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Objective: Higher self‐reported disability (high Health Assessment Questionnaire [HAQ] score) has been associated with hospitalizations and mortality in established rheumatoid arthritis (RA), but associations in early RA are unknown. Methods: Patients with early RA (symptom duration <1 year) enrolled in the Canadian Early Arthritis Cohort who initiated disease‐modifying antirheumatic drugs and had completed HAQ data at baseline and 1 year were included in the study. Discrete‐time proportional hazards models were used to estimate crude and multi‐adjusted associations of baseline HAQ and HAQ at 1 year with all‐cause mortality in each year of follow‐up. Results: A total of 1,724 patients with early RA were included. The mean age was 55 years, and 72% were women. Over 10 years, 62 deaths (3.6%) were recorded. Deceased patients had higher HAQ scores at baseline (mean ± SD 1.2 ± 0.7) and at 1 year (0.9 ± 0.7) than living patients (1.0 ± 0.7 and 0.5 ± 0.6, respectively; P < 0.001). Disease Activity Score in 28 joints (DAS28) was higher in deceased versus living patients at baseline (mean ± SD 5.4 ± 1.3 versus 4.9 ± 1.4) and at 1 year (mean ± SD 3.6 ± 1.4 versus 2.8 ± 1.4) (P < 0.001). Older age, male sex, lower education level, smoking, more comorbidities, higher baseline DAS28, and glucocorticoid use were associated with mortality. Contrary to HAQ score at baseline, the association between all‐cause mortality and HAQ score at 1 year remained significant even after adjustment for confounders. For baseline HAQ score, the unadjusted hazard ratio (HR) was 1.46 (95% confidence interval [95% CI] 1.02–2.09), and the adjusted HR was 1.25 (95% CI 0.81–1.94). For HAQ score at 1 year, the unadjusted HR was 2.58 (95% CI 1.78–3.72), and the adjusted HR was 1.75 (95% CI 1.10–2.77). Conclusion: Our findings indicate that higher HAQ score and DAS28 at 1 year are significantly associated with all‐cause mortality in a large early RA cohort. [ABSTRACT FROM AUTHOR]

The article discusses the predictive capacity in estimating the risk of all-cause mortality among patients with Rheumatoid Arthritis (RA). Topics include HAQ disability index score, with the results showing similar levels of association with mortality but without improvement in the fit of the model; and Rheumatic Disease Comorbidity Index and could increase the rate of all-cause mortality.

Background: This multicenter incident cohort aimed to characterize how often early rheumatoid arthritis (ERA) patients self‐report episodic joint inflammation (palindromic rheumatism) preceding ERA diagnosis and which characteristics differentiate these patients from those without prior episodic symptoms. Methods: Data were from patients with early confirmed or suspected RA (more than 6 weeks and less than 12 months) enrolled in the Canadian Early ArThritis CoHort (CATCH) between April 2017 to March 2018 who completed study case report forms assessing joint pain and swelling prior to ERA diagnosis. Chi‐square and t tests were used to compare characteristics of patients with and without self‐reported episodic joint inflammation prior to ERA diagnosis. Multivariable logistic regression was used to identify sociodemographic and clinical measures associated with past episodic joint inflammation around the time of ERA diagnosis. Results: A total of 154 ERA patients were included; 66% were female, and mean (SD) age and RA symptom duration were 54 (15) years and 141 (118) days. Sixty‐five (42%) ERA patients reported a history of episodic joint pain and swelling, half of whom reported that these symptoms preceded ERA diagnosis by over 6 months. ERA patients with past episodic joint inflammation were more often female, had higher income, were seropositive, had more comorbidities, fewer swollen joints, and lower Clinical Disease Activity Index (CDAI) around the time of ERA diagnosis (P < 0.05). These associations remained significant in multivariable regression adjusting for other sociodemographic and RA clinical measures. Conclusion: Almost half of ERA patients experienced episodic joint inflammation prior to ERA diagnosis. These patients were more often female, had higher income, and presented with milder disease activity at ERA diagnosis. [ABSTRACT FROM AUTHOR]

The effects of heat transfer by ventilation in snow are investigated theoretically. We draw together standard analytical results for fluid flow in porous media and apply them to the case of steady flows induced by periodic roughness elements. These solutions are used to estimate the relative magnitude of ventilation heat transfer in snow. We conclude that topography-driven ventilation is unlikely to have a significant impact on the larger scale energy balance of snow-covered regions since the airflow is confined to a shallow penetration depth or just the roughness elements themselves, rather than the bulk snowpack. In particular, for the limiting case of very warm and moisture saturated air flowing over a melting snow cover, we show that latent and sensible heat due to ventilation have about equal contributions and that this contribution is small compared to the overall surface flux as predicted by the Monin-Obukhov theory. [ABSTRACT FROM AUTHOR]