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- Armbrecht, G., et al.
(författare)
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Vertebral Scheuermann's disease in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over
- 2015
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 26:10, s. 2509-2519
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Tidskriftsartikel (refereegranskat)abstract
- The Summary In 27 centres across Europe, the prevalence of deforming spinal Scheuermann's disease in age-stratified population-based samples of over 10,000 men and women aged 50+ averaged 8 % in each sex, but was highly variable between centres. Low DXA BMD was un-associated with Scheuermann's, helping the differential diagnosis from osteoporosis. Introduction This study aims to assess the prevalence of Scheuermann's disease of the spine across Europe in men and women over 50 years of age, to quantitate its association with bone mineral density (BMD) and to assess its role as a confounder for the radiographic diagnosis of osteoporotic fracture. Methods In 27 centres participating in the population-based European Vertebral Osteoporosis Study (EVOS), standardised lateral radiographs of the lumbar and of the thoracic spine from T4 to L4 were assessed in all those of adequate quality. The presence of Scheuermann's disease, a confounder for prevalent fracture in later life, was defined by the presence of at least one Schmorl's node or irregular endplate together with kyphosis (sagittal Cobb angle > 40A degrees between T4 and T12) or a wedged-shaped vertebral body. Alternatively, the (rare) Edgren-Vaino sign was taken as diagnostic. The 6-point-per-vertebral-body (13 vertebrae) method was used to assess osteoporotic vertebral shape and fracture caseness. DXA BMD of the L2-L4 and femoral neck regions was measured in subsets. We also assessed the presence of Scheuermann's by alternative published algorithms when these used the radiographic signs we assessed. Results Vertebral radiographic images from 4486 men and 5655 women passed all quality checks. Prevalence of Scheuermann's varied considerably between centres, and based on random effect modelling, the overall European prevalence using our method was 8 % with no significant difference between sexes. The highest prevalences were seen in Germany, Sweden, the UK and France and low prevalences were seen in Hungary, Poland and Slovakia. Centre-level prevalences in men and women were highly correlated. Scheuermann's was not associated with BMD of the spine or hip. Conclusions Since most of the variation in population impact of Scheuermann's was unaccounted for by the radiological and anthropometric data, the search for new genetic and environmental determinants of this disease is encouraged.
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- Smolen, JS, et al.
(författare)
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EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update
- 2017
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 76:6, s. 960-977
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Tidskriftsartikel (refereegranskat)abstract
- Recent insights in rheumatoid arthritis (RA) necessitated updating the European League Against Rheumatism (EULAR) RA management recommendations. A large international Task Force based decisions on evidence from 3 systematic literature reviews, developing 4 overarching principles and 12 recommendations (vs 3 and 14, respectively, in 2013). The recommendations address conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs) (methotrexate (MTX), leflunomide, sulfasalazine); glucocorticoids (GC); biological (b) DMARDs (tumour necrosis factor (TNF)-inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab), abatacept, rituximab, tocilizumab, clazakizumab, sarilumab and sirukumab and biosimilar (bs) DMARDs) and targeted synthetic (ts) DMARDs (Janus kinase (Jak) inhibitors tofacitinib, baricitinib). Monotherapy, combination therapy, treatment strategies (treat-to-target) and the targets of sustained clinical remission (as defined by the American College of Rheumatology-(ACR)-EULAR Boolean or index criteria) or low disease activity are discussed. Cost aspects were taken into consideration. As first strategy, the Task Force recommends MTX (rapid escalation to 25 mg/week) plus short-term GC, aiming at >50% improvement within 3 and target attainment within 6 months. If this fails stratification is recommended. Without unfavourable prognostic markers, switching to—or adding—another csDMARDs (plus short-term GC) is suggested. In the presence of unfavourable prognostic markers (autoantibodies, high disease activity, early erosions, failure of 2 csDMARDs), any bDMARD (current practice) or Jak-inhibitor should be added to the csDMARD. If this fails, any other bDMARD or tsDMARD is recommended. If a patient is in sustained remission, bDMARDs can be tapered. For each recommendation, levels of evidence and Task Force agreement are provided, both mostly very high. These recommendations intend informing rheumatologists, patients, national rheumatology societies, hospital officials, social security agencies and regulators about EULAR's most recent consensus on the management of RA, aimed at attaining best outcomes with current therapies.
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- Wang, Zhao, et al.
(författare)
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Strong Secrecy for Interference Channels Based on Channel Resolvability
- 2018
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Ingår i: IEEE Transactions on Information Theory. - : Institute of Electrical and Electronics Engineers (IEEE). - 0018-9448 .- 1557-9654. ; 64:7, s. 5110-5130
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Tidskriftsartikel (refereegranskat)abstract
- Interference channels with confidential messages are studied under strong secrecy constraints, based on the framework of channel resolvability theory. It is shown that if the random binning rate for securing a confidential message is above the resolution of its corresponding wiretapped channel, strong secrecy can be guaranteed. The information-spectrum method introduced by Han and Verdu is generalized to an arbitrary interference channel to obtain a direct channel resolvability result as a first step. For stationary and memoryless channels with discrete output alphabets, the results show that the achievable rates under weak and strong secrecy constraints are the same. This result is then generalized to channels with continuous output alphabets by deriving a reverse direction of Pinsker's inequality to bound the secrecy measure from above by a function of the variational distance of relevant distributions. As an application, Gaussian interference channels are studied in which the agreement between the best known weak and strong secrecy rate regions also appear. Following the footsteps of Csiszar, Hayashi and of Bloch and Laneman, these results provide further evidence that channel resolvability is a powerful and general framework for strong secrecy analysis in multiuser networks.
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| 5. |
- Wang, Zhao, et al.
(författare)
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Strong Secrecy for Interference Channels from Channel Resolvability
- 2015
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Ingår i: 2015 49th Asilomar Conference on Signals, Systems and Computers. - : IEEE Computer Society. - 9781467385763 ; , s. 559-563
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Konferensbidrag (refereegranskat)abstract
- The achievable rate region is studied for interference channels with confidential messages under strong secrecy constraints. The problem is investigated based on the framework of the channel resolvability theory. The information-spectrum method introduced by Han and Verdu is first generalized to an arbitrary interference channel to obtain a direct channel resolvability result. The derived resolvability results are then shown to be the achievable strong secrecy rates for the stationary and memoryless interference channel. Our results provide further evidence that channel resolvability can be a powerful and general framework for strong secrecy analysis in multiuser networks.
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