Recent Advances in Treatment of Primary Central Nervous System Lymphoma

Opinion statement Therapeutic options are limited in primary central nervous system lymphoma (PCNSL) with no uniform consensus on optimal management and few published, randomized trials. High-dose methotrexate in combination with other chemotherapeutic agents forms the mainstay of treatment. There hasn’t been much progress beyond high-dose methotrexate in this disease, and although results from trials using high-dose chemotherapy and autologous stem-cell transplant seem promising, these need to be further validated. Moreover, the role of whole brain radiation in the upfront setting remains to be determined. However, international efforts in this direction are underway, with ongoing randomized trials in newly diagnosed PCNSL, more research on the molecular pathogenesis and biomarkers, and the use of novel agents in salvage therapy. There also is emphasis on quality of life parameters and neurocognitive status. Future treatment options should optimize high-efficacy rates while minimizing the risk of neurotoxicity

教育と初期キャリアの関連について

日本教育社会学会第48回大会, 1996年10月(九州大学), 課題研究Ⅰ 大卒雇用の構造変動と大学教

Study of onychomycosis

Background: Onychomycosis is one of the most common fungal nail infections caused by Dermatophytes, Non-Dermatophytic Molds (NDM) and Yeast. Though it is not life-threatening, can cause pain, discomfort, and disfigurement. It decreases the nail growth rate. Objectives: This study was carried out to document the clinico-mycological pattern and antifungal susceptibility pattern of onychomycosis.Methods: The study group included 130 consecutive patients with suspected fungal nail infections, attending Dermatology outpatient department of King George Hospital, Visakhapatnam, Andhra Pradesh during November 2012 to August 2014. The nail clippings of the patients were collected and subjected to KOH mounts for direct microscopy and fungal culture and antifungal susceptibility tests.Results: Onychomycosis was common among males (66.92%) than females (33.08%) with highest incidence was in age group 31-40 years (41.37%). Finger or toenails were exclusively involved in 32.18% and 55.18% patients respectively while these were involved concurrently in the rest of the 12.65% patients. Distal and lateral subungual onychomycosis seen in 64.36% of the patients was the most common clinical type. KOH and culture positivity were recorded in 56.92% and 48.46% cases respectively. Dermatophytes (50.58%) were predominant isolate followed by NDM (27.58%) and yeast (21.84%). Clotrimazole and ketoconazole were most effective antifungals against dermatophytes. For NDM, itraconazole, nystatin and amphotericin B and for yeast fluconazole and itraconazole were effective.Conclusions: The present study gives an insight about the aetiological agents causing onychomycosis and their anti-fungal susceptibility pattern in this region. Thus, it can help in taking adequate control measures to prevent it

Exchange bias effect in alloys and compounds

The phenomenology of exchange bias effects observed in structurally single-phase alloys and compounds but composed of a variety of coexisting magnetic phases such as ferromagnetic, antiferromagnetic, ferrimagnetic, spin-glass, cluster-glass and disordered magnetic states are reviewed. The investigations on exchange bias effects are discussed in diverse types of alloys and compounds where qualitative and quantitative aspects of magnetism are focused based on macroscopic experimental tools such as magnetization and magnetoresistance measurements. Here, we focus on improvement of fundamental issues of the exchange bias effects rather than on their technological importance

Elucidating the role of electron transfer in the photoluminescence of MoS2\mathrm{MoS_{2}} quantum dots synthesized by fs-pulse ablation

Herein, $\mathrm{MoS_{2}}$ quantum dot (QDs) with controlled optical, structural, and electronic properties are synthesized using the femtosecond pulsed laser ablation in liquid (fs-PLAL) technique by varying pulse-width, ablation power, and ablation time to harness the potential for next-generation optoelectronics and quantum technology. Furthermore, this work elucidates key aspects of the mechanisms underlying the near-UV and blue emission, the accompanying large Stokes-shift, and the consequent change in sample color with laser exposure parameters pertaining to $\mathrm{MoS_{2}}$ QDs. Through spectroscopic analysis, including UV-visible absorption, photoluminescence, and Raman spectroscopy, we successfully unravelled the mechanisms for the change in optoelectronic properties of $\mathrm{MoS_{2}}$ QDs with laser parameters. We realize that the occurrence of a secondary phase, specifically $\mathrm{MoO_{3-x}}$, is responsible for the significant Stokes-shift and blue emission observed in this QDs system. The primary factor influencing these activities is the electron transfer observed between these two phases, as validated by excitation dependent photoluminescence, XPS and Raman spectroscopies

NANO-LM: An updated scorecard for the clinical assessment of patients with leptomeningeal metastases

Background There are no validated tools for the clinical neurological assessment of patients with leptomeningeal metastases (LM). However, clinical examination during the course of the disease guides medical management and is part of response assessment in clinical trials. Because neuroimaging may not always be obtained owing to rapid clinical deterioration, clinical neurological assessment of LM is essential, and standardization is important to minimize rater disagreement. Methods The Response Assessment in Neuro-oncology-LM group launched a 2-step process, aiming at improving and standardizing the clinical assessment of patients with LM. We report here on the first step the establishment of a consensus scorecard. The task force had 9 virtual meetings to define general recommendations on neurological assessment and selected domains of interest that should be tested. Results Fourteen domains of neurological symptoms and signs were selected: level of consciousness, cognition, nausea and vomiting, vision, eye movement, facial strength, hearing, swallowing, speech, limb strength, limb ataxia, walking, and bladder bowel functions. For each item, a clear instruction on how to perform the assessment is provided with scoring criteria between 0 and 2. The general clinical status of the patient and use of steroids, pain medications, and antiemetics should be documented. Neurological sequelae from previous brain metastases or cancer treatment should be rated at the baseline evaluation; it should be specified when symptoms or signs may be related to a condition other than LM. Discussion A revised Neurological Assessment in Neuro-Oncology-LM consensus scorecard for clinical assessment has been established. An international prospective validation study of the proposal is currently ongoing (NCT06417710)

Elevated lipoprotein(a) and cardiovascular outcomes in prediabetes and diabetes: a systematic review and meta-analysis

Background: Elevated levels of lipoprotein(a) [Lp(a)] and diabetes have been identified as potential risk factors for coronary artery disease (CAD). This study investigates various Lp(a) levels’ impact on atherosclerotic cardiovascular disease (ASCVD) events in pre-diabetics and diabetics. Methods: We included retrospective studies in English until May 2023, exploring the link between high Lp(a) levels and cardiovascular outcomes in humans with diabetes, prediabetes, or normal glucose levels. Studies were sourced from PubMed, Scopus, and Google Scholar, emphasizing detailed population and outcome data. We excluded studies with major methodological issues, low-quality data, missing key information, duplicates, and non-human subjects. We included high-quality retrospective studies on Lp(a) and cardiovascular outcomes, using risk of bias tools like Newcastle-Ottawa Scale (NOS) to ensure data integrity, and resolved discrepancies through discussion. Binary random-effects models were employed to estimate pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Leave one out sensitivity analysis was performed. Heterogeneity was assessed using I2 statistics. For outcomes showing moderate or high heterogeneity, subgroup analyses were performed for follow-up duration or type of study. Results: A total of 20,271 patients with diabetes, prediabetes, and non-diabetics were included from three studies. In our analysis, compared to non-diabetics with Lp(a) \u3c 10 mg/dL, the risk of ASCVD increased with an increase in Lp(a) levels among pre-diabetics [Lp(a) \u3c 10 mg/dL (HR: 1.40, 95% CI: 1.17–1.67), Lp(a) 10–30 mg/dL (HR: 1.60, 95% CI: 1.30–1.96), Lp(a) \u3e30 mg/dL (HR: 2.08, 95% CI: 1.49–2.90)] and diabetics [Lp(a) \u3c 10 mg/dL (HR: 2.42, 95% CI: 1.97–2.98), Lp(a) 10–30 mg/dL (HR: 2.26, 95% CI: 1.64–3.12), Lp(a) \u3e30 mg/dL (HR: 4.17, 95% CI: 3.24–5.37)] with statistical significance (P\u3c 0.01). Conclusions: High Lp(a) (\u3e30 mg/dL) is associated with more ASCVD events in diabetics and pre-diabetics vs. Lp(a) \u3c 30 mg/dL, underscoring Lp(a)’s clinical importance in risk stratification and intervention