e unmet needs regarding individualized pain management, regardless of axSpA subgroup.
  To improve pneumococcal vaccination (PV) rates among rheumatology clinic patients on immunosuppressive therapy in the outpatient settings.
 
  This quality improvement project was based on the pre-post-intervention design. Phase I of the project targeted rheumatoid arthritis patients from thirteen rheumatology clinics (1/2013 to 7/2015) on immunosuppressive therapy to receive pneumococcal polysaccharide vaccine (PPSV23). In Phase II study (1/2016-10/2017), all patients on immunosuppressive medications irrespective of diagnosis were targeted to receive PPSV23 and the pneumococcal conjugate vaccine (PCV13). The Best Practice Alert (BPA)s for both PVs were developed based on CDC guidelines which appeared on electronic medical records for eligible patient at the time of assessment by the medical assistant. The BPA was designed to inform the vaccination status and enable physician to order PV or document refusal or deferral reasons. Education regarding vaccine guidelines, the BPAs, vaccination process, and regular feedback of results were important project interventions. The vaccination rates during pre-post intervention for each study phase were compared using Chi square test.
 
  During Phase I, PPSV23 vaccination rates improved from 27.9% pre-intervention rate to 61.5% (p<0.0001). During Phase II, 77% of patients had received either PPSV23 or PCV13 compared to 49.6% of patients in the pre-intervention period (p<0.0001). The documentation rates (vaccine received, ordered, patient refusal and deferral reasons) increased significantly in both phases.
 
  Electronic identification of vaccine eligibility and implementation of BPAs with capabilities to order and document significantly improved PV rates. The process has potential for self-sustainability and generalizability.
 Electronic identification of vaccine eligibility and implementation of BPAs with capabilities to order and document significantly improved PV rates. The process has potential for self-sustainability and generalizability.
  Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with cardiovascular disease. The treatment of arthritis by tumor necrosis factor-α (TNF-α) inhibitors may decrease the serum concentrations of vascular biomarkers. We determined circulating levels of oxidized low-density lipoprotein (oxLDL)/β
  glycoprotein I (β
  -GPI) complexes, antibodies to 60 kDa heat shock protein (anti-Hsp60), soluble urokinase plasminogen activator receptor (suPAR), and B-type natriuretic peptide (BNP) fragment in sera of RA and AS patients undergoing anti-TNF treatment.
 
  Fifty-three patients with RA/AS were treated with etanercept or certolizumab pegol for 1 year. Circulating oxLDL/β
  -GPI complex (AtherOx), anti-Hsp60 IgG, and BNP8-29 fragment levels were assessed by ELISA. suPAR levels were determined by suPARnostic Quick Triage test. Flow-mediated vasodilation (FMD), carotid intima-media thickness (CIMT), and arterial pulse wave velocity (PWV) were determined by ultrasound.
 
  One-year anti-TNF treatmeuPAR, and BNP.
  To evaluate the efficacy and safety of poseltinib (formerly LY3337641/HM71224), an irreversible covalent inhibitor of Bruton's tyrosine kinase in a 2-part, phase II trial (RAjuvenate; ClinicalTrials.gov NCT02628028) in adults with active rheumatoid arthritis (RA).
 
  In Part A, 36 patients with mildly active RA were randomized 1111 to oral poseltinib 5, 10, or 30 mg or placebo once daily for 4 weeks to assess safety and tolerability. No safety signals precluded moving to Part B, where 250 patients with moderate-to-severe RA were randomized 1111 to oral poseltinib 5 mg (n = 63), 10 mg (n = 62), or 30 mg (n = 63), or placebo (n = 62) once daily for 12 weeks. Parts A and B permitted stable doses of background disease-modifying antirheumatic drugs. The primary endpoint in Part B was proportion of patients achieving 20% improvement in American College of Rheumatology criteria (ACR20) at Week 12. Logistic regression compared each poseltinib dose to placebo for primary and secondary endpoints. Nonresponder imputation was used for missing data.
 
  After interim analysis showed low likelihood of demonstrating significant efficacy, the sponsor discontinued Part B of the study. One hundred and eighty-nine (76%) patients completed 12 weeks in Part B; 61 discontinued study treatment (27 [44%] due to study termination by sponsor). There was no statistically significant difference in ACR20 response between any dose of poseltinib and placebo at Week 12 (
  > 0.05 for all comparisons). Five serious adverse events occurred (n = 2, placebo; n = 3, 30 mg); there was 1 death due to a fall.
 
  While no safety findings precluded continuation, the study was terminated after interim data demonstrated low likelihood of benefit in RA.
 While no safety findings precluded continuation, the study was terminated after interim data demonstrated low likelihood of benefit in RA.DNA sequencing is the current key technology for historic or ancient biological samples and has led to many exciting discoveries in the field of paleogenomics. However, functional insights into tissue identity, cellular composition or gene regulation cannot be gained from DNA. Recent analyses have shown that, under favorable conditions, RNA can also be sequenced from ancient samples, enabling studies at the transcriptomic and regulatory level. Analyzing ancient RNA data from a Pleistocene canid, we find hundreds of intact microRNAs that are taxonomically informative, show tissue-specificity and have functionally predictive characteristics.  https://www.selleckchem.com/products/zebularine.html  With an extraordinary age of 14,300 years, these microRNA sequences are by far the oldest ever reported. The authenticity of the sequences is further supported by a) the presence of canid / Caniformia-specific sequences that never evolved outside of this clade, b) tissue-specific expression patterns (cartilage, liver and muscle) that resemble those of modern dogs and c) RNA damage patterns that are clearly distinct from those of fresh samples. By performing computational microRNA-target enrichment analyses on the ancient sequences, we predict microRNA functions consistent with their tissue pattern of expression. For instance, we find a liver-specific microRNA that regulates carbohydrate metabolism and starvation responses in canids. In summary, we show that straightforward paleotranscriptomic microRNA analyses can give functional glimpses into tissue identity, cellular composition and gene regulatory activity of ancient samples and biological processes that took place in the Pleistocene, thus holding great promise for deeper insights into gene regulation in extinct animals based on ancient RNA sequencing. .