tbuckley/cabot-search huggingface dataset:
OP0237 EXPOSURE TO ENVIRONMENTAL AIR POLLUTANTS AS A RISK FACTOR FOR PRIMARY SJÖGREN’S SYNDROME: A POPULATION-BASED COHORT STUDY
Authors: K. S. K. MA, L. T. Wang
Journal: Annals of the Rheumatic Diseases (2021)

Background: Recent studies suggest that air pollution may play a role in autoimmune diseases. However, few of them report the correlation between air pollution and primary Sjögren’s syndrome (pSS). Objectives: We sought to determine whether people exposed to environmental fine particulate of air pollution have a higher risk of developing pSS. Methods: We performed a retrospective population-based cohort study from the National Health Insurance Research Database (NHIRD) of Taiwan’s population, using the international Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to categorize each disease diagnosis. Air pollution data on Nitric oxide (NO), methane (CH4), and carbon monoxide (CO) were obtained from the Taiwan Air Quality-Monitoring Database (TAQMD), where daily air pollution data from community-based monitoring sites (78 sites since 1993) was available on a real-time basis. We followed up from January 1st, 1998 to the endpoint of SS diagnosis or to December 31, 2011.The daily average air pollutant concentrations were divided into 4 quartile-based groups (Q1-Q4). The incidence rate, hazard ratios (HRs), as well as 95% confidence intervals for pSS, were stratified by the quartiles of air pollutant concentration, and calculated with a Cox proportional regression model. Finally, Ingenuity Systems Pathway Analysis (IPA) was conducted to identify activated pathways among air way epithelial cells exposed to airborne coarse, fine, and ultrafine particles, and parotid gland tissues from pSS patients using Z-score visualization. Results: A total of 200 patients were diagnosed with SS. The mean age of patients with pSS was 53.1 years. The incidence of pSS was 0.11%. With the increase in exposure concentrations of nitrogen dioxide, methane, and carbon monoxide (from Q1 to Q4), the incidence rate for pSS of per 1000 person-years increased from 0.7 to 1.19, from 0.93 to 2.14, and from 0.57 to 1.06, respectively. Moreover, compared with Q1, the adjusted HR in Q4 after adjusting for age, gender, monthly income and urbanization levels increased to 1.86, 2.21 and 2.04, respectively. IPA analyses suggested that the underlying cellular mechanisms involved up-regulation of chronic inflammatory pathways including fibrosis signaling pathway. Conclusion: Exposure to air pollutants, specifically NO, CH4, and CO, was associated with SS development, mostly driven by fibrotic signaling cascades occurred during chronic inflammation. Disclosure of Interests: None declared
Comparative study on the antituberculous effect and mechanism of the traditional Chinese medicines NiuBeiXiaoHe extract and JieHeWan
Authors: Li-Yao Duan, Yan Liang, Wen-Ping Gong, Yong Xue, Jie Mi, Jie Wang, Lan Wang, Zai-Xing Jia, Hong Lei, Yu-Mei Liang, Jun Liu, Yue Zheng, Xue-Qiong Wu
Journal: Military Medical Research (2021)

Abstract Background The traditional Chinese medicine NiuBeiXiaoHe (NBXH) extract and Chinese medicine preparation JieHeWan (JHW) exhibit anti-tuberculosis effects. The anti- tuberculosis effect of NBXH was compared with that of JHW to elucidate the mechanism of action of NBXH. Methods BALB/c mice aged 6-8 weeks were randomly divided into a normal control group, Tuberculosis (TB) model group, JHW treatment group, and NBXH treatment group. After 3 and 13 weeks of treatment, the therapeutic effect in each group was evaluated by comparing lung histopathology, lung and liver colony counts, the number of spots representing effector T cells secreting IFN-γ in an ELISPOT, and the levels of Th1, Th2, and Th17 cytokines, which were measured by a cytometric bead array (CBA). Mouse RNA samples were subjected to transcriptome sequencing. Results After 13 weeks of treatment, the mean histopathological lesion area of the NBXH group was significantly smaller than that of the TB model group ( P &lt; 0.05). Compared with those in the TB model group, the lung colony counts in the JHW and NBXH groups were significantly decreased ( P &lt; 0.05), and the IL-2 and IL-4 levels in the NBXH group were significantly increased ( P &lt; 0.05). NBXH partly restored significant changes in gene expression caused by Mycobacterium tuberculosis ( M. tuberculosis ) infection. According to GO and KEGG analyses, the changes in biological process (BP), cell composition (CC) and molecular function (MF) terms and in signaling pathways caused by NBXH and JHW treatment were not completely consistent, but they were mainly related to the immune response and inflammatory response in the mouse TB model. Conclusions NBXH had therapeutic effects similar to those of JHW in improving lung histopathology, reducing lung colony counts, and regulating the levels of cytokines. NBXH restored significant changes in gene expression and repaired cell damage caused by M. tuberculosis infection by regulating immune-related pathways, which clarified the mechanism of action of NBXH.
Genetically Proxied Diurnal Preference, Sleep Timing, and Risk of Major Depressive Disorder
Authors: Iyas Daghlas, Jacqueline M. Lane, Richa Saxena, Céline Vetter
Journal: JAMA Psychiatry (2021)

Morning diurnal preference is associated with reduced risk of major depressive disorder (MDD); however, causality in this association is uncertain.To examine the association of genetically proxied morning diurnal preference with depression risk using mendelian randomization.This 2-sample mendelian randomization study used summary-level genetic associations with diurnal preference and MDD. Up to 340 genetic loci associated with diurnal preference in a meta-analysis of the UK Biobank and 23andMe cohorts were considered as genetic proxies for diurnal preference. The effect size of these variants was scaled using genetic associations with accelerometer-based measurement of sleep midpoint. Genetic associations with MDD were obtained from a meta-analysis of genome-wide association studies data from the Psychiatric Genomics Consortium and UK Biobank. The inverse-variance weighted method was used to estimate the association of genetically proxied morning diurnal preference, corresponding to a 1-hour earlier sleep midpoint, with MDD risk.Morning diurnal preference scaled to a 1-hour earlier, objectively measured sleep midpoint.Risk of MDD, including self-reported and clinically diagnosed cases, as ascertained in meta-analyses of genome-wide association studies.A total of 697 828 individuals (all of European ancestry) were in the UK Biobank and 23andMe cohorts; 85 502 in the UK Biobank had measurements of the sleep midpoint. A further 170 756 individuals with MDD and 329 443 control participants (all of European ancestry) were in the Psychiatric Genomics Consortium and UK Biobank data. Genetically proxied earlier diurnal preference was associated with a 23% lower risk of depression (odds ratio [OR] per 1-hour earlier sleep midpoint, 0.77 [95% CI, 0.63-0.94]; P = .01). This association was similar when restricting analysis to individuals with MDD as stringently defined by the Psychiatric Genomics Consortium (OR, 0.73 [95% CI, 0.54-1.00]; P = .05) but not statistically significant when defined by hospital-based billing codes in the UK Biobank (OR, 0.64 [95% CI, 0.39-1.06]; P = .08). Sensitivity analyses examining potential bias due to pleiotropy or reverse causality showed similar findings (eg, intercept [SE], 0.00 [0.001]; P = .66 by Egger intercept test).The results of this mendelian randomization study support a protective association of earlier diurnal preference with risk of MDD and provide estimates contextualized to an objective sleep timing measure. Further investigation in the form of randomized clinical trials may be warranted.
AB0163 ELECTROCARDIOGRAPHIC MANIFESTATIONS IN PATIENTS WITH SEROPOSITIVE RHEUMATOID ARTHRITIS
Authors: S. Spitsina, E. Mozgovaya, A. Trofimenko, S. Bedina, M. Mamus
Journal: Annals of the Rheumatic Diseases (2021)

Background: Cardiovascular disease in rheumatoid arthritis (RA) is more common than in general population. Particular attention should be paid to cardiac dysfunction, as their timely diagnosis strongly affects the general outcome. Objectives: To assess the prevalence of arrhythmias and conduction disorders in patients with seropositive RA without clinical manifestations of coronary artery disease, as well as to determine their relationship with activity and duration of RA. Methods: The research was carried out in agreement with the WMA Declaration of Helsinki principles. 48 patients with seropositive RA were included in the study. The exclusion criteria were: age over 60 years; obesity; congenital heart defects; coronary artery disease; peripheral atherosclerosis; thyroid disease; diabetes mellitus. All patients were assessed using general physical, laboratory and instrumental survey including CBC, blood chemistry panel, as well as ECG. RA diagnosis was verified using the 2010 ACR / EULAR classification criteria. Central tendencies were expressed as mean ±SD. Results: All the included persons were women. Their average age was 50.50 ± 7.22 years, and average duration of the disease was 8.13 ± 2.34 years. All patients had articular form (without systemic manifestations) of moderate and high activity. The patients were treated with basic and NSAIDs therapy; no glucocorticoids were applied at the time of the examination. Using 12-lead ECG arrhythmias and conduction disorders were revealed in 27 (56.25%) of RA patients. Sinus rhythm deviations had the highest (31.25%) prevalence for all arrhythmias, comprising sinus tachycardias (18.75%), sinus bradycardias (6.25%), and sinus arrhythmias (6.25%). Premature beats were registered in 12.5% cases, being supraventricular and ventricular ones in equal proportions. We have found left anterior bundle branch block in 6 (12.5%) of patients. Despite absence of any angina symptoms, 9 (18.75%) of patients had myocardial repolarization disturbances, either as ST depression deeper than 0.1 mV or as negative T wave appearance, which were quite similar to silent myocardial ischemia manifestations. All the patients with these two features had RA history of more than 10 years. There was no relationship between the prevalence of the manifestations and radiographic stage of RA. Conclusion: Arrhythmias and conduction disorders are quite frequent finding in seropositive RA (56.25% and 18.75%, respectively). Their incidence and severity do not coincide exactly with the radiographic progression in joints, while their prevalence generally increases with disease duration. These data highlight the importance of additional Holter ECG monitoring in RA for revelation and treatment of silent life-threatening cardiovascular complications. Disclosure of Interests: None declared
Adjuvant Versus Early Salvage Radiation Therapy for Men at High Risk for Recurrence Following Radical Prostatectomy for Prostate Cancer and the Risk of Death
Authors: Derya Tilki, Ming-Hui Chen, Jing Wu, Hartwig Huland, Markus Graefen, Thomas Wiegel, Dirk Böhmer, Osama Mohamad, Janet E. Cowan, Felix Y. Feng, Peter R. Carroll, Bruce J. Trock, Alan W. Partin, Anthony V. D'Amico
Journal: Journal of Clinical Oncology (2021)

PURPOSE Adjuvant compared with early salvage radiation therapy (sRT) following radical prostatectomy (RP) has not been shown to reduce progression-free survival in randomized controlled trials. However, these trials might have missed a benefit in men with adverse pathology at RP given that these men were under-represented and immortal time bias might have been present; herein, we investigate this possibility. METHODS We evaluated the impact of adjuvant versus early sRT on all-cause mortality (ACM) risk in men with adverse pathology defined as positive pelvic lymph nodes (pN1) or pGleason score 8-10 prostate cancer (PC) and disease extending beyond the prostate (pT3/4). We used a treatment propensity score to minimize potential treatment selection bias when estimating the causal effect of adjuvant versus early sRT on ACM risk and a sensitivity analysis to assess the impact that varying definitions of adverse pathology had on ACM risk adjusting for age at RP, PC prognostic factors, site, and the time-dependent use of post-RP androgen deprivation therapy. RESULTS After a median follow-up (interquartile range) of 8.16 (6.00-12.10) years, of the 26,118 men in the study cohort, 2,104 (8.06%) died, of which 539 (25.62%) were from PC. After excluding men with a persistent prostate-specific antigen, adjuvant compared with early sRT was associated with a significantly lower ACM risk among men with adverse pathology at RP when men with pN1 PC were excluded (0.33 [0.13-0.85]; P = .02) or included (0.66 [0.44-0.99]; P = .04). CONCLUSION Adjuvant radiation therapy should be considered in men with pN1 or pGleason score 8 to 10 and pT3/4 PC given the possibility that a significant reduction in ACM risk exists.
Developmental bifurcation of human T follicular regulatory cells
Authors: Saumya Kumar, Válter R. Fonseca, Filipa Ribeiro, Afonso P. Basto, Ana Água-Doce, Marta Monteiro, Dikélélé Elessa, Ricardo J. Miragaia, Tomás Gomes, Eliane Piaggio, Elodie Segura, Margarida Gama-Carvalho, Sarah A. Teichmann, Luis Graca
Journal: Science Immunology (2021)

Transcriptomics supports that human T reg cells differentiate into mature lymphoid tissue or circulating T follicular regulatory cells.
Are antigenic tests useful for detecting SARS-CoV-2 infections in patients accessing to emergency departments? Results from a North-West Italy hospital
Authors: Valeria Caramello, Adriana Boccuzzi, Vittoria Basile, Anita Ferraro, Alessandra Macciotta, Alberto Catalano, Giuseppe Costa, Paolo Vineis, Carlotta Sacerdote, Fulvio Ricceri
Journal: Journal of Infection (2021)
Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19
Authors: Tahmina Nasserie, Michael Hittle, Steven N. Goodman
Journal: JAMA Network Open (2021)

Infection with COVID-19 has been associated with long-term symptoms, but the frequency, variety, and severity of these complications are not well understood. Many published commentaries have proposed plans for pandemic control that are primarily based on mortality rates among older individuals without considering long-term morbidity among individuals of all ages. Reliable estimates of such morbidity are important for patient care, prognosis, and development of public health policy.
Tackling childhood obesity in the wake of covid-19: lessons from Chile
Authors: Rosemarie R Patterson, Sangeetha Sornalingam, Max Cooper
Journal: BMJ (2021)

Modi and Hanson highlight the importance of placing the health of children at the centre of post-pandemic measures to reduce social inequality, improve population health, and promote economic recovery. 1They rightly call for policies aimed at socioeconomic determinants of health, in order to break existing structures of disadvantage.
Association between Troponin I Levels during Sepsis and Postsepsis Cardiovascular Complications
Authors: Michael A. Garcia, Justin M. Rucci, Khanh K. Thai, Yun Lu, Patricia Kipnis, Alan S. Go, Manisha Desai, Nicholas A. Bosch, Adriana Martinez, Heather Clancy, Ycar Devis, Laura C. Myers, Vincent X. Liu, Allan J. Walkey
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

Rationale: Sepsis commonly results in elevated serum troponin levels and increased risk for postsepsis cardiovascular complications; however, the association between troponin levels during sepsis and cardiovascular complications after sepsis is unclear.Objectives: To evaluate the association between serum troponin levels during sepsis and 1 year after sepsis cardiovascular events.Methods: We analyzed adults aged ⩾40 years without preexisting cardiovascular disease within 5 years, admitted with sepsis across 21 hospitals from 2011 to 2017. Peak serum troponin I levels during sepsis were grouped as normal (⩽0.04 ng/ml) or tertiles of abnormal (>0.04 to ⩽0.09 ng/ml, >0.09 to ⩽0.42 ng/ml, or >0.42 ng/ml). Multivariable adjusted cause-specific Cox proportional hazards models with death as a competing risk were used to assess associations between peak troponin I levels and a composite cardiovascular outcome (atherosclerotic cardiovascular disease, atrial fibrillation, and heart failure) in the year following sepsis. Models were adjusted for presepsis and intrasepsis factors considered potential confounders.Measurements and Main Results: Among 14,046 eligible adults with troponin I measured, 2,012 (14.3%) experienced the composite cardiovascular outcome, including 832 (10.9%) patients with normal troponin levels, as compared with 370 (17.3%), 376 (17.6%), and 434 (20.3%) patients within each sequential abnormal troponin tertile, respectively (P < 0.001). Patients within the elevated troponin tertiles had increased risks of adverse cardiovascular events (adjusted hazard ratio [aHR]troponin0.04-0.09 = 1.37; 95% confidence interval [CI], 1.20-1.55; aHRtroponin0.09-0.42 = 1.44; 95% CI, 1.27-1.63; and aHRtroponin>0.42 = 1.77; 95% CI, 1.56-2.00).Conclusions: Among patients without preexisting cardiovascular disease, troponin elevation during sepsis identified patients at increased risk for postsepsis cardiovascular complications. Strategies to mitigate cardiovascular complications among this high-risk subset of patients are warranted.
AB0389 A COMBINED RHEUMATOLOGY-OPHTHALMOLOGY CLINIC IMPROVED DIAGNOSIS AND TREATMENT OF IMMUNE-MEDIATED AND INFLAMMATORY DISEASES AMONG PATIENTS PRESENTING WITH INFLAMMATORY EYE DISEASES
Authors: A. Giollo, F. Bosello, A. Bonora, M. Rossini
Journal: Annals of the Rheumatic Diseases (2021)

Background: Patients presenting with an inflammatory eye disease may have underlying immune-mediated and inflammatory diseases (IMIDs). However, IMIDs are challenging to diagnose. A combined rheumatology-ophthalmology evaluation could enhance detection of IMIDs in this group. Objectives: To investigate whether the implementation of a combined rheumatology-ophthalmology clinic could increase the sensibility of IMIDs diagnosis. Methods: A combined rheumatology-ophthalmology clinic started in January 2020. A rheumatologist with expertise in IMIDs assessed outpatients of a tertiary care ophthalmologic clinic specialised in inflammatory eye disease consecutively referred between 01/01/20 and 31/12/20. Two separate visits confirmed both ophthalmology and rheumatology diagnoses. The same period of the year 2019 was used as a comparator. Results: We noticed a three-fold increase in the number of ophthalmology patients who underwent an evaluation with a rheumatologist in 2020 compared to 2019 (41 vs 13, +315%; Table). There were no differences in sex distribution or age between the two years. However, the median time before rheumatology assessment was shorter in 2020 than 2019 (median days 0 [range 0-6] vs 12 [range 0-91]). IMIDs diagnoses increased by 27% in 2020 compared to 2019 (29/41 vs 7/13, 71% vs 54%), mainly driven by new diagnoses of systemic vasculitis and Behcet’s disease (Figure 1). There was also an increase in diagnoses of non-IMIDs systemic conditions (3 cancers and one infection in 2020 vs none in 2019). After rheumatology evaluation, immune-modulating therapy was initiated in 18/41 (44%) vs 3/13 (23%). Ophthalmology assessment and referrals to rheumatology Referrals 2019 (n=13 ) Referrals 2020 (n=41 ) Inflammatory eye disease, n (%) 6 (46) 36 (88) Uveitis, n 6 21 Vasculitis, n 2 4 AION, n 3 5 Conjunctivitis, n 1 0 Scleritis, episcleritis, n 0 1 Other, n 1 5 Conclusion: An integrated approach with rheumatologist appeared to remarkably increase the likelihood to detect IMIDs among patients presenting with inflammatory eye diseases. Disclosure of Interests: None declared
AB0607 DO HIP STRUCTURAL ANALYSIS MEASUREMENTS PREDICT FRACTURE RISK IN PATIENTS WITH POLYMYALGIA RHEUMATICA?
Authors: R. Ark, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2021)

Background: Polymyalgia Rheumatica (PMR) is an inflammatory condition which commonly affects the elderly. Risk of fracture is higher in this group of patients compared to the general population and can lead to increased morbidity and mortality (1). Hip structural analysis (HSA) is a technique that uses dual-energy X-ray absorptiometry (DEXA) images to assess hip bone structure (2). Objectives: To identify whether HSA measurements help predict fracture in patients with PMR. Methods: Data were collected from June 2004 to October 2010 from PMR patients who had a DEXA scan at a District General Hospital. This included hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), distance from centre of femoral head to centre of femoral neck (D1) and to inter-trochanteric line (D2), mean femoral neck diameter (D3), shaft angle (A) neck/shaft angle (Θ) and proximal femur strength index (SI) and distance from centre of mass of femoral neck to superior neck margin (Y). Fracture was predicted by a series of binomial logistic regression models, adjusted for age and sex. Odds ratios with 95% confidence intervals and area under the receiver operating characteristic curve (AUC) were calculated. Results: 714 patients with PMR were identified, 182 were male and the mean age was 70.5. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y were not significant predictors of fracture in regression models; odds ratios are included in Table 1. CSA predicted fracture risk; odds ratio was 0.988 with a 95% confidence interval of 0.980-0.997. The AUC for the CSA regression model was 0.6739. Table 1. Odds ratios of fracture for different HSA parameters HSA Parameter Odds Ratio (95% confidence interval ) HAL 1.008 (0.982 - 1.035) CSMI 1.000 (0.999 - 1.000) CSA 0.988 (0.980 - 0.997) D1 1.029 (0.972 - 1.089) D2 1.010 (0.981 - 1.040) D3 1.033 (0.962 - 1.109) Y 1.087 (0.966 - 1.223) A 0.983 (0.940 - 1.029) Θ 1.007 (0.975 - 1.039) SI 0.683 (0.406 - 1.150) Conclusion: These data suggest that CSA helps predict the risk of fracture in patients with PMR. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y do not predict fracture risk. Limitations of the study are that it was retrospective and only studied patients who underwent DEXA scans. The study may have been underpowered to detect the impact of some HSA measurements on fracture risk. References: [1]Chatzigeorgiou C, Mackie SL. Comorbidity in polymyalgia rheumatica. Reumatismo. 2018; 70 1:35-43. Available from: http://eprints.whiterose.ac.uk/132109/ \\. [2]Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, et al. Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 2008; 23 (12): 1892-1904. Available from: doi: https://doi.org/10.1359/jbmr.080802 Disclosure of Interests: None declared.