Liquid-liquid extraction of lithium using lipophilic dibenzo-14-crown-4 ether carboxylic acid in hydrophobic room temperature ionic liquid

Torrejos, Rey Eliseo C.,Nisola, Grace M.,Song, Ho Seong,Han, Jeong Woo,Lawagon, Chosel P.,Seo, Jeong Gil,Koo, Sangho,Kim, Hern,Chung, Wook-Jin Elsevier 2016 Hydrometallurgy Vol.164 No.-

<P><B>Abstract</B></P> <P>A green liquid-liquid extraction (LLE) system was developed for the recovery of lithium (Li<SUP>+</SUP>) from sodium and potassium ions, which are typically present at high concentrations in seawater. Dibenzo-14-crown-4ether (DB14C4) was functionalized with a long lipophilic alkyl C18 chain and a pendent proton ionizable carboxylic acid group to obtain a lithium (Li<SUP>+</SUP>) carrier system (DB14C4-C18-COOH) with high Li<SUP>+</SUP> extraction performance and good stability in the room temperature ionic liquid diluent, CYPHOSIL 109. The Li<SUP>+</SUP> extraction efficiency of DB14C4-C18-COOH/CYPHOSIL 109 can be enhanced by increasing the solution pH and DB14C4-C18-COOH concentration. Further examination of extraction results reveal 1:1 coordination between DB14C4-C18-COOH and Li<SUP>+</SUP> which was also supported by density functional theory calculations. At room temperature, the developed LLE system effectively extracted dilute Li<SUP>+</SUP> from Na<SUP>+</SUP> (selectivity α<SUB>Li</SUB> <SUP>+</SUP> <SUB>/Na</SUB> <SUP>+</SUP> =1954) and K<SUP>+</SUP> (α<SUB>Li</SUB> <SUP>+</SUP> <SUB>/K</SUB> <SUP>+</SUP> =138). Kinetic and thermodynamic parameters were evaluated for optimum Li<SUP>+</SUP> extraction conditions. Sequestered Li<SUP>+</SUP> can be easily recovered from the LLE system using dilute hydrochloric acid. Results from recycling tests showed stable Li<SUP>+</SUP> extraction performance hence it can be used for long term application. Overall results indicate the potential application of DB14C4-C18-COOH/CYPHOSIL 109 as a treatment step to recover Li<SUP>+</SUP> from brine or seawater.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Crown ether in RTIL CYPHOSIL 109 LLE system was developed for Li<SUP>+</SUP> recovery. </LI> <LI> Ligand lipophilic dibenzo14C4 crown ether with ionizable COOH group was synthesized. </LI> <LI> Highly selective LLE towards Li<SUP>+</SUP> in the presence of high Na<SUP>+</SUP> and K<SUP>+</SUP> concentration </LI> <LI> Ligand concentration, solution pH and temperature affected Li<SUP>+</SUP> extraction. </LI> <LI> Convenient Li<SUP>+</SUP> recovery and LLE reusability via dilute acid stripping treatment </LI> </UL> </P>

First observation ofγγ→pp¯K+K−and search for exotic baryons inpKsystems

Shen, C. P.,Yuan, C. Z.,Adachi, I.,Aihara, H.,Asner, D. M.,Aulchenko, V.,Aushev, T.,Ayad, R.,Babu, V.,Badhrees, I.,Bakich, A. M.,Barberio, E.,Behera, P.,Bhardwaj, V.,Bhuyan, B.,Biswal, J.,Bobrov, A.,B American Physical Society 2016 Physical review. D Vol.93 No.11

<P>The process gamma gamma -> p (p) over barK(+)K(-) and its intermediate processes are measured for the first time using a 980 fb(-1) data sample collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The production of p (p) over barK(+)K(-) and a Lambda(1520)(0) ((Lambda) over bar (1520)(0)) signal in the pK(-) ((p) over barK(+)) invariant mass spectrum are clearly observed. However, no evidence for an exotic baryon near 1540 MeV/c(2), denoted as Theta(1540)(0) ((Theta) over bar (1540)(0)) or Theta(1540)(++) (Theta(1540)(--)), is seen in the pK(-) ((p) over barK(+)) or pK(+) ((p) over barK(-)) invariant mass spectra. Cross sections for gamma gamma -> p (p) over barK(+)K(-), Lambda(1520)(0)(p) over barK(+) + c.c. and the products sigma(gamma gamma -> Theta(1540)(0)(p) over barK(+) + c.c.)B(Theta(1540)(0) -> pK(-)) and sigma(gamma gamma -> Theta(1540)(++)(p) over barK(-) + c.c.)B(Theta(1540)(++) -> pK(+)) are measured. We also determine upper limits on the products of the chi(c0) and chi(c2) two-photon decay widths and their branching fractions to p (p) over barK(+)K(-) at the 90% credibility level.</P>

Quality-of-life and performance status results from the phase III RAINBOW study of ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated gastric or gastroesophageal junction adenocarcinoma ^†

Al-Batran, S.-E.,Van Cutsem, E.,Oh, S. C.,Bodoky, G.,Shimada, Y.,Hironaka, S.,Sugimoto, N.,Lipatov, O. N.,Kim, T.-Y.,Cunningham, D.,Rougier, P.,Muro, K.,Liepa, A. M.,Chandrawansa, K.,Emig, M.,Ohtsu, A Oxford University Press 2016 Annals of Oncology Vol.27 No.4

<P><B>Background</B></P><P>The phase III RAINBOW trial demonstrated that the addition of ramucirumab to paclitaxel improved overall survival, progression-free survival, and tumor response rate in fluoropyrimidine–platinum previously treated patients with advanced gastric/gastroesophageal junction (GEJ) adenocarcinoma. Here, we present results from quality-of-life (QoL) and performance status (PS) analyses.</P><P><B>Patients and methods</B></P><P>Patients with Eastern Cooperative Oncology Group PS of 0/1 were randomized to receive ramucirumab (8 mg/kg i.v.) or placebo on days 1 and 15 of a 4-week cycle, with both arms receiving paclitaxel (80 mg/m<SUP>2</SUP>) on days 1, 8, and 15. Patient-reported outcomes were assessed with the QoL/health status questionnaires EORTC QLQ-C30 and EQ-5D at baseline and 6-week intervals. PS was assessed at baseline and day 1 of every cycle. Time to deterioration (TtD) in each QLQ-C30 scale was defined as randomization to first worsening of ≥10 points (on 100-point scale) and TtD in PS was defined as first worsening to ≥2. Hazard ratios (HRs) for treatment effect were estimated using stratified Cox proportional hazards models.</P><P><B>Results</B></P><P>Of the 665 patients randomized, 650 (98%) provided baseline QLQ-C30 and EQ-5D data, and 560 (84%) also provided data from ≥1 postbaseline time point. Baseline scores for both instruments were similar between arms. Of the 15 QLQ-C30 scales, 14 had HR < 1, indicating similar or longer TtD in QoL for ramucirumab + paclitaxel. Treatment with ramucirumab + paclitaxel was also associated with a delay in TtD in PS to ≥2 (HR = 0.798, <I>P</I> = 0.0941). Alternate definitions of PS deterioration yielded similar results: PS ≥ 3 (HR = 0.656, <I>P</I> = 0.0508), deterioration by ≥1 PS level (HR = 0.802, <I>P</I> = 0.0444), and deterioration by ≥2 PS levels (HR = 0.608, <I>P</I> = 0.0063). EQ-5D scores were comparable between treatment arms, stable during treatment, and worsened at discontinuation.</P><P><B>Conclusion</B></P><P>In patients with previously treated advanced gastric/GEJ adenocarcinoma, addition of ramucirumab to paclitaxel prolonged overall survival while maintaining patient QoL with delayed symptom worsening and functional status deterioration.</P><P><B>ClinicalTrials.gov</B></P><P>NCT01170663.</P>

Golimumab, a human antibody to tumour necrosis factor α given by monthly subcutaneous injections, in active rheumatoid arthritis despite methotrexate therapy: the GO-FORWARD Study

Keystone, E C,Genovese, M C,Klareskog, L,Hsia, E C,Hall, S T,Miranda, P C,Pazdur, J,Bae, S-C,Palmer, W,Zrubek, J,Wiekowski, M,Visvanathan, S,Wu, Z,Rahman, M U BMJ Publishing Group 2009 Annals of the Rheumatic Diseases Vol.68 No.6

<P><B>Objective:</B></P><P>The phase III GO-FORWARD study examined the efficacy and safety of golimumab in patients with active rheumatoid arthritis (RA) despite methotrexate therapy.</P><P><B>Methods:</B></P><P>Patients were randomly assigned in a 3 : 3 : 2 : 2 ratio to receive placebo injections plus methotrexate capsules (group 1, n  =  133), golimumab 100 mg injections plus placebo capsules (group 2, n  =  133), golimumab 50 mg injections plus methotrexate capsules (group 3, n  =  89), or golimumab 100 mg injections plus methotrexate capsules (group 4, n  =  89). Injections were administered subcutaneously every 4 weeks. The co-primary endpoints were the proportion of patients with 20% or greater improvement in the American College of Rheumatology criteria (ACR20) at week 14 and the change from baseline in the health assessment questionnaire-disability index (HAQ-DI) score at week 24.</P><P><B>Results:</B></P><P>The proportion of patients who achieved an ACR20 response at week 14 was 33.1% in the placebo plus methotrexate group, 44.4% (p = 0.059) in the golimumab 100 mg plus placebo group, 55.1% (p = 0.001) in the golimumab 50 mg plus methotrexate group and 56.2% (p<0.001) in the golimumab 100 mg plus methotrexate group. At week 24, median improvements from baseline in HAQ-DI scores were 0.13, 0.13 (p = 0.240), 0.38 (p<0.001) and 0.50 (p<0.001), respectively. During the placebo-controlled portion of the study (to week 16), serious adverse events occurred in 2.3%, 3.8%, 5.6% and 9.0% of patients and serious infections occurred in 0.8%, 0.8%, 2.2% and 5.6%, respectively.</P><P><B>Conclusion:</B></P><P>The addition of golimumab to methotrexate in patients with active RA despite methotrexate therapy significantly reduced the signs and symptoms of RA and improved physical function.</P>

Studies on Filariasis in Kinmen (Quemoy) Islands, Republic of China

Fan,P.C.,Wang,Y.C.,Liu,J.C.,Lo,H.S.,Hsu,Y.P.,Yen,C.H.,Lin,C.C.,Hsu,S.T. INSTITUTE OF TROPICAL MEDICINE YONSEI UNIVERSITY 1974 YONSEI REPORTS ON TROPICAL MEDICINE Vol.5 No.1

1972年 7月 1日부터 1973年 6月 30日까지 1年間 中華民國 臺?省 金門鳥에서 絲狀 症에 關한 調査硏究를 實施한 바 다음과 같은 結果를 얻었다. 1. 金門鳥 55村落에 居住하는 20,018 住民을 對象으로 調査한 바 血中 microfilariae (mf.) 兩性率은 8.8%였고 血液 20立方mm當 mf농도는 16.2였으며 絲狀 感染으로 因 臨床例 는 19.2%였다. 金門鳥 駐屯 軍人 2,428名에서 mf.양성율은 0.1%, mf. 감염농도는 20立方mm當 26.3이었으며 臨床例는 없었다. mf.感染濃度 및 臨床例에 있어 확실히 女性보다는 男性에서 高率을 보였으나 mf.陽性率은 兩性間에 差異가 없었다. mf.陽性率과 臨床例는 年齡의 增加와 一致하였으나 mf. 감렴농도는 年齡의 증가와 無關하였다. 2. 金文鳥 駐屯 軍人에 있어 주둔 其間과 絲狀 感染과는 關係가 없었으며 駐屯基地와 村落과의 距離와도 無關하였다. 軍人들은 모기에 물리지 않도록 잘 保護되어 있었고 주둔지역은 完全히 住民들과 격리되어 있었다. 3. 51村落으로부터의 血液檢査를 받은 1,470名의 絲狀 感染陽性者 中에서 臨床病勢르 보인 例는 19.2%였으며 女性보다는 男性에서 約 5倍가 많았다. 男性에 있어서의 大部分의 臨床例는 生殖器에 症狀을 보였는데 其中 10%는 象皮症을 가진 例는 2名뿐이었다. 4. 43村落의 家屋內에서 잡힌 모기는 4屬 14種(Culex 10種, Aedes 2種, Anopheles 1種, Armigeres 1種)이었으며 이들中 Cules P. fatigans와 Armigeres subalbatus가 大部分이었으나 其他 12種은 매우 적었다. Culcx mimesticus, C. (L) vorax, C. fuscocephala 및 Acdes nocturnus등 의 4新種은 처음으로 發見되었다. Culex p.fatigans는 現存「반크롭트」 絲狀 만을 옮기는 媒介昆 으로 알려져 있다. 治療前 8個 村落으로부터 잡은 438마리의 Culex p. fatigans에서 幼 을 內包하고 있는 모기는 1마리 平均 5.9마리의 絲狀 幼 을 갖고 있는 셈이었으며 全體 感染率은 11.9%, 感染期 幼 을 가진 모기는 10.5%이었다. 上記 8個 村落 住民을 治癒한 後의 樣狀은 治療前과 아주 달라서 모기 1마리當 平均 2.1마리의 幼 을 갖고 있었고 全體感染率은 2.2%, 感染期幼 內包率은 0.09%였다. 平均 pH가 7.4(6.4∼8.0)인 8個處의 모기 産卵場所에서 잡힌 모기 幼 은 모두 11種이었다. 有機燐劑의 一種인 Sumithion을 1平方m當 0.2gm의 농도로 모기 産卵場所 水面에 撒布하였던바 모든 모기 幼 에 對한 殺 果가 좋았다. 5. 總 1.590名의 絲狀 感染者에게 成人當 總量 5gm의 diethylcarbamazine을 10∼12日 間 服用시켜 보았다. 治療率은 80.6%, mf. 減少率은 96.9%였고 反應率는 67.2%였다. 여러 가지 副作用은 있었으나 一般的으로 輕微하였으며 患者가 참을 수 있었으므로 最高用量으로 投藥했을 경우에도 大部分 거절 하지 않았다. 8個 部落에서 捕獲된 Culex P. fatigans의 絲狀 幼 全體感染率, 感染期幼 內包率 및 感染濃度는 患者治療前에 各各 11.9%, 10.5%, 5.9였는데 治療後에는 2.2%, 0.09%, 2.1로 떨어져서 diethylcarbamazine은 microfilariae에 對한 殺충효果가 높을 뿐 아니라 絲狀충 만延을 組止시키는데 좋은 藥劑라고 思料된다 The present investigation is a serial study on “Filariasis in Kinmen (Quemoy) Islands”, which was performed from July 1, 1972 to June 30, 1973. The results are summarized as follows; 1. Parasitological investigation: Of 20,018 Kinmen Chinese in 55 villages examined, the microfilariae (mf.) rate of 8.8%, mf. density of 16.2 per 20cmm blood and clinical rate 19.2% were found: the corresponding figures for a total of 2,428 military personnel were 0.1%, 29.3 and 0.0% respectively. The mf. density and clinical rate were obviously higher in the males than in the females, but no difference was found for the microfilarial rate. The mf. rate and clinical rate were correspondingly increased with age, but there was no difference in mf. density. 2. Transmission of filariasis: It seems no any relation to the length of stationing of the Chinese troops on Kinmen Islands, and also no relation to the distance between the villages and camps; because the servicemen are well protected from the mosquito bites and bites and the camps are completely isolated, to and off limit to the villagers, though they have common places of entertainment. 3. Clinical investigation: Of 1,470 filarial carriers in 51 villages examined physically, the clinical rate of 19.2% was detected. It was about 5 times higher in males than in females. In the males, most of the cases the trouble in their reproductive organs, and 10% had elephantiasis; but in the females, the lymph nodes enlargement and chyluria were more common, only 2 cases had elephantiasis. The clinical rates increased corresponding with age. 4. Entomological investigation: Fourteen(14) species of 4 genera (10 Culex, 2 Aedes, 1 Anopheles and 1 Armigeres) of household mosquitoes were collected from indoor resting sites of 43 villages on kinmen Islands, in which, Cules P. fatigans and Armigeres subalbatus were the most common species, but the remaining 12 species are faily rare. Four (4) new species: Culex mimeticus, C. (L) vorax, C, fucocephala and Aedes noturnvs were found for the first time. Culex p.fatigans is still the only vector. in transmission of bancroftian filariasis. The infection rate of 11.9%, infective rate of 10.5% and 5.9 filarial larvae per infected mosquito were detected in 438 Culex p. fatigans from 8 villages before treatment. The corresponding figures were much lower in the above same villages after treatment (2.2%, 0.09% and 2.1). Eleven (11) species of moswquito larvae were collected from 8 kinds of breeding sites; where, the pH value of 7.4(ranged 6.4∼8.0) was measured. “Sumithion”is one of the organophosphorous compounds, which was first used on the water surface with the dosage of 0.2gm per square meter.A high insecticidal effect against different species of mosquito larvae was observed. 5. Chemotherapy of filariasis: Of 1.590 filarial carriers scheme, with a total does of 5 gm of diethylcarbamazine per adult case for a period of 10∼12 days schedule was performed. The cure rate of 80.6%, mf. reduction tate of 96.9% and reaction rate of 67.2% were found. Although many kinds of side effects were encountered, they were usually mild or transient and could be tolerated by the patients, thus there was almost no refused to the administration of the drug even if the drug was increased to the maximum dosage. The natural infection rate, infective rate and filarial larval density of Culex P. fatigans in 8 villages were found much higher before control measure (11.9%, 10.5% and 5.9%) than after control (2.2%, 0.09% and 2.1). It showed that diethylcarbamazine is a powerful microfilaricidal drug in eliminating the filarial infection and reducing this transmission.

Effect of Lipid Sources with Different Fatty Acid Profiles on Intake, Nutrient Digestion and Ruminal Fermentation of Feedlot Nellore Steers

Fiorentini, Giovani,Carvalho, Isabela P.C.,Messana, Juliana D.,Canesin, Roberta C.,Castagnino, Pablo S.,Lage, Josiane F.,Arcuri, Pedro B.,Berchielli, Telma T. Asian Australasian Association of Animal Productio 2015 Animal Bioscience Vol.28 No.11

The present study was conducted to determine the effect of lipid sources with different fatty acid profiles on nutrient digestion and ruminal fermentation. Ten rumen and duodenal fistulated Nellore steers (268 body weight${\pm}27kg$) were distributed in a duplicated $5{\times}5$ Latin square. Dietary treatments were as follows: without fat (WF), palm oil (PO), linseed oil (LO), protected fat (PF; Lactoplus), and whole soybeans (WS). The roughage feed was corn silage (600 g/kg on a dry matter [DM] basis) plus concentrate (400 g/kg on a DM basis). The higher intake of DM and organic matter (OM) (p<0.001) was found in animals on the diet with PF and WF (around 4.38 and 4.20 kg/d, respectively). Treatments with PO and LO decreased by around 10% the total digestibility of DM and OM (p<0.05). The addition of LO decreased by around 22.3% the neutral detergent fiber digestibility (p = 0.047) compared with other diets. The higher microbial protein synthesis was found in animals on the diet with LO and WS (33 g N/kg OM apparently digested in the rumen; p = 0.040). The highest C18:0 and linolenic acid intakes occurred in animals fed LO (p<0.001), and the highest intake of oleic (p = 0.002) and C16 acids (p = 0.022) occurred with the diets with LO and PF. Diet with PF decreased biohydrogenation extent (p = 0.05) of C18:1 n9,c, C18:2 n6,c, and total unsaturated fatty acids (UFA; around 20%, 7%, and 13%, respectively). The diet with PF and WF increased the concentration of $NH_3-N$ (p<0.001); however, the diet did not change volatile fatty acids (p>0.05), such as the molar percentage of acetate, propionate, butyrate and the acetate:propionate ratio. Treatments PO, LO and with WS decreased by around 50% the concentration of protozoa (p<0.001). Diets with some type of protection (PF and WS) decreased the effects of lipid on ruminal fermentation and presented similar outflow of benefit UFA as LO.

Effects of Different Fatty Acids and Levels on the Lipogenesis Capacity and Lipolysis Rate of Broilers In Vitro

Lien, T.F.,Wu, C.P.,Chen, K.L.,Yang, K.H. Asian Australasian Association of Animal Productio 2000 Animal Bioscience Vol.13 No.9

This study investigated the lipogenesis capacity of hepatocytes and lipolysis rate of adipocytes of broilers as affected by different fatty acids (trial one) and different linoleic acid (C18:2) levels (trial two). Twenty 6-wk old broilers were used; their hepatocytes and adipocytes were isolated for the in vitro study. In trial one, four treatments were tested. The control group in which no fatty acid was added, and the test groups to which were added $300{\mu}M$ of C16:0, C18:1 and C18:2, respectively. For trial two, different levels (0, $300{\mu}M$ and 1 mM) of C18:2 combined to fatty acid-free bovine serum albumin (BSA) were added to the medium. According to results of trial one, added fatty acids significantly reduced the incorporation by hepatocytes of [U,$^{14}C$]glucose into total lipid (p<0.05); the lipogenesis capacity in C18:2 group was the lowest. Although a similar pattern was found with [l,$^{14}C$]acetate, the groups only slightly differed in terms of lipogenesis capacity (p=0.11). In addition, the C18:2 group had a significantly (p<0.05) greater lipolysis rate than the C16:0 and control groups. Results of trial two indicated that C18:2 significantly (p<0.05) reduced lipogenesis capacity both for [U,$^{14}C$]glucose and [l,$^{14}C$]acetate, and markedly stimulated the lipolysis rate (p<0.05), displaying a dose response. Results presented herein demonstrate that C18:2 can reduce lipogenesis capacity and stimulate the lipolysis rate in broilers.

Effect of Lipid Sources with Different Fatty Acid Profiles on Intake, Nutrient Digestion and Ruminal Fermentation of Feedlot Nellore Steers

Giovani Fiorentini,Isabela P.C. Carvalho,Juliana D. Messana,Roberta C. Canesin,Pablo S. Castagnino,Josiane F. Lage,Pedro B. Arcuri,Telma T. Berchielli 아세아·태평양축산학회 2015 Animal Bioscience Vol.28 No.11

The present study was conducted to determine the effect of lipid sources with different fatty acid profiles on nutrient digestion and ruminal fermentation. Ten rumen and duodenal fistulated Nellore steers (268 body weight±27 kg) were distributed in a duplicated 5×5 Latin square. Dietary treatments were as follows: without fat (WF), palm oil (PO), linseed oil (LO), protected fat (PF; Lactoplus), and whole soybeans (WS). The roughage feed was corn silage (600 g/kg on a dry matter [DM] basis) plus concentrate (400 g/kg on a DM basis). The higher intake of DM and organic matter (OM) (p<0.001) was found in animals on the diet with PF and WF (around 4.38 and 4.20 kg/d, respectively). Treatments with PO and LO decreased by around 10% the total digestibility of DM and OM (p<0.05). The addition of LO decreased by around 22.3% the neutral detergent fiber digestibility (p = 0.047) compared with other diets. The higher microbial protein synthesis was found in animals on the diet with LO and WS (33 g N/kg OM apparently digested in the rumen; p = 0.040). The highest C18:0 and linolenic acid intakes occurred in animals fed LO (p<0.001), and the highest intake of oleic (p = 0.002) and C16 acids (p = 0.022) occurred with the diets with LO and PF. Diet with PF decreased biohydrogenation extent (p = 0.05) of C18:1 n9,c, C18:2 n6,c, and total unsaturated fatty acids (UFA; around 20%, 7%, and 13%, respectively). The diet with PF and WF increased the concentration of NH3-N (p<0.001); however, the diet did not change volatile fatty acids (p>0.05), such as the molar percentage of acetate, propionate, butyrate and the acetate:propionate ratio. Treatments PO, LO and with WS decreased by around 50% the concentration of protozoa (p<0.001). Diets with some type of protection (PF and WS) decreased the effects of lipid on ruminal fermentation and presented similar outflow of benefit UFA as LO.

Clinical efficacy and safety of abatacept in methotrexate-naive patients with early rheumatoid arthritis and poor prognostic factors

Westhovens, R,Robles, M,Ximenes, A C,Nayiager, S,Wollenhaupt, J,Durez, P,Gomez-Reino, J,Grassi, W,Haraoui, B,Shergy, W,Park, S-H,Genant, H,Peterfy, C,Becker, J-C,Covucci, A,Helfrick, R,Bathon, J BMJ Group 2009 Annals of the Rheumatic Diseases Vol.68 No.12

<P><B>Objectives:</B></P><P>To assess the efficacy and safety of abatacept in methotrexate-naive patients with early rheumatoid arthritis (RA) and poor prognostic factors.</P><P><B>Methods:</B></P><P>In this double-blind, phase IIIb study, patients with RA for 2 years or less were randomly assigned 1 : 1 to receive abatacept (∼10 mg/kg) plus methotrexate, or placebo plus methotrexate. Patients were methotrexate-naive and seropositive for rheumatoid factor (RF), anti-cyclic citrullinated protein (CCP) type 2 or both and had radiographic evidence of joint erosions. The co-primary endpoints were the proportion of patients achieving disease activity score in 28 joints (DAS28)-defined remission (C-reactive protein) and joint damage progression (Genant-modified Sharp total score; TS) at year 1. Safety was monitored throughout.</P><P><B>Results:</B></P><P>At baseline, patients had a mean DAS28 of 6.3, a mean TS of 7.1 and mean disease duration of 6.5 months; 96.5% and 89.0% of patients were RF or anti-CCP2 seropositive, respectively. At year 1, a significantly greater proportion of abatacept plus methotrexate-treated patients achieved remission (41.4% vs 23.3%; p<0.001) and there was significantly less radiographic progression (mean change in TS 0.63 vs 1.06; p = 0.040) versus methotrexate alone. Over 1 year, the frequency of adverse events (84.8% vs 83.4%), serious adverse events (7.8% vs 7.9%), serious infections (2.0% vs 2.0%), autoimmune disorders (2.3% vs 2.0%) and malignancies (0.4% vs 0%) was comparable for abatacept plus methotrexate versus methotrexate alone.</P><P><B>Conclusions:</B></P><P>In a methotrexate-naive population with early RA and poor prognostic factors, the combination of abatacept and methotrexate provided significantly better clinical and radiographic efficacy compared with methotrexate alone and had a comparable, favourable safety profile.</P>

Short term Efficacy of C0-C1 Mobilization in the Cervical Neutral Position in Upper Cervical Hypomobility: A Randomized Controlled Trial

César Hidalgo-García,José Miguel Tricás-Moreno,Orosia Lucha-López,Elena Estebanezde Miguel,Elena Bueno-Gracia,Silvia Pérez-Guillén,Pablo Fanlo-Mazas,Alazne Ruiz-de-Escudero,John Krauss 국제물리치료학회 2016 Journal of International Academy of Physical Ther Vol.7 No.1

The purpose of this study is to explore the effects of mobilization of C0-C1 and C7-T1 applied to asymptomatic individuals with reduced upper cervical rotation during the FRT. Design: parallel randomized controlled trial. 48 subjects(38.52 years±15.13) with C1-C2 rotation hypomobility in TFR joined the study and were randomized into three groups(C0, C7, control group). FRT in both directions was measured before and after the intervention. C0 intervention consisted of a dorsal translatoric mobilization of C0-C1 in the cervical neutral position. C7 intervention consisted of a ventral cranial translatoric mobilization of C7- T1 in neutral position and the control group maintained a supine position. C0 group experienced a FRT ROM to the restricted side increase of 17.64。(SD=4.55), that was significantly greater (P<0.001) than 5.95。 (SD=4.81) of the C7 group and 2.45。(SD=5.05) of the control group. The results showed that a dorsal translatoric mobilization of C0-C1 in neutral position restored the physiological FRT mobility in subjects with C1-C2 hypomobility and experienced statistical significant improvement in FRT as compared to a C7-T1 translatoric mobilization and a control group. (Level of evidence: 1b).