Outcome in patients with enthesitis related arthritis (ERA): juvenile arthritis damage index (JADI) and functional status

<p>Abstract</p> <p>Background</p> <p>Data on outcome of ERA is scarce and there is lack of well-accepted tools. JADI is a newly described outcome measure in JIA that has not been evaluated in ERA. We studied outcome in ERA using JADI and correlated it with traditional outcome measures.</p> <p>Methods</p> <p>We studied 49 consecutive patients of ERA with age ≥ 5 years and duration ≥ 1 year. Along with JADI, we recorded enthesitis, lumbar spinal anterior flexion by modified Schober's method, presence of inflammatory backache, loss of school years, HAQ-S, growth and pubertal delay. Parent's/patient's and physician's global assessments on 100 mm visual analogue scale.</p> <p>Results</p> <p>The median age was 18.0 (10–27) years and the median duration of disease was 6.0 (1–17) years. All the patients were male and half (53.1%) were HLA B 27 positive. Fourteen had decreased anterior lumbar flexion movement and 32 had inflammatory backache. Active enthesitis was present in 63.3%. Functionally, mild, moderate and severe disability was seen in 18.4%, 34.7% & 14.3% respectively. Sixty five percent of patients lost education years. Twenty-eight patients had damaged joints with median of 2.0 joints (0–9). Seventeen patients (34.7%) had damaged joints in JADI-A score with a median of 1.0 (0–12). Growth failure was the commonest extra articular damage (8.2%) in JADI-E. JADI correlated with HAQ-S, parent's or patient's & physician's global assessment (p < 0.01). Limitation of spinal mobility had high correlation with HAQ-S; correlation with JADI-A was low.</p> <p>Conclusion</p> <p>Three fourth of the ERA patients had functional limitations. Half of the patients had damaged joints. Even though JADI correlated well with traditional outcome measures, it underestimates joint damage, and does not assess enthesitis and spinal limitation which affect functional status in ERA. Inclusion of these may make it more useful for ERA.</p

Sensor-Network based Instrumentation for monitoring of withering in black tea production

 Proper level of withering plays an important role in overall quality of the produced tea. Withering is the first process in tea manufacturing and is considered the foundation of quality tea. In this paper, an in-situ instrumentation technique is proposed, which is validated experimentally for monitoring of parameters affecting the withering process of tea leaves in black tea production. In the proposed technique, distribution of relative humidity and temperature during withering process is monitored and recorded which would be useful for prediction of withering level using advanced soft computing tool. The implementation detail of a sensor network is presented in the paper. Using the sensor network, variations in the distribution of relative humidity and temperature in a withering trough is monitored and recorded

Window of opportunity in axial spondyloarthritis: A Stitch in Time

Axial spondyloarthritis comprising both non-radiographic axial spondyloarthritis and ankylosingspondylitis has a deleterious impact on the patient’s quality of life with a detrimental outcome ofstructural damage. Although in the current era of diagnostic advancements, axSpA can be diagnosedearly within a short period after the onset of symptoms, but still there is a delay of up to severalyears in many parts of the world. The concept of a window of opportunity is primarily derived fromrheumatoid arthritis, which is relevant in the context of axSpA based upon the early diagnosis and tocommence highly effective treatment with biologics like anti-TNF and anti-IL-17 to modify thedisease process for arresting structural damage or syndesmophytes formation. Still, challenges existfor early diagnosis of SpA in patients with low back pain which ultimately creates a barrier toeffective treatment initiation. More robust researches along with the available evidence on both theaspects of clinical and imaging factors are the way forward for the early identification of susceptibleindividuals for early intervention with a better outcome

A Multi-centre Study to Evaluate the Long-Term Efficacy and Safety of Biosimilar Infliximab (Infimab™) in Ankylosing Spondylitis in Real-world Clinical Settings - A perspective from Eastern India

Introduction: Owing to dearth of data on infliximab biosimilars in Indian patients, a pan-India case database-based study with infliximab biosimilar BOW015 (Infimab™) was carried out to capture its efficacy and safety in real world clinical settings in India. Here, we assessed its efficacy and safety in ankylosing spondylitis (AS) among patients in the East India cohort. Materials and methods: Data were collected from multiple centers across the eastern region of India. Patients diagnosed with AS, within the preceding 4-6 months during the preceding one year were included in the study. Patients who were given BOW015 for other indications, prior innovator infliximab or other biologics were excluded from the study. Primary variable was Ankylosing Spondylitis Disease Activity Scale (ASDAS) response defined as change of &gt; 2 in the ASDAS score from the baseline by 4-6 months of follow up. Results: The cohort consisted of 149 patients, predominantly male (69.8%), with mean (±SD) age of 36.75 (±11.11) years and mean (±SD) body weight of 58.26 (±15.4) kgs. Of the treated patients, 91 (61.1%) patients were administered four doses, 10 (6.7%) patients were administered three doses, 37 (24.8%) patients were administered two doses and 11 (7.4%) patients were administered only a single dose of BOW015. In the final analysis set, 81 patients had data at baseline and 4th visit. Among the 81 patients, 74 (91%) patients achieved major improvement, 5 (6%) patients achieved clinically important improvement and 2 (3%) were non-responders at 4th visit. Secondarily, cross categorization of the cohort into disease activity categories by number of infusions administered from baseline to 4th visit and assessment of trends in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were also carried out and these too confirmed the efficacy of BOW015. Conclusion: Infimab™ (BOW015) showed significant improvement in ASDAS and BASDAI in patients with AS at the end of 4-6 months of follow up with its clinical benefits being apparent as early as first dose of BOW015

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Elevated serum receptor activator of NFκB ligand (RANKL), osteoprotegerin (OPG), matrix metalloproteinase (MMP)3, and ProMMP1 in patients with juvenile idiopathic arthritis

We studied the serum levels of receptor activator of nuclear factor-kappaB ligand (RANKL), osteoprotegerin (OPG), pro-matrix metalloproteinase (MMP) 1, MMP3, and tissue inhibitor of metalloproteinase (TIMP) 1 in patients with juvenile idiopathic arthritis (JIA) and correlated these with different disease variables. Sera of 70 patients with JIA (ILAR 2001 criteria) and 33 age- and sex-matched controls were assayed by enzyme-linked immunosorbent assay. Nonparametric tests were used for analysis of data. The subtype distribution of the JIA patients was: enthesitis-related arthritis (ERA) 24, polyarticular 22, systemic onset 13, oligoarticular 8, and others 3. The median level of RANKL, OPG, pro-MMP1, MMP3, and TIMP-1 were elevated in JIA patients as compared to controls (p &lt; 0.001). There was no difference in levels among different types of JIA. RANKL/OPG ratio was elevated in all subtypes of JIA. MMP3/TIMP-1 ratio correlated with measures of disease activity including swollen and tender joint count, erythrocyte sedimentation rate, and disease activity score (rS 0.28, p &lt; 0.05). Ours is the first study to show elevated RANKL in serum of patients with JIA. Further, our data suggest that patients with ERA have similar levels to other forms of JIA. Association of the MMP3/TIMP-1 ratio with disease activity suggests that it may be a useful biomarker for follow-up

Phase behaviour and structural properties of two members of biphenylyl benzoate chiral mesogenic series

Phase behaviour and structural properties of two members of biphenylyl benzoate chiral meso-genic series (2F3R and 3F3R) have been investigated. While both the compounds exhibit SmC*phase over a wide temperature range, 2F3R forms orthogonal SmA* from tilted SmC* on heatingbut 3F3R melts directly to the isotropic phase. The SmA* phase of 2F3R is found to have de vriescharacteristics with small effective layer contraction. Both the samples on cooling form hexagonalSmF* phase below SmC* phase. On further cooling soft crystal like hexagonal SmJ* phase isformed in 2F3R, undergoing a change in the tilt direction, but in 3F3R, SmG* phase is formedwithout any change in the tilt direction. A coexistence phase of (SmC*+SmF*) is also observed ina certain temperature range. Slight differences in the dipole moment and molecular conforma-tion of the two molecules give rise to a subtle change in the intermolecular interaction and playan important role in the appearance of different phases in the two compounds. Cell parametersof SmF*, SmG*, SmJ* phases have also been determined. Layer spacings, tilt angles, averageintermolecular spacings and correlation lengths have been measured. How some of theseproperties compare with other members of the series has been discussed

Effect of silver nanoparticle doping on the physicochemical properties of a room temperature ferroelectric liquid crystal mixture

We have investigated the effect of doping of a small amount of silver nanoparticles (AgNPs) on the physicochemical properties of a room temperature ferroelectric liquid crystal mixture. Polarizing optical microscopy, differential scanning calorimetry, synchrotron X-ray diffraction, dielectric and electro-optic studies showed that the inclusion of AgNPs greatly influences the phase transition temperatures, structural, dielectric, and electro-optic properties. Doping slightly decreases the SmC*-SmA* and SmA*-Iso transition temperatures signifying decreased ordering which is also reflected in reduced tilt angles. The Goldstone mode dielectric increment of the nanocomposite increases twofold but the critical frequency decreases slightly. Spontaneous polarization of the mixture also increases significantly in the presence of AgNPs whereas the conductivity decreases indicating trapping of ions by the nanoparticles. Goldstone mode rotational viscosity decreases and as a result of which the switching time also decreases by 88 μs making the nano doped mixture more suitable for practical applications