Spondylarthropathies (including psoriatic arthritis): 244. Validity of Colour Doppler and Spectral Doppler Ultrasound of Sacroilicac Joints Againts Physical Examination as Gold Standard

Background: Sacroiliac joints (SJ) involvement is a distinctive and charasteristic feature of Spondyloarthritis (SpA) and x-ray is the test routinely used to make a diagnosis. However, x-ray reveals late structural damage but cannot detect active inflammation. The objective of this study was to assess the validity of Doppler ultrasound in SJ. Methods: Prospective blinded and controlled study of SJ, in which three populations were compared. We studied 106 consecutive cases, who were divided into three groups: a) 53 patients diagnosed with SpA who had inflammatory lumbar and gluteal pain assessed by a rheumatologist; b) 26 patients diagnosed with SpA who didn't have SJ tenderness and had normal physical examination; c) control group of 27 subjects (healthy subjetcs or with mechanical lumbar pain). All patients included that were diagnosed with SpA met almost the European Spondyloarthropathy Study Group (ESSG) classification criteria. Physical examination of the SJ included: sacral sulcus tenderness, iliac gapping, iliac compression, midline sacral thrust test, Gaenslen's test, and Patrick s test were used as gold standard. Both SJ were examined with Doppler ultrasound (General Electric Logiq 9, Wauwatosa WI, USA) fitted with a 9-14 Mhz lineal probe. The ultrasonographer was blinded to clinical data. Doppler in SJ was assessed as positive when both Doppler colour and resistance index (RI) < 0.75 within the SJ area were present. Statistical analysis was performed estimating sensitivity and specificity against gold standard. The Kappa correlation coefficient was used for reliability study. Results: 106 cases (53 female, 55 male; mean age 36 10 years) were studied. There were no statistical differences between groups related to age or sex. Physical examination of SJ was positive in 38 patients (59 sacroiliac joints). US detected Doppler signal within SJ in 37 patients (58 SJ): 33 of them were symptomatic SpA (52 SJ), one of them were asymptomatic SpA (1 SJ) and one was a healthy control (1 SJ). The accuracy of US when compared to clinical data as gold standard at subject level in the overall group was: sensitivity of 68.6% and specificity of 85.7%, positive predictive value of 70.5% and negative predictive value of 84.5%. A positive likelihood ratio of 4.8, a negative likelihood ratio of 0.36 and a kappa coefficient of 0.55 were achieved. Conclusions: Doppler US of SJ seems to be a valid method to detect active SJ inflammation. Disclosure statement: The authors have declared no conflicts of interes

Oncogene-Expressing Senescent Melanocytes Up-Regulate MHC Class II, a Candidate Melanoma Suppressor Function

Work in the lab of PDA was funded by CRUK program C10652/A16566, AI by Kay Kendall Leukemia Fund KKL1101, EM by the Medical research Council grants MR/K021095/1, MR/N023625/1

Manufacturing's role in innovation diffusion and technological substitution

SIGLEAvailable from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, Duesternbrook Weg 120, D-24105 Kiel / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Europe 1992 - challenge for competitiveness and innovation

SIGLEAvailable from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, Duesternbrook Weg 120, D-24105 Kiel / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Business systems as control systems

SIGLEAvailable from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, Duesternbrook Weg 120, D-24105 Kiel / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Controlling the market performance of new products

Available from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, Duesternbrook Weg 120, D-24105 Kiel / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

From Waste to Value – A System Dynamics Model for Strategic Decision Making in Closed-Loop Supply Chains

Abstract: The purpose of this paper is to develop a system dynamics model which allows an Original Equipment Manufacturer in the electronics industry to test different value recovery strategies in a Closed-Loop Supply Chain setting. Due to shortening product lifecycles and legislative regulations, companies face the challenge of handling products at their end-of-use or end-of-life. Accordingly, effective strategies for the collection and value recovery of these products have to be developed. The model presented in this paper is the preliminary result of an ongoing research project. First simulation experiments conducted on the current model structure on the one hand show the economic potential of an engagement in value recovery activities and on the other hand highlight the high complexity and connectivity inherited with various value recovery processes. Keywords: Closed-Loop Supply Chains; electronics industry, value recover

Enhancing Learning Capabilities by Providing Transparency in Business Simulators?

Prefabricated computer-based simulations usually offer a user-friendly interface. This allows inexperienced users fast access to the simulation because they do not have to possess specific knowledge about simulation techniques. Thus, giving simulation models an easy-to-use interface increases the acceptance of the simulation tool and draws attention to it. Learners are not only able to examine the results of their decisions but also the causes of these results using powerful system dynamics diagramming techniques. This adds transparency to the former black-boxes, producing so-called transparent-box business simulators. This article reports on an experiment evaluating the relevance and effects of structural transparency. This experimental design also can be used to examine other types of business simulators. Hypotheses regarding the effectiveness of transparency were tested. Results show the necessity for further research and collaboration