119 research outputs found
The first composite score predicting Digital Ulcers in systemic sclerosis patients using Clinical data, Imaging and Patient history-CIP-DUS
Background: Digital ulcers (DU) present a challenging complication in systemic sclerosis (SSc). The aim of this study was to combine clinical characteristics and imaging methods to a composite score for the prediction of DU in SSc patients.
Methods: Seventy-nine SSc patients received clinical examination, their patient history was taken and nailfold capillaroscopy (NC), colour Doppler ultrasonography (CDUS) and fluorescence optical imaging (FOI) of the hands were performed at baseline. Newly developed DU over a period of approximately 12 months were registered. We used criteria with area under the curve (AUC) of at least 0.6 in regard to the development of these new DU to create the score (CIP-DUS, clinical features, imaging, patient history-digital ulcer score).
Results: Twenty-nine percent of all SSc patients developed new DU during follow-up (48.1% diffuse, 18.4% limited SSc). Based on the cross-validated (cv) AUC, a weight (cvAUC > 0.6 and †0.65: 1; cvAUC > 0.65 and †0.7: 2; cvAUC > 0.7: 3) was assigned to each selected parameter. The performance of the final CIP-DUS was assessed with and without the CDUS/FOI component. For the scleroderma patterns in NC, three points were appointed to late, two to active and one point to early capillaroscopy pattern according to Cutolo et al. The CIP-DUS including the CDUS and FOI parameters resulted in a good diagnostic performance (AUC after cross-validation: 0.83, 95%CI 0.74 to 0.92) and was well calibrated (chi-square = 12.3, p = 0.58). The cut-off associated with the maximum of sensitivity and specificity was estimated at ℠10 points resulting in a sensitivity of 100% and specificity of 74% for new DU during follow-up. Excluding CDUS and FOI parameters leads to a non-statistically significant lower performance (AUC after cross-validation: 0.81, 95%CI 0.72 to 0.91). However, including CDUS and FOI resulted in a better classification of patients in respect to the outcome new DU in follow-up due to significantly better reclassification performance (NRI = 62.1, p = 0.001) and discrimination improvement (IDI = 9.7, p = 0.01).
Conclusion: A new score was introduced with the aim to predict digital ulcers. If applied correctly and with the new imaging techniques proposed, all patients at risk of digital ulcers throughout 12 months could be identified
Solution of the off-forward leading logarithmic evolution equation based on the Gegenbauer moments inversion
Using the conformal invariance the leading-log evolution of the off-forward
structure function is reduced to the forward evolution described by the
conventional DGLAP equation. The method relies on the fact that the anomalous
dimensions of the Gegenbauer moments of the off-forward distribution are
independent on the asymmetry, or skewedness, parameter and equal to the DGLAP
ones. The integral kernels relating the forward and off-forward functions with
the same Mellin and Gegenbauer moments are presented for arbitrary asymmetry
value.Comment: 11 pages, LaTeX, no figures, revised version, references adde
Preliminary definitions for the sonographic features of synovitis in children
Objectives Musculoskeletal ultrasonography (US) has the potential to be an important tool in the assessment of disease activity in childhood arthritides. To assess pathology, clear definitions for synovitis need to be developed first. The aim of this study was to develop and validate these definitions through an international consensus process. Methods The decision on which US techniques to use, the components to be included in the definitions as well as the final wording were developed by 31 ultrasound experts in a consensus process. A Likert scale of 1-5 with 1 indicating complete disagreement and 5 complete agreement was used. A minimum of 80% of the experts scoring 4 or 5 was required for final approval. The definitions were then validated on 120 standardized US images of the wrist, MCP and tibiotalar joints displaying various degrees of synovitis at various ages. Results B-Mode and Doppler should be used for assessing synovitis in children. A US definition of the various components (i.e. synovial hypertrophy, effusion and Doppler signal within the synovium) was developed. The definition was validated on still images with a median of 89% (range 80-100) of participants scoring it as 4 or 5 on a Likert scale. Conclusions US definitions of synovitis and its elementary components covering the entire pediatric age range were successfully developed through a Delphi process and validated in a web-based still images exercise. These results provide the basis for the standardized US assessment of synovitis in clinical practice and research
Monitoring of patients with rheumatoid arthritis by indocyanine green (ICG)-enhanced fluorescence optical imaging treated with anti-TNFα therapy
Background: Fluorescence optical imaging (FOI) enables visualisation of inflammation in both hands in rheumatoid arthritis (RA).
Objective: To investigate the usefulness of FOI in treatment monitoring under anti-TNF alpha therapy with certolizumab pegol (CZP) in patients with RA in comparison to clinical and laboratory outcome parameters.
Methods: CZP-naive patients with RA were eligible for this open-label study with an observational period of 52 weeks. Disease activity was monitored by the clinical score DAS28, tender/swollen joint count (TJC-28/SJC-28) and laboratory outcomes for systemic inflammation (CRP and ESR). FOI results were analysed in three different phases (P1-3) and PrimaVistaMode (PVM) by the FOI activity score (FOIAS).
Results: Twenty-eight RA patients (median age 52.5 years, 26 females, thirteen with a history of other biologic therapy) were included. DAS28 (CRP) decreased from moderate disease activity at baseline (median 4.6, IQR 1.8) to low disease activity at week (w)52 (median 2.7, IQR 2.1; p < 0.001). Statistically significant decreases could also be demonstrated for SJC-28 and TJC-28. CRP/ESR were reduced numerically from baseline to w52. FOIAS in P1 (early phase) showed a continuous decrease of enhancement during the course of treatment period: from baseline (median 1.5, IQR 9.3) over w6 (median 1.0, IQR 3.0; p= 0.069), w12 (median 0.5, IQR 3.0; p = 0.171), w24 (n = 27 , median 0.0, IQR 3.0; p = 0.004), until w52 (n= 18, median 0.0, IQR 2.8; p = 0.091), which could not be presented for FOIAS in P2, P3 and PVM.
Conclusion: FOI in P1 appears to be a valuable tool for fast and easy monitoring of treatment response to certolizumab in a clinical setting
What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review
Pathophysiology and treatment of rheumatic disease
Helicity-Flip Off-Foward Parton Distributions of the Nucleon
We identify quark and gluon helicity-flip distributions defined between
nucleon states of unequal momenta. The evolution of these distributions with
change of renormalization scale is calculated in the leading-logarithmic
approximation. The helicity-flip gluon distributions do not mix with any quark
distribution and are thus a unique signature of gluons in the nucleon. Their
contribution to the generalized virtual Compton process is obtained both in the
form of a factorization theorem and an operator product expansion. In deeply
virtual Compton scattering, they can be probed through distinct angular
dependence of the cross section.Comment: a few corrections made, references change
On Low-Energy Effective Actions in N = 2, 4 Superconformal Theories in Four Dimensions
We study some aspects of low-energy effective actions in 4-d superconformal
gauge theories on the Coulomb branch. We describe superconformal invariants
constructed in terms of N=2 abelian vector multiplet which play the role of
building blocks for the N=2,4 supersymmetric low-energy effective actions. We
compute the one-loop effective actions in constant N=2 field strength
background in N=4 SYM theory and in N=2 SU(2) SYM theory with four
hypermultiplets in fundamental representation. Using the classification of
superconformal invariants we then find the manifestly N=2 superconformal form
of these effective actions. While our explicit computations are done in the
one-loop approximation, our conclusions about the structure of the effective
actions in N=2 superconformal theories are general. We comment on some
applications to supergravity - gauge theory duality in the description of
D-brane interactions.Comment: 18 pages, latex, comments/reference adde
The Meson Light-Cone Distribution Amplitudes of Leading Twist Revisited
We give a complete re-analysis of the leading twist quark-antiquark
light-cone distribution amplitudes of longitudinal and transverse
mesons. We derive Wandzura-Wilczek type relations between different
distributions and update the coefficients in their conformal expansion using
QCD sum rules including next-to-leading order radiative corrections. We find
that the distribution amplitudes of quarks inside longitudinally and
transversely polarized mesons have a similar shape, which is in
contradiction to previous analyses.Comment: 21 pages, latex2e, requires a4wide.sty and epsf.sty, 6 PS figures
include
Scheme dependence of NLO corrections to exclusive processes
We apply the so-called conformal subtraction scheme to predict perturbatively
exclusive processes beyond leading order. Taking into account evolution
effects, we study the scheme dependence for the photon-to-pion transition form
factor and the electromagnetic pion form factor at next-to-leading order for
different pion distribution amplitudes. Relying on the conformally covariant
operator product expansion and using the known higher order results for
polarized deep inelastic scattering, we are able to predict perturbative
corrections to the hard-scattering amplitude of the photon-to-pion transition
form factor beyond next-to-leading order in the conformal scheme restricted to
the conformal limit of the theory.Comment: RevTeX, 25 pages, 2 figures, 5 tables, minor changes, to be published
in Phys. Rev.
The vertex with arbitrary gluon virtualities in the perturbative QCD hard scattering approach
We study the vertex for arbitrary gluon virtualities in
the time-like and space-like regions, using the perturbative QCD hard
scattering approach and an input wave-function of the -meson
consistent with the measured transition form
factor. The contribution of the gluonic content of the -meson is
taken into account, enhancing the form factor over the entire virtuality
considered. However, data on the electromagnetic transition form factor of the
-meson is not sufficient to quantify the gluonic enhancement. We
also study the effect of the transverse momenta of the partons in the
-meson on the vertex, using the modified
hard scattering approach based on Sudakov formalism. Analytic expressions for
the vertex are presented in limiting kinematic regions
and parametrizations are given satisfying the QCD anomaly, for real gluons, and
perturbative QCD behavior for large gluon virtualities, in both the time-like
and space-like regions. Our results have implications for the inclusive decay
and exclusive decays, such as , and in hadronic production processes .Comment: 23 pages, 19 figures (requires revtex4, amssymb, epsf); several typos
corrected, this version now identical to the one accepted for publication in
Phys. Rev.
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