IgG anti-apolipoprotein A-1 antibodies in patients with systemic lupus erythematosus are associated with disease activity and corticosteroid therapy: an observational study.

IgG anti-apolipoprotein A-1 (IgG anti-apoA-1) antibodies are present in patients with systemic lupus erythematosus (SLE) and may link inflammatory disease activity and the increased risk of developing atherosclerosis and cardiovascular disease (CVD) in these patients. We carried out a rigorous analysis of the associations between IgG anti-apoA-1 levels and disease activity, drug therapy, serology, damage, mortality and CVD events in a large British SLE cohort

Ensuring high standards of British Society for Rheumatology clinical guidelines: reflections from the coalface

Clinical guideline development by the Standards Audit Guidelines Working Group (SAGWG) is one of the most valued activities of the British Society for Rheumatology (BSR). In this article, based on a webinar [1], we reflect on our experiences of involvement in guidelines from working group membership to leadership of SAGWG to explain the process and highlight reasons why anyone can and should get involved. This editorial represents the opinion of the authors and not necessarily those of the National Health Service, National Institute for Health Research or Department of Healt

A systematic review and meta-analysis of the gonadotoxic effects of cyclophosphamide and benefits of gonadotropin releasing hormone agonists (GnRHa) in women of child-bearing age with autoimmune rheumatic disease

Objectives: To systematically review the risk of sustained amenorrhoea with intravenous (IV) cyclophosphamide in autoimmune rheumatic disease (ARD), and evaluate the efficacy of gonadotropin releasing hormone agonists (GnRHa) to reduce this risk. / Methods: Systematic search for papers reporting the incidence of sustained amenorrhoea ≥ 12 months in ARD following: IV cyclophosphamide; or GnRHa and IV cyclophosphamide compared to IV cyclophosphamide alone. / Results: From 31 articles and 1388 patients with a mean age of 27.7 years, sustained amenorrhoea occurred in 273 patients (19.7%). Of 56 patients (mean age range 23.9-25.6 years) receiving GnRHa and IV cyclophosphamide, and 37 controls (mean age range 25-30.1 years) given IV cyclophosphamide only, sustained amenorrhoea occurred in 2/56 (3.6%) patients treated with GnRHa, compared to 15/37 (40.5%) controls. Pooled odds ratio of sustained amenorrhoea with GnRHa and cyclophosphamide versus cyclophosphamide alone was 0.054 (95% CI 0.0115-0.2576 p<0.001), corresponding to a number needed to treat of 2.7 (95% CI 1.955-4.388) and absolute risk reduction of 36.95% (95% CI 35.6-38.4%). / Conclusion: Sustained amenorrhoea with IV cyclophosphamide was observed in patients with ARD, especially with increasing age and cumulative doses >5g. GnRHa reduced this risk and should be considered with IV cyclophosphamide in women of childbearing age with ARD

Magnetic properties of GdT2T_2Zn20_{20} (T = Fe, Co) investigated by X-ray diffraction and spectroscopy

We investigate the magnetic and electronic properties of the Gd$T_2$Zn$_{20}$ ($T$ = Fe and Co) compounds using X-ray resonant magnetic scattering (XRMS), X-ray absorption near-edge structure (XANES) and X-ray magnetic circular dichroism (XMCD) techniques. The XRMS measurements reveal that the GdCo$_2$Zn$_{20}$ compound has a commensurate antiferromagnetic spin structure with a magnetic propagation vector $\vec{\tau}$ = $(\frac{1}{2},\frac{1}{2},\frac{1}{2})$ below the N\'eel temperature ($T_N \sim$ 5.7 K). Only the Gd ions carry a magnetic moment forming an antiferromagnetic structure with magnetic representation $\Gamma_6$. For the ferromagnetic GdFe$_2$Zn$_{20}$ compound, an extensive investigation was performed at low temperature and under magnetic field using XANES and XMCD techniques. A strong XMCD signal of about 12.5 $\%$ and 9.7 $\%$ is observed below the Curie temperature ($T_C \sim$ 85 K) at the Gd-$L_2$ and $L_3$ edges, respectively. In addition, a small magnetic signal of about 0.06 $\%$ of the jump is recorded at the Zn $K$-edge suggesting that the Zn 4$p$ states are spin polarized by the Gd 5$d$ extended orbitals

Direct Observation of Electron Distributions Inside Millisecond Duration Electron Holes

Despite the importance of millisecond duration spatial structures [chorus wave nonlinearity or time domain structures (TDS)] to plasma dynamics, there have been no direct observations of the generation and interaction of these waves and TDS with electrons at the millisecond timescale required for their understanding. Through superposition of 0.195 ms Magnetospheric Multiscale Satellite electron measurements inside 37 superposed, millisecond duration electron holes, the first observations of electron spectra and pitch angle distributions on a submillisecond timescale have been obtained. They show that keV electrons inside the superposed electron hole are accelerated by several hundred volts and that the spectrum of electrons inside the electron hole contain several maxima and minima that are explained by a model of electron energy changes on entering the holes. We report the first observation of trapped electrons inside the TDS, in accordance with the theoretical requirement that such electrons must be present in order to form the phase space holes. Mechanisms of electron acceleration by electron holes (through perpendicular energy gain as the TDS moves into a converging magnetic field) and scattering (due to the perpendicular electric field) are discussed

The puzzle of the synthesis of the rare nuclide 138La

The calculations of the p-process in the O/Ne layers of Type II supernovae are quite successful in reproducung the solar system content of p-nuclides. They predict, however, a significant underproduction of the rare odd-odd nuclide 138La. A model for the explosion of a 25 Mo star with solar metallicity is used to suggest that electron neutrino captures on 138Ba may well be its most efficient production mechanism. The responsibility of an inadequate prediction of the 138La and 139La photodisintegration rates in the too low production of 138La is also examined quantitatively. A detailed discussion of the theoretical uncertainties in these rates suggest that the required rate changes are probably too high to be fully plausible. Their measurement would be most welcome. They would help disentangling the relative contributions of thermonuclear and neutrino processes to the 138La production.Comment: 4 pages to be published by A&A Letter

Confirmation of Parity Violation in the Gamma Decay of 180Hfm^{180}Hf^{m}

This paper reports measurements using the technique of On Line Nuclear Orientation (OLNO) which reexamine the gamma decay of isomeric $^{\rm 180}$Hf$^{\rm m}$ and specifically the 501 keV 8$^{\rm -}$ -- 6$^{\rm +}$ transition. The irregular admixture of E2 to M2/E3 multipolarity in this transition, deduced from the forward-backward asymmetry of its angular distribution, has for decades stood as the prime evidence for parity mixing in nuclear states. The experiment, based on ion implantation of the newly developed mass-separated $^{\rm 180}$Hf$^{\rm m}$ beam at ISOLDE, CERN into an iron foil maintained at millikelvin temperatures, produces higher degrees of polarization than were achieved in previous studies of this system. The value found for the E2/M2 mixing ratio, $\epsilon$ = -0.0324(16)(17), is in close agreement with the previous published average value $\epsilon$ = - 0.030(2), in full confirmation of the presence of the irregular E2 admixture in the 501 keV transition. The temperature dependence of the forward-backward asymmetry has been measured over a more extended range of nuclear polarization than previously possible, giving further evidence for parity mixing of the 8$^{\rm -}$ and 8$^{\rm +}$ levels and the deduced E2/M2 mixing ratio.Comment: 28 pages, 9 figures, accepted for publication in Physical Review

Outcomes following biosimilar TNF inhibitors use for inflammatory-mediated immune disorders in pregnancy

Background: Biosimilar tumour necrosis factor inhibitors (TNFi) are increasingly used to treat inflammatory immune-mediated disorders as they cost less than the originator biologic drug. More women are therefore becoming pregnant on biosimilar TNFi. This is the first paper to explore the safety and efficacy of biosimilar therapies in pregnancy. Methods: A retrospective review of clinical data reviewed pregnancy outcomes and inflammatory disease activity in 18 pregnancies where the mother was using a biosimilar TNFi at conception. Results: Biosimilar therapy was not associated with congenital abnormalities, preterm birth or other adverse pregnancy outcomes. Stopping biosimilar TNFi in pregnancy was associated with childbirth at an earlier gestation, as well as a flare of inflammatory disease in pregnancy or post-partum. Conclusions: Women and clinicians should feel confident in using biosimilar TNFi in early pregnancy, and continuing them through pregnancy to prevent flares in late pregnancy or the early post-partum

Kids in Communities Study (KiCS) study protocol: a cross-sectional mixed-methods approach to measuring community-level factors influencing early child development in Australia

Introduction: Healthy childhood development in the early years is critical for later adult health and well-being. Early childhood development (ECD) research has focused primarily on individual, family and school factors, but largely ignored community factors. The Kids in Communities Study (KiCS) will test and investigate community-level influences on child development across Australia. Methods and analysis: Cross-sectional mixed-methods study exploring community-level effects in 25 Australian local communities; selection based on community socioeconomic status (SES) and ECD using the Australian Early Development Census (AEDC), a population measure of child development, to create a local community 'diagonality type', that is, those performing better or worse (off-diagonal), or as expected (on-diagonal) on the AEDC relative to their SES. Data collection includes stakeholder interviews, parent and service provider focus groups, and surveys with general community residents and service providers, mapping of neighbourhood design and local amenities and services, analysis of policy documents, and the use of existing sociodemographic and early childhood education and care data. Quantitative data will be used to test associations between local community diagonality type, and ECD based on AEDC scores. Qualitative data will provide complementary and deeper exploration of these same associations. Ethics and dissemination: The Royal Children's Hospital Human Research Ethics Committee approved the study protocol (#30016). Further ethics approvals were obtained from State Education and Health departments and Catholic archdioceses where required. ECD community-level indicators will eventually be derived and made publically available. Findings will be published in peer-reviewed journals, community reports, websites and policy briefs to disseminate results to researchers, and key stakeholders including policymakers, practitioners and (most importantly) the communities involved.Sharon Goldfeld, Karen Villanueva, Robert Tanton, Ilan Katz, Sally Brinkman, Geoffrey Woolcock, Billie Giles-Cort