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  • Abstract Number: 401 • 2015 ACR/ARHP Annual Meeting

    Racial and Ethnic Disparities in Depression Diagnosis and Treatment for Adolescents with SLE: Analysis of a National Medicaid Sample

    Andrea Knight1, Ming Xie2 and David Mandell3, 1Pediatrics/Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, 2University of Pennsylvania, Center for Mental Health Policy and Services Research, Philadelphia, PA, 3Psychiatry and Pediatrics, University of Pennsylvania, Center for Mental Health Policy and Services Research, Philadelphia, PA

    Background/Purpose: Adolescents with systemic lupus erythematosus (SLE) are at high risk for depression. Racial/ethnic minorities are disproportionately affected by SLE, and previous studies suggest a…
  • Abstract Number: 402 • 2015 ACR/ARHP Annual Meeting

    Predicting Area Under the Curve of Mycophenolate Mofetil in Childhood-Onset Systemic Lupus Erythematosus

    Roberto Ezequiel Borgia1, Masanobu Takeuchi2, Deborah M. Levy3, Shinya Ito‎4 and Earl Silverman5, 1Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, 2Program of Physiology & Experimental Medicine, Peter Gilgan Centre For Research and Learning (PGCRL), The Hospital for Sick Children, Toronto ON, Toronto, ON, Canada, 3Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, 43Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children Toronto ON, Toronto, ON, Canada, 5Division of Rheumatology, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada

    Background/Purpose: Mycophenolate mofetil (MMF) is an immunosuppressive drug used off-label for the treatment of childhood-onset systemic lupus erythematosus (cSLE). Therapeutic drug monitoring (TDM) of MMF’s…
  • Abstract Number: 403 • 2015 ACR/ARHP Annual Meeting

    Proteinuria in Childhood Onset Lupus Nephritis: When Does It Go Away ?

    Justin Hung Tiong Tan1, Sook Fun Hoh2, Manasita Tanya1, Lena Das1, Ma Thin Mar Win3, Yiong Huak Chan3 and Thaschawee Arkachaisri1,4, 1Rheumatology and Immunology, KK Women's and Children's Hospital, Singapore, Singapore, 2Nursing, KK Women's and Children's Hospital, Singapore, Singapore, 3Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore, Singapore, 4Paediatrics, Duke-NUS Graduate Medical School, Singapore, Singapore

    Background/Purpose: The time to recovery from proteinuria in patients with lupus nephritis (LN) receiving standard treatment has been described in adult, but not in children.…
  • Abstract Number: 404 • 2015 ACR/ARHP Annual Meeting

    Long-Term Outcomes of Macrophage Activation Syndrome in Childhood-Onset Systemic Lupus Erythematosus

    Roberto Ezequiel Borgia1, Maya Gerstein1, Deborah M. Levy2, Earl Silverman2 and Linda T Hiraki2, 1Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, 2The Hospital for Sick Children, Toronto, ON, Canada

    Background/Purpose: Macrophage activation syndrome (MAS) is a life-threatening inflammatory complication of childhood-onset systemic lupus erythematosus (cSLE). There are few reports of long-term outcomes of MAS complicating cSLE.…
  • Abstract Number: 405 • 2015 ACR/ARHP Annual Meeting

    Anti-C1q Antibodies As Potential Diagnostic and Prognostic Biomarkers in Juvenile Systemic Lupus Erythematosus

    Thaschawee Arkachaisri1,2, Justin Hung Tiong Tan1, Manasita Tanya1, Sook Fun Hoh3, Lena Das4 and Jing Yao Leong5,6, 1Rheumatology and Immunology, KK Women's and Children's Hospital, Singapore, Singapore, 2Paediatrics, Duke-NUS Graduate Medical School, Singapore, Singapore, 3Nursing, KK Women's and Children's Hospital, Singapore, Singapore, 4Dept of Rheumatology, Cincinnati Children`s Hospital Medical Center, Cincinnati, OH, 5Duke-National University of Singapore Graduate Medical School, Singapore, Singapore, 6SingHealth Translational Immunology and Inflammation Centre, Singapore Health Services Pte Ltd, Singapore, Singapore

    Background/Purpose: Anti-C1q antibodies (AC1q) were shown to strongly correlate with the occurrence and activity of lupus nephritis in adult SLE. Data of the antibodies in…
  • Abstract Number: 406 • 2015 ACR/ARHP Annual Meeting

    Long Term Follow up of Inner City Pediatric Patients with Lupus Nephritis

    Janice Desir1, Beatrice Goilav2, Ellen Silver3 and Irene Blanco4, 1Pediatric Nephrology, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, NY, 2Division of Nephrology, Children's Hospital at Montefiore, Bronx, NY, 3Pediatrics, Albert Einstein College of Medicine, Bronx, NY, 4Medicine, Albert Einstein College of Medicine, Bronx, NY

    Background/Purpose: In children with SLE, 80% have renal involvement, which is a major prognostic factor for both morbidity and mortality. Few studies have focused on…
  • Abstract Number: 407 • 2015 ACR/ARHP Annual Meeting

    Inter-Observer Variability of the Histological Classification of Lupus Glomerulonephritis in Children

    Louise Oni1, Michael Beresford2, David Witte3, Anastasios Chatzitolios4, Neil Sebire5, Rajeev Shukla6, Jun Ying7 and Hermine I. Brunner8, 1Department of Paediatric Nephrology, Alder Hey Children's Hospital, Liverpool UK, Liverpool, England, 2University of Liverpool, Institute of Translational Medicine (Child Health), Alder Hey Children's Foundation NHS Trust, Liverpool, United Kingdom, 3Rheumatology, Cincinnati Children's Hospital, Cincinnati, OH, 4Department of Histopathology, Southmead Hospital, Bristol, UK, Bristol, England, 5Department of Paediatric Histopathology, Great Ormond Street Hospital for Children NHS Trust, London, England, 6Department of Paediatric Histopathology, Alder Hey Children's Hospital, Liverpool UK, Liverpool, England, 7Center for Biostatistical Services, University of Cincinnati College of Medicine, Cincinnati, OH, 8Pediatric Rheumatology Collaborative Study Group, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

    Background/Purpose: The gold standard for diagnosis and classification of lupus nephritis (LN) is according to the renal histology. The inter-observer reliability between histologists is variable.…
  • Abstract Number: 408 • 2015 ACR/ARHP Annual Meeting

    Characterization of Pediatric Systemic Lupus Erythematosus with Acquired Angioedema

    Marietta De Guzman1, Diana Bayer2, Roshni Sambasivan3, Debra Canter4, Martha Curry5 and Anna Carmela Sagcal-Gironella6, 1Pediatric Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 2Division of Allergy, Immunology andPulmonology, University of Iowa Carver College of Medicine, Iowa, IA, 3Pediatric Immunology, Allergy and Rheumatology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, 4Pediatric Immuology, Allergy and Rheumatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 5Pediatric Immunology, Allergy and Rheumatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 6Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX

    Background/Purpose: Acquired angioedema, defined as non-hereditary angioedema without associated urticaria, is an uncommon but potentially life-threatening feature among adults with systemic lupus erythematosus (SLE).  Although…
  • Abstract Number: 409 • 2015 ACR/ARHP Annual Meeting

    Disease Activity, Disease Damage and Predictive Factors in Juvenile Onset Mixed Connective Tissue Disease – a Norwegian Nationwide Study

    Siri Opsahl Hetlevik1, Berit Flatø1,2, Marite Rygg3,4, Ellen Berit Nordal5 and Vibke Lilleby6, 1Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, 2Department of Rheumatology, Oslo University Hospital, Institute for Clinical Medicine, University of Oslo, Oslo, Norway, 3Department of Pediatrics, St Olav University Hospital, Trondheim, Norway, 4Department of Laboratory Medicine, Children's and Women's health, Norwegian University of Science and Technology, Trondheim, Norway, 5Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway, 6Rheumatology, Oslo University Hospital, Oslo, Norway

    Background/Purpose: Mixed Connective Tissue Disease (MCTD) is a rare rheumatic disease with overlapping features from Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SSc) and Polymyositis. Juvenile…
  • Abstract Number: 410 • 2015 ACR/ARHP Annual Meeting

    Characteristics of the Juvenile Systemic Sclerosis Cohort within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

    Brandi E. Stevens1, Kathryn S. Torok2, Suzanne C. Li3, Nicole Hershey1, Megan Curran4, Gloria C. Higgins5, Katharine Moore6, C. Egla Rabinovich7, Anne M. Stevens8 and Childhood Arthritis and Rheumatology Research Alliance, Stanford, CA, 1Division of Rheumatology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 2Pediatric Rheumatology, Scleroderma Center of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 3Pediatrics, Joseph M Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ, 4Pediatric Rheumatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, 5Pediatric Rheumatology Ohio State University, Nationwide Childrens Hospital, Columbus, OH, 6Pediatric Rheumatology, Seattle Children's Hospital, Seattle, WA, 7Pediatric Rheumatology, Duke University Medical Center, Durham, NC, 8Seattle Children's Res Inst, Seattle Children's Hospital, University of Washington, Seattle, WA

    Background/Purpose: Systemic sclerosis (SSc) is a rare multisystem autoimmune disease characterized by vasculopathy and organ fibrosis. We present baseline data on the North American observational…
  • Abstract Number: 411 • 2015 ACR/ARHP Annual Meeting

    Patient Reported Outcomes in Juvenile Dermatomyositis: Assessing the Importance of Different Measures to Patients and Families

    Heather Tory1, Ruy Carrasco2, Thomas Griffin3, Melissa M. Hazen4, Adam M. Huber5, Philip Kahn6, Angela Byun Robinson7, Susan Kim8 and The Childhood Arthritis and Rheumatology Research Alliance Juvenile Dermatomyositis Quality Measures Workgroup, 1Rheumatology, Connecticut Children's Medical Center, Hartford, CT, 2Pediatric Rheumatology, Specially For Children, Austin, TX, 3Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 4Rheumatology, Children's Hospital Boston, Boston, MA, 5Pediatric rheumatology, IWK Health Centre, Halifax, NS, Canada, 6Pediatric Rheumatology, New York University, New York, NY, 7Pediatrics, Rainbow Babies & Children's Hospital / Case Medical Center, Cleveland, OH, 8Division of Immunology, Boston Children's Hospital, Boston, MA

    Background/Purpose: Patient reported outcomes (PROs) are becoming increasingly important in the care of patients with chronic disease. Involving patients in their own care significantly improves…
  • Abstract Number: 412 • 2015 ACR/ARHP Annual Meeting

    Update on the Juvenile Systemic Sclerosis Inception Cohort Project. Characteristics of the First 50 Patients at First Assessment. Www.Juvenile-Scleroderma.Com

    Ivan Foeldvari1, Jens Klotsche2, Valda Staņeviča3, Ekaterina Alexeeva4, Maria M. Katsicas5, Maria Teresa Terreri6, Ana Paula Sakamoto7, Rolando Cimaz8, Mikhail Kostik9, Tadey Avcin10, Maria Jose Santos11, Monika Moll12, Dana Nemkova13, Flavio Sztajnbok14, Cristina Battagliotti15, Juergen Brunner16, Despina Eleftheriou17, Alberto Sifuentes Giraldo18, Liora Harel19, Mahesh Janarthanan20, Tilmann Kallinich21, Kirsten Minden22, Susan Mary Nielsen23, Kathryn S. Torok24, Yosef Uziel25 and Nicola Helmus26, 1Hamburger Zentrum für Kinder-und Jugendrheumatologie, Hamburg, Germany, 2Epidemiology unit, German Rheumatism Research Center, Berlin, Germany, 3Pediatric cathedra, Riga Stradiņš University, Riga, Latvia, 4Rheumatology, Scientific Center of Children's Health, Moscow, Russia, 5Immunology & Rheumatology., Hospital de Pediatrìa Garrahan, Buenos Aires, Argentina, 6Pediatrics, Universidade Federal de Sao Paulo, São Paulo, Brazil, 7Assistant doctor, Pediatric Rheumatology Unit, Universidade Federal de São Paulo, São Paulo, Brazil, 8Department of Paediatrics, University of Florence and Anna Meyer Children's Hospital, Florence, Italy, Florence, Italy, 9State Pediatric Medical University, Saint-Petersburg, Russia, 10University Children's Hospital, Ljubljana, Slovenia, 11Rheumatology, Hospital Garcia de Orta, Almada, Portugal, 12Pediatric Rheumatology, University Childrenhospital, Tübingen, Germany, 13Pediatric Rheumatology Unit, Department of Pediatrics and Adolescent Medicine, General University Hospital in Prague, Prague, Czech Republic, 14Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 15Hospital de Niños Dr Orlando Alasia, Santa Fé, Argentina, 16Universitätsklinik für Kinder- u. Jugendheilkunde, Innsbruck, Austria, 17Paediatric Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom, 18Department of Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain, 19Pediatric Rheumatology Unit, Schneider Children's Medical Center,Tel Aviv University, Petach Tikvah, Israel, 20Pediatric Rheumatology, Chennai, India, 21Charite, University Medicine Berlin, Berlin, Germany, 22Chidlrens´ hospital, Charité University Medicine, Berlin, Germany, 23Rigshospitalet, Copenhagen, Denmark, 24Pediatric Rheumatology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 25Meir Medical Center, Kfar Saba, Israel, 26Hamburg Centre for Pediatric and Adolescent Rheumatology, Hamburg, Germany

    Background/Purpose: Juvenile systemic sclerosis (jSSc) is an orphan autoimmune disease. Currently just retrospective data exist regarding evolvement of organ involvement. In the previous retrospective studies…
  • Abstract Number: 413 • 2015 ACR/ARHP Annual Meeting

    Is There a Difference in the Presentation of Diffuse and Limited Subtype of Juvenile Systemic Sclerosis in Childhood? Results from the Juvenile Scleroderma Inception Cohort Www.Juvenile-Scleroderma.Com

    Ivan Foeldvari1, Jens Klotsche2, Valda Stanevicha3, Maria M. Katsicas4, Maria Teresa Terreri5, Ana Paula Sakamoto6, Rolando Cimaz7, Mikhail Kostik8, Tadey Avcin9, Maria Jose Santos10, Monika Moll11, Dana Nemkova12, Flavio Sztajnbok13, Cristina Battagliotti14, Juergen Brunner15, Despina Eleftheriou16, Alberto Sifuentes Giraldo17, Liora Harel18, Mahesh Janarthanan19, Tilmann Kallinich20, Kirsten Minden21, Susan Mary Nielsen22, Kathryn S. Torok23, Yosef Uziel24 and Nicola Helmus25, 1Hamburger Zentrum für Kinder-und Jugendrheumatologie, Hamburg, Germany, 2Epidemiology unit, German Rheumatism Research Center, Berlin, Germany, 3Pediatric cathedra, University Childrens Hospital, Riga, Latvia, 4Service of Immunology & Rheumatology. Hospital de Pediatrìa Prof Dr.Juan.P. Garrahan, MD, Buenos Aires, Argentina, 5Pediatrics, Universidade Federal de Sao Paulo, São Paulo, Brazil, 6Assistant doctor, Pediatric Rheumatology Unit, Universidade Federal de São Paulo, São Paulo, Brazil, 7Department of Paediatrics, University of Florence and Anna Meyer Children's Hospital, Florence, Italy, Florence, Italy, 8State Pediatric Medical University, Saint-Petersburg, Russia, 9University Children's Hospital, Ljubljana, Slovenia, 10Rheumatology, Hospital Garcia de Orta, Almada, Portugal, 11Pediatric Rheumatology, University Childrenhospital, Tübingen, Germany, 12Pediatric Rheumatology Unit, Department of Pediatrics and Adolescent Medicine, General University Hospital in Prague, Prague, Czech Republic, 13Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 14Hospital de Niños Dr Orlando Alasia, Santa Fé, Argentina, 15Universitätsklinik für Kinder- u. Jugendheilkunde, Innsbruck, Austria, 16Paediatric Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom, 17Department of Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain, 18Pediatric Rheumatology Unit, Schneider Children's Medical Center,Tel Aviv University, Petach Tikvah, Israel, 19Pediatric Rheumatology, Chennai, India, 20Charite, University Medicine Berlin, Berlin, Germany, 21Chidlrens´ hospital, Charité University Medicine, Berlin, Germany, 22Rigshospitalet, Copenhagen, Denmark, 23Pediatric Rheumatology, Scleroderma Center of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 24Meir Medical Center, Kfar Saba, Israel, 25Hamburg Centre for Pediatric and Adolescent Rheumatology, Hamburg, Germany

    Background/Purpose: Juvenile systemic sclerosis (jSSc) is an orphan autoimmune disease. Several publications in adults looked at the differences between limited and diffuse subtypes. There is…
  • Abstract Number: 414 • 2015 ACR/ARHP Annual Meeting

    Performance of the Adult Systemic Sclerosis Classification in Juvenile Systemic Sclerosis Patients. Results from the Juvenile Systemic Sclerosis Inception Cohorte Www.Juvenile-Scleroderma.Com

    Ivan Foeldvari1, Jens Klotsche2, Valda Stanevicha3, Ekaterina Alexeeva4, Maria M. Katsicas5, Maria Teresa Terreri6, Ana Paula Sakamoto7, Rolando Cimaz8, Mikhail Kostik9, Tadey Avcin10, Maria Jose Santos11, Monika Moll12, Dana Nemkova13, Flavio Sztajnbok14, Cristina Battagliotti15, Juergen Brunner16, Despina Eleftheriou17, Alberto Sifuentes Giraldo18, Liora Harel19, Mahesh Janarthanan20, Tilmann Kallinich21, Kirsten Minden22, Susan Mary Nielsen23, Kathryn S. Torok24, Yosef Uziel25 and Nicola Helmus26, 1Hamburger Zentrum für Kinder-und Jugendrheumatologie, Hamburg, Germany, 2Epidemiology unit, German Rheumatism Research Center, Berlin, Germany, 3University Childrens Hospital, Riga, Latvia, 4Rheumatology, Scientific Center of Children's Health, Moscow, Russia, 5Hospital de Pediatria, Buenos Aires, Argentina, 6Pediatrics, Universidade Federal de Sao Paulo, São Paulo, Brazil, 7Assistant doctor, Pediatric Rheumatology Unit, Universidade Federal de São Paulo, São Paulo, Brazil, 8Pediatric Rheumatology, Anna Meyer Children's Hospital, Florence, Italy, 9State Pediatric Medical University, Saint-Petersburg, Russia, 10University Children's Hospital, Ljubljana, Slovenia, 11Rheumatology, Hospital Garcia de Orta, Almada, Portugal, 12Pediatric Rheumatology, University Childrenhospital, Tübingen, Germany, 13Pediatric Rheumatology Unit, Department of Pediatrics and Adolescent Medicine, General University Hospital in Prague, Prague, Czech Republic, 14Pediatric Rheumatology Division, Adolescent Health Care Unit, Universida de do Estado do Rio de Janeiro., Rio de Janeiro, Brazil, 15Hospital de Niños Dr Orlando Alasia, Santa Fé, Argentina, 16Universitätsklinik für Kinder- u. Jugendheilkunde, Innsbruck, Austria, 17Paediatric Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom, 18Department of Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain, 19Pediatric Rheumatology Unit, Schneider Children's Medical Center,Tel Aviv University, Petach Tikvah, Israel, 20Pediatric Rheumatology, Chennai, India, 21Charite, University Medicine Berlin, Berlin, Germany, 22Epidemiology, Charite, DRFZ, Berlin, Germany, 23Rigshospitalet, Copenhagen, Denmark, 24Pediatric Rheumatology, Scleroderma Center of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 25Meir Medical Center, Kfar Saba, Israel, 26Hamburg Centre for Pediatric and Adolescent Rheumatology, Hamburg, Germany

    Background/Purpose: The new adult classifiction criteria (1) for Systemic Sclerosis (SSc) were recently published and the pediatric criteria were published in 2007 (2). None of…
  • Abstract Number: 415 • 2015 ACR/ARHP Annual Meeting

    Development of a Juvenile Systemic Sclerosis Response Index (JSSRI)

    Ivan Foeldvari1, Gyorgyi Zoltan2, Eileen Baildam3, Ezgi Deniz Batu4, Michael Blakley5, Mustafa Cakan6, Megan Curran7, Antonia Kienast8, Kim Fligelstone9, Dana Nemkova10, Clarissa Pilkington11, Nicolino Ruperto12, Maria Tsinti13, Elena Tsitsami14, Kristina Urbanvica15 and Tamas Constantin16, 1Hamburger Zentrum für Kinder-und Jugendrheumatologie, Hamburg, Germany, 2Semmelweiss University Budapest, Budapest, Hungary, 3Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom, 4Hacettepe University Vasculitis Center (HUVAC), Ankara, Turkey, 5Internal Medicine and Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at IU Health, Indianapolis, IN, 6Pediatric Rheumatology University Childrens Hospital Istanbul, Istanbul, Turkey, 7Pediatric Immunology/Rheum, UCSF, San Francisco, CA, 8Hamburg Centre for Pediatric and Adolescent Rheumatology, Hamburg, Germany, 9FESCA - Scleroderma parents organisation, UK, United Kingdom, 10Pediatric Rheumatology Unit, Department of Pediatrics and Adolescent Medicine, General University Hospital in Prague, Prague, Czech Republic, 11Paediatric Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom, 12Pediatrica II, Instituto Giannina Gaslini, PRINTO, Genoa, Italy, 13Ped rheum univ child hosp athen, Athena, Greece, 14First Department of Pediatrics, Athens University Medical School, Athens, Greece, 15Pediatric Rheumatology, Riga, Latvia, 16Semmelweis University, Budapest, Hungary

    Background/Purpose: Juvenile systemic sclerosis (jSSc) is an orphan disease. We have currently new promising effective medication to treat systemic sclerosis, but no valid outcome measures…
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All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

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