OBJECTIVE:To evaluate sex-based differences in clinical presentation, vascular phenotype, diagnostic approaches, treatment, adverse events and outcomes among patients with giant cell arteritis (GCA). METHODS:We analysed data from all patients diagnosed with GCA between 1 June 2013 and 29 March 2019 across 26 hospitals in Spain. Eligibility criteria included age ≥50 years and diagnosis confirmed by imaging, the 1990 American College of Rheumatology classification criteria, or expert clinical judgment. RESULTS:A total of 1675 patients were included. The extracranial phenotype was more prevalent in women (14.8% vs 9.9%; P = 0.039), while the mixed phenotype was more common in men (17.7% vs 11.7%; P = 0.002). Temporal artery ultrasound was more frequently positive in men (73.5% vs 65.1%; P = 0.025). Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) were prescribed more often in women (35.3% vs 28.2%; P = 0.005), while glucocorticoid and tocilizumab use did not differ by sex. Fractures (22.4% vs 10.9%; P = 0.010) and cataracts (6.0% vs 2.8%; P = 0.010) were significantly more frequent in women and men, respectively. Remission rates (23.1% vs 23.8%) and relapse frequencies (19.7% vs 19.3%) were similar between sexes. Mortality was higher in men (13.8% vs 6.6%; P < 0.001). CONCLUSIONS:Women more frequently exhibited the extracranial phenotype, required more csDMARDs, and experienced a higher incidence of fractures. In contrast, men more commonly presented with the mixed phenotype, had more cataracts, and showed a higher mortality rate. These findings highlight the importance of integrating sex as a key biological variable in GCA research and clinical management to support more tailored and effective therapeutic strategies.
Bu çalışma, Osmanlı esnaf teşkilatının üretim döngüsünü sürdürebilmek için ihtiyaç duyduğu finansman pratiklerini “çalışma sermayesi” perspektifiyle ve bir mekanizma analizi düzeyinde ele almaktadır. Mevcut literatürde genellikle para vakıfları ekseninde tartışılan esnaf finansmanı; bu araştırmada kamu fonları, sektörel sandıklar ve mülkiyetin finansallaşması üzerinden yeniden tanımlanmaktadır. Cumhurbaşkanlığı Devlet Arşivi kayıtları ve nitel araştırma yöntemleri kullanılarak 18. ve 19. Yüzyıl İstanbul odaklı bir veri seti analiz edilmiştir.Araştırma kapsamında, hammadde alımı için tahsis edilen “mübayaa sermayesi”, dükkân üzerindeki tasarruf haklarının modern finansmandaki teminat kavramıyla eşleşen “gedik” işlevi ve geri alım vaadiyle satış mantığıyla yürütülen “bey’ bi’l-vefa” pratikleri incelenmektedir. Ayrıca, bireysel iflas riskini kolektif bir sorumluluğa dönüştüren “kefalet-i müteselsile” sistemi ve borç ilişkilerini kayıt altına alan “temessük” disiplini çözümlenmektedir. Bu bütünleşik analiz, esnafın sadece bir üretim birimi değil, rasyonel bir mali ağın aktif bir paydaşı olduğunu göstermektedir. Çalışma, esnaf finansmanını sosyal yardımlaşma ve dayanışma odaklı geleneksel yaklaşımdan çıkararak, hammadde tedariki ve üretim döngüsünü merkeze alan rasyonel bir işletme finansmanı zemininde yeniden konumlandırmaktadır. Sonuç olarak, Osmanlı çalışma sermayesi rejimi; mülkiyeti sermayeye, riski ise kurumsal güvene tahvil ederek finansal istikrarı üretimin devamlılığı üzerinden inşa eden hibrit bir idari-ekonomik bağ olarak nitelenmektedir. Araştırma kapsamında, hammadde alımı için tahsis edilen “mübayaa sermayesi”, dükkân üzerindeki tasarruf haklarının modern finansmandaki teminat kavramıyla eşleşen “gedik” işlevi ve geri alım vaadiyle satış mantığıyla yürütülen “bey’ bi’l-vefa” pratikleri incelenmektedir. Ayrıca, bireysel iflas riskini kolektif bir sorumluluğa dönüştüren “kefalet-i müteselsile” sistemi ve borç ilişkilerini kayıt altına alan “temessük” disiplini çözümlenmektedir. Bu bütünleşik analiz, esnafın sadece bir üretim birimi değil rasyonel bir mali ağın aktif bir paydaşı olduğunu göstermektedir. Çalışma, esnaf finansmanını sosyal yardımlaşma ve dayanışma odaklı geleneksel yaklaşımdan çıkararak, hammadde tedariki ve üretim döngüsünü merkeze alan rasyonel bir işletme finansmanı zemininde yeniden konumlandırmaktadır. Sonuç olarak, Osmanlı çalışma sermayesi rejimi; mülkiyeti sermayeye, riski ise kurumsal güvene tahvil ederek finansal istikrarı üretimin devamlılığı üzerinden inşa eden hibrit bir idari-ekonomik bağ olarak nitelenmektedir.
Objective In 2020, the Spanish Society of Rheumatology (SER) and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) published joint recommendations on the management of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Since then, new evidence has emerged supporting an update focused on treatment. Methods A systematic literature review was conducted covering the period from October 2020 to October 2025. Results L-6 and JAK inhibitors (JAKi) show efficacy comparable to rituximab (RTX) and abatacept (ABA) in controlling joint disease, preserving pulmonary function, limiting radiological progression, and reducing RA-ILD-related mortality, without a significant increase in serious respiratory events. ABA has not demonstrated a lower risk of severe or opportunistic infections; therefore, these four options (ABA, RTX, anti-IL6, and JAKi) may be used interchangeably in RA-ILD patients requiring treatment intensification. In those with a progressive fibrosing phenotype and intolerance to nintedanib, pirfenidone may be considered. Conclusions Recent evidence has expanded the therapeutic options available for RA-ILD.
Objectives To determine the incidence rate of neoplasms among the GPSD population and compare it with the Spanish general population, as well as to identify its role as a paraneoplastic syndrome in terms of temporal criteria. Methods An observational, single-center, longitudinal study on GPSD patients (2015–2023) was conducted. Demographic, clinical variables and neoplasms found after GPSD diagnosis (excluding metastatic events or recurrences and non-melanoma skin cancer) were collected. In order to adjust by age and sex, we performed an indirect standardization method and calculated the standardized neoplasm ratio (SNR) and standardized incidence ratio (SIR). Results Among 334 patients, 16 (4.8%) developed neoplasms, with 11 diagnosed within the first two years (7 within the first year).The SNR was 4.03 (CI 95% 1.53–6.53) in women and 2.37 (CI 95% 0.47–4.27) in men. Considering the neoplasms diagnosed in the two first years, the SNR were 2.42 (CI 95% 0.484–4.356) in women and 2.11 (CI 95% 0.258–3.868) in men. Conclusion We observed a high incidence rate of neoplasms in our women GPSD patients. While no statistical significance was reached in men or in cases beyond two years post-diagnosis, a tendency toward higher rates was noted. These findings emphasize the need for further research on the potential oncologic implications of GPSD.
This study employs a Gaussian Process (GP) model to model the responses of the direct laser deposition (DLD) process, focusing on parameters such as ‘Width’, ‘Height’, ‘Depth’, ‘Dilution’ and ‘Cracks’. GP models, known for capturing complex relationships and providing uncertainty estimates, were trained on two datasets: one with preheating (PHT) and the other without PHT. This division enabled comparison of PHT’s influence on modelling accuracy and response characteristics. Interpretative analysis of the model predictions was performed using SHAP values (SHapley Additive exPlanations), which measure the importance of the input features (‘P’, ‘SS’, ‘FR’) and their influence on the model responses. The integrated approach of modelling with Gaussian Processes and interpretability analysis with SHAP allowed us to identify the most influential features and better understand the process dynamics. The results indicate that preheating (PHT) significantly affects cladding properties such as depth and dilution due to Marangoni convection and increased energy absorption by the substrate. The combination of GP models and SHAP values provided accurate predictions and information on the most influential factors in the process responses, allowing the optimization of the DLD process. This integrated methodology improved the accuracy of predictions and facilitated a more informed decision-making process, contributing to the optimization of laser processing.
