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  • 1
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    Online Resource
    Analysis of Regular Structures with Member Irregularity Using the Equilibrium Equations and the Singular Value Decomposition
    SAGE Publications ; 2013
    In:  Advances in Structural Engineering Vol. 16, No. 5 ( 2013-05), p. 823-843
    Details
    In: Advances in Structural Engineering, SAGE Publications, Vol. 16, No. 5 ( 2013-05), p. 823-843
    Abstract: In this paper an efficient method is presented for the analysis of those structures which can be formed by addition some members to regular structures. This method is also applicable when some members are reduced from regular structures. If a model is the union of a regular structure and some additional members, then these members are separated from the structure, and their effect is introduced through equilibrium matrix and added to that of the regular structure. For models which lack some members, pairs of hypothetical elements with positive and negative modulus of elasticity are added, and the members with negative modulus are separated from the structure resulting in a regular structure.
    Type of Medium: Online Resource
    ISSN: 1369-4332 , 2048-4011
    URL: Article
    DOI: 10.1260/1369-4332.16.5.823
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2026561-X
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  • 2
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    Erratum: A survey of medical students' attitudes and practices towards narcotics and psychotropic drugs
    CMV Verlag ; 2022
    In:  Journal of Current Biomedical Reports Vol. 3, No. 2 ( 2022-06-30), p. 103-
    Details
    In: Journal of Current Biomedical Reports, CMV Verlag, Vol. 3, No. 2 ( 2022-06-30), p. 103-
    Type of Medium: Online Resource
    ISSN: 2717-1906
    URL: Article
    DOI: 10.52547/JCBioR.3.2.103
    Language: Unknown
    Publisher: CMV Verlag
    Publication Date: 2022
    detail.hit.zdb_id: 3040888-X
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  • 3
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    2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease
    Wiley ; 2022
    In:  Arthritis & Rheumatology Vol. 74, No. 4 ( 2022-04), p. 586-596
    Details
    In: Arthritis & Rheumatology, Wiley, Vol. 74, No. 4 ( 2022-04), p. 586-596
    Abstract: To provide evidence‐based recommendations and expert guidance for the management of Kawasaki disease (KD), focusing on clinical scenarios more commonly addressed by rheumatologists. Methods Sixteen clinical questions regarding diagnostic testing, treatment, and management of KD were developed in the Patient/Population, Intervention, Comparison, and Outcomes (PICO) question format. Systematic literature reviews were conducted for each PICO question. We used the Grading of Recommendations, Assessment, Development and Evaluation method to assess the quality of evidence and formulate recommendations. Each recommendation required consensus from at least 70% of the Voting Panel. Results We present 1 good practice statement, 11 recommendations, and 1 ungraded position statement to guide the management of KD and clinical scenarios of suspected KD. These recommendations for KD are focused on situations in which input from rheumatologists may be requested by other managing specialists, such as in cases of treatment‐refractory, severe, or complicated KD. The good practice statement affirms that all patients with KD should receive initial treatment with intravenous immunoglobulin (IVIG). In addition, we developed 7 strong and 4 conditional recommendations for the management of KD or suspected KD. Strong recommendations include prompt treatment of incomplete KD, treatment with aspirin, and obtaining an echocardiogram in the setting of unexplained macrophage activation syndrome or shock. Conditional recommendations include use of IVIG with other adjuvant agents for patients with KD and high‐risk features of IVIG resistance and/or coronary artery aneurysms. These recommendations endorse minimizing risk to the patient by using established therapy promptly at disease onset and identifying situations in which adjunctive therapy may be warranted. Conclusion These recommendations provide guidance regarding diagnostic strategies, use of pharmacologic agents, and use of echocardiography in patients with suspected or confirmed KD.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    URL: Article
    DOI: 10.1002/art.v74.4
    DOI: 10.1002/art.42041
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2754614-7
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  • 4
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    Predictors of Hospitalization, Length of Stay, and Cost of Care Among Adults With Dermatomyositis in the United States
    Wiley ; 2017
    In:  Arthritis Care & Research Vol. 69, No. 9 ( 2017-09), p. 1391-1399
    Details
    In: Arthritis Care & Research, Wiley, Vol. 69, No. 9 ( 2017-09), p. 1391-1399
    Abstract: To determine the prevalence and risk factors for hospitalization with dermatomyositis and assess inpatient burden of dermatomyositis. Methods Data on 72,651,487 hospitalizations from the 2002–2012 Nationwide Inpatient Sample, a 20% stratified sample of all acute‐care hospitalizations in the US, were analyzed. International Classification of Diseases, Ninth Revision, Clinical Modification coding was used to identify hospitalizations with a diagnosis of dermatomyositis. Results There were 9,687 and 43,188 weighted admissions with a primary or secondary diagnosis of dermatomyositis, respectively. In multivariable logistic regression models with stepwise selection, female sex (logistic regression: adjusted odds ratio 2.05 [95% confidence interval (95% CI) 1.80, 2.34]), nonwhite race (African American: 1.68 [1.57, 1.79] ; Hispanic: 2.38 [2.22, 2.55]; Asian: 1.54 [1.32, 1.81] ; and multiracial/other: 1.65 [1.45, 1.88]), and multiple chronic conditions (2–5: 2.39 [2.20, 2.60] and ≥6: 2.80 [2.56, 3.07]) were all associated with higher rates of hospitalization for dermatomyositis. The weighted total length of stay (LOS) and inflation‐adjusted cost of care for patients with a primary inpatient diagnosis of dermatomyositis was 80,686 days and $168,076,970, with geometric means of 5.38 (95% CI 5.08, 5.71) and $11,682 (95% CI $11,013, $12,392), respectively. LOS and costs of hospitalization were significantly higher in patients with dermatomyositis compared to those without. Notably, race/ethnicity was associated with increased LOS (log‐linear regression: adjusted β [95% CI] for African American: 0.14 [0.04, 0.25] and Asian: 0.38 [0.22, 0.55] ) and cost of care (Asian: 0.51 [0.36, 0.67] ). Conclusion There is a significant and increasing inpatient burden for dermatomyositis in the US. There appear to be racial differences, as nonwhites have higher prevalence of admission, increased LOS, and cost of care.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    URL: Article
    DOI: 10.1002/acr.v69.9
    DOI: 10.1002/acr.23190
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2016713-1
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  • 5
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    Validation of International Classification of Diseases Codes for the Epidemiologic Study of Dermatomyositis
    Wiley ; 2017
    In:  Arthritis Care & Research Vol. 69, No. 5 ( 2017-05), p. 753-757
    Details
    In: Arthritis Care & Research, Wiley, Vol. 69, No. 5 ( 2017-05), p. 753-757
    Abstract: To assess the validity of using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) code 710.3 to identify adult patients with dermatomyositis in outpatient and inpatient settings. Methods Electronic medical records of adult patients with ICD‐9 code 710.3 between January 2001 and November 2014 (n = 511) were examined. Physician diagnosis, clinical findings, and diagnostic testing results were recorded. A dermatomyositis rating scale was assigned based on classic cutaneous findings and at least 2 additional clinical and diagnostic findings from the Bohan criteria. Sensitivity and positive predictive values (PPVs) were determined. Sensitivity analyses were performed to evaluate the accuracy of multiple ICD‐9 codes in the outpatient setting, as well as primary and secondary inpatient codes. Results The sensitivity and PPV for multiple 710.3 ICD‐9 codes in the outpatient setting were 0.89 and 0.35, respectively. The PPV for primary and secondary 710.3 inpatient codes was 0.95 and as high as 0.8. However, the sensitivity of ICD‐9 code 710.3 was poor in the inpatient setting (primary 0.23 and secondary 0.26). The most common reason for failure to meet appropriate dermatomyositis criteria was miscoding as diabetes mellitus (32%), followed by diagnosis at an outside institution (19%), dermatomyositis as a rule‐out diagnosis (10%), cutaneous dermatomyositis (8%), and juvenile dermatomyositis (6%). Conclusion One or more occurrences of ICD‐9 code 710.3 is insufficient to support the diagnosis of dermatomyositis in the outpatient setting. However, ICD‐9 710.3 codes appear to be valid in the inpatient setting.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    URL: Article
    DOI: 10.1002/acr.v69.5
    DOI: 10.1002/acr.23010
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2016713-1
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  • 6
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    Research priorities in childhood-onset lupus: results of a multidisciplinary prioritization exercise
    Springer Science and Business Media LLC ; 2019
    In:  Pediatric Rheumatology Vol. 17, No. 1 ( 2019-12)
    Details
    In: Pediatric Rheumatology, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1546-0096
    URL: Article
    DOI: 10.1186/s12969-019-0327-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2279468-2
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  • 7
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    Engaging patients and parents to improve mental health intervention for youth with rheumatological disease
    Springer Science and Business Media LLC ; 2021
    In:  Pediatric Rheumatology Vol. 19, No. 1 ( 2021-12)
    Details
    In: Pediatric Rheumatology, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2021-12)
    Abstract: Mental health disorders are common in youth with rheumatological disease yet optimal intervention strategies are understudied in this population. We examined patient and parent perspectives on mental health intervention for youth with rheumatological disease. Methods We conducted a mixed methods cross-sectional study, via anonymous online survey, developed by researchers together with patient/parent partners, to quantitatively and qualitatively examine youth experiences with mental health services and resources in North America. Patients ages 14–24 years with juvenile idiopathic arthritis, juvenile dermatomyositis, or systemic lupus erythematous, and parents of patients ages 8–24 with these diseases were eligible (not required to participate in pairs). Participants self-reported mental health problems (categorized into clinician-diagnosed disorders vs self-diagnosed symptoms) and treatments (e.g. therapy, medications) received for the youth. Multivariate linear regression models compared patient and parent mean Likert ratings for level of: i) comfort with mental health providers, and ii) barriers to seeking mental health services, adjusting for potential confounders (patient age, gender, disease duration, and patient/parent visual analog score for disease-related health). Participants indicated usefulness of mental health resources; text responses describing these experiences were analyzed by qualitative description. Results Participants included 123 patients and 324 parents. Patients reported clinician-diagnosed anxiety (39%) and depression (35%); another 27 and 18% endorsed self-diagnosed symptoms of these disorders, respectively. 80% of patients with clinician-diagnosed disorders reported receiving treatment, while 11% of those with self-diagnosed symptoms reported any treatment. Patients were less comfortable than parents with all mental health providers. The top two barriers to treatment for patients and parents were concerns about mental health providers not understanding the rheumatological disease, and inadequate insurance coverage. Over 60% had used patient mental health resources, and over 60% of these participants found them to be helpful, although text responses identified a desire for resources tailored to patients with rheumatological disease. Conclusion Self-reported mental health problems are prevalent for youth in this sample with rheumatological disease, and obstacles to mental health treatment include disease-related and logistic factors. Strategies are needed to improve acceptance and accessibility of mental health intervention, including routine mental health screening and availability of disease-specific mental health resources.
    Type of Medium: Online Resource
    ISSN: 1546-0096
    URL: Article
    DOI: 10.1186/s12969-021-00503-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2279468-2
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  • 8
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    Barriers to care in juvenile localized and systemic scleroderma: an exploratory survey study of caregivers’ perspectives
    Springer Science and Business Media LLC ; 2023
    In:  Pediatric Rheumatology Vol. 21, No. 1 ( 2023-04-25)
    Details
    In: Pediatric Rheumatology, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2023-04-25)
    Abstract: Juvenile localized scleroderma (LS) and systemic sclerosis (SSc) are rare pediatric conditions often associated with severe morbidities. Delays in diagnosis are common, increasing the risk for permanent damage and worse outcomes. This study explored caregiver perspectives on barriers they encountered while navigating diagnosis and care for their child’s scleroderma. Methods In this cross-sectional study, caregivers of juvenile LS or SSc patients were recruited from a virtual family scleroderma educational conference and a juvenile scleroderma online interest group. The survey queried respondents about their child’s condition and factors affecting diagnosis and treatment. Results The response rate was 61% (73/120), with 38 parents of LS patients and 31 parents of SSc patients. Most patients were female (80%) and over half were non-Hispanic white (55%). Most families had at least one person with a college education or higher (87%), traveled ≤ 2 h to see their rheumatologist (83%), and had private insurance (75%). Almost half had an annual household income ≥ $100,000 (46%). Families identified the following factors as barriers to care: lack of knowledge about scleroderma in the medical community, finding reliable information about pediatric scleroderma, long wait times/distances for a rheumatology/specialist appointment, balance of school/work and child’s healthcare needs, medication side effects, and identifying effective medications. The barrier most identified as a major problem was the lack of knowledge about juvenile scleroderma in the medical community. Public insurance, household income less than $100,000, and Hispanic ethnicity were associated with specific barriers to care. Lower socioeconomic status was associated with longer travel times to see the rheumatologist/specialist. Diagnosis and systemic treatment initiation occurred at greater than one year from initial presentation for approximately 28% and 36% of patients, respectively. Families of LS patients were commonly given erroneous information about the disease, including on the need and importance of treating active disease with systemic immunosuppressants in patients with deep tissue or rapidly progressive disease. Conclusion Caregivers of children with LS or SSc reported numerous common barriers to the diagnosis, treatment, and ongoing care of juvenile scleroderma. The major problem highlighted was the lack of knowledge of scleroderma within the general medical community. Given that most of the caregiver respondents to the survey had relatively high socioeconomic status, additional studies are needed to reach a broader audience, including caregivers with limited English proficiency, geographical limitations, and financial constraints, to determine if the identified problems are generalizable. Identifying key care barriers will help direct efforts to address needs, reduce disparities in care, and improve patient outcomes.
    Type of Medium: Online Resource
    ISSN: 1546-0096
    URL: Article
    DOI: 10.1186/s12969-023-00819-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2279468-2
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  • 9
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    Baseline characteristics of children with juvenile dermatomyositis enrolled in the first year of the new Childhood Arthritis and Rheumatology Research Alliance registry
    Springer Science and Business Media LLC ; 2022
    In:  Pediatric Rheumatology Vol. 20, No. 1 ( 2022-12)
    Details
    In: Pediatric Rheumatology, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2022-12)
    Abstract: To report baseline characteristics, patient reported outcomes and treatment of children with Juvenile Dermatomyositis (JDM) in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. Methods Children newly diagnosed with JDM were enrolled in the CARRA Registry from 41 pediatric rheumatology centers. Baseline patient demographics, disease characteristics, assessments, patient reported outcome and treatments were recorded. Results In the first year, 119 JDM participants were enrolled. Most were female (63.4%), and white (72.3%) with a median diagnosis age 8.0 years (IQR 4.0–11.5), and median age of disease onset 7.0 years (IQR 3.5–7.5). They had characteristic rashes (92.4%), elevated muscle enzymes (83.2%), physician global score 4.0 (IQR 2.5–5.0) and manual muscle testing score 63.5 (IQR 51.0–75.0). Calcinosis (3.4%) and interstitial lung disease ( 〈  1%) were uncommon. Myositis specific antibodies were measured and reported in nearly half of participants enrolled where anti-MJ followed by Anti-p155/140 were most common (11/49 and 7/53 respectively). Childhood Health Assessment Questionnaire (CHAQ) results showed mild-moderate disability (median 0.750, IQR 0.030–1.875), as did patient/parent global assessments of disease activity (median 3, patient IQR: 1.75–5.25; parent IQR: 1–7). Patient Reported Outcomes Measurement Information System (PROMIS®) Pediatric Global Health 7 scores, Pain Interference, Physical Function scores for Mobility, and Upper Extremity Function were commonly worse than 95% of the general pediatric population. Conclusions In its inaugural year, 119 JDM patients were successfully enrolled in participapte in the New CARRA Registy. This registry will provide the necessary foundation to advance clinical research to improve outcomes using traditional measures and patient reported outcomes. With the CARRA biorepository, this infrastructure will enable future translational research. Together, these efforts may aid in future clinical trials, including comparative effectiveness trials.
    Type of Medium: Online Resource
    ISSN: 1546-0096
    URL: Article
    DOI: 10.1186/s12969-022-00709-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2279468-2
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  • 10
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    Real World Use of an Internet Intervention for Pediatric Encopresis
    JMIR Publications Inc. ; 2008
    In:  Journal of Medical Internet Research Vol. 10, No. 2 ( 2008-06-30), p. e16-
    Details
    In: Journal of Medical Internet Research, JMIR Publications Inc., Vol. 10, No. 2 ( 2008-06-30), p. e16-
    Type of Medium: Online Resource
    ISSN: 1438-8871
    URL: Article
    DOI: 10.2196/jmir.1081
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2008
    detail.hit.zdb_id: 2028830-X
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