Early Disease Course and Predictors of Disability in Juvenile Rheumatoid Arthritis and Juvenile Spondyloarthropathy: A 3 Year Prospective Study

ABSTRACT. Objective. To describe the 3 year disease course in early juvenile rheumatoid arthritis (JRA) and juvenile spondyloarthropathy (JSpA), to compare the health status after 3 years of followup with that of normal controls, and to investigate the relationship between physical function at followup and disease characteristics recorded during the first 6 months. Methods: One hundred and ninety-seven children (median age 6.6 yrs) with JRA and JSpA and disease duration < 1.5 years were examined by a pediatric rheumatologist every 6 months for a median of 3.1 years. Controls were randomly selected from the National Population Register. Physical and psychosocial health was assessed by means of the Child Health Questionnaire and the Childhood Health Assessment Questionnaire (CHAQ). Disease course was analyzed by analysis of variance for repeated measurements. Results. Health status and disease activity improved over time. Treatment with disease modifying antirheumatic drugs was started in 58% of the patients at baseline. Patients with persistent oligoarthritis had the most favorable disease course. The patients with juvenile ankylosing spondylitis (JAS), syndrome of seronegative enthesopathy and arthropathy (SEA), and rheumatoid factor (RF) positive polyarthritis had the poorest health status. A significant improvement for the whole group was observed after 3 years in all measures of disease activity and health status, except pain. Patients had poorer physical function and general health and more pain than controls. Predictors of reduced physical function at followup were a high CHAQ disability index and a poor well-being assessed during the first 6 months. Conclusion. Health status and disease activity improved over time in patients under medical treatment. The patients with JAS/SEA and RF positive polyarthritis had poorer health than the patients in other subtypes. A high disability index and a poor well-being at baseline predicted reduced physical function after 3 years. (J Rheumatol 2005;32:1122-30

Serum levels of osteoprotegerin and receptor activator of nuclear factor -κB ligand in children with early juvenile idiopathic arthritis: a 2-year prospective controlled study

<p>Abstract</p> <p>Background</p> <p>The clinical relevance of observations of serum levels of osteoprotegerin (OPG) and receptor activator of nuclear factor -κB ligand (RANKL) in juvenile idiopathic arthritis (JIA) is not clear. To elucidate the potential role of OPG and RANKL in JIA we determined serum levels of OPG and RANKL in patients with early JIA compared to healthy children, and prospectively explored changes in relation to radiographic score, bone and lean mass, severity of the disease, and treatment.</p> <p>Methods</p> <p>Ninety children with early oligoarticular or polyarticular JIA (ages 6-18 years; mean disease duration 19.4 months) and 90 healthy children individually matched for age, sex, race, and county of residence, were examined at baseline and 2-year follow-up. OPG and RANKL were quantified by enzyme-immunoassay. Data were analyzed with the use of t-tests, ANOVA, and multiple regression analyses.</p> <p>Results</p> <p>Serum OPG was significantly lower in patients than controls at baseline, and there was a trend towards higher RANKL and a lower OPG/RANKL ratio. Patients with polyarthritis had significantly higher increments in RANKL from baseline to follow-up, compared to patients with oligoarthritis. RANKL was a significant negative predictor for increments in total body lean mass. Patients who were receiving corticosteroids (CS) or disease-modifying antirheumatic drugs (DMARDs) at follow-up had higher OPG/RANKL ratio compared with patients who did not receive this medication.</p> <p>Conclusions</p> <p>The data supports that levels of OPG are lower in patients with JIA compared to healthy children, and higher levels of RANKL is associated with more serious disease. RANKL was a significant negative predictor of lean mass in patients with JIA. The OPG/RANKL ratio was higher in patients on DMARDs or CS treatment.</p

The One Ocean Expedition: Science and Sailing for the Ocean We Want

The One Ocean Expedition (OOE) was a 20-month long circumnavigation of the globe by the Norwegian sail training vessel Statsraad Lehmkuhl, and a recognised part of the UN decade of Ocean Science for Sustainable Development. The ship was equipped with modern instrumentation to collect high-quality data on ocean physics, chemistry, and biology. Many of the data series were available in near real time from an open repository. The scientific programme was executed along the sailing route of Statsraad Lehmkuhl, with occasional stops for stationary work. The aim of the data collection on board the vessel was to improve knowledge about the state of the world's ocean with regards to the distribution and diversity of organisms, environmental status, climate, and human pressures on the marine ecosystem. Another aim of the expedition was to educate ocean scientists and strengthen ocean literacy. The main types of instrumentation are sensors that measure continuously underway including echosounder, hydrophone, temperature and salinity probes, and various instruments that collect and analyse water sampled from an inlet in the ship's hull, including for environmental DNA and microplastic. Here, we describe the scientific instrumentation onboard Statsraad Lehmkuhl and present preliminary results from the Atlantic part of the expedition. While there are many challenges to using a sail ship for scientific purposes, there are also some key benefits as the vessel is quiet and has a low footprint. Furthermore, the use of a common set of instruments and procedures across the ocean also removes an uncertainty factor when comparing data between ocean areas.The One Ocean Expedition: Science and Sailing for the Ocean We WantpublishedVersio

The One Ocean Expedition: Science and Sailing for the Ocean We Want

Source at https://www.hi.no/hi.The One Ocean Expedition (OOE) was a 20-month long circumnavigation of the globe by the Norwegian sail training vessel Statsraad Lehmkuhl, and a recognised part of the UN decade of Ocean Science for Sustainable Development. The ship was equipped with modern instrumentation to collect high-quality data on ocean physics, chemistry, and biology. Many of the data series were available in near real time from an open repository. The scientific programme was executed along the sailing route of Statsraad Lehmkuhl, with occasional stops for stationary work. The aim of the data collection on board the vessel was to improve knowledge about the state of the world's ocean with regards to the distribution and diversity of organisms, environmental status, climate, and human pressures on the marine ecosystem. Another aim of the expedition was to educate ocean scientists and strengthen ocean literacy. The main types of instrumentation are sensors that measure continuously underway including echosounder, hydrophone, temperature and salinity probes, and various instruments that collect and analyse water sampled from an inlet in the ship's hull, including for environmental DNA and microplastic. Here, we describe the scientific instrumentation onboard Statsraad Lehmkuhl and present preliminary results from the Atlantic part of the expedition. While there are many challenges to using a sail ship for scientific purposes, there are also some key benefits as the vessel is quiet and has a low footprint. Furthermore, the use of a common set of instruments and procedures across the ocean also removes an uncertainty factor when comparing data between ocean areas

Design, synthesis and biological evaluation of 6‐substituted quinolines derived from cabozantinib as c‐Met inhibitors

Based on the cabozantinib scaffold, novel c‐Met inhibitors were rationalized from the limited knowledge of structure‐activity relationships for the quinoline 6‐position. Emphasis was given to modifications capable of engaging in additional polar interactions with the c‐Met active site. In addition, ortho‐fluorinations of the terminal benzene ring were explored. Fifteen new molecules were synthesized and evaluated in a c‐Met enzymatic binding assay. A wide range of substituents were tolerated in the quinoline 6‐position, while the ortho‐fluorinations performed were shown to give considerable reductions in the c‐Met binding affinity. The antiproliferative effects of the compounds were evaluated in the NCI60 cancer cell line panel. Most notably, compounds 15b and 18b were able to inhibit cell proliferation more efficiently than cabozantinib in leukemia, CNS, and breast cancer cell lines. The in vitro data agreed well with the in silico docking results, where additional hydrogen bonding was identified in the enzymatic pocket for the para‐amino substituted 15b and 18b

Sarcopenia in patients with hip fracture: A multicenter cross-sectional study

Background: Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. Methods: A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Results: Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Conclusions: Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility

Does sarcopenia predict change in mobility after hip fracture? a multicenter observational study with one-year follow-up

Abstract Background Patients with hip fracture frequently have sarcopenia and are at great risk of loss of mobility. We have investigated if sarcopenia predicts change in mobility after hip fracture. Methods This is a prospective, multicenter observational study with one-year follow-up. Patients with hip fracture who were community-living and capable of walking before the fracture were included at three hospitals in Norway (2011–2013). The primary outcome of the study was change in mobility, measured by the New Mobility Score (NMS). Sarcopenia was determined postoperatively by anthropometry, grip strength, and NMS. Results We included 282 participants and sarcopenia status was determined in 201, of whom 38% (77/201) had sarcopenia, 66% (128/194) had low muscle mass, 52% (116/222) had low grip strength and 8% (20/244) had low pre-fracture mobility (NMS < 5). Sarcopenia did not predict change in mobility (effect 0.2 points; 95% CI –0.5 to 0.9, P = 0.6), but it was associated with having lower mobility at one-year (NMS 5.8 (SD 2.3) vs. 6.8 (SD 2.2), P = 0.003), becoming a resident of a nursing home (odds ratio 3.2, 95% CI 0.9 to 12.4, P = 0.048), and the combined endpoint of becoming a resident of a skilled nursing home or death (odds ratio 3.6, 95% CI 1.2 to 12.2, P = 0.02). Conclusions Sarcopenia did not predict change in mobility in the year after hip fracture