PTPN22 polymorphism and anti-cyclic citrullinated peptide antibodies in combination strongly predicts future onset of rheumatoid arthritis and has a specificity of 100% for the disease

We analysed relationships between the PTPN22 1858 polymorphism and antibodies to cyclic citrullinated peptide (CCP), rheumatoid factors (RFs) and the shared epitope (SE) gene (HLA-DRB1*0404 or 0401) and determined their combined predictive value for rheumatoid arthritis (RA) in individuals who subsequently developed RA. This case-control study was nested within the Medical Biobank of Northern Sweden. Patients with RA (n = 92) were identified from amongst blood donors antedating onset of disease by a median of 2.4 (interquartile range 1.2 to 4.9) years. Matched controls were selected randomly from the same cohorts (n = 368). Anti-CCP antibodies and RFs were determined using enzyme-linked immunoassays. Genotyping was performed using an ABI PRISM 7900HT instrument and HLA-SE genes were identified using PCR sequence-specific primers. The 1858T allele and also carriage of T were associated with future onset of RA (odds ratio (OR) = 2.29, 95% confidence interval (CI) 1.45–3.61 and OR = 2.64, 95% CI 1.56–4.47, respectively). The combination of the 1858T variant and anti-CCP antibodies gave 100% specificity for the disease. None of the 368 controls expressed this combination. The PTPN22 1858T variant and anti-CCP antibodies were clearly associated (OR = 3.80, 95% CI 1.51–9.57). A combination of the PTPN22 1858T variant and anti-CCP antibodies gave a much higher relative risk (>132.03) for developing RA than the combination of the T variant and HLA-SE (OR = 7.85). The PTPN22 1858T variant was associated with future development of RA. There was an association between the T variant and anti-CCP antibodies and their combination, found only among pre-patients, gives a very high relative risk for development of RA. The combination gave a specificity of 100% for diagnosing RA

Spectral statistics in chaotic systems with a point interaction

We consider quantum systems with a chaotic classical limit that are perturbed by a point-like scatterer. The spectral form factor K(tau) for these systems is evaluated semiclassically in terms of periodic and diffractive orbits. It is shown for order tau^2 and tau^3 that off-diagonal contributions to the form factor which involve diffractive orbits cancel exactly the diagonal contributions from diffractive orbits, implying that the perturbation by the scatterer does not change the spectral statistic. We further show that parametric spectral statistics for these systems are universal for small changes of the strength of the scatterer.Comment: LaTeX, 21 pages, 7 figures, small corrections, new references adde

The PTPN22 1858C/T polymorphism is associated with anti-cyclic citrullinated peptide antibody-positive early rheumatoid arthritis in northern Sweden

The PTPN22 1858C/T polymorphism has been associated with several autoimmune diseases including rheumatoid arthritis (RA). We have shown that carriage of the T variant (CT or TT) of PTPN22 in combination with anti-cyclic citrullinated peptide (anti-CCP) antibodies highly increases the odds ratio for developing RA. In the present study we analysed the association between the PTPN22 1858C/T polymorphism and early RA in patients from northern Sweden, related the polymorphism to autoantibodies and the HLA-DR shared epitope, and analysed their association with markers for disease activity and progression. The inception cohort includes individuals who also donated samples before disease onset. A case–control study was performed in patients (n = 505; 342 females and 163 males) with early RA (mean duration of symptoms = 6.3 months) and in population-based matched controls (n = 970) from northern Sweden. Genotyping of the PTPN22 1858C/T polymorphism was performed using a TaqMan instrument. HLA-shared epitope alleles were identified using PCR sequence-specific primers. Anti-CCP2 antibodies were determined using enzyme-linked immunoassays. Disease activity (that is, the number of swollen and tender joints, the global visual analogue scale, and the erythrocyte sedimentation rate) was followed on a regular basis (that is, at baseline and after 6, 12, 18 and 24 months). Both the 1858T allele and the carriage of T were associated with RA (χ2 = 23.84, P = 0.000001, odds ratio = 1.69, 95% confidence interval = 1.36–2.11; and χ2 = 22.68, P = 0.000002, odds ratio = 1.79, 95% confidence interval = 1.40–2.29, respectively). Association of the 1858T variant with RA was confined to seropositive disease. Carriage of 1858T and the presence of anti-CCP antibodies was independently associated with disease onset at an earlier age (P < 0.05 and P < 0.01, respectively), while the combination of both resulted in an even earlier age at onset. Smoking was identified as a risk factor independent of the 1858T variant and anti-CCP antibodies

Geometrical theory of diffraction and spectral statistics

We investigate the influence of diffraction on the statistics of energy levels in quantum systems with a chaotic classical limit. By applying the geometrical theory of diffraction we show that diffraction on singularities of the potential can lead to modifications in semiclassical approximations for spectral statistics that persist in the semiclassical limit $\hbar \to 0$. This result is obtained by deriving a classical sum rule for trajectories that connect two points in coordinate space.Comment: 14 pages, no figure, to appear in J. Phys.

Regulating Sustainable Finance in Capital Markets: A Perspective from Socially Embedded Decentered Regulation

We present an ab initio theoretical analysis of the temperature-dependent stability of inherently nanolaminated (Cr1−xMnx)2AlC. The results indicate energetic stability over the composition range x = 0.0 to 0.5 for temperatures ≥600 K. Corresponding thin film compounds were grown by magnetron sputtering from four elemental targets. X-ray diffraction in combination with analytical transmission electron microscopy, including electron energy-loss spectroscopy and energy dispersive x-ray spectroscopy analysis, revealed that the films were epitaxial (0001)-oriented single-crystals with x up to 0.16.Funding Agencies|European Research Council under the European Community|258509227754|Knut and Alice Wallenberg Foundation||Swedish Research Council|||DFG-SPP 1299|</p

Compatibility of Zr2AlCZr_{2}AlC MAX phase-based ceramics with oxygen-poor, static liquid lead-bismuth eutectic

This work investigates the compatibility of $Zr_{2}AlC$ MAX phase-based ceramics with liquid LBE, and proposes a mechanism to explain the observed local $Zr_{2}AlC$/LBE interaction. The ceramics were exposed to oxygen-poor ($C_{O}\le2.2 \cdot10^{-10}$ mass%), static liquid LBE at 500{\deg}C for 1000 h. A new $Zr_{2}(Al,Bi,Pb)C$ MAX phase solid solution formed in-situ in the LBE-affected $Zr_{2}AlC$ grains. Out-of-plane ordering was favorable in the new solid solution, whereby $\textit{A}$-layers with high and low-Bi/Pb contents alternated in the crystal structure, in agreement with first-principles calculations. Bulk $Zr_{2}(Al,Bi,Pb)C$ was synthesized by reactive hot pressing to study the crystal structure of the solid solution by neutron diffraction

Brain herniation in a patient with apparently normal intracranial pressure: a case report

Introduction Intracranial pressure monitoring is commonly implemented in patients with neurologic injury and at high risk of developing intracranial hypertension, to detect changes in intracranial pressure in a timely manner. This enables early and potentially life-saving treatment of intracranial hypertension. Case presentation An intraparenchymal pressure probe was placed in the hemisphere contralateral to a large basal ganglia hemorrhage in a 75-year-old Caucasian man who was mechanically ventilated and sedated because of depressed consciousness. Intracranial pressures were continuously recorded and never exceeded 17 mmHg. After sedation had been stopped, our patient showed clinical signs of transtentorial brain herniation, despite apparently normal intracranial pressures (less than 10 mmHg). Computed tomography revealed that the size of the intracerebral hematoma had increased together with significant unilateral brain edema and transtentorial herniation. The contralateral hemisphere where the intraparenchymal pressure probe was placed appeared normal. Our patient underwent emergency decompressive craniotomy and was tracheotomized early, but did not completely recover. Conclusions Intraparenchymal pressure probes placed in the hemisphere contralateral to an intracerebral hematoma may dramatically underestimate intracranial pressure despite apparently normal values, even in the case of transtentorial brain herniation