Rheumatoid arthritis treated with 6-months of first-line biologic or biosimilar therapy: an updated systematic review and network meta-analysis.

OBJECTIVES: The aim of this study was to estimate the effectiveness of first-line biologic disease modifying drugs(boDMARDs), and their approved biosimilars (bsDMARDs), compared with conventional (csDMARD) treatment, in terms of ACR (American College of Rheumatology) and EULAR (European League against Rheumatism) responses. METHODS: Systematic literature search, on eight databases to January 2017, sought ACR and EULAR data from randomized controlled trials (RCTs) of boDMARDs / bsDMARDs (in combination with csDMARDs, or monotherapy). Two adult populations: methotrexate (MTX)-naïve patients with severe active RA; and csDMARD-experienced patients with moderate-to-severe active RA. Network meta-analyses (NMA) were conducted using a Bayesian Markov chain Monte Carlo simulation using a random effects model with a probit link function for ordered categorical. RESULTS: Forty-six RCTs met the eligibility criteria. In the MTX-naïve severe active RA population, no biosimilar trials meeting the inclusion criteria were identified. MTX plus methylprednisolone (MP) was most likely to achieve the best ACR response. There was insufficient evidence that combination boDMARDs was superior to intensive (two or more) csDMARDs. In the csDMARD-experienced, moderate-to-severe RA population, the greatest effects for ACR responses were associated with tocilizumab (TCZ) monotherapy, and combination therapy (plus MTX) with bsDMARD etanercept (ETN) SB4, boDMARD ETN and TCZ. These treatments also had the greatest effects on EULAR responses. No clear differences were found between the boDMARDs and their bsDMARDs. CONCLUSIONS: In MTX-naïve patients, there was insufficient evidence that combination boDMARDs was superior to two or more csDMARDs. In csDMARD-experienced patients, boDMARDs and bsDMARDs were comparable and all combination boDMARDs / bsDMARDs were superior to single csDMARD

Fossil hot spot-ridge interaction in the Musicians Seamount Province: Geophysical investigations of hot spot volcanism at volcanic elongated ridges

The Musicians Seamount Province is a group of volcanic elongated ridges (VERs) and single seamounts located north of the Hawaiian Chain. A 327° trending seamount chain defines the western part of the province and has been interpreted as the expression of a Cretaceous hot spot beneath the northward moving Pacific Plate. To the east, elongated E-W striking ridges dominate the morphology. In 1999, wide-angle seismic data were collected across two 400 km long VERs. We present tomographic images of the volcanic edifices, which indicate that crustal thickening occurs in oceanic layer 2 rather than in layer 3. This extrusive style of volcanism appears to strongly contrast with the formation processes of aseismic ridges, where crustal thickening is mostly accommodated by intrusive underplating. High-resolution bathymetry was also collected, which yields a detailed image of the morphology of the VERs. From the occurrence of flat-top guyots and from the unique geomorphologic setting, two independent age constraints for the Pacific crust during the Cretaceous “quiet” zone are obtained, allowing a tectonic reconstruction for the formation of the Musicians VERs. Hot spot-ridge interaction leads to asthenosphere channeling from the plume to the nearby spreading center over a maximum distance of 400 km. The Musicians VERs were formed by mainly extrusive volcanism on top of this melt-generating channel. The proposed formation model may be applicable to a number of observed volcanic ridges in the Pacific, including the Tuamotu Isles, the eastern portion of the Foundation chain, and the western termination of the Salas y Gomez seamount chain

Accuracy assessment of an IKONOS derived DSM over urban and suburban area

peer reviewe

Urban use of VHR images on Bukavu (Democratic Republic of Congo)

peer reviewedThe main purpose of this study was to show potential uses of very high resolution (VHR) image in an urban analysis of Bukavu in the Democratic Republic of Congo. As for many of the Third-World cities, Bukavu grew up during the last decades and available topographical information on Bukavu dates back to the middle of the twentieth century. This lack of updated information can be compensated by an appropriate use of VHR images. In this study, IKONOS image recorded on the 14th February 2001 was used. Image registration are highly dependant on accurate Digital Elevation Models (DEM), these last ones are also useful in urban analyses. The range between the minimum and maximum altitudes observed in the image was more than 500 meters. Furthermore, the viewing inclination angle is more than 28 degrees. In this case, orthorectification is mandatory for correcting relief displacements. Nevertheless, the lack of good Ground Control Points (GPS’s) on the old topographic maps and the failure to collect field verification data in Bukavu explains the remaining global 2D RMSE of 10 meters. For easier image interpretation, multispectral (4m) and panchromatic (1m) images were fused together by means of the LMVM algorithm. Depending on the object, the Computer Aided Photo Interpretation (CAPI) uses or does not use the near infrared information (true or false colour composite). For a more detailed interpretation about the city morphology we draped the 1m multispectral fused image over the 1m resolution DEM grid. The Built-up Area Index (BAI) computed on the urban mask obtained by CAPI and classification of the vegetation, was compared with the 1954 situation interpreted from topographic maps. The present city shows higher BAI values and in the same time the centre of the city has clearly shifted southward. Statistical analyses are also done on built-up versus slope data. The lack of good GCP’s and the use of DEM produced inaccurate orthorectification which was not adequate for topographical features extraction. Nevertheless the present extensions of Bukavu built-up areas are more than the double of those observed at the beginning of the last half century. New constructions are located on steeper slopes where landslides are frequents. More features could be extracted from the Ikonos image if good GPS measurements were made and if verification by the city authorities was possible. Some practical applications of this study could involve determining better location of new Bukavu extensions

Magmatic evolution of the Easter Microplate - Crough Seamount region (Southwest Pacific)

The Easter microplate-Crough Seamount region located between 25° S–116° W and 25° S–122° W consists of a chain of seamounts forming isolated volcanoes and elongated (100–200 km in length) en echelon volcanic ridges oriented obliquely NE (N 065°), to the present day general spreading direction (N 100°) of the Pacific-Nazca plates. The extension of this seamount chain into the southwestern edge of the Easter microplate near 26°30′ S–115° W was surveyed and sampled. The southern boundary including the Orongo fracture zone and other shallow ridges ( 0.25) MORBs which are similar in composition to other more recent basalts from the Southwest and East Rifts spreading axes of the Easter microplate. Incompatible element ratios normalized to chondrite values [(Ce/Yb)N = 1−2.5}, {(La/Sm)N = 0.4−1.2} and {(Zr/Y)N = 0.7−2.5} of the basalts are also similar to present day volcanism found in the Easter microplate. The volcanics from the Easter microplate-Crough region are unrelated to other known South Pacific intraplate magmatism (i.e. Society, Pitcairn, and Salas y Gomez Islands). Instead their range in incompatible element ratios is comparable to the submarine basalts from the recently investigated Ahu and Umu volcanic field (Easter hotspot) (Scientific Party SO80, 1993) and centered at about 80 km west of Easter Island. The oblique ridges and their associated seamounts are likely to represent ancient leaky transform faults created during the initial stage of the Easter microplate formation (≈ 5 Ma). It appears that volcanic activity on seamounts overlying the oblique volcanic ridges has continued during their westward drift from the microplate as shown by the presence of relatively fresh lava observed on one of these structures, namely the first Oblique Volcanic Ridge near 25° S–118° W at about 160 km west of the Easter microplate West Rift. Based on a reconstruction of the Easter microplate, it is suggested that the Crough seamount (< 800 m depth) was formed by earlier (7–10 Ma) hotspot magmatic activity which also created Easter Island