Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity

COVID-19; Severe acute respiratory syndrome; Data setCOVID-19; Síndrome respiratorio agudo severo; Conjunto de datosCOVID-19; Síndrome respiratòria aguda severa; Conjunt de dadesBackground and Objectives Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed. Methods Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5,648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to intensive care unit [ICU], requiring artificial ventilation, and death) were assessed using multilevel mixed-effects ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were individually compared with glatiramer acetate, and anti-CD20 DMTs with pooled other DMTs and with natalizumab. Results Of 5,648 patients, 922 (16.6%) with suspected and 4,646 (83.4%) with confirmed COVID-19 were included. Male sex, older age, progressive MS, and higher disability were associated with more severe COVID-19. Compared with glatiramer acetate, ocrelizumab and rituximab were associated with higher probabilities of hospitalization (4% [95% CI 1–7] and 7% [95% CI 4–11]), ICU/artificial ventilation (2% [95% CI 0–4] and 4% [95% CI 2–6]), and death (1% [95% CI 0–2] and 2% [95% CI 1–4]) (predicted marginal effects). Untreated patients had 5% (95% CI 2–8), 3% (95% CI 1–5), and 1% (95% CI 0–3) higher probabilities of the 3 respective levels of COVID-19 severity than glatiramer acetate. Compared with pooled other DMTs and with natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. All associations persisted/enhanced on restriction to confirmed COVID-19. Discussion Analyzing the largest international real-world data set of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab), as well as male sex, older age, progressive MS, and higher disability are associated with more severe course of COVID-19.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: the operational costs linked to this study are funded by the Multiple Sclerosis International Federation (MSIF) and the Multiple Sclerosis Data Alliance (MSDA), acting under the umbrella of the European Charcot Foundation (ECF). The MSDA receives income from a range of corporate sponsors, recently including Biogen, Bristol-Myers Squibb (formerly Celgene), Canopy Growth Corporation, Genzyme, Icometrix, Merck, Mylan, Novartis, QMENTA, Quanterix, and Roche. MSIF receives income from a range of corporate sponsors, recently including Biogen, Bristol-Myers Squibb (formerly Celgene), Genzyme, Med-Day, Merck, Mylan, Novartis, and Roche. This work was supported by the Flemish Government under the Onderzoeksprogramma Artificiële Intelligentie (AI) Vlaanderen programme and the Research Foundation Fladers (FWO) for ELIXIR Belgium—Flanders (FWO) for ELIXIR Belgium. The central platform was provided by QMENTA, and the computational resources used in this work were provided by Amazon. The statistical analysis was carried out at CORe, The University of Melbourne, with support from NHMRC (1129189 and 1140766)

Driving pressure during general anesthesia for open abdominal surgery (DESIGNATION) : study protocol of a randomized clinical trial

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index <= 40 kg/m(2), scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which Delta P is lowest. In both groups of the trial, V-T is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events. Discussion DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery

The stellar-to-halo mass relation of GAMA galaxies from 100 deg2of KiDS weak lensing data

We study the stellar-to-halo mass relation of central galaxies in the range 9.7 5 × 1010h-2M&sun;, the stellar mass increases with halo mass as ˜ {}M_h^{0.25}. The ratio of dark matter to stellar mass has a minimum at a halo mass of 8 × 1011h-1M&sun; with a value of M_h/M_*=56_{-10}^{+16} [h]. We also use the GAMA group catalogue to select centrals and satellites in groups with five or more members, which trace regions in space where the local matter density is higher than average, and determine for the first time the stellar-to-halo mass relation in these denser environments. We find no significant differences compared to the relation from the full sample, which suggests that the stellar-to-halo mass relation does not vary strongly with local density. Furthermore, we find that the stellar-to-halo mass relation of central galaxies can also be obtained by modelling the lensing signal and stellar mass function of satellite galaxies only, which shows that the assumptions to model the satellite contribution in the halo model do not significantly bias the stellar-to-halo mass relation. Finally, we show that the combination of weak lensing with the stellar mass function can be used to test the purity of group catalogues

KiDS+GAMA:The weak lensing calibrated stellar-to-halo mass relation of central and satellite galaxies

We simultaneously present constraints on the stellar-to-halo mass relation for central and satellite galaxies through a weak lensing analysis of spectroscopically classified galaxies. Using overlapping data from the fourth data release of the Kilo-Degree Survey (KiDS), and the Galaxy And Mass Assembly survey (GAMA), we find that satellite galaxies are hosted by halo masses that are $0.53 \pm 0.39$ dex (68\% confidence, $3\sigma$ detection) smaller than those of central galaxies of the same stellar mass (for a stellar mass of $\log(M_{\star}/M_{\odot}) = 10.6$). This is consistent with galaxy formation models, whereby infalling satellite galaxies are preferentially stripped of their dark matter. We find consistent results with similar uncertainties when comparing constraints from a standard azimuthally averaged galaxy-galaxy lensing analysis and a two-dimensional likelihood analysis of the full shear field. As the latter approach is somewhat biased due to the lens incompleteness and as it does not provide any improvement to the precision when applied to actual data, we conclude that stacked tangential shear measurements are best-suited for studies of the galaxy-halo connection.Comment: 12 pages, 10 figures, accepted for publication in A&