#Covid4Rheum: an analytical twitter study in the time of the COVID-19 pandemic

Social media services, such as Twitter, offer great potential for a better understanding of rheumatic and musculoskeletal disorders (RMDs) and improved care in the field of rheumatology. This study examined the content and stakeholders associated with the Twitter hashtag #Covid4Rheum during the COVID-19 pandemic. The content analysis shows that Twitter connects stakeholders of the rheumatology community on a global level, reaching millions of users. Specifically, the use of hashtags on Twitter assists digital crowdsourcing projects and scientific collaboration, as exemplified by the COVID-19 Global Rheumatology Alliance registry. Moreover, Twitter facilitates the distribution of scientific content, such as guidelines or publications. Finally, digital data mining enables the identification of hot topics within the field of rheumatology

Thiamazole-induced arthritis

We report the case of a 42-year-old male patient with acute onset of asymmetrical polyarthritis of the medium and large joints as well as fever and elevated serological inflammation markers. The symptoms began shortly after initiation of thiamazole treatment for newly diagnosed Graves' disease. Antithyroid arthritis syndrome (AAS) is a rare but serious adverse side effect of antithyroid treatment with thioamides such as thiamazole. Clinically, AAS may present with myalgia, arthralgia, fever, exanthema and polyarthritis. In the case of suspected AAS, when possible the thionamide medication should be rapidly discontinued or modified in consultation with the endocrinologist. In some cases anti-inflammatory therapy with NSAID or corticosteroids may be required for symptom control

Macrophage activation syndrome in a patient with adult-onset Still’s disease following first COVID-19 vaccination with BNT162b2

Background: Adult-onset Still's disease (AOSD) is an autoinflammatory multi-systemic syndrome. Macrophage activation syndrome (MAS) is a potentially life-threatening complication of AOSD with a mortality rate of 10-20%. Especially viral infection is thought to be a common trigger for development of MAS. On the other hand, the occurrence of MAS following vaccinations is extremely rare and has been described in a few cases after measles or influenza vaccinations and more recently after ChAdOx1 nCoV-19 (COVID-19 viral vector vaccine, Oxford-AZ). Case presentation: We report the case of a twenty-year-old female with adult-onset Still's disease (AOSD), who developed a MAS six days after receiving her first COVID-19 vaccine dose of BNT162b2 (mRNA vaccine, BioNTech/Pfizer) with ferritin levels of 136,680 mu g/l (ref.: 13-150 mu g/l). Conclusions: To the best of our knowledge, this is the first case report of development of MAS in a patient with preexisting AOSD after vaccination in general, and SARS-CoV-2 vaccination in particular. The new mRNA vaccines have generally shown a reassuring safety profile, but it has been shown that nucleic acids in general, including mRNA can act as pathogen-associated molecular patterns that activate toll-like receptors with extensive production of pro-inflammatory cytokines and further activation of immune cells. Proving an interferon 1 response in our patient directly after vaccination, we think that in this particular case the vaccination might have acted as trigger for the development of MAS. Even if it remains difficult to establish causality in the case of rare adverse events, especially in patients with autoimmune or autoinflammatory conditions, these complications are important to monitor and register, but do not at all diminish the overwhelming positive benefit-risk ratio of licensed COVID-19 vaccines

Experience with the introduction of dry, urine-diverting sanitation systems in Ethiopia

To overcome the drawbacks of conventional sanitation systems, new approaches to sanitation are necessary. Human faeces and urine as well as greywater represent potential resources requiring efficient management. Thus, source-separating systems, which safe water and allow the recycling of nutrients to agriculture, can provide an alternative. These systems can even be integrated into multistorey houses, therefore addressing the need for resource efficient sanitation in condominium housing programmes. Several urine separating facilities are implemented in Ethiopia showing a high acceptance by their users. The cost comparison between source-separating systems and the conventional system for condominium houses shows an advantage for the new approach due to savings of water for toilet flushing as well as reduced costs for the treatment of the wastewater in septic tanks. The use of human urine as fertiliser in several trials resulted in significant benefits in terms of improved crop growth

Model curriculum of the German society for Rheumatology for advanced training in the discipline internal medicine and rheumatology. English version

With the implementation of the revision of the model training regulations for German physicians (Musterweiterbildungsverordnung, MWBO) in 2018, the area of each field in internal medicine was redefined and a restructuring of the training period for specialists in internal medicine and rheumatology took place [2]. The minimum training time requires 72 months, divided into two parts of 36 months each, which include both the common contents of the training as a specialist in internal medicine (“basic training”) as well as the specific contents of the specialist training in internal medicine and rheumatology. The basic training period in “internal medicine” requires acquisition of at least two specialist competences which do not belong to the specializing field. This training consists of 24 months and is complemented by 6 months of training in both an emergency department and an intensive care unit. The specialized training period in internal medicine and rheumatology also extends over 36 months, of which at least 24 months are completed in inpatient rheumatologic care as defined by the MWBO [2]. Exemptions from this regulation were introduced by individual State Medical Chambers (Landesärztekammern) to allow for a longer period of specialized training in outpatient rheumatologic care. Based on the MWBO of 2018, a model curriculum was developed by the Commission for Education and Training of the German Society of Rheumatology (Deutsche Gesellschaft für Rheumatologie, DGRh) on behalf of the board of the DGRh with regard to core competences in specialized training in internal medicine and rheumatology. This model curriculum focuses on advanced training competences which should be acquired within the 36 months of specialized training in internal medicine and rheumatology and does not include competences relevant to the general part of internal medicine training (basic training). In this review article, the model curriculum of the DGRh for specialized training in internal medicine and rheumatology is presented

Rheumatologische Weiterbildungsstellen in Deutschland

Hintergrund In den nächsten Jahren gehen viele Haus- bzw. Fachärzt:innen in den Ruhestand. Wie in anderen Disziplinen stellt sich in der Rheumatologie die Frage, ob ausreichend Weiterbildungsstellen zur Verfügung stehen, um das Versorgungsangebot bedarfsgerecht aufrechterhalten bzw. ausweiten zu können. Daher hat die Deutsche Gesellschaft für Rheumatologie (DGRh) ihre Kommission Fort- und Weiterbildung beauftragt, die aktuell zur Verfügung stehenden Weiterbildungsmöglichkeiten in Deutschland zu überprüfen. Ziel dieser Arbeit ist die Erfassung der Weiterbildungskapazität zur Fachärztin bzw. zum Facharzt für Innere Medizin und Rheumatologie. Methodik Im Rahmen dieser Studie erfolgte die Erhebung der Weiterbildungsbefugten, deren Tätigkeitsort und die Dauer von deren Weiterbildungsbefugnis über die Homepages der 17 Landesärztekammern. Basierend auf diesen Daten erfolgte dann eine deutschlandweite Umfrage zu den Weiterbildungsstellen. Ergebnisse Die Weiterbildung zum/zur Facharzt/Fachärztin für Rheumatologie erfolgte in Deutschland im Jahr 2021 an 229 Weiterbildungsorten. Dabei standen von 187 Weiterbildungsorten nähere Daten für eine Analyse zur Verfügung (81,7 %). Die Weiterbildungsorte verteilten sich dabei auf Kliniken (52,4 %) und Niederlassungen (47,6 %), wobei der Großteil (81,8 %) der insgesamt 478,4 Weiterbildungsstellen (Klinik: 391,4 und Niederlassung: 87) im Krankenhausbereich lag. Insgesamt waren zum Erhebungszeitpunkt 17,2 % aller Weiterbildungsstellen (Klinik: 11,4 % und Niederlassung: 43,1 %) nicht besetzt. Diskussion Die Studie zeigt, dass die meisten Weiterbildungsstellen in klinischen Einrichtungen vorhanden sind. Demgegenüber gibt es im niedergelassenen Bereich vergleichsweise wenige Weiterbildungsstellen, die zudem zur Hälfte nicht besetzt sind. Für eine optimale Nutzung bereits bestehender Weiterbildungskapazitäten müssen sektorübergreifende Weiterbildungskonzepte entwickelt und v. a. muss auch eine eigenständige Vergütung des Weiterbildungsaufwandes etabliert werden. In diesem Kontext muss eine gute rheumatologische Versorgung in ganz Deutschland dauerhaft gewährleistet sein, um den betroffenen ca. 2 Mio. Patienten mit entzündlich rheumatischen Erkrankung gerecht werden zu können

Pyrrole-Based Hydroxamates and 2-Aminoanilides: Histone Deacetylase Inhibition and Cellular Activities

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Close-to-threshold Meson Production in Hadronic Interactions

Studies of meson production at threshold in the hadron--hadron interaction began in the fifties when sufficient energies of accelerated protons were available. A strong interdependence between developments in accelerator physics, detector performance and theoretical understanding led to a unique vivid field of physics. Early experiments performed with bubble chambers revealed already typical ingredients of threshold studies, which were superseded by more complete meson production investigations at the nucleon beam facilities TRIUMF, LAMPF, PSI, LEAR and SATURNE. Currently, with the advent of the new cooler rings as IUCF, CELSIUS and COSY the field is entering a new domain of precision and the next step of further progress. The analysis of this new data in the short range limit permits a more fundamental consideration and a quantitative comparison of the production processes for different mesons in the few--body final states. The interpretation of the data take advantage of the fact that production reactions close-to-threshold are characterized by only a few degrees of freedom between a well defined combination of initial and exit channels. Deviations from predictions of phase-space controlled one-meson-exchange models are indications of new and exciting physics. Precision data on differential cross sections, isospin and spin observables -- partly but by no means adequately available -- are presently turning up on the horizon. There is work for the next years and excitement of the physics expected. Here we try to give a brief and at the same time comprehensive overview of this field of hadronic threshold production studies.Comment: 100 pages, Review article to be published in Prog. Part. Nucl. Phys. Vol. 49, issue 1 (2002

The Active Brains Digital Intervention to Reduce Cognitive Decline in Older Adults: Protocol for a Feasibility Randomized Controlled Trial.

BACKGROUND: Increasing physical activity, improving diet, and performing brain training exercises are associated with reduced cognitive decline in older adults. OBJECTIVE: In this paper, we describe a feasibility trial of the Active Brains intervention, a web-based digital intervention developed to support older adults to make these 3 healthy behavior changes associated with improved cognitive health. The Active Brains trial is a randomized feasibility trial that will test how accessible, acceptable, and feasible the Active Brains intervention is and the effectiveness of the study procedures that we intend to use in the larger, main trial. METHODS: In the randomized controlled trial (RCT), we use a parallel design. We will be conducting the intervention with 2 populations recruited through GP practices (family practices) in England from 2018 to 2019: older adults with signs of cognitive decline and older adults without any cognitive decline. Trial participants were randomly allocated to 1 of 3 study groups: usual care, the Active Brains intervention, or the Active Brains website plus brief support from a trained coach (over the phone or by email). The main outcomes are performance on cognitive tasks, quality of life (using EuroQol-5D 5 level), Instrumental Activities of Daily Living, and diagnoses of dementia. Secondary outcomes (including depression, enablement, and health care costs) and process measures (including qualitative interviews with participants and supporters) will also be collected. The trial has been approved by the National Health Service Research Ethics Committee (reference 17/SC/0463). RESULTS: Results will be published in peer-reviewed journals, presented at conferences, and shared at public engagement events. Data collection was completed in May 2020, and the results will be reported in 2021. CONCLUSIONS: The findings of this study will help us to identify and make important changes to the website, the support received, or the study procedures before we progress to our main randomized phase III trial. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number 23758980; http://www.isrctn.com/ISRCTN23758980. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/18929