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Nickel nanoparticles supported by commercial carbon paper (CP) are prepared by pulsed laser deposition with deposition time of 3, 6, and 12 min as a catalyst for urea electro-oxidation. The surface conditions and the morphologies of the prepared electrodes have been characterized by Raman spectroscopy, scanning electron microscopy, and transmission electron microscopy. Urea electro-oxidation reaction in KOH solution on the Ni/CP electrodes is investigated by cyclic voltammetry and chronoamperometry. The results show that the electrode with less Ni nanoparticle agglomeration shows higher peak current density, which was achieved in the 3 min deposition samples when normalized by electroactive surface areas. However, the highest current normalized by the area of the carbon paper was achieved in the 6 min deposition sample due to the larger quantity of Ni nanoparticles. All the samples show good stability. Our results suggest that the low density, low cost, and environmental friendly CP can be used as support for Ni nanoparticle as a catalyst for urea electro-oxidation. It thus has great potential for many applications involving urea oxidation, such as wastewater treatments.

Obtaining both high gravimetric capacitance (Cs_m) and high volumetric capacitance (Cs_V) in supercapacitors is still a great challenge. We prepared manganese oxide (MO) nanostructures by pulsed laser deposition, using a metallic Mn target in an O2 atmosphere with pressures ranging from 0.1 Torr to 2.0 Torr at room temperature. The morphology gradually changed from a dense film to nanofoam with different porosities and densities. Raman spectroscopy and X-ray photoelectron spectroscopy revealed a similar oxidation state despite distinct microstructures. Cs_m and Cs_V for the three typical nanostructures, namely thin films, perpendicular columnar structures and nanofoams, were compared. It was found that the highest Cs_m value was not obtained in the nanofoam sample with the highest porosity, but it was achieved in the sample with a perpendicular columnar structure with a Cs_m value of 976 F g−1 at 5 mV s−1. Such a configuration showed the highest Cs_V as well with a value of 830 F cm−3 at 5 mV s−1. The best performance with voltage scan rates higher than 50 mV s−1 was found in the nanofoam structures with the values of 612 F g−1 at 100 mV s−1 and 352 F g−1 at 300 mV s−1. Our research gives useful suggestions for material design in supercapacitor electrodes: a suitable microstructure can be used for applications focusing on different parameters of a supercapacitor. The results might be of general interest for the energy storage research community.

BackgroundIn real-life setting, a greater number of elderly rheumatoid arthritis (RA) patients with impaired glomerular filtration rate (GFR) needs treatment with biologic or target synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD) to achieve disease control and reduce NSAIDs intake. Long-term observational data from the real-life on the use of b/tsDMARD in these patients are scarce.ObjectivesThe aim of this study was to evaluate the retention rate of b/tsDMARD in RA patients with impaired GFR in real-life setting.MethodsData of RA patients treated with at least one b/tsDMARD were retrospectively analyzed form the national Italian GISEA registry from January 2016 to December 2021. Estimated-GFR (eGFR) was calculated with the Cockcroft-Gault equation at the time of any b/tsDMARD prescription. For the purpose of this study, patients were divided in two groups, patients with impaired GFR (eGFR ≤60) and patients with normal GFR (eGFR >60). The retention rate was calculated by the Kaplan-Meier method and compared between these two groups by a log-rank test.ResultsThe study population included 2443 treatment-line with b/tsDMARD from 1888 patients (female 80.4%, age 57±12 years, mean baseline CDAI 17±12, FR/ACPA+ 69.5%) who started a new b/tsDMARD. Disease characteristics are shown in Table 1. 288 treatments with b/tsDMARD were started in patients with impaired eGFR and 2155 in patients with normal eGFR. Compared to patients with eGFR >60, patients with eGFR ≤60 showed higher HAQ-DI (1.3±0.8 vs 1±0.8, pConclusionOur data show that impaired eGFR seems to not influence the persistence of b/tsDMARD treatment in RA patients.Disclosure of InterestsNone declared

We investigated the chemical, physical, and tribological properties of nanolubricants consisting of epoxidized sunflower oil with Cu nanoparticles as additive. These latter are produced by magnetron sputtering at distinct current levels in the deposition, to improve the development of nanolubricants by enhancing the nanoparticles dispersion. The nanolubricants are here characterized by Fourier transform infrared spectroscopy, zeta potential, ultraviolet–visible absorbance spectroscopy, small-angle X-ray scattering, and scanning electron microscopy. After all, the tribological properties of the bionanolubricants are investigated using a high-frequency reciprocating rig equipment, scanning electron microscopy, and energy dispersive spectroscopy. Our results disclose the nanolubricants produced using the magnetron sputtering technique have excellent nanoparticle dispersion, as well as good tribological performance.

BackgroundAnti-SARS-CoV2 vaccines showed a good efficacy in prevention of severe COVID-191. Their potential in induction of autoantibodies (abs) has not been well established1. One recent study demonstrated an increase of abs’ titre after anti-SARS-CoV2 vaccination only in patients with already pre-existing positivity2.ObjectivesTo evaluate the potential induction of abs after anti-SARS-CoV2 vaccination in a triple positive antiphospholipid antibodies (aPL) cohort.Methods18 subjects were enrolled [M/F= 17/1; median age=52 years; 5 Primary Antiphospholipid Syndrome (PAPS), 5 Systemic Lupus Erythematosus (SLE) with associated APS and 8 aPL carriers (1 Behçet Disease, 1 SLE, 4 Undifferentiated Connective Tissue Disease, 2 with no diagnosis of systemic autoimmune disease)]. Serum samples were collected before the first (T0) and at least one month after the second administration (T1) of the anti-SARS-CoV2 vaccine (16 BNT162b2, 1 mRNA-1273, 1 Gam-COVID-Vac).A wide panel of abs were evaluated through routinely methods.ResultsNone developed any additional sign of autoimmune diseases upon vaccination. Patients majority did not display any new autoantibody positivity (Table 1). Changes were observed in 3 patients: 1) one aPL carrier patient who was antinuclear antibodies (ANA) negative at T0 was found to be ANA positive at T1 [negative anti-double stranded DNA and anti-extractable nuclear antigen (ENA)]; this patient was actually ANA positive in her clinical history; 2) one aPL carrier patient affected by SLE, who was IgM and IgG aCL and IgG aB2GPI positive at T0, turned positive for IgM and IgA aB2GPI; 3) one aPL carrier patient affected by Behçet Disease, who was positive for IgM aCL and for IgM aB2GPI at T0, turned positive for IgA aCL and IgA aB2GPI.Table 1.Autoantibodies’ titre pre (T0) and post (T1) anti-SARS-CoV2 vaccination.AutoantibodiesLevel at T0Level at T1p-value*Patients positive at T0Patients positive at T1p-value°Anti-dsDNA28.7 (21.8-64.5)25.8 (15.9-68.5)0.1637/18 (38.9%)6/18 (33.3%)0.729(n.v. )aCL IgG88.1 (27.1-218.9)68.2 (18.8-181.3)0.11815/18 (83.3%)13/18 (72.2%)0.691(n.v. )aCL IgG11.9 (11.2-77.2)11.2 (11.2-24.5)0.4329/18 (50%)7/18 (38.9%)0.502(n.v. )aCL IgM20.8 (5.9-35.9)8.9 (3.3-21.6)0.0069/18 (50%)5/18 (27.8%)0.171(n.v. )aCL IgM30.4 (18.1-170.8)23.8 (11.2-82.3)0.02914/18 (77.8%)12/18 (66.7%)0.457(n.v. )aCL IgA11.7 (11.2-30.9)11.2 (11.2-17.6)0.0298/18 (44.4%)6/18 (33.3%)0.494(n.v. )aβ2GPI IgG230.4 (110.1-971.1)242.3 (33.7-652.9)0.08316/18 (88.9%)14/18 (77.8%)0.658(n.v. )aβ2GPI IgG9.3 (9.3-128.1)19.4 (9.3-126.9)0.8448/18 (44.4%)9/18 (50%)0.738(n.v. )aβ2GPI IgM16.9 (3.6-51.3)6.8 (1.5-23.1)0.0417/18 (38.9%)5/18 (27.8%)0.480(n.v. )aβ2GPI IgM19.8 (11.1-78.8)9.9 (9.3-52.4)0.1098/18 (44.4%)7/18 (38.9)0.735(n.v. )aβ2GPI IgA20.8 (9.3-39.9)9.3 (9.3-37.8)0.08010/18 (55.6%)7/18 (38.9%)0.317(n.v. )Antiphospholipid antibodies were determined with chemiluminescence (CU) and home-made ELISA (IU/ml) methods of detection. Pre and post-vaccine values are expressed as median (IQR). In bold, statistically significant comparisons. *Wilcoxon signed-rank test for paired variables was applied. °Chi-square test or Fisher’s exact test were applied.dsDNA=double-stranded DNA; aCL: anti-cardiolipin; aβ2GPI: anti-beta2-glycoprotein I; n.v.: normal value.All emerging aPL were low titre. None of the patients displayed raising aPL titres from low to medium-high.ConclusionAnti-SARS-CoV2 vaccination did not induce any clinical signs of autoimmunity in a cohort of patients with triple aPL positivity. Serology for autoantibodies remained stable in the majority of patients. Few patients experienced the emergence of low titre aPL, possibly as an expected inter-assay variation rather than an evolving “serological flare”.References[1]Ishay Y et al. Int Immunopharmacol. 2021;[2]Thurm C et al. medRxiv 2021.Disclosure of InterestsNone declared

BackgroundPsoriatic Arthritis (PsA) is a challenging diagnosis both for the absence of specific biomarkers and for its clinical heterogeneity, especially in its initial phases. Early onset of PsA is mostly characterized by mono-oligoarthritis, enthesitis, dactylitis, onychopathy, modest cutaneous involvement. At least 50% of early-PsA patients initially come at dermatologist’s attention because they carry only few musculoskeletal symptoms such as enthesitis and dactylitis. Rheumatological evaluation and ultrasound (US) demonstration of articular and entheseal inflammation allows to augment the probability of an early diagnosis in a short period of time.ObjectivesWe described patients referred to our derma-rheumatological clinic. We focused our attention on the main affected domain and on the advantages of a combined evaluation in terms of diagnosis, access to advanced therapies and short-term outcome.MethodsAll patients referred to our derma-rheumatological clinic by dermatologists from July 2017 to July 2019 for suspected PsA were considered in the present study. 55% of them were studied with US, according to clinical necessity. All the suspected domains were studied using both B-mode and Power Doppler.Results81 patients, sent to our attention for suspected PsA, were included. In 18 (37%) of them diagnosis was confirmed (Caspar criteria were satisfied). In these patients oligoarthritis (80%), enthesitis (40%), dactylitis (23%), sometimes in combination, were the most frequent presentations. In 25% of cases enthesitis was the only clinical feature. Articular disease activity was low to moderate in most of patients (DAPSA 14,83 ± 10,08). Disease duration at the diagnosis was 12 months in 90% of cases and the time occurring between symptoms and the first advanced therapy was 18 months in 50% of cases. US study allowed to redefine disease status in 30% of cases. Arthritis and enthesitis were the main domains where US evaluation gave more diagnostic value.Conclusionliterature reports a mean time to diagnosis and to start advanced pharmacological therapy respectively of 1,5 and 5 years. In our report, time to start advanced therapy was much lower than expected, falling in the so-called window of opportunity. US study importantly contributed to reach this target, allowing us to identify as soon as possible sub-clinical and pauci-symptomatic forms (low disease activity, prevailing entheseal domain), which could otherwise be misdiagnosed or have an important diagnostic delay. The attention of dermatologist and integrated evaluation allowed us to optimize our diagnostic-therapeutic work-up in patients affected by early PsA, allowing them to receive sooner advanced therapies, according to recent EULAR and GRAPPA recommendations.References[1]Lubrano E, et al. Residual Disease Activity and Associated Factors in Psoriatic Arthritis. J Rheumatol. 2020 Oct 1;47(10):1490-1495. Clinical Rheumatology (2020)[2]GRAPPA Treatment Recommendations: An Update From the 2020 GRAPPA Annual Meeting LC Coates et al. The Journal of Rheumatology Feb 2021, jrheum.201681.Disclosure of InterestsNone declared

BackgroundThe rate of antiphospholipid antibodies (aPL)negativization in antiphospholipid syndrome (APS) patients is uncertain, but it is estimated to be as high as 8%. aPL disappearance seems to be more frequent in patients positive for one single aPL test and appears to be related with the immunosuppressant/immunomodulatory treatment undertaken by the patient. Currently, a consensus definition of aPL negativization is lacking, as well as international recommendations on how to approach treatment in patients with a persistent aPL negative seroconversion.ObjectivesThe aim of our work was to evaluate the clinical approach and the level of consensus among experts from the APS Study Group of the Italian Society for Rheumatology (SIR-APS) in different clinical scenario addressing aPL negativization and its definition.MethodsExperts of SIR-APS were contacted using a survey methodology.ResultsA structured survey was circulated among 30 experts.Up to 90% of the interviewed experts agreed on defining aPL negativization as the presence of two negative determinations, one year apart (90%).Almost ful lconsensus exist among experts in some clinical settings, including: a) the role of aPL negativitation in the management of a thrombotic event determined by concomitant presence of cardiovascular risk factors, both modifiable and not modifiable (90%): b) approach to young patients with triple aPL positivity who experienced pulmonary arterial thrombotic event and tested negative for aPL detection after five year of vitamin K antagonist (VKA) treatment (90%); c)the use of “extra criteria” aPL antibodies testing before pondering VKA suspension (93%).ConclusionConsensus is needed to support the management of patients with APS in areas where controlled data are missing. A substantial agreement exists among expert in defying aPL negativization as the presence of two negative determinations, one year apart. On the contrary, VKA suspension should be embraced with extreme caution when it comes to APS patients, particularly if they experienced arterial thrombotic events and/or tested positive for triple aPL. Nevertheless, VKA cessation might be considered when risk factors are carefully monitored/treated and the presence for “extra criteria” aPL is ruled out.References[1]Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RHWM, DE, Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.[2]Coloma Bazán E, Donate López C, Moreno Lozano P, Cervera R, Espinosa G.Discontinuation of anticoagulation or antiaggregation treatment may be safe in patients with primary antiphospholipid syndrome when antiphospholipid antibodies became persistently negative. Immunol Res Immunol Res; 2013; 56: 358–61.[3]Radin M, Schreiber K, Sciascia S, Roccatello D, Cecchi I, Aguirre Zamorano MÁ, Cuadrado MJ. Prevalence of Antiphospholipid Antibodies Negativisation in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Multicentre Study. Thromb Haemost 2019; 119: 1920–6.AcknowledgementsItalian Society of RheumatologyDisclosure of InterestsNone declared

BackgroundApremilast (APR) is an oral PDE4 inhibitor approved for the treatment of Psoriatic Arthritis (PsA). Its effectiveness has been assessed in clinical trials1,2, but real-life data are still scarce.ObjectivesTo evaluate the retention rate (RR) of APR in PsA patients and the risk factors associated to APR inadequate response.MethodsRetrospective monocentric analysis of PsA patients (CASPAR criteria 2006) treated with APR between 2017 and 2021. Disease activity was evaluated at baseline (T0) and after 6 (T6), 12 (T12) and 24 (T24) months of therapy using DAPSA score. Data are expressed as median [IQR].ResultsThe cohort included 79 patients (41% males; age at PsA onset: 47 [37-58] years). PsA domains were: oligoarticular involvement (58%), enthesitis (42%), dactylitis (6%), axial involvement (13%), psoriasis (62%).Half patients presented dysmetabolic traits: 47% overweight/obesity, 34% arterial hypertension, 20% dyslipidemia.APR was prescribed mainly as first-line targeted therapy; in 42% APR was administered after the failure of ≥1 bDMARD.Contraindications to bDMARDs (47%) especially increased infectious risk (19/37) and current/previous malignancy (15/37), and mild PsA phenotype (27%) were the main reasons for APR choice.APR was discontinued in 61% after 4 [1-10] months because of inefficacy (25/48) or adverse events (AEs) (21/48; 81% gastrointestinal complaints). Patients who discontinued APR were compared with patients who continued APR (Table 1).Table 1.APR WITHDRAWALn=48APR CONTINUATIONn=31p valueFemales28 (58)19 (61)0.79Age at T0, years51 [44-58]57 [53-71]0.03PsA duration at T0, years5 [2-11]5 [0-12]0.81Oligoarticular involvement24 (50)20 (65)0.21Axial involvement6 (13)4 (13)1.00Enthesitis / dactylitis26 (54)11 (36)0.10DAPSA at T022 [16-28]18 [13-26]0.27APR in monotherapy26 (54)23 (74)0.07bDMARDs naïve24 (50)22 (71)0.07Results are presented as median [IQR] or number (%). Continuous variables were compared with Mann-Whitney test; categorical variables were compared with Chi Squared/exact Fisher test.The RR of APR was 62% at T6, 51% at T12 and 38% at T24 (Figure 1a).Figure 1.a) Overall RR of APR b) RR of APR in bDMARDs naïve vs previously treated with bDMARDs patients (exclusion of withdrawals for intolerance).In patients continuing therapy, APR showed a good efficacy, with a significant reduction of DAPSA score observed at T6 (13 [9-19]), T12 (11 [4-18]) and T24 (8 [3-10]) as compared to T0 (21 [14-28]) (pAn overall trend of reduction of the BMI (kg/m2) was observed (T0: 25 [22-28], T6: 24 [21-27], T12: 23 [21-26]); in overweight patients the BMI decreased significantly (28 [26-31] at T0 vs 27 [26-29] at last evaluation; pBecause of the high rate of discontinuations due to intolerance in the first months of therapy, we conducted a sub analysis: patients who continued APR (n=31) vs patients who discontinued it for inefficacy (n=25). A higher frequency of APR withdrawal was registered in younger patients (51 [47-57] vs 57 [53-71] years; p:0.01) previously treated with bDMARDs (71% vs 40%; p:0.02). Multivariate analysis confirmed these associations (OR [95% CI]: 0.1 [0.89-0.99], p:0.03 and 2.3 [1.70-59.17], p:0.01; respectively). The RR was higher in bDMARDs naïve patients compared with patients previously treated with bDMARDs (T6: 75% vs 67%, T12: 71% vs 63%, T24: 67% vs 34%; log-rank test= p:0.05) (Figure 1b).ConclusionThis study confirms the safety and effectiveness of APR in a real-life scenario. We experienced a higher APR withdrawal rate for AEs (44%) in the first months of therapy, compared to registration studies in which APR was suspended in (8%). However, when tolerated, APR maintained efficacy over time, as demonstrated by progressive DAPSA reduction. The higher RR in bDMARDs naïve patients suggests the early use of APR. Moreover, the reduction of BMI could favor APR use in dysmetabolic patients. These data need to be confirmed in larger studies.References[1]Edwards CJ et al. Ann Rheum Dis. 2016. 1Kavanaugh A et al. Arthritis Res Ther. 2019.Disclosure of InterestsNone declared

BackgroundIdiopathic inflammatory myositis (IIM) is a group of heterogeneous autoimmune diseases, characterized by myositis-specific (MSA) or myositis-associated autoantibodies (MAA). Muscle biopsy is the diagnostic gold standard, but correlations with elevated creatine level (CK) or MSA/MAA are unclear.ObjectivesTo evaluate the association between specific histological findings and clinical and/or serological features in IIM patients from a single tertiary Rheumatology referral center.MethodsWe retrospectively analyzed demographic and clinical data from medical charts, of 184 patients affected by IIM followed-up for >1 year. Muscle biopsies of 89 IIM patients were retrieved from deltoid, biceps or quadriceps muscle, snap-frozen and stored at -80°C and processed for routine histology and histochemistry.ResultsThe majority of our muscle biopsy cohort was represented by Dermatomyositis (DM) (39.3%), Polymyositis (PM) (29.2%) and Anti-synthetase syndrome (ASS) (13.5%), whereas the rest was composed of Overlap Syndrome (OS), Immune-Mediated Necrotizing Myopathy (IMNM) and Inclusion-Body Myositis (IMB) (13.5%, 2.2% and 2.2% respectively).DM presented perifascicular atrophy in 85% of cases and perivascular and perifascicular infiltration in only 40% of cases, similar to other types of IIMs. The overall histology finding was characterized by minimal inflammation and/or necrosis but major atrophy. In comparison, Polymyositis showed more endomysial infiltration and necrosis (Table 1). ASS was characterized by atrophy and perifascicular necrosis in 83% of cases, with perimysial and perivascular infiltration in 67% of cases. Those characteristics were observed both in anti-Jo-1+ (13.9%) as well as non-Jo-1+ ASS patients (13.2%). Non-Jo-1+ ASS patients presented endomysial infiltration, invading or enveloping the muscle fibers (not present in anti Jo-1+) (p: 0.036), with addition of rimmed vacuoles and aspecific clinical presentation. Moreover, in DM, anti-Mi2+ antibodies (9.3%) were significantly associated with perifascicular regeneration and endomysial infiltration, in comparison to both anti-TIF1γ+ (5.8%) and anti-NXP2+ patients (4.6%). No significant histopathological features were found in patients with anti-Ro52 autoantibodies (37.2%), that represented the most frequent MAA in our cohort.Table 1.BIOPSY CHARACTERISTICSASS 12 (%)PM 35 (%)DM 26 (%)p [OR] ASS vs PMp [OR] PM vs DMdiffuse atrophy3 (25)34 (97.1)8 (30.8)perifascicolar degeneration----29 (82.9)15 (57.7)----0.044 [3.544 (1.09-11.5)]prevalent necrosis----10 (28.6)1 (3.8)----0.017 [10 (1.19-84)]Jo1 12 (%)PL7/PL12 5 (%)p [OR]endomysial infiltration (invading fibers)03 (60)0.015 [inf]Mi2 8 (%)TIF1γ 5 (%)NXP2 4 (%)p [OR] Mi2 vs TIF1γp [OR] Mi2 vs NXP2perifascicolar regeneration8 (100)1 (20)00.007 [inf]0.002 [inf]endomysial infiltrate (surrounding fibers)6 (75)----0----0.061ConclusionNo significant associations emerged between CK levels, different types of IIM and MSA. Some histological features seem to define subtypes of DM. A precise definition of autoantibody profile in IIM could define not only a clinical phenotype but also the muscle damage distribution.Disclosure of InterestsNone declared

BackgroundIdiopathic Inflammatory Myopathies (IIM) are a group of disorders sharing the common feature of immune-mediated muscle injury. In IIM autoantibodies specific for (MSA) or associated to (MAA) myositis are present in 60-65% of cases (1). Although only anti-Jo-1 (2) are included in the EULAR 2017 criteria, the presence of MSA allows to identify clinical and prognostic phenotypes.ObjectivesAim of the work is to evaluate the positivity rate on sera analyzed by a line blot (LB) immunoassay able to detect MSA or MAA, the associated clinical diagnoses and the consistency with the antibody specificity.Methods267 sera were analyzed using a commercial LB (Autoimmune Inflammatory Myopathies 16 Ag Profile EUROLINE) between March 2017 and March 2021. The diagnosis was identified by analyzing the medical records.ResultsA positivity for at least one MSA/MAA was found in 118/267 sera (44.2%); MAA isolated in 22% of cases and a double/multiple positivity for MSA in 12.7%.The distribution of antibody positivity and the associated clinical diagnoses are shown in Table 1.Table 1.Autoantibody distribution and associated clinical diagnosis; for some patients there are multiple positivityAutoantibody specificityConsistent diagnosisTotal positivity n. (%)Isolated positivity n. (%)Concomitant presence of at least one MAA n. (%)Concomitant presence of MSA +/- MAA n. (%)n. (%)Type of IIMMSAMi-227 (22.9)16 (59.3)2 (7.4)9 (33.3)5 (18.6)2 DM/2 PM/1 ASSTif-1γ12 (10.2)4 (33.3)4 (33.3)4 (33.3)9 (75)5 CAM/4 DMPL-711 (9.4)4 (36.4)3 (27.3)4 (36.4)5 (45.5)ASSNXP-28 (6.8)3 (37.5)1 (12.5)4 (50)3 (37.5)DMSRP8 (6.8)3 (37.5)1 (12.5)4 (50)1 (12.5)PMJo-18 (6.8)2 (25)3 (37.5)3 (37.5)6 (75)ASSPL-127 (5.9)3 (42.9)04 (57.1)4 (57.1)ASSMDA55 (4.2)3 (60)02 (40)4 (80)2 CADM/1 DM/1 ASSOj4 (3.4)3 (75)01 (25)3 (75)ILDSAE3 (2.5)2 (66.7)1 (33.3)02 (66.7)DMEj2 (1.7)1 (50)1 (50)01 (50)ASSMAARo-5233 (28)12 (36.3)2 (6.1)19 (57.6)-PM-Scl19 (16.1)11 (57.9)3 (15.8)5 (26.3)-Ku6 (5.1)3 (50)1 (16.7)2 (33.3)-DM: Dermatoyositis, PM: Polymiositis, ASS: Antisynthetase Syndrome, CAM: Cancer-Associated Myositis, CADM: Clinical Amyopatic Dermatomyositis, ILD: Interstitial Lung DiseaseIn our cohort, the most common antibodies were anti-Ro52kD, positive in 33 sera (28%), while the most frequent MSA were anti-Mi-2, positive in 27 sera (22.9%).MSA most frequently found as an isolated positivity were anti-Oj (75%), while anti-Jo-1 as an isolated positivity were present only in 25% of cases.Considering the 118 sera with at least one MSA/MAA a diagnosis of IIM was made in 52 cases (44%); in 11 cases others systemic autoimmune diseases were identified.The consistency between antibody specificity with the clinical diagnoses was analyzed: for some antibodies, as anti-Jo-1 (80%), anti-MDA5 (75%) and anti-Tif-1gamma (75%), LB results were consistent with clinical diagnoses; while for others, as anti-Mi-2 (18,6%) and anti-SRP (12,5%), the agreement was lower.ConclusionThe use of LB in the diagnostic workout of IIM allowed the detection of MSA previously not found with routine methods. In our court low prevalence of anti-Jo-1 was found. This may be justified by the fact that anti-Jo-1 are included in the assays routinely used to identify anti-ENA antibodies, therefore these sera were not tested with an additional LB.With LB, a higher prevalence of double/multiple MSA positivity was found, compared to the 0.1% described with immunoprecipitation (IP) (3). LB give a semiquantitative result: low, medium or high titer, so the analysis of different titers, according with clinical data or IP, could be helpful in the interpretation of the co-existence of multiple MSA (4).References[1]Betteridge Z, et al. J Autoimmun.2019;101:48-55[2]Lundberg IE, et al. Ann Rheum Dis.2017;76:1955-1964[3]Cavazzana I, et al. J Immunol Methods.2016;433:1-5[4]Cavazzana I, et al. Ann Rheum Dis.2020;79:e152Disclosure of InterestsNone declared

BackgroundAntiphospholipid Syndrome (APS) is a rare autoimmune disease characterized by thrombotic events and/or pregnancy morbidities in the presence of confirmed positivity for antiphospholipid antibodies (aPL). Complement was demonstrated to be involved in aPL-related pregnancy loss in animal models and several groups investigated the significance of complement levels in human disease. C3 and C4 serum levels were assessed in several cohorts of pregnant patients with APS and/or aPL positivity in order to relate complement consumption with adverse pregnancy outcome (APO).According to some authors, hydroxychloroquine (HCQ) can control the activation of the complement system, improve pregnancy outcome and reduce aPL title.ObjectivesThis study was designed to verify the effect of HCQ in addition to low dose aspirin (LDA) + low molecular weight heparin (LMWH) treatment in a multicenter cohort of primary APS (PAPS) and aPL carriers pregnant women and the possible correlation with preconception serum C3/C4 levels.MethodsMedical records of pregnant women with confirmed positivity for aPL antibodies attending twelve referral centers from January 2010 to December 2020 were retrospectively evaluated. We considered as aPL-related APO: spontaneous abortions (ResultsWe have analyzed 164 singleton PAPS/aPL carrier pregnancies (22 aPL carriers - 13%) in 128 patients: all were treated with combination therapy (LDA+LMWH), and in 30 HCQ was added. 58 pregnancies (43%) had low levels of preconception C3/C4. A triple aPL positivity was observed in 54 pregnancies, 14 of them were treated with combination therapy + HCQ. When considering the whole cohort, the addition of HCQ had not significantly improved the gestational outcome. Further stratification was performed on the basis of complement consumption. In the group of patients with preconception low C3/C4 levels the addition of HCQ had not significantly improved pregnancy outcome. We have lastly evaluated 40 pregnancies with a high-risk profile (triple aPL positivity and complement consumption), in which we have found that HCQ significantly improved gestational outcome (p=0.018, Table 1).Table 1.Relationship between APO, therapy during pregnancy and risk profile.All pregnancies (n=164)Reduced C3/C4 (n=58)Triple aPL+ and reduced C3/C4 (n=40)LDA+LMWH (n, %)LDA+LMWH+HCQ (n, %)pLDA+LMWH (n, %)LDA+LMWH+HCQpLDA+LMWHLDA+LMWH+HCQp(n, %)(n, %)(n, %)APO62 (46%)16 (53%)ns32 (68%)4 (36%)ns23 (77%)3 (30%)0.018No APO72 (54%)14 (47%)15 (32%)7 (64%)7 (23%)7 (70%)Total1343047113010This observation could not be confirmed in patients with single or double aPL positivity.ConclusionThe study shows that administering HCQ in addition to combination therapy can improve gestational outcome in aPL/PAPS high-risk patients. This observation confirms that HCQ exerts a beneficial effect on aPL pregnancies by complement inhibition as it was shown in animal models. In addition, our results provide the clinicians a useful tool to implement conventional treatment in patients at high risk of pregnancy complication or loss.References[1]De Carolis S, et al. Is there any role for the hydroxychloroquine (HCQ) in refractory obstetrical antiphospholipid syndrome (APS) treatment? Autoimmun Rev 2015;14:760-2.[2]Mekinian A, et al. The efficacy of hydroxychloroquine for obstetrical outcome in antiphospholipid syndrome: data from a European multicenter retrospective study. Autoimmun Rev 2015;40:498-502.[3]Mekinian A et al. Obstetrical APS: is there a place for hydroxychloroquine to improve the pregnancy outcome? Autoimmun Rev 2015;14:23-9.Disclosure of InterestsNone declared

BackgroundAnti-Th/To antibodies, detected in 2-5% Systemic Sclerosis (SSc) patients, are associated to interstitial lung disease (ILD)1 in half of the cases. However, long-term data on ILD as well as on organ damage accrual are lacking.ObjectivesTo describe the clinical associations of anti-Th/To SSc patients, focusing on ILD, organ damage and mortality.MethodsMonocentric retrospective study. 1) Description of clinical associations of anti-Th/To SSc patients (2013 ACR/EULAR criteria). 2) Case-control study: anti-Th/To vs anti-Topoisomerase (anti-Topo)1 patients (1:3; matched for sex and age at SSc onset) regarding a) ILD b) organ damage c) survival. ILD progression was assessed through pulmonary function tests (PFTs) at baseline (T0) and after 1 (T1), 5 (T5), 10 (T10) and 20 (T20) years. Organ damage was evaluated with SCTD-Damage Index (SCTD-DI)2. Continuous data are expressed as median [IQR].ResultsWe identified 13 anti-Th/To patients (all Caucasians, F/M=10/3, median age at SSc onset: 50 [37-67] years). Anti-Th/To were assayed by RNA immunoprecipitation in 8/13 and by immunoblotting in 5/13 cases.1) 2/13 patients had SSc/myositis overlap syndrome: 1 associated to anti-SRP, 1 negative for myositis specific antibodies and affected by a synchronous (±3 years from onset) cancer. All presented lcSSc, 77% esophageal symptoms, 46% digital ulcers (DUs), 40% ILD, 39% telangiectasias, 39% heart involvement (3 pericarditis, 1 myocarditis in patient anti-SRP+, 1 arrhythmia), 15% gastrointestinal symptoms, 15% myositis and 8% calcinosis. No patients presented synovitis, joint contractures, pulmonary arterial hypertension nor scleroderma renal crisis.2a) Anti-Th/To ILD patients, as compared to 39 anti-Topo 1, less frequently required immunosuppression and never required antifibrotic or O2 therapy (Table 1); ILD progression (%pFVC decline ≥10% or %pFVC decline 5-10% and %pDLCO decline ≥15%) was shown for 3/13, albeit, after a longer interval than in 8/39 anti-Topo 1 progressors (15 [10-15] vs 1 [1-6.3] years, p:0.05); none died because of ILD.Table 1.anti-Th/To+ n=13anti-Topo 1+ n=39p-valueILD on HRTC4/10 (40)28/33 (85)0.01Immunosuppressants1/13 (8)16/39 (41)0.04Antifibrotic and/or O20/13 (0)8/39 (21)0.18PH secondary to ILD0/13 (0)6/39 (15)0.32SSc-ILD related death0/13 (0)6/39 (15)0.32%pFVC T0105 [85-114]90 [81-114]0.26%pFVC T1107 [97-112]88 [80-108]0.09%pFVC T597 [84-114]99 [83-111]0.88%pFVC T10103 [91-114]88 [80-112]0.23%pFVC T20104 [83-111]81 [74-103]0.35%pFVC 0/13 (0)3/39 (8)0.56%pFVC 0/12 (0)3/39 (8)1.00%pFVC 0/10 (0)3/33 (9)1.00%pFVC 0/7 (0)3/25 (12)1.00%pFVC 0/5 (0)1/8 (13)1.00Progressive fibrosis (PF)* [T1-T0]0/12 (0)5/39 (13)0.32PF* [T5-T0]1/10 (10)5/33 (15)1.00PF* [T10-T0]1/7 (14)4/25 (16)1.00PF* [T20-T0]2/5 (40)0/8 (0)0.20Continuous data are presented as median [IQR] and compared with Mann-Whitney test; categorical data are presented as number/number available data (%) and compared with Chi-square test/Fisher’s exact test. *Progressive fibrosis= %pFVC decline ≥10% or 5-10% %pFVC decline and %pDLCO decline ≥15%.2b) During 16 [6-20] years of follow-up, SCTD-DI score progressively increased, but remained low in all patients (SCTD-DI ≤5) and was significantly lower than in anti-Topo 1 (Figure 1a), mainly due to ILD, joint contractures and DUs in the latter group (85% vs 40%, p:0.01; 39% vs 0%, p:0.01; 77% vs 46%, p:0.08).Figure 1.2c) 4/13 patients died at 81 [75-86] years after 10 [8-13] years of disease duration, none due to SSc. The survival curves of the two groups are showed in Figure 1b.ConclusionIn this cohort anti-Th/To patients showed a mild SSc phenotype, characterized by lower organ damage, more favorable long-term ILD functional outcome (although detectable in 40% of patients) and higher survival, as compared to matched anti-Topo 1 patients. Larger multicenter studies are needed to confirm these data.References[1]Stochmal A. Clinic Rev Allerg Immunol. 2019. 2Ferdowsky N. Ann Rheum Dis. 2018.Disclosure of InterestsNone declared

BackgroundIn daily clinical practice, it is not rare to observe a relevant discordance between patient’s global assessment (PGA) and physician’s global assessment (PhGA), because of different illness perceptions.ObjectivesTo evaluate the presence of PGA/PhGA discrepancy in patients with Systemic Lupus Erythematosus (SLE) who achieved clinical remission and to evaluate how this discrepancy affects PROs. In addition, to explore whether this discordance could be influenced by the presence of additional elements affecting patients’ quality of life, such as comorbidities, sleep disturbances and psycho-emotional factors.MethodsOur study included adult SLE patients consecutively followed in a single Lupus Clinic from March to July 2021 fulfilling at minimum the definition of clinical remission of treatment according to Zen et al. (1) (cSLEDAI=0, corticosteroids ≤5mg/die, stable dosage of DMARD). Medical records including demographic data, clinical characteristics and outcomes measures were collected. Pain assessment, PGA and PhGA were rated on a visual analogue scale (0-100 mm) on the same day of the clinical evaluation. To analyse the discrepancy between PGA and PhGA, the [PGA-PhGA] variable was calculated, considering as discordant a difference ≥ 25 mm as previously proposed (2) All the subjects completed the following questionnaires: Health Assessment Questionnaire (HAQ), SF36 Health Survey, State-Trait Anxiety Inventory (STAI-Y1/Y2), Self-rating Depression Scale (SDS Zung) and Insomnia Severity Index. Statistical analysis was performed to compare concordant and discordant groups.ResultsThe study included 106 patients, (93 women, 13 men) with a median age of 48 (41-58) and a median SLE duration 227 months (124-330). At the last evaluation median SLEDAI was 0 (0-2) and median SLICC was 1 (0-1). According to Zen definitions of remission, 51 patients (48%) and 20 (19%) also fulfilled the criteria of clinical remission off corticosteroids and complete remission respectively. Nevertheless, in 24 patients (22,7%) [PGA-PhGA]≥25. Patients in the discordant group were older (median 58 years, IQR 49-62 vs 46, IQR 39-57; p=0,0043) and less frequently achieved the definition of clinical remission off corticosteroids (n=4, 16,7% vs n=47, 57,3%,pTable 1.Data are expressed as median and interquartile range (IQR) and compared using Mann-Whitney test.TOTAL N=106 (%)CONCORDANT GROUP (PGA-PhGA) DISCORDANT GROUP (PGA-PhGA) ≥25N=24 (%)P valueVAS-pain [0-100],10 (0-30)10 (0-20)50 (40-60)< 0.001SF-36 Physical Component Summary (PCS)50 (37,5-53)51 (44-54)30 (27,5-39)< 0.001SF-36 Mental Component Summary (PCS)48 (38-55)51 (40-55)40 (36-48,5)0,015STAI-Y1 [20-80]35 (30-47)33 (28,3-45,5)42 (36,5-49,5)0,013STAI-Y2 [20-80]37 (30-46)35 (29-43,3)42 (36-46)0,021Test di Zung [20-80]34,5 (29-43)33 (27-43)39 (35,5-44,5)0,008Insomnia severity index [0-28]6 (2-12)4 (1-9)9 (6,8-14,3)HAQ0 (0-0,1)0 (0-0)0,38 (0-0,6)< 0.001ConclusionIn our study we found that, even in patients considered in remission, in more than 20% of patients there is a considerable discordance between the global disease assessment reported by patients and their physicians. Patients that had a higher PGA also presented worse score at PROs. Our data seems to confirm that potential causes for discordance could be more related to the presence of non-inflammatory processes, depression, or anxiety than clinical manifestations or damage related to SLE.References[1]Zen et al. Ann. Rheum. Dis. 2015;74:2117–2122[2]Neville C, et al. J Rheumatol 2000;27:675-9Disclosure of InterestsNone declared

BackgroundPatients with autoimmune systemic diseases (ASDs) can be counted among frail populations as regards the predisposition to COVID-19 due to the frequent visceral organ involvement and comorbidities, as well as the ongoing immunomodulating treatments.ObjectivesOur long-term multicenter telephone survey prospectively investigated the prevalence, prognostic factors, and outcomes of COVID-19 in Italian ASD patients during the first 3 pandemic waves.MethodsA large series of 3,918 ASD patients (815 M, 3103 F; mean age 59±12SD years) was consecutively recruited at the 36 referral centers of COVID-19 & ASD Italian Study Group. In particular, ASD series encompassed the following conditions: rheumatoid arthritis (n: 981), psoriatic arthritis (n: 471), ankylosing spondylitis (n: 159), systemic sclerosis (n: 1,738), systemic lupus (172), systemic vasculitis (n: 219), and a miscellany of other ASDs (n: 178). The development of COVID-19 was recorded by means of telephone survey using standardized symptom-assessment questionnaire (1).ResultsA significantly increased prevalence of COVID-19 (8.37% vs 6.49%; pInterestingly, a significantly higher COVID-19-related death rate was observed in systemic sclerosis patients compared to the Italian general population (6.29% vs 2.95%; p=0.018). Other adverse prognostic factors to develop COVID-19 were the patients’ older age, male gender, pre-existing ASD-related interstitial lung involvement, and chronic steroid treatment. Conversely, patients treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) showed a significantly lower prevalence of COVID-19 compared to those without (3.58% vs 46.99%; p=0.000), as well as the chronic administration of low dose aspirin in a subgroup of SSc patients (with 5.57% vs without 27.84%; p=0.000).ConclusionThe cumulative impact of COVID-19 on ASD patients after the first 3 pandemic waves revealed less severe than that observed during the first phase of pandemic (1), especially with regards to the death rate that was comparable to the Italian general population in spite of the increased prevalence of complicating COVID-19 in the same ASD series.Ongoing long-term treatments, mainly csDMARDs, might usefully contribute to generally positive outcomes of in this frail patients’ population.Of note, a significantly increased COVID-19-related mortality was recorded in only SSc patients’ subgroup, possibly favored by pre-existing lung fibrosis. Among different ASD, SSc deserves special attention, since it shares the main pathological alterations with COVID-19, namely the interstitial lung involvement and the endothelial injury responsible for diffuse microangiopathy.Besides SSc, the patients’ subgroups characterized by older age, chronic steroid treatment, pre-existing interstitial lung disease, and/or impaired COVID-19 vaccine response (1-3), may deserve well-designed prevention and management strategies.References[1]Ferri C, et al. Ann Rheum Dis. 2020 Oct 14 doi: 10.1136/annrheumdis-2020-219113.[2]Ferri C et al. J Autoimmun. 2021 Dec;125:102744. doi: 10.1016/j.jaut.2021.102744.[3]Visentini M et al. Ann Rheum Dis. 2021 Nov 24. doi: 10.1136/annrheumdis-2021-221248Disclosure of InterestsNone declared

BackgroundThe research of circulating biomarkers in the field of chronic arthritis is still an unmet need, especially for the subgroup of seronegative arthritis [e.g., negative for anti-citrullinated peptides autoantibodies (ACPA) and/or rheumatoid factors (RF)]. In fact, in this clinical subset, there is a lack of soluble molecules which could help for a diagnostic or prognostic purpose, and the differential diagnosis between psoriatic arthritis (PsA) and seronegative rheumatoid arthritis (RA) is still a challenge. C-X-C motif chemokine 13 (CXCL13) is one of the most promising biomarkers recently identified, because of its association with active synovitis (1) and with a poor prognosis in RA (2), although there are still inadequate results to justify its routine use. No data are available of the determination of CXCL13 serum levels in PsA.ObjectivesTo analyze CXCL13 serum levels in a cohort of PsA patients with a history of peripheral involvement in comparison with RA.MethodsCross sectional analysis of consecutive patients with peripheral PsA [n:81; male/female=44/37; median age (25°-75° percentile)=54 (46-62) years; 28-joint Disease Activity Score-C Reactive Protein (CRP-DAS28)=1.9 (1.6-2.5); active psoriasis=43%; DAPSA (Disease Activity in PSoriatic Arthritis) score=8 (3-14)] and RA [n:143; male/female=30/113; age =62 (50-70) years; seropositive=67%; CRP-DAS28=2.1 (1.5-2.8)] was performed. 100 sex and age-matched healthy controls (HC) were enrolled. CXCL13 serum levels were assessed through commercial ELISA test (R&D).ResultsCXCL13 serum levels were higher in all the subgroups of patients [PsA: 50.9 (34.5-80.2) pg/mL, pConclusionThese results confirm the value of CXCL13 as a biomarker in the field of chronic arthritis. Its higher levels in seronegative RA than in PsA suggests its possible value in the differential diagnosis of these two subsets of arthritis.References[1]Bechman et al. BMC Rheumatology 2020;[2]Bugatti et al. Rheumatology 2014.Disclosure of InterestsNone declared

BackgroundIn the last years, the rate of successful pregnancies has significantly increased in Systemic Sclerosis (SSc)1 women. However, the long-term outcome of their children remains an unexplored issue.ObjectivesTo evaluate the neuropsychiatric (NP) outcome of children born to SSc mothers.MethodsAn ad-hoc questionnaire, regarding different aspects of child’s neurodevelopment (ND) (3 sections: childhood [0-5 years]; scholar age [6-11 years]; adolescence [12-18 years]), was created and administered to female SSc patients (ACR/EULAR 2013 criteria) attending our outpatient clinic during 2021 and who had at least 1 child. Children’s NP characteristics were compared between 3 subgroups: A) born >10 years before SSc diagnosis; B) born ≤10 years before SSc diagnosis; C) born after SSc diagnosis. Results below are expressed as number/total number of answers collected for each question.Results100 SSc women reported 189 pregnancies: 152 resulted in 154 live births (2 twin pregnancies).At least one NP alteration was reported in 42/119 (35%) subjects, more frequently in group B (57%), as compared to group A (31%, p:0.07) and group C (30%, p:0.09) although not statistically significant (Figure 1). Sleep irregularities were the most frequently reported disorder (15/42, 36%). Comparisons between the 3 subgroups for every NP outcome evaluated are shown in Table 1: overall, a higher rate of NP alterations were reported in children belonging to group B.Table 1.Analysis of NP outcomes: comparison of the 3 subgroups.A n=103B n=19C n=32N° of subjects evaluated forDISORDERS IN CHILDHOOD103/10319/1932/32Sleep irregularities6/79 (8)*4/13 (31)*5/27 (19)Motor difficulties0/77 (3)°2/13 (15)°2/26 (8)Difficulty in relationships0/78 (0)1/11 (9)2/26 (8)Difficulty in non-verbal communication skills0/78 (0)1/11 (9)2/26 (8)Difficulty in verbal communication skills1/77 (1)1/12 (8)2/26 (8)Difficulty in social integration6/77 (8)3/12 (25)1/25 (4)Cognitive difficulties0/77 (0)1/12 (8)0/26 (0)N° of subjects evaluated forDISORDERS IN SCHOLAR AGE103/10317/1917/32Difficulty in school lessons/homework7/77 (9)3/12 (25)0/15 (0)Behavioral problems during school period4/76 (5)1/12 (8)1/15 (7)School year repetition11/76 (15)2/13 (15)0/15 (0)N° of subjects evaluated forDISORDERS IN ADOLESCENCE101/10314/1911/32Difficulty in managing anger and aggression4/75 (5)0/11 (0)0/10 (0)Behavioral alterations0/75 (0)0/11 (0)0/10 (0)Difficulty in conduct2/73 (3)0/11 (0)2/10 (20)Mood alterations1/73 (1)1/11 (9)0/10 (0)Alterations of the feeding behavior1/75 (1)0/11 (0)0/10 (0)Anxiety problems1/75 (1)1/10 (10)0/10 (0)Results are presented as number/total number (%) of answers collected for each question. Variables were compared with Chi Squared/exact Fisher test. *p=0.03; °p=0.02.Figure 1.Children with ≥1 NP alteration: comparison of the 3 subgroups.In addition, SSc mothers declared that 7/123 (6%) children underwent a NP evaluation leading to a diagnosis in 3 cases: 1 cognitive delay, 1 learning disorder (LD) and 1 autism spectrum disorder (ASD). These children were born 1 and 5 years before and 3 years after SSc diagnosis, respectively. The prevalence of these diagnoses (0.8%) does not differ from general pediatric population.ConclusionChildren born to SSc mothers, had prevalence of major NP alterations (cognitive deficits, LDs, ASDs) similar to general pediatric population. A higher frequency of minor ND disorders, especially sleep irregularities, was observed in children within 10 years before maternal diagnosis, compared to the other groups, possibly suggesting an impact of maternal chronic disease on the relationship with child in the first years of life. To confirm these self-reported preliminary data, the extension of the study will consist in a systematic NP evaluation proposed to all the offspring of SSc mothers aged ≤18 years.References[1]Blagojevic J et al. 2019. J Rheumatol.AcknowledgementsGILS (Gruppo Italiano Lotta Sclerodermia) is kindly acknowledged for supporting the study with a grant.Disclosure of InterestsNone declared

BackgroundInterstitial lung disease (ILD) could be the first and only manifestation of idiopathic inflammatory myopathies (IIMs). Myositis-associated (MAA) or myositis-specific autoantibodies (MSA) are found in 60%-65% of cases [1, 2], but only anti-Jo1 have been included in EULAR 2017 criteria [3].ObjectivesAim of this work is to evaluate the presence of MSA/MAA in patients with ILD on serum analyzed by line blot (LB) immunoassay, the associated clinical diagnoses and the consistency of these diagnoses with antibody specificity.MethodsBetween march 2017 and march 2021, 267 sera were analyzed for MSA/MAA, 84 (31.4%) of which requested after a pneumological evaluation. The search was performed by LB (EUROLINE, Autoimmune Inflammatory Myopathies 16 Ag Profile). Medical records were analyzed for patients with at least one MSA/MAA and diagnosis divided in: connective tissue disease (CTD), interstitial pneumonia with autoimmune features (IPAF) or only pneumological diagnosis.ResultsA positivity for at least one MSA/MAA was found in 37/84 (44%) patients that had the following pneumological diagnosis: 13 non-specific interstitial pneumonia (NSIP, 35.1%), 10 organizing pneumonia (OP, 27%), 10 usual interstitial pneumonia (UIP, 27%), 1 acute interstitial pneumonia (AIP, 2.7%), 1 lymphoid interstitial pneumonia (LIP, 2.7%), 1 iatrogenic ILD for amiodarone (2.7%) and 1 idiopathic pulmonary artery hypertension (IPAH, 2.7%).Distribution of antibodies is reported in Table 1. The most frequent autoantibody was anti-Ro52 (13 sera, 35.2%), while anti-Mi2 was the most frequent MSA (10 sera, 32.4%) followed by anti-Jo1 and anti-SRP with 5 (13.5%) positive sera each. In Figure 1 the heat-map represents the frequency of MSA/MAA and their mutual associations. Multiple autoantibodies were found in 17 (46%) sera. More than one MSA was found in 8 (21.6%) sera of patients with the following diagnosis: 4 only pneumological diseases, 3 ASS and 1 IPAF.Table 1.Distribution of MSA/MAA and associated autoimmune diseasesAutoantibodies distribution N (%)Sera with a single MSA/MAA (N/positive; %)CTD* (N/positive; %)IPAF (N/positive; %)MSAJo-1 = 5 (13.5)2/5 (40)3/5 (60)0PL7 = 4 (10.8)02/4 (50)1/4 (25)PL12 = 6 (16.2)3/6 (50)3/6 (50)0OJ = 3 (8.1)2/3 (66.6)1/3 (33.3)2/3 (66.6)EJ = 1 (2.7)1/1 (100)1/1 (100)0Mi-2 = 10 (32.4)3/10 (30)2/10 (20)0NXP2 = 1 (2.7)001/1 (100)SRP = 5 (13.5)2/5 (40)2/5 (40)0TIF1gamma = 2 (5.4)01/2 (50)0MAARo-52 = 13 (35.2)3/13 (23)9/13 (69.2)1/13 (7.6)PM/Scl = 6 (18.9)4/6 (66.6)01/6 (16.6)For some patients there are multiple positive antibodies.*The following diagnosis were included: antisynthetase syndrome, dermatomyositis, polymyositis and systemic sclerosis.During the diagnostic work-up, at least one MSA/MAA were detected in 13 patients diagnosed with a CTD (35%), 5 with a IPAF (13%), 19 (51%) only a pneumological diagnosis. Of these 19 patients, 11 (57.9%) had a single autoantibody positivity (8 for a MSA, 3 for a MAA) while 8 (42.1%) had multiple positivity (4 with a MSA plus MAA and 4 with multiple MSA positivity).The most frequently diagnosed CTD was ASS with 9 patients (24.3%), followed by 2 polymyositis (5.4%), 1 dermatomyositis (2.7%) and 1 systemic sclerosis (2.7%). Pulmonary involvement in patients with CTD was represented by 9 cases of NSIP (69,3%) and 4 UIP (30,7%).ConclusionDuring the last 4 years about 1/3 of research for MSA/MAA requests to our laboratory had a pneumological indication and MSA/MAA were found in 44% of these patients. In patients with pulmonary involvement and MSA/MAA positivity 35% developed a CTD. Interstitial lung disease could be the first manifestation of a systemic autoimmune disease: research for MSA/MAA and a collaboration between rheumatologist and pneumologist allows a correct diagnostic work-up and therapeutic approach.References[1]Betteridge Z, et al. J Autoimmun 2019;101:48-55[2]Vojinovic T, et al. Clin Rev Allergy Immunol. 2021 Feb;60(1):87-94[3]Lundberg IE, et al. Ann Rheum Dis 2107;76:1955-1964Disclosure of InterestsNone declared

BackgroundIgG4-related disease (IgG4-RD) is a systemic disease characterized by lymphoplasmocellular infiltration and storiform fibrosis. Pancreas, biliary tract, lacrimal and salivary glands, lymph nodes and retroperitoneum are frequently involved, although the clinical presentation may vary [1].ObjectivesThe aim of this study is to retrospectively describe the clinical manifestations of a monocentric cohort of patients with IgG4-RD and analyze their clinical course by applying the validated IgG4-Related Disease Responder Index (RI) [2].MethodsWe enrolled 22 IgG4-RD patients classified with 2011 diagnostic criteria [3] and/or 2019 classification criteria [4].Results22 IgG4-RD patients (M/F=3.4/1), mostly Caucasian (91%), were diagnosed at a mean age of 59 years (44-74) with a median IgG4 concentration at diagnosis of 239 mg/dl (IQR 106-391 mg/dL). 14/22 (64%) patients fulfilled the 2011 classification criteria, while 8/22 (36%) were classified as possible (2), probable (5) or definitive (1) according to the diagnostic criteria of 2011. Organ involvement at diagnosis (T0) is described in Table 1. The organs most involved were lymph nodes, salivary glands and retroperitoneum. Patients were followed for a median of 49 months (IQR 16-88). Three patients were lost to follow-up. One patient died for pneumonia 96 months after diagnosis. During the follow-up 5 (23%) patients didn’t receive specific treatment, 1 (5%) was treated surgically, 6 (27%) with steroid only, 10 (45%) with steroid and immunosuppressants (with methotrexate and/or rituximab, tocilizumab, mycophenolate, cyclosporine, hydroxychloroquine, azathioprine) and/or surgical resection. A statistically significant reduction in RI between T0 and last follow-up (TLF) was observed in all the patients [from 6 (3-6) to 3 (1-4) p=0.010]. A significant reduction was also observed in the group of pharmacologically treated patients [from 6 (3-6) to 3 (1-4) p=0.035] but not in the group of patients without drug treatment (p = 0.174).Table 1.Organ involvement at diagnosisOrgan involvement T0N. Patients (%)Pancreas2 (9)Lymph nodes14 (64)Salivary glands13 (59)Lungs1 (5)Aorta and large blood vessels4 (18)Retroperitoneum, mediastinum, mesentery6 (27)Bile duct and liver3 (14)Kidneys2 (9)Pachymeninges1 (5)Orbits and lacrimal glands3 (14)Paranasal sinuses and / or nasal mucosa5 (23)ConclusionIn our cohort, patients were predominantly male with mean age at diagnosis of 59 years, consistent with literature data [1]. A statistically significant reduction in disease activity defined by reduction of RI was observed in patients who received immunosuppressive therapy. No significant reduction was observed in patients not pharmacologically treated.References[1]Dai Inoue et al. Medicine, 2015[2]Carruthers M.N. et al. Int J Rheumatol, 2012[3]Umehara H. et al. Mod Rheumatol, 2012[4]Wallace Z.S. et al. Ann Rheum Dis, 2020Disclosure of InterestsNone declared

BackgroundThere is growing interest in reproductive issues in patients with Spondyloarthritis (SpA) and Psoriatic arthritis (PsA).ObjectivesTo describe a real-life cohort of prospectively-followed pregnancies in SpA and PsA patients, focusing on obstetric outcome and on flare during pregnancies and post-partum.MethodsData on SpA and PsA pregnancies prospectively-followed in 2 European pregnancy clinics from 2010 to 2021 were retrospectively analysed.Disease activity was assessed using ASDAS-CRP or DAS28-CRP according to the main involvement (peripheral or axial). Disease flare was defined as the need to treatment modification (introduction or increase ≥5mg/day of prednisone, introduction of cDMARD or bDMARD). Miscarriages were excluded from the analysis of flares.ResultsData on 122 pregnancies (53 PsA and 69 ‘other SpA’: 39 axialSpA, 20 undifferentiated SpA, 6 IBD-related SpA, 4 reactive arthritis) in 102 patients (median age at conception: 34 [IQR: 31-36] years; median disease duration: 72 [24-132] months) were collected.We recorded 98 (86%) live births and 16 (14%) miscarriages (8 missing data).Cesarean section was performed in 15/98 (15%) cases. Median week of gestation at delivery was 39 [38-40]; 8 preterm births (Fourty-two pregnancies (40%) had at least 1 flare during pregnancy; 7 pregnancies had more than 1 flare. Overall, there were 13, 24 and 12 flares in the 1st, 2nd and 3rd trimester, respectively.A higher frequency of patients with axial involvement was observed in the ‘flare’ group as compared to pregnancies without flare (83% vs 59%, p=0.02) (Table 1).Table 1.Comparison between ‘flare’ and ‘without flare’ groups.FLARE (42)WITHOUT FLARE (64)pAge at conception (years)33 (31-37)33 (31-35)0.88Disease duration at conception (months)71 (24-120)60 (24-137)0.74PsA13 (31%)31 (48%)0.11‘Other SpA’29 (69%)33 (52%)0.11Axial involvement35 (83%)38 (59%)0.02Peripheral involvement30 (%)54 (%)0.17bDMARD useAny time before pregnancy16 (38%)19 (30%)0.49Stop at + pregnancy test/1st trimester8 (19%)4 (6%)0.09Start/continue 1st trimester7 (17%)10 (16%)0.89Start in 2ndtrimester5 (12%)00.02Start in 3rd trimester2 (5%)00.30Post-partum flare11/34 (32%)22/49 (45%)0.36Continuous variables were compared using Mann-Whitney test; categorical variables were compared using Chi-square with Yates’ correction or Fisher’s exact test.Medications resumed to treat flare were steroids (29 pregnancies), csDMARDs (14 pregnancies) and TNF-inhibitors (7 pregnancies: 5 during the 2nd and 2 during the 3rd trimester).A post-partum flare was registered in 33/83 (40%) of cases, without difference between ‘flare’ group vs ‘without flare’ group (Table 1), as well as between PsA vs ‘other SpA’ pregnancies (47% vs 33%, p=0.2).ConclusionIn this cohort of SpA pregnancies, 40% experienced a flare during pregnancy and 40% during post-partum. Flares occurred more frequently in the 2nd trimester and especially in patients with axial involvement, requiring the start of a TNF-inhibitor during the 2nd or the 3rd trimester in 7 pregnancies. Having a flare during pregnancy was not associated with a post-partum flare.Disclosure of InterestsNone declared

BackgroundSystemic Sclerosis (SSc) can strongly affect the quality of life of affected women. We aimed at designing a SSc-specific, patient-reported questionnaire to explore different aspects of women’s health.ObjectivesThe questionnaire was created together with Obstetricians-Gynecologists (70 questions, 5 sections) and administered to consecutive patients with SSc (2013 ACR/EULAR classification criteria) regularly attending our Clinic in May-December 2021. The Female Sexual Function Index (FSFI) questionnaire was also administered.MethodsThe questionnaire was created together with Obstetricians-Gynecologists (70 questions, 5 sections) and administered to consecutive patients with SSc (2013 ACR/EULAR criteria) regularly attending our Clinic in the period May-December 2021. The Female Sexual Function Index (FSFI) questionnaire was also administered.ResultsQuestionnaires were proposed to 114 patients; among 100 who accepted to participate (median age 59.0 [43.0-67.0], median disease duration 11.0 [6.0-17.0] years), 48% had received SSc diagnosis during reproductive age (Table 1.Results are presented as median [IQR] or number/number available data (%) based on patients answering the question. Continuous variables were compared with Mann-Whitney test; categorical variables with Fisher’s exact test.Total pregnancies (n= 189)Pregnancies after diagnosis (n= 42)Pregnancies before diagnosis (n= 147)p-value OR [95% CI]Maternal age at conception, years28.0 [24.0-32.0]32.0 [28.0-39.0]27.0 [23.0-30.0]< 0.001Live births152/189 (80.4)31/42 (73.8)121/147 (82.3)0.221Cesarean sections36/135 (26.7)17/31 (54.8)19/104 (18.3)< 0.0015.43 [2.30-12.9]Preterm births 32/109 (29.4)7/32 (21.9)25/77 (32.5)0.269Preterm births 7/32 (21.8)2/7 (28.6)5/25 (20.0)0.632Birth weight, kilograms3.3 [2.8-3.6]3.1 [2.5-3.5]3.3 [3.0-3.7]0.049≥ 1 Adverse Pregnancy Outcomes15/113 (13.3)8/31 (25.8)7/82 (8.5)0.0163.73 [1.22-11.39]Gestational hypertension4/113 (3.5)3/31 (9.7)1/82 (1.2)0.062Preeclampsia1/113 (0.9)1/31 (3.2)0/82 (0.0)0.274Eclampsia0/113 (0.0)0/31 (0.0)0/82 (0.0)1.000HELLP syndrome1/113 (0.9)0/31 (0.0)1/82 (1.2)1.000Gestational diabetes3/113 (2.7)2/31 (6.5)1/82 (1.2)0.182Intra Uterine Growth Restriction4/113 (3.5)2/31 (6.5)2/82 (2.4)0.302Perinatal deaths2/134 (1.5)0/32 (0.0)2/102 (1.9)1.000Neonatal Intensive Care Unit Admission11/134 (8.2)6/32 (18.8)5/102 (4.9)0.0224.48 [1.27-15.84]Perinatal infections8/134 (8.2)3/32 (9.4)5/102 (4.9)0.396Breastfeeding92/132 (69.7)22/32 (68.8)70/100 (70.0)0.893ConclusionThe newly created specific questionnaire was instrumental to facilitate physician-patient communication about ‘women’s health’, particularly in the field of sexuality which is characterized by a high frequency of dysfunction. Adverse outcomes are possible during SSc pregnancies and should be discussed during the multidisciplinary preconception counselling, along with measures to possibly reduce their risk.AcknowledgementsGILS (Gruppo Italiano Lotta Sclerodermia) is kindly acknowledged for supporting the study with a grant.Disclosure of InterestsNone declared

BackgroundOral glucocorticoids (GC) are the mainstay of treatment for giant cell arteritis (GCA) but chronic exposure to GC is associated with serious comorbidities.ObjectivesThe objective of this study was to determine the GC exposure and risk of GC-related adverse events (AEs) in GCA, validating the Glucocorticoid Toxicity Index (GTI) (1,2) in a cohort of real-world patients.Methods140 consecutive patients with GCA were enrolled in this retrospective monocentric study. All patients were older than 50 years of age, met the 1990 ACR criteria for GCA and/or had the evidence of a large vessel vasculitis at FDG-PET/CT scan. Patients’ clinical data were collected from clinical charts, calculating GC cumulative dose and GTI at baseline and in the following 5 years.Results140 patients were enrolled in the study: median (IQR) age at diagnosis 74 (67-79), Female: 97 (69%), Male: 43 (31%). According to vascular involvement patients were classified in cranial-GCA (C-GCA, n:91), large vessel-GCA (LV-GCA, n:21) and cranial and large vessel-GCA (LV-C-GCA, n:28). Furthermore, 50 (36%) patients were treated with only GC, 44 (31%) with GC+methotrexate (MTX), 46 (33%) with GC+tocilizumab (in 20 cases TCZ was started in the first 3 months after diagnosis: early-TCZ, in 26 cases after 3 months for relapses or AEs: late-TCZ).During the follow up, 57 (41%) patients presented at least one relapse. In the GC group 22 relapses in 18 patients were reported, in MTX group 33 relapses in 25 patients (with 15 relapses before and 18 after MTX start), in early-TCZ group no relapses were reported, in late-TCZ group 21 relapses in 14 patients (with 17 relapses before and 4 after TCZ start) were reported.Median cumulative GC doses after 1 and 5 years were respectively 7.9 (6.3-9.8) gr and 16.5 (13.8-18.9) gr in GC group, 8.7 (5.9-10.0) gr and 16.5 (13.2-20.7) gr in MTX group, 7.1 (5.5-8.0) gr and 13.3 (12.8-13.7) gr in early-TCZ and 7.7 (6.2-11.1) gr and 19.7 (12.2-23.8) gr in late-TCZ.Eighty-eight percent of patients developed at least one GC-AE, with infections and hypertension being the most common reported AEs (42% e 44%, respectively). Median GTI-CWS (Cumulative Worsening Score) after 1 year was 65 (20-137) in GC, 63 (10-95) in MTX, 51 (33-116) in TCZ-early, 44 (0-91) in TCZ-late. Median GTI-CWS after 5 years was 219 (118-240) in GC, 137 (65-206) in MTX, 147 (146-147) in TCZ-early, 200 (121-231) in TCZ-late. A correlation between GTI-CWS and the GC cumulative dose was found (after 5 years r: 0.295, p: 0.026).ConclusionChronic GC treatment is associated with a high risk of developing comorbidities. GTI score demonstrated to be an effective tool to assess GC-related AEs and proved to correlate with GC cumulative dose.TCZ confirmed its efficacy in reducing relapse rate, both in early and late-TCZ groups (3). TCZ showed for the first time in a real-life cohort a GC sparing effect, with a 19% reduction in GC cumulative dose and a 33% reduction in GTI-CWS in 5 years (comparing GC group vs early-TCZ group).References[1]Glucocorticoid Toxicity Index (Copyright © 2016, 2018. Massachusetts General Hospital. All rights reserved.)[2]Miloslavsky EM et al. Ann Rheum Dis. 2017 doi: 10.1136/annrheumdis-2016-210002.[3]Stone JH et al. N Engl J Med. 2017 doi: 10.1056/NEJMoa1613849.Disclosure of InterestsNone declared

Background:SARS-CoV-2 infection poses a serious challenge for patients with rheumatic autoimmune systemic diseases (ASD), characterized by marked immune-system dysregulation and frequent visceral organ involvement.Objectives:To evaluate the impact of Covid-19 pandemic in a large series of Italian patients with ASD.Methods:Our multicenter telephone survey (8-week period, March-April 2020) included a large series of 2,994 patients (584 M, 2,410 F, mean age 58.9±13.4SD years) with ASD followed at 34 tertiary referral centers of 14 regions of northern, central, and southern Italian macro areas, characterized by different prevalence of SARS-CoV-2 infection. According to currently used criteria, Covid-19 was classified as definite Covid-19 (signs or symptoms of Covid-19 confirmed by positive oral/nasopharyngeal swabs at PCR testing) or highly suspected Covid-19 (signs or symptoms highly suggestive of Covid-19, but not confirmed by PCR testing due to limited availability of virological tests in that period). The results were analyzed performing the Odds Ratio by Java-Stat 2-way Contingency Table Analysis.Results:The main findings of the survey study revealed a significantly increased prevalence of Covid-19 in:a.the whole series of ASD patients (definite Covid-19: 22/2994, 0.73%; p=0.0007;definite Covid-19 plus highly suspected Covid-19: 74/2,994, 2.47%; phttps://www.epicentro.iss.it/en/coronavirus/sars-cov-2-national-surveillance-system).b.the subgroup of patients with connective tissue diseases or systemic vasculitis (n = 1,901) compared to the subgroup of inflammatory arthritis (n = 1,093), namely rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis (definite Covid-19: 19/1,901, 0.99%, vs 3/1,093, 0.27%; p=0.036; definite Covid-19 plus highly suspected Covid-19: 69/1,901, 3.6%, vs 5/1,093, 0.45%; pc.the subgroup of patients with pre-existing interstitial lung involvement (n = 526) compared to those without (n = 2,468) (definite Covid-19: 10/526, 1.90%, vs 12/2,468, 0.48%; p=0.0015; definite Covid-19 plus highly suspected Covid-19: 33/526, 6.27%, vs 41/2,468, 1.66%; pOf interest, the prevalence of Covid-19 did not correlate with presence/absence of different comorbidities, mainly diabetes, cardio-vascular and/or renal disorders, as well as of ongoing treatments with biological DMARDs; while patients treated with conventional DMARDs showed a significantly lower prevalence of Covid-19 compared to those without. Covid-19 was more frequently observed in the patients’ populations from northern and central compared to southern Italian macro area with lower diffusion of pandemic. Clinical manifestations of Covid-19, observed in 74 patients, were generally mild or moderate; 4/9 individuals requiring hospital admission died for severe pneumonia.Conclusion:The prevalence of Covid-19 observed in ASD patients during the first wave of pandemic was significantly higher than that observed in Italian general population; moreover, the actual prevalence of Covid-19 might be underestimated due to the high number of mild variants as well as the possible clinical overlapping between these two conditions. Patients with ASD should be invariably regarded as ‘frail patients’ during the pandemic course, considering the risk of worse outcome in the acute phase of Covid-19, as well as the potential long-term effects of viral infection.The statistically significant association of Covid-19 with connective tissue diseases/systemic vasculitis, as well as with pre-existing interstitial lung involvement, suggests the presence of distinct clinico-pathological ASD subsets, characterized by markedly different patients’ vulnerability to SARS-CoV-2 infection.Disclosure of Interests:None declared

Supplemental Material for Autoantibodies’ titre modulation by anti-BlyS treatment in systemic lupus erythematosus by I Cavazzana, R Kumar, C Pozzari, R Ottaviani, M Fredi, S Piantoni, L Andreoli, A Tincani and F Franceschini in Lupus

Supplemental Material for Relationship between endothelial dysfunction, videocapillaroscopy and circulating CD3+CD31+CXCR4+ lymphocytes in systemic lupus erythematosus without cardiovascular risk factors by I. Cavazzana, S. Piantoni, E. Sciatti, M. Fredi, M. Taraborelli, I. Bonadei, P. Airò, M. Metra, A. Tincani, F. Franceschini and E. Vizzardi in Lupus

This study analyses data regarding the quality of surface water in the Pisan plain between the mouth of the Arno river, Pisa and Livorno in order to identify the origin of the high chloride content derived from the sea water in areas far from the coast. We used existing environmental monitoring data from the study area integrated with data from the present study. The study involved measuring the piezometric levels and electrical conductivity (EC), together with a chemical analysis of the surface water and phreatic aquifer (water table aquifer) samples. Data acquisition through sampling along coastline piezometers, was carried out in 2008. In the summer of 2012 we supplemented data regarding areas further inland with surveys of piezometric levels and EC in the hydrographic network and shallow wells. The distribution of salinity was compared with a three-year monitoring survey carried out at the water sampling points in the Tombolo forest, an area about 5 km from the coastline. All the collected data show the presence of significant salinisation generated by the sea water, which is carried towards the inner plain through an artificial watercourse (Navicelli channel) and its hydrographic network. In the dry season this channel contains no fresh water from upstream and sea water tends to flow up to the town of Pisa, about 7 km from the coast. The sea water carried by the channel infiltrates into the shallow aquifers directly or through the minor hydrographic network, thus polluting the internal areas of the Pisan plain. Potential hydraulic connections with the intensively exploited deeper aquifers might lead to the salinisation of the same aquifers. This phenomenon could be confused with seawater intrusion from the coast (deep shoreline salt-wedge).

Synthesis of nanoparticles free from toxic chemicals and solvents is highly seen for large-scale production processes, particularly for use in biomedical/biotechnological applications. So far, although several methods for synthesis of metal nanoparticles using citrus extracts have been described, none of them clarify which compounds are responsible for both reduction and stabilization of NPs. Here we report the role of citrus flavonoids, hesperidin, hesperetin, rutin, naringenin, quercetin and diosmin, in the synthesis of gold nanoparticles (AuNP) at room temperature. Only in the presence of the citrus flavonoids, diosmin (Dm), and hesperetin (Ht), the reduction of HAuCl4 in concentrations as high as 7 mM under alkaline conditions yielded concentrated and self-stabilized suspensions of uniform spherical nanoparticles with a narrow size distribution. We went further and focused on Ht, the most abundant flavonoid aglycone from citrus fruits known for its medicinal properties. HtAuNPs were characterized using high-resolution transmission electron microscopy, dynamic light scattering, X-ray photoelectron spectrometry and UV-Vis spectrophotometry. The NPs remained stable for months without significant changes in their shape and optical properties. Theoretical calculations using density functional theory were used to identify the functional groups involved in the electron transfer from the Ht molecules to gold, which seems to be the consequence of an initial complexation, leading to the reduction of Au3+ ions into Au0. Besides, this procedure provides a one-pot method, showing potential for large-scale.

Two superconducting intermetallic compounds in the Ni-Bi system, namely NiBi and NiBi3, can be formed as result of interdiffusion, if Ni/Bi are produced as bilayers at room temperature by pulsed laser deposition (PLD). These two equilibrium phases are responsible for the observed superconductivity in this kind of bilayer material. Due to different behavior in external magnetic fields, there appear two-step superconducting transitions in the electrical transport measurements. In this work we studied the superconducting and magnetic properties of the Ni-Bi bilayers with the formation of the two intermetallic compounds, NiBi and NiBi3, which have similar Tc ~ 4.0 K but very different upper critical magnetic fields at zero temperature [Bc2(0)]. The magnetic hysteresis loops of the pure NiBi3 phase show the behavior of a weak type II superconductor without strong pinning effect. Upon formation of the NiBi phase caused by highly energetic atoms during pulsed laser deposition, strong pinning effects appeared in the hysteresis loops below Tc. The isotherm V(I) curves show that the residual Ni layer does not induce spontaneous vortices in the NiBi or NiBi3 phases.

Manganese oxide nanofoam has been prepared by pulsed laser deposition, from a metallic Mn target in a 5 Torr pressure O 2 buffer atmosphere. The as-prepared samples were heat-treated at different temperatures (300 °C–500 °C) in air. Both as-deposited and heat-treated samples have a high porosity foam-like morphology, as shown by Field Emission Scanning Electron Microscopy. High Resolution Transmission Electron Microscopy revealed that the nanofoam is composed by linked nanoparticles with slight crystallization and growth of the nanoparticles due to heat-treatment, which was confirmed by X-ray diffraction, Raman Spectroscopy and X-ray Photoelectron Spectroscopy. These techniques also showed a variable oxide composition upon heat treatment. The supercapacitive properties of manganese oxide nanofoam treated at 300 °C exhibited a specific capacitance higher than 1000 F/g, in the 0 to +1.0 V potential range. After heat treatment at 400 °C and 500 °C, the specific capacitance decreased compared to that of the 300 °C treated sample. An increase of about 130% in the initial capacitance was obtained after 500 cycles for this sample. However, it decreases to one third of the maximum value after 5000 cycles. The results shows that the obtained manganese oxide nanofoam has very high specific capacitance but need to improve the cycle stability.

Composite thin films of polyaniline (PANI) nanofibers and graphene oxide (GO) nanoplatelets are synthesized through a simple electrodeposition process for electrochemical capacitors. The morphology and structure of the materials are investigated by field emission scanning electron microscopy, transmission electron microscopy, current sensing atomic force microscopy, X-ray photoelectron spectroscopy, Fourier transforms infrared spectroscopy, X-ray diffraction, and ultraviolet-visible spectroscopy. In the process of electrodeposition, the electrostatic interactions between the oxygen-functionalized graphene and aniline monomers at an electrolyte interface assisted the co-deposition of PANI nanofibers and GO nanoplatelets. These thin films have an excellent effect on the electrochemical properties with an electrochemical capacitance of 662 F g−1 at a low current density of 0.025 mA cm−2 with simultaneous high energy density (64.5 W h kg−1) and high power density (1159 W kg−1). The excellent electrochemical performance of the films is attributed to the unique structure of the material, showing synergy between PANI nanofibers and GO nanoplatelets.

Combustion synthesis, a widely spread technique employed to produce low-cost high-yield oxide powders, was used to prepare fluoride powders for the first time. Surface morphology and structure of erbium (Er3+) doped strontium fluoride (SrF2) powders were investigated by scanning electronic microscopy, energy dispersive X-ray and X-ray powder diffraction. Samples were prepared with and without aluminum (Al) and we observed that the presence of Al helps the powder to crystallize in a pure SrF2 single cubic phase. Luminescence spectral analysis was also performed and we observed that among the samples investigated the Er3+:SrF2 powder prepared with Al using glycine is the most efficient luminescence up-converter. The luminescence results concords with Raman data of the samples.