Verteporfin plus Ranibizumab for Choroidal Neovascularization in Age-related Macular Degeneration Twelve-month MONT BLANC Study Results

Purpose: To compare the efficacy and safety of same-day verteporfin photodynamic therapy (PDT) and intravitreal ranibizumab combination treatment versus ranibizumab monotherapy in neovascular age-related macular degeneration. Design: Prospective, multicenter, double-masked, randomized, active-controlled trial. Participants: We included 255 patients with all types of active subfoveal choroidal neovascularization. Methods: Patients were randomized 1: 1 to as-needed (pro re nata; PRN) combination (standard-fluence verteporfin 6 mg/m(2) PDT and ranibizumab 0.5 mg) or PRN ranibizumab monotherapy (sham infusion [5% dextrose] PDT and ranibizumab 0.5 mg). Patients received 3 consecutive monthly injections followed by PRN retreatments based on protocol-specific retreatment criteria. Main Outcome Measures: Mean change in best-corrected visual acuity (BCVA) from baseline to month 12, and the proportion of patients with treatment-free interval >= 3 months at any timepoint after month 2. Results: The mean change in BCVA at month 12 was +2.5 and +4.4 letters in the combination and monotherapy groups, respectively (P = 0.0048; difference: - 1.9 letters [95% confidence interval, -5.76 to 1.86], for having achieved noninferiority with a margin of 7 letters). The proportion of patients with a treatment-free interval of >= 3 months at any timepoint after month 2 was high, but did not show a clinically relevant difference between the treatment groups. Secondary efficacy endpoints included the mean number of ranibizumab retreatments after month 2 (1.9 and 2.2 with combination and monotherapy, respectively [P = 0.1373]). The time to first ranibizumab retreatment after month 2 was delayed by 34 days (about 1 monthly visit) with combination (month 6) versus monotherapy (month 5). At month 12, mean +/- standard error central retinal thickness decreased by 115.3 +/- 9.04 mu m in the combination group and 107.7 +/- 11.02 mu m in the monotherapy group. The mean number of verteporfin/sham PDT treatments was comparable in the 2 groups (combination, 1.7; monotherapy, 1.9). The safety profiles of the 2 groups were comparable, with a low incidence of ocular serious adverse events. Conclusions: The combination PRN treatment regimen with verteporfin PDT and ranibizumab was effective in achieving BCVA gain comparable with ranibizumab monotherapy; however, the study did not show benefits with respect to reducing the number of ranibizumab retreatment over 12 months. The combination therapy was well tolerated

Abrasive Wear Resistance of Cast Iron with Precipitates of Spheroidal VC Carbides

The paper presents the results of abrasive wear resistance tests carried out on high-vanadium cast iron with spheroidal VC carbides. The cast iron of eutectic composition was subjected to spheroidising treatment using magnesium master alloy. The tribological properties were examined for the base cast iron (W), for the cast iron subjected to spheroidising treatment (S) and for the abrasion-resistant steel (SH). Studies have shown that high-vanadium cast iron with both eutectic carbides and spheroidal carbides has the abrasion resistance twice as high as the abrasion-resistant cast steel. The spheroidisation of VC carbides did not change the abrasion resistance compared to the base high-vanadium grade

Local Officials as Partisan Operatives: The Effect of County Officials on Early Voting Administration

We explore whether officials in county governments follow their partisan allegiances when selecting and siting early voting locations. Because low-turnout elections are said to benefit Republicans and high-turnout elections to benefit Democrats, we hypothesize that majority-Republican county governments create fewer early voting sites than majority-Democrat county governments. Moreover, we expect the partisan composition of key officials in county government to affect the accessibility of early voting sites, with Republican-dominated county governments placing sites such that less of the population resides proximately. Using an originally collected data set, we assess how counties’ commissioners courts affect the number of sites generally. We then geocode early voting locations in Texas from the 2014, 2016, and 2017 general elections to determine the accessibility of such locations. Our results provide support for our theory that partisan county officials strategically maintain early voting sites to benefit their party\u27s electoral fortunes. Specifically, Republican-majority county governments employ fewer early voting locations than Democrat-majority county governments. Yet, both Democrat and Republican courts site early voting locations similarly. These findings suggest that Republican-majority county governments make decisions that increase the costs of voting by providing fewer sites, while Democrat-majority county governments seek to decrease the costs of voting by offering more sites, with both parties attempting to provide their party an electoral edge. Still, Republican- and Democratic-majority county governments site their early voting locations in similarly accessible ways, suggesting that other factors, besides partisanship, structure site location