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EtanerceptWith regard to difficult-to-treat areas, several clinical studies have provided evidence of the efficacy of etanercept in scalp and nail Psoriasis. An RCT with 124 patients with psoriasis and scalp involvement found that at week 12, there was a mean improvement in Psoriasis Scalp Severity Involvement (PSSI) score of 86.8% in the etanercept group compared with a 20.4% improvement in the placebo group (P < .0001).A retrospective study of nail psoriasis found that at 12 weeks, there was a 41.7% improvement in Nail Psoriasis Severity Index (NAPSI) score in patients treated with etanercept. The efficacy of etanercept in treating other forms of psoriasis such as pustular, erythrodermic, and palmoplantar has been reported in some RCTs, although the vast majority of data have been obtained from case series and reports.

Yes.I shall present data collected by Canadian ORS-2 in the Ardennes area in 1944–45Table 1 Shows that there is an approximate 4: 1 kill ratio for the Tank Destroyers.Three types of Tank Destroyer were deployed here:M10 with 3″ M7 gunM18 with 76 mm gun M1A1M36 with 90 mm M3There was no evidence from the research that one type was more successful than the others. This is to be expected as the main opponents were Panthers. The Panther glacis is invulnerable to all the above guns, the side armour is vulnerable to all.If we look at how vulnerable Tank Destroyers were (Table 2)It is notable that the losses to artillery (41%) are higher than the average tank loss to artillery (11%). See How effective was artillery (not anti-tank guns) at taking out tanks in WW2?Of course the statistics aren’t great, but it makes sense that the open top vehicles are more vulnerable to HE.Tank destroyers were shown to be more effective than anti-tank guns here, and this was confirmed by Ref 2 where they were shown to be 2–3 times more effective in the hands of the British Royal ArtilleryThe Tank Destroys described above were also popular with their crews. Below from Ref 3At the end of WWII in Europe, a Theater General Board was convened to evaluate the effectiveness of tank destroyers in that theatre. Based on studies of 49 actions, they concluded that the tank destroyer was “a most versatile weapon on the battlefield” and battalions had destroyed an average of 34 German tanks and SPGs, 17 artillery and A/T guns with one battalion claiming 105 enemy tanks destroyed.Annex: Combat Reports involving US Tank Destroyer Forces Taken from Reference 5Action 1a. DATE: "shortly after noon," 17 February 1943b. LOCATION: Sbeitla, Tunisiac. UNIT(S) INVOLVED: 601st Tank Destroyer Battalion (Combat Command B, 1st Armored Division) German: Elements of Group Stenkhoff. 21st Panzer 0 Divisiond. DESCRIPTION: 601st TD Battalion was screening the northern flank of CCB, 1st Armored Division,.when it was attacked by three groups of German tanks. It was forced to retreat toward Sbeitla. Se. ADDITIONAL COMMENTS: Fought for at least 1/2 hour, but there is no report of knocking out any German armor.f. MAJOR SOURCE(S) CONSULTED: Howe, Northwest Africa; Howe, Battle History.Action 3a. DATE: 23 March 1943b. LOCATION: El Guettarc. UNIT(S) INVOLVED: 601st TD Battalion; 899th TD Battalion; various battalions of 16th and 18th Infantry, 1st Division.d. DESCRIPTION: Near dawn the 3/16th Infantry and the 3/18th o Infantry encountered the 10th Panzer Divisiop, which was reconnoitering by fire along the northern side of the valley along southern slopes of Djebel el Mcheltat. The 601st TD Battalion was engaged with a "spearhead" until 0700. German attack split into three. One group overran the 32dField Artillery Battalion and part of the 5th Field Artillery Battalion. The battle centered around Hill 336. "German tank-infantry teams overran the American artillery and infantry positions east of Hill 336 in engagements which brought some hand-to-hand encounters, and heavy American losses." When the German attack reached a mine belt, however, it faltered. Losing 8 tanks to the minefield, and "nearly thirty" to TD fire, the German attack faltered. Pulling back a few miles, the German regrouped for a second attack later in the day, which also failed.e. ADDITIONAL COMMENTS: 33 TD guns were lost. This action 0 at El Guettar involved over 100 German tanks, and, quoting from Charles Baily's Faint Praise, displayed "almost a classic example of proper tank destroyer employment" (p. 57, re 601st TD Battalion).f. MAJOR SOURCE(S) CONSULTED: Howe, Northwest Africa, 560- 62 (quoted above); Baily, Faint Praise, 56-57; Carter, 0 "Operations of the Ist Battalion, 18th Infantry."Action 6a. DATE: 11 July 1944b. LOCATION:c. UNIT(S) INVOLVED: 823d Tank Destroyer Battalion; 39th and 47th Infantry Regiments (9th Infantry Division)d. DESCRIPTION: Co. A, 823d TD Battalion supporting 39th Infantry, and Co. C supporting 47th Infantry.Beginning about 0200 Germans attacked and made gains during the dark hours. After daybreak, the TDs were able to maneuver and drive off the German armor, leaving the infantry undefended. Attack was finally repulsed by 1600 after fighting all day. 47th Infantry suffered 124 casualties, and its 3d Battalion had its C.P. overrun and medical detachment captured.e. ADDITIONAL COMMENTS: I did not find this incident in the Green Books.f. MAJOR SOURCE(S) CONSULTED: After Action Report. Destroyer Battalion (photocopy, Armor School Library, F. Gillespie, History of the 47th InfantryAction 18a. DATE: "before daylight," 5 December 1944b. LOCATION: Lucherberg, Germanyc. UNIT(S) INVOLVED: (at the least) Company F, 145th Infantry, 104th I.D. German: 8th Regiment. 3d Parachute Divisiond. DESCRIPTION: "Employing some eight to ten tanks and assault guns and about 450 infantry ... the Germans sneaked into the village through the early morning darkne'ss. For several hours the fighting raged at close quarters. Two of the American tanks and one of the 57-mm. antitank guns were knocked out early in the engagement. One of the towed tank destroyers accounted for two German assault guns which bogged down in the mud on the fringe of the village. Firing upon a German infantryman who apparently was carrying explosives, a squad of American infantry watched in horror as the German literally disintegrated in a loud explosion. An enemy tank laid some direct hits into Company F's command post, killing several men, including the commander and the artillery observer." Nevertheless, thanks to "a noteworthy assist from mortars and artillery, the men of the 415th Infantry were in control of tha situation by 0830."e. ADDITIONAL COMMENTS: German losses included 2 Mark Vs, 2 Mark Vis, and two assault guns. According to 104th Division Artillery AAR, 8,000 rounds were fired in the vicinity of Lucherberg in two hours time.f. MAJOR SOURCE(S) CONSULTED: MacDonald, Siegfried Line.Action 22a. DATE: The Germans dealt their "hardest blows" on 21 December; however, there were numerous engagements with German armor during the period 19 - 22 December 1944.b. LOCATION: Dom Butgenbach, Belgiumc. UNIT(S) INVOLVED: 2/26th Infantry, 1st Infantry Division; 5th FA Battalion, 33d FA Battalion (also 1st I.D.); and other elements from the 26th Combat Team. Also, 634th TD Battalion. For-the first day, the 26th RCT was rather isolated, until the 16th Infantry arrived toward evening.- The 26th Infantry was tied into the 2d Infantry Division on its left flank. By 21 December, the 26th Infantry had "at least" ten FA Battalions in support, as the batteries of the 2d and 99th Infantry Divisions were tied into the 1st Division FCC. German: 25th Panzer Grenadier Regiment, 12th SS Panzer Regiment, 12th SS Panzer Division, or elements thereof, were present.d. DESCRIPTION: About three hours before dawn, 21 December 1944, German artillery began firing against the American front line, and continued until dawn. As Germans began to advance after dawn, American FOs called on "at least" ten battalions of artillery for defensive box barrages, which "succeeded in discouraging the German infantry." German armor attacked the battalion's right, "searching out the automatic weapons which had earlier helped check the infantry assault. ... the BAR and machine gun crews were wiped out." German armor moved through "this gaping hole' and headed for Dom Butgenbach. A Self-Propelled TD (634th TD Battalion) "accounted for seven tanks," and Sherman tanks accounted for two more, before being knocked out. Three German tanks succeeded in entering the village. Two were eventually destroyed by recently arrived 90mm TDs, while the third escaped.e. ADDITIONAL COMMENT'S: Actions against German armor took place 19-22 Doc 44. Artillery received greatest credit for ripelling the attack. Estimate is that over 10,000 rounds of artillery were fired in an 8 hour period.f. MAJOR SOURCE(S) CONSULTED: Cole, The Ardennes, 129 ff. (esp 131-33); CPT D. Rivette, "The Hot Corner at Dom Butgenbach," Infantry Journal (October 1945): 19-23Action 30a. DATE: 30 March 1945b. LOCATION: Kirchboren and other points, six miles from Paderborenc. UNIT(S) INVOLVED: "Task Force Richardson" (elements of 36th Armored Infantry and the 32d Armored), 3d Armored Divisiond. DESCRIPTION: "Hardly had Task Force Richardson resumed the advance when the point bumped into a defensive line hastily manned during the night by students from an SS panzer reconnaissance training battalion and an SS tank training replacement regiment, banded together with support from an SS tank replacement battalion of approximately sixty Tiger and Panther tanks into a unit named SS Ersatzbrigade Westfalen. By mid afternoon Richardson's men had forced their way into a town (Kirchborenj only six miles short of Paderboren. There they fought the rest of the day and much of the night against at least two tanks and more than 200 Germans, most of whom employed Panzerfaust' antitank weapons with suicidal fervor."e. ADDITIONAL COMMENTS: It is surprising that there is not more detail on what happened to all those tanks. The unit history cited below does not mention the sixty tanks. It does, hov'.e-''r, mnention a new German tank destroyer mounting a 128-mm. gun, and mentions the two-tank (destroyed by tank destroyers of the 702d FD Battalion) action.f. MAJOR SOURCE(S) CONSULTED: MacDonald, .as§t Offensive, 352 (quoted); Spearhead in the West, 142-44.ReferencesORS 2 report No 27 Anti Tank Guns in the ArdennesMORU Report 33 Tank Battle AnalysisGabel C R (1985) Seek, Strike and Destroy, US Army Tank Destroyer Doctrine in WWII p52Ibid p64Young V I et al (1990) Anti-Armor Defence Data Study Vol 1 SAIC

Quite effective, according to Operational Research.I shall present data collected by Canadian ORS-2 in the Ardennes area in 1944–45Table 1 Shows that there is an approximate 4: 1 kill ratio for the Tank Destroyers.Three types of Tank Destroyer were deployed here:M10 with 3″ M7 gunM18 with 76 mm gun M1A1M36 with 90 mm M3There was no evidence from the research that one type was more successful than the others. This is to be expected as the main opponents were Panthers. The Panther glacis is invulnerable to all the above guns, the side armour is vulnerable to all.If we look at how vulnerable Tank Destroyers were (Table 2)It is notable that the losses to artillery (41%) are higher than the average tank loss to artillery (11%). See How effective was artillery (not anti-tank guns) at taking out tanks in WW2?Of course the statistics aren’t great, but it makes sense that the open top vehicles are more vulnerable to HE.Tank destroyers were shown to be more effective than anti-tank guns here, and this was confirmed by Ref 2 where they were shown to be 2–3 times more effective in the hands of the British Royal Artillery.The Tank Destroys described above were also popular with their crews. Below from Ref 3At the end of WWII in Europe, a Theater General Board was convened to evaluate the effectiveness of tank destroyers in that theater. Based on studies of 49 actions, they concluded that the tank destroyer was “a most versatile weapon on the battlefield” and battalions had destroyed an average of 34 German tanks and SPGs, 17 artillery and A/T guns with one battalion claiming 105 enemy tanks destroyed.AnnexCombat Reports involving US Tank Destroyer Forces Taken from Reference 5Action 1a. DATE: "shortly after noon," 17 February 1943b. LOCATION: Sbeitla, Tunisiac. UNIT(S) INVOLVED: 601st Tank Destroyer Battalion (Combat Command B, 1st Armored Division) German: Elements of Group Stenkhoff. 21st Panzer 0 Divisiond. DESCRIPTION: 601st TD Battalion was screening the northern flank of CCB, 1st Armored Division,.when it was attacked by three groups of German tanks. It was forced to retreat toward Sbeitla. Se. ADDITIONAL COMMENTS: Fought for at least 1/2 hour, but there is no report of knocking out any German armor.f. MAJOR SOURCE(S) CONSULTED: Howe, Northwest Africa; Howe, Battle History.Action 3a. DATE: 23 March 1943b. LOCATION: El Guettarc. UNIT(S) INVOLVED: 601st TD Battalion; 899th TD Battalion; various battalions of 16th and 18th Infantry, 1st Division.d. DESCRIPTION: Near dawn the 3/16th Infantry and the 3/18th o Infantry encountered the 10th Panzer Divisiop, which was reconnoitering by fire along the northern side of the valley along southern slopes of Djebel el Mcheltat. The 601st TD Battalion was engaged with a "spearhead" until 0700. German attack split into three. One group overran the 32dField Artillery Battalion and part of the 5th Field Artillery Battalion. The battle centered around Hill 336. "German tank-infantry teams overran the American artillery and infantry positions east of Hill 336 in engagements which brought some hand-to-hand encounters, and heavy American losses." When the German attack reached a mine belt, however, it faltered. Losing 8 tanks to the minefield, and "nearly thirty" to TD fire, the German attack faltered. Pulling back a few miles, the German regrouped for a second attack later in the day, which also failed.e. ADDITIONAL COMMENTS: 33 TD guns were lost. This action 0 at El Guettar involved over 100 German tanks, and, quoting from Charles Baily's Faint Praise, displayed "almost a classic example of proper tank destroyer employment" (p. 57, re 601st TD Battalion).f. MAJOR SOURCE(S) CONSULTED: Howe, Northwest Africa, 560- 62 (quoted above); Baily, Faint Praise, 56-57; Carter, 0 "Operations of the Ist Battalion, 18th Infantry."Action 6a. DATE: 11 July 1944b. LOCATION:c. UNIT(S) INVOLVED: 823d Tank Destroyer Battalion; 39th and 47th Infantry Regiments (9th Infantry Division)d. DESCRIPTION: Co. A, 823d TD Battalion supporting 39th Infantry, and Co. C supporting 47th Infantry.Beginning about 0200 Germans attacked and made gains during the dark hours. After daybreak, the TDs were able to maneuver and drive off the German armor, leaving the infantry undefended. Attack was finally repulsed by 1600 after fighting all day. 47th Infantry suffered 124 casualties, and its 3d Battalion had its C.P. overrun and medical detachment captured.e. ADDITIONAL COMMENTS: I did not find this incident in the Green Books.f. MAJOR SOURCE(S) CONSULTED: After Action Report. Destroyer Battalion (photocopy, Armor School Library, F. Gillespie, History of the 47th InfantryAction 18a. DATE: "before daylight," 5 December 1944b. LOCATION: Lucherberg, Germanyc. UNIT(S) INVOLVED: (at the least) Company F, 145th Infantry, 104th I.D. German: 8th Regiment. 3d Parachute Divisiond. DESCRIPTION: "Employing some eight to ten tanks and assault guns and about 450 infantry ... the Germans sneaked into the village through the early morning darkne'ss. For several hours the fighting raged at close quarters. Two of the American tanks and one of the 57-mm. antitank guns were knocked out early in the engagement. One of the towed tank destroyers accounted for two German assault guns which bogged down in the mud on the fringe of the village. Firing upon a German infantryman who apparently was carrying explosives, a squad of American infantry watched in horror as the German literally disintegrated in a loud explosion. An enemy tank laid some direct hits into Company F's command post, killing several men, including the commander and the artillery observer." Nevertheless, thanks to "a noteworthy assist from mortars and artillery, the men of the 415th Infantry were in control of tha situation by 0830."e. ADDITIONAL COMMENTS: German losses included 2 Mark Vs, 2 Mark Vis, and two assault guns. According to 104th Division Artillery AAR, 8,000 rounds were fired in the vicinity of Lucherberg in two hours time.f. MAJOR SOURCE(S) CONSULTED: MacDonald, Siegfried Line.Action 22a. DATE: The Germans dealt their "hardest blows" on 21 December; however, there were numerous engagements with German armor during the period 19 - 22 December 1944.b. LOCATION: Dom Butgenbach, Belgiumc. UNIT(S) INVOLVED: 2/26th Infantry, 1st Infantry Division; 5th FA Battalion, 33d FA Battalion (also 1st I.D.); and other elements from the 26th Combat Team. Also, 634th TD Battalion. For-the first day, the 26th RCT was rather isolated, until the 16th Infantry arrived toward evening.- The 26th Infantry was tied into the 2d Infantry Division on its left flank. By 21 December, the 26th Infantry had "at least" ten FA Battalions in support, as the batteries of the 2d and 99th Infantry Divisions were tied into the 1st Division FCC. German: 25th Panzer Grenadier Regiment, 12th SS Panzer Regiment, 12th SS Panzer Division, or elements thereof, were present.d. DESCRIPTION: About three hours before dawn, 21 December 1944, German artillery began firing against the American front line, and continued until dawn. As Germans began to advance after dawn, American FOs called on "at least" ten battalions of artillery for defensive box barrages, which "succeeded in discouraging the German infantry." German armor attacked the battalion's right, "searching out the automatic weapons which had earlier helped check the infantry assault. ... the BAR and machine gun crews were wiped out." German armor moved through "this gaping hole' and headed for Dom Butgenbach. A Self-Propelled TD (634th TD Battalion) "accounted for seven tanks," and Sherman tanks accounted for two more, before being knocked out. Three German tanks succeeded in entering the village. Two were eventually destroyed by recently arrived 90mm TDs, while the third escaped.e. ADDITIONAL COMMENT'S: Actions against German armor took place 19-22 Doc 44. Artillery received greatest credit for ripelling the attack. Estimate is that over 10,000 rounds of artillery were fired in an 8 hour period.f. MAJOR SOURCE(S) CONSULTED: Cole, The Ardennes, 129 ff. (esp 131-33); CPT D. Rivette, "The Hot Corner at Dom Butgenbach," Infantry Journal (October 1945): 19-23Action 30a. DATE: 30 March 1945b. LOCATION: Kirchboren and other points, six miles from Paderborenc. UNIT(S) INVOLVED: "Task Force Richardson" (elements of 36th Armored Infantry and the 32d Armored), 3d Armored Divisiond. DESCRIPTION: "Hardly had Task Force Richardson resumed the advance when the point bumped into a defensive line hastily manned during the night by students from an SS panzer reconnaissance training battalion and an SS tank training replacement regiment, banded together with support from an SS tank replacement battalion of approximately sixty Tiger and Panther tanks into a unit named SS Ersatzbrigade Westfalen. By mid afternoon Richardson's men had forced their way into a town (Kirchborenj only six miles short of Paderboren. There they fought the rest of the day and much of the night against at least two tanks and more than 200 Germans, most of whom employed Panzerfaust' antitank weapons with suicidal fervor."e. ADDITIONAL COMMENTS: It is surprising that there is not more detail on what happened to all those tanks. The unit history cited below does not mention the sixty tanks. It does, hov'.e-''r, mnention a new German tank destroyer mounting a 128-mm. gun, and mentions the two-tank (destroyed by tank destroyers of the 702d FD Battalion) action.f. MAJOR SOURCE(S) CONSULTED: MacDonald, .as§t Offensive, 352 (quoted); Spearhead in the 'eost, 142-44.ReferencesORS 2 report No 27 Anti Tank Guns in the ArdennesMORU Report 33 Tank Battle AnalysisGabel C R (1985) Seek, Strike and Destroy, US Army Tank Destroyer Doctrine in WWII p52Ibid p64Young V I et al (1990) Anti-Armor Defence Data Study Vol 1 SAIC