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Maksymowych WP, Eshed I, Machado PM, Juhl Pedersen S, Weber U, De Hooge M, Sieper J, Wichuk S, Poddubnyy D, Rudwaleit M, Van der Heijde D, Landewé RBM, Lambert RG, Ǿstergaard M, Baraliakos X. FRI0317 CONSENSUS DEFINITIONS FOR MRI LESIONS IN THE SPINE OF PATIENTS WITH AXIAL SPONDYLOARTHRITIS: FIRST ANALYSIS FROM THE ASSESSMENTS IN SPONDYLOARTHRITIS INTERNATIONAL SOCIETY CLASSIFICATION COHORT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:A recent consensus from the ASAS MRI group has culminated in updated spine lesion definitions for axial spondyloarthritis (ASAS_MRI_defn)1. There has been no central reader evaluation of MRI scans from the ASAS Classification Cohort (ASAS-CC)2to determine the spectrum of MRI lesions in the spine in this cohort.Objectives:To determine the spectrum of active and structural lesions on MRI images of the spine from the ASAS-CC according to the consensus ASAS_MRI_defnupdate.Methods:ASAS_MRI_defnwere recorded by 9 central readers in an eCRF for global assessment and detailed scoring of each discovertebral unit and postero-lateral structures. Vertebral corner bone marrow edema (VCBME) and corner fat (VCFAT) lesions were recorded if present on 2 slices; facet joint, lateral, and posterior inflammatory lesions were recorded if present on a single slice. Vertebral corner erosion, bone spurs, and ankylosis were each scored on a single slice. Comparison of active and structural lesion frequencies by local rheumatologist diagnosis of axSpA was assessed descriptively according to ≥2 and majority reader (≥5/9) concordant data.Results:MRI scans of the spine were available from 69 cases with axSpA diagnosed in 44/64 (68.8%). VCBME was most frequent with ≥1 lesion in 32(46.4%) and 19 (27.5%) by ≥2 and ≥5/9 readers, respectively. VCFAT was the most frequent structural lesion with ≥1 lesion in 24 (34.8%) and 14 (20.3%) by ≥2 and ≥5/9 readers, respectively. There were significantly more VCBME lesions in axSpA patients than non-axSpA (mean(SD):1.8(2.7) vs 0.3 (0.5)) (p<0.001) while differences in VCFAT were not significant (Table). The presence of ≥2 VCBME had 90-95% specificity for axSpA. Significantly more VCBME and VCFAT were observed in the setting of radiographic sacroiliitis (modified New York criteria (mNY)).Conclusion:Spine lesions on MRI are relatively frequent in patients with undiagnosed back pain presenting to the rheumatologist. The presence of ≥2 VCBME, but not VCFAT, may have some diagnostic utility.References:[1]Maksymowych WP, et al. Arthritis Rheumatol 70 (suppl 10): 654, 2018[2]Rudwaleit et al. Ann Rheum Dis 2009;68: 777-83Vertebral Corner MRI lesionsmajority of readers (>=5)≥2 readersaxSpA=Yes (n=44)axSpA=No (n=20)p-valueaxSpA=Yes (n=44)axSpA=No (n=20)p-valueCorner Fat ≥112 (27.3%)2 (10%)0.1917 (38.6%)7 (35%)0.78Corner Fat ≥210 (22.7%)2 (10%)0.3113 (29.5%)4 (20%)0.64Corner Fat ≥38 (18.2%)1 (5%)0.2510 (22.7%)3 (15%)0.74Corner Fat ≥47 (15.9%)1 (5%)0.429 (20.5%)2 (10%)0.48Corner BME ≥117 (38.6%)1 (5%)0.00625 (54.5%)6 (30%)0.047Corner BME ≥215 (34.1%)1 (5%)0.01319 (43.2%)2 (10%)0.009Corner BME ≥311 (25%)0 (0%)0.01316 (36.4%)1 (5%)0.008Corner BME ≥48 (18.2%)0 (0%)0.09412 (27.3%)1 (5%)0.048mNY=Yes (n=10)mNY=No (n=49)p-valuemNY=Yes (n=10)mNY=No (n=49)p-valueCorner Fat ≥15 (50%)9 (18.4%)0.0475 (50%)17 (34.7%)0.48Corner Fat ≥25 (50%)7 (14.3%)0.0225 (50%)11 (22.4%)0.12Corner Fat ≥34 (40%)5 (10.2%)0.0364 (40%)9 (18.4%)0.20Corner Fat ≥44 (40%)4 (8.2%)0.0224 (40%)7 (14.3%)0.079Corner BME ≥15 (50%)11 (22.4%)0.1167 (70%)22 (44.9%)0.18Corner BME ≥25 (50%)9 (18.4%)0.0475 (50%)14 (28.6%)0.27Corner BME ≥35 (50%)6 (12.2%)0.0145 (50%)11 (22.4%)0.12Corner BME ≥45 (50%)3 (6.1%)0.0025 (50%)7 (14.3%)0.022Disclosure of Interests:Walter P. Maksymowych Grant/research support from: AbbVie, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB, Employee of: Chief Medical Officer of CARE Arthritis Limited, Speakers bureau: AbbVie, Janssen, Novartis, Pfizer, and UCB, Iris Eshed: None declared, Pedro M Machado Consultant of: PMM: Abbvie, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: PMM: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Susanne Juhl Pedersen Grant/research support from: Novartis, Ulrich Weber: None declared, Manouk de Hooge: None declared, Joachim Sieper Consultant of: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Speakers bureau: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Stephanie Wichuk: None declared, Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Martin Rudwaleit Consultant of: AbbVie, BMS, Celgene, Janssen, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB Pharma, Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead Sciences, Inc., Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma; Director of Imaging Rheumatology BV, Robert B.M. Landewé Consultant of: AbbVie; AstraZeneca; Bristol-Myers Squibb; Eli Lilly & Co.; Galapagos NV; Novartis; Pfizer; UCB Pharma, Robert G Lambert: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen
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Wetterslev M, Ǿstergaard M, Sørensen IJ, Weber U, Loft AG, Kollerup G, Juul L, Thamsborg G, Madsen O, Møllenbach Møller J, Juhl Pedersen S. SAT0548 DEVELOPMENT AND VALIDATION OF THREE PRELIMINARY MRI SACROILIAC JOINT COMPOSITE STRUCTURAL DAMAGE SCORES IN A 5-YEAR LONGITUDINAL STUDY OF PATIENTS WITH AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In axial spondyloarthritis (axSpA), MRI reliably detects structural lesions in the sacroiliac joints (SIJs). The SPARCC SIJ Structural Score (SSS)(1) is a reliable and validated method to assess the individual structural lesions of the SIJs, i.e. fat lesion, erosion, backfill (fat metaplasia in an erosion cavity) and ankylosis. Several MRI studies have indicated that bone destruction, i.e. erosion, is often followed by formation of new bone in the erosion cavity (backfill), ultimately leading to ankylosis(2).Objectives:The aim was to combine SPARCC SSS for erosion, backfill and ankylosis into a composite score for SIJ structural damage and to test this score in a 5-year follow up study.Methods:Thirty-three patients fulfilling ASAS criteria for axSpA were followed for 5 years after initiation of TNF inhibitor in the BIOSPA study(3). T1-weighted and STIR MRI sequences of the SIJs acquired at week 0, 46 and year 2, 3, 4, 5 were evaluated with SPARCC SSS. In each of 5 slices of each SIJ, erosion is scored 0-1 per joint quadrant (score range 0-40), backfill 0-1 per joint half (score range 0-20) and ankylosis 0-1 per joint half (score range 0-20). Based on the scores for erosion, backfill and ankylosis 3 versions of a preliminary Composite axSpA MRI SIJ Structural Damage Score (CSDS) were calculated:CSDS–A: (erosion score x0.5) + backfill score + ankylosis scoreCSDS–B: (erosion score x1) + (backfill score x4) + (ankylosis score x6)CSDS–C: (erosion score x1) < (backfill score x4) < (ankylosis score x6)The “<” indicates a hierarchical order, meaning that erosion was not scored if backfill was present in the same joint half and erosion and backfill were not scored if ankylosis was present in the joint half.Results:Patients were divided into two groups: patients with almost complete bilateral ankylosis (baseline SPARCC SSS Ankylosis ≥18, n=10) and patients with no/minor ankylosis (baseline SPARCC SSS Ankylosis ≤7, n=23). At baseline patients with no/minor ankylosis were younger, had shorter symptom duration, lower BASMI, higher SPARCC SIJ Inflammation, lower SSS Fat, Erosion, Backfill and Ankylosis, as compared with patients with almost complete ankylosis.At baseline, CSDS-A, -B and -C correlated positively with SPARCC SSS Fat and Ankylosis and modified New York criteria grading, and negatively with BASDAI and SPARCC inflammation. Change in CSDS-B and -C over 5 years correlated positively with change in SSS Fat and Ankylosis and negatively with change in SPARCC Inflammation. There was no change in the group with almost complete ankylosis.The annual progression for CSDS-B and -C was statistically significantly larger in year 1 compared with year 4 (p=0.01) and numerically larger compared with year 2 (p=0.075), 3 (p=0.382) and 5 (p=0.073). Figure 1 shows the annual change in patients with no/minor ankylosis.Conclusion:Three preliminary Composite Structural Damage Scores for MRI assessment of the SIJs in patients with axSpA, which allows scoring of MRI progression of erosion through backfill to ankylosis, were introduced. Progression was most pronounced the first year after TNF inhibitor initiation. This novel approach may be useful for monitoring structural progression in axSpA. We suggest that these methods are further tested for responsiveness and ability to differentiate between different therapies in randomized controlled trials.References:[1]Maksymowych WP et al. J Rheum 2015;42:79-86.[2]Maksymowych WP et al. Art Rheum 2014;66:2958-67.[3]Pedersen SJ et al. Scand J Rheum 2019;48:185-197.Disclosure of Interests:Marie Wetterslev: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Inge Juul Sørensen: None declared, Ulrich Weber: None declared, Anne Gitte Loft Grant/research support from: Novartis, Consultant of: AbbVie, MSD, Novartis, Pfizer and UCB, Speakers bureau: AbbVie, MSD, Novartis, Pfizer and UCB, Gina Kollerup Speakers bureau: Eli Lilly, Lars Juul: None declared, Gorm Thamsborg: None declared, Ole Madsen: None declared, Jakob Møllenbach Møller: None declared, Susanne Juhl Pedersen Grant/research support from: Novartis
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Bastos A, Ciais P, Friedlingstein P, Sitch S, Pongratz J, Fan L, Wigneron JP, Weber U, Reichstein M, Fu Z, Anthoni P, Arneth A, Haverd V, Jain AK, Joetzjer E, Knauer J, Lienert S, Loughran T, McGuire PC, Tian H, Viovy N, Zaehle S. Direct and seasonal legacy effects of the 2018 heat wave and drought on European ecosystem productivity. SCIENCE ADVANCES 2020; 6:eaba2724. [PMID: 32577519 PMCID: PMC7286671 DOI: 10.1126/sciadv.aba2724] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/14/2020] [Indexed: 05/23/2023]
Abstract
In summer 2018, central and northern Europe were stricken by extreme drought and heat (DH2018). The DH2018 differed from previous events in being preceded by extreme spring warming and brightening, but moderate rainfall deficits, yet registering the fastest transition between wet winter conditions and extreme summer drought. Using 11 vegetation models, we show that spring conditions promoted increased vegetation growth, which, in turn, contributed to fast soil moisture depletion, amplifying the summer drought. We find regional asymmetries in summer ecosystem carbon fluxes: increased (reduced) sink in the northern (southern) areas affected by drought. These asymmetries can be explained by distinct legacy effects of spring growth and of water-use efficiency dynamics mediated by vegetation composition, rather than by distinct ecosystem responses to summer heat/drought. The asymmetries in carbon and water exchanges during spring and summer 2018 suggest that future land-management strategies could influence patterns of summer heat waves and droughts under long-term warming.
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Mattei I, Alexandrov A, Alunni Solestizi L, Ambrosi G, Argiro S, Bartosik N, Battistoni G, Belcari N, Biondi S, Bisogni MG, Bruni G, Camarlinghi N, Carra P, Catanzani E, Ciarrocchi E, Cerello P, Clozza A, Colombi S, De Lellis G, Del Guerra A, De Simoni M, Di Crescenzo A, Donetti M, Dong Y, Durante M, Embriaco A, Emde M, Faccini R, Ferrero V, Ferroni F, Fiandrini E, Finck C, Fiorina E, Fischetti M, Francesconi M, Franchini M, Galli L, Gentile V, Hetzel R, Hild S, Iarocci E, Ionica M, Kanxheri K, Kraan AC, Lante V, Lauria A, La Tessa C, Lopez Torres E, Massimi C, Marafini M, Mengarelli A, Mirabelli R, Montesi MC, Morone MC, Morrocchi M, Muraro S, Narici L, Pastore A, Pastrone N, Patera V, Pennazio F, Placidi P, Pullia M, Ramello L, Ridolfi R, Rosso V, Rovituso M, Sanelli C, Sartorelli G, Sato O, Savazzi S, Scavarda L, Schiavi A, Schuy C, Scifoni E, Sciubba A, Secher A, Selvi M, Servoli L, Silvestre G, Sitta M, Spighi R, Spiriti E, Sportelli G, Stahl A, Tomassini S, Tommasino F, Traini G, Toppi M, Valeri T, Valle SM, Vanstalle M, Villa M, Weber U, Zoccoli A, Sarti A. Measurement of 12C Fragmentation Cross Sections on C, O, and H in the Energy Range of Interest for Particle Therapy Applications. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020. [DOI: 10.1109/trpms.2020.2972197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Krabbe S, Kröber G, Pedersen SJ, Østergaard M, Møller JM, Sørensen IJ, Jensen B, Madsen OR, Klarlund M, Weber U. Scoring magnetic resonance imaging (MRI) inflammation and structural lesions in sacroiliac joints of patients with axial spondyloarthritis: assessment of all MRI slices of the cartilaginous compartment versus standardized six or five slices. Scand J Rheumatol 2019; 49:200-209. [PMID: 31847676 DOI: 10.1080/03009742.2019.1675184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: The Spondyloarthritis Research Consortium of Canada (SPARCC) sacroiliac joint (SIJ) scoring system assesses six or five (6/5) semicoronal magnetic resonance imaging (MRI) slices for inflammation/structural lesions in patients with axial spondyloarthritis (axSpA). However, the cartilaginous SIJ compartment may be visible in a few additional slices. The objective was to investigate interreader reliability, sensitivity to change, and classification of MRI scans as positive or negative for various lesion types using an 'all slices' approach versus standard SPARCC scoring of 6/5 slices.Method: Fifty-three axSpA patients were treated with the tumour necrosis factor inhibitor golimumab and followed with serial MRI scans at weeks 0, 4, 16, and 52. The most anterior and posterior slices covering the cartilaginous compartment and the transitional slice were identified. Scores for inflammation, fat metaplasia, erosion, backfill, and ankylosis in the cartilaginous SIJ compartment were calculated for the 'all slices' approach and the 6/5 slices standard.Results: By the 'all slices' approach, three readers scored mean 7.2, 7.7, and 7.0 slices per MRI scan. Baseline and change scores for the various lesion types closely correlated between the two approaches (Pearson's rho ≥ 0.95). Inflammation score was median 13 (interquartile range 6-21, range 0-49) for 6/5 slices versus 14 (interquartile range 6-23, range 0-69) for all slices at baseline. Interreader reliability, sensitivity to change, and classification of MRI scans as positive or negative for various lesion types were similar.Conclusion: The standardized 6/5 slices approach showed no relevant differences from the 'all slices' approach and, therefore, is equally suited for monitoring purposes.
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Walsh L, Schneider U, Fogtman A, Kausch C, McKenna-Lawlor S, Narici L, Ngo-Anh J, Reitz G, Sabatier L, Santin G, Sihver L, Straube U, Weber U, Durante M. Research plans in Europe for radiation health hazard assessment in exploratory space missions. LIFE SCIENCES IN SPACE RESEARCH 2019; 21:73-82. [PMID: 31101157 DOI: 10.1016/j.lssr.2019.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 05/04/2023]
Abstract
The European Space Agency (ESA) is currently expanding its efforts in identifying requirements and promoting research towards optimizing radiation protection of astronauts. Space agencies use common limits for tissue (deterministic) effects on the International Space Station. However, the agencies have in place different career radiation exposure limits (for stochastic effects) for astronauts in low-Earth orbit missions. Moreover, no specific limits for interplanetary missions are issued. Harmonization of risk models and dose limits for exploratory-class missions are now operational priorities, in view of the short-term plans for international exploratory-class human missions. The purpose of this paper is to report on the activity of the ESA Topical Team on space radiation research, whose task was to identify the most pertinent research requirements for improved space radiation protection and to develop a European space radiation risk model, to contribute to the efforts to reach international consensus on dose limits for deep space. The Topical Team recommended ESA to promote the development of a space radiation risk model based on European-specific expertise in: transport codes, radiobiological modelling, risk assessment, and uncertainty analysis. The model should provide cancer and non-cancer radiation risks for crews implementing exploratory missions. ESA should then support the International Commission on Radiological Protection to harmonize international models and dose limits in deep space, and guarantee continuous support in Europe for accelerator-based research configured to improve the models and develop risk mitigation strategies.
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Simeonov Y, Weber U, Schuy C, Zink K. PV-099 MC simulations and dose measurements of a patient-specific 3D range-modulator for proton therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30519-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pedersen SJ, Weber U, Said-Nahal R, Sørensen IJ, Loft AG, Kollerup G, Juul L, Frandsen PB, Thamsborg G, Madsen OR, Møller J, Balding L, Jurik AG, Østergaard M. Structural progression rate decreases over time on serial radiography and magnetic resonance imaging of sacroiliac joints and spine in a five-year follow-up study of patients with ankylosing spondylitis treated with tumour necrosis factor inhibitor. Scand J Rheumatol 2018; 48:185-197. [PMID: 30422733 DOI: 10.1080/03009742.2018.1506822] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate temporal changes in structural progression assessed by serial conventional radiography and magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) and spine in patients with ankylosing spondylitis (AS) treated with tumour necrosis factor (TNF) inhibitor for 5 years. METHOD Forty-two patients were included and 33 patients were followed for 5 years in a prospective investigator-initiated study. Conventional radiographs were required four times and MRI seven times. The modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS); Spondyloarthritis Research Consortium of Canada (SPARCC) MRI SIJ and Spine Inflammation, and SPARCC MRI SIJ Structural Score (SSS) for Fat, Erosion, Backfill, and Ankylosis; and the Canada-Denmark MRI scores for Spine Inflammation, Fat, Erosion, and New Bone Formation (NBF) were applied. RESULTS Compared with baseline, MRI Inflammation had decreased significantly at week 22 (spine)/week 46 (SIJ) and thereafter. MRI SIJ Fat (from week 22), SIJ Ankylosis, Spine NBF, and mSASSS had increased significantly at week 46 and thereafter. SIJ Erosion had decreased from year 2. The annual progression rate in mSASSS was significantly higher during weeks 0-46 compared to week 46 to year 3. In multivariate regression analyses, baseline SIJ Inflammation and Backfill were independent predictors of 5 year progression in SIJ Ankylosis. Spine Erosion predicted progression in Spine NBF. Longitudinally, Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index, MRI Spine Inflammation, Fat, and Erosion scores were significantly associated with mSASSS. SIJ Inflammation, Fat, Erosion, and Backfill scores were longitudinally associated with SIJ Ankylosis. Structural progression was not associated with body mass index, smoking, or Assessment of SpondyloArthritis international Society Non-Steroidal Anti-Inflammatory Drug Index. CONCLUSION In a 5 year follow-up study of patients with AS treated with TNF inhibitor, structural progression decreased over time.
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Pfuhl T, Horst F, Schuy C, Weber U. Dose build-up effects induced by delta electrons and target fragments in proton Bragg curves—measurements and simulations. ACTA ACUST UNITED AC 2018; 63:175002. [DOI: 10.1088/1361-6560/aad8fc] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
ZusammenfassungSeit erstmals Interaktionen von Blut und körperfremden Materialien bei der chronischen Hämodialysebehandlung beobachtet wurden, folgten zahlreiche Untersuchungen, um das Phänomen der Biokompatibilität zu ergründen. Dies hatte zur Folge, daß erhebliche Verbesserungen bei den Membranen, Schlauchsystemen, Geräten und der Behandlung selbst erzielt werden konnten. Im folgenden wird versucht, einen Überblick über die auslösenden Ursachen und die Phänomene, die durch die Interaktion von Blut mit körperfremden Oberflächen verursacht werden, aufzuzeigen.Die Probleme, die bei der Entwicklung biokompatibler Membranen vorhanden sind, scheinen in naher Zukunft noch nicht alle lösbar zu sein. Unsere ganze Sorgfalt muß daher der Hämodialysebehandlung selbst und der Verringerung ihrer möglichen Nebenwirkungen, die z.B. durch Reste von Sterilisationsmitteln, endotoxinhaltige Dialysierflüssigkeiten hervorgerufen werden können, gelten. Besonders im Hinblick darauf, daß die Zahl der Patienten, die Biomaterialien benötigen, rasch zunimmt und diese Patienten länger leben, wodurch sie den Gefahren durch die Biounverträglichkeit der Materialien länger ausgesetzt werden, sind wir alle aufgefordert, unseren Patienten eine risikoarme Hämodialyse zu ermöglichen served in the treatment of chronic hemodialysis, numerous investigations were performed to definite the phenomena of biocompatibility. As a consequence, considerable improvements in membranes, tube systems, equipments and in the treatment itself have been accomplished. The following is an attempt to demonstrate the initiating causes and the phenomena which results from the interaction of blood with artificial surfaces.The problems being encountered in the development of biocompatible membranes are not likely to all be solved in the near future. We must, therefore, concentrate all our efforts on the hemodialysis treatment itself and on the reduction of its possible side-effects which can, for example, be caused by the remnants of sterilizing agents, dialysis fluid containing endotoxin, etc. Especially in view of the fact that the number of patients requiring biomaterials is rapidly increasing and that these patients are living longer, whereby they are exposed to the dangers of bioincompatibility of the materials for a longer period of time, we are all called upon to provide low-risk hemodialysis for our patients.
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Baumann K, Flatten V, Weber U, Engenhart-Cabillic R, Zink K. EP-1902: Analysing the effects of Bragg curve degradation due to lung parenchyma in treatment planning. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32211-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Simeonov Y, Weber U, Penchev P, Printz Ringbæk T, Zink K. OC-0601: Development and Monte Carlo simulations of a novel 3D range-modulator for proton therapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30911-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Rovituso M, Schuy C, Weber U, Brons S, Cortés-Giraldo MA, La Tessa C, Piasetzky E, Izraeli D, Schardt D, Toppi M, Scifoni E, Krämer M, Durante M. Fragmentation of 120 and 200 MeV u−14He ions in water and PMMA targets. Phys Med Biol 2017; 62:1310-1326. [DOI: 10.1088/1361-6560/aa5302] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, Braun J. Deutsche Übersetzung und krosskulturelle Adaptation des ASAS-Gesundheitsindex. Z Rheumatol 2016; 75:993-998. [PMID: 27785609 DOI: 10.1007/s00393-016-0218-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kiltz U, van der Heijde D, Boonen A, Bautista-Molano W, Burgos-Vargas R, Chiowchanwisawakit P, Duruoz T, El-Zorkany B, Essers I, Gaydukova I, Géher P, Gossec L, Grazio S, Gu J, Khan MA, Kim TJ, Maksymowych WP, Marzo-Ortega H, Navarro-Compán V, Olivieri I, Patrikos D, Pimentel-Santos FM, Schirmer M, van den Bosch F, Weber U, Zochling J, Braun J. Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set: translation and cross-cultural adaptation into 15 languages. RMD Open 2016; 2:e000311. [PMID: 27752358 PMCID: PMC5051462 DOI: 10.1136/rmdopen-2016-000311] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/06/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022] Open
Abstract
Introduction The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages. Methods Translation and cross-cultural adaptation has been carried out following the forward–backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included. Results The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option ‘not applicable’ was added to two items of the ASAS HI to improve appropriateness. Discussion This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures.
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Weber A, Weber U. Erwerbstätig mit Hörschädigung in Sachsen, Sachsen-Anhalt und Thüringen. HNO 2016; 64:743-50. [DOI: 10.1007/s00106-016-0174-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hermansen LT, Loft AG, Christiansen AA, Munk HL, Gilbert L, Jurik AG, Arnbak B, Manniche C, Weber U, Østergaard M, Pedersen SJ, Barington T, Junker P, Hørslev-Petersen K, Hendricks O. No diagnostic utility of antibody patterns against Klebsiella pneumoniae capsular serotypes in patients with axial spondyloarthritis vs. patients with non-specific low back pain: a cross-sectional study. Scand J Rheumatol 2016; 46:296-302. [DOI: 10.1080/03009742.2016.1205659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Simeonov Y, Penchev P, Ringbaek TP, Brons S, Weber U, Zink K. SU-F-T-184: 3D Range-Modulator for Scanned Particle Therapy: Development, Monte Carlo Simulations and Measurements. Med Phys 2016. [DOI: 10.1118/1.4956321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pedersen S, Weber U, Said-Nahal R, Sørensen I, Loft A, Tvede N, Kollerup G, Juul L, Thamsborg G, Madsen O, Østergaard M. SAT0417 Evolution of MRI Inflammation and Structural Lesions on Serial Scans over 5 Years in Patients with Ankylosing Spondylitis Treated with Tumor-Necrosis-Factor-Alpha Inhibitors: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wieczorrek G, Weber U, Wienke A, Egner E, Schröder J, Vogt A, Müller-Werdan U, Weber A, Steighardt J, Girschick C, Schlitt A. [Adherence to Phase III Cardiac Rehabilitation Programs: A Prospective, Randomized Comparison between a Conventionally Conducted Program and a Tai Chi-Based Program]. SPORTVERLETZUNG-SPORTSCHADEN 2016; 30:95-100. [PMID: 27064493 DOI: 10.1055/s-0042-100952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In patients with cardiac diseases, lifestyle changes such as an increase in physical activity are recommended to prevent further cardiac events. In Germany this is possible by attending outpatient heart groups. A problem inherent in these programs is the lack of adherence since more than two thirds of patients stop attending cardiac rehabilitation programs after six months. An alternative to the conventional implementation of heart groups is Tai Chi, which was found to improve adherence to cardiac rehabilitation programs in international studies. METHODS Patients were randomly assigned to a conventional heart group or a heart group with Tai Chi exercises. At the beginning of the study, a medical history was taken and physical and instrumental tests were carried out, including an assessment of anxiety/depression (HADS questionnaire) and physical well-being (SD-12). Follow-up tests were performed every three months. RESULTS Patients were 62.6 ± 8.5 years old, the mean BMI was 28.6 ± 62 kg/m(2), and the proportion of women was 29.8 %. The groups were different in terms of age (conventional heart group: 65.0 ± 7.5; Tai Chi group: 59.9 ± 8.9 years). Therefore, age-adjusted analyses were performed in addition to the planned analyses. Regarding the primary endpoint of the study, there was no difference between the groups. After twelve months, 50 % of subjects were active in the Tai Chi group and 48 % in the conventional heart group (odds ratio 0.92, p = 0.891). After adjustment for age by logistic regression, the odds ratio was 0.47 (p = 0.285). Furthermore, both the participation period in weeks (Tai Chi group: 43.3 ± 26.0; conventional group: 45.5 ± 24.2, p = 0.766) and the participation rate (Tai Chi group: 66.8 ± 19.2 % Tai Chi, conventional group: 76.3 ± 16.5 %, p = 0.074) did not differ between the two groups. A further analysis showed a non-significant trend for improvement of anxiety, depression and physical well-being in the Tai Chi group compared with the conventional group. CONCLUSION The insight gained in international studies regarding a better adherence to Tai Chi-guided prevention programs was not transferable to heart group participants from Germany. However, there was a trend regarding a better mental condition in the Tai Chi group.
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Witt M, Weber U, Simeonov Y, Zink K. SU-E-T-671: Range-Modulation Effects of Carbon Ion Beams in Lung Tissue. Med Phys 2015. [DOI: 10.1118/1.4925034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hermansen L, Loft A, Christiansen A, Gilbert L, Garg K, Karvonen K, Jurik A, Weber U, Manniche C, Jensen T, Arnbak B, Østergaard M, Pedersen S, Barington T, Kolmos H, Hørslev-Petersen K, Hendricks O. FRI0194 Is There an Association Between Spondyloarthritis and Antibodies Towards Borrelia, Ehrlichia and Chlamydia Species? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Baumann K, Weber U, Simeonov Y, Zink K. SU-E-T-590: Optimizing Magnetic Field Strengths with Matlab for An Ion-Optic System in Particle Therapy Consisting of Two Quadrupole Magnets for Subsequent Simulations with the Monte-Carlo Code FLUKA. Med Phys 2015. [DOI: 10.1118/1.4924953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Weber U, Peláez-Ballestas I, Julian B, Pedersen S, Lόpez A, Maksymowych W, Burgos-Vargas R. FRI0238 Reliability of Sacroiliac Joint MRI Assessment in a Population-Based Cohort of Patients with Possible Inflammatory Back Pain:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Baumann K, Weber U, Simeonov Y, Zink K. SU-E-T-121: Analyzing the Broadening Effect On the Bragg Peak Due to Heterogeneous Geometries and Implementing User-Routines in the Monte-Carlo Code FLUKA in Order to Reduce Computation Time. Med Phys 2015. [DOI: 10.1118/1.4924482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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