Significance of cutting plane in liquid metal embrittlement severity quantification

The automotive industry is turning to advanced high strength steels (AHSS) to reduce vehicle weight and increase fuel efficiency. However, the zinc coating on AHSS can cause liquid metal embrittlement (LME) cracking during resistance spot welding. To understand the problem, the severity of the cracking must be measured. Typically, this is done from the weld cross-section. Currently, there is no standard procedure to determine which plane through the weld must be examined to gauge cracking severity, leading to a variety of practices for choosing a cutting plane. This work compares the magnitude and variability of LME severity measured from the plane of exhibiting the most severe surface cracking to arbitrarily chosen planes. The plane exhibiting the most severe cracks had more and longer cracks on the cross-section than the arbitrarily chosen plane, resulting in a higher crack severity measurement. This higher absolute measurement increased the relative accuracy of the examination, allowing for fewer welds to be examined to precisely determine the effect of LME mitigation methods on cracking severity, how welding parameters affect LME cracking severity and the predicted LME affected strength of a particular weld.

Prediction of Short- and Medium-term Efficacy of Biosimilar Infliximab Therapy. Do Trough Levels and Antidrug Antibody Levels or Clinical And Biochemical Markers Play the More Important Role?

BACKGROUND AND AIMS

Biosimilar infliximab CT-P13 received European Medicines Agency [EMA] approval in June 2013 for all indications of the originator product. In the present study, we aimed to evaluate the predictors of short- and medium-term clinical outcome in patients treated with the biosimilar infliximab at the participating inflammatory bowel disease [IBD] centres in Hungary.

METHODS

Demographic data were collected and a harmonised monitoring strategy was applied. Clinical and biochemical activities were evaluated at Weeks 14, 30, and 54. Trough level [TL] and anti-drug antibody [ADA] concentrations were measured by enzyme-linked immunosorbent assay [ELISA] [LT-005, Theradiag, France] at baseline at 14, 30 and 54 weeks and in two centres at Weeks 2 and 6.

RESULTS

A total of 291 consecutive IBD patients (184 Crohn's disease [CD] and 107 ulcerative colitis [UC]) were included. In UC, TLs at Week 2 predicted both clinical response and remission at Weeks 14 and 30 (clinical response/remission at Week 14: area under the curve [AUC] = 0.81, p < 0.001, cut-off: 11.5 μg/ml/AUC = 0.79, p < 0.001, cut-off: 15.3μg/ml; clinical response/remission at Week 30: AUC = 0.79, p = 0.002, cut-off: 11.5 μg/ml/AUC = 0.74, p = 0.006, cut-off: 14.5 μg/ml), whereas ADA positivity at Week 14 was inversely associated with clinical response at Week 30 [58.3% vs 84.8% ,p = 0.04]. Previous anti-tumour necrosis factor [TNF] exposure was inversely associated with short-term clinical remission [Week 2: 18.8% vs 47.8%, p = 0.03, at Week 6: 38.9% vs 69.7%, p = 0.013, at Week 14: 37.5% vs 2.5%, p = 0.06]. In CD, TLs at Week 2 predicted short-term [Week 14 response/remission, AUCTLweek2 = 0.715-0.721, p = 0.05/0.005] but not medium-term clinical efficacy. In addition, early ADA status by Week 14 [p = 0.04-0.05 for Weeks 14 and 30], early clinical response [p < 0.001 for Weeks 30/54] and normal C-reactive protein [CRP] at Week 14 [p = 0.005-0.0001] and previous anti-TNF exposure [p = 0.03-0.0001 for Weeks 14, 30, and 54] were associated with short-and medium-term clinical response and remission.

CONCLUSIONS

In UC, early TLs were predictive for short- and medium-term clinical efficacy, whereas in CD, Week 2 TLs were associated only with short-term clinical outcomes.

Reasons for patients' delay in response to symptoms of acute myocardial infarction

Survival in the acute phase of myocardial infarction and the subsequent prognosis are critically dependent on the time between onset of symptoms and medical intervention. Studies have shown that the time that patients take to decide to seek help accounts for most of the delay. We documented the length of time from onset of symptoms to arrival in hospital for 201 patients consecutively admitted to one of four hospitals in the Regional Municipality of Ottawa-Carleton between October 1986 and February 1987 for suspected acute myocardial infarction. Of the 160 survivors 42% waited more than 4 hours (a critical time for effective thrombolytic therapy) before coming to hospital, and nearly a third did not arrive within 6 hours. On the basis of interviews conducted with 42 patients, sociodemographic factors, education, past experience with an acute myocardial infarction, a previous diagnosis of angina and a coronary-prone behaviour pattern did not explain the delay. How patients perceived the seriousness of their symptoms and how they used other illness-related coping strategies explained 46% of the variance in the delay. Interventions aimed at reducing the delay between onset of symptoms and treatment must focus on patients' preadmission behaviour.

Risk factors for myocardial infarction: the importance of relaxation

Several risk factors for acute myocardial infarction (AMI) were examined, including history of smoking and hypercholesterolemia, income, education, coronary-prone behaviour by Structured Interview (SI) and the type and quality of stress-reducing relaxing activities, in a case-control study. Our sample included 100 AMI patients (80 males and 20 females, with mean ages 57.3 and 64.1 years, respectively), as well as 100 age- and sex-matched controls. Univariate differences between cases and controls were significant for history of smoking, income level, SI-defined hostility, SI-defined suppression of hostility, amount and type of relaxing activities and history of hypercholesterolemia. Multivariable analyses demonstrated that AMI patients reported significantly lower levels of relaxation and income, but higher levels of suppressed hostility and a higher incidence of hypercholesterolemia. Our findings confirm the significance of hostility and particularly suppressed hostility as AMI risk factors; furthermore, inadequate relaxation was identified as an independent risk factor associated with AMI.