The impact of early intra-articular corticosteroid injections on the outcome of oligoarticular juvenile idiopathic arthritis

Contexte Un objectif important de la prise en charge de l'arthrite juvénile oligoarticulaire serait d'altérer le cours de la maladie à l'aide d'une thérapie hâtive. Nous avons étudié l'effet des injections intra-articulaires de corticostéroïdes hâtives sur les chances d'atteindre un décompte d'articulation active de zéro et une maladie inactive. Méthode Les données démographiques, cliniques et thérapeutiques des patients avec oligoarthrite juvénile enrôlés dans une étude prospective longitudinale pancanadienne ont été collectées pendant 2 ans. Une injection hâtive était définie comme étant reçue dans les 3 premiers mois suivant le diagnostic. Les équations d'estimation généralisées ont été utilisées pour l'analyse statistique. Résultats Trois cent dix patients ont été inclus. Cent onze (35.8%) ont reçu une injection hâtive. Ces derniers avaient une maladie plus active lors de l'entrée dans l'étude. Les patients exposés à une injection hâtive avaient une chance similaire d'obtenir un décompte d'articulation active de zéro, OR 1.52 (IC95% 0.68-3.37), p=0.306 mais étaient significativement moins à risque d'avoir une maladie inactive, OR 0.35 (IC95% 0.14-0.88), p=0.026. Interprétation Dans cette cohorte de 310 patients avec oligoarthrite juvénile, les injections hâtives de corticostéroïdes n'ont pas mené à une probabilité plus élevée d'atteindre un décompte d'articulation active de zéro ou une maladie inactive. Des problématiques méthodologiques intrinsèques à l'utilisation de données observationnelles pour fins d'estimation d'effets thérapeutiques auraient pu biaiser les résultats. Nous ne pouvons affirmer avec certitude que les injections hâtives n'améliorent pas le décours de la maladie. Des études prospectives adressant les limitations soulevées seront requises pour clarifier la question.

On the question of proportionality of the count of observed Scrapie cases and the size of holding

Background: The present paper investigates the question of a suitable basic model for the number of scrapie cases in a holding and applications of this knowledge to the estimation of scrapie-ffected holding population sizes and adequacy of control measures within holding. Is the number of scrapie cases proportional to the size of the holding in which case it should be incorporated into the parameter of the error distribution for the scrapie counts? Or, is there a different - potentially more complex - relationship between case count and holding size in which case the information about the size of the holding should be better incorporated as a covariate in the modeling? Methods: We show that this question can be appropriately addressed via a simple zero-truncated Poisson model in which the hypothesis of proportionality enters as a special offset-model. Model comparisons can be achieved by means of likelihood ratio testing. The procedure is illustrated by means of surveillance data on classical scrapie in Great Britain. Furthermore, the model with the best fit is used to estimate the size of the scrapie-affected holding population in Great Britain by means of two capture-recapture estimators: the Poisson estimator and the generalized Zelterman estimator. Results: No evidence could be found for the hypothesis of proportionality. In fact, there is some evidence that this relationship follows a curved line which increases for small holdings up to a maximum after which it declines again. Furthermore, it is pointed out how crucial the correct model choice is when applied to capture-recapture estimation on the basis of zero-truncated Poisson models as well as on the basis of the generalized Zelterman estimator. Estimators based on the proportionality model return very different and unreasonable estimates for the population sizes. Conclusion: Our results stress the importance of an adequate modelling approach to the association between holding size and the number of cases of classical scrapie within holding. Reporting artefacts and speculative biological effects are hypothesized as the underlying causes of the observed curved relationship. The lack of adjustment for these artefacts might well render ineffective the current strategies for the control of the disease.

Joint retrievals of cloud and drizzle in marine boundary layer clouds using ground-based radar, lidar and zenith radiances

Active remote sensing of marine boundary-layer clouds is challenging as drizzle drops often dominate the observed radar reflectivity. We present a new method to simultaneously retrieve cloud and drizzle vertical profiles in drizzling boundary-layer clouds using surface-based observations of radar reflectivity, lidar attenuated backscatter, and zenith radiances under conditions when precipitation does not reach the surface. Specifically, the vertical structure of droplet size and water content of both cloud and drizzle is characterised throughout the cloud. An ensemble optimal estimation approach provides full error statistics given the uncertainty in the observations. To evaluate the new method, we first perform retrievals using synthetic measurements from large-eddy simulation snapshots of cumulus under stratocumulus, where cloud water path is retrieved with an error of 31 g m−2 . The method also performs well in non-drizzling clouds where no assumption of the cloud profile is required. We then apply the method to observations of marine stratocumulus obtained during the Atmospheric Radiation Measurement MAGIC deployment in the Northeast Pacific. Here, retrieved cloud water path agrees well with independent three-channel microwave radiometer retrievals, with a root mean square difference of 10–20 g m−2.

Joint use of attribute importance rankings and non-attendance data in choice experiments

The joint and alternative uses of attribute non-attendance and importance ranking data within discrete choice experiments are investigated using data from Lebanon examining consumers’ preferences for safety certification in food. We find that both types of information; attribute non-attendance and importance rankings, improve estimates of respondent utility. We introduce a method of integrating both types of information simultaneously and find that this outperforms models where either importance ranking or non-attendance data are used alone. As in previous studies, stated non-attendance of attributes was not found to be consistent with respondents having zero marginal utility for those attributes

Progression of articular and extraarticular damage in oligoarticular juvenile idiopathic arthritis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

New family of zero-current-switching PWM converter

A new family of dc-to-dc pulse-width-modulated (PWM) converters is presented. These converters feature soft-commutation at zero-current (ZC) in the active switches. The new ZCS-PWM Boost and new ZCS-PWM Zeta converters, both based on the new ZCS-PWM soft-commutation cell proposed, are used as examples to illustrate the operation of the new family of converters.

Joint Reprocessing of GPS, GLONASS and SLR

A joint reprocessing of GPS, GLONASS and SLR observations has been carried out at TU Dresden, TU Munich, AIUB and ETH Zurich. Common a priori models have been applied for the processing of all types of observation to ensure both consistent parameter estimates and the rigorous combination of microwave and optical measurements. Based on that reprocessing results, we evaluate the impact of adding GLONASS observations to the standard GPS data processing. In particular, changes in station position time series and day boundary overlaps of consecutive satellite arcs are analyzed. In addition, the GNSS orbits derived from microwave measurements are validated using independent SLR range measurements. Our SLR residuals indicate a significant improvement compared to previous results. Furthermore, we evaluate the performance of our high-rate (30s) combined GNSS satellite clocks and discuss associated zero-difference phase residuals.