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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Rheumatoid arthritis &#40;RA&#41; is the most common chronic inflammatory disease that affects about 1&#37; of the population&#46; RA is characterized by symmetric polyarthritis and widespread systemic manifestations lead to joint damage and functional disability&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> Among those manifestations&#44; fatigue is very frequent and present in more than 40&#37; of patients with RA using different diagnostic tools&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">2&#44;3</span></a> Fatigue in RA can be defined as a sustained feeling of generalized exhaustion that interferes with activities&#44; which is different from normal tiredness&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a> Fatigue has a meaningful contribution to the impaired quality of life and thus adding to disease burden&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">5</span></a> that can make management of RA more challenging&#46; Even though&#44; patients with RA indicated they are not properly supported in the management of RA-fatigue in the healthcare services&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> In routine daily practice&#44; RA patients are evaluated for their disease activity and treatment response&#59; however&#44; silent comorbidities of the disease such as fatigue&#44; anxiety&#44; depression and poor sleep are usually not addressed and thus not controlled&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Although it is the most prevalent complaint in patients with RA&#44; the cause of fatigue is still unknown&#46; Fatigue appears to be multifactorial and associated with multiple determinants &#40;inflammatory and non-inflammatory factors&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">2&#44;7</span></a> Possible inflammatory causes could be RA disease-related components&#44; including pain and disease activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">8&#8211;10</span></a> In addition&#44; there are non-specific factors associated with fatigue such as sleep disturbances&#44; depressed mood&#44; and physical inactivity&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">2&#44;7&#44;9</span></a> The majority of studies handled the effect of these variables &#40;disease activity&#44; poor sleep&#44; and mood disturbance&#41; on fatigue separately&#46; There are relatively few data on the impact of these factors together on fatigue in RA&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">9&#44;11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Cultural and religious aspects are important components that play role in expression of fatigue&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a> The country of residence has an important influence on the level of fatigue and fatigue levels known to be variable across countries&#46; Thus the data about fatigue cannot be transferred between different countries&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> Fatigue levels and its effects can be modified by cultural differences&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a> Therefore&#44; fatigue in RA remains an &#8220;unmet need&#8221; and more illustration of the contributing factors especially in different RA populations is required&#46; There are limited studies evaluating the contributors of fatigue among Egyptian RA patients&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> To our knowledge&#44; the contributions of poor sleep quality&#44; mood disturbance&#44; and disease activity altogether on fatigue has not been systematically studied among Egyptian patients with RA&#46; The objective of this study was to investigate the presence of fatigue&#44; poor sleep quality and depression in patients compared to healthy controls&#46; Also&#44; to analyze the possible relationship between sleep&#44; mood status&#44; and disease-specific variables with fatigue in RA patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study Design and Participants</span><p id="par0020" class="elsevierStylePara elsevierViewall">This cross-sectional study was carried out at the Rheumatology Department&#44; Assiut University Hospital&#44; Assiut&#44; Egypt&#46; From March 2014 to September 2015&#44; patients who met the 2010 American College of Rheumatology&#47;European League Against Rheumatism &#40;ACR&#47;EULAR&#41; criteria for RA<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a> and were able to understand and respond to the questionnaires were recruited to this study&#46; Patients who had a history of malignancies&#44; major cognitive deficits&#44; overlapping connective tissue diseases or currently receiving antipsychotic treatment were excluded from the study&#46; As a reference group&#44; age- and sex-matched apparently healthy volunteer subjects were randomly selected and enrolled in the study as the control group&#46; All subjects provided informed consent to participate in this study and the study was approved by the local ethics committee&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Sociodemographic&#44; Clinical and Laboratory Assessments</span><p id="par0025" class="elsevierStylePara elsevierViewall">All subjects included in the study underwent sociodemographic data collection&#46; For RA patients&#44; disease-specific variables such as disease duration&#44; morning stiffness &#40;MS&#41;&#44; current medications were evaluated&#46; RA disease activity was measured by rheumatologists using the 28-joint disease activity score &#40;DAS28&#41; including swollen joint count &#40;SJC&#41;&#44; tender joint count &#40;TJC&#41;&#44; the patients&#8217; global assessment &#40;PGA&#41; score and erythrocyte sedimentation rate &#40;ESR&#41; &#40;mm&#47;h&#41;&#46; Remission was defined by DAS28-ESR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>2&#46;6&#44; patients with DAS28-ESR &#8805;2&#46;6 and &#60;3&#46;2 was considered to have mild or low disease activity&#44; patients with &#8805;3&#46;2 to less than or equal to 5&#46;1 were considered moderate&#44; and high activity was defined by DAS28-ESR more than 5&#46;1&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Questionnaires Assessment</span><p id="par0030" class="elsevierStylePara elsevierViewall">All participants were interviewed personally to answer the study questionnaires delivered to them by the trained investigator &#40;AR&#41; who was blind to the patients&#8217; clinical status&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Fatigue Assessment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Fatigue was measured by the Multidimensional Assessment of Fatigue-Global Fatigue Index &#40;MAF-GFI&#41; questionnaire&#44; which has been validated previously in RA&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">5</span></a> and in Arabic RA population after its translation&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> MAF-GFI is a self-reported questionnaire evaluates four dimensions of fatigue&#59; degree and severity &#40;MAF1&#41;&#44; distress &#40;MAF2&#41;&#44; interference on activities of daily living &#40;MAF3&#41; and timing of fatigue &#40;MAF4&#41;&#46; MAF-GFI total score is calculated&#44; with higher scores represented more severe fatigue&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Sleep Quality Assessment</span><p id="par0040" class="elsevierStylePara elsevierViewall">All subjects completed the Pittsburgh Sleep Quality Index &#40;PSQI&#41; questionnaire that evaluates sleep quality during the last month&#46; PSQI has been used as an assessment tool to evaluate sleep quality in RA and it was previously translated and validated in Arabic RA patients&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> PSQI measures 7 components including subjective sleep quality&#44; sleep latency&#44; sleep duration&#44; sleep efficiency&#44; sleep disturbances&#44; use of sleep medication and daytime dysfunction&#46; The PSQI total score is calculated by summing the 7 component scores&#44; with poor sleep quality was defined when the PSQI total score was more than 5&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Depression Assessment</span><p id="par0045" class="elsevierStylePara elsevierViewall">The Beck Depression Inventory &#40;BDI&#41; was used for assessment of the depression in RA patients&#46; Arabic version of BDI was validated and used to predict depression in RA&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> The BDI consists of 21 questions&#44; and the total score of 0&#8211;13 is considered minimal &#40;normal up and down&#41;&#44; 14&#8211;19 is mild&#44; 20&#8211;28 is moderate and 29&#8211;63 is severe depression&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Statistical Analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Data were tested for normality by Shapiro&#8211;Wilk test and were normally distributed&#46; Data are presented by means and standard deviation &#40;SD&#41; for continuous variables and by frequencies and percentages for categorical variables&#46; Differences between groups were examined by independent samples <span class="elsevierStyleItalic">t</span>-test or chi square when appropriate&#46; Correlations were performed with Pearson correlation coefficient&#46; Multiple linear regression analyses that included significant variables associated with fatigue &#40;dependent variable&#41; in bivariate analyses were computed and expressed with beta coefficient &#40;<span class="elsevierStyleItalic">&#946;</span>&#41; and 95&#37; confidence interval &#40;CI&#41;&#46; A <span class="elsevierStyleItalic">P</span> value of &#8804;&#46;05 was considered as statistically significant in all analyses&#46; Data were analyzed using the Statistical Package for Social Science version 16 &#40;SPSS Inc&#46;&#59; Chicago&#44; IL&#44; USA&#41;&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">RA Patients&#8217; Characteristics</span><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 115 patients with RA&#44; 93&#37; females&#44; with mean age was 45&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;9 years and mean disease duration was 8&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;6 years participated in the study&#46; Participants&#8217; characteristics are illustrated in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Comparison Between RA Patients and Controls in the Assessment Variables</span><p id="par0060" class="elsevierStylePara elsevierViewall">All RA and 46 matched subjects were able to complete the study questionnaires&#46; There was no significant age or sex difference between them&#44; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; Overall&#44; RA patients have significantly higher mean scores of fatigue severity&#44; total MAF-GFI score&#44; PSQI score&#44; and BDI score compared to control subjects&#44; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; 54&#46;8&#37; of RA are poor sleeper compared to 34&#46;8&#37; in the controls &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;032&#41;&#44; and average of 29&#46;6&#37; of RA patients have moderate to severe depression versus 14&#46;3&#37; within the controls &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Correlations of Fatigue With Variables Among RA</span><p id="par0065" class="elsevierStylePara elsevierViewall">The mean fatigue score has moderate positive correlation with disease activity &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;407&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; while mild correlations with disease duration &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;200&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;032&#41; and ESR &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;183&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;050&#41;&#46; Also&#44; total MAF-GFI score is strongly correlated with poor sleep quality &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;657&#59; <span class="elsevierStyleItalic">p</span> &#60;&#46;001&#41; and with higher depression &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;550&#59; <span class="elsevierStyleItalic">P &#60;&#46;</span>001&#41;&#44; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; No significant differences in fatigue score are found between those using different drug treatments and those not&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The mean fatigue&#44; sleep quality and depression scores are higher among RA patients with hypertension compared to those without&#44; however it did not reach statistical significant &#40;<span class="elsevierStyleItalic">P</span> &#62; &#46;05&#41; for all&#46; RA patients with concomitant diabetes have significantly higher frequencies of fatigue and poor sleep &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;025 and <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;013&#59; respectively&#41;&#44; while depression level did not reach significance &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;074&#41; between patient groups&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Determinants of Fatigue Among RA Patients</span><p id="par0075" class="elsevierStylePara elsevierViewall">The statistically significant correlated variables with MAF scores from <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> were included in the multiple regression analysis&#46; Sleep quality was the strongest determining parameters of fatigue &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;478&#59; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;733&#8211;1&#46;591&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; followed by DAS28-ESR &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;215&#59; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;620&#8211;2&#46;941&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;003&#41; and depression &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;173&#59; 95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#8211;0&#46;418&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;048&#41;&#46; The three variables could explain 49&#46;1&#37; of the variation in fatigue scores&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Fatigue is reported to be the most disabling factor by RA patients&#44; with a negative impact on disease outcome and quality of life&#44; therefore examining the factors associated with the levels of fatigue is important in clinical practice&#46; The present study showed that fatigue levels&#44; sleep and mood disturbances are higher in Egyptian patients with RA than healthy subjects&#46; Also&#44; poor sleep&#44; severe depression as long as higher disease activity were significant determinants of fatigue in the RA patients&#46; The current reported mean fatigue score among RA patients was comparable to that observed previously using the same fatigue tool measurement&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">19&#44;20</span></a> There was a wide range of prevalence of RA-fatigue has been reported in the literature&#44; with the difference in assessment tools and the ethnicity of RA populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">3&#44;21</span></a> Higher fatigue rate has been found in other rheumatic diseases&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a> with depression and sleep disturbances have been reported to influence fatigue&#46; Fibromyalgia&#44; which is known with high fatigue level&#44; poor sleep quality and depression among other factors were common&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">While RA fatigue has been viewed as the byproduct of inflammatory process&#44; others have shown that psychosocial factors may play a role&#46; The inflammatory perspective of depression and fatigue in RA has been investigated&#46; Different inflammatory cytokines&#44; such as tumor necrosis factor &#40;TNF&#41;-&#945;&#44; interleukin &#40;IL&#41;-1 and IL-6 are important proinflammatory cytokines implicated in chronic fatigue and all of these are contributors in the inflammatory state in RA&#46; Furthermore&#44; social&#44; family&#44; work and daily living activities are multiple aspects may have an impact on fatigue&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The relationship between fatigue and examined determinants in RA are variable&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a> most likely because of the multifactorial etiology of fatigue &#40;physiological&#44; psychological&#44; as well as the disease aspects&#41;&#46; Disease duration was found to be correlated with fatigue&#46; However&#44; Stebbings et al&#46; showed that longer disease duration was associated with severe fatigue&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> a recent systematic review found that RA patients experience greater fatigue in irrespective of disease duration&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">8</span></a> The advanced age was not associated with greater fatigue in RA patients which is corresponding to prior study&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> Association between fatigue and disease activity in RA is controversial&#46; A significant correlation between fatigue and ESR was noted in the RA patients as in other&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">8</span></a> DAS28-ESR has several components and this makes it better than measuring inflammation only&#46; In this study&#44; there was correlation between fatigue and overall DAS28-ESR in accordance with previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">10&#44;15&#44;24</span></a> In contrary&#44; fatigue was not correlated with the ESR value and disease activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">3&#44;20</span></a> Fatigue was reported among RA patients in remission or a low disease activity&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> This difference may be related to differences in the characteristics of the patient cohorts&#46; Moreover&#44; in a large longitudinal study despite decreased inflammation with RA treatment&#44; fatigue severity remained unchanged&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> Specifically tailored interventions to reduce fatigue should be offered to RA patients&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">According to our results&#44; RA therapy that is based on the administration of disease-modifying anti-rheumatic drugs &#40;DMARDs&#41;&#44; immunosuppressant drugs&#44; has no impact on fatigue level in consistent with Abdel-Magied et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> However previous work showed some evidence that TNF-inhibitors and to lesser extent DMARDs can reduce fatigue&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> there are relatively few data on whether conventional DMARDs only improve fatigue&#46; Those authors present a different view when it comes to the importance of the type of therapy in the severity of fatigue&#46; They claim that methods of treatment have an impact on decreased fatigue perception among RA patients&#46; Furthermore&#44; longitudinal studies focusing on the effectiveness of DMARDs and new therapies on fatigue seem to be necessary&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">A high percentage RA patients have low quality of sleep&#44; in accordance with the authors&#44;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">21&#44;26</span></a> with more than half of RA patients were poor sleepers&#46; In our study&#44; overall PSQI score &#40;6&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&#41; was similar to Elazeem et al&#46; findings in Egyptian RA patients using PSQI &#40;6&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> Sleep disturbance was strongly associated with fatigue in RA patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">11&#44;27</span></a> While fatigue may disturb sleep quality&#44; the disturbance in the sleep may also lead to greater fatigue and thus vicious cycle&#46; The significant association between total PSQI score and DAS28-ESR score is observed in this study which emphasizes that painful joints and inflammation precipitate poor sleep and decreased alertness&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;20&#44;28</span></a> In agreement with other authors&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> we found no significant association between PSQI and the use of DMARDs or NSAIDs &#40;data not shown&#41;&#46; From another prospect&#44; depression represents a component of the vicious cycle of RA constitutional symptoms and can impede the remission of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> The medical literature suggests heterogeneous prevalence rates of depression in RA&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> Depression score recorded in RA study population is comparable to the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">27</span></a> Presence of severe fatigue&#44; high disease activity as well as poor sleep in RA patients could explain the higher number of RA cases with depression&#46; Depression has been found to be associated with the fatigue within the RA cohort in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">3&#44;20</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">There are limited integrative data aiming at characterizing RA-related fatigue from a whole viewpoint&#46; Fatigue&#44; poor sleep&#44; depression and disease activity can be the cause and the outcome in this viscous cycle&#46; These findings support the results reported in different RA ethnic population&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">11&#44;22&#44;26</span></a> In a recent review by Katz&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">7</span></a> an empirical model of the causes of RA fatigue showed that these variables had direct and indirect effects on fatigue and explained the majority of variation in fatigue&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The major strengths of this study are the multiple multidimensional measurements used in the assessment of the variables&#44; which all had been validated in RA&#46; However&#44; being cross-sectional design&#44; the causality of the relationships cannot be determined&#46; Some of the measure used may be affected by each other&#46; Further research is needed to investigate whether improvements in sleep&#44; depression and disease activity can reduce fatigue&#46; Some other variables such as levels of pain did not included&#59; which have been shown to have strong associations with fatigue&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a> Stebbing et al&#46; found that fatigue in RA patients had no significant association with pain but was associated with depression and anxiety&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> Despite these limitations&#44; though&#44; our findings were consistent with other research&#46; Most of the studies about fatigue in patients with RA have been done in western countries and very few from developing countries&#46; If we consider cultural differences&#44; research from developing countries would be helpful to reveal ethnic differences&#46; Future research in this field should aim at finding instruments covering all related dimensions of fatigue in patients with RA&#46; Furthermore&#44; the future investigations able to understand the underlying pathophysiological mechanisms of fatigue are needed&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusion</span><p id="par0115" class="elsevierStylePara elsevierViewall">In conclusion&#44; severe fatigue&#44; poor sleep and depression are more common in Egyptian patients with RA&#46; The results of this study would suggest that fatigue may not solely result of RA disease activity&#44; but may be the result of a constellation of multiple factors that include depression&#44; and poor sleep&#46; That is to say&#44; evaluation of the fatigue and its determinants in RA assessment must be included in clinical practice&#46; These results will be better to validate and replicate in RA patients from different ethnic origin&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Funding</span><p id="par0120" class="elsevierStylePara elsevierViewall">The study was not funded by grant&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflict of Interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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          "palabras" => array:5 [
            0 => "Depression"
            1 => "Disease activity"
            2 => "Fatigue"
            3 => "Rheumatoid arthritis"
            4 => "Sleep disturbance"
          ]
        ]
      ]
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1262806"
          "palabras" => array:5 [
            0 => "Depresi&#243;n"
            1 => "Actividad de la enfermedad"
            2 => "Fatiga"
            3 => "Artritis reumatoide"
            4 => "Trastorno del sue&#241;o"
          ]
        ]
      ]
    ]
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Rheumatoid arthritis &#40;RA&#41; is a chronic inflammatory disease&#44; characterized by polyarthritis and systemic manifestations&#46; RA-fatigue is a significant problem and adds on disease burden&#46; Sleep disturbance&#44; depression&#44; and disease activity are suggested contributing factors to RA-fatigue&#59; however&#44; their combined role did not examine before among Egyptian RA patients&#46; The objective of the study was to investigate the presence of fatigue&#44; sleep and mood disturbances in RA patients&#46; Also&#44; to evaluate the possible association of poor sleep&#44; depression&#44; and disease activity with RA-fatigue&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This cross-sectional study included 115 RA patients diagnosed according to the 2010 ACR-EULAR criteria and 46 age and sex matched controls&#46; Fatigue using the Multidimensional Assessment of Fatigue-Global Fatigue Index&#44; sleep using the Pittsburgh Sleep Quality Index and mood status using Beck Depression Inventory were assessed for all participants&#46; RA disease activity was evaluated using disease activity score-28 joints&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">RA patients had higher mean fatigue&#44; sleep disturbance&#44; and depression scores &#40;27&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;9&#44; 6&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&#44; and 12&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;3&#59; respectively&#41; than controls &#40;22&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44; 4&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 7&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;9&#59; respectively&#41; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; Poor sleep&#44; depression and higher disease activity were significantly correlated with fatigue &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;4&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;65&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;55&#59; respectively&#41; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The three variables may explain up to 49&#46;1&#37; of the variation in fatigue on multiple regression analysis&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Fatigue&#44; poor sleep&#44; and depression are more common in Egyptian patients with RA&#46; A remarkably higher fatigue was associated with poor sleep&#44; depression&#44; and high disease activity&#44; thus monitoring these silent comorbidities in clinical practice is required&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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            "identificador" => "abst0020"
            "titulo" => "Conclusion"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La artritis reumatoide &#40;AR&#41; es una enfermedad inflamatoria cr&#243;nica&#44; caracterizada por poliartritis y manifestaciones sist&#233;micas&#46; La fatiga asociada a AR es un problema importante y aumenta la carga de la enfermedad&#46; La alteraci&#243;n del sue&#241;o&#44; la depresi&#243;n y la actividad de la enfermedad son factores sugeridos que contribuyen a la fatiga asociada a AR&#59; sin embargo&#44; su papel no se ha examinado previamente en pacientes egipcios con AR&#46; El objetivo del estudio fue investigar la presencia de fatiga y alteraciones del sue&#241;o y humor en pacientes con AR&#46; Adem&#225;s&#44; evaluar la posible asociaci&#243;n del sue&#241;o deficiente&#44; depresi&#243;n y la actividad de la enfermedad con la fatiga asociada a AR&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudio transversal incluy&#243; 115 pacientes con AR&#44; diagnosticados seg&#250;n los criterios de la ACR-EULAR 2010 y 46 pacientes de control emparejados por edad y sexo&#46; Se evalu&#243; en todos los participantes la fatiga mediante el &#237;ndice de evaluaci&#243;n multidimensional de la fatiga y la fatiga global&#44; el sue&#241;o utilizando el &#237;ndice de calidad del sue&#241;o de Pittsburgh y el estado de &#225;nimo mediante el Inventario de Depresi&#243;n de Beck&#46; La actividad de la enfermedad de la AR se evalu&#243; utilizando la medida de la actividad de enfermedad-28 articulaciones&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con AR presentaron en promedio una mayor fatiga&#44; alteraci&#243;n del sue&#241;o y puntuaciones de depresi&#243;n &#40;27&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;9&#59; 6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;6 y 12&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;3&#44; respectivamente&#41; que los pacientes de control &#40;22&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#59; 4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3 y 7&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;9&#44; respectivamente&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El sue&#241;o deficiente&#44; la depresi&#243;n y una mayor actividad de la enfermedad se correlacionaron significativamente con la fatiga &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;4&#59; r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;65&#59; r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;55&#44; respectivamente&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Las 3 variables pueden explicar hasta el 49&#44;1&#37; de la variaci&#243;n en fatiga en el an&#225;lisis de regresi&#243;n m&#250;ltiple&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La fatiga&#44; el sue&#241;o deficiente y la depresi&#243;n son m&#225;s comunes en pacientes egipcios con AR&#46; Una notablemente alta fatiga se asoci&#243; con un sue&#241;o deficiente&#44; depresi&#243;n y alta actividad de la enfermedad&#44; por lo que se requiere el control de estas comorbilidades silenciosas en la pr&#225;ctica cl&#237;nica&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "M&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Differences in MAF-GFI between RA patients who use and those not use specific drug therapy&#46; <span class="elsevierStyleItalic">Abbreviations</span>&#58; MAF-GFI&#58; multidimensional assessment of fatigue-global fatigue index&#59; MTX&#58; methotrexate&#59; HCQ&#58; hydroxychloroquine&#59; LFN&#58; leflunomide&#59; SZS&#58; sulfasalazine&#59; AZA&#58; azathioprine&#59; NSAIDs&#58; nonsteroidal anti-inflammatory drugs&#46; <span class="elsevierStyleItalic">Legend</span>&#58; The differences in multidimensional assessment of fatigue-global fatigue index &#40;MAF-GFI&#41; between RA patients who use specific drug therapy and who do not show no significant difference in fatigue score were found&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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            "identificador" => "at1"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; morning stiffness &#40;MS&#41;&#44; DAS28-ESR&#58; disease activity score&#44; ESR&#58; erythrocyte sedimentation rate&#44; DMARDs&#58; disease modifying anti-rheumatic drugs&#44; NSAIDs&#58; nonsteroidal anti-inflammatory drugs&#46;</p>"
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                  \t\t\t\t">8&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MS duration &#40;min&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;4&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">77 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High activity &#40;&#62;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">92 &#40;80&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Leflunomide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;57&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sulfasalazine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Azathioprine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Combined DMARDs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">89 &#40;77&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Systemic Steroids&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;30&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NSAIDs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">53 &#40;46&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ESR &#40;mm&#47;h&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobin level &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">86 &#40;75&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;541&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">22&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;004&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#46;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Interference with activities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Timing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PSQI total score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sleep duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;232&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sleep disturbance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sleep latency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Day dysfunctions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sleep efficiency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;129&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Use of sleep medication &#40;yes&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;7&#37;&#47;98&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2&#37;&#47;97&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;399&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sleep quality good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;45&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;65&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Poor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;54&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;34&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>BDI total score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">BDI interpretation</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No depression &#40;minimal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;39&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;63&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;31&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;21&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderate depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;14&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;14&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                      "doi" => "10.1053/berh.2002.0257"
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                        "tituloSerie" => "Best Pract Res Clin Rheumatol"
                        "fecha" => "2002"
                        "volumen" => "16"
                        "paginaInicial" => "707"
                        "paginaFinal" => "722"
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              "identificador" => "bib0155"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Fatigue and factors related to fatigue in rheumatoid arthritis&#58; a systematic review"
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                        0 => array:2 [
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                            0 => "S&#46; Nikolaus"
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                    0 => array:1 [
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                        "tituloSerie" => "Arthritis Care Res &#40;Hoboken&#41;"
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                        "volumen" => "65"
                        "paginaInicial" => "1128"
                        "paginaFinal" => "1146"
                      ]
                    ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Fatigue in rheumatoid arthritis reflects pain&#44; not disease activity"
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                            3 => "B&#46; Khoshaba"
                            4 => "D&#46;L&#46; Scott"
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                        "tituloSerie" => "Rheumatology"
                        "fecha" => "2006"
                        "volumen" => "45"
                        "paginaInicial" => "885"
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                          0 => array:2 [
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                        "paginaFinal" => "99"
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                      "titulo" => "Assessment of fatigue in rheumatoid arthritis and its relation to pain and disease activity measures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;A&#46; Abdel-Magied"
                            1 => "A&#46; Lotfi"
                            2 => "F&#46; Ali"
                            3 => "M&#46; Hamdy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Egypt Rheumatol Rehabil"
                        "fecha" => "2015"
                        "volumen" => "42"
                        "paginaInicial" => "178"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2010 rheumatoid arthritis classification criteria&#58; an American College of Rheumatology&#47;European League Against Rheumatism collaborative initiative"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Aletaha"
                            1 => "T&#46; Neogi"
                            2 => "A&#46;J&#46; Silman"
                            3 => "J&#46; Funovits"
                            4 => "D&#46;T&#46; Felson"
                            5 => "C&#46;O&#46; Bingham 3rd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.27584"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2010"
                        "volumen" => "62"
                        "paginaInicial" => "2569"
                        "paginaFinal" => "2581"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20872595"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "AB0365 sleep disorders in Moroccan patients with rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Lakhdar"
                            1 => "F&#46; Allali"
                            2 => "L&#46; Medrare"
                            3 => "S&#46; El Kabbaj"
                            4 => "I&#46; Ben Slama"
                            5 => "A&#46; Ngeuleu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2014"
                        "volumen" => "73"
                        "numero" => "Suppl&#46; 2"
                        "paginaInicial" => "925LP"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Arabic version of the Major Depression Inventory as a diagnostic tool&#58; reliability and concurrent and discriminant validity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;H&#46; Fawzi"
                            1 => "M&#46;M&#46; Fawzi"
                            2 => "W&#46; Abu-Hindi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.26719/2012.18.4.304"
                      "Revista" => array:6 [
                        "tituloSerie" => "East Mediterr Health J"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "304"
                        "paginaFinal" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22768690"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fatigue and severity of rheumatoid arthritis in Moroccan patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Ibn Yacoub"
                            1 => "B&#46; Amine"
                            2 => "A&#46; Laatiris"
                            3 => "F&#46; Wafki"
                            4 => "F&#46; Znat"
                            5 => "N&#46; Hajjaj-Hassouni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00296-011-1876-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "2012"
                        "volumen" => "32"
                        "paginaInicial" => "1901"
                        "paginaFinal" => "1907"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21448644"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of fatigue correlates in rheumatoid arthritis and osteoarthritis&#58; disparity in associations with disability&#44; anxiety and sleep disturbance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Stebbings"
                            1 => "P&#46; Herbison"
                            2 => "T&#46;C&#46;H&#46; Doyle"
                            3 => "G&#46;J&#46; Treharne"
                            4 => "J&#46; Highton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/kep367"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology"
                        "fecha" => "2009"
                        "volumen" => "49"
                        "paginaInicial" => "361"
                        "paginaFinal" => "367"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20007746"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improvement of fatigue in patients with rheumatoid arthritis treated with biologics&#58; relationship with sleep disorders&#44; depression and clinical efficacy&#46; A prospective&#44; multicentre study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Genty"
                            1 => "B&#46; Combe"
                            2 => "M&#46; Kostine"
                            3 => "E&#46; Ardouin"
                            4 => "J&#46; Morel"
                            5 => "C&#46; Lukas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2017"
                        "volumen" => "35"
                        "paginaInicial" => "85"
                        "paginaFinal" => "92"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28967370"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-reported fatigue and its impact on patients with systemic lupus erythematosus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Sterling"
                            1 => "K&#46; Gallop"
                            2 => "P&#46; Swinburn"
                            3 => "E&#46; Flood"
                            4 => "A&#46; French"
                            5 => "S&#46; Al Sawah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0961203313511554"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lupus"
                        "fecha" => "2014"
                        "volumen" => "23"
                        "paginaInicial" => "124"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24197552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fibromyalgia&#58; a clinical review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;J&#46; Clauw"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2014.3266"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2014"
                        "volumen" => "311"
                        "paginaInicial" => "1547"
                        "paginaFinal" => "1555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24737367"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "24"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fatigue in rheumatoid arthritis&#59; a persistent problem&#58; a large longitudinal study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;W&#46; van Steenbergen"
                            1 => "R&#46; Tsonaka"
                            2 => "T&#46;W&#46;J&#46; Huizinga"
                            3 => "A&#46; Boonen"
                            4 => "A&#46;H&#46;M&#46; van der Helm-van"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/rmdopen-2014-000041"
                      "Revista" => array:5 [
                        "tituloSerie" => "RMD Open"
                        "fecha" => "2015"
                        "volumen" => "1"
                        "paginaInicial" => "e000041"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26509063"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of fatigue in rheumatoid arthritis patients in remission or in a low disease activity state"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;L&#46; Olsen"
                            1 => "E&#46; Lie"
                            2 => "T&#46;K&#46; Kvien"
                            3 => "H&#46;A&#46; Zangi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Care Res &#40;Hoboken&#41;"
                        "fecha" => "2016"
                        "volumen" => "68"
                        "paginaInicial" => "1043"
                        "paginaFinal" => "1048"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Can rheumatoid arthritis affect sleep in Egyptian patients&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;I&#46;A&#46; Elazeem"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Egypt Rheumatol"
                        "fecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0280"
              "etiqueta" => "27"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Sleep quality in rheumatoid arthritis&#58; relationship between the disease severity&#44; depression&#44; functional status and the quality of life"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "M&#46; Bozkurt"
                            3 => "Y&#46; Bez"
                            4 => "M&#46;G&#46; Cetincakmak"
                            5 => "L&#46; Yazmalar"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4021/jocmr1648w"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Med Res"
                        "fecha" => "2014"
                        "volumen" => "6"
                        "paginaInicial" => "44"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24400031"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "The contribution of pain and depression to self-reported sleep disturbance in patients with rheumatoid arthritis"
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                            2 => "M&#46; Kay"
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                            4 => "M&#46;R&#46; Irwin"
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                        "volumen" => "153"
                        "paginaInicial" => "107"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22051047"
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                ]
              ]
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                      "titulo" => "Fatigue in older adults&#58; an early indicator of the aging process&#63;"
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                          "etal" => false
                          "autores" => array:1 [
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                        "tituloSerie" => "Aging Clin Exp Res"
                        "fecha" => "2010"
                        "volumen" => "22"
                        "paginaInicial" => "100"
                        "paginaFinal" => "115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20440097"
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