Rheumatoid arthritis - clinical aspects: 134. Predictors of Joint Damage in South Africans with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) causes progressive joint damage and functional disability. Studies on factors affecting joint damage as clinical outcome are lacking in Africa. The aim of the present study was to identify predictors of joint damage in adult South Africans with established RA. Methods: A cross-sectional study of 100 black patients with RA of >5 years were assessed for joint damage using a validated clinical method, the RA articular damage (RAAD) score. Potential predictors of joint damage that were documented included socio-demographics, smoking, body mass index (BMI), disease duration, delay in disease modifying antirheumatic drug (DMARD) initiation, global disease activity as measured by the disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and autoantibody status. The predictive value of variables was assessed by univariate and stepwise multivariate regression analyses. A p value <0.05 was considered significant. Results: The mean (SD) age was 56 (9.8) years, disease duration 17.5 (8.5) years, educational level 7.5 (3.5) years and DMARD lag was 9 (8.8) years. Female to male ratio was 10:1. The mean (SD) DAS28 was 4.9 (1.5) and total RAAD score was 28.3 (12.8). The mean (SD) BMI was 27.2 kg/m2 (6.2) and 93% of patients were rheumatoid factor (RF) positive. More than 90% of patients received between 2 to 3 DMARDs. Significant univariate predictors of a poor RAAD score were increasing age (p = 0.001), lower education level (p = 0.019), longer disease duration (p < 0.001), longer DMARD lag (p = 0.014), lower BMI (p = 0.025), high RF titre (p < 0.001) and high ESR (p = 0.008). The multivariate regression analysis showed that the only independent significant predictors of a higher mean RAAD score were older age at disease onset (p = 0.04), disease duration (p < 0.001) and RF titre (p < 0.001). There was also a negative association between BMI and the mean total RAAD score (p = 0.049). Conclusions: Patients with longstanding established RA have more severe irreversible joint damage as measured by the clinical RAAD score, contrary to other studies in Africa. This is largely reflected by a delay in the initiation of early effective treatment. Independent of disease duration, older age at disease onset and a higher RF titre are strongly associated with more joint damage. The inverse association between BMI and articular damage in RA has been observed in several studies using radiographic damage scores. The mechanisms underlying this paradoxical association are still widely unknown but adipokines have recently been suggested to play a role. Disclosure statement: C.I. has received a research grant from the Connective Tissue Diseases Research Fund, University of the Witwatersrand. All other authors have declared no conflicts of interes

Solid-state synthesis of NASICON (Na3Zr2Si2PO12) using nanoparticle precursors for optimisation of ionic conductivity

In this work, the effect of varying the size of the precursor raw materials SiO2 and ZrO2 in the solid-state synthesis of NASICON in the form Na3Zr2Si2PO12 was studied. Nanoscale and macro-scale precursor materials were selected for comparison purposes, and a range of sintering times were examined (10, 24 and 40 h) at a temperature of 1230 °C. Na3Zr2Si2PO12 pellets produced from nanopowder precursors were found to produce substantially higher ionic conductivities, with improved morphology and higher density than those produced from larger micron-scaled precursors. The nanoparticle precursors were shown to give a maximum ionic conductivity of 1.16 × 10−3 S cm−1 when sintered at 1230 °C for 40 h, in the higher range of published solid-state Na3Zr2Si2PO12 conductivities. The macro-precursors gave lower ionic conductivity of 0.62 × 10−3 S cm−1 under the same processing conditions. Most current authors do not quote or consider the precursor particle size for solid-state synthesis of Na3Zr2Si2PO12. This study shows the importance of precursor powder particle size in the microstructure and performance of Na3Zr2Si2PO12 during solid-state synthesis and offers a route to improved predictability and consistency of the manufacturing process

FRAUD CLAIM DETECTION USING SPARK

Objective:To reduce the fraud claims in health insurances companies and to improve outcomes in health care industryAnalysis:In the existing system, Apache hadoopand Apache hive is used for processing data, it is a batch processing system. In proposed system, Apache spark is used for processing streaming data. Findings:EHR record is used as data source, it contains unique id for patients across world, so it is very easy to detect fraud claim with help of patientid. Apache spark processing streaming data on regular basis. But in existing system Apache hadoop and Apache hive takes hours of time to process the stored data.Improvement:Rule based model machine learning algorithm is used for detecting and automating the fraud claim and Apachespark is used for fast processing data, so it is moreaccurate and fast

Polyol mediated synthesis of tungsten trioxide and Ti doped tungsten trioxide Part 1: Synthesis and characterisation of the precursor material

Polyol mediated synthesis for the preparation of tungsten trioxide and titanium doped tungsten trioxide has been reported. The reaction was carried out using chlorides of tungsten and titanium in diethylene glycol medium and water as the reagent for hydrolysis at 190 8C. Formation of a blue coloured dimensionally stable suspension of the precursor materials was observed during the course of the reaction. The particle sizes of the precursor materials were observed to be around 100 nm. The precursor materials were annealed to give tungsten trioxide and titanium doped tungsten trioxide. The precursor materials were characterised using TGA/DTA, FT-IR, optical spectra, SEM, TEM and powder XRD methods. It was observed that the doping of titanium could be effected at least up to 10% of Ti in WO3. The TGA/DTA studies indicated that WO3xH2O is the dominant material that formed during the polyol mediated synthesis. The XRD data of the annealed samples revealed that the crystalline phase could be manipulated by varying the extent of titanium doping in the tungsten trioxide matrix

On the structural changes, mechanism and kinetics of stabilization of lignin blended polyacrylonitrile copolymer fiber

Polyacrylonitrile(PAN)/lignin blend fiber prepared by continuous wet spinning process in dimethylsulfoxie(DMSO) was thermally stabilized under oxygen atmosphere in a continuous multizone oven at different heating temperature. The thermal behaviour of PAN/lignin fiber (PL fiber) stabilized were characterized by differential scanning calorimetry(DSC) under nitrogen atmosphere. The cyclization kinetics parameters such as activation energy(Ea), rate constant(k), pre-exponential factor(A) and extent of oxidation reaction (EOR) at different temperature were calculated from Kissinger and Ozawa method. FTIR analysis was used to investigate the structural changes and calculate the cyclization index and dehydrogenation index of stabilized PL fiber. The cyclization index values for the temperature of stabilization from 235 °C to 265 °C varied from 40 to 85%. The variation in density, elemental composition and mechanical properties of PL fiber stabilized at different temperature was determined. The density of the stabilized fiber varied from 1.225 to 1.385 g/cc as the stabilization temperature increased from 235 to 265 °C. The mechanism of thermal stabilization of and a set of temperature profile for a complete stabilization of PL fiber has been deduced from the various characterization

Wet spinning of low cost carbon fiber precursor-lignin incorporated polyacrylonitrile co-polymer fiber

Low cost carbon fiber from lignin is a promising biobased feedstock since lignin is by product in many industries. In the present work spinning of concentrated solution of lignin blended with polyacrylonitrile copolymer have been investigated. The wet spinning experiments of PAN/Lignin blend solution to obtain the precursor fiber in continuous form have been successfully demonstrated. Rheological measurements are carried out to optimize the wet spinning process parameters such as to ascertain the dissolution and extrusion temperature. The gel formation temperature of PAN/Lignin blend solutions are determined by the plot of tan δ Vs temperature plot. The FTIR analysis confirms that there is no discernible chemical reaction or crosslinking between PAN and lignin. The resulting precursor fiber from PAN/Lignin blend solution displayed a tensile strength and modulus of 2.36 gpd and 76 gpd respectively. REFERENCE

Polymer-graphene composites as anticorrosive materials

Corrosion of structural metals is a universal problem that causes economic and environmental damage every year due to the gradual failure of conventional protective coatings over time. In the past, graphene has emerged as a promising anticorrosive material owing to its unique properties such as chemical inertness, impermeability, and high conductivity, although scalability is still a big issue. This chapter outlines the utility and recent advances in graphene and graphene-derived materials containing polymer-based anticorrosive coatings. Additionally, an overview of pure graphene corrosion protective coating is also given. The potential applications of various polymer-graphene composites in the field of metal corrosion protection and their viability and challenges in near-future applications are also discussed