Prevalence and clinical value of IgA and hidden rheumatoid factors in juvenile rheumatoid arthritis

Background: Juvenile rheumatoid arthritis (JRA) is so difficult to be diagnosed early and a small subgroup of patients has positive IgM rheumatoid factor (RF) detected by the standard agglutination techniques.Objective: To investigate the prevalence of IgA and hidden RFs among patients with JRA, to evaluate their diagnostic value in comparison to classic RF and to outline their relation to disease activity, severity as well as to therapy.Methods: The study included 46 patients with JRA (31 females and 15 males). Thirty patients had polyarticular JRA, 9 had oligoarticular JRA and 7 had systemic-onset JRA. Twelve patients had active disease. Thirteen systemic lupus erythematosus patients and 32 healthy subjects were studied as controls. Evaluation was carried out clinically and radiologically (using modified Larsen scoring). Laboratory investigations included CBC, ESR, classic IgM RF (latex agglutination), ANA (indirect  immunofluorescence), IgA-RF (ELISA) and hidden RF seropositivity (ion exchange chromatography).Results: All JRA patients had significantly higher IgA-RF (121.5 ± 195.4 mg/dL) and positivity of hidden RF (56.5%) than lupus (14 ± 6.6 mg/dL and 7.7% respectively) and healthy controls (13.7 ± 6.2 mg/dL and 0% respectively). Classic IgM RF had only 10.9% sensitivity in diagnosing JRA. IgA and hidden RFs had higher sensitivities (50% and 56.5% respectively). Specificity, positive and negative predictive values of IgA-RF were 97.7%, 95.8% and 65.7% and for hidden RF, they were 95.5%, 92.9% and 68.3%. Interestingly, combined positivity of IgA and hidden RFs had 100% specificity and positive predictive value for JRA. Classic RF did not correlate with disease activity and severity in terms of ESR, activity score and Larsen Index. In contrast, patients with active disease had significantly higher value of IgA-RF and positivity of hidden RF than those with quiescent disease. Also, IgA-RF had significant positive correlation with ESR, activity score and Larsen index. Similarly, patients with positive hidden RF had significantly higher values of ESR, activity score and Larsen index than those with negative hidden RF. Steroid therapy was associated with significantly higher level of IgA-RF and positivity of hidden RF, perhaps related to disease severity.Conclusion: IgA and hidden RFs are more sensitive tests in diagnosing JRA than classic IgM RF. Also, the combined positivity of IgA and hidden RFs can confirm the diagnosis of JRA in doubtful cases. The fact that IgA and hidden RFs gave positive results in the meantime that classic RF was negative, together with their significant relation to disease activity and severity highlights their clinical value as reliable laboratory markers of JRA.Key words: juvenile rheumatoid arthritis, rheumatoid factors, IgA-RF, hidden RF, SLE

A lack of association between elevated serum levels of S100B protein and autoimmunity in autistic children

<p>Abstract</p> <p>Background</p> <p>S100B is a calcium-binding protein that is produced primarily by astrocytes. Increased serum S100B protein levels reflect neurological damage. Autoimmunity may have a role in the pathogenesis of autism in some patients. Autoantibodies may cross the blood-brain barrier and combine with brain tissue antigens, forming immune complexes and resulting in neurological damage. We are the first to investigate the relationship between serum levels of S100B protein, a marker of neuronal damage, and antiribosomal P protein antibodies in autistic children.</p> <p>Methods</p> <p>Serum S100B protein and antiribosomal P antibodies were measured in 64 autistic children in comparison to 46 matched healthy children.</p> <p>Results</p> <p>Autistic children had significantly higher serum S100B protein levels than healthy controls (<it>P </it>< 0.001). Children with severe autism had significantly higher serum S100B protein than patients with mild to moderate autism (<it>P </it>= 0.01). Increased serum levels of antiribosomal P antibodies were found in 40.6% of autistic children. There were no significant correlations between serum levels of S100B protein and antiribosomal P antibodies (<it>P </it>= 0.29).</p> <p>Conclusions</p> <p>S100B protein levels were elevated in autistic children and significantly correlated to autistic severity. This may indicate the presence of an underlying neuropathological condition in autistic patients. Antiribosomal P antibodies may not be a possible contributing factor to the elevated serum levels of S100B protein in some autistic children. However, further research is warranted to investigate the possible link between serum S100B protein levels and other autoantibodies, which are possible indicators of autoimmunity to central nervous system in autism.</p

Vitamin D in the general population of young adults with autism in the Faroe Islands

Vitamin D deficiency has been proposed as a possible risk factor for developing autism spectrum disorder (ASD). 25-Hydroxyvitamin D3 (25(OH)D3) levels were examined in a cross-sectional population-based study in the Faroe Islands. The case group consisting of a total population cohort of 40 individuals with ASD (aged 15–24 years) had significantly lower 25(OH)D3 than their 62 typically-developing siblings and their 77 parents, and also significantly lower than 40 healthy age and gender matched comparisons. There was a trend for males having lower 25(OH)D3 than females. Effects of age, month/season of birth, IQ, various subcategories of ASD and Autism Diagnostic Observation Schedule score were also investigated, however, no association was found. The very low 25(OH)D3 in the ASD group suggests some underlying pathogenic mechanism

New Public Management reforms in Europe and their effects: findings from a 20-country top executive survey

This article assesses the impact of New Public Management (NPM)-style reforms in European countries as perceived by top public sector officials. Using data from an executive survey conducted in 20 European countries, we look at the relationship between five key NPM reforms (downsizing, agencification, contracting out, customer orientation and flexible employment practices) and four dimensions of public sector performance: cost efficiency, service quality, policy coherence and coordination, and equal access to services. Structural equation modelling reveals that treating service users as customers and flexible employment are positively related to improvements on all four dimensions of performance. Contracting out and downsizing are both positively related to improved efficiency, but downsizing is also associated with worse service quality. The creation of autonomous agencies is unrelated to performance. This suggests that policy-makers seeking to modernize the public sector should prioritize managerial reforms within public organizations over structural transformations

Reliability and validity study of Persian modified version of MUSIC (musculoskeletal intervention center) – Norrtalje questionnaire

<p>Abstract</p> <p>Background</p> <p>Musculoskeletal disorders (MSDs) are a major health problem in the world. Self-reported questionnaires are a known method for estimating the prevalence of MSDs among the population. One of the studies concerning MSDs and their relation to work-related physical and psychosocial factors, as well as non-work-related factors, is the MUSIC-Norrtalje study in Sweden. In this study, the research group developed a questionnaire, which has been validated during its development process and is now considered a well-known instrument. The aim of this study is to validate the Persian version of this questionnaire.</p> <p>Methods</p> <p>The first step was to establish two expert panel groups in Iran and Sweden. The Focus Group Discussion (FGD) method was used to detect questionnaire face and content validity. To detect questionnaire reliability, we used the test-retest method.</p> <p>Results</p> <p>Except for two items, all other questions that respondents had problems with in the focus group (20 of 297), had unclear translations; the ambiguity was related to the stem of the questions and the predicted answers were clear for the participants. The concepts of 'household/spare time' and 'physical activity in the workplace' were not understood by the participants of FGD; this has been solved by adding further descriptions to these phrases in the translation. In the test-retest study, the reliability coefficient was relatively high in most items (only 5 items out of 297 had an ICC or kappa below 0.7).</p> <p>Conclusion</p> <p>The findings from the present study provide evidence that the Persian version of the MUSIC questionnaire is a reliable and valid instrument.</p

Search for New Physics in e mu X Data at D0 Using Sleuth: A Quasi-Model-Independent Search Strategy for New Physics

We present a quasi-model-independent search for the physics responsible for electroweak symmetry breaking. We define final states to be studied, and construct a rule that identifies a set of relevant variables for any particular final state. A new algorithm ("Sleuth") searches for regions of excess in those variables and quantifies the significance of any detected excess. After demonstrating the sensitivity of the method, we apply it to the semi-inclusive channel e mu X collected in 108 pb^-1 of ppbar collisions at sqrt(s) = 1.8 TeV at the D0 experiment during 1992-1996 at the Fermilab Tevatron. We find no evidence of new high p_T physics in this sample.Comment: 23 pages, 12 figures. Submitted to Physical Review

Oral health status of 12-year-old school children in Khartoum state, the Sudan; a school-based survey

<p>Abstract</p> <p>Background</p> <p>Few studies have investigated the prevalence of dental caries among school children in the past decades in Sudan rendering it difficult to understand the status and pattern of oral health.</p> <p>Methods</p> <p>A school-based survey was conducted using stratified random cluster sampling in Khartoum state, Sudan. Data was collected through interviews and clinical examination by a single examiner. DMFT was measured according to WHO criteria. Gingival index (GI) of Loe & Silness and Plaque index (PI) of Silness & Loe were used.</p> <p>Results</p> <p>The mean DMFT for 12-year-olds was found to be 0.42 with a significant caries index (SiC) of 1.4. Private school attendees had significantly higher DMFT (0.57) when compared to public school attendees (0.4). The untreated caries prevalence was 30.5%. In multivariate analysis caries experience (DMFT > 0) was found to be significantly and directly associated with socioeconomic status. The mean GI for the six index teeth was found to be 1.05 (CI 1.03 – 1.07) and the mean PI was 1.30 (CI 1.22 – 1.38).</p> <p>Conclusion</p> <p>The prevalence of caries was found to be low. The school children with the higher socioeconomic status formed the high risk group.</p

Ratio of the Isolated Photon Cross Sections at \sqrt{s} = 630 and 1800 GeV

The inclusive cross section for production of isolated photons has been measured in \pbarp collisions at $\sqrt{s} = 630$ GeV with the \D0 detector at the Fermilab Tevatron Collider. The photons span a transverse energy ($E_T$) range from 7-49 GeV and have pseudorapidity $|\eta| < 2.5$. This measurement is combined with to previous \D0 result at $\sqrt{s} = 1800$ GeV to form a ratio of the cross sections. Comparison of next-to-leading order QCD with the measured cross section at 630 GeV and ratio of cross sections show satisfactory agreement in most of the $E_T$ range.Comment: 7 pages. Published in Phys. Rev. Lett. 87, 251805, (2001

The Dijet Mass Spectrum and a Search for Quark Compositeness in bar{p}p Collisions at sqrt{s} = 1.8 TeV

Using the DZero detector at the 1.8 TeV pbarp Fermilab Tevatron collider, we have measured the inclusive dijet mass spectrum in the central pseudorapidity region |eta_jet| < 1.0 for dijet masses greater than 200 Gev/c^2. We have also measured the ratio of spectra sigma(|eta_jet| < 0.5)/sigma(0.5 < |eta_jet| < 1.0). The order alpha_s^3 QCD predictions are in good agreement with the data and we rule out models of quark compositeness with a contact interaction scale < 2.4 TeV at the 95% confidence level.Comment: 11 pages, 4 figures, 2 tables, submitted to Phys. Rev. Let