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Background:Real world use of oral prophylactic migraine therapies is often limited by poor patient tolerance. The objective of this study was to describe the demographics and clinical characteristics of patients prescribed erenumab following its launch in Canada (September 2018) and to evaluate the real-world treatment persistence and dose management. Methods:This was a retrospective, descriptive analysis of de-identified secondary patient data that includes baseline demographics, clinical characteristics, plus erenumab treatment management, collected through Novartis’ Go Program® (Patient Support Program). Only data collected from patients with a documented informed consent were included in the analysis. Results:14,282 patients met eligibility criteria. The mean age of patients was 46.3 years, 83.0% were female, and 66.1% reported having ≥15 monthly migraine days. 52.5% were initiated on the 140 mg dose of erenumab and 59.3% of those who initiated the 70 mg dose escalated to 140 mg within 360 days. After 360 and 450 days, the KM-derived persistence was 71.0% and 63.4%, respectively. Conclusions:The high persistence reported here suggests that erenumab has a meaningful degree of tolerability in the real-world setting and increases confidence that the real-world use and benefits of erenumab will not be undermined by the poor persistence observed with traditional migraine prophylactic agents.

In the trypsin-mediated semisynthetic transformation of pig insulin into an ester of insulin of human sequence, the B30 alanine residue of the pig hormone is replaced by an ester of threonine. The mechanism of this reaction was investigated by carrying out the transformation in a medium containing water enriched with 18O. Subsequent analysis by combined g.l.c.-mass spectrometry demonstrated that the oxygen isotope, is incorporated into the B29 carbonyl group of the insulin ester product. This result, together with those of appropriate controls, supports the conclusion that the transformation occurs, in the system studied, by a mechanism involving hydrolysis followed by coupling, and not by direct transpeptidation as has been previously found the case for another such system [Markussen & Schaumberg (1983) in Peptides 1982 (Bláha & Malon, eds.), pp. 387-394, W. de Gruyter, Berlin and New York].

Abstract: N-type layers in GaAs with high free electron concentrations have been produced by multiple implantation of Ga, As, or P with dopant species such as Se, Si, or Ge. The implants that have been investigated include Si, Si + P, Ge, Ge + As, Se, and Se + Ga. The multiple implants Si + P, Ge + As, and Se + Ga gave higher peak carrier concentrations, especially at lower anneal temperatures, than did the respective single implants Si, Ge, and Se. In fact, Ge when implanted alone produced a p-type layer while the Ge + As multiple implant produced an n-type layer. Multiple implants with Si and Ge as dopants showed significant thermal diffusion during the anneal. Multiple implants of Ga with Se, on the other hand, resulted in reduced thermal diffusion in comparison with single Se implants.

Seizures during thrombolytic therapy for ischemic stroke have not previously been described as a favorable prognostic sign. We report three patients with severe stroke (NIH Stroke Scale NIHSS score 15 to 20) who experienced a seizure during tissue plasminogen activator (tPA) infusion. While initially raising alarm about possible hemorrhage, the seizures heralded dramatic recovery (an immediate 15-point NIHSS score improvement after tPA; NIHSS score 0 or 1 at 24 hours). We propose that the seizures during thrombolysis may indicate cortical reperfusion and/or hyperperfusion due to early recanalization of an acutely occluded intracranial artery.

THE beautiful research of Lord Rayleigh and Prof. Ramsay has proved up to the hilt that in argon they have discovered an unknown gas which is remarkable for some of its physical properties, and especially for its extraordinary chemical inertness.

At the present time any spectroscopic observations of coloured flames are peculiarly interesting, and I am glad to see the origin of the blue or violet flame produced by common salt and other chlorides again discussed in your pages.

THE new regulation of the Science and Art Department, quoted in Mr. Simmons's letter, was issued only in 1897: it was impossible, therefore, that the effect of it on the day schools could be shown in the tables that form part of our last report. The results may begin to show themselves in the report of next year, but only as an addition to the increase due to the greater attention still being paid to natural science in the lower part of the schools. It is to be hoped that this aggregate increase will be a large one; but it will evidently be very difficult to assign to each cause its proper proportion.

IN the notes that appeared in your journal of December 11 (p. 133), you gave a very full account of some papers lately published in the Bulletin de la Société Chimique de Paris, on optical dispersion, by Messrs. Barbier and Roux.

I OBSERVE that in your issue of June 17 (p. 157) there is an article by Mr. Gordon Thompson on “The Determination of the Index of Refraction of a Fluid by Means of the Microscope.” The method there described was, I believe, first proposed by the Duke de Chaulnes in 1767; and in 1876 was suggested by Dr. Royston Pigott in connection with his refractometer. It was employed in 1878 by Dr. Sorby for recognising the minerals in thin slices of rocks; and in 1884 by Dr. Bleekrode in determining the refraction of liquefied gases (Proc. Royal Society, vol. xxxvii. p. 343). In these two instances the ordinary method was unavailable. The proposed method has not been much used owing to the fact that the index of refraction cannot be at all depended upon beyond the third place of decimals.

WHILE the very valuable display of educational appliances is still on view at the Health Exhibition, I should like to draw attention to the school museums which are becoming now an important element in the teaching of science. In Mr. Lant Carpenter's papers they were only slightly alluded to, though he did full justice to the technical exhibits. In the recent Instructions to Her Majesty's Inspectors it is laid down that an infant school which deserves to be considered “excellent” and to receive a corresponding merit grant should have a cabinet of objects which it is suggested should be partly collected by the children themselves. This of course is making teachers anxious to form such collections, and the London School Board supplies a cabinet wherever there is a promising nucleus for such a museum; it also supplies to any teacher that desires it a small box of chemical apparatus for making simple experiments on these objects, with instructions for the use of the different pieces of apparatus. One of these sets of apparatus forms part of the exhibit of the London Board. Of course the collection of the infants' department will be of a miscellaneous character, but in the museums that are now being formed in many of the boys' and girls' departments something better may be aimed at. The School Cabinet in Room No. 4 is filled principally from the schools in the neighbourhood of South Kensington. There are stuffed birds and a small crocodile, together with neatly-mounted skulls of animals, and specimens of corals, shells, and sponges, all from the collections at Park Walk, Chelsea. From other schools there are the skeleton of a rabbit dissected by a boy of eleven years of age, insects, reptiles, and other objects. There is also a collection from the Silver Street School at Kensington, contributed by scholars, teachers, and managers, comprising colonial products of various descriptions, specimens of different kinds of wood, many of them cut from the trees blown down by the great storm that was so destructive in Kensington Gardens in the autumn of 1881. There are also specimens of horseshoes with their appropriate nails, and illustrations of the successive processes in the manufacture of iron, cotton, and jute. These are all properly named and labelled by the schoolmaster. The lowest shelf of the cabinet contains illustrations of the geology of Peckham, ranging from the sands and gravels of the ancient Thames, the London Clay, the Woolwich and Reading beds, and the Thanet Sands, down to the Chalk. These form part of a fine collection at the Nunhead Passage Board School, Peckham. From the same school also there is a separate cabinet of minerals, which is displayed in the corridor. Some of the training colleges have formed good museums, as is evidenced by the collection from the Wesleyan College in Westminster.