Stress Management in Borderline Hypertension

Roll 138. Annette & Phyllis O'Callaghan. Image 14 of 22. (June, 1954) [PHO 1.138.20]The Boleslaus Lukaszewski (Father Luke) Photographs contain more than 28,000 images of Saint Louis University people, activities, and events between 1951 and 1970. The photographs were taken by Boleslaus Lukaszewski (Father Luke), a Jesuit priest and member of the University's Philosophy Department faculty

Emotional valence and arousal affect reading in an interactive way: neuroimaging evidence for an approach-withdrawal framework

A growing body of literature shows that the emotional content of verbal material affects reading, wherein emotional words are given processing priority compared to neutral words. Human emotions can be conceptualised within a two-dimensional model comprised of emotional valence and arousal (intensity). These variables are at least in part distinct, but recent studies report interactive effects during implicit emotion processing and relate these to stimulus-evoked approach-withdrawal tendencies. The aim of the present study was to explore how valence and arousal interact at the neural level, during implicit emotion word processing. The emotional attributes of written word stimuli were orthogonally manipulated based on behavioural ratings from a corpus of emotion words. Stimuli were presented during an fMRI experiment while 16 participants performed a lexical decision task, which did not require explicit evaluation of a word's emotional content. Results showed greater neural activation within right insular cortex in response to stimuli evoking conflicting approach-withdrawal tendencies (i.e., positive high-arousal and negative low-arousal words) compared to stimuli evoking congruent approach vs. withdrawal tendencies (i.e., positive low-arousal and negative high-arousal words). Further, a significant cluster of activation in the left extra-striate cortex was found in response to emotional than neutral words, suggesting enhanced perceptual processing of emotionally salient stimuli. These findings support an interactive two-dimensional approach to the study of emotion word recognition and suggest that the integration of valence and arousal dimensions recruits a brain region associated with interoception, emotional awareness and sympathetic functions

Experience with telemedicine among rheumatology clinicians during the COVID-19 pandemic: an international survey

Objective: The aim was to assess rheumatology clinicians' perceptions of telemedicine and their experiences before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted a cross-sectional online survey and collected responses from rheumatology clinicians worldwide, between November 2020 and February 2021, regarding use and perceptions of telemedicine in rheumatology. We summarized data with descriptive statistics and qualitative analysis for free-text responses. Results: The survey was completed by 349 rheumatology clinicians from 49 countries; 59% were female and about two-thirds were in the 30-50 years age group. Academic affiliations were held by 55% of participants, and 44% were from North America. Before the pandemic, 24% of participants had experience with telemedicine, whereas about three-quarters used telemedicine for the first time during the pandemic. Overall, 56% thought they provided less adequate care with telemedicine. More than half of clinicians felt that telemedicine was adequate for evaluating crystalline arthritis, inflammatory arthritis and lupus flares. Telemedicine was felt to be inadequate for flares of myositis, vasculitis and scleroderma. Technical problems were reported in 29% of telemedicine encounters and were most commonly related to patient-encountered difficulties. Conclusion: Most rheumatology clinicians used telemedicine for the first time during the pandemic. The quality of care provided was thought to be inferior to that provided in person for specific clinical situations. Additional efforts are needed to address barriers to effective telemedicine, such as patient-related technology issues, challenges with building rapport and performing a physical examination, and to define the appropriate scope of clinical scenarios conducive to telemedicine

SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease : Results from the COVID-19 Global Rheumatology Alliance provider registry

Funding Information: members of the COVID-19 Global Rheumatology Alliance and do not necessarily represent the views of the American College of Rheumatology (ACR), EULAR, the UK National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health or any other organisation. Competing interests KLH reports she has received non-personal speaker’s fees from AbbVie and grant income from BMS, UCB and Pfizer, all unrelated to this manuscript; KLH is supported by the NIHR Manchester Biomedical Research Centre. LG reports personal consultant fees from AbbVie, Amgen, BMS, Biogen, Celgene, Gilead, Janssen, Lilly, Novartis, Pfizer, Samsung Bioepis, Sanofi-Aventis and UCB, and grants from Amgen, Lilly, Janssen, Pfizer, Sandoz, Sanofi and Galapagos, all unrelated to this manuscript. AS reports research grants from a consortium of 14 companies (among them AbbVie, BMS, Celltrion, Fresenius Funding Information: Kabi, Gilead/Galapagos, Lilly, Mylan/Viatris, Hexal, MSD, Pfizer, Roche, Samsung, Sanofi-Aventis and UCB) supporting the German RABBIT register and personal fees from lectures for AbbVie, MSD, Roche, BMS, Lilly and Pfizer, all unrelated to this manuscript. LC has not received fees or personal grants from any laboratory, but her institute works by contract for laboratories among other institutions, such as AbbVie Spain, Eisai, Gebro Pharma, Merck Sharp & Dohme España, Novartis Farmaceutica, Pfizer, Roche Farma, Sanofi-Aventis, Astellas Pharma, Actelion Pharmaceuticals España, Grünenthal and UCB Pharma. EF-M reports personal consultant fees from Boehringer Ingelheim Portugal and that LPCDR received support for specific activities: grants from AbbVie, Novartis, Janssen-Cilag, Lilly Portugal, Sanofi, Grünenthal, MSD, Celgene, Medac, Pharmakern and GAfPA; grants and non-financial support from Pfizer; and non-financial support from Grünenthal, outside the submitted work. IB reports personal consultant fees from AbbVie, Novartis, Pfizer and Janssen, all unrelated to this manuscript. JZ reports speaker fees from AbbVie, Novartis and Janssen/Johnson & Johnson, all unrelated to this manuscript. GR-C reports personal consultant fees from Eli Lilly and Novartis, all unrelated to this manuscript. JS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers: R01 AR077607, P30 AR070253 and P30 AR072577), and the R Bruce and Joan M Mickey Research Scholar Fund. JS has received research support from Amgen and Bristol Myers Squibb and performed consultancy for Bristol Myers Squibb, Gilead, Inova, Janssen and Optum, unrelated to this work. LW receives speaker’s bureau fees from Aurinia Pharma, unrelated to this manuscript. SB reports no competing interests related to this work. He reports non-branded consulting fees for AbbVie, Horizon and Novartis (all <$10 000). MGM has no competing interests related to this work. She serves as a patient consultant for BMS, BI JNJ and Aurinia (all <$10 000). RG reports no competing interests related to this work. Outside of this work she reports personal and/or speaking fees from AbbVie, Janssen, Novartis, Pfizer and Cornerstones and travel assistance from Pfizer (all <$10 000). JH reports no competing interests related to this work. He is supported by grants from the Rheumatology Research Foundation and has salary support from the Childhood Arthritis and Rheumatology Research Alliance. He has performed consulting for Novartis, Sobi and Biogen, all unrelated to this work (<$10 000). ESi reports non-financial support from Canadian Arthritis Patient Alliance, outside the submitted work. PS reports personal fees from the American College of Rheumatology/Wiley Publishing, outside the submitted work. ZW reports grant support from Bristol Myers Squibb and Principia/Sanofi and performed consultancy for Viela Bio and MedPace, outside the submitted work. His work is supported by grants from the National Institutes of Health. PMM has received consulting/speaker’s fees from AbbVie, BMS, Celgene, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this study. PMM is supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC). PCR reports no competing interests related to this work. Outside of this work PCR reports personal fees from AbbVie, Atom Bioscience, Eli Lilly, Gilead, GlaxoSmithKline, Janssen, Kukdong, Novartis, UCB, Roche and Pfizer; meeting attendance support from BMS, Pfizer and UCB; and grant funding from Janssen, Novartis, Pfizer and UCB Pharma (all <$10 000). JY reports no competing interests related to this work. Her work is supported by grants from the National Institutes of Health (K24 AR074534 and P30 AR070155). Outside of this work, she has received research grants or performed consulting for Gilead, BMS Foundation, Pfizer, Aurinia and AstraZeneca. Funding Information: Twitter Jean Liew @rheum_cat, Loreto Carmona @carmona_loreto, Pedro M Machado @pedrommcmachado and Philip C Robinson @philipcrobinson Contributors All authors contributed to the study design, data collection, interpretation of results and review/approval of the final submitted manuscript. JL and MG are guarantors for this manuscript. Funding MG reports grants from the National Institutes of Health, NIAMS, outside the submitted work. KLH is supported by the NIHR Manchester Biomedical Research Centre. JS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers: R01 AR077607, P30 AR070253 and P30 AR072577), and the R Bruce and Joan M Mickey Research Scholar Fund. JH is supported by grants from the Rheumatology Research Foundation. ZW is supported by grants from the National Institutes of Health. PMM is supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC). JY is supported by grants from the National Institutes of Health (K24 AR074534 and P30 AR070155). Publisher Copyright: ©Objective. While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2.  Methods. We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients' demographic and clinical characteristics and COVID-19 symptoms and outcomes. Results SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77% female, 56% white). The majority (n=140/197, 71%) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36-83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died. Conclusion. More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population.publishersversionPeer reviewe

Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases : Results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Funding Information: Competing interests SES has received funding from the Vasculitis Foundation and the Vasculitis Clinical Research Consortium unrelated to this work. JL has received research grant funding from Pfizer unrelated to this work. ES is a Board Member of the Canadian Arthritis Patient Alliance, a patient run, volunteer-based organisation whose activities are primarily supported by independent grants from pharmaceutical companies. MP was supported by a Rheumatology Research Foundation Scientist Development grant. DA-R is a Scientific Advisor for GlaxoSmithKilne unrelated to this work. FB reports personal fees from Boehringer, Bone Therapeutics, Expanscience, Galapagos, Gilead, GSK, Merck Sereno, MSD, Nordic, Novartis, Pfizer, Regulaxis, Roche, Sandoz, Sanofi, Servier, UCB, Peptinov, TRB Chemedica and 4P Pharma outside of the submitted work. No funding relevant to this manuscript. RC: speakers bureau for Janssen, Roche, Sanofi, AbbVie. KD reports no COI-unpaid volunteer president of the Autoinflammatory Alliance. Any grants or funding from pharma is received by the non-profit organisation only. CLH received funding under a sponsored research agreement unrelated to the data in the paper from Vifor Pharmaceuticals. LeK has received a research grant from Lilly unrelated to this work. AHJK participated in consulting, advisory board or speaker's bureau for Alexion Pharmaceuticals, Aurinia Pharmaceuticals, Annexon Biosciences, Exagen Diagnostics and GlaxoSmithKilne and received funding under a sponsored research agreement unrelated to the data in the paper from GlaxoSmithKline. JSingh has received consultant fees from Crealta/ Horizon, Medisys, Fidia, PK Med, Two Labs, Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM, Trio Health, Medscape, WebMD and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JSingh owns stock options in TPT Global Tech, Vaxart Pharmaceuticals and Charlotte’s Web Holdings. JSingh previously owned stock options in Amarin, Viking and Moderna Pharmaceuticals. JSingh is on the speaker’s bureau of Simply Speaking. JSingh is a member of the executive of Outcomes Measures in Rheumatology (OMERACT), an organisation that develops outcome measures in rheumatology and receives arms-length funding from eight companies. JSingh serves on the FDA Arthritis Advisory Committee. JSingh is the chair of the Veterans Affairs Rheumatology Field Advisory Committee. JSingh is the editor and the Director of the University of Alabama at Birmingham (UAB) Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. NSingh is supported by funding from the Rheumatology Research Foundation Investigator Award and the American Heart Association. MFU-G has received research support from Pfizer and Janssen, unrelated to this work. SB reports personal fees from Novartis, AbbVie, Pfizer and Horizon Pharma, outside the submitted work. RG reports personal fees from AbbVie New Zealand, Cornerstones, Janssen New Zealand and personal fees and non-financial support Pfizer New Zealand (all <US$10 000) outside the submitted work. PMM reports personal fees from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer and UCB, grants and personal fees from Orphazyme, outside the submitted work. PCR reports personal fees from AbbVie, Gilead, Lilly and Roche, grants and personal fees from Novartis, UCB Pharma, Janssen and Pfizer and non-financial support from BMS, outside the submitted work. PS reports honoraria from Social media editor for @ACR_Journals, outside the submitted work. ZSW reports grants from NIH, BMS and Principia/ Sanofi and personal fees from Viela Bio and MedPace, outside the submitted work. JY reports personal fees from Pfizer and Eli Lilly, and grants and personal fees from AstraZeneca, outside the submitted work. MJL reports grants from American College of Rheumatology, during the conduct of the study and consulting fees from AbbVie, Amgen, Actelion, Boehringer Ingelheim, BMS, Celgene, Gilead, J&J, Mallinckrodt, Novartis, Pfizer, Roche, Sandoz, Sanofi, Sobi and UCB, outside the submitted work. LGR was supported by the Intramural Research Program of the National Institute of Environmental Health Sciences (NIEHS; ZIAES101074) of the National Institutes of Health. JH reports grants from Childhood Arthritis and Rheumatology Research Alliance (CARRA) and Rheumatology Research Alliance, and personal fees from Novartis, Pfizer and Biogen, outside the submitted work. JSimard received research grant funding from the National Institutes of Health unrelated to this work (NIAMS: R01 AR077103 and NIAID R01 AI154533). JSparks has performed consultancy for AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead, Inova Diagnostics, Optum and Pfizer unrelated to this work. Funding Information: Funding This study was supported by the European Alliance of Associations for Rheumatology and American College of Rheumatology Research and Education Foundation. Dr. Lisa Rider's involvement was supported in part by the Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Background. We describe the early experiences of adults with systemic rheumatic disease who received the COVID-19 vaccine. Methods From 2 April to 30 April 2021, we conducted an online, international survey of adults with systemic rheumatic disease who received COVID-19 vaccination. We collected patient-reported data on clinician communication, beliefs and intent about discontinuing disease-modifying antirheumatic drugs (DMARDs) around the time of vaccination, and patient-reported adverse events after vaccination. Results We analysed 2860 adults with systemic rheumatic diseases who received COVID-19 vaccination (mean age 55.3 years, 86.7% female, 86.3% white). Types of COVID-19 vaccines were Pfizer-BioNTech (53.2%), Oxford/AstraZeneca (22.6%), Moderna (21.3%), Janssen/Johnson & Johnson (1.7%) and others (1.2%). The most common rheumatic disease was rheumatoid arthritis (42.3%), and 81.2% of respondents were on a DMARD. The majority (81.9%) reported communicating with clinicians about vaccination. Most (66.9%) were willing to temporarily discontinue DMARDs to improve vaccine efficacy, although many (44.3%) were concerned about rheumatic disease flares. After vaccination, the most reported patient-reported adverse events were fatigue/somnolence (33.4%), headache (27.7%), muscle/joint pains (22.8%) and fever/chills (19.9%). Rheumatic disease flares that required medication changes occurred in 4.6%. Conclusion. Among adults with systemic rheumatic disease who received COVID-19 vaccination, patient-reported adverse events were typical of those reported in the general population. Most patients were willing to temporarily discontinue DMARDs to improve vaccine efficacy. The relatively low frequency of rheumatic disease flare requiring medications was reassuring.publishersversionPeer reviewe

Prolonged COVID-19 symptom duration in people with systemic autoimmune rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

OBJECTIVE: We investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs). METHODS: We analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021-15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression. RESULTS: We identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81). CONCLUSION: Most people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs

COVID-19 vaccine perceptions and uptake: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Funding Information: MP, KK, and ES contributed equally and are co-first authors. JHS, JASp, and JFS contributed equally and are co-senior authors. The authors thank Berk Degirmenci, Christele Feliix, Shangyi Jin, Candace A Palmerlee, Andrea Peirce, Lisa G Rider, Esra Sari, Robert Tseng, and Leslie Wang for their invaluable contributions to the GRA Vax Survey. MP, KK, ES, SES, and JWL contributed to data collection, data quality control, and data analysis and interpretation. AAA, DA-R, SA, RPB, FB, IB, YPEC, RC, AD-G, ED, KLD, TAG, CLH, RH, BFH, EH, LK, AK, AHJK, DFLL, CL, EFM, BM, SM, MN, ADS, JASi, NS, MFU-G, JW, KJY, and EAZ-T, critically revised the manuscript and provided intellectual content. TTM, CH, MJL, ML, GF, and LT contributed to planning and data collection, reviewed the manuscript, and provided important intellectual content. SB, WC, RG, PMM, PCR, PS, ZSW, and JY contributed to the acquisition, analysis, and interpretation of the data. JASp, JFS, and JSH directed the work, designed the data collection methods, and contributed to the analysis and interpretation of the data. MP, KK, ES, SES, JWL, SB, WC, RG, PMM, PCR, PS, ZSW, JY, JASp, JFS, and JSH drafted and revised the manuscript critically for important intellectual content and gave final approval of the version to be published. SES, JWL, KK, JFS, and JASp had full access to the data and verify the credibility of the underlying data. All authors have read, revised, and approved this manuscript and take final responsibility for the decision to submit for publication. MP reports clinical trials participation with AbbVie and grants from Rheumatology Research Foundation, outside the submitted work. ES is a board member of the Canadian Arthritis Patient Alliance, a patient run, volunteer-based organisation whose activities are primarily supported by independent grants from pharmaceutical companies. JWL has received research grant funding from Pfizer unrelated to this work. SES reports research funding related to clinical trials from AstraZeneca (MANDARA), outside of the submitted work and is supported by the Vasculitis Clinical Research Consortium and Vasculitis Foundation outside of the submitted work. DA-R is a scientific advisor for GlaxoSmithKilne unrelated to this work. RC reports speaker fees from Janssen, Roche, Sanofi, and AbbVie, outside of the submitted work. AD-G reports grants from the Center for Disease Control and Prevention, Rheumatology Research Foundation, and Mayo Clinic, outside the submitted work. KLD is an unpaid volunteer president of the Autoinflammatory Alliance and reports grants from Novartis, Sobi, National Institutes of Health (NIH), and Horizon Bio, all received by the non-profit organisation outside of the submitted work. CLH received funding under a sponsored research agreement unrelated to the data in the paper from Vifor Pharmaceuticals. RH reports grants from AbbVie, Amgen, Boehringer Ingleheim, Johnson and Johnson, Lilly, Novartis, Pfizer, and Union Chimique Belge, all paid to Spondylitis Association of America, consultant fees from GlaxoSmithKline and Novartis, outside the submitted work. RH also owns stocks (<20 shares and representing <4% of personal investments) in AbbVie, Amgen, Bristol Myers Squibb, GlaxoSmithKline, Johnson & Johnson, Eli Lilly, Merck, Novartis, Pfizer, Teva, and Union Chimique Belge. AHJK reports personal fees from Exagen Diagnostics, Alexion Pharmaceuticals, and Aurinia Pharmaceuticals, grants from National Institutes of Health, Rheumatology Research Foundation, and Helmsley Charitable Trust, grants and personal fees from GlaxoSmithKline, outside the submitted work. EFM reports personal fees from Boehringer Ingelheim, and that Liga Portuguesa Contra as Doenças Reumaticas has received grants from AbbVie, Novartis, Lilly Portugal, Amgen Biofarmacêutica, Grünenthal, Merck Sharp & Dohme, Medac and from A Menarini Portugal–Farmacêutica; grants and non-financial support from Pfizer and Grünenthal, outside the submitted work. JASi has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two labs, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, United BioMed, Trio Health, Medscape, WebMD, and Practice Point communications; and the National Institutes of Health, and the American College of Rheumatology. JASi owns stock options in TPT Global Tech, Vaxart pharmaceuticals, and Charlotte's Web Holdings and previously owned stock options in Amarin, Viking and Moderna pharmaceuticals. JASi is on the speaker's bureau of Simply Speaking and is a member of the executive of Outcomes Measures in Rheumatology, an organisation that develops outcome measures in rheumatology and receives funding from eight companies . JASi also serves on the FDA Arthritis Advisory Committee and is the chair of the Veterans Affairs Rheumatology Field Advisory Committee. JASi is also the editor and the Director of the University of Alabama at Birmingham Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. MFU-G has received research support from Pfizer and Janssen, unrelated to this work. SB reports non-branded consulting fees from Novartis, AbbVie, Pfizer, and Horizon Pharma, outside the submitted work, and is a Pfizer employee as of September, 2021. RG reports personal fees from AbbVie New Zealand, Cornerstones, Janssen New Zealand, and Novartis, and personal fees and non-financial support Pfizer Australia (all <AU$10,000) outside the submitted work. PMM reports personal fees from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and Union Chimique Belge; and grants and personal fees from Orphazyme, outside the submitted work. PCR reports personal fees from AbbVie, Gilead, Lilly, and Roche; grants and personal fees from Novartis, Union Chimique Belge, Janssen, and Pfizer; and non-financial support from Bristol Myers Squibb, outside the submitted work. PS reports honoraria from bring the social media editor for the American College of Rheumatology journals, outside the submitted work. ZSW reports grants from NIH, Bristol Myers Squibb, and Principia/Sanofi; and personal fees from Viela Bio and MedPace, outside the submitted work. JY reports personal fees from Pfizer and Eli Lilly, and grants and personal fees from AstraZeneca, outside the submitted work. CH reports personal fees from AstraZeneca and Aurinia Pharmaceuticals, outside the submitted work. MJL reports grants from American College of Rheumatology, during the conduct of the study and consulting fees from AbbVie, Amgen, Actelion, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Gilead, Johnson and Johnson, Mallinckrodt, Novartis, Pfizer, Roche, Sandoz, Sanofi, Sobi, and Union Chimique Belge, outside the submitted work. JSH reports grants from Childhood Arthritis and Rheumatology Research Alliance and Rheumatology Research Alliance, and personal fees from Novartis, Pfizer, and Biogen, outside the submitted work. JASp reports grants from National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and R Bruce and Joan M Mickey Research Scholar Fund; and consulting fees for AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Optum, and Pfizer, unrelated to this work. JFS received research grant funding from the National Institutes of Health unrelated to this work (NIAMS R01 AR077103, and NIAID R01 AI154533). All other authors report no competing interests. This study was funded by the American College of Rheumatology (ACR). The ACR was not involved in any aspect of study design, collection, analysis, or interpretation of data, writing of the report, or the decision to submit the paper for publication. The views expressed here are those of the authors and participating members of the COVID-19 Global Rheumatology Alliance and do not necessarily represent the views of the ACR, the European Alliance of Associations for Rheumatology, the UK National Health Service, the National Institute for Health Research, or the UK Department of Health, or any other organisation. Researchers interested in performing additional analyses from survey data are invited to submit proposals through the COVID-19 Global Rheumatology Alliance at rheumcovid.org . For approved projects, we will provide summary tables and data analyses as requested. We do not currently have institutional review board approval to make the raw data available to other researchers.publishersversionpublishe

results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Funding Information: MP, KK, and ES contributed equally and are co-first authors. JHS, JASp, and JFS contributed equally and are co-senior authors. The authors thank Berk Degirmenci, Christele Feliix, Shangyi Jin, Candace A Palmerlee, Andrea Peirce, Lisa G Rider, Esra Sari, Robert Tseng, and Leslie Wang for their invaluable contributions to the GRA Vax Survey. MP, KK, ES, SES, and JWL contributed to data collection, data quality control, and data analysis and interpretation. AAA, DA-R, SA, RPB, FB, IB, YPEC, RC, AD-G, ED, KLD, TAG, CLH, RH, BFH, EH, LK, AK, AHJK, DFLL, CL, EFM, BM, SM, MN, ADS, JASi, NS, MFU-G, JW, KJY, and EAZ-T, critically revised the manuscript and provided intellectual content. TTM, CH, MJL, ML, GF, and LT contributed to planning and data collection, reviewed the manuscript, and provided important intellectual content. SB, WC, RG, PMM, PCR, PS, ZSW, and JY contributed to the acquisition, analysis, and interpretation of the data. JASp, JFS, and JSH directed the work, designed the data collection methods, and contributed to the analysis and interpretation of the data. MP, KK, ES, SES, JWL, SB, WC, RG, PMM, PCR, PS, ZSW, JY, JASp, JFS, and JSH drafted and revised the manuscript critically for important intellectual content and gave final approval of the version to be published. SES, JWL, KK, JFS, and JASp had full access to the data and verify the credibility of the underlying data. All authors have read, revised, and approved this manuscript and take final responsibility for the decision to submit for publication. MP reports clinical trials participation with AbbVie and grants from Rheumatology Research Foundation, outside the submitted work. ES is a board member of the Canadian Arthritis Patient Alliance, a patient run, volunteer-based organisation whose activities are primarily supported by independent grants from pharmaceutical companies. JWL has received research grant funding from Pfizer unrelated to this work. SES reports research funding related to clinical trials from AstraZeneca (MANDARA), outside of the submitted work and is supported by the Vasculitis Clinical Research Consortium and Vasculitis Foundation outside of the submitted work. DA-R is a scientific advisor for GlaxoSmithKilne unrelated to this work. RC reports speaker fees from Janssen, Roche, Sanofi, and AbbVie, outside of the submitted work. AD-G reports grants from the Center for Disease Control and Prevention, Rheumatology Research Foundation, and Mayo Clinic, outside the submitted work. KLD is an unpaid volunteer president of the Autoinflammatory Alliance and reports grants from Novartis, Sobi, National Institutes of Health (NIH), and Horizon Bio, all received by the non-profit organisation outside of the submitted work. CLH received funding under a sponsored research agreement unrelated to the data in the paper from Vifor Pharmaceuticals. RH reports grants from AbbVie, Amgen, Boehringer Ingleheim, Johnson and Johnson, Lilly, Novartis, Pfizer, and Union Chimique Belge, all paid to Spondylitis Association of America, consultant fees from GlaxoSmithKline and Novartis, outside the submitted work. RH also owns stocks (<20 shares and representing <4% of personal investments) in AbbVie, Amgen, Bristol Myers Squibb, GlaxoSmithKline, Johnson & Johnson, Eli Lilly, Merck, Novartis, Pfizer, Teva, and Union Chimique Belge. AHJK reports personal fees from Exagen Diagnostics, Alexion Pharmaceuticals, and Aurinia Pharmaceuticals, grants from National Institutes of Health, Rheumatology Research Foundation, and Helmsley Charitable Trust, grants and personal fees from GlaxoSmithKline, outside the submitted work. EFM reports personal fees from Boehringer Ingelheim, and that Liga Portuguesa Contra as Doenças Reumaticas has received grants from AbbVie, Novartis, Lilly Portugal, Amgen Biofarmacêutica, Grünenthal, Merck Sharp & Dohme, Medac and from A Menarini Portugal–Farmacêutica; grants and non-financial support from Pfizer and Grünenthal, outside the submitted work. JASi has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two labs, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, United BioMed, Trio Health, Medscape, WebMD, and Practice Point communications; and the National Institutes of Health, and the American College of Rheumatology. JASi owns stock options in TPT Global Tech, Vaxart pharmaceuticals, and Charlotte's Web Holdings and previously owned stock options in Amarin, Viking and Moderna pharmaceuticals. JASi is on the speaker's bureau of Simply Speaking and is a member of the executive of Outcomes Measures in Rheumatology, an organisation that develops outcome measures in rheumatology and receives funding from eight companies . JASi also serves on the FDA Arthritis Advisory Committee and is the chair of the Veterans Affairs Rheumatology Field Advisory Committee. JASi is also the editor and the Director of the University of Alabama at Birmingham Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. MFU-G has received research support from Pfizer and Janssen, unrelated to this work. SB reports non-branded consulting fees from Novartis, AbbVie, Pfizer, and Horizon Pharma, outside the submitted work, and is a Pfizer employee as of September, 2021. RG reports personal fees from AbbVie New Zealand, Cornerstones, Janssen New Zealand, and Novartis, and personal fees and non-financial support Pfizer Australia (all <AU$10,000) outside the submitted work. PMM reports personal fees from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and Union Chimique Belge; and grants and personal fees from Orphazyme, outside the submitted work. PCR reports personal fees from AbbVie, Gilead, Lilly, and Roche; grants and personal fees from Novartis, Union Chimique Belge, Janssen, and Pfizer; and non-financial support from Bristol Myers Squibb, outside the submitted work. PS reports honoraria from bring the social media editor for the American College of Rheumatology journals, outside the submitted work. ZSW reports grants from NIH, Bristol Myers Squibb, and Principia/Sanofi; and personal fees from Viela Bio and MedPace, outside the submitted work. JY reports personal fees from Pfizer and Eli Lilly, and grants and personal fees from AstraZeneca, outside the submitted work. CH reports personal fees from AstraZeneca and Aurinia Pharmaceuticals, outside the submitted work. MJL reports grants from American College of Rheumatology, during the conduct of the study and consulting fees from AbbVie, Amgen, Actelion, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Gilead, Johnson and Johnson, Mallinckrodt, Novartis, Pfizer, Roche, Sandoz, Sanofi, Sobi, and Union Chimique Belge, outside the submitted work. JSH reports grants from Childhood Arthritis and Rheumatology Research Alliance and Rheumatology Research Alliance, and personal fees from Novartis, Pfizer, and Biogen, outside the submitted work. JASp reports grants from National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and R Bruce and Joan M Mickey Research Scholar Fund; and consulting fees for AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Optum, and Pfizer, unrelated to this work. JFS received research grant funding from the National Institutes of Health unrelated to this work (NIAMS R01 AR077103, and NIAID R01 AI154533). All other authors report no competing interests. This study was funded by the American College of Rheumatology (ACR). The ACR was not involved in any aspect of study design, collection, analysis, or interpretation of data, writing of the report, or the decision to submit the paper for publication. The views expressed here are those of the authors and participating members of the COVID-19 Global Rheumatology Alliance and do not necessarily represent the views of the ACR, the European Alliance of Associations for Rheumatology, the UK National Health Service, the National Institute for Health Research, or the UK Department of Health, or any other organisation. Researchers interested in performing additional analyses from survey data are invited to submit proposals through the COVID-19 Global Rheumatology Alliance at rheumcovid.org . For approved projects, we will provide summary tables and data analyses as requested. We do not currently have institutional review board approval to make the raw data available to other researchers.publishersversionpublishe

Exposure to concentrated ambient particles does not affect vascular function in patients with coronary heart disease

BACKGROUND: Exposure to fine particulate air pollution is associated with increased cardiovascular morbidity and mortality. We previously demonstrated that exposure to dilute diesel exhaust causes vascular dysfunction in humans. OBJECTIVES: We conducted a study to determine whether exposure to ambient particulate matter causes vascular dysfunction. METHODS: Twelve male patients with stable coronary heart disease and 12 age-matched volunteers were exposed to concentrated ambient fine and ultrafine particles (CAPs) or filtered air for 2 hr using a randomized, double-blind cross-over study design. We measured peripheral vascular vasomotor and fibrinolytic function, and inflammatory variables—including circulating leukocytes, serum C-reactive protein, and exhaled breath 8-isoprostane and nitrotyrosine—6–8 hr after both exposures. RESULTS: Particulate concentrations (mean ± SE) in the exposure chamber (190 ± 37 μg/m(3)) were higher than ambient levels (31 ± 8 μg/m(3)) and levels in filtered air (0.5 ± 0.4 μg/m(3); p < 0.001). Chemical analysis of CAPs identified low levels of elemental carbon. Exhaled breath 8-isoprostane concentrations increased after exposure to CAPs (16.9 ± 8.5 vs. 4.9 ± 1.2 pg/mL, p < 0.05), but markers of systemic inflammation were largely unchanged. Although there was a dose-dependent increase in blood flow and plasma tissue plasminogen activator release (p < 0.001 for all), CAPs exposure had no effect on vascular function in either group. CONCLUSIONS: Despite achieving marked increases in particulate matter, exposure to CAPs—low in combustion-derived particles—did not affect vasomotor or fibrinolytic function in either middle-aged healthy volunteers or patients with coronary heart disease. These findings contrast with previous exposures to dilute diesel exhaust and highlight the importance of particle composition in determining the vascular effects of particulate matter in humans