Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Ligation module for in-vitro selection in DNA computing

In this paper a classical AI problem is proposed to be solved by DNA computing: theorem proving. Since the complexity grows exponentially with the size of the problem, the solving process should be done in parallel. Massive parallelism is one of the advantages of DNA computers. It will be shown that the resolution refutation proof can be readily implemented by DNA hybridisation and ligation. Microreactors lend themselves to a relatively simple implementation of DNA computing. Not only is the design of the DNA critical for the success of the system but also the architecture of the microfluidic structure. Here the DNA performs the computation, while the microfluidics aids the biochemical steps necessary to manipulate the DNA, i.e. hybridisation and ligation

Central Auditory Processing Disorder in Patients with Amnestic Mild Cognitive Impairment

Background. This study was conducted to comprehensively examine the central auditory processing (CAP) abilities of patients with amnestic mild cognitive impairment (aMCI) as well as to compare the results with cognitively normal elderly controls. Methods. A total of 78 participants were screened through pure-tone audiometry and word recognition score in order to exclude peripheral auditory dysfunction. Forty-five people passed screening tests, and 33 people failed. Finally, 25 aMCI (mean age = 71.52±4.8; male : female = 24 : 76) and 20 controls (mean age = 73.45±4.32; male : female = 45 : 55) were enrolled in the study. Seven CAP tests (frequency pattern test, duration pattern test, Gap-In-Noise© test, dichotic digits test, low-pass filtered word test, speech perception in noise test, and binaural fusion test) were conducted only after the two groups passed the screening. A linear mixed model was applied to analyze CAP tests except for the binaural fusion test. For the binaural fusion test, the independent t-test was used to compare the means of test score between two groups. Results. The aMCI group had a decrease in the mean score of the frequency pattern test, duration pattern test, Gaps-In-Noise© test, dichotic digits test, and speech perception in noise test compared with the control group. Conclusion. The aMCI group’s CAP abilities were significantly lower than those of the control group. Thus, if the cognitive assessment and hearing evaluation are conducted in combination, the sensitivity of the diagnostic process for aMCI will be increased

A flat-field soft X-ray spectrometer for X-ray absorption spectroscopy measurement of warm dense matter

A flat-field soft X-ray spectrometer operating in the spectral range of 250–1240 eV was designed and built for warm dense matter and high-energy density plasma physics. It employs a grazing incidence toroidal mirror as a focusing optic, an aberration-corrected varied line-spacing concave grating with 2400 lines/mm as a dispersive element, and a charge coupled device as an X-ray detector. The dispersion and energy resolution are calibrated with a high-power laser-produced plasma and X-ray free electron laser sources. A resolving power over 370 was achieved over the entire spectral range. A super broadband spectrum in the range of 250–1000 eV was measured from the laser-produced bismuth plasma. The signal-to-noise ratio of 130 was obtained with an average of 10 pulses. These results demonstrate the capability of the spectrometer for single laser shot based experiments for warm dense matter and high energy density plasma research. © 2018 Elsevier B.V11sciescopu

Postmorbid learning of saxophone playing in a patient with frontotemporal dementia

<p>Some patients with frontotemporal dementia (FTD) show an artistic enhancement of musical abilities. However, no patients with FTD, to date, have been reported to be able to learn how to play a musical instrument after disease onset. Herein we describe a patient (J. K.) who had never played any musical instruments premorbidly, but who learned to play the saxophone after being diagnosed with a behavioral variant of FTD. He mastered a repertoire that consisted of 10 pieces of Korean folk songs over a period of three years. Furthermore, his saxophone skills were high enough to outperform other students in his class.</p