tbuckley/cabot-search huggingface dataset:
THU0235 Ankylosing spondylitis and rheumatoid arthritis hospitalisation trends in the us: data from national inpatient sample
Authors: P. Karmacharya, P. Shrestha, R. Dhital, D.R. Poudel
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Ankylosing spondylitis (AS) imposes significant morbidity and disability in the affected population. Hospitalisation trends provide an insight as to burden of disease and long-term data is lacking. We evaluated AS related hospitalisation trends in the US from 2001–13, comparing it to the more common inflammatory arthritis- rheumatoid arthritis (RA). <h3>Objectives</h3> To evaluate AS related hospitalisation trends in the US in comparision to the more common inflammatory arthritis- RA <h3>Methods</h3> Using the Nationwide Inpatient Sample (NIS) data from 2009–2011, we identified patients≥18 years with AS and RA at primary diagnosis positions based on ICD-9 codes 720.0 and 714.0, 714.2, 714.30–714.33 respectively. We also excluded patients with psoriatic arthritis and inflammatory bowel disease to improve the specificity of codes used. We used the trend weight (contained in the variable TRENDWT) supplied by HCUP to study the annual trends of hospitalizations in AS and RA (2001–13). We used Stata version 13.0 (College Station, TX) and Joinpoint regression analysis software to calculate yearly trends. <h3>Results</h3> NIS database from 2001–2013 contained 36 883 (weighted count, n=175,356) patients with RA and 1377 (weighted count- 6,554) patients with AS. A decreasing trend in AS and RA hospitalizations was noted with an annual percentage change (APC) of 5.35 and 4.28 respectively (p&lt;0.05) (table 1 and figure 1). <h3>Conclusions</h3> While recent studies have shown a rise in incidence of AS, the hospitalisation rates have declined similar to RA. Our study findings may reflect increased recognition of inflammatory back pain in the primary care setting and prompt referral and diagnosis due to improved imaging techniques of the spine and pelvis. Furthermore, the use of biologics, such as TNF and IL-6 inhibitors have significantly improved outcomes. <h3>Disclosure of Interest</h3> None declared
FRI0602 Eular ‘points to consider’ for the conduction of workforce requirement studies in rheumatology
Authors: C. Dejaco, P. Putrik, J. Unger, D. Aletaha, G. Bianchi, J.W. Bijlsma, A. Boonen, N. Cikes, A. Finckh, L. Gossec, T.K. Kvien, J. Madruga Dias, E. Matteson, F. Sivera, T. Stamm, Z. Szekanecz, D. Wiek, A. Zink, S. Ramiro, F. Buttgereit
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> EULAR has developed several recommendations and strategies for early referral, diagnosis and treatment of rheumatic diseases. These strategies, however, can only be implemented if sufficient manpower is available. An estimation of how many rheumatologists are needed to meet current and future population needs must be provided in order to counsel health care planners and decision makers. Current methods used for forecasting manpower are disparate, as are the variables incorporated into workforce projection models. Consequently, projections for the need of rheumatologists may vary by a factor of five between studies.(<sup>1</sup> <h3>Objectives</h3> The aim of this project was to develop EULAR points to consider on the methodology of future workforce calculation models for rheumatologists in order to produce reliable, standardised and realistic estimates. <h3>Methods</h3> The EULAR Standardised Operating Procedures were followed. A systematic literature review (SLR) was conducted to retrieve workforce models in rheumatology and other specialities. The task force consisted of 20 experts (rheumatologists, health professionals and representatives from PARE) from 11 EULAR countries and the USA. Points to consider were based on expert opinion informed by the SLR, followed by group discussions with consensus obtained through informal voting. The level of agreement with the recommendations was voted anonymously. <h3>Results</h3> A total of 10 points to consider were formulated (table 1). The task force recommends models integrating supply (=workforce available to rheumatology), demand (=health services requested by the population) and needs (=health services that are considered appropriate to serve the population). Projections of workforce requirements should consider all factors relevant for current and future workload in and outside rheumatology patient care. Forecasts of workforce supply should consider demography and attrition of rheumatologists, as well as the effects of new developments in health care. <h3>Conclusions</h3> These are the first EULAR points to consider providing guidance on the methodology and the parameters to be applied in future national and international workforce requirement studies in rheumatology. <h3>Reference</h3> [1] Dejaco C, et al. Arthritis Care Res2016. <h3>Disclosure of Interest</h3> None declared
Abstract MP26: Obesity is Associated With Accelerated Epigenetic Aging in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Sadiya S Khan, Yinan Zheng, Laura A Colangelo, Wei Zhang, Cora E Lewis, Philip Greenland, Donald M Lloyd-Jones, Lifang Hou
Journal: Circulation (2018)

Background: Obesity is associated with increased risk of cardiovascular and other age-related diseases that may represent accelerated aging. As methylation levels in DNA change with aging, epigenetic age (EA), which integrates whole-genome methylation has emerged as a novel biomarker of aging and has been associated with mortality and age-related morbidity. Epigenetic age acceleration (EAA), is based on the residual value of 353 previously defined methylation markers regressed on chronologic age (CA), and is thus independent of CA. Therefore, we sought to examine the association of obesity and EAA in midlife. Methods: A subset of participants in the CARDIA cohort (n=1200) randomly selected (balanced on race and sex) underwent genome-wide DNA methylation profiling with the Illumina EPIC array from exam year 15 (2000-01 [age 33-45 years]) and 20 (2005-06 [38-50 years] for calculation of EAA. Body mass index (BMI) was measured at Y15 and Y20, respectively. We used linear regression to examine the association of obesity (independent variable) with EAA after adjusting for CA, race, sex, education, study center, smoking status, physical activity, and alcohol intake. Results: Participants were 52% female and 41% black and had mean BMI 28.5±6.2 kg/m 2 at Y15 and 29.2±6.4 kg/m 2 at Y20. At Y15, participants who were obese had 1.04 (0.38) years higher EAA compared to normal BMI participants (p&lt;0.01, Figure) . Similar results were observed at Y20. Results were similar when evaluating the association of BMI continuously with EAA (p&lt;0.05). Conclusions: EAA is a promising molecular biomarker of aging associated with obesity. Changes in DNA methylation may serve as an intermediate phenotype prior to the onset of age-associated pathologies related to obesity.
Combination Chemotherapy Plus Dasatinib Leads to Comparable Rates of Overall Survival and Relapse-Free Survival As Allogeneic Hematopoietic Stem Cell Transplantation in Philadelphia Positive Acute Lymphoblastic Leukemia
Authors: Jeremy Chang, Golnaz Vahdani, George Yaghmour, Kum-Ja Lee, Ashley Weissman, Mojtaba Akhtari
Journal: Blood (2018)
Everybody should have access to occupational health services
Authors: Anne Raynal, Robert Hermanns, Susan Robson, Mark Weir, Daniel Carry
Journal: BMJ (2019)

Sen’s call for the provision of high quality occupational health services and support, not only for doctors but all healthcare professionals, is laudable.1 This can be enacted only by our democratically elected representatives, who also have to balance the needs of other essential workers who contribute to our society and economy.

Calling for this service only for healthcare workers, …
THU0080 Serum irisin and myostatin levels in patients with rheumatoid arthritis
Authors: J.M.D.S. Silva, R. C. D. E. Santo, E.C. Freitas, N.F.T. Braz, É.L.M. Vieira, M. F. B. R. Guimarães, A. C. S. E. Silva, A.M. Kakehasi, R.M. Xavier
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) patients have loss of muscle mass. The balance between muscle protein synthesis and degradation is regulated by cytokines and growth factors, named myokines, such as irisin and myostatin. Myokines are mainly expressed by skeletal muscle and exert systemic effects promoting crosstalk among different tissues. Irisin increases cortical bone mass and its low levels are related to muscle atrophy and obesity[,<sup>1, 2</sup> while myostatin is a negative regulator of muscle growth and regeneration and has a direct role in osteoclastogenesis of inflammatory bone destruction[.<sup>3, 4</sup> <h3>Objectives</h3> To evaluate serum levels of irisin and myostatin and body composition of RA patients and controls. <h3>Methods</h3> 122 female patients with RA, mean age 53 years, mean disease activity score (DAS28) 4.09, mean disease duration 11.2 years and mean body mass index 27.33 kg/m<sup>2</sup> were included. 69 age and sex-matched healthy subjects were enrolled as control group. Irisin (Phoenix Pharmaceuticals) and myostatin (R and D Systems) serum levels were evaluated by ELISA. Fat mass index (FMI;Kg/m<sup>2</sup>) and appendicular lean mass index (ALMI;Kg/m<sup>2</sup>) were assessed by total body dual-energy x-ray absorptiometry. Student's t test and Spearman correlation were performed. Significance was set at p&lt;0.05. <h3>Results</h3> RA patients had decreased serum levels of irisin (25,61±8,25 <i>vs</i> 30,36±10,95 ng/ml; p&lt;0.05) and myostatin (3011,28±1271,11 <i>vs</i> 4049,08±1610,01 pg/ml; p&lt;0.05), decreased ALMI (6,09±0,88 <i>vs</i> 6,50±1,10; p&lt;0.05) and increased FMI (11,26±3,30 <i>vs</i> 9,44±2,65; p&lt;0.05), compared to controls. No correlations were observed among irisin and myostatin levels and ALMI and FMI. Of the 122 RA patients, 40 were analysed for the use of biologic medication. Serum levels of irisin and myostatin were different between RA patients treated and non-treated with biologics (table 1). <h3>Conclusions</h3> RA patients presented loss of lean mass and gain of fat mass, as well as lower irisin and myostatin serum levels, in comparison with controls. Additionally, the use of biologic medication by patients impacted on myokines serum levels. Further analyses are needed for a better comprehension of irisin and myostatin roles in RA, and to verify their correlation to other RA features. <h3>References</h3> [1] Colaianni G, et al. Proc Natl Acad Sci2015;112(39):12157–62. [2] Chang J, et al. Geriatr Gerontol Int. 2017;17(11):2266–2273. [3] Huang Z, et al. Cell Signal2011;23(9):1441–6. [4] Dankbar B, et al. Nat Med2015;21(9):1085–90. <h3>Disclosure of Interest</h3> None declared
FRI0360 Disease severity of proliferative lupus nephritis in maghrebians
Authors: F. Tamirou, N. Costedoat-Chalumeau, G. Medkouri, E. Daugas, E. Hachulla, N. Jourde-Chiche, A. Karras, V. le Guern, V. Gnemmi, M. Jadoul, F.A. Houssiau
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The negative influence of African-American ethnicity on the prognosis of lupus nephritis (LN) is well known but – to the best of our knowledge – the impact of Maghrebian ethnicity has never been evaluated, although the disease is purported to be quite prevalent and severe in North Africa. <h3>Objectives</h3> To study the influence of Maghrebian ethnicity on the clinical and pathological presentation of LN, the renal relapse rate, the renal and overall survival and the predictive value of an early proteinuria decrease for good long-term renal outcome in this population compared to native Europeans. <h3>Methods</h3> We retrospectively reviewed the files of an inception cohort of 194 patients with proliferative LN followed in 7 lupus centres belonging to three groups: Europeans living in Belgium/France (E; n=111), Maghrebians living in Europe, <i>in casu</i> Belgium/France (ME; n=43) and Maghrebians living in Morocco (MM; n=40). Baseline presentation was compared between these 3 groups but complete long-term outcome data were available only for E and ME patients. <h3>Results</h3> At presentation, clinical (gender, age, nephrotic syndrome, serum creatinine, eGFR, uP/C ratio) and pathological (ISN/RPS class) characteristics of LN did not differ between E, ME and MM patients. At one year, renal remission was met in 73%, 63% and 68% in E, ME and MM patients, respectively. Achievement of a target proteinuria below 0.7 g/day one year after treatment initiation was 76%, 63% and 68%, respectively. Nevertheless, while proteinuria measured at month 12 accurately predicted a serum creatinine value &lt;1 mg/dl at 7 years in E patients, this was not the case in the ME group, in whom serum creatinine at month 12 performed better. Renal relapses were more common in ME patients (54%) than in E patients (29%) (p&lt;0.01). Time to renal flare and to ESRD was shorter in ME patients compared to E patients (p&lt;0.0001 and p&lt;0.05, respectively) as shown in figure 1. At last follow-up, mean proteinuria, serum creatinine and eGFR did not differ between E and ME patients, nor did the percentage of patients who died or suffered from ESRD or permanent renal impairment. <h3>Conclusions</h3> Despite a similar disease profile at onset, the prognosis of LN is more severe in Maghrebians living in Europe compared to native Europeans, with a higher relapse rate and a shorter time to ESRD. <h3>Disclosure of Interest</h3> None declared
Predicting EGFR mutation status in lung adenocarcinoma on computed tomography image using deep learning
Authors: Shuo Wang, Jingyun Shi, Zhaoxiang Ye, Di Dong, Dongdong Yu, Mu Zhou, Ying Liu, Olivier Gevaert, Kun Wang, Yongbei Zhu, Hongyu Zhou, Zhenyu Liu, Jie Tian
Journal: European Respiratory Journal (2019)

Epidermal growth factor receptor (EGFR) genotyping is critical for treatment guidelines such as the use of tyrosine kinase inhibitors in lung adenocarcinoma. Conventional identification of EGFR genotype requires biopsy and sequence testing which is invasive and may suffer from the difficulty of accessing tissue samples. Here, we propose a deep learning model to predict EGFR mutation status in lung adenocarcinoma using non-invasive computed tomography (CT). We retrospectively collected data from 844 lung adenocarcinoma patients with pre-operative CT images, EGFR mutation and clinical information from two hospitals. An end-to-end deep learning model was proposed to predict the EGFR mutation status by CT scanning. By training in 14 926 CT images, the deep learning model achieved encouraging predictive performance in both the primary cohort (n=603; AUC 0.85, 95% CI 0.83–0.88) and the independent validation cohort (n=241; AUC 0.81, 95% CI 0.79–0.83), which showed significant improvement over previous studies using hand-crafted CT features or clinical characteristics (p&lt;0.001). The deep learning score demonstrated significant differences in EGFR-mutant and EGFR-wild type tumours (p&lt;0.001). Since CT is routinely used in lung cancer diagnosis, the deep learning model provides a non-invasive and easy-to-use method for EGFR mutation status prediction.
AB0316 Is there a need to relook at the cut offs of rheumatoid factor in indian population ?
Authors: V. Vasdev
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Population specific cut offs of titers of Rheumatoid Factor (RF) in diagnosis of Rheumatoid arthritis (RA) and the role of anti citrullinated peptide antibiodies (ACPA) remains unknown. <h3>Objectives</h3> To define cut offs for RF titres in diagnosis of RA in Indian population <h3>Methods</h3> RF titers of consecutive adult RA patients fulfilling <sup>ACR 1987</sup> as well as ACR/<sup>EULAR 2010</sup> criteria were compared with healthy normal and diseased non RA controls encountered in the rheumatology OPD of a tertiary care Armed forces Hospital using ROC-AUC analysis. Reclassification of disease phenotype as seropositive and seronegative RA using various the cutoffs was looked into and corresponding Anti-CCP titers in the subset of patients with RA was analysed. <h3>Results</h3> Overall 589 cases of RA (range: 18–69 years; 29.9% Females) were compared with age and sex matched 192 non RA and 51 controls. Mean (+-SE) RF titers in RA cases was 107.7 IU/L (+- 6.17) while that in non RA disease cases was 29.3 IU/L (+- 6.08) and normal healthy controls 14.7 IU/L(0.43). ROC analysis revealed a cutoff titer of 20.3 IU/L (AUC 0.705 (95% CI:0.66–0.74)) with the best combination of sensitivity and specificity for a diagnosis of RA from non RA and healthy controls. With the currently used cut offs of 60 IU/L in our centre as well as high titre RF as per ACR/<sup>EULAR 2010</sup> criteria, subjects were seropositive in 286/589 (48.5%) cases. Cutoffs of 40 IU/L and 20 IU/L led to a label of seropositivity in 322 (54.7%) and 396 (67.2%) cases respectively. Simultaneous Anti-CCP was done in 480 (81.4%) cases: 363 (75.6%) of these were positive. Using a cutoff of 60 IU/L as seropositive RA, anti CCP positivity was noted in 246/286 (86%) cases while with a cutoff of 40 IU/L and 20 IU/L it was 278/322 (86.3%) and 334/396 (84.3%) respectively. The RF titers in 117 anti-CCP negative cases was &gt;20,&gt;40 and&gt;60 IU/L in 62 (52.9%), 44 (37.6%) and 40 (34.1%) cases respectively. <h3>Conclusions</h3> For this cohort of Indian population, a cut off of 20 IU/L of RF titers has the best performance for a diagnosis of RA with an additional 18.7% cases labelled as seropositive as against the current ACR cutoffs. Anti CCP positivity also no substantially changed by using this lower cutoff. There is a need to reevaluate the population specific RF titers in conjunction with anti- CCP in Indian population. <h3>Disclosure of Interest</h3> None declared
Potential Unintended Effects of Medicare’s Bundled Payments for Care Improvement Program
Authors: Alyssa Bilinski, Laura Hatfield
Journal: JAMA (2019)

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Molecular Analysis of Plasma From Patients With ROS1-Positive NSCLC
Authors: Ibiayi Dagogo-Jack, Marguerite Rooney, Rebecca J. Nagy, Jessica J. Lin, Emily Chin, Lorin A. Ferris, Jennifer Ackil, Jochen K. Lennerz, Richard B. Lanman, Justin F. Gainor, Alice T. Shaw
Journal: Journal of Thoracic Oncology (2019)
AstraZeneca hires top US cancer doctor who resigned over undisclosed pharma links
Authors: Owen Dyer
Journal: BMJ (2019)

Leading US breast cancer expert Jose Baselga, who resigned four months ago as chief medical officer at one of America’s best known cancer hospitals after reports that he failed to disclose industry links in dozens of research articles, has been hired to lead the oncology research efforts of the UK based pharmaceutical company AstraZeneca, one of the companies to which he was linked.

Baselga resigned as physician-in-chief and left Memorial Sloan Kettering Cancer Center in New York City in September after an investigation by the New York Times and ProPublica showed that …
Chidamide, Decitabine, Cytarabine, Aclarubicin, and Granulocyte Colony-Stimulating Factor (CDCAG) in Adults with Relapsed/Refractory Acute Myeloid Leukemia: Final Results from a Phase 1/2 Study
Authors: Lixin Wang, Guofeng Chen, Jianliang Shen, Jianmin Luo, Meiyun Fang, Xudong Wei, Yinghua Li, Zhuogang Liu, Yin Zhang, Sujun Gao, Xin Wang, Xiaoning Gao, Wei Zhou, Yigai Ma, Hui Liu, Xinquan Li, Linhua Yang, Li Yu
Journal: Blood (2018)
SP0021 How to assess dactylitis+demo
Authors: E. Naredo
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Dactylitis is a hallmark feature of psoriatic arthritis (PsA) and other spondyloarthritis, although it can also be present in other conditions such as sarcoidosis, gout or infections. Regarding PsA, dactylitis, which occurs in 30% to 50% of patients, is a highly discriminative feature for PsA diagnosis in early disease as well as a predictor factor for structural damage development. On ultrasound, dactylitis is a complex and heterogeneous "imaging syndrome" that includes a variey of elementary lesions, i.e. enthesitis (finger extensor tendon, collateral ligaments, flexor fibrous sheaths, flexor pulleys, functional entheses), tenosynovitis, paratenonitis, synovitis, subcutaneous/peritendon tissue inflammation, and proliferative and erosive bone changes. High resolution B-mode ultrasound offers a detailed anatomical imaging of the different lesions present in dactylitis as well as Doppler ultrasound provides information on the inflammatory activity of the involved structures and tissues. <h3>Disclosure of Interest</h3> None declared