AB1378 RELATION BETWEEN SHARP SCORE AND RADIOLOGICAL PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE OBSERVATION

Objectives

to analyse rheumatoid arthritis (RA)-patients depending on their individual peak radiographic progression.

Methods

61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to the Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (7 years FUP, median 7,7 [7,4;8,6]). The general characteristics of the group are presented in the Table 1. Hands and feet ultrasound (US) with grayscale (GS), power Doppler (PD), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9, and 12 months after. Radiographs were obtained at baseline, at 12 months, 4 years, and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Structural damage progression was evaluated by change in the Sharp van der Heijde score (ΔSHS) between baseline and 1,4 and 7 year. We determined the individual peak radiographic progression (Δ SHS scores/time) in RA- patients.

Table 1.

General characteristics

CharacteristicAt baselineAfter 1 year follow-upAfter 4 years follow-upAfter 7 years follow-upMedian age, years50,0 [38,0; 59,0]Disease duration, months7 [4; 20]GS6 [4; 9]PD2 [1; 6]DAS 285,6 [4,8; 6,5]2,88 [2,02; 3,93]3,76 [2,94; 5,09]4,03 [3,42; 4,74]ESR, mm/h35,0 [13,0; 50,0]12,0 [8,0; 28,0]22,0 [14,0; 36,0]22,0 [14,0; 36,0]CRP, mg/l10,6 [3,8; 32,3]2,9 [1,1; 7,1]3,0 [1,2; 8,8]3,0 [1,2; 8,8]Rheumatoid Factor, positive results53 (87%)Anti-CPA, positive results52 (85%)Erosion score0 [0; 3]1 [0; 4]2 [0; 6]3 [1; 11]Joint-space narrowing score57,0 [31,0; 88,0]62,0 [31,0; 92,0]93,0 [77,0; 106,0]98,0 [77,0; 110,0]Modified total Sharp score70,0 [31,0; 88,0]71,0 [31,0; 93,0]97,0 [79,0; 112,0]102,0 [78,0; 117,0]

Results

RA progression by 1 years FUP was identified in 10% (6 p) of pts, 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts.

All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). In the group Rg + GS at baseline was significantly higher than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04).

We analyzed relation between SHS (erosion score and total Sharp score) 7 years FUP, individual peak radiographic progression and Δ erosion score and total Sharp score in the observation periods: 0-1 years, 1-4 years, 4-7 years and 0-7 years. The following correlations were identified of erosion score 7 years FUP with Δ erosion score in all observation periods (r=0,33 p=0,016, r=0,54 p=0,000, r=0,68 p=0,000, r=0,84 p=0,000, respectively) and with individual peak radiographic progression in the observation periods 1-4 years, 4-7 years, 0-7 years (r=0,54 p=0,000, r=0,49 p=0,000, r=0,84 p=0,000, respectively). The following correlations were identified of total Sharp score 7 years FUP with Δ total Sharp score in the observation periods 4-7 years, 0-7 years (r=0,43 p=0,000, r=0,34 p=0,007, respectively) and with individual peak radiographic progression in the observation periods 4-7 years, 0-7 years (r=0,43 p=0,000, r=0,34 p=0,007, respectively).

Conclusion

These data show that the radiological progression increases over time at different rates.

Disclosure of Interests

None declared

AB0257 ADHERENCE TO TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background

Adherence is defined as the degree of agreement between a patient’s behavior (taking medication, changing lifestyle, or adhering to treatment recommendations) and the prescriptions of a physician or medical staff. The patient’s adherence to treatment is an important factor influencing the effectiveness of therapy, the course of the disease. In Russia, a universal questionnaire was developed to assess the level of adherence to drug therapy, medical care, lifestyle changes, and general adherence to treatment.

Objectives

To analyze the adherence to treatment, medical care and recommendations for lifestyle changes in patients with RA.

Methods

The cross-sectional study included 88 women with RA (ACR/EULAR 2010), the mean age - 63.0±8.1 years, the duration of the disease - 22.4±9.3 years. Adherence was assessed using the Russian questionnaire, which determines the low, average, and high levels of adherence to drug therapy, medical care, recommendations for lifestyle changes, and general adherence to treatment. All patients completed The Hospital Anxiety and Depression Scale (HADS) for the evaluation of anxious and depressive symptoms and HAQ (Health Assessment Questionnaire) to explore functional disability. All patients took a clinical examination, assessment of the anamnestic data, X-ray of hands, feet.

Results

Most of RA patients had an average level of adherence to drug therapy - 51 (58%); medical care - 45 (51%); low level of adherence to lifestyle recommendations – 63 (72%). Assessment of general adherence to treatment showed: 30 (34%) people had a low level of adherence, 51 (58%) - medium, and 7 (8%) - high. Elderly age (p=0.00), anxiety (p=0.02) and depression (p=0.04) were associated with low adherence to medical care. The use of glucocorticoids (GCs) was associated with high adherence to drug therapy (p=0.01). The number of patients taking disease-modifying anti-inflammatory drugs and biologic disease-modifying antirheumatic drugs, functional disability (HAQ) and the radiographic stage of RA (classified according to Steinbrocker) did not differ significantly in patients with different levels of adherence.

Conclusion

Most of RA patients had an average level of adherence to drug therapy, medical care, and a low level of adherence to recommendations for lifestyle changes. Patients taking GCs have a high level of adherence to drug therapy. Mental disorders (anxiety and depression) and elderly age are associated with low adherence to medical care.

Disclosure of Interests

None declared

AB1379 PREDICTORS OF RADIOLOGICAL PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE OBSERVATION

Objectives

to identify the prognostic role of ultrasound signs (US) in radiologic progression in RA patients

Methods

61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to the Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (7 years FUP, median 7,7 [7,4;8,6]). Among them 40 patients with early RA, mean age 51,0 [43,0; 60,0], disease duration 5 [3; 6,5] months. The general characteristics of the group are presented in the Table 1. Hands and feet ultrasound (US) with grayscale (GS), power Doppler (PD), and destructive changes (erosion), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9, and 12 months after. Radiographs were obtained at baseline, at 12 months, 4 years, and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Radiographic progression was documented based on Sharp/Van der Heijde modified score changes during the follow-up.

Table 1.

General characteristics

CharacteristicAt baselineAfter 7 years follow upMedian age, years50,0 [38,0; 59,0]Disease duration, months7 [4; 20]GS6 [4; 9]PD2 [1; 6]DAS 285,6 [4,8; 6,5]4,03 [3,42; 4,74]ESR, mm/h35,0 [13,0; 50,0]22,0 [14,0; 36,0]CRP, mg/l10,6 [3,8; 32,3]3,0 [1,2; 8,8]Rheumatoid Factor, positive results53 (87%)Anti-CPA, positive results52 (85%)Mean erosion score0 [0; 3]3 [1; 11]Mean joint-space narrowing score57,0 [31,0; 88,0]98,0 [77,0; 110,0]Modified total Sharp score70,0 [31,0; 88,0]102,0 [78,0; 117,0]

Results

52 ACPA+ (85%) and 9 ACPA− (15%) patients presented among the 61 patients with RA. RA progression by 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts.

During the 7 years FUP 42 of 61 patients had radiographic progression: the count of erosion increased from 0 [0; 3] to 3 [1; 11]. At the same time, on the background of therapy during the first year, a decrease in ultrasound signs of inflammation was determined according to the GS and PD: from 6 [4; 9] to 4 [2; 6] p = 0.000 and from 2 [1; 6] to 0 [0; 2] p = 0.000, respectively, and increase in the number of joints with erosions (from 1 [0; 2] to 2 [0; 3], p = 0.000).

All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). In the group Rg + GS at baseline was significantly higher than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04). CRP at 3 months and at 6 months was significantly higher in RG+ group than in RG- group (4,15 [1,2; 8,7] and 1,2 [0; 3,5], respectively, p=0.03 and 2,35 [0,8; 10,1] and 0,4 [0; 4,3], respectively, p=0.025).

Conclusion

Thus, we obtained the first data on the important prognostic role of ultrasound in assessing the progression of early RA in a prospective seven-year follow-up.

Disclosure of Interests

None declared

AB0918 EVALUATION OF X-RAY PROGRESSION AT 6 YEARS FOLLOW-UP OF TREAT-TO-TARGET STRATEGY IN EARLY PSORIATIC ARTHRITIS

Background

In Psoriatic arthritis (PsA) patients (pts) persistence inflammation in the peripheral joins leading bone erosions, joint space narrowing and new bone formation. Tight control of PsA disease improved joint and skin outcomes, but the number of pts with erosions increased [1]. Despite of clinical improvement no long-term treat to target (T2T) strategy data on radiographs progression yet [2].

Objectives

To study X-ray progression in PsA pts treated according to T2Tstrategy at the early stage of disease at 6 years (yrs) follow-up.

Methods

30 (M/F–17/13) PsA pts fulfilling CASPAR criteria, mean age 44.7±11.4 yrs, median (Me) PsA duration 78.5 [66;95] month (mos), Me follow-up 71 [60;86] mos, Me DAPSA 24 [7;45]. All pts was treated according to T2T strategy at the early stage with MTX alone or in combination with iTNF within 2 yrs. When T2T study was ended all pts were treated according to standard care. All pts underwent standard clinical examination of PsA activity, DAPSA was calculated. Radiographs of the hands and feet were available for 30 pts at baseline and 26 (86.6%) at 6-yrs follow-up. Radiographs of the hands and feet were scored using the modified van der Heijde-Sharp (m-v-d-HS) scoring method for PsA assessing both erosion, joint space narrowing (JSN) and total score (TS) m-v-d-HS. Scoring was done by two readers. The number of pts with erosions was calculated at baseline and 6 yrs later. M±SD, Me [Q25; Q75], Me (Min-Max), Mann-Whitney test were performed. All p<0.05 were considered to indicate statistical significance.

Results

At 6 yrs follow-up Me TS m-v-d-HS and JSN significantly increased from 34 (0-104) to 50 (6-253) and from 34 (0-97) to 50 (6-127) accordingly (p=0.006 and p=0.011); count of erosion from 0 (0-13) to 4 (0-128), p=0.002. In 19 out of 26 pts significantly negative X-Ray progression in the feet and hands by TS m-v-d-HS, count erosion, joint space narrowing was seen (for all p<0.05). In 7 out of 26 pts no X-Ray progression was found. PsA activity by DAPSA was significantly higher in pts with X-ray progression compare to those without progression 14.1 [5.19;33.67] and 2.22 [0.55;13.54] accordingly (p=0.04). 6 yrs later the number of pts with erosions significantly increased from 12 out of 26 (46%) at baseline to 22 out of 26 (85%) pts accordingly (p=0.002).

Conclusion

At 6 yrs follow-up negative radiographic progressions in the hand and feet found in mostly early PsA pts despite of tight control treatment strategy within 2 yrs.

References

[1]Coates LC, Moverley AR, McParland L, Brown S, Navarro-Coy N, O’Dwyer JL, Meads DM, Emery P, Conaghan PG, Helliwell PS. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015 Dec 19;386(10012):2489-98

[2]Coates LC, Mahmood F, Freeston J, Emery P, Conaghan PG, Helliwell PS. Long-term follow-up of patients in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) trial. Rheumatology (Oxford). 2020 Apr 1;59(4):807-810

Disclosure of Interests

Polina Tremaskina: None declared, Elena Loginova Speakers bureau: Janssen, Tatiana Korotaeva Speakers bureau: Pfizer, MSD,

AbbVie, Novartis-Sandoz, JSC Biocad, Janssen, UCB, Lilly, Anastasiia Sukhinina: None declared, Svetlana Glukhova: None declared, Alexander Smirnov: None declared, Alexander Lila: None declared

Balamuthia spinosa n. sp. (Amoebozoa, Discosea) from the brackish-water sediments of Nivå Bay (Baltic Sea, The Sound) - a novel potential vector of Legionella pneumophila in the environment

We have found a new free-living amoeba species named Balamuthia spinosa n. sp. (Amoebozoa, Discosea) in the bottom sediments of the brackish-water Nivå Bay (Baltic Sea, The Sound). This species resembles members of the genus Stygamoeba morphologically and was (mis)identified as belonging to this genus during the initial investigation. However, SSU rRNA gene data show that it robustly groups with Balamuthia mandrillaris sequence among Acanthopodida and represents a new species of the genus Balamuthia. Fragments of Legionella pneumophila genome were found among the NGS contigs obtained from B. spinosa n. sp., suggesting that this species may be a vector of Legionella in the environment. We discuss a remarkable morphological and ultrastructural similarity between the genus Balamuthia and the genus Stygamoeba. In addition, our phylogenetic analysis based on the SSU rRNA gene sequences revealed a close relationship between the genera Stygamoeba and Vermistella. It is one more confirmation of the order Stygamoebida, which was formed basing on the morphological evidence. The position of these branches close to Thecamoebida clade is congruent with current phylogenomic data.

Thecamoeba astrologa n. sp. - A new species of the genus Thecamoeba (Amoebozoa, Discosea, Thecamoebida) with an unusually polymorphic nuclear structure

Thecamoeba astrologa n. sp. was isolated from a plant litter sample. This species has a complex locomotive morphology, to a certain extent intermediate between the striate and the rugose morphotype. The shape of the actively moving cell is similar to that of striate thecamoebians, such as T. quadrilineata. However, in a slow movement, they can be easily confused with rugose species, like T. similis. Thecamoeba astrologa normally has peripheral asterisk-like nucleoli, which are unique among known thecamoebids. However, the structure of the nucleus is unusually variable during the growth of the culture and in some cases may become almost a vesicular one. The phylogenetic analysis based on the 18S rRNA gene sequence shows that this species belongs to the clade of thecamoebids, consisting of species possessing vesicular nuclei. This finding indicates that the structure of the nucleus derived from a single or few observations (as it usually happens in faunistic or ecological studies) may not be a reliable character of a thecamoebid amoeba. In some species nuclei may be highly polymorphic and dominating nuclear structure may depend on the age of the culture. Nuclei with constantly or temporarily peripheral nucleoli are now known in both major phylogenetic branches of the genus Thecamoeba.

Aminated Graphene-Graft-Oligo(Glutamic Acid) /Poly(ε-Caprolactone) Composites: Preparation, Characterization and Biological Evaluation

Biodegradable and biocompatible composites are of great interest as biomedical materials for various regeneration processes such as the regeneration of bones, cartilage and soft tissues. Modification of the filler surface can improve its compatibility with the polymer matrix, and, as a result, the characteristics and properties of composite materials. This work is devoted to the synthesis and modification of aminated graphene with oligomers of glutamic acid and their use for the preparation of composite materials based on poly(ε-caprolactone). Ring-opening polymerization of N-carboxyanhydride of glutamic acid γ-benzyl ester was used to graft oligomers of glutamic acid from the surface of aminated graphene. The success of the modification was confirmed by Fourier-transform infrared and X-ray photoelectron spectroscopy as well as thermogravimetric analysis. In addition, the dispersions of neat and modified aminated graphene were analyzed by dynamic and electrophoretic light scattering to monitor changes in the characteristics due to modification. The poly(ε-caprolactone) films filled with neat and modified aminated graphene were manufactured and carefully characterized for their mechanical and biological properties. Grafting of glutamic acid oligomers from the surface of aminated graphene improved the distribution of the filler in the polymer matrix that, in turn, positively affected the mechanical properties of composite materials in comparison to ones containing the unmodified filler. Moreover, the modification improved the biocompatibility of the filler with human MG-63 osteoblast-like cells.

AB0792 IMAGING METHODS IN PREDICTING A RADIOLOGIC PROGRESSION IN RA

Background:

Rheumatoid arthritis (RA) is the chronic inflammatory joint disease, and it is responsible for structural damage. Several studies have shown that ACPA + patients were more likely than ACPA− patients to develop erosive changes on radiography. Ultrasound (US) is a well-established method of diagnosis and follow-up in RA, which at the moment may have a prognostic value in assessing the outcomes of the disease.

Objectives:

to identify the prognostic role of US in radiologic progression in RA patients.

Methods:

85 RA pts, mean age 53,0 [44,0; 61,0] yrs, mean disease duration 8 [4; 24] months were treated with MTX and biologics according to Treat-To-Target concept. Among them 56 patients with early RA, mean age 53,5 [45,5; 61,0], disease duration 5 [3; 7,5] months. Hands and feet ultrasound (US) with gray scale (GS), power Doppler (PD) and destructive changes (erosion), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9 and 12 months after. A binary scoring system (presence/absence of erosions) of the joints examined was used. Radiographs were obtained at baseline and 4 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Radiographic progression was documented based on Sharp/Van der Heijde modified score changes during the follow up.

Results:

71 ACPA+ (84%) and 14 ACPA− (16%) patients presented among the 85 patients with RA, among them 49 ACPA+ (87%) and 7 ACPA− (13%) with early RA.

RA progression by 4 years the follow-up period was identified in 39% of pts.

During the follow-up period 33 of 85 patients had radiographic progression: the count of erosion increased from 0 [0; 3] to 2 [0; 6]. At the same time, on the background of therapy, a decrease in ultrasound signs of inflammation was determined according to the GS and PD: from 6 [4; 9] to 1 [0; 2] p = 0.000 and from 2 [1; 6] to 0 [0; 1] p = 0.000, respectively, and increase in the number of joints with erosions (from 1 [0; 2] to 2 [0; 4], p = 0.000).

In the group with early RA, the changes were similar.

In ACPA+ general group the count of erosion at 4 years was significantly higher than in ACPA− general group (3 [0; 7] and 0 [0; 1], respectively, p=0.0026).

In ACPA+ early RA group the number of joints with erosions by US at baseline was significantly higher than in ACPA− early RA group (1 [0; 1] and 0 [0; 0], respectively, p=0.017). In ACPA+ early RA group the count of erosion at 4 years was significantly higher than in ACPA− early RA group (2 [0; 4] and 0 [0; 0], respectively, p=0.009) (Table 1)

Table 1.

Characteristic of the groups (general group)

at baselineACPA+(71 pts)ACPA- (14 pts)pThe number of joints with erosions by US1 [0; 2]0 [0; 1]0,36The number of erosions by X-ray1 [0; 4]0 [0; 1]0,06after 4 years follow upThe number of joints with erosions by US2 [0; 4]1 [0; 2]0,16The number of erosions by X-ray3 [0; 7]0 [0; 1]0,0026Characteristic of the groups (early RA group)at baselineACPA+(49 pts)ACPA- (7 pts)pThe number of joints with erosions by US1 [0; 1]0 [0; 0]0,017The number of erosions by X-ray0 [0; 2]0 [0; 0]0,11after 4 years follow upThe number of joints with erosions by US2 [0; 3]1 [0; 1]0,22The number of erosions by X-ray2 [0; 4]0 [0; 0]0,009

Conclusion:

Thus, in early RA is advisable to perform an US of the hands and feet to select a group of patients with potentially rapid radiological progression. US evaluation of patients with non-early stage RA is not very important for assessing the prognosis.

Disclosure of Interests:

None declared

AB0245 ANALYSIS OF THE CLINICAL AND ANTIDESTRUCTIVE EFFECTS OF RITUXIMAB DEPENDING ON GENDER IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation of the synovial tissue and destruction of the underlying cartilage and bones. It was found that RA more often affects women than men, with a sex ratio of 3: 1. And the question of the influence of gender on the outcomes and course of RA remains controversial, there is no consensus on whether RA is worse in women or men. Recent reports indicate that women are less likely to achieve remission than men. Women suffer from RA at an earlier age and have higher markers of disease activity such as DAS28 and HAQ. Rituximab is a chimeric monoclonal antibody that targets the CD20 molecule expressed on the surface of B cells, it has been successfully and widely used for the treatment of rheumatoid arthritis, so it is of interest to assess whether gender influences the therapeutic and radiological effects of RTX.

Objectives:

The aim of this study was to analyze the impact of gender on the response to rituximab (RTX) in patients with RA.

Methods:

Initially, 221 women(w), 27 men(m), were examined to assess the clinical and X-ray effect (88w/6m), who received RTX treatment (1000 mgx2 or 500 mgx2). Both groups were comparable in terms of the main clinical and laboratory characteristics (age, duration of the disease, the number of preceding DMARDs, in both groups most patients were RF + and ACCP +, a high degree of activity according to DAS 8 - men - 5.6 [4.6-6.7], women - 6.04 [5.2-6.63] Initially, the degree of radiological changes in men is slightly higher than in women (p> 0.05). Clinical effect was scored by EULAR criteria, radiographic progression was assessed using Sharp/van der Heijde modified scoring method.

Results:

When assessing the clinical effect after 48 weeks in men, a significantly better effect of RTX treatment was noted in comparison with women (Δ DAS28, a significantly better effect was noted in men - Δ DAS28 =3.75[2.8-4.14], and Δ DAS28=1.3[0.37-2.72] in women, (p=0.04). Analyzing the X-ray effect after 48 weeks of RTM treatment: the absence of progression in terms of the total score in 83.33% of men and 60.98% of women; there was no progression in narrowing of the joint space in 83.33% of men and 65.85% of women, noteworthy that the account of erosion practically reaches statistical significance - inhibition of destruction in 100% of men and 74.31% of women (p = 0.06).

Conclusion:

Thus, having analyzed the clinical and antidestructive effects of RTM therapy depending on gender, we can conclude that the effect is significantly higher in the male group. Also, there is a tendency towards more effective inhibition of radiographic progression in men.

Disclosure of Interests:

None declared

AB0498 INFLUENCE OF SYNOVITIS OF THE HIP JOINTS ON X-RAY PROGRESSION OF COXITIS IN AXIAL SPONDYLOARTHRITIS. RESULTS OF TWO YEARS FOLLOW-UP

Background:

Almost half of patients with axial spondyloarthritis (axSpA) in Russia have hip joint lesions (HJ), but only in 7% of cases it becomes so severe and requires arthroplasty. The causes and rates of progression of coxitis have not been studied.

Objectives:

To assess the relationship between disease activity and the sonographic synovitis of the hip joint with the progression of X-ray coxitis in patients with axSpA with a 2-year follow-up.

Methods:

The study included 77 patients (mean age 28 ± 5.92 years) with axSpA (ASAS criteria 2009), who were followed up for at least 2 years. Among them, AS (mNY criteria, 1984) had 66 (86%) patients, and nonradiographic axSpA - 11 (14%). The median duration of the disease was 30 [3–60] months, BASDAI - 4.5 [3.2; 5.9], BASFI - 2.4 [0.9; 4.8]. All patients underwent clinical examination, X-ray and ultrasound investigation of the hip joint during the monitoring period. For ultrasound, coxitis was considered an increase in the cervical-capsular distance (CCD) of more than 7 mm. An increase in BASRI hip by 1 stage in 2 years was considered as progression of radiographic coxitis (PRC).

Results:

At the time of enrollment, 66 (86%) patients out of 77 patients had pain in the hip joint, and after 24 months - 48 (62%) (p> 0.05). At the time of inclusion, the median pain in the hip joint was 4 [2; 5]; severe pain (≥4.0) had 38% of patients. The median CCD at the time of inclusion was 7.3 [6.4; 8.2] mm, and two years later 6.6 [5.9; 8.2] mm (p> 0.05). At the sonographic examination at the beginning of follow-up 63 (82.0%) patients had coxitis, and after 2 years - 45 (58%) (p <0.05). X-ray coxitis at the time of inclusion was present in 19 (25%) patients, and after 2 years - in 48 (62%) (p <0.05). Depending on the presence or absence of PRC after 2 years, the patients were divided into 2 groups (Table 1). All patients with PRC at the start of the study had sonographically diagnosed synovitis, while among those without progression, only half of them; relative risk of X-ray progression in the presence of ultrasound of synovitis (RR) = 10.5 (p <0.05). The groups did not differ in terms of activity indicators and the presence of extra-axial manifestations.

Table 1.

Characteristics of patients with axSpA at the time of inclusion in the study who had PRC after 24 months of observation.

ParametrsΔBASRI hip=0n=33ΔBASRI hip >0n = 44pSex (m/w), n22/1132/12>0,05The duration of the disease, m., Мe [25;75‰]36 [19;132]48 [24;84]>0,05Age, years, Мe [25;75 ‰]30 [26;34]28 [24;34]>0,05BASDAI, Мe [25;75 ‰]4,3 [3,1;5,8]4,7 [3,8;6,3]>0,05BASFI, Мe [25;75 ‰]3,4 [0,6;5,6]2,1 [1,1;4,2]>0,05ASDAS (SRP), Мe [25;75 ‰]2,6 [1,6;3,9]3,2 [2,3;4,2]>0,05ESR, mm/h, Мe [25;75 ‰]15 [7;30]23,0 [12;35]>0,05SRP, mg/l, Мe [25;75 ‰]12,8 [1,8;31,0]17,8 [5,6; 50,3]>0,05Peripheral arthritis, n %26 (79%)32 (73%)>0,05US synovitis n%19 (58%)44 (100%)<0,05*Pain in HJ n%28 (85%)38 (86%)>0,05

Conclusion:

X-ray progression of coxitis is associated with ultrasound synovitis and does not depend on the activity of the disease.

Disclosure of Interests:

None declared.

The integrated diagnostic suite of the C-2W experimental field-reversed configuration device and its applications

In the current experimental device of TAE Technologies, C-2W (also called "Norman"), record breaking advanced beam-driven field-reversed configuration (FRC) plasmas are produced and sustained in steady state utilizing variable energy neutral beams (15-40 keV, total power up to 20 MW), advanced divertors, bias electrodes, and an active plasma control system. This fully operational experiment is coupled with a fully operational suite of advanced diagnostic systems. The suite consists of 60+ individual systems spanning 20 categories, including magnetic sensors, Thomson scattering, interferometry/polarimetry, spectroscopy, fast imaging, bolometry, reflectometry, charged and neutral particle analysis, fusion product detection, and electric probes. Recently, measurements of main ion temperatures via a diagnostic neutral beam, axial profiles of energy flux from an array of bolometers, and divertor and edge plasma parameters via an extensive set of electric probes, interferometers, and spectrometers have all been made available. All the diagnostics work together to provide a complete picture of the FRC, fast-ion inventory, and edge plasma details enabling tomographic reconstruction of plasma parameter profiles and real-time plasma control.

SIMULATION OF A THROWING DEVICE FOR WRESTLERS

Aim. The paper aims to develop a model of a training device for wrestlers that helps to improve technique and special physical fitness. Materials and Methods. The study investigates the process of developing technical skills and special physical fitness in wrestlers. The following research methods were applied: analysis of scientific and methodical literature and practical experience, pedagogical observation, pedagogical experiment. The efficacy of the device was tested together with the Perm Krai federation of sports and combat sambo during 2018–2019 academic year. Thirty wrestlers aged from 14 to 16 years participated in the study (CG, n = 15; EG, n = 15). All wrestlers were of different weight categories and possessed a title of Candidate for Master of Sport. Results. The results of the pedagogical experiment testify to a significant advantage (p < 0.05) of sambo wrestlers in the experimental group over sambo wrestlers in the control group in terms of special physical fitness. Competitive activity of the experimental group is more stable, and the growth of sportsmanship is higher than that of the control group. Conclusion. The authors developed a model of a training device for wrestlers to improve their technical skills and special physical fitness. However, the engineering and technical component of the training device is not perfect and requires further improvement.

Vannella primoblina n. sp. - an unusual species of the genus Vannella (Amoebozoa, Discosea, Vannellida) with pronounced dorsal ridges and folds

Amoebae of the order Vannellida (Amoebozoa, Discosea) have a fairly recognizable spatulate, fan-shaped or semi-circular outlines and a wide area of frontal hyaloplasm. They can be easily distinguished from the other groups of lobose amoebae even by light microscopy. The dorsal side of these amoebae is usually smooth and rarely bears ridges or folds, which are never numerous or regular. We have isolated an unusual species of vannellid amoebae, called Vannella primoblina n. sp. from a terrestrial substrate. It has well-developed dorsal relief consisting of regularly appearing folds and ridges. This amoeba superficially resembles members of the genus Thecamoeba. However, molecular analysis showed that this strain belongs to the genus Vannella. This finding indicates that dorsal folds may also be a characteristic of some species of vannellid amoebae and probably are a functional detail of the cell morphology rather than an apomorphy of Thecamoebida lineage. Overall outlines of the cell and the presence of the expanded frontal hyaline area remains the most reliable characters used to differentiate vannellid amoebae from other gymnamoebae lineages.

INFLUENCE OF NON-DRUG THERAPY ON REHABILITATION TIME AND SKEET SHOOTING AFTER RHINOSURGICAL INTERVENTIONS

Aim. The paper aims to study the effect of low-frequency ultrasonic cavitation on tissue regeneration and return to skeet shooting in athletes after rhinosurgical interventions. Materials and methods. 16 skeet shooters with eustachitis provoked by nasal septum deviation were treated in the department of otorhinolaryngology at Chelyabinsk city clinical hospital No 1 in the period from 2019 to 2020. Comprehensive postoperative treatment was combined with low-frequency ultrasonic cavitation therapy. Treatment was provided on a daily basis in accordance with clinical recommendations. Objective and subjective clinical and rhinological data about nasal mucous membranes were studied, as well as the effect of low-frequency ultrasonic cavitation on regeneration processes and auditory tube function recovery. Results. The use of low-frequency ultrasonic cavitation therapy in early postoperative period improves regeneration of operated cavities, removes tissue swelling, and restores ventilation function of the auditory tube. Conclusions. Short-term application of low-frequency ultrasonic irrigation of nasal cavities allows to improve tissue regeneration, restore tubal function, remove postsurgical alternative inflammation and swelling of nasal cavity mucosa, return to skeet shooting.

INFLUENCE OF THE ACTING SUBSTANCE SODIUM DICLOFENAC ON BONE MARROW CELLS

In humans and mammals, the homeostasis system is supported by many organs and systems, but hematopoietic remains one of the most important. A negative effect on the hematopoietic system is rejected by many factors, but the first place remains for drugs, which one in three are non-steroidal anti-inflammatory drugs (NSAIDs). The most popular among them remains the active substance "Diclofenac Sodium", which is part of many drugs. The purpose of the work is to study the action of the active substance Diclofenac sodium and its effect on the erythrocyte series of bone marrow cells of white laboratory mice in an experiment. The studies were conducted on white laboratory mice, males, 6 months old, 60 grams. The animals were divided into three groups, the first received 0.09 mg of Diclofenac sodium in the quadriceps of the thigh, the second - 0.18 mg and the third physiological solution for 96 hours. After observing all the rules of bioethics, the animals were slaughtered and the bone marrow was examined using pure immuno-magnetic separation techniques. During the study, it became known that in the first group the number of erythroblasts increased by 75%, while in the second group by 166.5%, due to the blocking of differentiation into more mature cells. The number of reticular cells decreased by 33.4%, while in the second group by 60%. A decrease in the erythrokaryocyte maturation index in the first group by 42.6% whereas in the second by 32.5%, primarily due to immature red blood cell precursors. In the first group, the leuko-erythrokaryoid ratio decreased by 9.5%, while in the second group by 12.3%. The number of megakaryocytes due to the predominant blockade of cyclooxygenase-2 increased in the first group by 266.6%, while in the second by 733.3%. It was found that the most favorable effect on red bone marrow cells has a dose of 0.09 mg, while 0.18 mg has a toxic effect and contributes to the development of cardiovascular complications.

Overall Survival of Patients With ALK-Positive Metastatic Non-Small-Cell Lung Cancer in the Russian Federation: Nationwide Cohort Study

PURPOSE

The overall survival (OS) results in patients with ALK-positive metastatic non–small-cell lung cancer (NSCLC) have rarely been reported. The aim of this prospective-retrospective cohort study was to obtain real-world data on the use of crizotinib or chemotherapy in patients with ALK-positive metastatic NSCLC in Russia.

PATIENTS AND METHODS

Patients with epidermal growth factor receptor–negative metastatic NSCLC were screened in 23 cancer centers. To be eligible, patients were required to have confirmation of ALK rearrangement. Patients were treated with crizotinib (250 mg twice daily; n = 96) or the investigator’s choice of platinum-based chemotherapy (n = 53). The primary end point was OS.

RESULTS

A total of 149 ALK-positive patients were included. Mean age was 53 years in both groups. Patients were predominately women (59%) and never-smokers (74%), and most patients had adenocarcinoma histology (95%). At a median follow-up time of 15 months, 79 of the 149 patients included in the analysis had died. Median OS from the start of treatment was 31 months (95% CI, 28.5 to 33.5 months) in the crizotinib group and 15.0 months (95% CI, 9.0 to 21.0 months) in the chemotherapy group (P < .001). The objective response rate was 34% in the crizotinib group. Among patients with brain metastasis, one complete response (6%) and five partial responses (31%) were achieved. Grade 3 adverse events were observed in three patients (3%) in the crizotinib group.

CONCLUSION

The improved OS observed in crizotinib clinical trials in ALK-positive NSCLC was also observed in the less selective patient populations treated in daily practice in Russia. The use of standard chemotherapy in these patients remains common but seems inappropriate as a result of the effectiveness of newer treatments, such as crizotinib.

AB1075 PRESENCE POWER DOPPLER ULTRASOUND AS A PREDICTOR OF RADIOGRAPHIC DAMAGE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to destructive changes and dysfunction of the joints. Ultrasound (US) is used in current practice as an early diagnostic method for detecting structural damage to articular surfaces. US changes in early RA are considered as one of the ways of predicting disease outcomes.

Objectives:

to detect power doppler (PD) contribution in evaluation of radiographic RA progression in long term.

Methods:

85 RA pts, mean age 53,0 [44,0; 61,0] yrs, mean disease duration 8 [4; 24] months were treated by Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (4 years FUP). The wrist, MCP2 and MCP3, PIP2, PIP3, MTP2 and MTP5 joints of the clinically dominant side were examined by US (GS and PD). Clinical, laboratory parameters and US examination was performed at baseline, at Mo 3, 6, 9 and 12. The X-ray was conducted before treatment and in the end of the study. Structural damage progression was evaluated by change in the Sharp van der Heijde score (ΔSHS) between baseline and 4 year.

We categorized pts into 5 groups according to the occurrence of positive PD: 1) without PD throughout the observational period [the negative (N)], 2) positive PD limited to the period from the baseline to Mo 3 [the therapeutic response (R)], 3) positive PD limited to the period from the baseline to Mo 6-9 [the therapeutic late-response (LR)], 4) intermittent occurrence of PD in the observational period [the intermittently positive (IP)] and 5) with persistent positive PD throughout the observational period [the persistently positive (PP)].

Results:

80% of pts had PD synovitis at baseline. PD-synovitis dropped from 2 [1,0; 6,0] to 0 [0,0; 2,0] scores at Mo 12. RA progression by 4 years FUP was identified in 13% of pts. The X-ray erosion score at 4 years FUP in these groups – N, R, LR, IP and PP - were dependent by PD from baseline to Mo 12 (mean level 1 [0; 2]; 2 [0; 4], 3 [0; 5], 1 [0; 2] and 4,5 [1; 10] respectively), but statistically significant differences were found between N and PP groups.

Cox multivariate analysis identified that presence PD-synovitis at baseline was associated with risk of radiographic progression at 4 years (HR 3,68 95% CI 1,03 – 13,15, р = 0,045).

Conclusion:

Thus, PD-synovitis has a prognostic value for increasing destructive radiographic changes.

References:

no

Disclosure of Interests:

None declared

AB1112 THE DIAGNOSTIC OF THE OSTEOARTHRITIS OF THE HANDS BY CONVENTIONAL RADIOGRAPHY

Background:

The most severe phenotype of osteoarthritis (OA) is currently considered to be an inflammatory or erosive phenotype (EOA). There is currently no reliable x-ray picture of this disease in the literature, and the question of whether it is an independent form of OA, a natural more pronounced stage of progression, or a separate nosology is debated in the literature.

Objectives:

To identify the localization, frequency, and severity of pain and radiological symptoms in patients with EOA and non-erosive (NOA) disease in the interphalangeal (DIP and PIP) and metacarpal (MCP) joints of the hands.

Methods:

64 women with diagnosis of OA of the hand (HOA) joints according to the ACR criteria were included into study after signing the informed consent form. Mean age was 65.28 ± 6.82 years (48-77), mean BMI 27,7 ± 4,4 kg/m2, mean disease duration 12 ± 8,1 years. Individual patient’s medical record included relevant anthropometric data, records from case history and clinical examination, AUSCAN scores, patient’s articular status. Instrumental diagnostic methods included plain radiography of the hand joints in an anterior-posterior projection. The images were described in accordance with the Kellgren&Lawrence (K&L) system.

When evaluating radiographs of 64 patients with HOA, the most common was stage II (49%) according to K&L, and the most common symptoms in distal (DIP), proximal (PIP) interphalangeal and MCP were joint space narrowing (JSN) (100%, 100%, and 95%, respectively) and osteophytes (OP) (88%, 70%, and 45%, respectively). Subchondral osteosclerosis (SO) (5%), erosions (8%), and subluxations (3%) in MCP, as well as subluxation in PIP (6%) were less common. Statistica 10.0 was used for statistical analysis.

23 patients had EOA, 37 had NOA. Depending on the presence of erosions in interphalangeal joints patients were divided into 2 groups comparable in terms of age, age of OA onset and duration of disease (the average age of patients with EOA interphalangeal joints was 68 + 6.15 years, and mean disease duration 18,34 + 7.11 years; in the group without erosive changes in the average age amounted to 65,13±5.43 years, mean disease duration of 16.56±8.4 years).

Results:

EOA DIP and PIP was detected in 15 (23%) with radiological changes corresponding to stages III-IV of HOA and in 8 people (12%) with stage II on the K&L scale. Patients with stage I according to standard radiography had no erosive process.

In DMFs OP (100% and 78%, OR=1.28, 95%, CI [1.08-1.5], p=0.02), SO (74% and 11%, OR=6.8, 95%, CI [2.6-17.8], p<0,0001), subchondral cysts (SC) (61% and 24%, OR=2.5, 95%, CI [1.3-4.82], p=0.005) and subluxations (43% and 14%, OR=3.2, 95%, CI [1.3-8.23], p=0.01) were significantly more often found in patients with EOA. In PIPs SO (43% AND 5%, OR=8.04, 95%, CI [1.93-33.5], p=0.0005), SC (52% and 27%, OR=1.93, 95%, CI [0.1-3.73], p=0.045) and subluxations (17% and 0%, p=0.01) were significantly more frequently detected in patients with EOA compared to the non-erosive group. According to the results of the AUSCAN questionnaire, a significantly greater severity of pain was found in patients with EOA (65%) in comparison with the non-erosive (30%) form of HOA (OR=2.19, 95%, CI [1.23-3.9], p=0.008).

Conclusion:

DIPs is most often affected in OA of interphalangeal joints, less often PIPs, the most common symptoms are JSN and OP. At EOA in addition to more frequent detection OP, cysts, SO, subluxations in DIPs, SO, cysts and subluxations in PIPs, there is also significantly more pronounced pain according to AUSCAN data, it can be concluded that EOA is more severe in comparison with the non-erosive form of HOA.

Disclosure of Interests:

Danil Kudinsky: None declared, Ludmila Alekseeva Grant/research support from: Bayer, Alexander Smirnov: None declared, Alexander Volkov: None declared, Olga Alekseeva: None declared, Elena Taskina: None declared, Anastasiia Sukhinina: None declared

AB0915 BONE MINERAL DENSITY AND FRACTURE FREQUENCY IN PREMENOPAUSAL WOMEN WITH RHEUMATIC DISEASES

Background:

The onset of the disease in young and middle age is typical for rheumatic diseases (RDS), but most studies on osteoporosis were conducted in patients (pts) older than 50 years, which included postmenopausal women.

Objectives:

To assess bone mineral density (BMD), fracture frequency and the factors associated with low BMD in premenopausal women with RDs.

Methods:

160 women (median age, 36 [29; 43] years): 120 pts with RDs (43 rheumatoid arthritis (RA), 53 systemic sclerosis (SSc) and 24 psoriatic arthritis (PsA)) and 40 age-matched healthy controls were enrolled in the study. We performed a dual-energy X-ray absorptiometry (DXA, Hologic Discovery A, USA) to measure BMD in lumbar spine, femoral neck and total hip. BMD decreasing grade was evaluated by the Z-score <-2SD. All pts were interviewed using a unified questionnaire including assessment of daily dietary calcium intake. Serum vitamin D, C-reactive protein and erythrocyte sedimentation rate (ESR) measurements were done.

Results:

25% pts with RDs and only 8% healthy controls have low BMD (p=0.02). RA, SSc and PsA pts had low BMD in 37%, 21% and 13%, respectively, that was more often than in healthy women (p=0.004, p=0.046 and p= 0.081, respectively). 9,3% RA pts and 7,5% SSc pts had low energy fractures. BMD of RDs pts in all areas of measurement demonstrated a direct correlation with height, weight, body mass index, and serum vitamin D concentration and an inverse correlation with the cumulative dose of glucocorticoids. Also, proximal femur BMD inversely correlated with RDs duration. BMD of femoral neck and total hip inversely correlated with C-reactive protein level in SSc pts. In RA women we found a direct correlation between lumbar spine and femur neck BMD and ESR.

Conclusion:

25% of premenopausal women with RDs had reduced BMD and needed monitoring and osteoporosis prevention, while 9.3% pts with RA and 7.5% women with SSc needed anti-osteoporotic treatment.

Disclosure of Interests:

None declared

SAT0474 WHAT DETERMINES THE EFFECT OF THERAPY WITH DENOSUMAB ON BONE IN WOMEN WITH RHEUMATOID ARTHRITIS AND OSTEOPOROSIS

Background:

RANK-ligand is essential for osteoclast development, activation, and survival and it is a key mediator of increased osteoclast activity in rheumatoid arthritis (RA). Denosumab is a monoclonal antibody that binds RANK-ligand.

Objectives:

The aim of this study was to evaluate the effects of denosumab on bone mineral density (BMD) and to define a contribution of factors: anamnesis, clinical/laboratory markers, glucocorticoids (GC) intake, etc. on the response to therapy with denosumab in women with RA and osteoporosis (OP).

Methods:

66 postmenopausal women (mean age 59,6±7,4) with RA (mean duration 17,7±10,4 years) and OP received s/c denosumab 60 mg every 6 months pro 12 months. RF-positive were 72%, ACCP – 74% of patients. 34 (49%) patients continued GC. At baseline and after 12 months it was carried out the dual energy x-ray absorptiometry at 3 sites: lumbar spine (L1-L4), hip neck (HN) and distal forearm (DF) and x-ray of hands and feet (Sharp/van der Heijde (SVH) score). The Statistica 6.0 was used.

Results:

After therapy it was noted the increase (р < 0,05) of BMD in L1-L4 and HN, a tendency to increase (р =0,0529) in DF. Mean BMD (L1-L4) before\after the treatment was 0,821 ± 0,104 g/cm2vs 0,864 ± 0,110 g/cm2, at HN was 0,625 ± 0,089 g/сm2vs 0,639 ± 0,088 g/сm2, at DF was 0,498 ± 0,090 g/сm2vs 0,503 ± 0,089 g/сm2. The mean change of BMD (%) after 12 months at L1-L4 was +4,6%, at HN +2,8%, at DF +0,7%. Positive response (increase or stabilization of BMD) was noted in 89% patients at L1-L4, 67% - at HN and 60% - at DF. Analysis of influence of various factors (statistically significant) on the response to therapy is presented in the Table.

Table.

Influence of various factors on the response to therapy with denosumab after 12 months of treatment (n=66)

DXA sitePositive response on therapy is associated withNegative response on therapy is associated withL1-L4–- GC intake (> 3 months in anamnesis) (р = 0,034);- the beginning of GC intake after menopause (р = 0,023)Hip neck- higher concentration of the RF (initially and in dynamics) (р < 0,05);- the beginning of menopause later than RA onset (р = 0,024)- GC intake (> 3 months in anamnesis) (р = 0,024)Forearm (distal 1/3)- RF-positivity (р = 0,02)- back correlates with increase in erosion score and total SVH score: r = –0,360 (р < 0,05)

Conclusion:

After 12 months of therapy with denosumab in postmenopausal women with RA and OP it was shown the significant increase of BMD in L1-L4 and HN, a tendency to increase in DF. The mean change of BMD (%) after 12 months was +4,6% at L1-L4, at HN +2,8%, at DF +0,7%. Positive response on denosumab (BMD) was noted in 89% patients at L1-L4, 67% - at HN and 60% - at DF. Analysis of influence of factors on the response to therapy showed that positive response on therapy in NH and DF was associated with RF-positivity. The distinct contribution to the negative response in L1-L4 and HN was associated with GC intake (previous intake more than 3 months in the anamnesis) and purpose of the GC after menopause onset. Also, negative response in DF back correlated with increase in erosion score and total SVH score.

Disclosure of Interests:

None declared

AB1042 ASSESSMENT OF BONE MINERAL DENSITY AND FREQUENCY FRACTURES PERIPHERAL SKELETON BONES IN PATIENTS WITH ALKAPTONURIA

Background:

Objectives:

To assess the bone mineral density (BMD) of the skeleton using the Hologic Discovery A DXA, determine the frequency of low-energy skeletal bone fractures among adult patients with alkaptonuria (AKU), and identibjectivefy factors that affect the occurrence of fractures.

Methods:

AKU is a rare genetic disease (1 case per 250,000) which occur to severe damage to the spine and large joints. Serious problem in this category of patients is a decrease in BMD. The study included 40 patients with a reliable diagnosis of AKU (23 men and 17 women) aged from 33 to 78 years (mean 60.32±9.1). Densitometry of the lumbar spine was performed in 40 patients; of the forearm bones in 34 patients; of the proximal femur in 32 patients (8 patients were not examined due to bilateral hip joint replacement).

Results:

Normal values of spinal BMD were found in 26 patients (65%), osteopenia – in 12 (30%) and osteoporosis – in 2 (5%) patients. In the proximal parts of the femur, osteoporosis was detected in 12 patients (30%), osteopenia in 13 (32.5%), and normal in 7 (17.5%) patients. In the bones of the forearm, osteoporosis was found in 22 patients (55%), osteopenia – in 8 (20%), and norm – in 4 (10%) patients. The BMD values (g / cm2) in the group were as follows:

Table 2.

Disease and treatment characteristics of 2 discrete phenotypes (Systemic and Chronic articular)

Systemic formChronic articular formTotalPatients (n)10616Duration of follow-up (years), median (range)13 (3-24)14 (1-14)14 (1-24)Duration of disease prior to bDMARDs (months)7.5 (2-120)21 (3-36)10.5 (2-120)Number of cDMARDs prior to bDMARDs2 (1-2)1 (1-4)2 (1-4)Patients on concomittant cDMARDs, n (n/N%)10 (100%)6 (100%)16 (100%)Type of 1stbDMARD (n)3 TCZ, 2 anti-TNFa, 4 Anakinra, 1 Canakinumab4 anti-TNFa, 2 TCZPatients on bDMARD at the end of follow-up (n/N%)6 (60%)6 (100%)12 (75%)Time to steroids discontinuation after bDMARD initiation (months)7.5 (2-22)4.5 (3-36)6.5 (2-36)NMeanPercentiles25th75thBMD L1-L4401,060,881,25BMD Prox.Femur320,560,610,81BMD Forearm340,480,430,54

Peripheral bone fractures were diagnosed in 15 (32.6%) patients – 9 men and 6 women; 25 (62.5%) patients had no fractures. For the first time, fractures were reported in patients aged from 33 to 69 years (mean 55.9±9.5). The localization of fractures was as follows: femur – in 8 patients (20%), forearm – in 6 (15%), shin bones – in 1 (2.5%) patients. Despite lower BMD rates in women, there were no significant differences in the frequency of fractures depending on sex. Correlation analysis (for Spearman) showed the relationship of fractures with age (r= -0.31, p<0.05), femur BMD in general (r= -0.53, p<0.01) and forearm BMD (r= -0.44, p<0.01).

Conclusion:

There is a high incidence of osteoporosis, mainly in the proximal femur and forearm in patients of the older age group with AKU. In the lumbar spine (due to the development of calcification of the intervertebral discs and ligamentous apparatus), osteoporosis is rarely detected, but the frequency of osteopenia is quite high. 32.6% patients had a history of skeletal bone fractures, and the sex of the patients did not affect the risk of fractures. The occurrence of fractures in patients with AKU is associated with low BMD values of the proximal femur.

Disclosure of Interests:

None declared

Search for Electron Antineutrino Appearance in a Long-Baseline Muon Antineutrino Beam

Electron antineutrino appearance is measured by the T2K experiment in an accelerator-produced antineutrino beam, using additional neutrino beam operation to constrain parameters of the Pontecorvo-Maki-Nakagawa-Sakata (PMNS) mixing matrix. T2K observes 15 candidate electron antineutrino events with a background expectation of 9.3 events. Including information from the kinematic distribution of observed events, the hypothesis of no electron antineutrino appearance is disfavored with a significance of 2.40σ and no discrepancy between data and PMNS predictions is found. A complementary analysis that introduces an additional free parameter which allows non-PMNS values of electron neutrino and antineutrino appearance also finds no discrepancy between data and PMNS predictions.

DIFFERENTIATED APPROACH TO THE DEVELOPMENT OF SPECIAL PHYSICAL QUALITIES IN SAMBO WRESTLERS

Aim. The article deals with developing the scheme of differentiating means for the development of special physical qualities in sambo wrestlers. Materials and Methods. We studied a differentiated development of special physical qualities in sambo wrestlers. During the study, we used the following methods: the analysis of scientific and methodical literature, generalization of practical experience, pedagogical monitoring, pedagogical experiment, somatotyping, pedagogical control tests, statistical processing of the results obtained. We conducted a series of searching experiments with 48 (16 – microsomal, 16 – mesosomal, 16 – macrosomal) sambo wrestlers from the youth team of the Perm regional Federation of sports and combat Sambo. Results. The analysis of the data obtained proves the necessity of developing an experimental scheme for differentiating means for the development of special physical qualities in sambo wrestlers depending on their somatotype. Conclusion. High-performance results require constant improvement of the training system for sambo wrestlers. Taking into account morphological features while differentiating means for the development of special physical qualities in sambo wrestlers positively influences their performance.

[THE CELLULAR COMPOSITION OF THE EPITHELIUM OF THE VILLUS OF THE MUCOUS MEMBRANE OF THE DUODENUM OF RATS IN THE CONDITIONS OF EPICHLOROHYDRIN AND DRUG INFLUENCE]

Purpose of the research is to study the nature of the disorders of the villi of the duodenal mucous membrane (MM) in conditions of long-acting ECH as well as to substantiate experimentally the effectiveness of the use of the extract of Echinacea purpurea (EP) and thiotriazoline for the purpose of these disorders correction. The withdrawal of the rats from the experiment was carried out on the 1st, 7th, 15th, 30th and 60th day after the completion of the administration of ECH, EP extract and thiotriazoline. Histological processing of duodenum fragments was performed according to the standard method. The cell composition of the villus epithelium of duodenal MM was evaluated using a laboratory microscope of the MC 100 (Micros, Austria) and the Microvisible software (version 1.11.10). The determination of the significance of differences was carried out according to the Mann-Whitney U criterion. Differences were considered significant at p<0.05. Prolonged action of ECH led to a decrease in the number of cells in one villus of duodenal MM. This decrease persisted after the end of the administration of this chemical. There was a decrease in the number of columnar epithelial cells, goblet exocrinocytes and argyrophil endocrinocytes. In rats that did not receive ECH, administration of an EP extract was accompanied by a short-term increase in the number of columnar epithelial cells in one villus of duodenal MM. The administration of thiotriazolin to rats that did not receive ECH caused a short-term increase in the number of cells in one villus of duodenal MM and the number of columnar epithelial cells in the one villus of duodenal MM. The use of EP extract on the background of inhalations of ECH reduced the degree of decrease in the number of cells in one villus of duodenal MM and the number of columnar epitheliocytes in one villus of duodenal MM, reduced the degree and duration of reduction in the number of goblet exocrinocytes in one villus of duodenal MM, reduced the duration of reduction in the number of argyrophil endocrinocytes in one villus of duodenal MM. The use of thiotriazolin during the administration of ECH led to a decrease in the degree and duration of a decrease in the number of cells in one villus of duodenal MM and the number of columnar epithelial cells in one villus of duodenal MM, and also prevented the occurrence of a decrease in the number of goblet exocrinocytes and argyrophil endocrinocytes in one villus of duodenal MM.

Search for CP Violation in Neutrino and Antineutrino Oscillations by the T2K Experiment with 2.2×10^{21} Protons on Target

The T2K experiment measures muon neutrino disappearance and electron neutrino appearance in accelerator-produced neutrino and antineutrino beams. With an exposure of 14.7(7.6)×10^{20} protons on target in the neutrino (antineutrino) mode, 89 ν_{e} candidates and seven anti-ν_{e} candidates are observed, while 67.5 and 9.0 are expected for δ_{CP}=0 and normal mass ordering. The obtained 2σ confidence interval for the CP-violating phase, δ_{CP}, does not include the CP-conserving cases (δ_{CP}=0, π). The best-fit values of other parameters are sin^{2}θ_{23}=0.526_{-0.036}^{+0.032} and Δm_{32}^{2}=2.463_{-0.070}^{+0.071}×10^{-3}  eV^{2}/c^{4}.

Phase transitions in a programmable quantum spin glass simulator

Understanding magnetic phases in quantum mechanical systems is one of the essential goals in condensed matter physics, and the advent of prototype quantum simulation hardware has provided new tools for experimentally probing such systems. We report on the experimental realization of a quantum simulation of interacting Ising spins on three-dimensional cubic lattices up to dimensions 8 × 8 × 8 on a D-Wave processor (D-Wave Systems, Burnaby, Canada). The ability to control and read out the state of individual spins provides direct access to several order parameters, which we used to determine the lattice's magnetic phases as well as critical disorder and one of its universal exponents. By tuning the degree of disorder and effective transverse magnetic field, we observed phase transitions between a paramagnetic, an antiferromagnetic, and a spin-glass phase.

Observations of the Interaction and Transport of Fine Mode Aerosols with Cloud and/or Fog in Northeast Asia from Aerosol Robotic Network (AERONET) and Satellite Remote Sensing

Analysis of sun photometer measured and satellite retrieved aerosol optical depth (AOD) data has shown that major aerosol pollution events with very high fine mode AOD (>1.0 in mid-visible) in the China/Korea/Japan region are often observed to be associated with significant cloud cover. This makes remote sensing of these events difficult even for high temporal resolution sun photometer measurements. Possible physical mechanisms for these events that have high AOD include a combination of aerosol humidification, cloud processing, and meteorological co-variation with atmospheric stability and convergence. The new development of Aerosol Robotic network (AERONET) Version 3 Level 2 AOD with improved cloud screening algorithms now allow for unprecedented ability to monitor these extreme fine mode pollution events. Further, the Spectral Deconvolution Algorithm (SDA) applied to Level 1 data (L1; no cloud screening) provides an even more comprehensive assessment of fine mode AOD than L2 in current and previous data versions. Studying the 2012 winter-summer period, comparisons of AERONET L1 SDA daily average fine mode AOD data showed that Moderate Resolution Imaging Spectroradiometer (MODIS) satellite remote sensing of AOD often did not retrieve and/or identify some of the highest fine mode AOD events in this region. Also, compared to models that include data assimilation of satellite retrieved AOD, the L1 SDA fine mode AOD was significantly higher in magnitude, particularly for the highest AOD events that were often associated with significant cloudiness.

True Tapping Mode Scanning Near-Field Optical Microscopy with Bent Glass Fiber Probes

In scanning near-field optical microscopy, the most popular probes are made of sharpened glass fiber attached to a quartz tuning fork (TF) and exploiting the shear force-based feedback. The use of tapping mode feedback could be preferable. Such an approach can be realized, for example, using bent fiber probes. Detailed analysis of fiber vibration modes shows that realization of truly tapping mode of the probe dithering requires an extreme caution. In case of using the second resonance mode, probes vibrate mostly in shear force mode unless the bending radius is rather small (ca. 0.3 mm) and the probe's tip is short. Otherwise, the shear force character of the dithering persists. Probes having these characteristics were prepared by irradiation of a tapered etched glass fiber with a CW CO₂ laser. These probes were attached to the TF in double resonance conditions which enables achieving significant quality factor (4000-6000) of the TF + probe system (Cherkun et al., 2006). We also show that, to achieve a truly tapping character, dithering, short, and not exceeding 3 mm lengths of a freestanding part of bent fiber probe beam should also be used in the case of nonresonant excitation.

Satellite Ocean Aerosol Retrieval (SOAR) algorithm extension to S-NPP VIIRS as part of the 'Deep Blue' aerosol project

The Suomi National Polar-Orbiting Partnership (S-NPP) satellite, launched in late 2011, carries the Visible Infrared Imaging Radiometer Suite (VIIRS) and several other instruments. VIIRS has similar characteristics to prior satellite sensors used for aerosol optical depth (AOD) retrieval, allowing the continuation of space-based aerosol data records. The Deep Blue algorithm has previously been applied to retrieve AOD from Sea-viewing Wide Field-of-view Sensor (SeaWiFS) and Moderate Resolution Imaging Spectro-radiometer (MODIS) measurements over land. The SeaWiFS Deep Blue data set also included a SeaWiFS Ocean Aerosol Retrieval (SOAR) algorithm to cover water surfaces. As part of NASA's VIIRS data processing, Deep Blue is being applied to VIIRS data over land, and SOAR has been adapted from SeaWiFS to VIIRS for use over water surfaces. This study describes SOAR as applied in version 1 of NASA's S-NPP VIIRS Deep Blue data product suite. Several advances have been made since the SeaWiFS application, as well as changes to make use of the broader spectral range of VIIRS. A preliminary validation against Maritime Aerosol Network (MAN) measurements suggests a typical uncertainty on retrieved 550nm AOD of order ±(0.03+10%), comparable to existing SeaWiFS/MODIS aerosol data products. Retrieved Ångström exponent and fine mode AOD fraction are also well-correlated with MAN data, with small biases and uncertainty similar to or better than SeaWiFS/MODIS products.

The MERRA-2 Aerosol Reanalysis, 1980 - onward, Part I: System Description and Data Assimilation Evaluation

The Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2) updates NASA's previous satellite era (1980 - onward) reanalysis system to include additional observations and improvements to the Goddard Earth Observing System, Version 5 (GEOS-5) Earth system model. As a major step towards a full Integrated Earth Systems Analysis (IESA), in addition to meteorological observations, MERRA-2 now includes assimilation of aerosol optical depth (AOD) from various ground- and space-based remote sensing platforms. Here, in the first of a pair of studies, we document the MERRA-2 aerosol assimilation, including a description of the prognostic model (GEOS-5 coupled to the GOCART aerosol module), aerosol emissions, and the quality control of ingested observations. We provide initial validation and evaluation of the analyzed AOD fields using independent observations from ground, aircraft, and shipborne instruments. We demonstrate the positive impact of the AOD assimilation on simulated aerosols by comparing MERRA-2 aerosol fields to an identical control simulation that does not include AOD assimilation. Having shown the AOD evaluation, we take a first look at aerosol-climate interactions by examining the shortwave, clear-sky aerosol direct radiative effect. In our companion paper, we evaluate and validate available MERRA-2 aerosol properties not directly impacted by the AOD assimilation (e.g. aerosol vertical distribution and absorption). Importantly, while highlighting the skill of the MERRA-2 aerosol assimilation products, both studies point out caveats that must be considered when using this new reanalysis product for future studies of aerosols and their interactions with weather and climate.

Evaluation of NASA Deep Blue/SOAR aerosol retrieval algorithms applied to AVHRR measurements

The Deep Blue (DB) and Satellite Ocean Aerosol Retrieval (SOAR) algorithms have previously been applied to observations from sen-sors like the Moderate Resolution Imaging Spectroradiometers (MODIS) and Sea-viewing Wide Field-of-view Sensor (SeaWiFS) to provide records of mid-visible aerosol optical depth (AOD) and related quantities over land and ocean surfaces respectively. Recently, DB and SOAR have also been applied to Ad-vanced Very High Resolution Radiometer (AVHRR) observations from several platforms (NOAA11, NOAA14, and NOAA18), to demonstrate the potential for extending the DB and SOAR AOD records. This study provides an evaluation of the initial version (V001) of the resulting AVHRR-based AOD data set, including validation against Aerosol Robotic Network (AERONET) and ship-borne observations, and comparison against both other AVHRR AOD Research (GESTAR), Universities Space Research Association. records and MODIS/SeaWiFS products at select long-term AERONET sites. Although it is difficult to distil error characteristics into a simple expression, the results suggest that one standard deviation confidence intervals on retrieved AOD of ±(0.03+15%) over water and ±(0.05+25%) over land represent the typical level of uncertainty, with a tendency towards negative biases in high-AOD conditions, caused by a combination of algorithmic assumptions and sensor calibration issues. Most of the available validation data are for NOAA18 AVHRR, although performance appears to be similar for the NOAA11 and NOAA14 sensors as well.

Unprecedented simultaneous enhancement in damage tolerance and fatigue resistance of zirconia/Ta composites

Dense (>98 th%) and homogeneous ceramic/metal composites were obtained by spark plasma sintering (SPS) using ZrO₂ and lamellar metallic powders of tantalum or niobium (20 vol.%) as starting materials. The present study has demonstrated the unique and unpredicted simultaneous enhancement in toughness and strength with very high flaw tolerance of zirconia/Ta composites. In addition to their excellent static mechanical properties, these composites also have exceptional resistance to fatigue loading. It has been shown that the major contributions to toughening are the resulting crack bridging and plastic deformation of the metallic particles, together with crack deflection and interfacial debonding, which is compatible with the coexistence in the composite of both, strong and weak ceramic/metal interfaces, in agreement with predictions of ab-initio calculations. Therefore, these materials are promising candidates for designing damage tolerance components for aerospace industry, cutting and drilling tools, biomedical implants, among many others.

A mass resolved, high resolution neutral particle analyzer for C-2U

C-2U is a high-confinement, advanced beam driven field-reversed configuration plasma experiment which sustains the configuration for >5 ms, in excess of typical MHD and fast particle instability times, as well as fast particle slowing down times. Fast particle dynamics are critical to C-2U performance and several diagnostics have been deployed to characterize the fast particle population, including neutron and proton detectors. To increase our understanding of fast particle behavior and supplement existing diagnostics, an E ∥ B neutral particle analyzer was installed, which simultaneously measures H⁰ and D⁰ flux with large dynamic range and high energy resolution. Here we report the commissioning of the E ∥ B analyzer, confirm the instrument has energy resolution ΔE/E≲0.1 and a dynamic range E_max/E_min∼30, and present measurements of initial testing on C-2U.

Absolute calibration of neutron detectors on the C-2U advanced beam-driven FRC

In the C-2U fusion energy experiment, high power neutral beam injection creates a large fast ion population that sustains a field-reversed configuration (FRC) plasma. The diagnosis of the fast ion pressure in these high-performance plasmas is therefore critical, and the measurement of the flux of neutrons from the deuterium-deuterium (D-D) fusion reaction is well suited to the task. Here we describe the absolute, in situ calibration of scintillation neutron detectors via two independent methods: firing deuterium beams into a high density gas target and calibration with a 2 × 10⁷ n/s AmBe source. The practical issues of each method are discussed and the resulting calibration factors are shown to be in good agreement. Finally, the calibration factor is applied to C-2U experimental data where the measured neutron rate is found to exceed the classical expectation.