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The burden and treatment landscape of rheumatoid arthritis (RA) is poorly understood. This research aimed to identify evidence on quality of life, caregiver burden, economic burden, treatment patterns and clinical outcomes for patients with moderate RA in the United Kingdom.
A systematic literature review was performed across multiple databases and screened against pre-defined inclusion criteria.
2,610 records were screened; seven studies presenting evidence for moderate RA were included. These patients were found to incur substantial burden, with moderate to severe levels of disability. Compared with patients in remission, moderate RA patients reported higher levels of disability and decreased EQ-5D utility scores. The majority of patients did not feel that their current therapy adequately controlled their disease or provided sufficient symptom relief. In the United Kingdom, NICE have not approved advanced therapies (such as biological disease-modifying anti-rheumatic drugs) for patients with moderate studies that investigate their burden and the impact of treating them earlier. Such information would help guide future treatment decisions and ensure the most effective use of resources to gain the best outcomes for patients with moderate RA.Social communication differences are seen in autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD), but the brain mechanisms contributing to these differences remain largely unknown. To address this gap, we used a data-driven and diagnosis-agnostic approach to discover brain correlates of social communication differences in ASD, ADHD, and OCD, and subgroups of individuals who share similar patterns of brain-behavior associations. A machine learning pipeline (regression clustering) was used to discover the pattern of association between structural brain measures (volume, surface area, and cortical thickness) and social communication abilities. Participants (n = 416) included children with a diagnosis of ASD (n = 192, age = 12.0[5.6], 19% female), ADHD (n = 109, age = 11.1[4.1], 18% female), or OCD (n = 50, age = 12.3[4.2], 42% female), and typically developing controls (n = 65, age = 11.6[7.1], 48% female). The analyses revealed (1) associations with social communication abilities in distributed cortical and subcortical networks implicated in social behaviors, language, attention, memory, and executive functions, and (2) three data-driven, diagnosis-agnostic subgroups based on the patterns of association in the above networks. Our results suggest that different brain networks may contribute to social communication differences in subgroups that are not diagnosis-specific.The lymphatic vasculature is an integral component of the cardiovascular system. It is essential to maintain tissue fluid homeostasis, direct immune cell trafficking and absorb dietary lipids from the digestive tract. Major advances in our understanding of the genetic and cellular events important for constructing the lymphatic vasculature during development have recently been made. These include the identification of novel sources of lymphatic endothelial progenitor cells, the recognition of lymphatic endothelial cell specialisation and heterogeneity, and discovery of novel genes and signalling pathways underpinning developmental lymphangiogenesis. Here, we review these advances and discuss how they inform our understanding of lymphatic network formation, function and dysfunction.
In pre-clinical studies, pinolenic acid (PNLA), an omega-6-polyunsaturated fatty acid from pine nuts has shown anti-inflammatory effects. We aimed to investigate the effect of PNLA in human cell lines and peripheral blood mononuclear cells (PBMCs) from rheumatoid arthritis (RA) patients and healthy controls (HCs).
Modified Boyden chamber was used to assess chemokine-induced migration of THP-1 monocytes. Macropinocytosis was assessed using lucifer yellow and ox-LDL uptake using Dil-oxLDL in THP-1 macrophages and human monocyte-derived macrophages (HMDM). IL6, TNFα and PGE2 release by lipopolysaccharide (LPS) stimulated PBMCs from RA patients and HCs were measured by ELISA. The transcriptomic profile of PNLA treated, LPS activated PBMCs was investigated by RNA-sequencing.
PNLA reduced THP-1 cell migration by 55% (p< 0.001). Macropinocytosis and Dil-oxLDL uptake were reduced by 50% (p< 0.001) and 40% (p< 0.01) in THP-1 macrophages and 40% (p< 0.01) and 25% (p< 0.05) in HMDM, respectively. PNLA reduced IL6 and TNFα release from LPS stimulated PBMCs from RA by 60% (p< 0.001) and by 50% and 35% respectively (p< 0.01) for HCs. PNLA also reduced PGE2 levels in such PBMCs from RA patients and HCs (p< 0.0001). Differentially expressed genes included upregulated expression of pyruvate dehydrogenase kinase-4, plasminogen activator inhibitor-1, fructose bisphosphatase 1 and N-Myc downstream-regulated gene, which have potential roles in regulating immune and metabolic pathways. Pathway analysis predicted upstream activation of nuclear receptors peroxisome proliferator-activated receptors involved in anti-inflammatory processes, and inhibition of NF-κB and STAT1.
PNLA has immune-metabolic effects on monocytes and PBMC which are pathogenic in RA and atherosclerosis. Dietary PNLA supplementation may be beneficial in RA.
PNLA has immune-metabolic effects on monocytes and PBMC which are pathogenic in RA and atherosclerosis. R16 concentration Dietary PNLA supplementation may be beneficial in RA.A coupled phase-field and hydrodynamic model is introduced to describe a two-phase, weakly compressible smectic (layered phase) in contact with an isotropic fluid of different density. A non-conserved smectic order parameter is coupled to a conserved mass density in order to accommodate non-solenoidal flows near the smectic-isotropic boundary arising from density contrast between the two phases. The model aims to describe morphological transitions in smectic thin films under heat treatment, in which arrays of focal conic defects evolve into conical pyramids and concentric rings through curvature dependent evaporation of smectic layers. The model leads to an extended thermodynamic relation at a curved surface that includes its Gaussian curvature, non-classical stresses at the boundary and flows arising from density gradients. The temporal evolution given by the model conserves the overall mass of the liquid crystal while still allowing for the modulated smectic structure to grow or shrink. A numerical solution of the governing equations reveals that pyramidal domains are sculpted at the center of focal conics upon a temperature increase, which display tangential flows at their surface.
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