Antibodies to Tamm-Horsfall protein associated with renal damage and urinary tract infections in adults

Autoantibodies to Tamm-Horsfall protein associated with renal damage and urinary tract infections in adults. Forty-seven adults with urinary tract infection (UTI), 9 with recent acute pyelonephritis and 38 with previous renal infection, were investigated for the presence of autoantibodies to Tamm-Horsfall protein (THP). All patients except 6 had or had had vesicoureteric reflux (VUR). In patients with recent acute pyelonephritis, only IgA antibodies were significantly elevated. Among the patients with previous UTI, more than 6 months before the time of testing, a graded response was found for IgG and IgM specific antibodies, with the lowest value in those with renal damage and elevated serum creatinine and the highest in those with a normal X-ray. A negative correlation was found between IgG antibodies to THP and elevated serum creatinine (r = -0.76, P < 0.02). No significant correlation was found between VUR itself and antibodies to THP. A low IgG antibody level to THP in patients with a history of previous UTI seems to be a useful indicator of renal scarring. Possible immunologic mechanisms behind the low antibody level and the renal damage are discussed.Auto-anticorps anti-protéine de Tamm-Horsfall associés à des lésions rénales et à des infections urinaires chez l'adulte Quarante-sept adultes atteints d'infection urinaire, 9 ayant une pyélonéphrite aiguë récente et 38 une infection rénale antérieure ont été étudiés pour la présence d'auto-anticorps anti-protéine de Tamm-Horsfall (THP). Tous les malades sauf six avaient ou avaient eu un reflux vésico-urétéral. Chez les malades ayant un antécédent récent de pyélonéphrite seul les anti-corps IgA étaient significativement élevés. Parmi les malades dont l'antécédent d'infection urinaire remontait à plus de six mois une réponse a été obtenue pour les anti-corps spécifiques IgG et IgM, avec la valeur la plus faible chez ceux qui étaient atteints de lésions rénales et avaient une créatininémie élevée et la valeur la plus élevée chez ceux qui étaient indemnes de lésions radiologiques. Une corrélation négative a été observée entre les anti-corps IgG anti THP et l'augmentation de la créatininémie (r = -0,76, P < 0,02). Il n'a pas été observé de corrélation significative entre le reflux par lui-même et les anti-corps anti THP. Un taux faible d'anti-corps IgG anti THP chez des malades ayant des antécédents d'infection urinaire peut être un indicateur utile de lésions rénales. Les mécanismes immunologiques qui peuvent sous tendre le taux faible d'anti-corps et les lésions rénales sont discutés

Cyber-Physical Production Testbed: Literature Review and Concept Development

Many researchers use virtual and simulation-based testbed technology for research in production and maintenance optimization. Although, the virtual environment produces good results, it cannot imitate the unexpected changes that occur in actual production. There are very few physical testbeds emulating actual production environment. The aim of this paper is to present a concept of a cyber-physical production testbed based on review of Cyber-Physical Systems (CPS) testbeds in research. The testbed consists of a semi-automatic production line equipped with system monitoring tools, data analysis capabilities and commercial software. This testbed will be used for demonstration of data acquisition for production and maintenance prioritization. Additionally, the testbed will be used for research in IoT platforms for production optimization

Design concept towards a human-centered learning factory

Learning factories play an important role when studying multi-disciplinary problems. Such a problem is to support operators in multi-variant assembly. Multi-variants cause problems with product quality, production time as well as cognitive load and therefore it is important to find ways to support operators in this context. To assess the effects of multi variants, a design concept were developed in a learning factory environment (SIILab, CPPS-testbed). The concept was constructed at a conveyer belt with three assembly stations using Casat software for instruction presentations. The following aspects were included in the human-centered learning factory: studying the introduction of advanced automation, managing product variety, supporting operators in finding information and supporting existing human-automation interactions

Effects of Information Content in Work Instructions for Operator Performance

Operators remain as important resources in complex final assembly. To sustain a multi-variant production, it is necessary for operators to manage high demands from a cognitive workload perspective. In such situations, work instructions can support operators cognitively. However, work instructions are often insufficient or unused in final assembly. In this paper, results from testbed experiments are presented where assembly work was supported by different types of work instructions with differing information content. Results indicate that operator performance in terms of perceived cognitive workload and information quality are affected by the presented content of information in work instructions

Assembly 4.0: Wheel Hub Nut Assembly Using a Cobot

To achieve a flexible and adaptable assembly system (assembly 4.0) a combination of enabling resources and technologies are required. Collaborative robots (Cobots) are one such technology that can offer higher flexibility and quick adaptability in assembly systems. Cobots are becoming more common in the manufacturing industry, the use and application of cobots are constantly growing. Combining cobots with IIoT gives the possibilities to also communicate with cobots and employees to achieve an effective assembly system. This paper presents a design research experiment conducted using cobots in a lab environment. The experiment studies the use of cobots in a final assembly environment with the focus on testing feasibility, improving quality and ergonomics of a real industrial operation. The experiment setup is presented in detail and the results are discussed along with future research directions

Coping with chronic pain: In-depth interviews with children suffering from Juvenile Chronic Arthritis

This study examined from the perspective of children with Juvenile Chronic Arthritis, their experiences of coping with chronic pain in daily life. In-depth interviews were conducted with 22 children (6–17 years). The grounded theory method was applied for analysing the taped and transcribed interviews. Seven descriptive categories were grounded in the data, labelled (1) “controlling strategies”, (2) “avoidance strategies”, (3) “cognitive strategies”, (4) “compliance with the treatment”, (5) “seeking social support”, and (6) “recovering”. A core category was identified and labelled “making me different”. The children seem to be caught in a dilemma. In one way the chosen coping strategy reduces chronic pain and in another way the strategy increases stress and feelings of being different from non-disabled peers. Our results indicate the great importance of social support from the children's environment

Ultrasonography and color Doppler of proximal gluteal enthesitis in juvenile idiopathic arthritis: a descriptive study

Background: The presence of enthesitis (insertional inflammation) in patients with juvenile idiopathic arthritis (JIA) is difficult to establish clinically and may influence classification and treatment of the disease. We used ultrasonography (US) and color Doppler (CD) imaging to detect enthesitis at the small and deep-seated proximal insertion of the gluteus medius fascia on the posterior iliac crest where clinical diagnosis is difficult. The findings in JIA patients were compared with those obtained in healthy controls and with the patients' MRI results. Methods: Seventy-six proximal gluteus medius insertions were studied clinically (tenderness to palpation of the posterior iliac crest) and by US and CD (echogenicity, thickness, hyperemia) in 38 patients with JIA and in 38 healthy controls, respectively (median age 13 years, range 7-18 years). In addition, an additional MRI examination of the sacroiliac joints and iliac crests was performed in all patients. Results: In patients with focal, palpable tenderness, US detected decreased echogenicity of the entheses in 53% of the iliac crests (bilateral in 37% and unilateral in 32%). US also revealed significantly thicker entheses in JIA patients compared to healthy controls (p < 0.003 left side, p < 0.001 right side). There was no significant difference in thickness between the left and right sides in individual subjects. Hyperemia was detected by CD in 37% (28/76) of the iliac crests and by contrast-enhanced MRI in 12% (6/50). Conclusions: According to US, the gluteus medius insertion was thicker in JIA patients than in controls, and it was hypoechoic (enthesitis) in about half of the patients. These findings may represent chronic, inactive disease in some of the patients, because there was only limited Doppler flow and MRI contrast enhancement. The present study indicates that US can be useful as an adjunct to clinical examination for improved assessment of enthesitis in JIA. This may influence disease classification, ambition to treat, and choice of treatment regimen

Prognostic factors for the disease course and 8-year outcome in Nordic children with oligoarticular-onset juvenile idiopathic arthritis

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