A New Switch and Crossing Design: Introducing the Back to Back Bistable Switch

A new track swtich and crossing (S&C), the back to back bistable (B2B) switch, is proposed that has shown potential to significantly reduce the wheel/rail contact forces through the switch due to its more continuous wheel/rail contact interface and more uniform track stiffness arising from the elimination of the crossing nose. This offers a major reduction on maintenance cost of future S&Cs. The paper explains the concept and identifies the design guidelines for a current layout and uses vehicle/turnout dynamic modelling to predict wheel rail forces through a switch to identify performance improvements relative to a conventional S&C. Both multi-body simulation (MBS) and Finite Element (FE) model have been developed to account for dynamic and thermal analysis. The new design has shown improvements in lateral and vertical wheel-rail contact forces and less relative rail displacements due to thermal effect compared to the conventional S&C

Infliximab biosimilar-to-biosimilar switching in patients with inflammatory rheumatic disease:clinical outcomes in real-world patients from the DANBIO registry

OBJECTIVE: Successful uptake of biosimilars in rheumatology is limited by lack of real-world evidence regarding effectiveness of biosimilar-to-biosimilar switching. We investigated infliximab biosimilars CT-P13-to-GP1111 switching among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA). METHODS: Observational cohort study from the DANBIO registry. Patients were classified as originator-naïve or originator-experienced. Retention rates of 1-year GP1111 treatment were explored (Kaplan-Meier). We identified baseline factors (at the time of switch) associated with withdrawal of GP1111 (multivariable Cox-regression analyses with HRs including originator treatment history). Changes in subjective and objective measures of disease activity 4 months before and after the switch were assessed in individual patients. RESULTS: Of 1605 patients (685 RA, 314 PsA and 606 AxSpA, median disease duration was 9 years, 37% in Clinical Disease Activity Index/Ankylosing Spondylitis Disease Activity Score remission), 1171 were originator-naïve. Retention rates at 1-year were 83% (95% CI: 81% to 85%) and 92% (95% CI: 90% to 95%) for the originator-naïve and originator-experienced, respectively. GP1111 retention rates were higher in originator-experienced compared to originator-naïve with RA (HR=0.4 (95% CI: 0.2 to 0.7)) and PsA (HR=0.2 (95% CI: 0.1 to 0.8)), but not significantly for AxSpA: HR=0.6 (95% CI: 0.3 to 1.2). Lower disease activity was associated with higher retention. Changes in disease activity preswitch and postswitch were close to zero. CONCLUSION: This real-world observational study of more than 1600 patients with inflammatory arthritis showed high 1-year retention following a nationwide infliximab biosimilar-to-biosimilar switch. Retention was higher in originator-experienced and in patients with low disease activity, suggesting outcomes to be affected by patient-related rather than drug-related factors