A smooth transition protocol for patients with multifocal motor neuropathy going from intravenous to subcutaneous immunoglobulin therapy: an open-label proof-of-concept study

Intravenous immunoglobulin (IVIG) is the first-line therapy for multifocal motor neuropathy (MMN). This open-label multi-centre study (NCT00701662) assessed the efficacy, safety, and convenience of subcutaneous immunoglobulin (SCIG) in patients with MMN over 6 months, as an alternative to IVIG. Eight MMN patients (42-66 years), on stable IVIG dosing, received weekly SCIG at doses equivalent to previous IVIG using a "smooth transition protocol". Primary efficacy endpoint was the change from baseline to week 24 in muscle strength. Disability, motor function, and health-related quality of life (HRQL) endpoints were also assessed. One patient deteriorated despite dose increase and was withdrawn. Muscle strength, disability, motor function, and health status were unchanged in all seven study completers who rated home treatment as extremely good. Four experienced 18 adverse events, of which only two were moderate. This study suggests that MMN patients with stable clinical course on regular IVIG can be switched to SCIG at the same monthly dose without deterioration and with a sustained overall improvement in HRQL.

Solar thermal decoupled water electrolysis process I: Proof of concept

A new concept for a solar thermal electrolytic process was developed for the production of H-2 from water. A metal oxide is reduced to a lower oxidation state in air with concentrated solar energy. The reduced oxide is then used either as an anode or solute for the electrolytic production of H-2 in either an aqueous acid or base solution. The presence of the reduced metal oxide as part of the electrolytic cell decreases the potential required for water electrolysis below the ideal 1.23 V required when H-2 and O-2 evolve at 1 bar and 298 K. During electrolysis, H-2 evolves at the cathode at 1 bar while the reduced metal oxide is returned to its original oxidation state, thus completing the H-2 production cycle. Ideal sunlight-to-hydrogen thermal efficiencies were established for three oxide systems: Fe2O3-Fe3O4, Co3O4-CoO, and Mn2O3-Mn3O4. The ideal efficiencies that include radiation heat loss are as high or higher than corresponding ideal values reported in the solar thermal chemistry literature. An exploratory experimental study for the iron oxide system confirmed that the electrolytic and thermal reduction steps occur in a laboratory scale environment.