Progressive multifocal leukoencephalopathy reports in rheumatoid arthritis concerning different treatment patterns-an exploratory assessment using the food and drug administration adverse event reporting system

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare but potentially life-threatening brain infection caused by the John Cunningham virus. PML is a known adverse effect associated with molecular-targeted drugs and immunosuppressive agents. Recent concerns have emerged regarding the link between methotrexate (MTX) and PML. However, limited information exists on the influence of concomitant drug use in rheumatoid arthritis (RA) treatment, where various medications are often used together.Methods: To explore treatment patterns and patient background that affect PML reporting in RA, we analyzed data on RA cases from the Food and Drug Administration Adverse Event Reporting System (FAERS; JAPIC AERS) database between 1997 and 2019.Results and Discussion: Our analysis revealed significantly elevated crude and adjusted reporting odds ratios (aROR) for MTX, rituximab (RIT), azathioprine, and cyclophosphamide. When considering treatment patterns, the concomitant use of MTX and RIT showed a higher aROR than using MTX or RIT alone. Additional TNF-α inhibitors or glucocorticoids did not increase PML reports. Moreover, male sex and older age were associated with increased PML reports. While limitations are inherent in studies using spontaneous reporting data, our exploratory assessment suggests an association between PML and the combination of MTX and RIT and a higher risk in men and older patients. These findings help enhance our understanding of PML risk factors in the context of RA treatment

Experimental Results of Network-Assisted Interference Suppression Scheme Using Adaptive Beam-Tilt Switching

This paper introduces a network-assisted interference suppression scheme using beam-tilt switching per frame for wireless local area network systems and its effectiveness in an actual indoor environment. In the proposed scheme, two access points simultaneously transmit to their own desired station by adjusting angle of beam-tilt including transmit power assisted from network server for the improvement of system throughput. In the conventional researches, it is widely known that beam-tilt is effective for ICI suppression in the outdoor scenario. However, the indoor effectiveness of beam-tilt for ICI suppression has not yet been indicated from the experimental evaluation. Thus, this paper indicates the effectiveness of the proposed scheme by analyzing multiple-input multiple-output channel matrices from experimental measurements in an office environment. The experimental results clearly show that the proposed scheme offers higher system throughput than the conventional scheme using just transmit power control

Interleukin-17 Promotes Autoimmunity by Triggering a Positive-Feedback Loop via Interleukin-6 Induction

Tensile deformation and failure behavior at room temperature of the open cell nickel and copper foams with high porosity (96%) fabricated with the slurry foaming process at Mitsubishi Materials Corporation, Japan, was studied. In-situ observation of the deformation and failure behavior was conducted with a digital microscope. Stress-strain curves were measured, in which a non-contact extensometer was employed to detect the strain of the samples accurately. Electric resistance was measured to monitor the damage evolution. Finite element stress analysis was conducted to calculate the morphological change of cells with applied strain and the stress distribution in cells. It was revealed that the deformation and failure progressed through the following four stages; stage I characterized by the elastic deformation, stage II by plastic deformation, stage III by the co-occurrence of plastic deformation and cumulative failure of struts and stage IV by the chain reaction of strut failure nearly in a limited cross-section, respectively. Also it was found that the distribution of failure strain of struts in stage III, measured from the serrations in the stress-strain curve, could be described by the Weibull distribution, with which the transition from stage II to III was identified. Also, the result of the statistical analysis suggested that the average failure strain of the struts in the foam is much higher than the strain at ultimate stress of the foam

Risk factors related to the reduction of subjective taste ability in middle-to old-aged nursing home residents in Sri Lanka : a cross-sectional study

The purpose of this study is to verify the factors significantly related to the reduction of subjective taste ability of 1,015 middle-aged and elderly (50 - 96 years old) at 25 randomized selected nursing homes in Sri Lanka. Binary logistic regression analyses by gender were performed using IBM SPSS on following variables. A dependent variable is taste ability, and 27 independent variables are age, daily lifestyle, nutritional problems, general status, dental status and physiological thresholds of taste abilities (sweet, salt, sour, bitter, and umami). Smell ability (p < 0.001 - 0.05) and the Self-Report Questionnaire, 20-item version :SRQ 20 (p < 0.01 - 0.05) were significant risk factors of reducing taste ability in both genders. Especially, smell ability was closely linked to taste ability. Existence of comprehensive perception of “flavor” composed of taste and smell ability was illustrated. Significant gender differences factors were observed in long term care needs (p < 0.05), sleeping (p < 0.01 - 0.001), bowel condition (p < 0.05) in males; and height (p < 0.05), weight (p < 0.05), BMI 3 categories (p < 0.05), and brushing (p < 0.05) in females. Other variables such as age and five types of physiological taste ability were not significant in both genders. The results of this investigation also strongly indicated that the perception of subjective sense of taste was different from the objective sense of taste. Epidemiological studies such as cohort or intervention studies focusing on a relationship between subjective taste ability and sense of smell are necessary to identify more accurate and changeable risk factors for dysgeusia in order to improve elderly’s nutritional intake in Sri Lanka

Clinical outcomes for olfactory neuroblastoma

BackgroundOlfactory neuroblastoma (ONB) is a rare malignant tumor arising from the olfactory neuroepithelium. The standard of care for ONB is surgical resection; however, detailed treatment protocols vary by institution. Our treatment protocol consists of endoscopic skull base surgery (ESBS) for endoscopically resectable cases and induction chemotherapy followed by craniotomy combined with ESBS for locally advanced cases, with postoperative radiotherapy performed for all cases. Chemoradiotherapy (CRT) is performed in unresectable cases. In this study, we evaluate our treatment protocol and outcomes for ONB.MethodsA retrospective review of patients with ONB was conducted. Outcomes included survival outcomes and perioperative data.ResultsFifteen patients (53.6%) underwent ESBS, 12 (42.9%) underwent craniotomy combined with ESBS, and 1 (3.6%) received CRT. The 5- and 10-year overall survival rates for all patients were 92.9% and 82.5%, respectively, with a median follow-up period of 81 months. The 5- and 10-year disease-free survival rates were 77.3% and 70.3%, respectively, and the 5- and 10-year local control rates were 88.2% and 80.2%, respectively. Patients undergoing ESBS demonstrated a significantly shorter operating time, period from operation to ambulation, hospitalization period, and less blood loss than those undergoing craniotomy combined with ESBS.ConclusionOur treatment protocol was found to afford favorable outcomes. Patients who underwent endoscopic resection showed lower complication rates and better perioperative data than those who underwent craniotomy combined with ESBS. With appropriate case selection, ESBS is considered a useful approach for ONB