Developing the Polish Educational Needs Assessment Tool (Pol-ENAT) in rheumatoid arthritis and systemic sclerosis: a cross-cultural validation study using Rasch analysis

Objectives: To undertake cross-cultural adaptation and validation of the educational needs assessment tool (ENAT) for use with people with rheumatoid arthritis (RA) and systemic sclerosis (Ssc) in Poland. Methods: The study involved two main phases: (i) cross-cultural adaptation of the ENAT from English into Polish and (ii) Cross-cultural validation of Pol-ENAT. The first phase followed an established process of cross-cultural adaptation of self-report measures. The second phase involved completion of the Pol-ENAT by patients and subjecting the data to Rasch analysis to assess the construct validity, reliability and cross-cultural invariance. Results: An adequate conceptual equivalence was achieved following the adaptation process. The dataset for validation comprised a total of 278 patients, 237 (85.3%) of which were female. In each disease group (145, RA and 133, SSC), the 7 domains of the Pol-ENAT were found to fit the Rasch model, 2(df)=16.953(14), p=0.259 and 8.132(14), p=0.882 for RA and SSc respectively. Reliability (person separation index, PSI>0.85) was high. Cross-cultural differential item functioning (DIF) was detected in some subscales and DIF-adjusted conversion tables were calibrated to enable cross-cultural comparison of data between Poland and the UK. Conclusion: Pol-ENAT is a robust measure of educational needs for people with RA and SSc in Poland. The tool has been shown to have sufficient cross-cultural validity to enable data pooling and comparisons between Poland and the UK

Assembling of xyloglucans and lectin onto si wafers and onto amino-terminated surfaces

Immobilization of xyloglucans extracted from Hymenaea coubaril (HXG) and Tamarindus indica seeds (TXG) on Si/SiO2 wafers or amino-terminated wafers from aqueous solution at concentration of 0.5 g L-1 and pH 3.5 has been investigated by means of ellipsometry and atomic force microscopy (AFM) measurements. Experiments were carried out under equilibrium conditions (adsorption) and non-equilibrium conditions (casting). Under equilibrium conditions neither TXG nor HXG chains adsorbed from solution onto Si/SiO2 surfaces, indicating that negatively charged SiO- groups on the surface do not attract XG chains. Casting TXG and HXG solutions onto Si/SiO2 surfaces led to layers (2.4 ± 0.4) nm and (3.8 ± 0.9) nm thick, respectively. TXG and HXG adsorbed onto amino-terminated surfaces forming layers (1.0 ± 0.1) nm and (1.3 ± 0.1) nm thick, respectively. Upon casting solutions of TXG and HXG onto amino-terminated surfaces, aggregates and fibrils appeared more frequently on the surface, increasing the mean thickness and roughness values. Regardless the substrate, HXG chains tended to form thicker layers than TXG chains did. This trend can be explained with basis on the molecular characteristics of HXG, namely, higher molecular weight and persistence length. The adsorption isotherms of concanavalin A (Con A) onto HXG- and TXG-covered amino-terminated wafers presented maximum adsorbed amount of (3.3 ± 0.3) mg m-2. AFM images shown Con A molecules as small entities densely packed on the surface. The presence of fibrils and aggregates was observed only when the TXG and HXG surfaces were prepared by casting. There ConA molecules adsorbed predominantly on regions free of fibrils and aggregates

The influence of doxycycline on articular cartilage in experimental osteoarthrosis induced by iodoacetate

The experiment was performed on 36 Wistar rats. On the first day of the experiment iodoacetate was administered to the left posterior knee joint of the 18 rats which composed Group I. The second group of 18 rats received additionally doxycycline (doxy) through the gastric tube in doses comparable with those of doxycycline used in humans. The experiment lasted 21 days. The animals were sacrificed after 7, 14 and 21 days in groups of 6 rats each. In sections stained with Safranin 0 semiquantitative histochemical intensity tests were performed on articular cartilage glycosaminoglycans (GAG) using a four-point scale (0–3). In the first group examined destructive lesions in the articular cartilage and weak reactivity on GAG were noted at all stages of the experiment. The intensity of GAG staining was higher in the second group after 14 and especially after 21 days, which may suggest a protective action of doxy on articular cartilage

Self-regulated charge transfer and band tilt in nm-scale polar GaN films

To date, the generic polarization of Bernardini, Fiorentini and Vanderbilt (PBFV) has been widely used to address the issue of polarity in III-V nitride semiconductors, but improvements in nitride materials and the performance of optoelectronic devices have been limited. The current first-principles calculation for the electronic structures of nm-scale [0001] GaN films show that the internal electric fields and the band tilt of these films are in opposite direction to those predicted by PBFV. Additionally, it is determined that an intrinsic self-regulated charge transfer across the film limits the electrostatic potential difference across the film, which renders the local conduction band energy minimum (at the Ga-terminated surface) approximately equal to the local valence band energy maximum (at the N-terminated surface). This effect is found to occur in films thicker than ~4nm

Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial

Objective: Assess ustekinumab efficacy (week 24/week 52) and safety (week 16/week 24/week 60) in patients with active psoriatic arthritis (PsA) despite treatment with conventional and/or biological anti-tumour necrosis factor (TNF) agents. Methods: In this phase 3, multicentre, placebo-controlled trial, 312 adults with active PsA were randomised (stratified by site, weight (≤100 kg/>100 kg), methotrexate use) to ustekinumab 45 mg or 90 mg at week 0, week 4, q12 weeks or placebo at week 0, week 4, week 16 and crossover to ustekinumab 45 mg at week 24, week 28 and week 40. At week 16, patients with <5% improvement in tender/swollen joint counts entered blinded early escape (placebo→45 mg, 45 mg→90 mg, 90 mg→90 mg). The primary endpoint was ≥20% improvement in American College of Rheumatology (ACR20) criteria at week 24. Secondary endpoints included week 24 Health Assessment Questionnaire-Disability Index (HAQ-DI) improvement, ACR50, ACR70 and ≥75% improvement in Psoriasis Area and Severity Index (PASI75). Efficacy was assessed in all patients, anti-TNF-naïve (n=132) patients and anti-TNF-experienced (n=180) patients. Results: More ustekinumab-treated (43.8% combined) than placebo-treated (20.2%) patients achieved ACR20 at week 24 (p<0.001). Significant treatment differences were observed for week 24 HAQ-DI improvement (p<0.001), ACR50 (p≤0.05) and PASI75 (p<0.001); all benefits were sustained through week 52. Among patients previously treated with ≥1 TNF inhibitor, sustained ustekinumab efficacy was also observed (week 24 combined vs placebo: ACR20 35.6% vs 14.5%, PASI75 47.1% vs 2.0%, median HAQ-DI change −0.13 vs 0.0; week 52 ustekinumab-treated: ACR20 38.9%, PASI75 43.4%, median HAQ-DI change −0.13). No unexpected adverse events were observed through week 60. Conclusions: The interleukin-12/23 inhibitor ustekinumab (45/90 mg q12 weeks) yielded significant and sustained improvements in PsA signs/symptoms in a diverse population of patients with active PsA, including anti-TNF-experienced PsA patients

Assessment of education requirements for patients with rheumatoid arthritis, based on the Polish version of the Educational Needs Assessment Tool (Pol-ENAT), in the light of some health problems – A cross-sectional study

© 2016, Institute of Agricultural Medicine. All rights reserved. Introduction. Patients with chronic rheumatoid arthritis (RA) need advice in order to face the problems of everyday life, as well as suffering associated with the disease. Health professionals should attempt to raise the level of resourcefulness and independence of the patient. Objective. To assess the relationship between the deficit of knowledge about RA and the degree of pain, fatigue, morning stiffness, assessment of disease activity as well as functional efficiency. Materials and method. The study was conducted on 277 patients with RA in 7 rheumatologic centres in Poland. The method applied was the questionnaire Pol-ENAT (0–156); HAQ DI (0–3); analog scales (0–100). Results. Mean (SD) age was 53.28 (13.01) and disease duration 13.70 (10.63) years. The mean (SD) value was 54.93 (23.17) for pain, 52.97 (21.98) for fatigue, 48.28 (24.76) for morning stiffness (0–100 mm). HAQ DI was 1.40 (0.66), with an upward trend with duration of disease (

Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST–RA database

OBJECTIVE: To analyse associations between the clinical status of patients with rheumatoid arthritis (RA) and the gross domestic product (GDP) of their resident country. METHODS: The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) cohort includes clinical and questionnaire data from 6004 patients who were seen in usual care at 70 rheumatology clinics in 25 countries as of April 2008, including 18 European countries. Demographic variables, clinical characteristics, RA disease activity measures, including the disease activity score in 28 joints (DAS28), and treatment-related variables were analysed according to GDP per capita, including 14 "high GDP" countries with GDP per capita greater than US$24,000 and 11 "low GDP" countries with GDP per capita less than US$11,000. RESULTS: Disease activity DAS28 ranged between 3.1 and 6.0 among the 25 countries and was significantly associated with GDP (r = -0.78, 95% CI -0.56 to -0.90, r(2) = 61%). Disease activity levels differed substantially between "high GDP" and "low GDP" countries at much greater levels than according to whether patients were currently taking or not taking methotrexate, prednisone and/or biological agents. CONCLUSIONS: The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in "low GDP" than in "high GDP" countries. These findings may alert healthcare professionals and designers of health policy towards improving the clinical status of patients with RA in all countries