 until December 31st 2020 were used. At each visit, patient's disease activity was assessed including remission status (measured with several metrics). Through linkage to national health and death registers, patients were followed up for incident ACS up to six months from each visit. We compared the short-term risk of ACS in patients not in remission vs. in remission using Cox regression analyses with robust standard errors, adjusted for country and covariates (e.g., age, sex, prednisolone use, comorbidities). We also explored disease activity categories as exposure. Results: We included 212,493 visits (10,444 from Norway and 202,049 from Sweden) among 41,250 patients (72% women, mean age at visit 62 years). During the 6-month follow-ups, we observed 524 incident ACS events. Compared to patients in remission, patients currently not in remission had an increased rate of ACS: adjusted hazard ratio (95% confidence interval) 1.52 (1.24–1.85) with DAS28 metric. The crude absolute six-month risks were 0.2% for patients in remission vs. 0.4% for patients with DAS28 high disease activity. The use of alternative RA disease activity and remission metrics provided similar results. Conclusion: Failure to reach remission is associated with elevated short-term risks of ACS, underscoring the need for CV risk factor optimization in these patients
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