The effect of three years of TNF alpha blocking therapy on markers of bone turnover and their predictive value for treatment discontinuation in patients with ankylosing spondylitis: a prospective longitudinal observational cohort study

INTRODUCTION: The aim of this study was to investigate the effect of three years of tumor necrosis factor-alpha (TNF-alpha) blocking therapy on bone turnover as well as to analyze the predictive value of early changes in bone turnover markers (BTM) for treatment discontinuation in patients with ankylosing spondylitis (AS). METHODS: This is a prospective cohort study of 111 consecutive AS outpatients who started TNF-alpha blocking therapy. Clinical assessments and BTM were assessed at baseline, three and six months, as well as at one, two, and three years. Z-scores of BTM were calculated to correct for age and gender. Bone mineral density (BMD) was assessed yearly. RESULTS: After three years, 72 patients (65%) were still using their first TNF-alpha blocking agent. In these patients, TNF-alpha blocking therapy resulted in significantly increased bone-specific alkaline phosphatase, a marker of bone formation; decreased serum collagen-telopeptide (sCTX), a marker of bone resorption; and increased lumbar spine and hip BMD compared to baseline. Baseline to three months decrease in sCTX Z-score (HR: 0.394, 95% CI: 0.263 to 0.591), AS disease activity score (ASDAS; HR: 0.488, 95% CI: 0.317 to 0.752), and physician's global disease activity (HR: 0.739, 95% CI: 0.600 to 0.909) were independent inversely related predictors of time to treatment discontinuation because of inefficacy or intolerance. Early decrease in sCTX Z-score correlated significantly with good long-term response regarding disease activity, physical function and quality of life. CONCLUSIONS: Three years of TNF-alpha blocking therapy results in a bone turnover balance that favors bone formation, especially mineralization, in combination with continuous improvement of lumbar spine BMD. Early change in sCTX can serve as an objective measure in the evaluation of TNF-alpha blocking therapy in AS, in addition to the currently used more subjective measures

Binary coalescence from case A evolution -- mergers and blue stragglers

We constructed some main-sequence mergers from case A binary evolution and studied their characteristics via Eggleton's stellar evolution code. Both total mass and orbital angular momentum are conservative in our binary evolutions. Some mergers might be on the left of the ZAMS as defined by normal surface composition on a CMD because of enhanced surface helium content. The study also shows that central hydrogen content of the mergers is independent of mass. As a consequence, we fit the formula of magnitude and B-V of the mergers when they return back to thermal equilibrium with maximum error 0.29 and 0.037, respectively. Employing the consequences above, we performed Monte Carlo simulations to examine our models in NGC 2682 and NGC 2660. In NGC 2682, binary mergers from our models cover the region with high luminosity, but its importance is much less than that of AML. Our results are well-matched to the observations of NGC2660 if there is about 0.5Mo of mass loss in the merger process.Comment: 14 pages, 12 figures. accepted by MNRA

Relying on satiety cues in food consumption : studies on the role of social context, appearance focus, and mindfulness

Consumers eat at various sequential occasions throughout the day. The current thesis addresses the question of how one consumption episode can affect the amount of consumption at a subsequent episode. The thesis focuses specifically on how the social context during a consumption episode affects subsequent consumption, and on when consumers rely on hunger and satiety cues in sequential consumption episodes

A method for sensitivity analysis to assess the effects of measurement error in multiple exposure variables using external validation data

Measurement error in self-reported dietary intakes is known to bias the association between dietary intake and a health outcome of interest such as risk of a disease. The association can be distorted further by mismeasured confounders, leading to invalid results and conclusions. It is, however, difficult to adjust for the bias in the association when there is no internal validation data

Op weg naar Park Essenburg : advies aan Bewonersgroep ProGroen Rotterdam

Bewonersgroep ProGroen in Rotterdam is voor het behoud van een miskende groenstrook van circa twaalf hectare tussen de spoordijk en Essenburgsingel. Ze wil dat het gebied in de deelgemeente Delfshaven het groene en duurzame karakter behoudt en dat het in de toekomst goed bruikbaar is en blijft voor alle mensen uit de buurt en de stad. De Wetenschapswinkel ziet voor ProGroen de opgave weggelegd om aan te tonen dat de strook een waardevol groenelement is in de stad. Het park draagt bij aan de sociale cohesie: het vergroot het aantal ontmoetingsplekken in de wijk, biedt laagdrempelige aanleidingen om contact te leggen en motiveert bewoners te investeren in relaties in de buurt. Daarnaast biedt het park de wijkbewoners nieuwe mogelijkheden om in contact te komen met groen, met natuur. De eerste concrete invulling van het park is PlukTuin Essenburg RFC. Deze PlukTuin, een buurttuin, wordt aangelegd op een voormalige parkeerplaats. Opzet is dat bewoners de PlukTuin zelf aanleggen en onderhoude

Vygotsky in English: What Still Needs to Be Done

At present readers of English have still limited access to Vygotsky’s writings. Existing translations are marred by mistakes and outright falsifications. Analyses of Vygotsky’s work tend to downplay the collaborative and experimental nature of his research. Several suggestions are made to improve this situation. New translations are certainly needed and new analyses should pay attention to the contextual nature of Vygotsky’s thinking and research practice

Computational Aeroelastic Analysis of the Ares Launch Vehicle During Ascent

This paper presents the static and dynamic computational aeroelastic (CAE) analyses of the Ares crew launch vehicle (CLV) during atmospheric ascent. The influence of launch vehicle flexibility on the static aerodynamic loading and integrated aerodynamic force and moment coefficients is discussed. The ultimate purpose of this analysis is to assess the aeroelastic stability of the launch vehicle along the ascent trajectory. A comparison of analysis results for several versions of the Ares CLV will be made. Flexible static and dynamic analyses based on rigid computational fluid dynamic (CFD) data are compared with a fully coupled aeroelastic time marching CFD analysis of the launch vehicle