Diagnostic accuracy of ultrasonography in relation to salivary gland biopsy in Sjögren's syndrome: a systematic review with meta-analysis.

OBJECTIVES: To evaluate the accuracy of major salivary gland ultrasonography (SGUS) in relation to minor salivary gland biopsy (mSGB) in the diagnosis of Sjögren's syndrome (SS). METHODS: A systematic review and meta-analysis were performed. Ten databases were searched to identify studies that compared the accuracy of SGUS and mSGB. The risk of bias was assessed, data were extracted, and univariate and bivariate random-effects meta-analyses were done. RESULTS: A total of 5000 records were identified; 13 studies were included in the qualitative synthesis and 10 in the quantitative synthesis. The first meta-analysis found a sensitivity of 0.86 (95% CI: 0.74-0.92) and specificity of 0.87 (95% CI: 0.81-0.92) for the predictive value of SGUS scoring in relation to the result of mSGB. In the second meta-analysis, mSGB showed higher sensitivity and specificity than SGUS. Sensitivity was 0.80 (95% CI: 0.74-0.85) for mSGB and 0.71 (95% CI: 0.58-0.81) for SGUS, and specificity was 0.94 (95% CI: 0.87-0.97) for mSGB and 0.89 (95% CI: 0.82-0.94) for SGUS. CONCLUSIONS: The diagnostic accuracy of SGUS was similar to that of mSGB. SGUS is an effective diagnostic test that shows good sensitivity and high specificity, in addition to being a good tool for prognosis and for avoiding unnecessary biopsies. More studies using similar methodologies are needed to assess the accuracy of SGUS in predicting the result of mSGB. Our results will contribute to decision-making for the implementation of SGUS as a diagnostic tool for SS, considering the advantages of this method.

Cold Ion-Molecule Chemistry: The Very Different Reactions of He⁺ with CO and NO.

The ion-molecule reactions He+ + CO → He + C+ + O and He+ + NO → He + N+ + O have been measured at collision energies between 0 and kB · 10 K. Strong variations of the rate coefficients are observed below kB · 5 K. The rate of the He+ + CO reaction decreases by ~30% whereas that of the He+ + NO reaction increases by a factor of ~1.5. These observations are interpreted in the realm of an adiabatic-channel capture model as arising from interactions between the ion charge and the dipole and quadrupole moments of CO and NO. We show that the different low-energy behavior of these reactions originates from the closed- vs. open-shell electronic structures of CO and NO.

Reaction of an Ion and a Free Radical near 0 K: He+ + NO → He + N+ + O.

The reactions between ions and free radicals are among the fastest chemical reactions. They are predicted to proceed with large rates, even near 0 K, but so far, this prediction has not been verified experimentally. We report on measurements of the rate coefficient of the reaction between the ion He+ and the free radical NO at collision energies in the range between 0 and ∼ kB·10 K. To avoid heating of the ions by stray electric fields, the reaction is observed within the large orbit of a Rydberg electron of principal quantum number n ≥ 30, which shields the ion from external electric fields without affecting the reaction. Low collision energies are reached by merging a supersonic beam of He Rydberg atoms with a supersonic beam of NO molecules and adjusting their relative velocity using a chip-based Rydberg-Stark decelerator and deflector. We observe a strong enhancement of the reaction rate at collision energies below ∼kB·2 K. This enhancement is interpreted on the basis of adiabatic-channel capture-rate calculations as arising from the near-degenerate rotational levels of opposite parity resulting from the Λ-doubling in the X 2Π1/2 ground state of NO. With these new results, we examine the reliability of broadly used approximate analytic expressions for the thermal rate constants of ion-molecule reactions at low temperatures.

Multipole-moment effects in ion-molecule reactions at low temperatures: part III - the He+ + CH4 and He+ + CD4 reactions at low collision energies and the effect of the charge-octupole interaction.

We present experimental and theoretical studies of the He+ + CH4 and He+ + CD4 reactions at collision energies in the kB·(0-10) K range. Helium atoms in a supersonic beam are excited to a low-field-seeking Rydberg-Stark state and merged with a supersonic beam of CH4 or CD4 using a curved surface-electrode deflector. The ion-molecule reactions are studied within the orbit of the helium Rydberg [He(n)] electron, which suppresses stray-electric-fields-induced heating and makes it possible to reach very low collision energies. The collision energy is varied by adjusting the velocity of the He(n) atoms with the surface deflector, keeping the velocity of the methane beam constant. The reaction product ions (C(H/D)p+ with p∈ {1,2,3}) are collected in a time-of-flight mass spectrometer and monitored as a function of the collision energy. No significant energy-dependence of the total reaction yields of either reactions is observed. The measured relative reaction rate coefficient for the He+ + CH4 reaction is approximately twice higher than the one for the He+ + CD4 reaction. The CH+, CH2+ and CH3+ (CD+, CD2+ and CD3+) ions were detected in ratios 0.28(±0.04) : 1.00(±0.11) : 0.11(±0.04) [0.35(±0.07) : 1.00(±0.16):0.04+0.09-0.04]. We also present calculations of the capture rate coefficients for the two reactions, in which the interaction between the charge of the helium ion and the octupole moment of the methane molecule is included. The rotational-state-specific capture rate coefficients are calculated for states with J = (0-3) at collision energies below kB·15 K. After averaging over the rotational states of methane populated at the rotational temperature of the supersonic beam, the calculations only predict extremely weak enhancements (in the order of ∼0.4%) of the rate coefficients compared to the Langevin rate constant kL over the collision-energy range considered.

Multipole-moment effects in ion-molecule reactions at low temperatures: part II - charge-quadrupole-interaction-induced suppression of the He+ + N2 reaction at collision energies below kB·10 K.

We report on an experimental and theoretical investigation of the He+ + N2 reaction at collision energies in the range between 0 and kB·10 K. The reaction is studied within the orbit of a highly excited Rydberg electron after merging a beam of He Rydberg atoms (He(n), n is the principal quantum number), with a supersonic beam of ground-state N2 molecules using a surface-electrode Rydberg-Stark decelerator and deflector. The collision energy Ecoll is varied by changing the velocity of the He(n) atoms for a fixed velocity of the N2 beam and the relative yields of the ionic reaction products N+ and N2+ are monitored in a time-of-flight mass spectrometer. We observe a reduction of the total reaction-product yield of ∼30% as Ecoll is reduced from ≈kB·10 K to zero. An adiabatic capture model is used to calculate the rotational-state-dependent interaction potentials experienced by the N2 molecules in the electric field of the He+ ion and the corresponding collision-energy-dependent capture rate coefficients. The total collision-energy-dependent capture rate coefficient is then determined by summing over the contributions of the N2 rotational states populated at the 7.0 K rotational temperature of the supersonic beam. The measured and calculated rate coefficients are in good agreement, which enables us to attribute the observed reduction of the reaction rate at low collision energies to the negative quadrupole moment, Qzz, of the N2 molecules. The effect of the sign of the quadrupole moment is illustrated by calculations of the rotational-state-dependent capture rate coefficients for ion-molecule reactions involving N2 (negative Qzz value) and H2 (positive Qzz value) for |J, M〉 rotational states with J ≤ 5 (M is the quantum number associated with the projection of the rotational angular momentum vector J⃑ on the collision axis). With decreasing value of |M|, J⃑ gradually aligns perpendicularly to the collision axis, leading to increasingly repulsive (attractive) interaction potentials for diatomic molecules with positive (negative) Qzz values and to reaction rate coefficients that decrease (increase) with decreasing collision energies.

Multipole-moment effects in ion-molecule reactions at low temperatures: part I - ion-dipole enhancement of the rate coefficients of the He+ + NH3 and He+ + ND3 reactions at collisional energies Ecoll/kB near 0 K.

The energy dependence of the rates of the reactions between He+ and ammonia (NY3, Y = {H,D}), forming NY2+, Y and He as well as NY+, Y2 and He, and the corresponding product branching ratios have been measured at low collision energies Ecoll between 0 and kB·40 K using a recently developed merged-beam technique [Allmendinger et al., ChemPhysChem, 2016, 17, 3596]. To avoid heating of the ions by stray electric fields, the reactions are observed within the large orbit of a highly excited Rydberg electron. A beam of He Rydberg atoms was merged with a supersonic beam of ammonia using a curved surface-electrode Rydberg-Stark deflector, which is also used for adjusting the final velocity of the He Rydberg atoms, and thus the collision energy. A collision-energy resolution of about 200 mK was reached at the lowest Ecoll values. The reaction rate coefficients exhibit a sharp increase at collision energies below ∼kB·5 K and pronounced deviations from Langevin-capture behaviour. The experimental results are interpreted in terms of an adiabatic capture model describing the rotational-state-dependent orientation of the ammonia molecules by the electric field of the He+ atom. The model faithfully describes the experimental observations and enables the identification of three classes of |JKMp〉 rotational states of the ammonia molecules showing different low-energy capture behaviour: (A) high-field-seeking states with |KM| ≥ 1 correlating to the lower component of the umbrella-motion tunnelling doublet at low fields. These states undergo a negative linear Stark shift, which leads to strongly enhanced rate coefficients; (B) high-field-seeking states subject to a quadratic Stark shift at low fields and which exhibit only weak rate enhancements; and (C) low-field-seeking states with |KM| ≥ 1. These states exhibit a positive Stark shift at low fields, which completely suppresses the reactions at low collision energies. Marked differences in the low-energy reactivity of NH3 and ND3-the rate enhancements in ND3 are more pronounced than in NH3-are quantitatively explained by the model. They result from the reduced magnitudes of the tunnelling splitting and rotational intervals in ND3 and the different occupations of the rotational levels in the supersonic beam caused by the different nuclear-spin statistical weights. Thermal capture rate constants are derived from the model for the temperature range between 0 and 10 K relevant for astrochemistry. Comparison of the calculated thermal capture rate coefficients with the absolute reaction rates measured above 27 K by Marquette et al. (Chem. Phys. Lett., 1985, 122, 431) suggests that only 40% of the close collisions are reactive.

Ion-Molecule Reactions below 1 K: Strong Enhancement of the Reaction Rate of the Ion-Dipole Reaction He

The reaction between He^{+} and CH_{3}F forming predominantly CH_{2}^{+} and CHF^{+} has been studied at collision energies E_{coll} between 0 and k_{B}·10 K in a merged-beam apparatus. To avoid heating of the ions by stray electric fields, the reaction was observed within the orbit of a highly excited Rydberg electron. Supersonic beams of CH_{3}F and He(n) Rydberg atoms with principal quantum number n=30 and 35 were merged and their relative velocity tuned using a Rydberg-Stark decelerator and deflector, allowing an energy resolution of 150 mK. A strong enhancement of the reaction rate was observed below E_{coll}/k_{B}=1 K. The experimental results are interpreted with an adiabatic capture model that accounts for the state-dependent orientation of the polar CH_{3}F molecules by the Stark effect as they approach the He^{+} ion. The enhancement of the reaction rate at low collision energies is primarily attributed to para-CH_{3}F molecules in the J=1, KM=1 high-field-seeking states, which represent about 8% of the population at the 6 K rotational temperature of the supersonic beam.