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Bristlecone pine (Pinus longaeva) (PILO) trees exhibit exceptional longevity. Their tree‐ring width (TRW) series offer valuable insights into climatic variability. Maximum latewood density (MXD) typically correlates better with temperature variations than TRW, yet PILO MXD records are non‐existent due to methodological challenges related to tree‐ring structure. Here, we used an X‐ray Computed Tomography (X‐ray CT) toolchain on 51 PILO cores from the California White Mountains to build a chronology that correlates significantly (r = 0.66, p < 0.01) with warm‐season (March‐September) temperature over a large spatial extent. This led to the first X‐ray CT‐based temperature reconstruction (1625–2005 CE). Good reconstruction skill (RE = 0.51, CE = 0.32) shows that extending MXD records across the full length of the PILO archive could yield a robust warm‐season temperature proxy for the American Southwest over millennia. This breakthrough opens avenues for measuring MXD in other challenging conifers, increasing our understanding of past climate further, particularly in lower latitudes. Plain Language Summary: Ancient Bristlecone pine trees can live for several millennia and hold invaluable climate information. Their annual rings were used to develop millennium‐length records of the Holocene climate. Maximum latewood density (MXD), which is the highest wood density value in the latewood of a tree ring, has been shown to closely follow summer temperature in different conifer species, but not yet in Bristlecone pine. The gnarly and twisted growth of these ancient trees has presented significant hurdles for MXD analysis. Here we apply an X‐ray Computed Tomography toolchain that allows us to 3D scan through the tissue of a tree ring and to map MXD variations. Using this new technique, we were able to reconstruct warm‐season temperature for the American Southwest back to 1625 CE. With these findings, we are confident that a full‐length reconstruction (back to 2575 BCE) can yield the longest annually resolved temperature reconstruction for this continent. Key Points: We present the first X‐ray Computed Tomography‐derived maximum latewood density‐based temperature reconstruction using Bristlecone pine tree coresBristlecone pine maximum latewood density is a reliable proxy for warm‐season temperature over a large part of the American SouthwestOur reconstruction (1625–2005 CE) contains low‐frequency variability and can be prolonged over a large part of the Holocene [ABSTRACT FROM AUTHOR]

In patients with rheumatoid arthritis (RA) in sustained remission, tapering of biological disease-modifying anti-rheumatic drugs can be considered. Tapering has already been investigated, but its feasibility remains to be determined. Therefore, we explored the feasibility of tapering etanercept in RA in a setting close to practice. Patients with RA in 28-joint Disease Activity Score (DAS28) remission (≥ 6 months) and treated with etanercept 50 mg weekly (≥ 1 year) were included in the pragmatic 1 year open-label multicentre randomized controlled TapERA (Tapering Etanercept in Rheumatoid Arthritis) trial. Patients were assigned to continue etanercept weekly or to taper to every other week (EOW). Patients who lost remission [DAS28–C-reactive protein (CRP) ≥ 2.6] were re-escalated to etanercept weekly. The primary outcome was the proportion of patients maintaining DAS28-CRP remission for 6 months. Sixty-six patients were randomized to etanercept weekly (n = 34) or EOW (n = 32). After 6 months, 26/34 patients (76%) in the weekly and 19/32 (59%) in the EOW group maintained disease control (p = 0.136). In the EOW group, 20/32 patients (63%) remained on their tapered treatment during the trial. Two patients reintroduced weekly etanercept themselves. Ten patients were re-escalated to etanercept weekly by the rheumatologist, after a median (interquartile range) interval of 3.0 (2.0–6.0) months. Among these patients, 7/10 regained remission after re-escalation, four of them at the next study visit. Although non-inferiority could not be demonstrated, tapering of etanercept to EOW appeared feasible in patients in sustained remission. [ABSTRACT FROM AUTHOR]

Exercise represents an effective interventional strategy to improve glycaemic control in type 2 diabetes patients. However, the impact of exercise intensity on the benefits of exercise training remains to be established. In the present study, we compared the clinical benefits of 6 months of continuous low- to moderate-intensity exercise training with those of continuous moderate- to high-intensity exercise training, matched for energy expenditure, in obese type 2 diabetes patients. Fifty male obese type 2 diabetes patients (age 59 ± 8 years, BMI 32 ± 4 kg/m2) participated in a 6 month continuous endurance-type exercise training programme. All participants performed three supervised exercise sessions per week, either 55 min at 50% of whole body peak oxygen uptake $$ \left( {\mathop V\limits^{ \cdot } {\text{O}}_{{2{\text{peak}}}} } \right) $$ (low to moderate intensity) or 40 min at 75% of $$ \mathop V\limits^{ \cdot } {\text{O}}_{{2{\text{peak}}}} $$ (moderate to high intensity). Oral glucose tolerance, blood glycated haemoglobin, lipid profile, body composition, maximal workload capacity, whole body and skeletal muscle oxidative capacity and skeletal muscle fibre type composition were assessed before and after 2 and 6 months of intervention. The entire 6 month intervention programme was completed by 37 participants. Continuous endurance-type exercise training reduced blood glycated haemoglobin levels, LDL-cholesterol concentrations, body weight and leg fat mass, and increased $$ \mathop V\limits^{ \cdot } {\text{O}}_{{2{\text{peak}}}} $$, lean muscle mass and skeletal muscle cytochrome c oxidase and citrate synthase activity ( p < 0.05). No differences were observed between the groups training at low to moderate or moderate to high intensity. When matched for energy cost, prolonged continuous low- to moderate-intensity endurance-type exercise training is equally effective as continuous moderate- to high-intensity training in lowering blood glycated haemoglobin and increasing whole body and skeletal muscle oxidative capacity in obese type 2 diabetes patients. ISRCTN32206301 None [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the effects of methotrexate (MTX), alone or in combination with intravenous (IV) methylprednisolone (MP) or infliximab, on magnetic resonance imaging (MRI)-detected synovitis, bone edema, and erosive changes in patients with early rheumatoid arthritis (RA). METHODS: Forty-four patients with early RA were randomized to receive MTX alone (MTX group), MTX plus IV MP (IV MP group), or MTX plus infliximab (infliximab group), infused on day 0 and weeks 2, 6, 14, 22, 30, 38, and 46. Gadolinium-enhanced MRI scans of the metacarpophalangeal joints, wrists, and metatarsophalangeal joints were performed at baseline, week 18, and week 52. RESULTS: Scores for MRI-detected synovitis and bone edema improved over time in the 3 groups, with significantly lower synovitis scores in the infliximab group compared with the MTX group and significantly lower bone edema scores in the infliximab group compared with the MTX and the IV MP groups. Scores for MRI-detected erosion significantly increased over time in all groups. There were no differences in erosion scores between the MTX group and the other groups. It is of note that patients treated with IV MP showed more significant progression in MRI-detected erosions compared with patients treated with infliximab. At week 22, response rates according to the American College of Rheumatology 20% improvement criteria (ACR20), the ACR50, and the ACR70 were significantly higher in both the IV MP group and the infliximab group compared with the MTX group. At week 52, remission was achieved in 40% of patients in the MTX group and in 70% of patients in the IV MP and infliximab groups. Health Assessment Questionnaire scores improved significantly over time in all groups, with patients receiving IV MP experiencing significantly more improvement compared with patients treated with MTX alone. No severe side effects were observed, except 1 case of MTX-related pneumonitis. CONCLUSION: The combination of MTX and infliximab is superior to MTX alone for reducing MRI-detected signs of synovitis and bone edema in patients with early RA. Progression of MRI-detected erosion was greater in patients treated with MTX plus IV MP compared with that in patients who received MTX plus infliximab. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about a 61-year-old man with oligoarthritis in the right wrist and second and third MCP joints of the right hand.