A Survey of Research on Productivity Analysis Using Microdata - Impact of Entry, Exit, Economic Globalization, Innovation and Systemic Reform (Japanese)

This paper examines productivity analysis - using firm and business level data, which has rapidly become popular in recent years - from the perspective of three influential factors, namely, entry and exit, globalization, and innovation and systemic reform. It also examines technical aspects, such as the methods for estimating productivity and the availability of data, and summarizes issues for future research, in light of past research developments. It specifically identifies four points as issues for future research: (1) The need for research into the impact of systemic reforms, such as regulatory reform and the liberalization of imports, on entry, exit, and productivity; (2) Improvements in research into the impact of direct inward investment in Japan; (3) Research into the impact on cross-industrial regulations; and (4) Improvements in the environment for the availability of data about companies and businesses.

The exacerbation risk prediction by fractional exhaled nitric oxide in younger and elder children with bronchial asthma

The usefulness of the Fractional exhaled nitric oxide (FeNO) measurements for asthma exacerbation risk prediction in asthmatic children is controversial. Fifty-seven asthmatic children who were regularly treated and had previously been stable for at least 3 months were enrolled. The asthma excerbations risk prediction by the FeNO levels and age contribution on it were investigated. As analyzed all the patients, FeNO cut off value for the significant risk of asthma exacerbation was 36.9 ppb (risk odds was 5.1 [95% C.I., 1.8 to 15.0], chi square valve = 9.0, p=0.0028). However, sensitivity and specificity were not adequate for predicting asthma exacerbation (Sensitivity, 77.8%; Specificity, 59.9%; Area under the curve [AUC], 0.674). These parameters were improved only when 6-10 year old children were assessed (FeNO threshold=39.9 ppb, risk odds=10.2 [3.1 to 33.1], chi square valve 14.8, p=0.0001); Sensitivity, 80.8%; Specificity, 71.8%; AUC, 0.758). High value of FeNO is a risk factor for the asthma exacerbation, and FeNO measurement may be more useful for asthma control in younger children than elder asthmatic children

Sulfamethoxazole / Trimethoprim confer no change on the clinical course of Kawasaki disease

Kawasaki disease (KD) is one of the most common vasculitis in childhood, but its etiology is still unknown. We hypothesized that Sulfamethoxazole / Trimethoprim (S/T) would inhibit overproduction of cytokine due to heat shock protein produced by intestinal bacteria in patients with KD and improve the clinical course of KD indirectly. We have conducted a prospective study to assess the usefulness of S/T for KD. For patients with KD (S/T group, N=23), we use S/T in addition to the standard treatment in the guidelines such as intravenous immunoglobulin (IVIG) and moderate dose aspirin. The control group (non S/T group, N=32) is patients with KD treated with the standard treatment in the guidelines. The baseline characteristics did not demonstrate notable differences between the two groups. We compare duration of fever, rate of initial IVIG failure, the day of illness membranous desquamation appeared, and the occurrence of coronary artery lesion (CAL) between two groups. Membranous desquamation appeared rather earlier in S/T group than in non S/T group (11.4±3.0 day of illness vs 12.9±3.5 day of illness, P=0.078), but there was no statistically significant difference. Duration of fever (39±59 hours vs 42±57 hours, P=0.41), rate of initial IVIG failure (26% vs 31%, P=0.30), and number of CAL (8.6% vs 9.3%, P=0.87) were found no significant difference between two groups. These data indicated that the use of S/T in acute phase of KD didn\u27t improve any clinical course of KD

Long-term survival with RAS-associated autoimmune leukoproliferative disorder with somatic KRAS mutation:A case report

　RAS -associated autoimmune leukoproliferative disorder (RALD) is a recently reported rare nonmalignant autoimmune disorder. The characteristic clinical findings of RALD include monocytosis, leukocytosis, lymphoproliferation, and autoimmune phenomena. RALD is defined by somatic mutations in KRAS or NRAS . It is a new disease that was reported by Niemela and Takagi in 2011. The prognosis and incidence are currently unknown and the treatment strategy has not yet been established.　Here we describe the long-term survival of a patient with who displayed a somatic KRAS G12D mutation. His clinical features and labolatory data were overlapped with juvenile myelomonocytic leukemia and chronic myelomonocytic leukemia. Mercaptopurine hydrate, hydroxycarbamide and azacitizine were administered to control white blood cell count and improve clinical symptoms. He had a long survival time without hematopoietic stem cell transplantation

Feasibility of methotrexate discontinuation following tocilizumab and methotrexate combination therapy in patients with long-standing and advanced rheumatoid arthritis: a 3-year observational cohort study

Objectives: Methotrexate (MTX) is associated with extensive side effects, including myelosuppression, interstitial pneumonia, and infection. It is, therefore, critical to establish whether its administration is required after achieving remission with tocilizumab (TCZ) and MTX combination therapy in patients with rheumatoid arthritis (RA). Therefore, the aim of this multicenter, observational, cohort study was to evaluate the feasibility of MTX discontinuation for the safety of these patients. Methods: Patients with RA were administered TCZ, with or without MTX, for 3 years; those who received TCZ+MTX combination therapy were selected. After remission was achieved, MTX was discontinued without flare development in one group (discontinued [DISC] group, n = 33) and continued without flare development in another group (maintain [MAIN] group, n = 37). The clinical efficacy of TCZ+MTX therapy, patient background characteristics, and adverse events were compared between groups. Results: The disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) at 3, 6, and 9 months was significantly lower in the DISC group (P < .05, P < .01, and P < .01, respectively). Further, the DAS28-ESR remission rate at 6 and 9 months and Boolean remission rate at 6 months were significantly higher in the DISC group (P < .01 for all). Disease duration was significantly longer in the DISC group (P < .05). Furthermore, the number of patients with stage 4 RA was significantly higher in the DISC group (P < .01). Conclusions: Once remission was achieved, MTX was discontinued in patients who responded favorably to TCZ+MTX therapy, despite the prolonged disease duration and stage progression