Multiple myeloma (MM) is a plasma cell dyscrasia that is common among patients with autoimmune diseases. However, the association between ulcerative colitis (UC) and multiple myeloma (MM) is yet to ...be established. We aimed to evaluate the prevalence of MM among patients with UC in the United States.
This cross-sectional cohort analysis used the National Inpatient Sample from 2015-2018 to assess the overall MM prevalence among patients with and without UC, and within specific demographic subgroups. Prevalences were compared using a logistic regression model controlling for sex and age.
The crude prevalence of MM among patients with UC (
= 1750) compared with patients without UC (
= 366,265) was 0.44% vs. 0.37%, respectively. Patients with UC had increased overall odds of having MM (odds ratio (OR), 1.26). Males with UC had higher prevalence of MM (53.7% vs. 46.3%, respectively) than females. Patients with UC and MM were more likely to be African American than White (15.6% vs. 9.2%, respectively). Patients with UC age >64 had a higher prevalence of MM than those aged below 65 (70.9% vs. 29.1%, respectively). Patients with UC who were obese (BMI > 30) had a higher prevalence of MM than those who were non-obese (12.6% vs. 8.3%).
Overall, UC appears to be associated with MM. This association can be particularly observed in specific demographic groups, such as obese, African American males, or patients >64 years of age. Thus, a high degree of clinical suspicion for MM is warranted, even with minimal symptomatology, in patients with UC, in particular among elder, obese, and African American males.
The PI3K-AKT pathway has pleiotropic effects, and its inhibition has long been of interest in the management of prostate cancer, where a compensatory increase in PI3K signaling has been reported ...following Androgen Receptor (AR) blockade. Prostate cancer cells can also bypass AR blockade through induction of other hormone receptors, in particular the glucocorticoid receptor (GR). Here we demonstrate that AKT inhibition significantly decreases cell proliferation through both cytostatic and cytotoxic effects. The cytotoxic effect is enhanced by AR inhibition and is most pronounced in models that induce compensatory GR expression. AKT inhibition increases canonical AR activity and remodels the chromatin landscape, decreasing enhancer interaction at the GR gene (NR3C1) locus. Importantly, it blocks induction of GR expression and activity following AR blockade. This is confirmed in multiple in vivo models, where AKT inhibition of established xenografts leads to increased canonical AR activity, decreased GR expression, and marked anti-tumor activity. Overall, our results demonstrate that inhibition of the PI3K/AKT pathway can block GR activity and overcome GR-mediated resistance to AR-targeted therapy. Ipatasertib is currently in clinical development, and GR induction may be a biomarker to identify responsive patients or a responsive disease state.
The Internet of Things (IoT) is the next generation of internet-connected information communication technologies (ICT). IoT typically integrates supply chain activities to enhance green supply chain ...performance (GSCP). Since every organization has different IoT capabilities in comparison with other organizations, GSCP can enable supply chain integration activities for enhanced performance. The implementation of an IoT system can reduce the consumption of organizational resources like energy, electricity, and time and can increase the operational speed to gain better logistics and, ultimately, improved supply chain performance. This study has developed and empirically tested the relationship between IoT capabilities, energy consumption behavior (ECB), supply chain integration, green training (GT), and supply chain practices. Such a multidisciplinary relationship has not previously been established in the literature. The proposed study can fulfill the literature gap and opens new horizons for interdisciplinary research. Data used in this study are collected through offline and online survey methods. A total number of 250 out of 400 respondents participated in the survey. Data has been analyzed through partial least square—structure equation modeling (PLS—SEM) technique. The results of this study empirically test the developed model. IoT has a positive effect on supplier integration (SI), and customer integration (CI). Furthermore, SI and CI have a mediating role between IoT and GSCP, and GT has a positive impact on GSCP. It is concluded that the implementation of IoT can integrate CI and SI to increase GSCP. GT and ECB can ultimately improve GSCP. Additionally, the use of technology and GT can motivate employees to save energy and protect the environment to increase GSCP.
Background The endoscopic endonasal approach (EEA) has been gaining popularity for resection of adult craniopharyngiomas. However, the safety and effectiveness of the procedure in comparison to the ...traditional transcranial approach (TCA) remains unestablished as previous reviews are outdated.
Methods A literature search without language restriction was conducted in PubMed, Cochrane database, and Web of Science from conception to July 9, 2021. Cohort studies and case series that compared EEA with TCA and assessed postoperative complications, recurrence, and 30-day mortality were included. Articles, where data for adult populations could not be extracted or calculated, were excluded. Article selection and data extraction in a predesigned data extraction form were conducted in duplicate. Pooled participant data were included in a random-effects model.
Results The search yielded 227 articles, from which eight cohort studies containing 11,395 patients were included (EEA: 6,614 patients, TCA: 4,781 patients). Six studies were good quality and two were fair quality according to the Newcastle Ottawa Scale. There were significantly higher rates of cerebrospinal fluid leak (risk ratio RR=0.23, 95% confidence interval CI 0.17-0.32, p<0.00001, I2=0%) and lower rates of postoperative hypopituitarism (RR=1.40, 95% CI 1.30-1.51, p<0.00001, I 2 =0%), hydrocephalus (RR=6.95, 95% CI 5.78-8.36, p<0.00001, I2=0%), visual impairment (RR=1.52, 95% CI 1.34-1.73, p<0.00001, I 2 =0%), and 30-day mortality (RR=5.63, 95% CI 3.87-8.19, p<0.00001, I 2 =0%) after EEA. Non-significant lower rates of postoperative diabetes insipidus (RR=1.12, 95% CI 0.78-1.61, p=0.53, I 2 =85%) and recurrence of tumor (RR=2.69, 95% CI 0.35-20.81, p=0.34, I 2 =47%) were seen after EEA.
Conclusion EEA may be associated with reduced postoperative hypopituitarism, hydrocephalus, visual impairment, and 30-day mortality and higher rates of cerebrospinal fluid leak. These findings do not account for differences in tumor size and extension between the EEA and TCA cohorts. Further research on patients with comparable tumor characteristics is required to fully assess outcomes.
BACKGROUNDThe endoscopic endonasal approach (EEA) has been gaining popularity for resection of adult craniopharyngiomas. However, the safety and effectiveness of the procedure in comparison to the ...traditional transcranial approach (TCA) remains unestablished as previous reviews are outdated. METHODSA literature search without language restriction was conducted in PubMed, Cochrane database, and Web of Science from conception to July 9, 2021. Cohort studies and case series that compared EEA with TCA and assessed postoperative complications, recurrence, and 30-day mortality were included. Articles, where data for adult populations could not be extracted or calculated, were excluded. Article selection and data extraction in a predesigned data extraction form were conducted in duplicate. Pooled participant data were included in a random-effects model. RESULTSThe search yielded 227 articles, from which eight cohort studies containing 11,395 patients were included (EEA: 6,614 patients, TCA: 4,781 patients). Six studies were good quality and two were fair quality according to the Newcastle Ottawa Scale. There were significantly higher rates of cerebrospinal fluid leak (risk ratio RR=0.23, 95% confidence interval CI 0.17-0.32, p<0.00001, I²=0%) and lower rates of postoperative hypopituitarism (RR=1.40, 95% CI 1.30-1.51, p<0.00001, I²=0%), hydrocephalus (RR=6.95, 95% CI 5.78-8.36, p<0.00001, I²=0%), visual impairment (RR=1.52, 95% CI 1.34-1.73, p<0.00001, I²=0%), and 30-day mortality (RR=5.63, 95% CI 3.87-8.19, p<0.00001, I²=0%) after EEA. Non-significant lower rates of postoperative diabetes insipidus (RR=1.12, 95% CI 0.78-1.61, p=0.53, I²=85%) and recurrence of tumor (RR=2.69, 95% CI 0.35-20.81, p=0.34, I²=47%) were seen after EEA. CONCLUSIONEEA may be associated with reduced postoperative hypopituitarism, hydrocephalus, visual impairment, and 30-day mortality and higher rates of cerebrospinal fluid leak. These findings do not account for differences in tumor size and extension between the EEA and TCA cohorts. Further research on patients with comparable tumor characteristics is required to fully assess outcomes.
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