Shaping the future of our training

Peer reviewedPublisher PD

Introducing mobile fracture prevention services with DXA in Northern Scotland : A comparative study of three rural communities

The authors would like to thank the Grampian Osteoporosis Trust for funding the purchase of the mobile DXA scanner and the set-up costs of the service, and the University of Aberdeen Development Trust for funding the project evaluation.Peer reviewedPostprin

Risk of severe COVID-19 in patients with inflammatory rheumatic diseases treated with immunosuppressive therapy in Scotland

Objective: To investigate the association of severe coronavirus disease 2019 (COVID-19) in patients with inflammatory rheumatic diseases (IRDs) treated with immunosuppressive drugs. Method: A list of 4633 patients on targeted – biological or targeted synthetic – DMARDs in March 2020 was linked to a case– control study that includes all cases of COVID-19 in Scotland. Results: By 22 November 2021, 433 of the 4633 patients treated with targeted DMARDS had been diagnosed with COVID-19, of whom 58 had been hospitalized. With all those in the population not on DMARDs as the reference category, the rate ratio for hospitalized COVID-19 associated with DMARD treatment was 2.14 [95% confidence interval (CI) 2.02–2.26] in those on conventional synthetic (cs) DMARDs, 2.01 (95% CI 1.38–2.91) in those on tumour necrosis factor (TNF) inhibitors as the only targeted agent, and 3.83 (95% CI 2.65–5.56) in those on other targeted DMARDs. Among those on csDMARDs, rate ratios for hospitalized COVID-19 were lowest at 1.66 (95% CI 1.51–1.82) in those on methotrexate and highest at 5.4 (95% CI 4.4–6.7) in those on glucocorticoids at an average dose > 10 mg/day prednisolone equivalent. Conclusion: The risk of hospitalized COVID-19 is elevated in IRD patients treated with immunosuppressive drugs compared with the general population. Of these drugs, methotrexate, hydroxychloroquine, and TNF inhibitors carry the lowest risk. The highest risk is associated with prednisolone. A larger study is needed to estimate reliably the risks associated with each class of targeted DMAR

Stratified glucocorticoid monotherapy is safe and effective for most cases of giant cell arteritis

Funding: We are grateful to Versus Arthritis (grant 12159) for supporting our work.Peer reviewedPublisher PD

Simulated Casualties and Medics for Emergency Training

The MediSim system extends virtual environment technology to allow medical personnel to interact with and train on simulated casualties. The casualty model employs a three-dimensional animated human body that displays appropriate physical and behavioral responses to injury and/or treatment. Medical corpsmen behaviors were developed to allow the actions of simulated medical personnel to conform to both military practice and medical protocols during patient assessment and stabilization. A trainee may initiate medic actions through a mouse and menu interface; a VR interface has also been created by Stansfield\u27s research group at Sandia National Labs

The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms : the CONTAIN study

Funding This work was supported by Versus Arthritis [Grant Number: 20748] and the British Society for Rheumatology. The funding for the original studies included were from Versus Arthritis (MAmMOTH) and the British Society for Rheumatology (BSRBR-AS and BSR-PsA). Daniel Whibley is supported by a Versus Arthritis Foundation Fellowship [Grant Number 21742] Acknowledgements We are grateful to help from staff at the National Ankylosing Spondylitis Society and specifically to patient partners Lynne Laidlaw (for help with designing questionnaire) and Susan Davis (for commenting on the manuscript). The authors do not report any conflicts of interest. GJM conceived the idea for the study and all authors were involved in the detailed planning. MH, KK, EM-B and MB were responsible for obtaining ethics and research governance approvals. MB undertook the analysis which was independently verified by GTJ. GJM, with input from MB, drafted the manuscript, and all authors contributed important intellectual content via written comments. We thank Linda Dean for comments on the manuscript. Data Availability Statement The data within the article which relate to the collection of BSR register data are owned by the BSR – access to these data are subject to application being made to the BSR: Registers (rheumatology.org.uk) . For other data in the article, application can be made for access to the data by contacting the corresponding author.Peer reviewedPublisher PD

Hypoxia Sensitive Metal β-Ketoiminate Complexes Showing Induced Single Strand DNA Breaks and Cancer Cell Death by Apoptosis

A series of ruthenium and iridium complexes have been synthesised and characterised with 20 novel crystal structures discussed. The library of β-ketoiminate complexes has been shown to be active against MCF-7 (human breast carcino-ma), HT-29 (human colon carcinoma), A2780 (human ovarian carcinoma) and A2780cis (cisplatin resistant human ovarian carcinoma) cell lines, with selected complexes being more than three times as active as cisplatin against the A2780cis cell line. Complexes have also been shown to be highly active under hypoxic conditions, with the activities of some complexes increasing with a decrease in O2 concentration. The enzyme thioredoxin reductase is over-expressed in cancer cells and complexes reported herein have the advantage of inhibiting this enzyme, with IC50 values measured in the nanomolar range. The anti-cancer activity of these complexes was further investigated to determine whether activity is due to effects on cellular growth or cell survival. The complexes were found to induce significant cancer cell death by apoptosis with levels induced correlating closely with activity in chemosensitivity studies. As a possible cause of cell death, the ability of the complexes to induce damage to cellular DNA was also assessed. The complexes failed to induce double strand DNA break or DNA crosslinking but induced significant levels of single DNA strand breaks indi-cating a different mechanism of action to cisplatin

Search for solar bosonic dark matter annual modulation with COSINE-100

We present results from a search for solar bosonic dark matter using the annual modulation method with the COSINE-100 experiment. The results were interpreted considering three dark sector bosons models: solar dark photon; DFSZ and KSVZ solar axion; and Kaluza-Klein solar axion. No modulation signal that is compatible with the expected from the models was found from a data-set of 2.82 yr, using 61.3 kg of NaI(Tl) crystals. Therefore, we set a 90$\%$ confidence level upper limits for each of the three models studied. For the solar dark photon model, the most stringent mixing parameter upper limit is $1.61 \times 10^{-14}$ for dark photons with a mass of 215 eV. For the DFSZ and KSVZ solar axion, and the Kaluza-Klein axion models, the upper limits exclude axion-electron couplings, $g_{ae}$, above $1.61 \times 10^{-11}$ for axion mass below 0.2 keV; and axion-photon couplings, $g_{a\gamma\gamma}$, above $1.83 \times 10^{-11}$ GeV$^{-1}$ for an axion number density of $4.07 \times 10^{13}$ cm$^{-3}$. This is the first experimental search for solar dark photons and DFSZ and KSVZ solar axions using the annual modulation method. The lower background, higher light yield and reduced threshold of NaI(Tl) crystals of the future COSINE-200 experiment are expected to enhance the sensitivity of the analysis shown in this paper. We show the sensitivities for the three models studied, considering the same search method with COSINE-200.Comment: 13 pages, 16 figure