Ultrasound features of Achilles enthesitis in psoriatic arthritis: a systematic review

Objectives The objectives were to evaluate the methodological and reporting quality of ultrasound (US) studies of Achilles enthesitis in people with psoriatic arthritis (PsA), to identify the definitions and scoring systems adopted and to estimate the prevalence of ultrasound features of Achilles enthesitis in this population. Methods A systematic literature review was conducted using the AMED, CINAHL, MEDLINE, ProQuest and Web of Science databases. Eligible studies had to measure US features of Achilles enthesitis in people with PsA. Methodological quality was assessed using a modified Downs and Black Quality Index tool. US protocol reporting was assessed using a checklist informed by the European League Against Rheumatism (EULAR) recommendations for the reporting of US studies in rheumatic and musculoskeletal diseases. Results Fifteen studies were included. One study was scored as high methodological quality, 9 as moderate and 5 as low. Significant heterogeneity was observed in the prevalence, descriptions, scoring of features and quality of US protocol reporting. Prevalence estimates (% of entheses) reported included hypoechogenicity [mean 5.9% (s.d. 0.9)], increased thickness [mean 22.1% (s.d. 12.2)], erosions [mean 3.3% (s.d. 2.5)], calcifications [mean 42.6% (s.d. 15.6)], enthesophytes [mean 41.3% (s.d. 15.6)] and Doppler signal [mean 11.8% (s.d. 10.1)]. Conclusions The review highlighted significant variations in prevalence figures that could potentially be explained by the range of definitions and scoring criteria available, but also due to the inconsistent reporting of US protocols. Uptake of the EULAR recommendations and using the latest definitions and validated scoring criteria would allow for a better understanding of the frequency and severity of individual features of pathology.

Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Endoscopy is the gold standard for objective assessment of colonic disease activity in inflammatory bowel disease (IBD). Non-invasive colonic imaging using bowel ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) may have a role in quantifying colonic disease activity. We reviewed the diagnostic accuracy of these modalities for assessment of endoscopically or histopathologically defined colonic disease activity in IBD. We searched Embase, MEDLINE, and the Web of Science from inception to 20 September 2021. QUADAS-2 was used to evaluate the studies’ quality. A meta-analysis was performed using a bivariate model approach separately for MRI and US studies only, and summary receiver operating characteristic (ROC) curves were obtained. CT studies were excluded due to the absence of diagnostic test data. Thirty-seven studies were included. The mean sensitivity and specificity for MRI studies was 0.75 and 0.91, respectively, while for US studies it was 0.82 and 0.90, respectively. The area under the ROC curves (AUC) was 0.88 (95% CI, 0.82 to 0.93) for MRI, and 0.90 (95% CI, 0.75 to 1.00) for US. Both MRI and US show high diagnostic accuracy in the assessment of colonic disease activity in IBD patients.

A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy

Introduction: This systematic literature review analyzed published evidence on IgA nephropathy (IgAN), focusing on US epidemiology, health-related quality of life (HRQoL), and economic burden of illness. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Embase®, MEDLINE®, Cochrane, and Econlit (January 2010 to June 2020) were searched, along with relevant congresses (2017-2020). Results: Of 123 epidemiologic studies selected for data extraction, 24 reported IgAN diagnosis rates ranging from 6.3% to 29.7% among adult and pediatric patients undergoing renal biopsy, with all reported US rates <15%. No US studies reported IgAN prevalence. A meta-analysis of US studies calculated an annual incidence of 1.29/100 000 people, translating to an annual US incidence of 4236 adults and children. Relative to Europe, the United States had more patients diagnosed with IgAN in later chronic kidney disease stages. US rates of transition to end-stage renal disease (ESRD) ranged from 12.5% to 23% during 3-3.9 years of observation, rising to 53% during 19 years of observation. Across 8 studies reporting HRQoL, pain and fatigue were the most reported symptoms, and patients consistently ranked kidney function and mortality as the most important treatment outcomes. Patients with glomerulopathy reported worse mental health than healthy controls or hemodialysis patients; proteinuria was significantly associated with poorer HRQoL and depression. Conclusion: While economic evidence in IgAN remains sparse, management of ESRD is a major cost driver. IgAN is a rare disease where disease progression causes increasing patient burden, underscoring the need for therapies that prevent kidney function decline and HRQoL deterioration while reducing mortality.

Enthesitis in Psoriatic Arthritis, the Sonographic Perspective

Purpose of Review To provide an overview of the ultrasound (US) studies focusing on enthesitis in psoriatic arthritis (PsA). Recent Findings Last-generation US equipment has demonstrated the ability to detect subtle morphostructural and vascular abnormalities at entheseal level. US is able to identify pathologic changes in both “classical” (i.e., the site of attachment of tendons, ligaments, and joint capsules into the bone) and “functional” entheses (i.e., anatomical regions where tendons or ligaments wrap around bony pulleys). Summary US has the potential to be the first-line method in the assessment of enthesitis. In the present review we critically discussed the current definitions of US enthesitis, the scoring systems, and the main fields of application (i.e., the detection of enthesitis in PsA and psoriasis, the identification of different disease subsets, and the assessment of response to treatment).

The skin crawls, the stomach turns: ectoparasites and pathogens elicit distinct defensive responses in humans

Disgust has long been viewed as a primary motivator of defensive responses to threats posed by both microscopic pathogens and macroscopic ectoparasites. Although disgust can defend effectively against pathogens encountered through ingestion or incidental contact, it offers limited protection against ectoparasites, which actively pursue a host and attach to its surface. Humans might, therefore, possess a distinct ectoparasite defence system—including cutaneous sensory mechanisms and grooming behaviours—functionally suited to guard the body's surface. In two US studies and one in China, participants (N = 1079) viewed a range of ectoparasite- and pathogen-relevant video stimuli and reported their feelings, physiological sensations, and behavioural motivations. Participants reported more surface-guarding responses towards ectoparasite stimuli than towards pathogen stimuli, and more ingestion/contamination-reduction responses towards pathogen stimuli than towards ectoparasite stimuli. Like other species, humans appear to possess evolved psychobehavioural ectoparasite defence mechanisms that are distinct from pathogen defence mechanisms.

The skin crawls, the stomach turns: ectoparasites and pathogens elicit distinct defensive responses in humans

Disgust has long been viewed as a primary motivator of defensive responses to threats posed by both microscopic pathogens and macroscopic ectoparasites. Although disgust can defend effectively against pathogens encountered through ingestion or incidental contact, it offers limited protection against ectoparasites, which actively pursue a host and attach to its surface. Humans might, therefore, possess a distinct ectoparasite defence system—including cutaneous sensory mechanisms and grooming behaviours—functionally suited to guard the body's surface. In two US studies and one in China, participants ( N = 1079) viewed a range of ectoparasite- and pathogen-relevant video stimuli and reported their feelings, physiological sensations, and behavioural motivations. Participants reported more surface-guarding responses towards ectoparasite stimuli than towards pathogen stimuli, and more ingestion/contamination-reduction responses towards pathogen stimuli than towards ectoparasite stimuli. Like other species, humans appear to possess evolved psychobehavioural ectoparasite defence mechanisms that are distinct from pathogen defence mechanisms.

A Rapid Evidence Assessment of the impact of probation caseloads on reducing recidivism and other probation outcomes

We undertook a Rapid Evidence Assessment to explore the existing empirical evidence relating to the impact of probation caseloads on recidivism. Over 3,000 potentially relevant papers were sifted from which five were deemed robust enough to be analysed in detail. All five were US studies which examined the impact of particular initiatives to reduce caseloads and were delivered by mainstream community-based probation officers. All recorded reductions in measured outcomes compared to comparators. Overall, although the number of robust studies remains quite small for such a key area of consideration, there appears to be a growing body of evidence that lower probation caseloads have a positive impact in terms of reducing reoffending in the USA. All five studies looked at a range of criminal justice outcomes including technical probation violations, violations for new arrests and reconvictions. Interestingly, although researchers were expecting to find a higher rate of probation violations among the cohorts supervised by probation officers with lower caseloads (due to the increased intensity of supervision), this did not turn out to be the case.

Digging Up the Past and Surviving El Salvador’s Phantoms: Salvadoran-American Post-Conflict Traumatic Memory and Reconciliation

This article focuses on Salvadoran-American poetry that explores Salvadorans’ national traumas of war and displacement. In these poems, war trauma evolves into a post-conflict, post-migration trauma that calls for reconciliation with war memories as well as with a violent, unstable present. This study focuses on the poetry of Jorge Argueta (1961), William Archila (1968), and Javier Zamora (1990), three poets born in El Salvador and immigrants to the US. Studies of trauma and reconciliation in post-conflict societies frame the analysis of poetry that digs up and reconstitutes the dead for a Salvadoran diaspora still un-reconciled with its trauma.

Satellite Calibration/Validation and Related Activities Carried out through NASA/ESA Joint Program Planning Group Subgroup

&lt;p&gt;The NASA/ESA Joint Program Planning Group (JPPG) subgroup on satellite calibration/validation was created to facilitate coordinated efforts between ESA, NASA, and their respective investigator communities to enhance calibration and/or validation activities for current and/or future satellite missions. The cooperation enabled through this activity includes airborne campaigns, use of surface-based measurements, and satellite-to-satellite intercomparisons. Numerous examples of such activities exist over the ten years of the JPPG. In this talk, examples of calibration/validation focused activities, accomplishments, and future plans will be presented. A particular focus will be on how the COVID-19 pandemic has affected field work planned for 2020 and 2021.&amp;#160; The JPPG subgroup also includes joint European-US studies of satellite results that integrate the results of both parties&amp;#8217; observational capabilities, and the status of those activities will be presented as well.&lt;/p&gt;