Chinese registry of rheumatoid arthritis: IV. Correlation and consistency of rheumatoid arthritis disease activity indices in China

Background:Disease activity indices(DAIs)including disease activity score 28(DAS28),simplified disease activity index(SDAI),and clinical disease activity index(CDAI)have been widely used in clinical practice and research studies of rheumatoid arthritis(RA).The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA.Methods:A cross-sectional study,including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018,was conducted.The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots,quadratic weighted kappa,and discordance rates in the crosstab.For other indices,the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis.Results:A total of 30,501 patients were included,of whom 80.46%were women.Most individuals were with moderate disease activity or high disease activity.High correlations among DAS28-erythrocyte sedimentation rate(ESR)and DAS28-C-reactive protein(CRP),SDAI and CDAI were observed.Similarly,the weighted kappa value among the indices was high.In Bland-Altman plots,a positive difference between DAS28-ESR and DAS28-CRP was observed,with an absolute difference of>1.2 in 3079(10.09%)patients.In crosstab,approximately 30%of the patients were classified into different groups.Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR,DAS28-CRP,and CDAI were 3.06,2.37,and 3.20,respectively.Conclusions:Although DAIs had high correlations and weighted kappa values,the discordance between DAIs was significant in Chinese patients with RA.The four DAIs are not interchangeable.

Influence of upstream solar wind on magnetic field distribution in the Martian nightside ionosphere

Using over eight years of Mars Atmosphere and Volatile Evolutio N(MAVEN)data,from November 2014 to May 2023,we have investigated the Martian nightside ionospheric magnetic field distribution under the influence of upstream solar wind drivers,including the interplanetary magnetic field intensity(∣BIMF∣),solar wind dynamic pressure(PS W),solar extreme ultraviolet flux(EUV),and Martian seasons(L s).Our analysis reveals pronounced correlations between magnetic field residuals and both∣BIMF∣and PS W.Correlations observed with EUV flux and Ls were weaker—notably,magnetic field residuals increased during periods of high EUV flux and at Mars perihelion.We find that the IMF penetrates to an altitude of 200 km under a wide range of upstream conditions,penetrating notably deeper under high∣BIMF∣andPSWconditions.Our analysis also indicates that EUV flux and IMF cone angle have minimal impact on IMF penetration depth.Those findings provide useful constraints on the dynamic nature of Martian atmospheric escape processes and their evolution,suggesting that historical solar wind conditions may have facilitated deeper IMF penetration and higher rates of ionospheric escape than are observed now.Moreover,by establishing criteria for magnetic‘quiet’conditions,this study offers new insights into the planet’s magnetic environment under varying solar wind influences,knowledge that should help refine models of the Martian crustal magnetic field.

Appraisal of active tectonics in Hindu Kush:Insights from DEM derived geomorphic indices and drainage analysis

Landscapes in tectonically active Hindu Kush （NW Pakistan and NE Alghanistanl result from a complex integration of the effects of vertical and horizontal crustal block motions as well as erosion and deposition processes. Active tectonics in this region have greatly influenced the drainage system and geomorphic expressions. The study area is a junction of three important mt^unlain ranges （Hindu Kush-Karakorunl-Himalayas） and is thus an ideal natural laboratory to investigate the relative tectonic activity resulting from the India-Eurasia collision. We evaluate active tectonics using DEM derived drainage network and geomorphic indices hypsometric integral （Hl）. stream-length gradient （SL）, fractal dimension （FD）, basin asymmetry factor （AF）, basin shape index （B,）, valley floor width to wllley height ratio （Vf） and motmtain front sinuosity （Star）. The results obtained from these indices were combined to yield an index of relative active tectonics （IRAT） using GIS. The average of the seven measured geomorphic indices was used to ewfluate the distri- bution of relative tectonic activity in the study area. We defined tour classes to define the degree of rela- tive tectonic activity： class 1 very high （1.0 ≤ IRAT 〈 1.3）; class 2 high （1.3 ≥ IRAT 〈 1.5）： class 3--moderate （1.5 〉 IRAT 〈 1.8）; and class 4--low （1.8 〉 IRAT）. In view of the results, we conclude that this combined approach allows the identification of the highly deformed areas related to active tectonics. Landsat imagery and field observations also evidence the presence of active tectonics based on the deflected streams, deformed landforms, active mountain fronts and triangular facets. The indicative values of IRAT are consistent with the areas of known relative uplift rates, landforms and geology.

Fluidizate-Explosive Occurrences in Ophiolites as Indicator of the Subduction Zone Activity: The Urals Example

It is known that the formation of oceanic crust occurs in different geodynamic settings,accompanying by the emergence of mantle-magmatic ophiolite complexes having a distinctive properties.In the process of mantle-crustal evolution of the ophiolites are undergoing significant changes with the formation of peculiar(on structure and composition)rocks,sometimes with unusual mineral paragenesis.The presence of such rocks in mélange tectonic zones greatly complicates to determine their origin.In the Ural folded belt(length more than 2,000 km)separating the East European Platform and the West Siberian sedimentary basin,ophiolites are widespread forming a chain of mafic-ultramafic massifs(Fig.1)located in the allochthonous position with mélange at the bottom(Puchkov,2013).With the Urals ophiolites are associated occurrences of eclogites,jadeites,ruby and other rocks of unclear nature,sometimes regarded as potentially diamondiferous.Such formations of unclear genesis include the associating with ophiolites metabasites of higher alkalinity composing the body in the mantle peridotites of the mélange Main Uralian Fault(MUF)zone(Shmelev,2005).By this time they are determined in different parts of the fault zone,but most completely are known in the Sub Polar Urals,where are distinguished under the name of Sertynya alkaline-ultramafic complex,which is located just 25 km east of Hartes kimberlitic complex(Fig.1).Formally,its affiliation to diamond-bearing associations is confirmed by finding of grains and fragments of natural diamond in the weathering crust.A detailed study of the rock complexes shows that in reality they have a polygenic nature,combine theelements of proper magmatic and fluidizate-explosive formations,the appearance of which was interfaced with the processes at the slab-mantle wedge boundary in subduction zones.Polygenic nature of the rocks is reflected in the existence of three interrelated structural-geological units:(1)bodies and dikes of uniformmetadiabasesanddensefine-grainedmetadolerites(lamprophyres),(2)fluidal-brecciated dolerites('tuff breccias')and(3)structural weathering crust with angular or rounded fragments(blocks)of metadolerites and serpentinites.The rocks have experienced rodingitization and permeated with net of veins a vesuvianite composition.The host peridotite matrix(harzburgites and dunites)has undergone serpentinizationandchloritization.Structural relationships give grounds for distinguishing in the history of the complex formation the magmatic proper(dolerite dyke and lamprophyre intrusion)and infiltration fluidizate-explosive(metasomatic transformation of dolerite)stages.Peculiarities of petrography and mineralogy of rock complexes does not allow to compare them with lamproites and kimberlites.Metadiabases demonstrate relics of ophitic structure,as primary paragenesis is completely replaced by aggregate of chlorite,zoisite and leucoxene.Dolerites(lamprophyres)have a uniform fine-grained or porphyry structure with phenocrysts of clinopyroxene,brown amphibole and leucoxene(sphene),which are immersed in a fine-scaly aggregate of light green mica.In the rocks amphibole,garnet and vesuvian are present.Clinopyroxene corresponds to augite with moderate content of titanium and alumina(up to 3.5wt.%),showing a normal magmatic zonation in composition.Mica previously wrongly called as phlogopite,actually has an extremely ferrous composition and corresponds to biotite(annite).Amphibole is presented by magmatic titaniferous tschermakite hornblende and metamorphic(bluish)variety of sodium-calcium composition(taramite).Garnet is presented by exceptionally grossular of rodingite type.Mineralogy of weathering crust reveals similar features,but in the samples it is marked the presence of muscovite,orthoclase and weakly ferrous diopside.An important feature of the weathering crust is the presence of shear surfaces on minerals,resulting in fracturing due to internal stress,confirming the explosive nature of protolith.The bulk chemical composition of rocks is characterized by significant variations in the content of silica(30-46 wt.%)and alkalis(0-6.5 wt.%).These metabasites have consistently a low magnesia number and high titanium oxide content(1.5-3.0 wt.%).Side by side with these are been established the uniform slope REE distribution trends similar to the trend of oceanic basalts N-MORB type(Fig.2).The level of trace element compositions does not depend on variations in the alkalinity of the rocks,but clearly correlates with the titanium content.Unlike them the Hartes kimberlites demonstrate the distribution with deficit of HREE,andthe level of the elements content is correlated with the alkalinity of rocks(Mahotkin et al.,1998).Another important geochemical feature of the Sertynya complex rocks is a regular behavior of the mobile LILE elements(Cs,Rb,Ba,K).In the varieties of rocks with mica enriched by alkalis,it is recorded extremely high level of LILE,exceeding the level of contents in N-MORB basalts at 10-10000 times!In the metabasites varieties with low level of alkalinity,LILE content is sharply(except Cs)reduced to minimum values(Fig.2).The observed pattern of the element distribution is undoubtedly the result of postmagmatic fluid-metasomatic alteration of the original rocks.Tectonic position and the primary composition characteristics of the metadolerites give reason to consider them as fragments of the ophiolite sheeted dike complex(Shmelev,2005).The famous dike complexes in the ophiolite massifs of the MUF zone(east of mélange)belong to suprasubduction formations of Paleozoic age.However the obtained mainly ancient U-Pb zircon dating(up to Archean inclusive)for metadolerites of the Sertynya complex,make it possible to assume its Vendian-Early Cambrian(530-617 Ma)age.It permits to compare the Sertynya metabasites with the Vendian metaophiolites of the MUF zone in the Middle Urals(Petrov et al.,2010).It is noteworthy that similar age datings(520-550 Ma)are also established for kimberlites of the Hartes complex located to the west of ophiolites.Therefore,thepresenceofthe Vendian-Cambrian ophiolite of MOR-type in the MUF mélange zone,'changing'to the east of Ordovician ophiolites SSZ-type,seems quite possible.The obtained data allow to suggest an original interpretation of nature of the Urals fluidizate-explosive formations considering the process specifics in the subduction zones(Bebout and Barton,2002).Accordingto this model,the pre-Ordovician(?)oceanic crust has undergone transformations and deformations on the slab-mantle wedge boundary during the subduction.As a result of slab dehydration it occurred a flow of aqueous fluids,which were enriched with the extracted from sedimentary rocks the LILE elements and percolated through the mantle substrate with dolerite dyke complex.Interaction with them led to the formation of chlorite-zoisite and/or mica(biotite-bearing)fluidizates and in the presence of a gas phase-fluidizate-explosive breccias with subsequent development of weathering crust.In the surrounding peridotites an explosive process is marked by the formation of pseudokimberlite breccias.Fluidized-explosive occurrences in mantle peridotites of mélange zones should be considered as indicators of the subduction slab-mantle interaction at relatively shallow levels involving enriched LILE fluids(without melts participation),rising as the front from the subduction zone.In this interpretation,there is no need toappealtothealkaline-ultramaficor lamproit-kimberlite hypothesis of the genesis of these formations,however,the question of their potential diamondiferous remains to be open.The proposed interpretation of the fluidizate-explosive occurrences makes it possible to comprehendthat in reality the mélange is a complex formation with signs of not onlycollisional(as usually is considered),but also of earlier subduction events.

Clinical relevance of endoscopic assessment of inflammation in ulcerative colitis: Can endoscopic evaluation predict outcomes?

Ulcerative colitis(UC) is a chronic inflammatory bowel condition characterised by a relapsing and remitting course. Symptom control has been the traditional mainstay of medical treatment. It is well known that histological inflammatory activity persists despite adequate symptom control and absence of endoscopic inflammation. Current evidence suggests that presence of histological inflammation poses a greater risk of disease relapse and subsequent colorectal cancer risk. New endoscopic technologies hold promise for developing endoscopic markers of mucosal inflammation. Achieving endoscopic and histological remission appears be the future aim of medical treatments for UC. This review article aims to evaluate the use of endoscopy as a tool in assessment of mucosal inflammation UC and its correlation with disease outcomes.

Quaternary tectonic control on channel morphology over sedimentary low land:A case study in the Ajay-Damodar interfluve of Eastern India

The style of active tectonic on the deformation and characterization of fluvial landscape has been investigated on three typical skrike-slip fault zones of the Ajay-Damodar Interfluve（ADI） in Eastern India through field mapping,structural analysis and examination of digital topography（ASTER-30 m）,multispectral imageries,and Google Earth images,Channel morphology in Quaternary sediment is more deformed than Cenozoic lateritic tract and igneous rock system by the neotectonic activities,The structural and lithological controls on the river system in ADI region are reflected by distinct drainage patterns,abrupt change in flow direction,offset river channels,straight river lines,ponded river channel,marshy lands,sag ponds,palaeo-channels,alluvial fans,meander cutoffs,multi-terrace river valley,incised compressed meander,convexity of channel bed slope and knick points in longitudinal profile,Seven morphotectonic indices have been used to infer the role of neotectonic on the modification of channel morphology,A tectonic index map for the ADI region has been prepared by the integration of used morphotectonic indices,which is also calibrated by Bouguer gravity anomaly data and field investigation.

Simplified performance indices and active control force of vibration isolation systems with elastic base

Influence of the elasticity of the base on vibration isolation performances of single layer, double layer and floating raft vibration isolation systems is investigated systematically. Characteristics of vibration coupling between different vibration isolation systems and different elastic bases are analyzed. Moreover the characteristics of vibration acceleration level difference and force transmissibility of different vibration isolation systems are discussed and their simpli- fled expressions are given. In addition the required control forces of active vibration isolation under different installations of actuators for different vibration isolation systems are compared. The results show that for all vibration isolation systems, the addition of the stiffness and damping of the base can enhance their vibration acceleration level difference and force transmissibility. Moreover for floating raft vibration isolation system, the addition of the stiffness and damping of the raft can enhance its vibration isolation performance and reduce the control force required bv active vibration isolation.