New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review.

A comprehensive, up-to-date systematic review (SR) of the new-onset rheumatic immune-mediated inflammatory diseases (R-IMIDs) following COVID-19 vaccinations is lacking. Therefore, we investigated the demographics, management, and prognosis of new R-IMIDs in adults following SARS-CoV-2 vaccinations. A systematic literature search of Medline, Embase, Google Scholar, LitCovid, and Cochrane was conducted. We included any English-language study that reported new-onset R-IMID in adults following the post-COVID-19 vaccination. A total of 271 cases were reported from 39 countries between January 2021 and May 2023. The mean age of patients was 56 (range 18-90), and most were females (170, 62.5%). Most (153, 56.5%) received the Pfizer BioNTech COVID-19 vaccine. Nearly 50% of patients developed R-IMID after the second dose of the vaccine. Vasculitis was the most prevalent clinical presentation (86, 31.7%), followed by connective tissue disease (66, 24.3%). The mean duration between the vaccine's 'trigger' dose and R-IMID was 11 days. Most (220, 81.2%) received corticosteroids; however, 42% (115) received DMARDs such as methotrexate, cyclophosphamide, tocilizumab, anakinra, IV immunoglobulins, plasma exchange, or rituximab. Complete remission was achieved in 75 patients (27.7%), and 137 (50.6%) improved following the treatment. Two patients died due to myositis. This SR highlights that SARS-CoV-2 vaccines may trigger R-IMID; however, further epidemiology studies are required.

The impact of the COVID-19 pandemic and stringent social distancing measures on health-related quality of life and COVID-19 infection rates in patients with rheumatic disease: a longitudinal analysis through the pandemic.

Objective: The aim was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic and stringent social isolation measures on patients with rheumatic disease (RD) from the beginning of the pandemic (April 2020). Methods: In this UK-based single-centre, prospective, observational cohort study, all RD follow-up patients at our centre were invited by SMS text message in April 2020 to participate in the study. Participants completed questionnaires at four time points between April 2020 and December 2021. We collected demographics, clinically extremely vulnerable (CEV) status, short form 12 mental (MCS) and physical health component scores (PCS) for health-related quality of life, vaccination status, COVID-19 infection rates and incidence of long COVID. Results: We enrolled 1605 patients (female, 69.0%; CEV, 46.5%); 906 of 1605 (56.4%) completed linked responses to our final questionnaire. MCS improved (+0.6, P < 0.05), whereas PCS scores deteriorated (-1.4, P < 0.001) between April 2020 and December 2021. CEV patients had worse mental and physical health scores than non-CEV patients at entry (PCS, 36.7 and 39.3, respectively, P < 0.001; MCS, 40.9 and 43.0, respectively, P < 0.001) and at each time point throughout the study; both mental and physical health outcomes were worse in CEV compared with non-CEV patients (P < 0.001 and P = 0.004, respectively). At study close, 148 of 906 (16.3%) reported COVID infection, with no difference in infection, vaccination or long COVID rates between CEV and non-CEV patients. Conclusions: Mental and physical health in RD patients has changed throughout the pandemic; outcomes for both metrics of health were worse in CEV patients, although there were no differences in infection rates between the groups. These data might assist the understanding and planning of future health-care policy and social restrictions in RD patients. Trial registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT04542031.

SARS-CoV-2 vaccine responses following CD20-depletion treatment in patients with haematological and rheumatological disease: a West Midlands Research Consortium study.

B-cell-depleting agents are among the most commonly used drugs to treat haemato-oncological and autoimmune diseases. They rapidly induce a state of peripheral B-cell aplasia with the potential to interfere with nascent vaccine responses, particularly to novel antigens. We have examined the relationship between B-cell reconstitution and SARS-CoV-2 vaccine responses in two cohorts of patients previously exposed to B-cell-depleting agents: a cohort of patients treated for haematological B-cell malignancy and another treated for rheumatological disease. B-cell depletion severely impairs vaccine responsiveness in the first 6 months after administration: SARS-CoV-2 antibody seroprevalence was 42.2% and 33.3% in the haemato-oncological patients and rheumatology patients, respectively and 22.7% in patients vaccinated while actively receiving anti-lymphoma chemotherapy. After the first 6 months, vaccine responsiveness significantly improved during early B-cell reconstitution; however, the kinetics of reconstitution was significantly faster in haemato-oncology patients. The AstraZeneca ChAdOx1 nCoV-19 vaccine and the Pfizer BioNTech 162b vaccine induced equivalent vaccine responses; however, shorter intervals between vaccine doses (<1 m) improved the magnitude of the antibody response in haeamto-oncology patients. In a subgroup of haemato-oncology patients, with historic exposure to B-cell-depleting agents (>36 m previously), vaccine non-responsiveness was independent of peripheral B-cell reconstitution. The findings have important implications for primary vaccination and booster vaccination strategies in individuals clinically vulnerable to SARS-CoV-2.

Rationally designed Shewanella oneidensis Biofilm Toilored Graphene-Magnetite Hybrid Nanobiocomposite as Reusable Living Functional Nanomaterial for Effective Removal of Trivalent Chromium.

Sustainable treatment of wastewater containing trivalent chromium (Cr3+) remains a significant challenge owing to the several limitations of the existing methodologies. Herein, combination of biosynthesis and Response Surface Methodology (RSM) for the fabrication and optimization of Shewanella oneidensis biofilm functionalized graphene-magnetite (GrM) nanobiocomposite was adopted as a 'living functional nanomaterial' (viz. S-GrM) for effective removal of Cr3+ ions from aqueous solution. In the biosynthetic process, S. oneidensis cells reduced the GO-akaganeite complex and adhered on the as-synthesized GrM nanocomposite to form S-GrM hybrid-nanobiocomposite. The process parameters for fabrication of S-GrM hybrid-nanobiocomposite was optimized by RSM based on four responses of easy magnetic separation, biofilm formation along with protein, and carbohydrate contents in extracellular polymeric substances (EPS). The morphology and chemical composition of S-GrM hybrid-nanobiocomposite were investigated using various spectroscopic and microscopic analyses and subsequently explored for removal of Cr3+ ions. The hybrid-nanobiocomposite effectively removed 304.64 ± 14.02 mg/g of Cr3+ at pH 7.0 and 30 °C, which is found to be very high compared to the previously reported values. The high surface area of graphene, biofilm biomass of S. oneidensis and plenty of functional groups provided a unique structure to the S-GrM hybrid-nanobiocomposite for efficient removal of Cr3+ through synergistic interaction. The FTIR and zeta potential studies confirmed that electrostatic and chelation/complexation reaction played key roles in the adsorption process. The fabrication of S-GrM nanobiocomposite thus creates a novel hybrid 'living functional nanomaterial' for low cost, recyclable, and sustainable removal of Cr3+ from wastewater.

Outcomes in rheumatoid arthritis patients treated with abatacept: a UK multi-centre observational study.

BACKGROUND: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes chronic synovitis, resulting in progressive joint destruction and functional disability and affects approximately 400,000 people in the UK. This real-world study aimed to describe the characteristics, treatment patterns and clinical outcomes of patients who received abatacept in UK clinical practice. METHODS: This was a multi-centre, retrospective, observational study of patients with RA treated with abatacept at four UK centres between 01 January 2013 and 31 December 2017. Data were collected from medical records of each patient from the index date (date of first bDMARD initiation) until the most recent visit, death or end of study (31 December 2017). RESULTS: In total, 213 patients were included in the study. Patients received up to eight lines of therapy (LOTs). Treatment with abatacept, or any other bDMARD, was associated with reductions in DAS28-ESR and DAS28-CRP scores at 6 and 12 months. The distribution of EULAR responses (good/moderate/no response) tended to be more favourable for patients when receiving abatacept than when receiving other bDMARDs (22.8%/41.3%/35.9% versus 16.6%/41.4%/42.1% at 6 months, and 27.9%/36.1%/36.1% versus 21.2%/34.5%/44.2% at 12 months). Patients receiving abatacept at LOT1 (n = 68) spent significantly longer on treatment compared with patients receiving other bDMARDs (53.4 vs. 17.4 months; p< 0.01); a similar trend was observed for LOT2. Among patients who discontinued after 6 months, a greater proportion experienced infection requiring antibiotics when receiving other bDMARDs compared to those receiving abatacept. CONCLUSIONS: RA patients who received bDMARDs, including abatacept, experienced reduced disease activity. When receiving abatacept as first or second line of therapy, patients persisted with treatment significantly longer than those receiving other bDMARDs.

Investigation on pyrolysis and incineration of chrome-tanned solid waste from tanneries for effective treatment and disposal: an experimental study.

Chrome-tanned leather solid wastes (leather finished trimmings (LFT) and chrome shavings (CS)) from tanneries were studied using pyrolysis and incineration. Detailed characterization of CS and LFT indicated higher calorific value of 15.77 MJ/kg and 19.97 MJ/kg respectively, which makes it suitable for thermal treatment. Thermal Gravimetric Analysis (TGA) of CS and LFT recorded a weight loss of 79.82% and 68.22% at 800 °C respectively. Energy-dispersive X-ray spectroscopy and scanning electron microscopy analysis for CS and LFT were also carried out. Pyrolysis of CS and LFT was carried out using a fixed bed-type pyrolysis unit at a temperature of 500 ± 10 °C for a reaction time of 30 min and three different by-products (bio-oil, biochar and pyrolytic gas) were obtained as a result of pyrolysis. From pyrolysis process, higher bio-oil yields of 52 wt.% and 49 wt.% from LFT and CS with calorific value of 28.0 and 27.8 MJ/kg respectively were obtained. The calorific values of the biochar obtained from LFT and CS were found to be 20.5 and 23.0 MJ/kg respectively. Incineration was carried out in the existing incineration facility of 150 kg/h capacity at a temperature of 1200 °C. The results of incineration process showed a higher weight reduction (93.0 wt.%) and higher concentration of gaseous emissions, revealing the need for off-gas treatment. Further, FT-IR spectra of residual ash from the incineration process revealed the occurrence of oxidation of trivalent chromium to its hexavalent form, which could be a potential raw material in the metallurgical/chemical industry for the synthesis of sodium chromate or ferrochrome alloy. Comparative experimental investigations of pyrolysis and incineration revealed that incineration could be a potential treatment and disposal option, in developing countries like India, for chrome-tanned leather solid wastes from tanneries, for producing heat energy and the residue with potential utilization viability in another industry paving a way towards circular economy.

Bio-reserves inventory-improving substrate management for anaerobic waste treatment in a fast-growing Indian urban city, Chennai.

India is one among the Asia's newly industrialized countries, in which urban centres generate large amount of municipal solid wastes due to the rapid urbanization. To demonstrate urban waste potentials for biogas production by anaerobic digestion, a comprehensive analysis on the availability of organic waste hotspots and its biogas potential for the exemplary case of Chennai, India, was undertaken. The identified hotspots and their biogas potential were plotted with Geographical Information System as thematic maps. The results of biogas potential tests revealed strong variations in the biogas potentials of individual waste streams from 240.2 to 514.2 mLN/g oDM (organic dry matter) with oDM reduction in the range of 36.4-61.5 wt.-%. Major waste generation hotspots were identified from the surveyed urban bio-reserves and the biogas potentials within an effective area of 5 km radius surrounding the hotspot were estimated. It was found that the biogas potential of individual hotspots ranged between 38.0-5938.7 m3/day. Further results revealed that the biogas potential during anaerobic co-digestion, by considering nearby bio-reserves in the effective areas of major hotspots, with and without residential organic waste, ranged between 4110.4-18-106.1 m3/day and 253.2-5969.5 m3/day, originating from 144.0-620.0 tons and 3.1-170.5 tons, respectively. Despite variations in the composition of the wastes, the Carbon/Nitrogen ratio, oDM reduction, biogas production and substrate availability were improved during co-digestion of nearby bio-reserves within the major hotspots, thereby improving the prevailing barriers in substrate management during anaerobic digestion of wastes.