HPV-Related Multi-Phenotypic Sinonasal Carcinoma with Aggressive Clinical Behavior; A Rare Case

Introduction/Objective

Human Papilloma Virus (HPV)-related multiphenotypic sinonasal carcinoma, previously known as HPV-related sinonasal carcinoma with adenoid cystic carcinoma-like features, is a rare type of sinonasal carcinoma with both epithelial-derived and salivary gland-type morphologic features. It is associated with high-risk HPV, but lacks MYB gene rearrangements.

Methods/Case Report

We report a case of a 59-year-old male who presented with a rapidly growing sinonasal mass. On MRI, a left nasal cavity lesion was identified growing laterally along the frontal process of the maxilla, extending into the middle meatus and into the maxillary sinus. Patient underwent a complex left medial maxillectomy, spheno- ethmoidectomy, and sinusotomy. On gross evaluation, the left inferior turbinate and sidewall demonstrated a 4 cm unremarkable turbinate with attached friable soft tissue. Microscopic examination revealed sections of carcinoma with various architectural patterns comprised of foci with adenoid cystic carcinoma-like morphology, basaloid squamous cell carcinoma and adenocarcinoma. The tumor showed positive immunostaining for P40, but focal reactivity to S100 and rare scattered reactivity with CD117. INI-1 immunostain was retained in tumor cells. P16 immunostain was strong and diffuse and high-risk cocktail HPV RNA ISH was positive. However, MYB FISH testing was equivocal.

Morphologic and immunophenotypic findings were consistent with HPV-related multiphenotypic sinonasal carcinoma. The tumor involved the olfactory nerve fibers requiring a skull base resection and showed extension into the dura mater.

Results (if a Case Study enter NA)

NA

Conclusion

HPV related multiphenotypic sinonasal carcinoma is a recently described entity that can pose significant diagnostic challenge. It typically has an indolent clinical course with potential for late recurrences. This case study highlights the potential aggressive nature of this type of sinonasal carcinoma, despite association with high-risk HPV, and use of ancillary testing in aiding diagnosis.

Utility of device-derived daily activity, a novel digital biomarker, to predict ventricular arrhythmias – data from the CERTITUDE registry

Background

While there have been prior studies showing an association between activity and outcomes, there have been no studies examining the temporal relationship between device-derived daily activity, a novel digital biomarker, and ventricular tachyarrhythmias (VT).

Purpose

In a big dataset with over 55,000 pacemaker, ICD, and CRT devices, we aimed to identify whether changes in activity predict VT, or else VT predict changes in activity.

Methods

The CERTITUDE registry comprises a de-identified database of over 55,000 U.S. BIOTRONIK pacemaker, ICD, CRT devices, and loop recorders active on Home Monitoring®. Daily data on leads, arrhythmias, and physiological parameters such as activity are captured. Patient activity is reported daily as percentage active during the day, assessed by a one-axis accelerometer at ∼0.4 Hz frequency. Analysis to ascertain temporal changes in device-derived activity associated with treated VT was performed using the first event per device and 7-day activity windows (baseline, pre- and post-event). Baseline period was defined as 31–38 days prior to VT. VT events were categorized by heart rate (≤200 bpm,>200 bpm) and treatment (shock with or without ATP, ATP alone). Differences in activity between baseline, and pre- and post-VT were analyzed using the binomial proportion test.

Results

A total of 16,475 devices (9732 ICDs, 6743 CRT-Ds) had activity data available for analysis. The cumulative follow-up duration was 18,355 years (5.6 million days with transmission). Of the 2636 VT events analyzed, 1409 had a heart rate >200 bpm, and 593 were treated with shock. Patients with VT events >200 bpm treated with shock had a significant reduction in activity post-VT with a median −8.7% reduction (IQR −24.6%; 7.3%, p<0.001). However, there was no reduction in activity before the VT>200 bpm (p=0.690) (Figure). VT events >200 bpm treated with ATP alone were not associated with reduction in activity before or after the episode. Similarly, VT events ≤200 bpm treated with shock were also associated with a reduction in activity following the event (−5.8%, IQR −29.5, 12.3%, p=0.003), but not prior to the VT event.

Conclusions

In this report from the CERTITUDE registry, we have shown a temporal decline in device-derived activity following ventricular arrhythmias>200 bpm and ≤200 bpm treated with a shock, but not in patients treated with ATP. Monitoring device-derived activity post-VT events with a shock could provide relevant clinical information and potentially warrant intensified treatment.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Biotronik

Model Selection for the Preclinical Development of New Drug-Radiotherapy Combinations

Radiotherapy plays an essential role in the treatment of more than half of all patients with cancer. In recent decades, advances in devices that deliver radiation and the development of treatment planning software have helped radiotherapy attain precise tumour targeting with minimal toxicity to surrounding tissues. Simultaneously, as more targeted drug therapies are being brought into the market, there has been significant interest in improving cure rates for cancer by adding drugs to radiotherapy to widen the therapeutic window, the difference between normal tissue toxicity and treatment efficacy. The development of new combination therapies will require judicious adaptation of preclinical models that are routinely used for traditional drug discovery. Here we highlight the strengths and weaknesses of each of these preclinical models and discuss how they can be used optimally to identify new and clinically beneficial drug-radiotherapy combinations.

Observation of D_{s}^{±}/D^{0} Enhancement in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of charm-strange meson D_{s}^{±} production at midrapidity in Au+Au collisions at sqrt[s_{NN}]=200  GeV from the STAR experiment. The yield ratio between strange (D_{s}^{±}) and nonstrange (D^{0}) open-charm mesons is presented and compared to model calculations. A significant enhancement, relative to a pythia simulation of p+p collisions, is observed in the D_{s}^{±}/D^{0} yield ratio in Au+Au collisions over a large range of collision centralities. Model calculations incorporating abundant strange-quark production in the quark-gluon plasma and coalescence hadronization qualitatively reproduce the data. The transverse-momentum integrated yield ratio of D_{s}^{±}/D^{0} at midrapidity is consistent with a prediction from a statistical hadronization model with the parameters constrained by the yields of light and strange hadrons measured at the same collision energy. These results suggest that the coalescence of charm quarks with strange quarks in the quark-gluon plasma plays an important role in D_{s}^{±}-meson production in heavy-ion collisions.

Breast Angiosarcoma Surveillance Study: UK national audit of management and outcomes of angiosarcoma of the breast and chest wall

BACKGROUND

Breast angiosarcomas are rare tumours of vascular origin. Secondary angiosarcoma occurs following radiotherapy for breast cancer. Angiosarcomas have high recurrence and poor survival rates. This is concerning owing to the increasing use of adjuvant radiotherapy for the treatment of invasive breast cancer and ductal cancer in situ (DCIS), which could explain the rising incidence of angiosarcoma. Outcome data are limited and provide a poor evidence base for treatment. This paper presents a national, trainee-led, retrospective, multicentre study of a large angiosarcoma cohort.

METHODS

Data for patients with a diagnosis of breast/chest wall angiosarcoma between 2000 and 2015 were collected retrospectively from 15 centres.

RESULTS

The cohort included 183 patients with 34 primary and 149 secondary angiosarcomas. Median latency from breast cancer to secondary angiosarcoma was 6 years. Only 78.9 per cent of patients were discussed at a sarcoma multidisciplinary team meeting. Rates of recurrence were high with 14 of 28 (50 per cent ) recurrences in patients with primary and 80 of 124 (64.5 per cent ) in those with secondary angiosarcoma at 5 years. Many patients had multiple recurrences: total of 94 recurrences in 162 patients (58.0 per cent). Median survival was 5 (range 0-16) years for patients with primary and 5 (0-15) years for those with secondary angiosarcoma. Development of secondary angiosarcoma had a negative impact on predicted breast cancer survival, with a median 10-year PREDICT prognostic rate of 69.6 per cent, compared with 54.0 per cent in the observed cohort.

CONCLUSION

A detrimental impact of secondary angiosarcoma on breast cancer survival has been demonstrated. Although not statistically significant, almost all excess deaths were attributable to angiosarcoma. The increased use of adjuvant radiotherapy to treat low-risk breast cancer and DCIS is a cause for concern and warrants further study.

Measurement of e^{+}e^{-} Momentum and Angular Distributions from Linearly Polarized Photon Collisions

The Breit-Wheeler process which produces matter and antimatter from photon collisions is experimentally investigated through the observation of 6085 exclusive electron-positron pairs in ultraperipheral Au+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements reveal a large fourth-order angular modulation of cos4Δϕ=(16.8±2.5)% and smooth invariant mass distribution absent of vector mesons (ϕ, ω, and ρ) at the experimental limit of ≤0.2% of the observed yields. The differential cross section as a function of e^{+}e^{-} pair transverse momentum P_{⊥} peaks at low value with sqrt[⟨P_{⊥}^{2}⟩]=38.1±0.9  MeV and displays a significant centrality dependence. These features are consistent with QED calculations for the collision of linearly polarized photons quantized from the extremely strong electromagnetic fields generated by the highly charged Au nuclei at ultrarelativistic speed. The experimental results have implications for vacuum birefringence and for mapping the magnetic field which is important for emergent QCD phenomena.

Insights into purification of contaminated water with activated charcoal derived from hamburger seed coat

Hamburger seed coat is a readily available agricultural waste product generated in large quantities annually. In this study, activated charcoal was produced using hamburger seed coat activated with zinc chloride and its physicochemical properties such as fixed carbon, specific surface area, volatile matter, ash and moisture content were investigated. Scanning electron microscopy and Fourier transform infrared spectrometry techniques were used to study the surface morphology and variations in the absorption bands of functional groups, respectively. The adsorbent biosorption of pollutants abilities from contaminated water was investigated using standard methods with a view to ascertaining the adsorbent purification potential. The results showed that the adsorbent was of high porous structure with adsorption capacity significantly correlated with iodine value. The physicochemical properties of the contaminated water treated with the adsorbent were comparable with commercial activated charcoal (control)-treated water but indicated a significant decrease (p < 0.05) in the pH, temperature, total dissolved solids, total suspended solids, conductivity, turbidity, alkalinity, hardness, biochemical oxygen demand, chemical oxygen demand, anions and heavy metal ions when compared to the untreated water. With the exception of alkalinity, other parameters investigated in the water treated with the test adsorbent fell within the standards set for potable water. Results of this study therefore revealed possibility of converting large quantities of hamburger seed coat wastes that could constitute environmental pollution to a profitable product that could be employed for treatment of wastewater.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13762-021-03577-8.

Supraclavicular Brachial Plexus Block: Comparison of Varying Doses of Dexmedetomidine with Ropivacaine

Background Alpha-2 adrenergic receptor agonists have been the focus of interest nowadays as an adjuvant to local anesthesia due to its excellent sedative, analgesic, antihypertensive, anesthetic sparing and hemodynamic stabilizing properties. The ideal dose of dexmedetomidine for brachial plexus block is matter of debate. Objective To find the appropriate minimal dose of dexmedetomidine with desired clinical effects and minimal side-effects, we compared different doses (25 mcg, 50 mcg, 75 mcg and 100 mcg) of dexmedetomidine as an adjuvant to ropivacaine. Method One hundred fifty patients of ASA I and II, aged (18-60) years, weighing (50-60) kilograms undergoing upper limb surgeries under brachial plexus block were enrolled in this prospective, double blind, randomized control study. Patients in all group received 19 ml of 0.5% ropivacaine in common. In addition; group RD25, RD50, RD75 and RD100 received 25 mcg, 50 mcg, 75 mcg and 100 mcg of dexmedetomidine diluted in 1 ml of normal saline (NS) respectively whereas group RD00 received only 1 ml of NS. The duration of analgesia was the primary outcome whereas block characteristics, hemodynamic parameters, oxygen saturation, sedation score and adverse effects were taken as secondary outcome. Statistical analysis was done using ANOVA test, Chi-square test and Scheffe's multiple comparison tests. Result The demographic profile and baseline hemodynamic variables were comparable in all five groups. Increasing dose of dexmedetomidine showed significant improvement in block characteristics but associated with increase in sedation and incidence of bradycardia. Conclusion We conclude that dexmedetomidine 50 mcg would be an appropriate dose as adjuvant to local anesthesia in brachial plexus block.

POS0014 TIME-TRENDS IN COCAINE AND HALLUCINOGEN USE DISORDER HOSPITALIZATIONS IN RHEUMATIC DISEASES: A NATIONAL TIME-TRENDS STUDY

Background:

Cocaine use disorder is a frequent cause of drug use disorders in the U.S. Although hallucinogen use disorder is less common, both are potentially preventable public health issues. To our knowledge, epidemiological studies estimating burden of cocaine or hallucinogen use disorders in common Musculoskeletal diseases (MSDs) are lacking.

Objectives:

To assess national time-trends in cocaine use and hallucinogen use disorders in people with MSDs

Methods:

This study used the U.S. National Inpatient Sample (NIS), a de-identified national all-payer inpatient health care database (https://www.hcup-us.ahrq.gov/nisoverview.jsp) from 1998-2014. The NIS is a 20% stratified sample of hospital discharges in the U.S. It is commonly used to derive national estimates of hospitalization and outcomes. Cocaine or hallucinogen use disorder hospitalization was defined in a validated approach as the presence of the following International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes: cocaine use disorder, 304.2x, or 305.6x; and hallucinogen use disorder, 304.5x or 305.3x; hospitalizations for drug use in remission, drug counseling, rehabilitation or detoxification were excluded, as in previous studies. MSDs were identified based on the respective ICD-9 codes, a validated approach (5-9), in non-primary position: Gout: 274.xx; rheumatoid arthritis (RA): 714.xx; Fibromyalgia: 729.1; osteoarthritis (OA): 715.xx; or low back pain (LBP): 724.

Results:

In 1998-2000, the highest frequency of cocaine use hospitalizations was in people with LBP: LBP (n=5,914), followed by OA (n=4,931), gout (n=2,093), RA (n=2,026), and fibromyalgia (n=1,620). In 2013-2014, the order changed slightly with OA (n=22,185), followed by LBP (n=16,810), gout (n=10,570), RA (n=8,975), and fibromyalgia (n=5,680). Respective rates per 1 million U.S. NIS hospitalizations in 2013-2014 and the relative increase from 1998-2000 to 2013-2014 were: Gout, 10.2 (increase, 4.1-fold); OA, 21.4 (3.5-fold); fibromyalgia, 5.48 (2.5-fold); RA, 8.66 (3.4-fold); and LBP, 16.22 (1.8-fold; Figure 1).

In 1998-2000, hallucinogen use disorder hospitalizations were as follows: LBP (n=176), followed by OA (n=63), RA (n=42), fibromyalgia (n=41) and gout (n<10; cells with frequency of 10 of fewer are reported as <10 per NIS guidance). In 2013-2014, the frequency order was the similar, with the highest numbers for LBP (n=525) followed by OA (n=400), RA (n=395), gout (n=135) and fibromyalgia (n=125). Respective rates per 1 million US NIS hospitalizations in 2013-2014 and the relative increase from 1998-2000 to 2013-2014 were: Gout, 0.13 (increase, 25-fold); OA, 0.39 (5.5-fold); fibromyalgia, 0.12 (2-fold); RA, 0.38 (8.5-fold); and LBP, 0.51 (2-fold; Figure 1).

Conclusion:

This study confirmed an increasing rate of both, cocaine use and hallucinogen use disorder hospitalizations in people with 5 MSDs over a 17-year period from 1998-2014 in the U.S.

Figure 1.

Time-trends in the rates of hospitalization with cocaine use and hallucinogen use disorder (A), non-home discharge (B), and in-hospital mortality (C) per 100,000 NIS hospitalization claims. The x-axis shows rate per 100,000 NIS hospitalization claims and the y-axis the study periods

Acknowledgements:

I thank John D. Cleveland, MS of the University of Alabama at Birmingham for performing data analyses according to the protocol.

Disclosure of Interests:

Jasvinder Singh Shareholder of: JAS owns stock options in TPT Global Tech, Vaxart pharmaceuticals and Charlotte’s Web Holdings, Inc. JAS previously owned stock options in Amarin, Viking and Moderna pharmaceuticals., Consultant of: JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio Health, Medscape, WebMD, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, the National Institutes of Health and the American College of Rheumatology. JAS is on the speaker’s bureau of Simply Speaking. JAS is a member of the executive of Outcomes Measures in Rheumatology (OMERACT), an organization that develops outcome measures in rheumatology and receives arms-length funding from 12 companies.

POS1124 IDENTIFYING POTENTIAL CLASSIFICATION CRITERIA FOR CALCIUM PYROPHOSPHATE DEPOSITION DISEASE (CPPD): RESULTS FROM THE INITIAL PHASES

Background:

Classification criteria for calcium pyrophosphate deposition disease (CPPD) will facilitate clinical research on this common crystalline arthritis. ACR/EULAR are jointly sponsoring development of CPPD classification criteria using a multi-phase process.

Objectives:

To report preliminary results from the first two phases of a four-phase process for developing CPPD classification criteria.

Methods:

CPPD classification criteria development is overseen by a 12-member Steering Committee. Item generation (Phase I) included a scoping literature review of five literature databases and contributions from a 35-member Combined Expert Committee and two Patient Research Partners. Item reduction and refinement (Phase II) involved a Combined Expert Committee meeting, discussions among Clinical, Imaging, and Laboratory Advisory Groups, and an item rating exercise to assess the influence of individual items toward classification. The Steering Committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development.

Results:

Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The Advisory Groups eliminated items they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases (see Table 1). As numerous imaging items were rated +3, the Steering Committee recommended focusing on imaging of the knee, wrist, and one additional affected joint for calcification suggestive of CPP crystal deposition.

Conclusion:

The ACR/EULAR CPPD classification criteria working group has adopted both data- and expert-driven approaches, leading to 56 candidate items broadly categorized as clinical, imaging, and laboratory features. Remaining steps for criteria development include domain establishment, item weighting through a multi-criteria decision analysis exercise, threshold score determination, and criteria validation.

Table 1.

Categories of items retained for future phases of classification criteria development

Age in decade at symptom onsetAcute inflammatory arthritis (e.g. knee, wrist, 1st MTP joint*)Recurrence and pattern of joint involvement (e.g. 1 self-limited episode, >1 self-limited episode)Physical findings (e.g. palpable subcutaneous tophus*, psoriasis*)Co-morbidities and family history (e.g. Gitelman disease, hemochromatosis, familial CPPD)Osteoarthritis location and features (e.g. 2nd or 3rd MCP joint, wrist)Synovial fluid findings (e.g. CPP crystals present, CPP crystals absent on 1 occasion* or 2 occasions*, monosodium urate crystals present*)Laboratory findings (e.g. hypomagnesemia, hyperparathyroidism, rheumatoid factor*, anti-CCP*)Plain radiograph: calcification in regions of fibro- or hyaline cartilage+Plain radiograph: calcification of the synovial membrane/capsule/tendon+Conventional CT: calcification in regions of fibro- or hyaline cartilage+Conventional CT: calcification of the synovial membrane/capsule/tendon+Ultrasound: CPP crystal deposition in fibro- or hyaline cartilage+Ultrasound: CPP crystal deposition in synovial membrane/capsule/tendons+Dual-energy CT: CPP crystal deposition in fibro- or hyaline cartilage+Dual-energy CT: CPP crystal deposition in synovial membrane/capsule/tendon+

*Potential negative predictor +Assessed in the knee, wrist, and/or 1 additional affected joint

Disclosure of Interests:

Sara Tedeschi Consultant of: NGM Biopharmaceuticals, Tristan Pascart: None declared, Augustin Latourte Consultant of: Novartis, Cattleya Godsave: None declared, Burak Kundaki: None declared, Raymond Naden: None declared, William Taylor: None declared, Nicola Dalbeth Speakers bureau: Abbvie and Janssen, Consultant of: AstraZeneca, Dyve, Selecta, Horizon, Arthrosi, and Cello Health, Tuhina Neogi: None declared, Fernando Perez-Ruiz: None declared, Ann Rosenthal: None declared, Fabio Becce Consultant of: Horizon Therapeutics, Grant/research support from: Siemens Healthineers, Eliseo Pascual: None declared, Mariano Andrés: None declared, Thomas Bardin: None declared, Michael Doherty: None declared, Hang Korng Ea: None declared, Georgios Filippou: None declared, John FitzGerald: None declared, Marwin Gutierrez: None declared, Annamaria Iagnocco: None declared, Tim Jansen Speakers bureau: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Consultant of: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Minna Kohler Speakers bureau: Lilly, Consultant of: Novartis, Frederic Lioté: None declared, Mark Matza: None declared, Geraldine McCarthy Consultant of: PK Med, Roberta Ramonda: None declared, Anthony Reginato: None declared, Pascal Richette: None declared, Jasvinder Singh Speakers bureau: Simply Speaking, Consultant of: Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, Francisca Sivera: None declared, Alexander So: None declared, Lisa Stamp: None declared, Janeth Yinh: None declared, Chio Yokose: None declared, Robert Terkeltaub Consultant of: Sobi, Horizon Therapeutics, Astra-Zeneca, Selecta, Grant/research support from: Astra-Zeneca, Hyon Choi: None declared, Abhishek Abhishek Consultant of: NGM Biopharmaceuticals.

POS0510 EPIDEMIOLOGY OF COCAINE AND HALLUCINOGEN USE DISORDER HOSPITALIZATIONS IN RHEUMATIC DISEASES

Background:

Cocaine use disorder is a frequent cause of drug use disorders in the U.S. Although hallucinogen use disorder is less common, both are potentially preventable public health issues. To our knowledge, epidemiological studies estimating burden of cocaine or hallucinogen use disorders in common Musculoskeletal diseases (MSDs) are lacking.

Objectives:

To assess national time-trends in cocaine use and hallucinogen use disorders in people with MSDs

Methods:

This study used the U.S. National Inpatient Sample (NIS), a de-identified national all-payer inpatient health care database (https://www.hcup-us.ahrq.gov/nisoverview.jsp) from 1998-2014. The NIS is a 20% stratified sample of hospital discharges in the U.S. It is commonly used to derive national estimates of hospitalization and outcomes. Cocaine or hallucinogen use disorder hospitalization was defined in a validated approach as the presence of the following International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes: cocaine use disorder, 304.2x, or 305.6x; and hallucinogen use disorder, 304.5x or 305.3x; hospitalizations for drug use in remission, drug counseling, rehabilitation or detoxification were excluded, as in previous studies. MSDs were identified based on the respective ICD-9 codes, a validated approach (5-9), in non-primary position: Gout: 274.xx; rheumatoid arthritis (RA): 714.xx; Fibromyalgia: 729.1; osteoarthritis (OA): 715.xx; or low back pain (LBP): 724.

Results:

In 1998-2000, the highest frequency of cocaine use hospitalizations was in people with LBP: LBP (n=5,914), followed by OA (n=4,931), gout (n=2,093), RA (n=2,026), and fibromyalgia (n=1,620). In 2013-2014, the order changed slightly with OA (n=22,185), followed by LBP (n=16,810), gout (n=10,570), RA (n=8,975), and fibromyalgia (n=5,680). Respective rates per 1 million U.S. NIS hospitalizations in 2013-2014 and the relative increase from 1998-2000 to 2013-2014 were: Gout, 10.2 (increase, 4.1-fold); OA, 21.4 (3.5-fold); fibromyalgia, 5.48 (2.5-fold); RA, 8.66 (3.4-fold); and LBP, 16.22 (1.8-fold; figure 1).

Figure 1.

Time-trends in the rates of hospitalization with cocaine use and hallucinogen use disorder (A), non-home discharge (B), and in-hospital mortality (C) per 100,000 NIS hospitalization claims. The x-axis shows rate per 100,000 NIS hospitalization claims and the y-axis the study periods

In 1998-2000, hallucinogen use disorder hospitalizations were as follows: LBP (n=176), followed by OA (n=63), RA (n=42), fibromyalgia (n=41) and gout (n<10; cells with frequency of 10 of fewer are reported as <10 per NIS guidance). In 2013-2014, the frequency order was the similar, with the highest numbers for LBP (n=525) followed by OA (n=400), RA (n=395), gout (n=135) and fibromyalgia (n=125). Respective rates per 1 million US NIS hospitalizations in 2013-2014 and the relative increase from 1998-2000 to 2013-2014 were: Gout, 0.13 (increase, 25-fold); OA, 0.39 (5.5-fold); fibromyalgia, 0.12 (2-fold); RA, 0.38 (8.5-fold); and LBP, 0.51 (2-fold; figure 1).

Conclusion:

This study confirmed an increasing rate of both, cocaine use and hallucinogen use disorder hospitalizations in people with 5 MSDs over a 17-year period from 1998-2014 in the U.S.

Acknowledgements:

John D. Cleveland, MS of the University of Alabama at Birmingham for performing data analyses according to the protocol.

Disclosure of Interests:

Jasvinder Singh Speakers bureau: JAS is on the speaker’s bureau of Simply Speaking. JAS is a member of the executive of Outcomes Measures in Rheumatology (OMERACT), an organization that develops outcome measures in rheumatology and receives arms-length funding from 12 companies., Consultant of: consultant fees from Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio Health, Medscape, WebMD, Two labs Inc., Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Practice Point communications, the National Institutes of Health and the American College of Rheumatology.

Global Polarization of Ξ and Ω Hyperons in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

Global polarization of Ξ and Ω hyperons has been measured for the first time in Au+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements of the Ξ^{-} and Ξ[over ¯]^{+} hyperon polarization have been performed by two independent methods, via analysis of the angular distribution of the daughter particles in the parity violating weak decay Ξ→Λ+π, as well as by measuring the polarization of the daughter Λ hyperon, polarized via polarization transfer from its parent. The polarization, obtained by combining the results from the two methods and averaged over Ξ^{-} and Ξ[over ¯]^{+}, is measured to be ⟨P_{Ξ}⟩=0.47±0.10(stat)±0.23(syst)% for the collision centrality 20%-80%. The ⟨P_{Ξ}⟩ is found to be slightly larger than the inclusive Λ polarization and in reasonable agreement with a multiphase transport model. The ⟨P_{Ξ}⟩ is found to follow the centrality dependence of the vorticity predicted in the model, increasing toward more peripheral collisions. The global polarization of Ω, ⟨P_{Ω}⟩=1.11±0.87(stat)±1.97(syst)% was obtained by measuring the polarization of daughter Λ in the decay Ω→Λ+K, assuming the polarization transfer factor C_{ΩΛ}=1.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Nonmonotonic Energy Dependence of Net-Proton Number Fluctuations

Nonmonotonic variation with collision energy (sqrt[s_{NN}]) of the moments of the net-baryon number distribution in heavy-ion collisions, related to the correlation length and the susceptibilities of the system, is suggested as a signature for the quantum chromodynamics critical point. We report the first evidence of a nonmonotonic variation in the kurtosis times variance of the net-proton number (proxy for net-baryon number) distribution as a function of sqrt[s_{NN}] with 3.1  σ significance for head-on (central) gold-on-gold (Au+Au) collisions measured solenoidal tracker at Relativistic Heavy Ion Collider. Data in noncentral Au+Au collisions and models of heavy-ion collisions without a critical point show a monotonic variation as a function of sqrt[s_{NN}].

HIV cure research in the time of COVID-19 - Antiretroviral therapy treatment interruption trials: A discussion paper

This discussion paper addresses the safety of HIV cure studies, particularly those involving stopping antiretroviral therapy, known as an analytic treatment interruption (ATI) in the context of the SARS-CoV-2 pandemic. More than 30 studies listed on ClinicalTrials.gov include an ATI and many others were planned to begin over the next 12 months but most were halted due to the COVID-19 pandemic. We consider the ethics, risks and practical considerations to be taken into account before re-opening HIV cure clinical trials, noting the specific risks of ATI in the context of circulating SARS-CoV-2.

COVID-19 effects on the kidney

Apart from pulmonary disease, acute kidney injury (AKI) is one of the most frequent and most severe organ complications in severe coronavirus disease 2019 (COVID-19). The SARS-CoV‑2 virus has been detected in renal tissue. Patients with chronic kidney disease (CKD) before and on dialysis and specifically renal transplant patients represent a particularly vulnerable population. The increasing number of COVID-19 infected patients with renal involvement led to an evolving interest in the analysis of its pathophysiology, morphology and modes of virus detection in the kidney. Meanwhile, there are ample data from several autopsy and kidney biopsy studies that differ in the quantity of cases as well as in their quality. While the detection of SARS-CoV‑2 RNA in the kidney leads to reproducible results, the use of electron microscopy for visualisation of the virus is difficult and currently critically discussed due to various artefacts. The exact contribution of indirect or direct effects on the kidney in COVID-19 are not yet known and are currently the focus of intensive research.