Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Second-Order Analytical Uncertainty Analysis in Life Cycle Assessment

Life cycle assessment (LCA) results are inevitably subject to uncertainties. Since the complete elimination of uncertainties is impossible, LCA results should be complemented by an uncertainty analysis. However, the approaches currently used for uncertainty analysis have some shortcomings: statistical uncertainty analysis via Monte Carlo simulations are inherently uncertain due to their statistical nature and can become computationally inefficient for large systems; analytical approaches use a linear approximation to the uncertainty by a first-order Taylor series expansion and thus, they are only precise for small input uncertainties. In this article, we refine the analytical uncertainty analysis by a more precise, second-order Taylor series expansion. The presented approach considers uncertainties from process data, allocation, and characterization factors. We illustrate the refined approach for hydrogen production from methane-cracking. The production system contains a recycling loop leading to nonlinearities. By varying the strength of the loop, we analyze the precision of the first- and second-order analytical uncertainty approaches by comparing analytical variances to variances from statistical Monte Carlo simulations. For the case without loops, the second-order approach is practically exact. In all cases, the second-order Taylor series approach is more precise than the first-order approach, in particular for large uncertainties and for production systems with nonlinearities, for example, from loops. For analytical uncertainty analysis, we recommend using the second-order approach since it is more precise and still computationally cheap