Socioeconomic deprivation is associated with reduced response and lower treatment persistence with TNF inhibitors in rheumatoid arthritis

Objective To investigate the association between socioeconomic deprivation and outcomes following TNF inhibitor (TNFi) treatment. Methods Individuals commencing their first TNFi in the British Society for Rheumatology Biologics Register for RA (BSRBR-RA) and Biologics in RA Genetics and Genomics Study Syndicate (BRAGGSS) cohort were included. Socioeconomic deprivation was proxied using the Index of Multiple Deprivation and categorized as 20% most deprived, middle 40% or 40% least deprived. DAS28-derived outcomes at 6 months (BSRBR-RA) and 3 months (BRAGGSS) were compared using regression models with the least deprived as referent. Risks of all-cause and cause-specific drug discontinuation were compared using Cox models in the BSRBR-RA. Additional analyses adjusted for lifestyle factors (e.g. smoking, BMI) as potential mediators. Results 16 085 individuals in the BSRBR-RA were included (mean age 56 years, 76% female), of whom 18%, 41% and 41% were in the most, middle and least deprived groups, respectively. Of 3459 included in BRAGGSS (mean age 57, 77% female), proportions were 22%, 36% and 41%, respectively. The most deprived group had 0.3-unit higher 6-month DAS28 (95% CI 0.22, 0.37) and were less likely to achieve low disease activity (odds ratio [OR] 0.76; 95% CI 0.68, 0.84) in unadjusted models. Results were similar for 3-month DAS28 (β = 0.23; 95% CI 0.11, 0.36) and low disease activity (OR 0.77; 95% CI 0.63, 0.94). The most deprived were more likely to discontinue treatment (hazard ratio 1.18; 95% CI 1.12, 1.25), driven by ineffectiveness rather than adverse events. Adjusted estimates were generally attenuated. Conclusion Socioeconomic deprivation is associated with reduced response to TNFi. Improvements in determinants of health other than lifestyle factors are needed to address socioeconomic inequities

Computing and Information Technology Challenges for 21st Century Financial Market Regulators

Part 3: Governance, Openess and InstitutionsInternational audienceThis paper reports on a research effort designed to begin to systematically identify the most critical computing and information technology-related challenges facing financial market regulation activities. Computing and information technology adaptation in financial markets create a paradox. Information technology is needed for effective governing of financial markets, yet advances in information technology and the increasingly complex adaptations of that technology make it more difficult for regulators to have a clear picture of what is actually happening. Drawing on in-depth interviews with professionals from the financial market community, this paper outlines three primary challenges facing regulation efforts: 1) information sharing and integration, 2) mediating interrelationship among financial market constituents, 3) data-driven decision making. The paper concludes with recommendations for future research about the challenges an

Quantification of additives in nickel watt's bath by cyclic voltammeric stripping technique

The characterization of nickel deposits and quantification and optimisation of the various additives in a Watts bath can be done successfully using the cyclic voltammetric study stripping technique (CVS). This technique can be used as an on-line process which can be very helpful, for industry. This powerful analytical tool takes advantage of the polarisation effect. In this paper an attempt has been made to study the effects of saccharin, butynediol, coumarin on the deposit characteristics of nickel. CVS has been used to quantify saccharin, butynediol, coumarin content in a standard Watts bath. The implamentation of the CVS technique in areas such as PC board production has increased the process yield, decreased the downtime and decreased the usage of excess of additiv