Estimated prevalence, incidence and healthcare costs of Sjögren's syndrome in France: a national claims-based study.

OBJECTIVES: To estimate prevalence, incidence and mortality rates, and annual healthcare costs of primary Sjögren's syndrome (pSS) and SS associated with other autoimmune disorders (SS+AID) in France. METHODS: French national healthcare claims-based study within the prospective Système National des Données de Santé database that includes the majority of the French population. An algorithm was developed to identify patients with SS and SS-related healthcare claims were analysed between 2011 and 2018. RESULTS: Overall, 23 848 patients with pSS and 14 809 with SS+AID were identified. From 2011 to 2018, the prevalence rate increased slightly for pSS (23-32 per 100000) and SS+AID (16-20 per 100 000), with females comprising 90%-91% and 92%-93% of cases, respectively. The incidence rate of SS per 100 000 persons decreased from 2012 (pSS: 4.3; SS+AID: 2.0) to 2017 (pSS: 0.7; SS+AID: 0.3). Mortality rates per 100 000 persons increased from 2012 to 2018 in patients with pSS (0.2-0.8) or SS+AID (0.1-0.5); mean age of death also increased. Artificial tears and hydroxychloroquine were the most common drug reimbursements. Less than half of patients received annual specialist care from a dentist or ophthalmologist. Healthcare costs associated with SS increased from 2011 to 2018 and exceeded the national estimate of expected costs for chronic diseases. CONCLUSION: In this large French population database study, the low prevalence of pSS confirms that it is an orphan disease. SS is clinically and economically burdensome; these findings may help clinicians better understand routine healthcare received by patients.

Increased mortality in patients with RA-associated interstitial lung disease: data from a French administrative healthcare database.

OBJECTIVES: Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). The objectives of this study were to estimate mortality rate in patients with RA-ILD and identify factors affecting mortality. METHODS: Data from a French national claims database (Système National des Données de Santé) from 2013 to 2018 were analysed. Adults with an RA diagnosis (International Classification of Diseases (ICD)-10 codes M05, M06.0, M06.8 and M06.9) were included. ILD diagnosis was defined with ICD-10 code J84. Mortality rates were compared between patients with RA with and without ILD, using Cox proportional hazards regression, after matching 1:1 for age, sex, age at RA-ILD onset and RA duration. RESULTS: Among 173 132 patients with RA, 4330 (3%) also had ILD (RA-ILD). After matching, RA-ILD was associated with an increased mortality rate (HR 3.4, 95% CI 3.1 to 3.9). The HR for mortality was greater for: patients aged <75 years (HR 4.8, 95% CI 3.9 to 5.9) versus ≥75 years (HR 3.0, 95% CI 2.6 to 3.5); patients with ILD onset occurring before RA onset (HR 8.4, 95% CI 5.5 to 13.0) versus ILD onset occurring after RA onset (HR 2.9, 95% CI 2.6 to 3.3); and men (HR 5.2, 95% CI 4.4 to 6.2) versus women (HR 3.6, 95% CI 3.0 to 4.2). CONCLUSION: In this nationwide cohort study, RA-ILD was associated with increased mortality rate (vs in patients with RA without ILD), notably for those aged <75 years, those whose ILD preceded RA onset and men.

Feasibility and Preliminary Effects of a 1-Week Vestibular Rehabilitation Day Camp in Children with Developmental Coordination Disorder.

AIM: This pilot study investigated the feasibility and preliminary effects of an intensive 1-week day camp program for children with Developmental Coordination Disorder (DCD) that focused on vestibular rehabilitation. METHODS: Ten participants (6-10 years) were assessed twice pre-intervention, post intervention, and at 8-week follow-up. Videonystagmography, Video Head Impulse Tests (vHIT), and Modified Emory Clinical Vestibular Chair Test (m-ECVCT) test were assessed at baseline. Outcomes measures were gaze stability (Dynamic Visual Acuity; DVA), functional gait (Functional Gait Assessment; FGA), balance (Sensory Organization Test), motor function (Bruininks-Oseretsky Test), and participation (Miller Function and Participation). RESULTS: No abnormal results were detected from the videonystagmography, vHIT and m-ECVCT. There was a 100% attendance rate at the camp and assessment sessions. FGA scores significantly improved following intervention and changes were maintained at follow-up. The number of children with abnormal DVA scores decreased from 3 to 1 to 0 between pre-intervention, post-intervention, and follow-up. There were no significant changes in any of the other outcomes following intervention. CONCLUSIONS: Intensive vestibular rehabilitation delivered in a day camp format is feasible and show positive preliminary effects on functional gait and dynamic visual acuity in children with DCD.

Diversity and species composition of arbuscular mycorrhizal fungi across maize fields in the southern part of Belgium.

Arbuscular mycorrhizal fungi (AMF) are key actors among soil microbial inhabitants, forming beneficial associations with most horticultural plants and crops (e.g., maize). For maize, the world most cultivated cereal, data on AMF species diversity in fields is sparse and even totally nonexistent in the southern part of Belgium where maize represents 8% of the cultivated area. In the present study, 14 maize fields in South Belgium under conventional, conversion, or organic management were analyzed for AMF diversity and species composition using 454 pyrosequencing. A large part (54%) of the 49 AMF species observed were unknown or have not been described in the literature. AMF diversity highly varied among fields, with the number of species ranging between 1 and 37 according to the field. A statistically significant effect of management was measured on AMF diversity, with the highest Hill index values (diversity and richness) under the organic management system compared with conventional management or conversion. Our results suggest a positive effects of organic management on AMF diversity in maize. They also highlight the rather high diversity or richness of AMF and the large portion of sequences not yet ascribed to species, thereby emphasizing a need to intensify AMF identification in cropping systems.

Two-year abatacept retention rate in clinical practice in the French ACTION cohort.

OBJECTIVES: Abatacept retention rates were evaluated in the French cohort in the prospective ACTION study (2010-2013), which included patients with moderate-to-severe rheumatoid arthritis managed in everyday clinical practice and started on intravenous abatacept therapy. METHODS: Two-year abatacept retention rates were evaluated in 455 patients classified according to treatment line, body mass index (BMI), and status for rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA). RESULTS: After 2 years, the overall abatacept retention rate was 44%. The retention rate was non-significantly higher in the patients with vs. without a history of unresponsiveness to at least one biologic (48.1% vs. 41.8%, respectively). No significant retention rate differences were found across BMI categories (444 patients; <25, 45.5%; ≥25 to <30, 48.9%; and ≥30, 36.6%). Neither were any significant differences demonstrated according to RF and ACPA status (RF+ and ACPA+, 45.7%; RF+ or ACPA+, 43.8%; and FR- and ACPA-, 39.1%). CONCLUSION: The 44% 2-year retention rate in the French ACTION cohort supports the usefulness of abatacept therapy. In this study, retention was not associated with treatment line, BMI, or antibody status.

Initiation and continuation of oral anticoagulant prescriptions for stroke prevention in non-valvular atrial fibrillation: A cohort study in primary care in France.

BACKGROUND: Oral anticoagulants are prescribed in non-valvular atrial fibrillation for stroke prevention; however, little is known about the current management of anticoagulation in France, particularly given the availability of non-vitamin K antagonist oral anticoagulants in recent years. AIMS: To describe the characteristics of patients prescribed oral anticoagulants, and assess treatment persistence in French primary care. METHODS: We conducted a cohort study of patients with non-valvular atrial fibrillation, who were newly prescribed oral anticoagulants between 1 January 2014 and 31 January 2016, using French primary care data (IMS Longitudinal Patient Database). Adjusting for baseline characteristics, risk of non-persistence (switch or discontinuation) was compared using Cox regression. RESULTS: Of 4111 patients, 1710 were newly prescribed vitamin K antagonists, 1257 rivaroxaban, 744 apixaban and 400 dabigatran. The median age was 76 years, and 57.5% were male. History of hypertension was the most common co-morbidity (68.1%). Compared with vitamin K antagonists, non-persistence was higher with rivaroxaban (hazard ratio: 1.28; 95% confidence interval: 1.13-1.45) and dabigatran (hazard ratio: 1.42; 95% confidence interval: 1.20-1.69) and similar with apixaban (hazard ratio: 1.12; 95% confidence interval: 0.96-1.32). CONCLUSIONS: Non-persistence (treatment discontinuation or switch) with vitamin K antagonists was lower than with rivaroxaban and dabigatran in French primary care; however, non-persistence with the newest drug, apixaban, was similar to vitamin K antagonists. Larger studies with longer follow-up are needed to support these findings. This study is registered on ClinicalTrials.gov (NCT02488421).

Broad-spectrum detection and quantitation methods of Soil-borne cereal mosaic virus isolates.

A broad-spectrum reverse transcription-polymerase chain reaction (RT-PCR) protocol was developed for detecting Soil-borne cereal mosaic virus (SBCMV) isolates, responsible for mosaic diseases in Europe, using primers targeting the highly conserved 3'-untranslated region of RNA-1 and RNA-2 of SBCMV. The 3'-end region is a privileged target for the detection of a wide range of isolates, because of sequence conservation, of the tRNA-like structure, the major role in viral replication and the signal amplification due to the presence of numerous genomic and subgenomic RNAs. The primers were also designed for virus quantitation using real-time RT-PCR with SYBR-Green chemistry. No cross-reaction with Wheat spindle streak mosaic virus, frequently associated with SBCMV, was observed. The use of RT-PCR and real-time quantitative RT-PCR allowed a more sensitive detection and quantitation of SBCMV to be made than was the case with ELISA. The methods enabled European isolates of SBCMV from Belgium, France, Germany, Italy and the UK to be detected and quantified. Real-time RT-PCR represents a new tool for comparing soil inoculum potential as well as cultivar resistance to SBCMV.

Proof-of-principle of surface detection with air-guided quantum cascade lasers.

We report a proof-of-principle of surface detection with air-guided quantum cascade lasers. Laser ridges were designed to exhibit an evanescent electromagnetic field on their top surface that can interact with material or liquids deposited on the device. We employ photoresist and common solvents to provide a demonstration of the sensor setup. We observed spectral as well as threshold currents changes as a function of the deposited material absorption curve. A simple model, supplemented by 2D numerical finite element method simulations, allows one to explain and correctly predict the experimental results.

Design of mid-IR and THz quantum cascade laser cavities with complete TM photonic bandgap.

We present the design of mid-infrared and THz quantum cascade laser cavities formed from planar photonic crystals with a complete in-plane photonic bandgap. The design is based on a honeycomb lattice, and achieves a full in-plane photonic gap for transverse-magnetic polarized light while preserving a connected pattern for efficient electrical injection. Candidate defects modes for lasing are identified. This lattice is then used as a model system to demonstrate a novel effect: under certain conditions - that are typically satisfied in the THz range - a complete photonic gap can be obtained by the sole patterning of the top metal contact. This possibility greatly reduces the required fabrication complexity and avoids potential damage of the semiconductor active region.

Expression and regulation of the SCD2 desaturase in the rat ovary.

Despite the significant role of the lipid reserve in cell structure and function, very few studies have provided detailed descriptions of unsaturated fatty acid synthesis in the ovary. In the present study, we have shown by RT-PCR, Northern blot, and Western blot analyses the mRNA and protein expression of SCD2 (stearoyl-coenzyme A desaturase 2; also named delta 9 desaturase) in rat ovary. We also have localized Scd2 mRNA by in situ hybridization, mainly in granulosa cells of antral follicles, cumulus oophorus, and corpus luteum. Interestingly, either no or very weak SCD2 expression was observed in primordial follicles and oocytes. After eCG injection for 24 h in immature rats (age, 22 days), the level of SCD2 expression and SCD activity in ovary was increased by approximately fourfold (P < 0.05), and the response was further increased 48 h after hCG treatment. As expected, eCG/hCG treatment increased expression of the steroidogenesis enzymes (CYP11A1 and HSD3B) and STAR. We also found a decrease in the SCD2 expression and SCD activity in the corpus luteum at Days 10 and 15 compared to Day 3 of gestation, paralleled by a decrease in the expression of the steroidogenesis enzymes and STAR. To investigate the molecular mechanisms involved in the regulation of SCD2 expression in ovary, we performed primary culture of rat granulosa cells. We observed that both insulin-like growth factor 1 (IGF1) (7.5 x 10(-8)g/ml) and FSH (350 x 10(-8)g/ml) increased SCD2 expression and SCD activity by approximately threefold. Using specific inhibitors, we demonstrated that the MAPK3/MAP1 and PIK3R1/AKT pathways are involved in the IGF1- and FSH-induced SCD2 expression, respectively. The SCD2 is expressed and active in rat ovary, and it may be involved in the regulation of follicular growth and/or the oocyte maturation.

Design, fabrication and optical characterization of quantum cascade lasers at terahertz frequencies using photonic crystal reflectors.

We designed, fabricated and characterised electrically injected quantum cascade lasers with photonic crystal reflectors emitting at terahertz frequencies (3.75 THz). These in-plane emitting structures display typical threshold current densities of 420 A/cm2 and output powers of up to 2 mW under pulsed excitation. The emission characteristics are shown to be robust, as with increasing current the emission remains singlemode with no drift in wavelength, this results from the narrow reflectivity band of the photonic crystal reflectors.