Causal relationship between rheumatoid arthritis and epilepsy in a European population: a univariate and multivariate Mendelian randomization study

BackgroundSeveral previous studies have reported an association between rheumatoid arthritis (RA) and epilepsy, but the causal relationship is unclear. The aim of this study was to assess the connection between RA and epilepsy in a European population using Mendelian randomization (MR).MethodsGenome-wide association study summary data on RA and epilepsy from European populations were included. Univariate MR (UVMR) and multivariate MR were used to investigate the causal relationship between the two conditions. Three analysis methods were applied: inverse variance weight (IVW), MR-Egger, and weighted median, with IVW being the primary method. Cochran Q statistics, MR-PRESSO, MR-Egger intercept, leave-one-out test, and MR-Steiger test were combined for the sensitivity analysis.ResultsUVMR showed a positive association between RA and epilepsy risk (OR=1.038, 95% CI=1.007–1.038, p=0.017) that was supported by sensitivity analysis. Further MVMR after harmonizing the three covariates of hypertension, alcohol consumption, and smoking, confirmed the causal relationship between RA and epilepsy (OR=1.049, 95% CI=1.011–1.087, p=0.010).ConclusionThis study demonstrated that RA is associated with an increased risk of epilepsy. It has emphasized that the monitoring of epilepsy risk in patients diagnosed with RA should be strengthened in clinical practice, and further studies are needed in the future to explore the potential mechanism of action connecting the two conditions

SR-XRF analysis of Polytrichum in the Fildes Peninsula, Antarctica

In order to study the element contents and distribution of various mosses collected in the Antarctica, we analyzed the heavy elements of 3 species of Polytrichum in the Fildes Peninsula, P. alpinum, P. juniperinum and P. alpestre, by synchrotron radiation X-ray fluorescence (SR-XRF). The result shows that the elements, such as K, Ca, Mn, Fe, Cu, Zn and Sr, are nearly the same in Polytrichum. The peak intensity of K is higher than that of Ca, and the peak intensity of Ca is higher than that of Fe in P. alpinum. In P. juniperinum, the peak intensity of K is higher than that of Ca, and the peak intensity of Ca is close to that of Fe. The peak intensity of K is nearly equal to those of Ca and Fe in P. alpestre. Therefore, the habitats of 3 species of Polytrichum are similar in the Fildes Peninsula. By XRF analyzing of different parts of P. alpestre, we found that the peak intensities of relative concentration of elements are obviously different. The peak intensity of K in apical-bud is the highest in organism. The peak intensity ratio of K/Ca is 1.30, but they are below 1.0 in all the other parts. The peak intensity of Mn in pseudo-root is the highest in organism, and the peak intensity ration of Mn/Fe is 0.21, the biggest. In the parts of older leaf and pseudo-root, the ratios of Cu/Zn are 1.20 and 1.84 respectively, whereas they are less than 1 in the other parts. The element Br is seen specially in the older leaf and pseudo-root, that may result from the organs aged, and enhance the ability of anti-rottenness itself

Prognostic Nomogram for Patients with Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy.

This study was aimed to define possible predictors of overall survival in nasopharyngeal carcinoma (NPC). Patients were treated with intensity-modulated radiation therapy (IMRT), to establish an effective prognostic nomogram that could provide individualized predictions of treatment outcome in this setting. We reviewed the records of 533 patients with non-metastatic NPC who underwent IMRT with or without concurrent chemotherapy at the Department of Radiation Oncology of Sun Yat-Sen University from 2002 to 2009; none of these patients received induction or adjuvant chemotherapy. These data sets were used to construct a nomogram based on Cox regression. Nomogram performance was determined via a concordance index (C-index) and a calibration curve which was compared with the TNM staging system for NPC. The results were validated in an external cohort of 442 patients from the Department of Radiation Oncology of Wenzhou Medical College who were treated during the same period. Results showed that the greatest influence on survival were primary gross tumor volume, age, tumor stage and nodal stage (2002 Union for International Cancer Control [UICC] staging system), which were selected into the nomogram. The C-index of the nomogram for predicting survival was 0.748 (95%CI, 0.704-0.785), which was statistically higher than that of TNM staging system (0.684, P<0.001). The calibration curve exhibited agreement between nomogram-predicted and the actual observed probabilities for overall survival. In the validation cohort, the nomogram discrimination was superior to the TNM staging system (C-index: 0.768 vs 0.721; P = 0.026). In conclusion, the nomogram proposed in this study resulted in more-accurate prognostic prediction for patients with NPC after IMRT and compared favorably to the TNM staging system; this individualized information will aid in patient counseling and may be used for de-escalation trials in the future

Multivariate analyses of overall survival with Cox proportional hazards model for patients with nasopharyngeal carcinoma in the training cohort (<i>N</i> = 533).

<p>Abbreviations: T stage, clinical tumor stage; N stage, clinical nodal stage; GTV, gross tumor volume; HR, hazard ratio.</p><p>Multivariate analyses of overall survival with Cox proportional hazards model for patients with nasopharyngeal carcinoma in the training cohort (<i>N</i> = 533).</p

(A) Calibration curves for 5-year probabilities of overall survival in the training cohort of 533 patients and (B) the validation cohort of 442 patients.

<p>Patients were grouped by quartiles of predicted risk. Nomogram-predicted probability is plotted on the x-axis; observed probability is plotted on the y-axis (Kaplan-Meier estimates). Vertical bars = 95% confidence index.</p

Multivariate analyses of overall survival with Cox proportional hazards model for patients with nasopharyngeal carcinoma in the training cohort (<i>N</i> = 533).

<p>Abbreviations: T stage, clinical tumor stage; N stage, clinical nodal stage; GTV, gross tumor volume; HR, hazard ratio.</p><p>Multivariate analyses of overall survival with Cox proportional hazards model for patients with nasopharyngeal carcinoma in the training cohort (<i>N</i> = 533).</p

The nomogram developed for the 5-year prediction of overall survival.

<p>Point scores for gross tumor volume (GTV) were identified based on the T stage. To estimate risk, points for each variable were calculated by drawing a straight line from a patient’s variable value to the axis labeled “Points.” The score sum is converted to a probability in the lowest axis.</p