Background and objectives
The 52‐week, randomized, double‐blind, noninferiority, government‐funded NOR‐SWITCH trial demonstrated that switching from infliximab originator to less expensive biosimilar ...CT‐P13 was not inferior to continued treatment with infliximab originator. The NOR‐SWITCH extension trial aimed to assess efficacy, safety and immunogenicity in patients on CT‐P13 throughout the 78‐week study period (maintenance group) versus patients switched to CT‐P13 at week 52 (switch group). The primary outcome was disease worsening during follow‐up based on disease‐specific composite measures.
Methods
Patients were recruited from 24 Norwegian hospitals, 380 of 438 patients who completed the main study: 197 in the maintenance group and 183 in the switch group. In the full analysis set, 127 (33%) had Crohn's disease, 80 (21%) ulcerative colitis, 67 (18%) spondyloarthritis, 55 (15%) rheumatoid arthritis, 20 (5%) psoriatic arthritis and 31 (8%) chronic plaque psoriasis.
Results
Baseline characteristics were similar in the two groups at the time of switching (week 52). Disease worsening occurred in 32 (16.8%) patients in the maintenance group vs. 20 (11.6%) in the switch group (per‐protocol set). Adjusted risk difference was 5.9% (95% CI −1.1 to 12.9). Frequency of adverse events, anti‐drug antibodies, changes in generic disease variables and disease‐specific composite measures were comparable between arms. The study was inadequately powered to detect noninferiority within individual diseases.
Conclusion
The NOR‐SWITCH extension showed no difference in safety and efficacy between patients who maintained CT‐P13 and patients who switched from originator infliximab to CT‐P13, supporting that switching from originator infliximab to CT‐P13 is safe and efficacious.
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Plant-based food materials (PBFM) are complex in nature as they encompass porous, hygroscopic, and amorphous properties. Accurate measurement and determination of mechanical properties are required ...for proper handling of PBFM during harvesting, post-harvesting, transportation, packaging, and storing. Properties are also essential as input parameters for the mathematical modelling of food processing such as drying and cooking. In addition, the quality and texture of PBFM are strongly related to their mechanical properties. The mechanical properties including Young modulus, Poisson's ratio, creep, and shear modulus are related to the load-deformation behaviour of PBFM and are dependent on many factors that have not been properly investigated in the prior research. Porosity, moisture content, structural heterogeneity, pectin network, and the dimension of cells of PBFM are the main factors that can quantify the required level of mechanical properties for food processing. The effects of all these factors on food preservation, processing, transportation, and packaging have not been shown in previous research works. This review critically assesses the structural properties that can affect the mechanical properties of PBFM. It also presents the factors that influence changes in the properties and food microstructure, while processing of PBFM. An enhanced understanding of the relationships between mechanical properties and their influencing factors can guide to design (modelling) of appropriate handling processes and equipment during harvesting, post-harvesting, transporting, processing, and preservation operations. The establishment of possible relations between structural and mechanical properties can enhance the accuracy of the design and specification of the unit operations.
Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the ...various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes.
A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. Patient records were reviewed for union of bone, bone and functional outcomes and complications.
The most common organism for infection was identified to be
. At the time of final follow-up all patients had achieved union except two, one of whom had to undergo amputation due to non-union and sepsis. Majority of the patients had an excellent score as per ASAMI grading system for bone and function results. The most common complication noted was pin track infections.
In our experience, Ilizarov external fixator is better suited for infected non-union of tibia because it can provide a stable mechanical environment, bone transport, correct deformities, and enable weight bearing and hence we recommend its use for the same.
This is a cohort study including 283 patients who underwent breast and urological procedures in three UK centres during the peak of COVID-19. COVID-related 30-day mortality was zero, as well as ...COVID-related admissions. Only 12 patients developed COVID-19 symptoms, although none had a positive COVID swab. Non-emergency surgery for breast and urological conditions was safe during the peak of the COVID-19 pandemic, provided contemporaneous safety measures were followed.
Summary
Thyroid hormones (THs) are involved in the development of lymphoid organs and regulation of immune function in birds. However, their role as an immune‐modulator in the hyperthyroid state is ...still debatable. To explore the interrelationship of thyroxine (T4) and the immune system, chicks were divided into three groups. Group I was comprised of control birds, who received the basal diet while group II and III were given diets supplemented with 5 μg and 10 μg thyroxine/kg feed, respectively, from 15 to 28 days of age. Cell‐mediated immune response was evaluated through in vitro abdominal macrophage phagocytosis assay, macrophage nitric oxide (NO) production, heterophil‐to‐lymphocyte (H:L) ratio and delayed‐type hypersensitivity response against phytohemagglutinin (PHA). Humoural immune response was assessed through serum IgG and IgM antibody production against sheep red blood cells (SRBCs) and antibody production against infectious bronchitis virus (IBV). Sampling was carried out at 7, 14 and 21 days of treatment. Results have shown higher levels (p < .001) of circulating T4 in both treatment groups compared to the control group. There was a lower (p < .05) macrophage engulfment percentage, an increase in H:L ratio (p < .001) in treated birds, while their NO production remained higher (p < .05) in thyroxine supplemented groups after bacterial lipopolysaccharide stimulation. The humoural immune response revealed a significant decline (p < .001) in IgG, IgM antibody production against SRBCs but IBV circulating antibodies increased with age. In conclusion, hyperthyroidism has a strong co‐relation with decreased immune performance of birds.
With the aim of developing drug delivery systems, it was shown that nanoparticles of mesoporous silica molecular sieve MCM-41 with average size 100-150 nm and specific surface 655 m
2
/g could ...include 202 mg of emodin per one gram of the carrier and release more than 85% of this compound at pH 8 during 48 h.
Chinese fir (Cunninghamia lanceolata) is a prized timber species, which is grown in China from more than a thousand years. According to 8th national forest inventory data, Chinese fir plantations ...area expanded over an area of 11 million hectares, which occupies almost 18.2% area of all plantations in China principally in southern China. Successive rotations with clear cutting have become a common practice for Chinese fir plantations. These management practices on continues bases have led to a declining in yield production. Therefore, a serious concern has been raised on the Chinese fir plantations less yield and long-term productivity decline, particularly about the current rotation regime. In this review, we discussed the general causes of Chinese fir productivity decline and their effective solution. In forest conservation, the decline in soil quality is a serious ecological problem and recalcitrant litter, monoculture planting has aggravated the mechanism of soil degradation in Chinese fir plantations. The deteriorated soil properties in Chinese fir plantations were well mirrored in the reduction of plantation growth. Traditional plantation method of successive rotation without the period of fallow and management system of clear cutting, complete ploughing, burning of site and residues removal could be blamed for site degradation resulting in the poor growth and productivity decline of Chinese fir plantations. Complete burning and clear-cutting can lead to soil degradation by the loss of nutrients and organic matter. Therefore, a comprehensive knowledge of Chinese fir in terms of low productivity causes and solutions will allow us better forest management strategies and better development of plantation and afforestation throughout China.
Abstract Introduction This study was undertaken to observe changes in cardiac parameters along with clinical and laboratory changes after renal transplantation. Patients and Methods Cardiac ...parameters were evaluated by M-mode 2-dimensional echocardiography before transplantation and at monthly intervals. All subjects had functioning grafts at the time of the evaluations. Results Fifty-two allograft recipients underwent pretransplant parameters for comparison to those at posttransplant months 1, 3, 6, and 12. When changes at month 1 and 3 were observed among 22 patients, improvements were evident at month 3. Comparisons of pretransplant versus month 3 showed systolic blood pressure (SBP), 161 ± 16 to 133 ± 26 mmHg ( P < .002); diastolic BP (DBP), 101 ± 9 to 86 ± 11 mmHg, ( P < .006); hemoglobin (Hgb), 7.3 ± 1.6 to 11.2 ± 3.9 g/dL ( P < .006); left atrial diameter (LAD), 41 ± 5 to 35 ± 3 mm ( P < .001); left ventricular muscle mass index (LVMI), 379 ± 114 to 248 ± 58 g/m2 ( P < .001); and left ventricular end diastolic volume index (LVEDVI), 96 ± 28 to 64 ± 17 mL/m2 ( P < .002). When changes at months 3, 6, and 12 were observed among 30 patients, improvements evident at month 3 were maintained. Comparisons of pretransplant and 3 and 12 months observations showed SBP, 157 ± 17, 131 ± 14, to 126 ± 10 mm Hg ( P < .001); DBP, 97 ± 10, 83 ± 16, to 85 ± 6 mmHg ( P < .001); Hgb, 7 ± 1, 13 ± 2, to 13 ± 2 g/dL ( P < .001); LAD, 39 ± 7, 35 ± 3, to 34 ± 4 mm ( P < .05); LVMI, 275 ± 91, 191 ± 38, to 159 ± 26 g/m2 ( P < .001); and LVEDVI, 87 ± 29, 56 ± 34, to 49 ± 24 mL/m2 ( P < .001). Conclusion Significant improvements in cardiac parameters were evident by the third month post-renal transplantation; the changes were maintained over a longer period among patients with functional grafts.
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