Rheumatoid arthritis - treatment: 180. Utility of Body Weight Classified Low-Dose Leflunomide in Japanese Rheumatoid Arthritis

Background: In Japan, more than 20 rheumatoid arthritis (RA) patients died of interstitial pneumonia (IP) caused by leflunomide (LEF) were reported, but many of them were considered as the victims of opportunistic infection currently. In this paper, efficacy and safety of low-dose LEF classified by body weight (BW) were studied. Methods: Fifty-nine RA patients were started to administrate LEF from July 2007 to July 2009. Among them, 25 patients were excluded because of the combination with tacrolimus, and medication modification within 3 months before LEF. Remaining 34 RA patients administered 20 to 50 mg/week of LEF were followed up for 1 year and enrolled in this study. Dose of LEF was classified by BW (50 mg/week for over 50 kg, 40 mg/week for 40 to 50 kg and 20 to 30 mg/week for under 40 kg). The average age and RA duration of enrolled patients were 55.5 years old and 10.2 years. Prednisolone (PSL), methotrexate (MTX) and etanercept were used in 23, 28 and 2 patients, respectively. In case of insufficient response or adverse effect, dosage change or discontinuance of LEF were considered. Failure was defined as dosages up of PSL and MTX, or dosages down or discontinuance of LEF. Last observation carried forward method was used for the evaluation of failed patients at 1 year. Results: At 1 year after LEF start, good/ moderate/ no response assessed by the European League Against Rheumatism (EULAR) response criteria using Disease Activity Score, including a 28-joint count (DAS28)-C reactive protein (CRP) were showed in 14/ 10/ 10 patients, respectively. The dosage changes of LEF at 1 year were dosage up: 10, same dosage: 5, dosage down: 8 and discontinuance: 11 patients. The survival rate of patients in this study was 23.5% (24 patients failed) but actual LEF continuous rate was 67.6% (11 patients discontinued) at 1 year. The major reason of failure was liver dysfunction, and pneumocystis pneumonia was occurred in 1 patient resulted in full recovery. One patient died of sepsis caused by decubitus ulcer infection. DAS28-CRP score was decreased from 3.9 to 2.7 significantly. Although CRP was decreased from 1.50 to 0.93 mg/dl, it wasn't significant. Matrix metalloproteinase (MMP)-3 was decreased from 220.0 to 174.2 ng/ml significantly. Glutamate pyruvate transaminase (GPT) was increased from 19 to 35 U/l and number of leukocyte was decreased from 7832 to 6271 significantly. DAS28-CRP, CRP, and MMP-3 were improved significantly with MTX, although they weren't without MTX. Increase of GPT and leukopenia were seen significantly with MTX, although they weren't without MTX. Conclusions: It was reported that the risks of IP caused by LEF in Japanese RA patients were past IP history, loading dose administration and low BW. Addition of low-dose LEF is a potent safe alternative for the patients showing unsatisfactory response to current medicines, but need to pay attention for liver function and infection caused by leukopenia, especially with MTX. Disclosure statement: The authors have declared no conflicts of interes

Zuarbeiten zu Forschungsprojekten "Industry 4.0" as Promising Technology: Emergence, Semantics and Ambivalent Character Soziologisches Arbeitspapier Nr. 48/2016 "Industry 4.0" as Promising Technology: Emergence, Semantics and Ambivalent Character Herausge

Die Soziologischen Arbeitspapiere erscheinen in loser Folge. Mit ihnen werden Aufsätze (oft als Preprint), sowie Projektberichte und Vorträge publiziert. Die Arbeitspapiere sind daher nicht unbedingt endgültig abgeschlossene wissenschaftliche Beiträge. Sie unterliegen jedoch in jedem Fall einem internen Verfahren der Qualitätskontrolle. Die Reihe hat das Ziel, der Fachöffentlichkeit soziologische Arbeiten aus der Wirtschafts-und Sozialwissenschaftlichen Fakultät der Technischen Universität Dortmund vorzustellen. Anregungen und kritische Kommentare sind nicht nur willkommen, sondern ausdrücklich erwünscht. Abstract This contribution deals with the ongoing discourse about the new quality, perspectives and social consequences of the application of today's digital technologies. It focuses primarily on the German situation. The basic perspective of the German discourse is that new potential applications of digital technologies are opening fully new forms of production and marketing of industrial goods, so that it should now be possible to speak of a foreseeable "Fourth Industrial Revolution", also referred to as "Industry 4.0". The contribution asks about the *conditions for the preconditions for the genesis and development of the discourse on Industry 4.0. Three theses are discussed: First, Industry 4.0 has the character of a "promising technology" based on the premise that advances in digital technologies will bring about new and positive technological, economic and social advantages. This is the point of reference for the expectations and coordinated activities of heterogeneous actors. Second, the precondition for this is a semantic architecture of the promising technology that engenders through a generalizing rhetoric a high degree of societal acceptance of the Industry 4.0 discourse. Third, the technological promise has an ambivalent character. On the one hand it exhibits the character of a techno-utopia with its far-reaching generalization. On the other hand, this discourse has provoked increasingly skeptical and critical positions emphasizing social risks and negative social consequences. Finally, the expectation is formulated that the Industry 4.0 discourse foreseeably will take the path of a typical technological "hype cycle". 3 Introductory remarks 1 The label "Industry 4.0" has intensively characterized for several years the German debate over the future of the industrial sector. Also under this label a great number of R&D, industry, research and policy measures have been initiated in the meantime. The programmatic publications issuing from these initiatives, as well as conferences, congresses and expositions on the topic are now so many as to hardly permit any concise overview. The basic perspective of this discourse is that new potential applications of digital technologies are opening fully new forms of production and marketing of industrial goods, so that it should now be possible to speak of a foreseeable "fourth industrial revolution". This discourse is also occurring in the context of the international debate over the new qualities, perspectives and consequences of the application of today's digital technologies -also called by some the "second machine age", or the "internet of things" The following argumentation will refer primarily to the German debate on Industry 4.0, while exploring the international dimension of the digitization debate rather only marginally and comparatively. The aim will be to shed light to some extent on the increasingly intensive discourse of recent years about Industry 4.0 in regard to the conditions that engendered it and the perspectives for its development, as well as to estimate its foreseeable scope. The following three theses are the point of departure for this: Second, the precondition for this is a semantic architecture of the promising technology that engenders through a generalizing rhetoric a high degree of societal acceptance of the Industry 4.0 discourse. Third, the technological promise has an ambivalent character. On the one hand with its far-reaching generalization it shows a character of a techno-utopia. *On the other hand, it exhibits the character of a techno-utopia with its far-reaching generalization. Paradoxically, on the other hand reacting to this discourse are increasingly skeptical and critical positions that warn of serious negative social risks and consequences. Finally, the expectation is formulated that the Industry 4.0 discourse will foreseeably take the path of a typical technological "hype cycle". The empirical basis of the following argumentation is, for one, information gathered for many years over the course of ongoing observations of the Industry 4.0 discussion at the most various levels of politics and in enterprises. For another thing, the arguments are supported by assessments of documents and Internet sources on the Industry 4.0 discourse, a wider and ongoing literature research, as well as on empirical findings of ongoing research projects on Industry 4.0. 2. On the emergence of the "Industry 4.0" discourse To substantiate the first thesis of "Industry 4.0" as "promising technology" one can refer to an identical concept from sociological innovation research. This concept -also going by the label of the "sociology of expectations" -asks what the coordination mechanisms are between heterogeneous actors in the course of technology development, and what the constitutive conditions are for the emergence of new technology fields (e.g. van The concept can be roughly divided analytically into three sequential process steps. First, the formulation of programmatic development perspectives, called an expectation statement; second, the project of a collective agenda which increasingly structures the actions of participating and interested actors; and third, this interaction context solidifies gradually 5 into a relatively stable action-context with a specific new logic and level of normative commitment. If the Industry 4.0 discourse is analyzed within this conceptual framework, the following steps and sub-steps can be differentiated. Expectation statement Point of departure of the current Industry 4.0 discourse was a projection of future economic development which predicted the technologically grounded potentials as well as far-reaching societal transformations. This projection was first presented to a larger audience during the Hannover Messe in the spring of 2011. The originators of this concept 2 heralded an industrial "paradigm shift" for Germany on the basis of new digital technologies that must be realized without delay. This projection insists that industrial development is currently on the threshold of nothing less than a new, "fourth industrial revolution" driven by the dramatically developing application possibilities of digital and intelligent production technologies. As the urgent reason for this they insist that Germany must be able to assert itself as a production site in a high- Setting a collective agenda In the following step a process emerges that can be understood as the generation of a collectively acknowledged agenda on which is oriented the further behavior of the actors. The central mechanism is that the "expectation statement" undergoes a progressive specification 8 and differentiation of the partial themes, whereby forward-looking scenarios above all gain in significance Semantics of the technological promise Overall, the Industry 4.0 discourse exhibits a strong simultaneous dynamic with the continued structuring of the technologies' development. The "technological promise" has the function of a leitmotiv for the most diverse activities of heterogeneous actors on many social and political levels. Referring to my second thesis (section 1) above, the process of generating a stable discourse arena requires a comprehensible semantic architecture of the technology promise, and discourse mechanisms that make possible through generalization a large measure of widely distributed compatibility. This semantic architecture -to follow Alfred Kieser's instructive discourse-theoretical analysis of "modes and myths" of management

Zuarbeiten zu Forschungsprojekten GOVERNANCE OF COMPLEX SYSTEMS A MULTI-LEVEL MODEL Soziologisches Arbeitspapier Nr. 42/2015 Governance of complex systems A multi-level model Herausgeber: Ansprechpartnerin

Die Soziologischen Arbeitspapiere erscheinen in loser Folge. Mit ihnen werden Aufsätze (oft als Preprint), sowie Projektberichte und Vorträge publiziert. Die Arbeitspapiere sind daher nicht unbedingt endgültig abgeschlossene wissenschaftliche Beiträge. Sie unterliegen jedoch in jedem Fall einem internen Verfahren der Qualitätskontrolle. Die Reihe hat das Ziel, der Fachöffentlichkeit soziologische Arbeiten aus der Wirtschafts-und Sozialwissenschaftlichen Fakultät der Technischen Universität Dortmund vorzustellen. Anregungen und kritische Kommentare sind nicht nur willkommen, sondern ausdrücklich erwünscht

Netzengpässe als Herausforderung für das Stromversorgungssystem. Optionen zur Weiterentwicklung des Marktdesigns

Herausgeber: Deutsche Akademie der Naturforscher Leopoldina e. V

CO2 bepreisen, Energieträgerpreise reformieren. Wege zu einem sektorenübergreifenden Marktdesign

Herausgeber: Deutsche Akademie der Naturforscher Leopoldina e. V

Über eine CO2-Bepreisung zur Sektorenkopplung: Ein neues Marktdesign für die Energiewende. Impuls

Herausgeber: Deutsche Akademie der Naturforscher Leopoldina e.V., acatech und Union der deutschen Akademien der Wissenschafte