Systemic lupus erythematosus: one year in review 2024.

Systemic lupus erythematosus (SLE) is classically regarded as the landmark of systemic autoimmune diseases, characterised by protean, multi-systemic manifestations and a highly variable clinical course.Over the last years, both clinical and translational clinical research efforts led to significant steps forward in management and treatment of SLE. However, numerous aspects of SLE, from pathogenesis to treatment, still remain challenging, and several unmet needs persist for both patients and physicians. Following the previous annual reviews of this series, herewith, we aim to report the most relevant new updates on SLE, issued in 2023. In particular, we focused on biomarkers, clinical aspects and outcomes, comorbidities, as well as new treatment targets and real-world evidence.

Multimodal ultrasound muscle assessment in patients with rheumatic diseases: a patient-based reliability study.

Objectives: The aim was to explore the inter-reliability of a newly developed US scanning protocol (multimodal US) for the assessment of different aspects of sarcopenia-related muscle involvement, including muscle mass, muscle quality and muscle stiffness [using point shear-wave elastography (SWE)], in patients with rheumatic and musculoskeletal diseases (RMDs). Methods: Quadriceps muscle mass (i.e. muscle thickness), muscle quality (i.e. muscle echogenicity evaluated with both a visual semi-quantitative scale and a dedicated software package for image analysis, ImageJ) and point SWE measurements were obtained by two rheumatologists (blinded to each other's evaluation) in consecutive RMD patients without previous/current myositis or neuromuscular disorders.Inter-reliability was assessed using the intraclass correlation coefficient (ICC) for continuous variables and Cohen's kappa (κ) for categorical variables. Results: A total of 45 RMD patients were enrolled [mean age 54.5 (16.0) years, male-to-female ratio 1:1.5, mean BMI 24.6 (4.6) kg/m2], 10 with PsA, 7 RA, 5 AS, 5 PMR, 4 SLE, 4 gout, 4 OA, 3 FM and 3 SSc. The grade of inter-rater reliability was excellent for muscle mass [ICC = 0.969 (0.953 < ICC < 0.979)]. Regarding muscle echogenicity, the agreement was substantial/almost perfect using the visual semi-quantitative scale (weighted linear = 0.793, weighted squared = 0.878) and excellent using ImageJ analysis [ICC = 0.916 (0.876 < ICC < 0.944)]. Finally, a good agreement was obtained for point SWE measurements [ICC = 0.76 (0.712 < ICC < 0.8)]. Conclusion: Multimodal US is a novel and reliable tool for the evaluation of different aspects of muscle involvement (muscle mass, muscle quality and muscle stiffness) in RMD patients.

Muscle involvement in systemic lupus erythematosus: multimodal ultrasound assessment and relationship with physical performance.

OBJECTIVES: The objectives of this study were (1) to explore US findings for muscle mass, muscle quality and muscle stiffness in SLE patients and healthy subjects; (2) to investigate the relationship between the US muscle findings and physical performance in SLE patients and healthy subjects. METHODS: Quadriceps muscle thickness was used for assessment of muscle mass, muscle echogenicity (using a visual semi-quantitative scale and grayscale analysis with histograms) for assessment of muscle quality, and point shear-wave elastography (SWE) for assessment of muscle stiffness in 30 SLE patients (without previous/current myositis or neuromuscular disorders) and 15 age-, sex- and BMI-matched healthy subjects. Hand grip strength tests and short physical performance battery (SPPB) tests were carried out in the same populations. RESULTS: No difference was observed between SLE patients and healthy subjects for quadriceps muscle thickness (35.2 mm ±s.d. 6.8 vs 34.8 mm ± s.d. 6.0, respectively, P = 0.79). Conversely, muscle echogenicity was significantly increased in SLE patients (visual semi-quantitative scale: 1.7 ± s.d. 1.0 vs 0.3 ± s.d. 0.5, respectively, P < 0.01; grayscale analysis with histograms: 87.4 mean pixels ± s.d. 18.8 vs 70.1 mean pixels ± s.d. 14.0, respectively, P < 0.01). Similarly, SWE was significantly lower in SLE patients compared with healthy subjects {1.5 m/s [interquartile range (IQR) 0.3] vs 1.6 m/s (IQR 0.2), respectively, P = 0.01}. Muscle echogenicity was inversely correlated with grip strength (visual semi-quantitative scale, Rho: -0.47, P = 0.01; grayscale analysis with histograms, Rho: -0.41, p < 0.01) and SPPB (visual semi-quantitative scale, Rho: -0.50, P < 0.01; grayscale analysis with histograms Rho: -0,46, P < 0.01). CONCLUSIONS: US assessment of muscle echogenicity and stiffness is useful for the early detection of muscle involvement in SLE patients.

Towards a Socialization of the EU's New Economic Governance Regime? EU Labour Policy Interventions in Germany, Ireland, Italy and Romania (2009-2019).

In response to the last recession, the European Union (EU) adopted a new economic governance (NEG) regime. An influential stream of EU social policy literature argues that there has been more emphasis on social objectives in the NEG regime in more recent years. This article shows that this is not the case. It does so through an in-depth analysis of NEG prescriptions on wage, employment protection and collective bargaining policy in Germany, Italy, Ireland and Romania between 2009 and 2019. Our main conclusion is that the EU's interventions in these three industrial relations policy areas continue to be dominated by a liberalization agenda that is commodifying labour, albeit to a different degree across the uneven but nonetheless integrated European political economy. This finding is important, as countervailing transnational trade union action is the more likely, the more there is a common threat. Even so, our contextualized analysis also enables us to detect contradictions that could provide European labour movements opportunities to pursue countervailing action.

Biological Sound vs. Anthropogenic Noise: Assessment of Behavioural Changes in Scyliorhinus canicula Exposed to Boats Noise.

Despite the growing interest in human-made noise effects on marine wildlife, few studies have investigated the potential role of underwater noise on elasmobranch species. In this study, twelve specimens of small-spotted catshark (Scyliorhinus canicula) were exposed to biological and anthropogenic sounds in order to assess their behavioural changes in response to prey acoustic stimuli and to different amplitude levels of shipping noise. The sharks, individually held in aquariums, were exposed to four experimental acoustic conditions characterized by different spectral (Hz) components and amplitude (dB re 1 µPa) levels. The swimming behaviour and spatial distribution of sharks were observed. The results highlighted significant differences in swimming time and in the spatial use of the aquarium among the experimental conditions. When the amplitude levels of biological sources were higher than those of anthropogenic sources, the sharks' swimming behaviour was concentrated in the bottom sections of the aquarium; when the amplitude levels of anthropogenic sources were higher than biological ones, the specimens increased the time spent swimming. Moreover, their spatial distribution highlighted a tendency to occupy the least noisy sections of the aquarium. In conclusion, this study highlighted that anthropogenic noise is able to affect behaviour of catshark specimens and the impact depends on acoustic amplitude levels.

Temporal patterns in the soundscape of the shallow waters of a Mediterranean marine protected area.

The study of marine soundscapes is an emerging field of research that contributes important information about biological compositions and environmental conditions. The seasonal and circadian soundscape trends of a marine protected area (MPA) in the Mediterranean Sea have been studied for one year using an autonomous acoustic recorder. Frequencies less than 1 kHz are dominated by noise generated by waves and are louder during the winter; conversely, higher frequencies (4-96 kHz) are dominated by snapping shrimp, which increase their acoustic activity at night during the summer. Fish choruses, below 2 kHz, characterize the soundscape at sunset during the summer. Because there are 13 vessel passages per hour on average, causing acoustic interference with fish choruses 46% of the time, this MPA cannot be considered to be protected from noise. On the basis of the high seasonal variability of the soundscape components, this study proposes a one-year acoustic monitoring protocol using the soundscape methodology approach and discusses the concept of MPA size.

Are mussels able to distinguish underwater sounds? Assessment of the reactions of Mytilus galloprovincialis after exposure to lab-generated acoustic signals.

This study examined the effects of lab-generated acoustic signals on the behaviour and biochemistry of Mediterranean mussels (Mytilus galloprovincialis). The experiment was carried out in a tank equipped with a video-recording system using six groups of five mussels exposed to five acoustic treatments (each treatment was replicated three times) for 30min. The acoustic signals, with a maximum sound pressure level of 150dB rms re 1µPa, differed in frequency range as follows: low (0.1-5kHz), mid-low (5-10kHz), mid (10-20kHz), mid-high (20-40kHz) and high (40-60kHz). The exposure to sweeps did not produce any significant changes in the mussels' behaviour. Conversely, the specimens exposed to the low frequency band treatment showed significantly higher values of the following biochemical stress parameters measured in their plasma and tissues: glucose, total proteins, total haemocyte number (THC), heat shock protein 70 (Hsp70) expression, and Acetylcholinesterase (AChE) activity. The responses observed in the mussels exposed to low frequency sweeps enable us to suppose a biological and ecological role for this sound, which contains the main frequencies produced by both shipping traffic and the acoustic emissions of fish.

Vessel noise pollution as a human threat to fish: assessment of the stress response in gilthead sea bream (Sparus aurata, Linnaeus 1758).

This study examined the effects of boat noise pollution on the stress indices of gilthead sea bream (Sparus aurata, Linnaeus 1758). To assess the stress response in these fish, biometric values and plasma parameters such as ACTH, cortisol, glucose, lactate, haematocrit, Hsp70, total protein, cholesterol, triglycerides and osmolarity were analysed. After acclimatization of the animals, the experiment was carried out in a tank fitted with underwater speakers where the fish were exposed to sound treatments (in duplicate) consisting of: 10 days of no sound (control treatment; the animals were only exposed to the experimental tank's background noise) and 10 days of noise derived from original recordings of motor boats, including recreational boats, hydrofoil, fishing boat and ferry boat (vessel noise treatment). The exposure to noise produced significant variations in almost all the plasma parameters assessed, but no differences were observed in weights and fork lengths. A PERMANOVA analysis highlighted significantly increased values (p < 0.05) of ACTH, cortisol, glucose, lactate, haematocrit, Hsp70, cholesterol, triglycerides and osmolarity in the fish exposed to vessel noise for 10 days. This study clearly highlights that anthropogenic noise negatively affects fish, and they are valuable targets for detailed investigations into the effects of this global pollutant. Finally, these experimental studies could represent part of the science that is able to improve the quality of the policies related to management plans for maritime spaces (Marine Strategy Framework Directive 56/2008 CE) that are aimed at stemming this pollutant phenomenon.

Behavioural and biochemical stress responses of Palinurus elephas after exposure to boat noise pollution in tank.

This study examined the effects of boat noise on the behavioural and biochemical parameters of the Mediterranean spiny lobster (Palinurus elephas). The experiment was conducted in a tank equipped with a video and audio recording system. 18 experimental trials, assigned to boat noise and control conditions, were performed using lobsters in single and group of 4 specimens. After a 1h habituation period, we audio- and video-recorded the lobsters for 1h. During the experimental phase, the animals assigned to the boat groups were exposed to boat noise pollution (a random sequence of boat noises). Exposure to the noise produced significant variations in locomotor behaviours and haemolymphatic parameters. Our results indicate that the lobsters exposed to boat noises increased significantly their locomotor activities and haemolymphatic bioindicator of stressful conditions such as glucose, total proteins, Hsp70 expression and THC when tested both singly and in groups.

The underwater acoustic activities of the red swamp crayfish Procambarus clarkii.

This study describes the underwater acoustic behavior of the red swamp crayfish Procambarus clarkii. The study was conducted both in a tank and in the natural environment. The tank was equipped with video and acoustic recording systems. Observations were conducted to identify the underwater acoustic signals produced and their association with behavioral events and the movement status of the animals. In a lake in a natural reserve, a remote acoustic recording station was used to study the circadian underwater acoustic activity of the crayfish and to assess the acoustic features of the signals. The red swamp crayfish produces irregular trains of wide-band pulses (duration 0.4 ms, SPL(PK) 128 dB re 1 µPa, peak frequency 28 kHz, bandwidth(RMS) 20 kHz). The production of signals is positively related to intraspecific interactions (encounter/approach, fighting and successive Tail Flips). In the natural environment, acoustic activity is almost absent during the day, increases abruptly at sunset and continues until dawn. This study reveals the previously unknown underwater acoustic signals of Procambarus clarkii and the potential of passive acoustic methods to monitor the presence, the abundance and the behavioral activities of this invasive species.