58 research outputs found
EULAR COVID-19 registry: lessons learnt and future considerations.
Future disease outbreaks of epidemic proportion are inevitable. Advance planning and preparation is essential to mitigate future public health risks; the WHO emphasises the importance of in-depth evaluation of response to and lessons learnt from a national/international pandemic.1 Research is critical to an informed, evidence-based response, therefore establishing pandemic research study protocols, systems to manage and report data, and rapid response teams are considered key to well-prepared, accelerated research in public health emergencies.2
Establishing international data collection registries poses many challenges, which are only amplified in the urgent nature of a global pandemic. The aim of this manuscript is to reflect on the successes and challenges of the European Alliance of Associations for Rheumatology (EULAR) COVID-19 registry3 to better understand how the rheumatology community (and other disease-specific communities) can be better prepared for rapid response research in the future. In particular, we consider the successes and challenges of the registry, what can be learnt from this experience, and what procedures and resources should be established and strengthened now in preparation for future pandemics
Domestic ventilation rates, indoor humidity and dust mite allergens : are our homes causing the asthma pandemic?
This paper is concerned with historical changes in domestic ventilation rates, relative humidity and the associated risk of house dust mite colonization. A controlled trial evaluated allergen and water vapour control measures on the level of house dust mite (HDM) Der p1 allergen and indoor humidity, concurrently with changes in lung function in 54 subjects who completed the protocol. Mechanical heat recovery ventilation units significantly reduced moisture content in the active group, while HDM allergen reservoirs in carpets and beds were reduced by circa 96%. Self reported health status confirmed a significant clinical improvement in the active group. The study can form the basis for assessing minimum winter ventilation rates that can suppress RH below the critical ambient equilibrium humidity of 60% and thus inhibit dust mite colonization and activity in temperate and maritime in' uenced climatic regions
Constraints on Low-Mass WIMP Interactions on 19F from PICASSO
Recent results from the PICASSO dark matter search experiment at SNOLAB are
reported. These results were obtained using a subset of 10 detectors with a
total target mass of 0.72 kg of 19F and an exposure of 114 kgd. The low
backgrounds in PICASSO allow recoil energy thresholds as low as 1.7 keV to be
obtained which results in an increased sensitivity to interactions from Weakly
Interacting Massive Particles (WIMPs) with masses below 10 GeV/c^2. No dark
matter signal was found. Best exclusion limits in the spin dependent sector
were obtained for WIMP masses of 20 GeV/c^2 with a cross section on protons of
sigma_p^SD = 0.032 pb (90% C.L.). In the spin independent sector close to the
low mass region of 7 GeV/c2 favoured by CoGeNT and DAMA/LIBRA, cross sections
larger than sigma_p^SI = 1.41x10^-4 pb (90% C.L.) are excluded.Comment: 23 pages, 7 figures, to be published in Phys. Lett.
Dark Matter Spin-Dependent Limits for WIMP Interactions on 19-F by PICASSO
The PICASSO experiment at SNOLAB reports new results for spin-dependent WIMP
interactions on F using the superheated droplet technique. A new
generation of detectors and new features which enable background discrimination
via the rejection of non-particle induced events are described. First results
are presented for a subset of two detectors with target masses of F of
65 g and 69 g respectively and a total exposure of 13.75 0.48 kgd. No
dark matter signal was found and for WIMP masses around 24 GeV/c new limits
have been obtained on the spin-dependent cross section on F of
= 13.9 pb (90% C.L.) which can be converted into cross section
limits on protons and neutrons of = 0.16 pb and = 2.60 pb
respectively (90% C.L). The obtained limits on protons restrict recent
interpretations of the DAMA/LIBRA annual modulations in terms of spin-dependent
interactions.Comment: Revised version, accepted for publication in Phys. Lett. B, 20 pages,
7 figure
The ZEPLIN-III dark matter detector: instrument design, manufacture and commissioning
We present details of the technical design and manufacture of the ZEPLIN-III
dark matter experiment. ZEPLIN-III is a two-phase xenon detector which measures
both the scintillation light and the ionisation charge generated in the liquid
by interacting particles and radiation. The instrument design is driven by both
the physics requirements and by the technology requirements surrounding the use
of liquid xenon. These include considerations of key performance parameters,
such as the efficiency of scintillation light collection, restrictions placed
on the use of materials to control the inherent radioactivity levels,
attainment of high vacuum levels and chemical contamination control. The
successful solution has involved a number of novel design and manufacturing
features which will be of specific use to future generations of direct dark
matter search experiments as they struggle with similar and progressively more
demanding requirements.Comment: 25 pages, 19 figures. Submitted to Astropart. Phys. Some figures down
sampled to reduce siz
Patient-reported wellbeing and clinical disease measures over time captured by multivariate trajectories of disease activity in individuals with juvenile idiopathic arthritis in the UK: a multicentre prospective longitudinal study
Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous disease, the signs and symptoms of which can be
summarised with use of composite disease activity measures, including the clinical Juvenile Arthritis Disease Activity
Score (cJADAS). However, clusters of children and young people might experience different global patterns in their
signs and symptoms of disease, which might run in parallel or diverge over time. We aimed to identify such clusters in
the 3 years after a diagnosis of JIA. The identification of these clusters would allow for a greater understanding of
disease progression in JIA, including how physician-reported and patient-reported outcomes relate to each other over
the JIA disease course. /
Methods: In this multicentre prospective longitudinal study, we included children and young people recruited before
Jan 1, 2015, to the Childhood Arthritis Prospective Study (CAPS), a UK multicentre inception cohort. Participants
without a cJADAS score were excluded. To assess groups of children and young people with similar disease patterns in
active joint count, physicianâs global assessment, and patient or parental global evaluation, we used latent profile analysis
at initial presentation to paediatric rheumatology and multivariate group-based trajectory models for the following
3 years. Optimal models were selected on the basis of a combination of model fit, clinical plausibility, and model parsimony. /
Finding: Between Jan 1, 2001, and Dec 31, 2014, 1423 children and young people with JIA were recruited to CAPS,
239 of whom were excluded, resulting in a final study population of 1184 children and young people. We identified
five clusters at baseline and six trajectory groups using longitudinal follow-up data. Disease course was not well
predicted from clusters at baseline; however, in both cross-sectional and longitudinal analyses, substantial proportions
of children and young people had high patient or parent global scores despite low or improving joint counts and
physician global scores. Participants in these groups were older, and a higher proportion of them had enthesitisrelated JIA and lower socioeconomic status, compared with those in other groups. /
Interpretation: Almost one in four children and young people with JIA in our study reported persistent, high patient
or parent global scores despite having low or improving active joint counts and physicianâs global scores. Distinct
patient subgroups defined by disease manifestation or trajectories of progression could help to better personalise
health-care services and treatment plans for individuals with JIA. /
Funding: Medical Research Council, Versus Arthritis, Great Ormond Street Hospital Childrenâs Charity, Oliviaâs Vision,
and National Institute for Health Researc
Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry
OBJECTIVES: To describe the safety of vaccines against SARS-CoV-2 in people with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD). METHODS: Physician-reported registry of I-RMD and non-inflammatory RMD (NI-RMDs) patients vaccinated against SARS-CoV-2. From 5 February 2021 to 27 July 2021, we collected data on demographics, vaccination, RMD diagnosis, disease activity, immunomodulatory/immunosuppressive treatments, flares, adverse events (AEs) and SARS-CoV-2 breakthrough infections. Data were analysed descriptively. RESULTS: The study included 5121 participants from 30 countries, 90% with I-RMDs (n=4604, 68% female, mean age 60.5 years) and 10% with NI-RMDs (n=517, 77% female, mean age 71.4). Inflammatory joint diseases (58%), connective tissue diseases (18%) and vasculitis (12%) were the most frequent diagnostic groups; 54% received conventional synthetic disease-modifying antirheumatic drugs (DMARDs), 42% biological DMARDs and 35% immunosuppressants. Most patients received the Pfizer/BioNTech vaccine (70%), 17% AstraZeneca/Oxford and 8% Moderna. In fully vaccinated cases, breakthrough infections were reported in 0.7% of I-RMD patients and 1.1% of NI-RMD patients. I-RMD flares were reported in 4.4% of cases (0.6% severe), 1.5% resulting in medication changes. AEs were reported in 37% of cases (37% I-RMD, 40% NI-RMD), serious AEs in 0.5% (0.4% I-RMD, 1.9% NI-RMD). CONCLUSION: The safety profiles of SARS-CoV-2 vaccines in patients with I-RMD was reassuring and comparable with patients with NI-RMDs. The majority of patients tolerated their vaccination well with rare reports of I-RMD flare and very rare reports of serious AEs. These findings should provide reassurance to rheumatologists and vaccine recipients and promote confidence in SARS-CoV-2 vaccine safety in I-RMD patients
COVID-19 in Pregnant Women With Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance
OBJECTIVE: To describe coronavirus disease-2019 (COVID-19) and pregnancy outcomes in patients with rheumatic disease who were pregnant at the time of infection. METHODS: Since March 2020 the COVID-19 Global Rheumatology Alliance (GRA) has collected cases of patients with rheumatic disease with COVID-19. We report details of pregnant women at the time of COVID-19 infection, including obstetric details separately ascertained from providers. RESULTS: We report on 39 patients, including 22 with obstetric detail available. The mean and median age was 33 years, range 24-45 years. Rheumatic disease diagnoses included: rheumatoid arthritis (n=9), systemic lupus erythematosus (n=9), psoriatic/other inflammatory arthritides (n=8) and anti-phospholipid antibody syndrome (n=6). Most had a term birth (16/22), with 3 pre-term births, one termination, one miscarriage and one woman yet to deliver at time of report. A quarter (n=10/39) of pregnant women were hospitalised following COVID-19 diagnosis. Two of 39 (5%) required supplemental oxygen (both hospitalised); no patient died. The majority did not receive specific medication treatment for their COVID-19 (n=32/39, 82%), seven patients received some combination of anti-malarials, colchicine, anti-IL-1beta, azithromycin, glucocorticoids, and lopinavir/ritonavir. CONCLUSION: Women with rheumatic diseases who were pregnant at the time of COVID-19 had favourable outcomes. These data have limitations due to the small size and methodology, though they provide cautious optimism for pregnancy outcomes for women with rheumatic disease given the increased risk of poor outcomes that have been reported in other series of pregnant women with COVID-19
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