Tenderness scale

Fig. 3. Distribution of 438 duplicate half tests over the tenderness scale (Deather age and Reiman, 1946).

The indications for therapy with SBC-5-IMNs in DMARD-Refractory RA are ESR > 40 mm (ESR of knee OA very rarely exceeds 40 mm) and VAS > 4. Patients are considered to have DMARD-Refractory RA (DR-RA) if optimal dosages of single and combined oral DMARDs (corticosteroids, hydroxychloroquine, sulphasalazine, and MTX) have been used for 2 months without lowering of the ESR with 1 mm or more, with a decrease of the swollen and tender joint count of less than 1 and the VAS still above 10 (scale 0-100) at month 1 and 2 compared with baseline. 

Rheumatoid arthritis Tender, swollen joints, visual analogue scale for pain acute phase reactants (ESR, C-reactive protein), duration of early morning stiffness, preservation of function... 

Buccal testosterone tablets provide sustained release of testosterone and also bypass first-pass metabolism in the liver. Small-scale work with a bioadhesive buccal tablet of testosterone has shown that adequate serum concentrations can be obtained and that the buccal tablet (administered twice daily) is well tolerated (102). Other work has confirmed that twice-daily buccal application is optimal to maintain therapeutic serum concentrations of testosterone and its metabolites (103-105) however, it appears that about one patient in six initially has a degree of oral discomfort from the presence of the mucoadhesive tablet, although this fades after a few days and does not seriously affect compliance. Common adverse effects of buccal testosterone include gum irritation, pain, and tenderness, and edema (106) and headache (107). 

Co. Ltd (SPR) was founded to recycle the waste plastics collected in Sapporo city, where 13 500 t has been baled every year. This system has received excellent support by Sapporo city. However, only half of the baled plastics is used in the SPR liquefaction plant located just next to the baling plant due to the tender system controlled by JCPRA. Thus, the operating ratio of the SPR plant is not so high, and this also raises the treatment cost of waste plastics, as does the small scale. The remaining half is used for the iron and steel industry, far from Sapporo. The third liquefaction plant constructed at Mikasa city, Hokkaido stopped this March, since sufficient raw plastic waste could not be obtained. 

If the number of service providers is limited—either because of the administrative costs involved or because of the desire to achieve potential economies of scale—some degree of competition can be retained by awarding the contract (or contracts) by public tender. Tendering for service providers allows the voucher agency to make a selection based on price and quality. In drawing up the announcement, it is essential to make the... 

This vegetable, which is considered to be a delicacy, is a thistlelike plant. The edible flower bud is characterized by green leaflike scales (bracts) that enclose it. Both the bracts and the base of the flower (receptacle), which is called the heart, are eaten. In some places, the tender young leaf stalk may also be consumed. Fig. A-41 depicts a typical globe artichoke. 

A follow-up paper a little later in 1967 tried a similar exercise, but included the tender price for the HinWey Point AGR bid for comparison. Hinkley B had two reactors each of 625 MW (E). The cost of the 350 MW SGHWR was scaled up to an equivalent size. The Hinkley B tender price was quoted at 75.44 million whereas the equivalent SGHWR was costed at 50.13 million. Hinkley B would cost very much more than its tender price, but with the inflation of the 1970s it would be difficult to compare the final cost with the tender price. 

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