Abatacept in children with juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled withdrawal trial

Background Some children with juvenile idiopathic arthritis either do not respond, or are intolerant to, treatment with disease-modifying antirheumatic drugs, including anti-tumour necrosis factor (TNF) drugs. We aimed to assess the safety and efficacy of abatacept, a selective T-cell costimulation modulator, in children with juvenile idiopathic arthritis who had failed previous treatments.Methods We did a double-blind, randomised controlled withdrawal trial between February, 2004, and June, 2006. We enrolled 190 patients aged 6-17 years, from 45 centres, who had a history of active juvenile idiopathic arthritis; at least five active joints; and an inadequate response to, or intolerance to, at least one disease-modifying antirheumatic drug. All 190 patients were given 10 mg/kg of abatacept intravenously in the open-label period of 4 months. of the 170 patients who completed this lead-in course, 47 did not respond to the treatment according to predefined American College of Rheumatology (ACR) paediatric criteria and were excluded. of the patients who did respond to abatacept, arthritis, and 62 were randomly assigned to receive placebo at the same dose and timing. The primary endpoint was time to flare of arthritis. Flare was defined as worsening of 30% or more in at least three of six core variables, with at least 30% improvement in no more than one variable. We analysed all patients who were treated as per protocol. This trial is registered, number NCT00095173.Findings Flares of arthritis occurred in 33 of 62 (53%) patients who were given placebo and 12 of 60 (20%) abatacept patients during the double-blind treatment (p=0.0003). Median time to flare of arthritis was 6 months for patients given placebo (insufficient events to calculate IQR); insufficient events had occurred in the abatacept group for median time to flare to be assessed (p=0.0002). The risk of flare in patients who contined abatacept was less than a third of that for controls during that double-blind period (hazard ratio 0.31, 95% CI 0.16-0.95). During the double-blind period, the frequency of adverse events did not differ in the two treatment groups, Adverse events were recorded in 37 abatacept recipients (62%) and 34 (55%) placebo recipients (p=0.47); only two serious adverse events were reported, bouth in controls (p=0.50).Interpretation Selective modulation of T-cell costimulation with abatacept is a rational alternative treatment for children with juvenile idiopathic arthritis.Funding Bristol-Myers Squibb.

Studies on double selenates. I. Thermal decomposition of lanthanum and alkali metal double selenates

Thermogravimetry, differential thermal analysis and other methods of analysis have been used to study the decomposition of hydrated lanthanum and alkali metal double selenates up to 1300°C. The results showed slight variations in the initial temperature of the various intermediate decomposition stages of the double selenates, as compared with the initial temperature of the corresponding decomposition of the simple selenates. The results also permitted the suggestion of mechanisms of thermal decomposition of these compounds. © 1980.

Lithium-lanthanum double chromates

Synthesis and crystallographic data are reported for low and high temperature forms of LiLa(CrO4)2. The compounds are closely related to lamellar rare earth phosphates and arsenates of sodium and to RbLu(CrO4)2. Lattice parameters of the orthorhombic (low temperature) and monoclinic (high temperature) forms are given. The low temperature form is moisture sensitive and Li+ ions are easily displaced by protons. Thermal decomposition takes place at 250 °C and results in the formation of LiCrO2, LaCrO4, LaCrO3 and Cr2O3. © 1993.

Lanthanum-lithium-sodium double chromates as ionic conductors

Lanthanum-lithium-sodium double chromates Li1-xNaxLa(CrO4)2 were prepared and analysed by means of admittance spectroscopy. Their a.c. conductivity parameters are correlated with structural details of high and low temperature forms of pure lanthanum-lithium double chromates. Lithium compounds show the lowest conductivity values and the highest activation energy for ion motion, while the sample Li0.5Na0.5La(CrO4)2 exhibits the highest conductivity 10-5 S cm-1 and the lowest activation energy 0.58 eV.

Comment on Majoron emitting neutrinoless double beta decay in the electroweak chiral gauge extensions

We point out that if the Majoron-like scheme is implemented within a 3-3-1 model, there must exist at least three different mass scales for the scalar vacuum expectation values in the model. ©1999 The American Physical Society.

Double-blind comparison of venlafaxine and amitriptyline in outpatients with major depression with or without melancholia

The purpose of this study was to compare the efficacy and tolerability of venlafaxine and amitriptyline in outpatients with major depression with or without melancholia. This was an 8-week, multicentre, randomized, double-blind, parallel-group comparison of venlafaxine and amitriptyline. Outpatients with DSM-IV major depression, a minimum score of 20 on the 21-item Hamilton Depression Rating Scale (HAM-D), and depressive symptoms for at least 1 month were eligible. Patients were randomly assigned to venlafaxine or amitriptyline, both drugs titrated to a maximum of 150 mg/day until study day 15. The primary efficacy variables were the final on-therapy scores on the HAM-D, Montgomery-Asberg Depression Rating Scale and Clinical Global Impression severity scales. Data were evaluated on an intent-to-treat basis using the LOCF method. One hundred and 16 patients were randomized, and 115 were evaluated for efficacy. Both drugs showed efficacy in the treatment of depression with or without melancholia. No significant differences were noted between treatments for any efficacy parameter. However, significantly (p < 0.05) more patients in the amitriptyline group had at least one adverse event. These results should support the efficacy and tolerability of venlafaxine in comparison with amitriptyline for treating major depression with or without melancholia.

Neutrinoless double beta decay with and without Majoron-like boson emission in a 3-3-1 model

We consider the contributions to the neutrinoless double beta decays in a SU(3)L⊗U(1)N electroweak model. We show that for a range of parameters in the model there are diagrams involving vector-vector-scalar and trilinear scalar couplings which can be potentially as contributing as the light massive Majorana neutrino exchange one. We use these contributions to obtain constraints upon some mass scales of the model, such as the masses of the new charged vector and scalar bosons. We also consider briefly the decay in which, in addition to the two electrons, a Majoron-like boson is emitted. ©2001 The American Physical Society.

double-struck D signn-forced symmetry breaking of double-struck O sign (2)-equivariant problems

We use singularity theory to classify forced symmetry-breaking bifurcation problems f(z, λ, μ) = f1 (z, λ) + μf2(z, λ, μ) = 0, where f1 is double-struck O sign (2)-equivariant and f2 is double-struck D sign n-equivariant with the orthogonal group actions on z ∈ ℝ2. Forced symmetry breaking occurs when the symmetry of the equation changes when parameters are varied. We explicitly apply our results to the branching of subharmonic solutions in a model periodic perturbation of an autonomous equation and sketch further applications.

Electromyographic validation of the double pulley equipment during movements of the lower limbs

The double pulley equipment was tested on ten male volunteers during contraction of the semitendinosus and biceps femoris (caput longum) muscles in the following movements of the lower limbs: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. The myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. The semitendinosus and biceps femoris muscles presented the highest potentials in movements 1; 2; 7, 8 and 9, whereas the potentials in the remaining movements were negligible. The pattern of activity of the semitendinosus and the biceps femoris was similar in exercises 1, 2, 3, 4 and 8. The potentials of the semitendinosus prevailed in movements 5, 6 and 7, and the strongest potentials observed in movement 9 were those of the biceps femoris.

Multipath reduction from GPS double differences using wavelets: How far can we go?

Wavelets are being extensively used in Geodetic applications. In this paper, the Multi-Resolution Analysis (MRA) using wavelets is applied to pseudorange and carrier phase GPS double differences (DDs) in order to reduce multipath effects. The wavelets were already applied to GPS carrier phase DDs, but some questions remain: How good can be the results, and are all multipath effects reduced? The answers to these questions are discussed in this paper. Thus, the wavelet transform is used to decompose the DD signals, splitting them in lower resolution components. After the decomposition process, the wavelet shrinkage is performed by thresholding to eliminate the components relative to multipath effects. Then, the DD observation can be reconstructed. This new DD signal is used to perform the baseline processing. The daily multipath repeatability was verified. With the application of the proposed approach, the results showed that the reliability of the ambiguity resolution and accuracy of the results improved when compared with the standard procedure. Furthermore, the method showed to be very efficient computationally, because, it is not noticed, at practical level, difference in the time span between the processing with and without application of the proposed method. However, only the high frequency multipath was eliminated.

Low intensity laser therapy in the treatment of temporomandibular disorders: A double-blind study

This study aimed to evaluate the effectiveness of low intensity laser therapy (LILT) in 30 patients presenting temporomandibular joint (TMJ) pain and mandibular dysfunction in a random and double-blind research design. The sample, divided into experimental group (1) and placebo group (2), was submitted to the treatment with infrared laser (780 nm, 30 mW, 10 s, 6.3 J/cm2) at three TMJ points. The treatment was evaluated throughout six sessions and 15, 30 and 60 days after the end of the therapy, through visual analogue scale (VAS), range of mandibular movements and TMJ pressure pain threshold. The results showed a reduction in VAS (p < 0.001) and through the ANOVA with repeated measures it was observed that the groups did not present statistically significant differences (P = 0.2060), as the averages of the evaluation times (P = 0.3955) and the interaction groups evaluation times (P = 0.3024), considering the MVO. The same occurred for RLE (P = 0.2988, P = 0.1762 and P = 0.7970), LLE (P = 0.3265, P = 0.4143 and P = 0.0696), PPTD (P = 0.1558, P = 0.4695 and P = 0.0737) and PPTE (P = 0.2376, P = 0.3203 and P = 0.0624). For PE, there were not statistically significant differences for groups (P = 0.7017) and the interaction groups evaluation times (P = 0.6678), even so in both groups the PE varied with time (P = 0.0069). © 2005 Blackwell Publishing Ltd.

Double optical monitoring of time-dependent film formation

A brief overview of optical monitoring for vacuum and wet bench film deposition processes is presented. Interferometric and polarimetric measurements are combined with regard to simultaneous real-time monitoring of refractive index and physical thickness. Monitor stability and accuracy are verified with transparent oil standards. This double optical technique is applied to dip coating with a multi-component Zirconyl Chloride aqueous solution, whose time varying refractive index and physical thickness curves indicate significant sensitivity to changes of film flow properties during the process.

Double Higgs production at the LHC as a robust test of little Higgs models

We analyze double Higgs boson production at the LHC in the context of Little Higgs models. In double Higgs production, the diagrams involved are directly related to those that cause the cancellation of the quadratic divergence of the Higgs self-energy, so this mode provides a robust prediction for this class of models. We find that in extensions of this model with the inclusion of a so-called T-parity, there is a significant enhancement in the cross sections as compared to the Standard Model. © 2006 American Institute of Physics.