Anxiety associates with pain and disability but not increased measures of inflammation for adolescent patients with juvenile idiopathic arthritis

Objectives To explore whether anxiety and depression associate with clinical measures of disease for adolescent JIA patients. To explore whether anxiety and depression associate with increased peripheral pro‐inflammatory cytokine levels in adolescent JIA patients and in healthy adolescent controls. Methods 136 patients with JIA and 88 healthy controls aged 13‐18 completed questionnaires on anxiety and depressive symptoms. For JIA patients, pain, disability, physician visual analogue scale (VAS) and number of joints with active inflammation (active joint count) were recorded. In a sub‐sample, we assessed lipopolysaccharide‐stimulated IL‐6 production from peripheral blood mononuclear cells, serum IL‐6, cortisol and C‐reactive protein (CRP) levels. Data were analysed by linear regression analysis. Results Levels of anxiety and depressive symptoms for JIA patients were not significantly different to healthy controls. For JIA patients, anxiety significantly associated with disability (β=0.009, p=0.002), pain (β=0.029, p=0.011) and physician VAS (β=0.019, p=0.012), but not active joint count (β=0.014, p=0.120). Anxiety did not associate with any laboratory measures of inflammation for JIA patients. These relationships were also true for depressive symptoms. For healthy controls, anxiety (but not depressive symptoms) showed a trend towards an association with stimulated IL‐6 (β=0.004, p=0.052). Conclusions Adolescent JIA patients experience equivalent levels of anxiety and depressive symptoms as healthy adolescents. For adolescent JIA patients, anxiety and depressive symptoms associate with pain, disability and physician VAS but not with inflammation

Vulnerability of bridges to fire

Even if recent effort in developing methodology and measures for design structures against fire and explosions has been mostly focused on buildings, bridges can also be very sensitive to those actions, aswitnesses by some recent bridge accidents, which caused major economic losses and also endangered people safety in few cases. Purpose of this paper is making a focus on the state of the art of the research and current regulations concerning the response of bridges to fire. Several cases of bridge fires are reported and a focus is made on the occurrence and consequence of bridge fires, considering both the costs deriving by structural damages and by limited serviceability and other indirect societal aspects. Few cases of recent bridge fire are reviewed in detail and structural consequences are highlighted, distinguishing between damages directly induced by fire and damages induced by local failures