Notes

Your re-greening regarding northeastern Hawaiian rivers: A great unparalleled riparian alteration.
Patient self-report scales are invaluable in psoriatic arthritis (PsA), as they allow physicians to rapidly assess patient perspectives of disease activity. We aimed to assess the agreement of the visual analog scale (VAS), a 100-mm horizontal line, and the numerical rating scale (NRS), a 21-point scale ranging from 0 to 10 in increments of 0.5, in patients with PsA.

Data were collected prospectively across 3 UK hospital trusts from 2018 to 2019. All patients completed the VAS and NRS for pain, arthritis, skin psoriasis (PsO), and global disease activity. A subset completed an identical pack 1 week later. Demographic and clinical data were also collected. Agreement was assessed using medians and the Bland-Altman method. Intraclass correlation coefficients (ICCs) were used to assess test-retest reliability. Spearman rank correlation coefficients were used to assess dependency between scale scores and clinical variables.

Two hundred ten patients completed the study; 1 withdrew consent. Thus, 209 were analyzed. For pain, arthritis, skin PsO, and global disease activity, the difference between the VAS and NRS lay mostly within 1.96 SD of the mean, suggesting reasonable agreement between the 2 scales. Among the patients, 64.1% preferred the NRS. The ICCs demonstrated excellent test-retest reliability for both VAS and NRS. Higher VAS and NRS scores were associated with increased tender/swollen joint count, poorer functional status, and greater life impact.

The VAS and NRS show reasonable agreement in key patient-reported outcomes in PsA. Results from both scales are correlated with disease severity and life impact.
The VAS and NRS show reasonable agreement in key patient-reported outcomes in PsA. Results from both scales are correlated with disease severity and life impact.
RA patients with diabetes might have worse clinical outcomes and adverse events compared to non-diabetes patients. We evaluated the effects of diabetes on HAQ (Health Assessment Questionnaire) change and outpatient infection in RA patients.

Using the ACR's Rheumatology Informatics System for Effectiveness (RISE) EHR-based registry, we identified RA patients who had ≥1 rheumatologist visit with a HAQ measured (index visit) in 2016, ≥1 previous visit, and a subsequent outcome visit with same HAQ measured at 12 months (± 3 months). We identified diabetes by diagnosis codes, medications, or lab values. Outpatient infection was defined by diagnosis codes or anti-infective medications. We calculated mean HAQ change and incidence rate (IR) of outpatient infections among patients with and without diabetes. BVD-523 Generalized linear models and Cox regression were used to calculate the adjusted mean HAQ change and hazard ratios (HR).

We identified 3,853 RA patients with diabetes and 18,487 without diabetes. The mean HAQ change between index and outcome visit among diabetes patients was 0.03 and non-diabetic was 0.002 (p<0.01). We identified 761 outpatient infections for diabetic patients with an IR of 22.6 (95% CI 21.0-24.2) per 100 person years and 3,239 among non-diabetic patients with an IR of 19.8 (19.1-20.5). The adjusted HR of outpatient infection among diabetes was 0.99 (0.91-1.07), compared to non-diabetes patients.

RA patients with concomitant diabetes had greater worsening, or less improvement, in their functional status, suggesting additional interventions may be needed for RA patients with diabetes to optimize treatment and other comorbidities.
RA patients with concomitant diabetes had greater worsening, or less improvement, in their functional status, suggesting additional interventions may be needed for RA patients with diabetes to optimize treatment and other comorbidities.
Osteoporosis is a growing healthcare burden. By identifying osteoporosis-promoting genetic variations, we can spotlight targets for new pharmacologic therapies that will improve patient outcomes. In this metaanalysis, we analyzed mesenchymal stem cell (MSC) biomarkers in patients with osteoporosis.

We employed our Search Tag Analyze Resource for the Gene Expression Omnibus (STARGEO) platform to conduct a metaanalysis to define osteoporosis pathogenesis. We compared 15 osteoporotic and 14 healthy control MSC samples. We then analyzed the genetic signature in Ingenuity Pathway Analysis.

The top canonical pathways identified that were statistically significant included the serine peptidase inhibitor kazal type 1 pancreatic cancer pathway, calcium signaling, pancreatic adenocarcinoma signaling, axonal guidance signaling, and glutamate receptor signaling. Upstream regulators involved in this disease process included
, dexamethasone,
,
, and
.

Although there has been extensive research looking at theral important genes involved in osteoporosis pathogenesis including ESR1, CTNNβ1, CREB1, and ERBB2. ESR1 has been shown to have numerous polymorphisms, which may play a prominent role in osteoporosis. The Wnt pathway, which includes the CTNNβ1 gene identified in our study, plays a prominent role in bone mass regulation. Wnt pathway polymorphisms can increase susceptibility to osteoporosis. Our analysis also suggests a potential mechanism for ERBB2 in osteoporosis through Semaphorin 4D (SEMA4D). Our metaanalysis identifies several genes and pathways that can be targeted to develop new anabolic drugs for osteoporosis treatment.
To compare differences in clinical activity and remuneration between male and female rheumatologists and to evaluate associations between physician gender and practice sizes and patient volume, accounting for rheumatologists' age, and calendar year effects.

We conducted a population-based study in Ontario, Canada, between 2000 to 2015 identifying all rheumatologists practicing as full-time equivalents (FTEs) or above and assessed differences in practice sizes (number of unique patients), practice volumes (number of patient visits), and remuneration (total fee-for- service billings) between male and female rheumatologists. Multivariable linear regression was used to evaluate the effects of gender on practice size and volume separately, accounting for age and year.

The number of rheumatologists practicing at ≥ 1 FTE increased from 89 to 120 from 2000 to 2015, with the percentage of females increasing from 27.0% to 41.7%. Males had larger practice sizes and practice volumes. Remuneration was consistently higher for males (median difference of CAD $46,000-102,000 annually).
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