Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Raffier, B; Hirschi, M; Trautinger, F; Schmidt, P; Stetter, M; Hundstorfer, M; Reinhart, V; Monshi, B; Pirkhammer, D; Richter, L; Hamberger, N; Metz, S; Feldmann, R; Semmelweis, K; Lackner, K; Tomi, N; Kolle, H; Hafner, F; Brodmann, M; Kuen Spiegel, M; Minmair, G; Heil, Pm; Broil, H; Holzer, G; Illmer, X; Rintelen, B; Sautner, J; Takacs, M; Thun, M; Zemanova, I; Soukup, T; Smrzova, A; Bohmova, J; Prochazkova, L; Nemec, P; Fojtik, Z; Suchy, D; Becvar, R; Olsen, Ab; Sondergaard, Kh; Luosu jarvi, R; Vidqvist, Kl; Madaule, S; Beneton, N; Maillard, H; Charlanne, H; Granelbrocard, F; Hachulla, E; Hatron, Py; Jourdain, N; Lambert, M; Launay, D; Morell, S; Woijtasik, G; Skowron, F; Zenone, T; Dadban, A; Lok, C; Ferrandiz, D; Magybertrand, N; Moiton, Mp; Taieb, A; Balquiere, S; Belin, E; Droitcourt, C; Julien, S; Prey, S; Boulon, C; Constans, J; Doutre, Ms; Kostrzwewa, E; Richez, C; Greco, M; Misery, L; Sassolas, B; Collet, E; Berthier, S; Leguy Seguin, V; Imbert, B; Carpentier, P; Blaise, S; Couraud, A; Doeffel Hantz, V; Spars, A; Bezanahary, H; Boussely, N; Dumonteil, S; Fauchais, Al; Goudran, G; Loustaud Ratti, V; Manea, P; Vidal, E; Coppere, B; Desmursclavel, H; Girard Madoux MH,; Hot, A; Ninet, J; Granel, B; Cohen, Jd; Keynote, A; Khau van Kien, A; Le Quellec, A; Riviere, S; Rullier, P; Bessis, D; Farcas, C; Bravetti, V; Moline, T; Wahl, D; Zuily, S; Granel Brocard, F; Agard, C; Durant, C; Fuzibet, Jg; Queyrel, V; Berezne, A; Guillevin, L; Mouthon, L; Cabane, J; Tiev, K; Toledano, C; Lazareth, I; Michon Pasturel, U; Priollet, P; Reguiai, Z; Cazaletslacoste, C; Jego, P; Letremy, A; Perlat, A; Duval Modeste AB,; Chatelus, E; Chiffot, H; Sibillia, J; Sordet, C; Adoue, D; Couret, B; Moulis, G; Pugnet, G; Sailler, L; Diot, E; Gaches, F; Farge, D; Keshtmand, H; Frances, C; von Elling, A; Bora, D; Ebel, J; Ahmadi Simab, K; Klein, E; Hahn, K; Schulze, K; Rasche, C; Riemekasten, G; Lee, Hh; Deuschle, K; Mattat, K; Becker, M; Worm, M; Mensing, C; Klings, D; Mensing, H; Messall, J; Zuper, R; Eilbacher, P; Saar, P; Kaufmann, P; Hallermann, C; Schmidt, K; Wahn, H; Schildt, K; Schuart, T; Kaczmarczyk, A; Kellner, C; von Oelhafen, J; Baron von Bildering, P; Kunze, S; Kleiner, Hj; Alsheimer, B; Schuetz, N; Miirker Hermann, E; Gottl, Kh; Weiss, E; Reischel, N; Kern, S; Goettl, Kh; Goetheuniversitiitsklinikum, Jw; Himsel, A; Henkemeier, U; Schwarting, A; Hazenbiller, A; Nichelmann, V; Rumbaur, C; Boesenberg, I; Schmeiser, T; Mueller Ladner, U; Unholzer, A; Starz, H; Welzel, J; Plaumann, K; Stoeckl, F; Sperling, S; Podda, M; Wagner, N; Rapprich, H; Niedermeier, A; Messer, G; Sardy, M; Bekou, V; Dill MUller, D; Wlodarz, M; Belloni, B; Huettig, B; Ziai, M; Hein, R; Kneitz, C; Federow, I; Schneider, K; Semmler, M; Hapke, S; Metzler, C; Stein, T; Enderlein, M; Kayser, M; Werthmann, M; Guenther, Cu; Neul, S; Hellmich, B; Loeffler, C; Pflugfelder, J; Karaenke, P; Mueglich, C; Tony, Hp; Marina, P; Popp, M; Mittag, M; Mittag, M; Baumann, C; Baumann, C; Scheib, Eg; Scheib, Eg; Brand, H; Wilhelm, Hu; Wilhelm, Hu; Bohm, J; Dyballa, J; Boehm, J; Taggeselle, J; Taggeselle, J; Luthke, K; Wuerzburg, I; Luthke, K; Niefanger, K; Niefanger, K; Mayer, L; Drabek, J; Harmuth, W; Harmuth, W; Dietl, S; Moritz, D; Dietl, S; Gause, A; Gause, A; Gaubitz, M; Hallecker, A; Gaubitz, M; Krupp, E; Rumpel, H; Moosig, F; Frey, P; Kahl, S; Linke, M; Merk, B; Bloching, Hh; Ochs, W; Kurthen, R; Kurthen, R; Eiden, E; Guertler, I; Aries, Pm; Kirchberg, S; Jahnke, K; Mettler, S; Toeller, S; Zwenger, S; Langer, He; Deininger, F; Hartmann, F; Neeck, G; Neek, G; Wernitzsch, H; Meier, L; Herr, U; Meier, U; Aaig, W; Schwarting, A; Bruckner, L; Sheikh, N; Wollenhaupt, J; Krog, B; Wollersdorfer, E; Hall, R; Diehm, C; Tiggers, C; Peters, J; Kirschke, J; Schroeder, Jo; Zeuner, R; Uhlig, S; Barth, S; Huegel, R; Glaeser, R; Schaefer, C; Monshausen, M; Mengden, T; Funkert, A; Blank, N; Lupaschko, S; Voss, B; Megahed, M; Sadeghlar, F; Seidel, M; Wasmuth, Jc; Kreuter, A; Vosswinkel, J; Pfoehler, C; Gerber, A; Haust, M; Hoff, Np; Mota, R; Akanay Diesel, S; Homey, B; Katzemich, A; Erfurt Berge, C; Sticherling, M; Beyer, C; Distler, J; Mitchell, A; Freundlieb, C; Rushentsova, U; Hermanns, G; Blaschke, S; Fiene, M; Wessel, C; Norgauer, J; Rabe, B; Schuster, J; Scholz, J; Kremer, K; Robakidze Torbahn, M; Moinzadeh, P; Dohse, A; Muhlack, A; Schultz, L; Schult, S; Frambach, Y; Kruse, S; Kettenbach, A; Fell, I; Schweda, K; Steinbrink, K; Podobinska, M; Fieri beck, G; Schanz, S; Pfeiffer, C; Hassel, R; Herrgott, I; Sunderkoetter, C; Guenzel, J; Athanassiou, P; Dimitroulas, T; Settas, L; Kritikos, I; Tsifetaki, N; Garyfallos, A; Vasilopoulos, D; Boura, P; Kamali, S; Aslanidis, S; Vlachoyannopoulos, P; Galanopoulo, V; Sakkas, L; Koutroubas, A; Elezoglou, T; Galanopoulos, N; Grier, A; Murray, M; O'Rourke, M; Del Papa, N; Maglione, W; Zeni, S; Foti, R; Benenati, A; De Vita, S; Ferraccioli, G; Grassi, W; de Angeli, R; Pomponio, G; Mussi, A; Colonna, L; Airo, P; Zingarelli, S; Scorza, R; Serverino, A; Puppo, F; Negrini, S; Roma, I; Salsano, F; Triolo, G; Mazzuca, S; Carignola, R; Gatti, S; Lunardi, G; Riccieri, V; Salvarani, Carlo; Bajocchi, G; Varcasia, G; Marasini, B; Belloll, L; Matucci Cerinic, M; de Luca, R; Stisi, S; Bellissimo, S; Fusaro, E; Pellerito, R; Cozzi, F; Rizzo, M; Bartoluzzi, A; Trotta, F; Cantatore, F; Corrado, A; Ferri, Clodoveo; Colaci, Michele; Malavolta, N; Mule, R; Galeazzi, M; Lapadula, G; Mathieu, A; Vacca, A; Giacomelli, R; Cipriani, P; Montecucco, Cm; Codullo, V; Bucci, R; Battaglia, E; Valentini, G; Cuomo, G; Terlizzi, N; Serafino, L; Reumatologia, Uo; Bombardieri, S; Della Rossa, A; Doveri, M; Perricone, R; de Mattia, M; Pallotta, S; Groenendael, Jh; Seys, P; Goekoop, Rj; Han, Kh; Wlarvens, M; Bonte Mineur, F; de Bois MH,; de Beus WM,; van Zeben, D; Vonk, M; Knaapen, Hk; Smit, A; Bootsma, H; Ton, E; Voskuyl, A; Dutmer, Ea; Stalk, Jn; Madland, Tm; Seip, M; Hoffmann Vold AM,; Bitter, H; Stocklund Thomsen, R; Resende, C; Ponte, C; Martinho, S; Silva, F; Ferreira, P; Grilo, A; Riso, N; Santos, C; Camara, I; Costa, J; Alves, J; Oliveira, S; Almeida, I; Silva, I; Cordeiro, A; Coelho, P; Lukac, J; Dolnicar, As; Espinosa, G; Mejia, Jc; Ramos, M; Plasin Rodriguez MA,; Mera, A; Blanco, Js; Diaz, Jj; Losada, L; Perez, E; Maneiro, Jr; Caamano, M; Fermindez, S; Insua, Sa; Barbado, J; Fonseca, Em; Nufio, Fj; Castellvi, I; Garcia de Ia Pena, P; Bellido, D; Paulino, M; Garcia, Pv; Salas, V; Minguez, Md; Sanchez, Ma; Urrego, C; Martin, I; Rueda, A; Calvo, J; Ripoll, Mm; Torres, Mc; Corteguera, M; Maceiras, F; Cruz, J; Mosquera, Ja; Gomez, R; Area, B; Carrio, I; Rubio, M; Castellvi Barranco, I; Santos, P; Simeon, Cp; Fonollosa, V; Egurbide, Mv; Garcia de Vicuna, R; Vicente, E; Villaverde, V; Fernandez, C; Garcia, E; Uson, J; Miguelez, R; Callejas, Jl; Ortego, N; Roman, J; Alegre Sancho JJ,; Robles, A; Rios, Jj; Bonilla, Mg; Sanchez Andrade, A; Vazquez, Tr; Miranda, Ja; Saez, L; Zea, A; De la Puente, C; Martinez, Fg; Aguirre, Ma; Collado, P; Cruz, A; Crespo, M; Sanchez Roman, J; Castillo, Mj; Garcia, Am; Muniz, G; Hedin, Pj; Stahl, C; Bracin, T; Nordin, A; Albertsson, K; Rydvald, Y; Thorsson, C; Hermansson, E; Maurer, B; Verner, D; Schmidt Bosshard, R; Hall, F; Murphy, K; Lamb, J; Anderson, M; Moots, R; Buch, M; Bissell, L; Madhok, R; Hampson, R; D'Cruz, D; Choong, Lm; Gordon, P; Dobson, J; Salerno, R; Nisar, M; Williams, C; Wilcox, L; Denton, C; Ochiel, R; Ngcozana, T; Parker, L; Vincent, R; Mchugh, N; Cole, S; Brown, S; James, J; Herrick, A; Manning, J; Moore, T; Faizal, A; Skyes, H; Smythe, A; Hamilton, A.

OBJECTIVES: Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease. METHODS: Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment. RESULTS: This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and ≥3 DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28%, 42%, and 48%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35%, 54%, and 63%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs. CONCLUSIONS: With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from others.

Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry / Raffier, B; Hirschi, M; Trautinger, F; Schmidt, P; Stetter, M; Hundstorfer, M; Reinhart, V; Monshi, B; Pirkhammer, D; Richter, L; Hamberger, N; Metz, S; Feldmann, R; Semmelweis, K; Lackner, K; Tomi, N; Kolle, H; Hafner, F; Brodmann, M; Kuen Spiegel, M; Minmair, G; Heil, Pm; Broil, H; Holzer, G; Illmer, X; Rintelen, B; Sautner, J; Takacs, M; Thun, M; Zemanova, I; Soukup, T; Smrzova, A; Bohmova, J; Prochazkova, L; Nemec, P; Fojtik, Z; Suchy, D; Becvar, R; Olsen, Ab; Sondergaard, Kh; Luosu jarvi, R; Vidqvist, Kl; Madaule, S; Beneton, N; Maillard, H; Charlanne, H; Granelbrocard, F; Hachulla, E; Hatron, Py; Jourdain, N; Lambert, M; Launay, D; Morell, S; Woijtasik, G; Skowron, F; Zenone, T; Dadban, A; Lok, C; Ferrandiz, D; Magybertrand, N; Moiton, Mp; Taieb, A; Balquiere, S; Belin, E; Droitcourt, C; Julien, S; Prey, S; Boulon, C; Constans, J; Doutre, Ms; Kostrzwewa, E; Richez, C; Greco, M; Misery, L; Sassolas, B; Collet, E; Berthier, S; Leguy Seguin, V; Imbert, B; Carpentier, P; Blaise, S; Couraud, A; Doeffel Hantz, V; Spars, A; Bezanahary, H; Boussely, N; Dumonteil, S; Fauchais, Al; Goudran, G; Loustaud Ratti, V; Manea, P; Vidal, E; Coppere, B; Desmursclavel, H; Girard Madoux, Mh; Hot, A; Ninet, J; Granel, B; Cohen, Jd; Keynote, A; Khau van Kien, A; Le Quellec, A; Riviere, S; Rullier, P; Bessis, D; Farcas, C; Bravetti, V; Moline, T; Wahl, D; Zuily, S; Granel Brocard, F; Agard, C; Durant, C; Fuzibet, Jg; Queyrel, V; Berezne, A; Guillevin, L; Mouthon, L; Cabane, J; Tiev, K; Toledano, C; Lazareth, I; Michon Pasturel, U; Priollet, P; Reguiai, Z; Cazaletslacoste, C; Jego, P; Letremy, A; Perlat, A; Duval Modeste, Ab; Chatelus, E; Chiffot, H; Sibillia, J; Sordet, C; Adoue, D; Couret, B; Moulis, G; Pugnet, G; Sailler, L; Diot, E; Gaches, F; Farge, D; Keshtmand, H; Frances, C; von Elling, A; Bora, D; Ebel, J; Ahmadi Simab, K; Klein, E; Hahn, K; Schulze, K; Rasche, C; Riemekasten, G; Lee, Hh; Deuschle, K; Mattat, K; Becker, M; Worm, M; Mensing, C; Klings, D; Mensing, H; Messall, J; Zuper, R; Eilbacher, P; Saar, P; Kaufmann, P; Hallermann, C; Schmidt, K; Wahn, H; Schildt, K; Schuart, T; Kaczmarczyk, A; Kellner, C; von Oelhafen, J; Baron von Bildering, P; Kunze, S; Kleiner, Hj; Alsheimer, B; Schuetz, N; Miirker Hermann, E; Gottl, Kh; Weiss, E; Reischel, N; Kern, S; Goettl, Kh; Goetheuniversitiitsklinikum, Jw; Himsel, A; Henkemeier, U; Schwarting, A; Hazenbiller, A; Nichelmann, V; Rumbaur, C; Boesenberg, I; Schmeiser, T; Mueller Ladner, U; Unholzer, A; Starz, H; Welzel, J; Plaumann, K; Stoeckl, F; Sperling, S; Podda, M; Wagner, N; Rapprich, H; Niedermeier, A; Messer, G; Sardy, M; Bekou, V; Dill MUller, D; Wlodarz, M; Belloni, B; Huettig, B; Ziai, M; Hein, R; Kneitz, C; Federow, I; Schneider, K; Semmler, M; Hapke, S; Metzler, C; Stein, T; Enderlein, M; Kayser, M; Werthmann, M; Guenther, Cu; Neul, S; Hellmich, B; Loeffler, C; Pflugfelder, J; Karaenke, P; Mueglich, C; Tony, Hp; Marina, P; Popp, M; Mittag, M; Mittag, M; Baumann, C; Baumann, C; Scheib, Eg; Scheib, Eg; Brand, H; Wilhelm, Hu; Wilhelm, Hu; Bohm, J; Dyballa, J; Boehm, J; Taggeselle, J; Taggeselle, J; Luthke, K; Wuerzburg, I; Luthke, K; Niefanger, K; Niefanger, K; Mayer, L; Drabek, J; Harmuth, W; Harmuth, W; Dietl, S; Moritz, D; Dietl, S; Gause, A; Gause, A; Gaubitz, M; Hallecker, A; Gaubitz, M; Krupp, E; Rumpel, H; Moosig, F; Frey, P; Kahl, S; Linke, M; Merk, B; Bloching, Hh; Ochs, W; Kurthen, R; Kurthen, R; Eiden, E; Guertler, I; Aries, Pm; Kirchberg, S; Jahnke, K; Mettler, S; Toeller, S; Zwenger, S; Langer, He; Deininger, F; Hartmann, F; Neeck, G; Neek, G; Wernitzsch, H; Meier, L; Herr, U; Meier, U; Aaig, W; Schwarting, A; Bruckner, L; Sheikh, N; Wollenhaupt, J; Krog, B; Wollersdorfer, E; Hall, R; Diehm, C; Tiggers, C; Peters, J; Kirschke, J; Schroeder, Jo; Zeuner, R; Uhlig, S; Barth, S; Huegel, R; Glaeser, R; Schaefer, C; Monshausen, M; Mengden, T; Funkert, A; Blank, N; Lupaschko, S; Voss, B; Megahed, M; Sadeghlar, F; Seidel, M; Wasmuth, Jc; Kreuter, A; Vosswinkel, J; Pfoehler, C; Gerber, A; Haust, M; Hoff, Np; Mota, R; Akanay Diesel, S; Homey, B; Katzemich, A; Erfurt Berge, C; Sticherling, M; Beyer, C; Distler, J; Mitchell, A; Freundlieb, C; Rushentsova, U; Hermanns, G; Blaschke, S; Fiene, M; Wessel, C; Norgauer, J; Rabe, B; Schuster, J; Scholz, J; Kremer, K; Robakidze Torbahn, M; Moinzadeh, P; Dohse, A; Muhlack, A; Schultz, L; Schult, S; Frambach, Y; Kruse, S; Kettenbach, A; Fell, I; Schweda, K; Steinbrink, K; Podobinska, M; Fieri beck, G; Schanz, S; Pfeiffer, C; Hassel, R; Herrgott, I; Sunderkoetter, C; Guenzel, J; Athanassiou, P; Dimitroulas, T; Settas, L; Kritikos, I; Tsifetaki, N; Garyfallos, A; Vasilopoulos, D; Boura, P; Kamali, S; Aslanidis, S; Vlachoyannopoulos, P; Galanopoulo, V; Sakkas, L; Koutroubas, A; Elezoglou, T; Galanopoulos, N; Grier, A; Murray, M; O'Rourke, M; Del Papa, N; Maglione, W; Zeni, S; Foti, R; Benenati, A; De Vita, S; Ferraccioli, G; Grassi, W; de Angeli, R; Pomponio, G; Mussi, A; Colonna, L; Airo, P; Zingarelli, S; Scorza, R; Serverino, A; Puppo, F; Negrini, S; Roma, I; Salsano, F; Triolo, G; Mazzuca, S; Carignola, R; Gatti, S; Lunardi, G; Riccieri, V; Salvarani, Carlo; Bajocchi, G; Varcasia, G; Marasini, B; Belloll, L; Matucci Cerinic, M; de Luca, R; Stisi, S; Bellissimo, S; Fusaro, E; Pellerito, R; Cozzi, F; Rizzo, M; Bartoluzzi, A; Trotta, F; Cantatore, F; Corrado, A; Ferri, Clodoveo; Colaci, Michele; Malavolta, N; Mule, R; Galeazzi, M; Lapadula, G; Mathieu, A; Vacca, A; Giacomelli, R; Cipriani, P; Montecucco, Cm; Codullo, V; Bucci, R; Battaglia, E; Valentini, G; Cuomo, G; Terlizzi, N; Serafino, L; Reumatologia, Uo; Bombardieri, S; Della Rossa, A; Doveri, M; Perricone, R; de Mattia, M; Pallotta, S; Groenendael, Jh; Seys, P; Goekoop, Rj; Han, Kh; Wlarvens, M; Bonte Mineur, F; de Bois, Mh; de Beus, Wm; van Zeben, D; Vonk, M; Knaapen, Hk; Smit, A; Bootsma, H; Ton, E; Voskuyl, A; Dutmer, Ea; Stalk, Jn; Madland, Tm; Seip, M; Hoffmann Vold, Am; Bitter, H; Stocklund Thomsen, R; Resende, C; Ponte, C; Martinho, S; Silva, F; Ferreira, P; Grilo, A; Riso, N; Santos, C; Camara, I; Costa, J; Alves, J; Oliveira, S; Almeida, I; Silva, I; Cordeiro, A; Coelho, P; Lukac, J; Dolnicar, As; Espinosa, G; Mejia, Jc; Ramos, M; Plasin Rodriguez, Ma; Mera, A; Blanco, Js; Diaz, Jj; Losada, L; Perez, E; Maneiro, Jr; Caamano, M; Fermindez, S; Insua, Sa; Barbado, J; Fonseca, Em; Nufio, Fj; Castellvi, I; Garcia de Ia Pena, P; Bellido, D; Paulino, M; Garcia, Pv; Salas, V; Minguez, Md; Sanchez, Ma; Urrego, C; Martin, I; Rueda, A; Calvo, J; Ripoll, Mm; Torres, Mc; Corteguera, M; Maceiras, F; Cruz, J; Mosquera, Ja; Gomez, R; Area, B; Carrio, I; Rubio, M; Castellvi Barranco, I; Santos, P; Simeon, Cp; Fonollosa, V; Egurbide, Mv; Garcia de Vicuna, R; Vicente, E; Villaverde, V; Fernandez, C; Garcia, E; Uson, J; Miguelez, R; Callejas, Jl; Ortego, N; Roman, J; Alegre Sancho, Jj; Robles, A; Rios, Jj; Bonilla, Mg; Sanchez Andrade, A; Vazquez, Tr; Miranda, Ja; Saez, L; Zea, A; De la Puente, C; Martinez, Fg; Aguirre, Ma; Collado, P; Cruz, A; Crespo, M; Sanchez Roman, J; Castillo, Mj; Garcia, Am; Muniz, G; Hedin, Pj; Stahl, C; Bracin, T; Nordin, A; Albertsson, K; Rydvald, Y; Thorsson, C; Hermansson, E; Maurer, B; Verner, D; Schmidt Bosshard, R; Hall, F; Murphy, K; Lamb, J; Anderson, M; Moots, R; Buch, M; Bissell, L; Madhok, R; Hampson, R; D'Cruz, D; Choong, Lm; Gordon, P; Dobson, J; Salerno, R; Nisar, M; Williams, C; Wilcox, L; Denton, C; Ochiel, R; Ngcozana, T; Parker, L; Vincent, R; Mchugh, N; Cole, S; Brown, S; James, J; Herrick, A; Manning, J; Moore, T; Faizal, A; Skyes, H; Smythe, A; Hamilton, A.. - In: CLINICAL AND EXPERIMENTAL RHEUMATOLOGY. - ISSN 1593-098X. - STAMPA. - 31 (2 Suppl 76):(2013), pp. 71-80.