One-month Time Period Research Articles

Comparative Evaluation of Sorption and Solubility of Core Buildup Materials in Different pH Media: An In-Vitro Study.

To evaluate and compare the sorption and solubility of two different core buildup materials in different pH media for periods of one day, one week, and one month. Sixty samples were prepared and divided into Group A (30 resin-based samples) and Group B (30 glass ionomer cement (GIC)-based samples). The sorption and solubility of the different materials were calculated by weighing the samples before and after desiccation and media immersion for periods of one day, one week, and one month. Groups were compared using the Mann-Whitney U test, and for different media, the intragroup significance of the mean difference was performed using the Friedmann test and Wilcoxon signed rank test at a significance level of p<0.05. After immersion for different time periods, the resin-based core buildup material (Core X flow) showed less sorption and solubility as compared to the glass ionomer-based core buildup material (Secure Core Z) for all time periods, with a significant difference seen for a time period of one week and one month and being nonsignificant for a time period of one day. Core X flow had lower sorption and solubility values when compared to Secure Core Z, as per the International Organization for Standardization (ISO) 4049 standards, except for a one-month time period in alkaline media.

When Antimicrobial Treatment and Surgical Prophylaxis Collide: A Stewardship Opportunity.

Background: In 2002, the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Centers for Disease Control and Prevention (CDC) established the Surgical Infection Prevention (SIP) project for the purposes of developing and standardizing quality improvement measures known to reduce the rates of post-operative surgical site infections (SSIs). Four years later the Surgical Care Improvement Project (SCIP), an expansion of SIP, was published in governmental Specifications Manual for National Inpatient Quality Measures and provided several additional initiatives applicable to the perioperative period. Central to both projects are the assurance of the timeliness, selection, and duration of peri-operative surgical prophylactic antibiotics. In support of this objective, various medical associations, such as the American Society of Health-System Pharmacists (ASHP) and the Infectious Diseases Society of America (IDSA), have developed the Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery. To ensure compliance with quality measures, hospitals are required to report data to the Physicians Quality Reporting System, which is then reviewed by CMS for reimbursement purposes and to measure hospital performance. To maintain optimal standards of care and satisfy all core measures, it is expected that patients undergoing most categories of surgical procedures receive prophylactic antibiotics. We recognized that patients already being administered antimicrobial therapy as treatment for the condition requiring the surgery not uncommonly also were prescribed unwarranted and redundant pre-operative antibiotics. Our study was meant to quantify such antibiotic redundancy, which only risks the development of antimicrobial resistance and adverse events, to bolster our and other hospitals antimicrobial stewardship programs. Methods: A retrospective analysis of computerized hospital records over a one-month period of time (November 2022) was conducted focusing on hospital admissions that involved surgical operative procedures. Only those patients who had received a pre-operative surgical prophylactic antibiotic were included in the analysis. Results: Of the 92 surgeries that fulfilled the inclusion criteria, 38 (41.3%) were performed on patients who were already receiving therapeutic antibiotics for more than 24 hours targeted to treat the infection for which they were undergoing surgery. These included laparoscopic cholecystectomy (24), appendectomy (12), wound debridement (12), and soft tissue incision and drainage procedures (9), comprising nearly 50% of each type of these operations performed during the study time period. Conclusion: These findings demonstrate a clear opportunity to strengthen both our, and presumably other, hospitals antimicrobial stewardship programs. Together with physician education, granting the pharmacy the ability to cancel unnecessary and redundant surgical prophylactic antibiotics would conceivably be of great benefit.

The Effect of Intra-articular Hypertonic Dextrose Prolotherapy on Pain, Quality of Life, and Functional Outcomes Scores in Patients With Knee Osteoarthritis.

Introduction Knee osteoarthritis is a common chronic condition leading to pain and debility. Prolotherapy is a safe and cost-effective treatment option. Our team conducted a case series to examine the effect of prolotherapy on functional measures and quality of life in patients with knee osteoarthritis. Methods Our case series included 15 total patients consisting of male and female patients aged 50-85 years old with a prior diagnosis of knee osteoarthritis and moderate pain. The patients completed baseline Western Ontario and McMaster Universities Arthritis Index (WOMAC) and EuroQol-5 Dimension (EQ5D) surveys and received an ultrasound-guided intra-articular prolotherapy injection. The patients were then followed up by Telehealth at one-, two-, and three-monthpost-procedure. Results Data points for 15 patients were recorded over the duration of the three months. Results revealed significantly improved functional scores from the baseline period (M = 0.60) to the one-month (M = 0.43), two-month (M = 0.48), and three-month (M = 0.46), observed power = 0.99. Participants reported significantly lower pain scores between the baseline period (M = 0.60) compared to the one-month (M = 0.34), two-month (M = 0.35) and three-month (M = 0.39) periods. There was no statistical significance across time in participants' EQ5D scores. The repeated-measures analysis of variance (ANOVA) revealed no statistically significant differences in participants scores between the baseline (M = 64.4), one-month (M = 68.93), two-month (M = 68.47), or three-month (M = 68.33), observed power = 0.31. There were no statistically significant differences in participants WOMAC stiffness scores between the baseline (M = 0.67), one-month (M = 0.46), two-month (M = 0.57), or three-month (M = 0.56) periods, observed power = 0.73. The results revealed no significant change in participants' EQ5D and WOMAC stiffness scores. The results support a statistically significant improvement in patients' self-reported functioning and pain scores between the baseline and one-month, two-month, and three-month periods. Discussion The significant improvement in function occurred between the baseline and one-month time periods and the pain reduction was sustained throughout the two-month and three-month periods. Our study supports prolotherapy as an effective treatment option to improve pain and function in knee osteoarthritis. The study could be repeated with a large sample size to further investigate the effects of prolotherapy on quality-of-life measures.

Impact of a New Module to Enhance the Learning of Ethical Principles in Students of Phase I MBBS Course

ABSTRACT Background: Healthcare decisions need to be based not only on clinical and technical grounds but also on ethical considerations. Aims: To develop a module for teaching ethics to newly admitted medical students and help medical students recognize the importance of being sensitive to ethical issues in daily clinical practice and develop the ability to address the ethical concerns of patients efficiently. Methodology: An interactive module was developed and introduced among first-phase MBBS students over a period of 4 weeks after taking institutional ethical clearance and informed consent of the participants. Results: Two hundred students of First Phase MBBS batch 2021-2022 participated in the study. Students performed significantly better in the post-test examination (mean ± standard deviation: 89.65 ± 4.9) as compared to the pretest examination (mean ± standard deviation: 49.34 ± 12.02); P value &lt;.0001**. Students and faculty members were satisfied with the teaching-learning methodology implemented. In the one-month period of time, 48 students could complete the Good Clinical Practice course available at https://gcp.nidatraining.org/with more than 80% marks after appearing for 11 examinations and receiving certificates valid for three years. Conclusions: The present module on medical ethics introduced among first-phase MBBS students helped them to learn the core principles of ethics in medicine. It increased their critical thinking and problem-solving abilities.

UV-Vis Spectrophotometric Analysis of DNA Retrieval for DNA Storage Applications

Informational Deoxyribonucleic Acid (iDNA) has gained the attention of many researchers and pioneer companies for the development of novel storage systems for the long-term and high-density storing of information. This research focuses on the physical storage of iDNA strands to address some of the current challenges by evaluating the accuracy of the process of iDNA retrieval from the surface after the dehydration process. For this aim, a UV-Vis spectrophotometric technique was used to measure the concentration of the DNA samples. Although spectroscopy has been widely employed for the evaluation of DNA concentration and contamination in a solution, it has not been used to investigate dry-state DNA, which is one of the preferred storage formats for the long-term retention of information. These results demonstrate that the UV-Vis spectrophotometric technique can be used to accurately measure dry-state DNA before the retrieval and its residues after the DNA retrieval process. This paper further examines the storage/retrieval process by investigating the relationship between the storage time and the amount of retrieved DNA or the DNA residue left on various surfaces. Based on the experimental results demonstrated and discussed in this paper, UV-Vis spectrophotometry can be used for monitoring dry-state DNA with a high accuracy larger than 98%. Moreover, these results reveal that the hydrophilicity and hydrophobicity of the surface do not significantly affect DNA retrieval over a one-month time period.

Impact of enhanced personal protective equipment on colonoscopy performance during the COVID-19 pandemic.

Background and study aims Using personal protective equipment (PPE) can reduce risk of disease transmission. During the COVID-19 pandemic, enhanced PPE (EPPE) is recommended when performing endoscopy. We aimed to evaluate the impact of EPPE on colonoscopy performance when compared to standard PPE (SPPE). Patients and methods A review of electronic medical records and endoscopy reports of consecutive patients who underwent colonoscopy during two similar one-month time periods (in 2019 and during the COVID-19 pandemic in 2020) was performed. SPPE was used in 2019 and EPPE was used in 2020. Patient clinical data and procedure-related information were captured and analyzed. The primary outcomes were time to cecum (TTC) and total procedure time. Secondary outcomes were adenoma detection rate (ADR), polyp detection rate (PDR) and cecal intubation rate (CIR). Statistical analysis was performed using STATA v16.1. Results Two hundred and forty-seven colonoscopy procedures were analyzed. Baseline demographics and indications for colonoscopy of patients in both groups were similar. There were no significant differences in median TTC (10.0 vs 10.0 min, P = 0.524) or total procedure time (22.5 vs 23.0 min, P = 0.946) between colonoscopy performed in SPPE and EPPE. The ADR, PDR and CIR were also similar. Conclusion Our findings suggest that use of EPPE does not affect colonoscopy performance.

Acceleration of glass alteration rates induced by zeolite seeds at controlled pH

As the glass-water reaction proceeds, certain glass compositions undergo a delayed acceleration in the alteration rate – a phenomenon that is commonly referred to as Stage III behavior – which generally coincides with zeolite formation. However, studying Stage III in the laboratory is difficult because the time scale required to observe Stage III behavior can vary from months to several years, and the solution conditions that initiate this acceleration remain poorly understood. Consequently, the development of a corrosion test method capable of quantifying Stage III rates in a timely manner would be of great benefit to both the scientific community and policy makers concerned with nuclear waste disposal. In this work, we induced and measured the acceleration in the corrosion rate of the AFCI glass by seeding static corrosion tests with zeolite Na–P2 at imposed pH90°C values ranging from 9.5 to 11.5. The log10 induced Stage III rates increased linearly with increasing pH and were measured to be between the forward and residual rates of AFCI. Tests designed to compare induced Stage III rates obtained for different seeding times showed that the induced Stage III rates were faster in the absence of an alteration layer. In summary, the use of the seeded test method allows for a quantification of induced Stage III rates in a relatively short, one-month time period.

Contextual Factors and Organizational Commitment: Examining the Mediating Role of Thriving at Work

Thriving at work refers to a psychological experience of learning (cognitive dimension) and vitality (affective dimension) to the workplace. Based on the Social Exchange Theory and the Socially Embedded Model of thriving, the purpose of this research is to observe whether contextual variables such as fairness perception, trust, and managerial coaching are related to affective organizational commitment and to examine if thriving at work plays a mediating role in these proposed relationships. Data was collected in two waves over a one-month time period from 936 employees of diverse public and private sectors. Strong empirical evidence was found for all direct and indirect hypothesized relationships through Smart PLS 3.0 (SmartPLS GmbH, Bönningstedt, Germany, 2015). The implications of the findings are also discussed.

Cannabis Use among Patients in a Rural Academic Palliative Care Clinic.

Background: Therapeutic cannabis is being more widely used by patients to manage multiple symptoms, but the patterns of use in the palliative care population are not well defined. Objective: The primary aim of this pilot study was to describe the use of cannabis among patients attending a palliative care clinic (PCC). Design: The study was a retrospective chart review of patients seen at four different interval points during 2017 and 2018 in an ambulatory palliative care setting. Setting/Subjects: The study was conducted at a 396-bed rural academic medical center in the PCC, where the majority of patients have oncological diseases. Results: Clinicians saw 299 unique patients during the four one-month time periods reviewed. Eighty-three patients (27%) reported use of any form of cannabis. The most common reasons for cannabis use were pain (n = 49, 59%), anorexia (n = 16, 19%), insomnia (n = 14, 17%), nausea (n = 13, 16%), anxiety (n = 8, 10%), and depression (n = 5, 6%). Twenty-six patients (31%) used cannabis for more than one symptom. Among the 83 patients using cannabis, 60 (72%) were also prescribed opioids with 32% on immediate-release only and 25% on both immediate- and extended-release opioids. These 60 patients on opioids and cannabis represent 33% of all patients prescribed opioids in this clinic. Tetrahydrocannabinol was present in 25% of the 73 urine drug screens. Conclusions: Our data show a significant minority of patients in a PCC use cannabis. Further research should focus on more detailed information about formulation use, methods of ingestion, perceived efficacy, side effects, cost, and standardization of clinical practices. Given the prevalence of cannabis use, further research into its efficacy, side effects, and safety is needed, including whether patients with prior/active substance use receive more or less benefit or harm from cannabis use.

Cutaneous Manifestations of Disseminated Histoplasmosis in a Patient with AIDS

Introduction: Disseminated histoplasmosis is often seen in immunocompromised individuals, such those with acquired immunodeficiency syndrome (AIDS). The initial infection mainly involves the lungs but it may develop into a disseminated form especially in immunocompromised patients. Since it can be a systemic disease with cutaneous manifestations, dermatologists must be able to recognize its clinical presentation to ensure prompt management.Case: We present a man in his 50s with past medical history of AIDS who developed disseminated histoplasmosis with skin and gastrointestinal involvement over a one-month period of time. Despite receiving induction therapy with intravenous amphotericin B followed by oral itraconazole, the patient expired. His death was attributed to his persistently low CD4 T-cell count and secondary bacteremia.Discussion: This condition should be recognized early and treated aggressively. However, patients with multiple comorbidities are at increased risk of mortality even despite adequate treatment. This case highlights the significant mortality risk of disseminated histoplasmosis in patients with AIDS.

Electrochemical Hydrogen Peroxide Sensor Based on Macroporous Silicon.

Macroporous silicon was prepared through an anodization process; the prepared samples showed an average pore size ranging from 4 to 6 microns, and the depth of the pores in the silicon wafer was approximately 80 microns. The prepared samples were tested for hydrogen peroxide (H2O2) concentrations, which can be used for industrial and environmental sensing applications. The selected H2O2 concentration covered a wide range from 10 to 5000 μM. The tested samples showed a linear response through the tested H2O2 concentrations with a sensitivity of 0.55 μA μM–1∙cm–2 and lower detection limits of 4.35 μM at an operating voltage of 5 V. Furthermore, the electrode exhibited a rapid response with a response time of ca. two seconds. Furthermore, the prepared sensor showed a reasonable stability over a one-month time period.

Service innovation in the hotel industry: culture, behavior, performance

ABSTRACTThe aim of this study is to focus on the service innovation culture (SIC) in the formation of frontline employees’ (FLE) innovation performance based on two fit theories. More specifically, the research evaluates and examines the mediating role of challenge-oriented citizenship behavior (COCB) and charged behavior in the aforementioned relationship. To test the hypotheses, two-step structural equation modeling with bootstrapping estimation was conducted in AMOS, using data from 215 full-time frontline hotel employees over a one-month time period. This study establishes that the development of a SIC is positively related to the innovation performance of FLE. Likewise, the results indicate that there is a partially mediating role for the COCB and expanded charged behavior (encompassing vitality and creative self-efficacy) of FLE in the relationship between SIC and innovation performance. The findings of this study highlight the need for managers to incorporate a secure and trusting work environment so FLE will eagerly participate in the service innovation process by voicing their novel ideas. Managers can also consider the significance of the employee selection procedures and take advantage of employing university graduate for frontline service jobs.

Cryopreserved Amniotic Membrane, Autologous Serum Eye Drops, and Tea-Tree Oil Lid Scrubs in combination for the treatment of Keratoconjunctivitis in a Staphylococcus Hypersensitive Teenager

Abstract&#x0D; Background and Objective: The purpose is to present an interventional case report detailing recurrent bilateral keratoconjunctivitis secondary to Staphylococcus hypersensitivity in a teenage female. At least three times yearly, for five years, the patient has experienced episodes of severe bilateral catarrhal infiltrative or phlyctenular keratoconjunctivitis. Comprehensive corneal and conjunctival cultures had been historically performed, twice, yielding only growth of Staphylococcus aureus and epidermidis. Prior short-term treatment regimens of topical steroids and antibiotics had not prevented recurrences.&#x0D; Methods: This is an interventional case report: In this patient, placement of a topical cryopreserved amniotic membrane, Prokera Slim (PKS by BioTissue), after one week of topical steroid treatment (Durezol (difluroprednate 0.05%) qid) in the right eye (OD) is compared to a steroid (difluroprednate 0.05%) taper in the left eye (OS) over an approximate one-month time period. Both eyes then continue chronic, long-term maintenance therapy with autologous serum eye drops (ASED) dosed six times daily and tea tree oil containing lids scrubs (SteriLid Foam by TheraTears) two times daily, until the present time. Supportive meibomian gland expression for meibomian gland dysfunction was also performed at the three month treatment mark.&#x0D; Results: The PKS treatment in the right eye resulted in superior visual acuity and ocular comfort when compared to a steroid taper in the left eye over an approximate one-month time period. These results were maintained in the left eye at the 12 month- time frame. The right eye experienced a recurrence when the patient self-discontinued all therapy in both eyes at the 4 month mark. With re-initiation of maintenance therapy of ASED and tea tree oil containing lids scrubs, she has remained symptom-free for over eight months in the right eye. &#x0D; Conclusions: Further comparison and study of the treatment modalities above could result in a potentially faster, safer, and superior treatment and prevention protocol for topical ocular inflammation in Staphylococcus hypersensitive keratoconjunctivitis, particularly in pediatric populations.&#x0D;

Managing a crisis: A framing analysis of press releases dealing with the Fukushima nuclear power station crisis

The purpose of this study is to explore how TEPCO used press releases which dealt with the Fukushima nuclear crisis that occurred in March 2011 attempting to restore its reputation by analyzing frames used in the press releases. To conduct this research, 300 press releases from the TEPCO website were gathered during an approximately one-month time period (March 11, 2011 to April 5, 2011) after the earthquake and tsunami first struck Japan. According to the findings of this study, TEPCO utilized the official updates frame predominately more than the other three frames: attribution, announcement, and apology. By providing official updates, the company consistently attempted to keep the public informed in order to avoid information gaps. Furthermore, TEPCO used the attribution frame more than the apology frame. More precisely, the organization evaded its accountability by assigning blame to the earthquake and apologized only when definitely necessary—such as regarding a loss of employees and discomforts caused by the crisis. With regard to the announcement frame, the company recognized that only a small amount of information was necessary for the public.

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care.

Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

No Magic Bullet: A Theory-Based Meta-Analysis of Markov Transition Probabilities in Studies of Service Systems for Persons With Mental Disabilities

A random-effects meta-analysis of studies that used Markov transition probabilities (TPs) to describe outcomes for mental health service systems of differing quality for persons with serious mental illness was implemented to improve the scientific understanding of systems performance, to use in planning simulations to project service system costs and outcomes over time, and to test a theory of how outcomes for systems varying in quality differ. Nineteen systems described in 12 studies were coded as basic (B), maintenance (M), and recovery oriented (R) on the basis of descriptions of services provided. TPs for studies were aligned with a common functional-level framework, converted to a one-month time period, synthesized, and compared with theory-based expectations. Meta-regression was employed to explore associations between TPs and characteristics of service recipients and studies. R systems performed better than M and B systems. However, M systems did not perform better than B systems. All systems showed negative as well as positive TPs. For approximately one-third of synthesized TPs, substantial interstudy heterogeneity was noted. Associations were found between TPs and service recipient and study variables Conclusions: Conceptualizing systems as B, M, and R has potential for improving scientific understanding and systems planning. R systems appear more effective than B and M systems, although there is no "magic bullet" system for all service recipients. Interstudy heterogeneity indicates need for common approaches to reporting service recipient states, time periods for TPs, service recipient attributes, and service system characteristics. TPs found should be used in Markov simulations to project system effectiveness and costs of over time.

Empirical Models of Social Learning in a Large, Evolving Network

This paper advances theories of social learning through an empirical examination of how social networks change over time. Social networks are important for learning because they constrain individuals’ access to information about the behaviors and cognitions of other people. Using data on a large social network of mobile device users over a one-month time period, we test three hypotheses: 1) attraction homophily causes individuals to form ties on the basis of attribute similarity, 2) aversion homophily causes individuals to delete existing ties on the basis of attribute dissimilarity, and 3) social influence causes individuals to adopt the attributes of others they share direct ties with. Statistical models offer varied degrees of support for all three hypotheses and show that these mechanisms are more complex than assumed in prior work. Although homophily is normally thought of as a process of attraction, people also avoid relationships with others who are different. These mechanisms have distinct effects on network structure. While social influence does help explain behavior, people tend to follow global trends more than they follow their friends.

Breathing retraining for African-American adolescents with asthma: a pilot study of a school-based randomized controlled trial

Objective: Asthma affects approximately seven million children/adolescents in the USA, with African-American children disproportionately affected. Breathing retraining techniques have been shown to improve asthma outcomes in adults, though research in youth is limited. The purpose of this pilot study was to test the feasibility and preliminary efficacy of a school-based randomized controlled trial of breathing retraining for asthma outcomes and anxiety symptoms in a sample of urban, African-American adolescents. Methods: Adolescents were randomized into either the intervention group (20-min breathing retraining plus education) or control group (20-min standard education). Participants completed two study visits, one month apart. Asthma control, asthma quality of life and lung functioning (FEV1 and peak flow) were the primary outcomes, and state anxiety (pre-post the intervention) and trait anxiety (over the one-month period) were the secondary outcomes. Results: Thirty-three African-American adolescents participated in the study, with a 90% retention rate between visit 1 and visit 2. Asthma control and asthma quality of life, significantly improved over time (p ≤ 0.01) with no differences between intervention and control groups. State anxiety significantly decreased (p ≤ 0.01) immediately post intervention at both time points with no differences between groups. There were no significant differences found in lung functioning or trait anxiety over the one-month time period. Conclusions: These preliminary results suggest that breathing retraining is a feasible, acceptable and potentially efficacious intervention (although no significant differences between groups were found) for improving asthma symptoms in urban adolescents with asthma in a school-based setting.

Investigating organizational core values in NCAA athletic departments

Purpose – The purpose of this paper is to survey National Collegiate Athletic Association (NCAA) Division I administrators (N=437) in the USA to identify the organizational values that are deemed as having the highest priority by administrators when carrying out the mission of their athletic department. Design/methodology/approach – The research utilized an online survey to examine the organizational values within NCAA athletic departments. The surveys were distributed during a one-month time period. Findings – The data demonstrated that academic excellence, student-athlete experience, and health/safety were rated as the organizational values with the highest priority in athletic departments. In addition, the study also illustrated that that the priority level of the individual values varied when focussing on the different levels of administrators. Originality/value – The understanding of value systems within sport organizations and proper implementation of value-driven leadership can enhance organizational efficiency through providing guidance to practitioners in decision-making processes and strategy development, and through providing consistent organizational philosophies that can influence employee behavior. Additionally, this paper builds upon empirical research exploring values within the intercollegiate athletic industry in the USA through a variety of theoretical frameworks including Schein’s organizational culture model (2010), Fishbein and Ajzen’s theory of reasoned action (1975), and Collins and Porras’s vision framework (2000).

SAT0051 Alternative Ways to Analyze Remission: Applying the Conrew Score and Patient Vector Graph to Camera –Trial II Data

BackgroundIn the two-year Computer Assisted Management in Early Rheumatoid Arthritis-trial II (CAMERA-II) (1), patients with early rheumatoid arthritis were randomized to a methotrexate (MTX-) based tight control strategy with either...