Search

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is part of the variant type of the Stiff Person Syndrome (SPS) and is a rare neurological disease. We report here a patient with PERM who had thymoma and was positive for anti-glutamic acid decarboxylase (anti-GAD) antibodies. Her symptoms improved after treatment with hormones and gamma globulin. We also summarized the literature review of patients with PERM accompanied by tumors reported. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the efficacy and safety of adding anti‐epidermal growth factor receptor [EGFR] MoAbs to various chemotherapy regimens in patients with RAS wild‐type metastasized colorectal cancer (RAS WT metastatic colorectal cancer [mCRC]) and to identify the optimal combination regimens. Methods: We searched MEDLINE, EMBASE, and CENTRAL from the inception date to 20th May 2019. Randomized clinical trials investigating chemotherapy with or without anti‐EGFR MoAbs in treatment of patients with RAS WT mCRC were included. Results: Eighteen studies involving 8848 participants were eligible. Comparing with oxaliplatin‐based chemotherapy, adding anti‐EGFR MoAbs benefited only in progression‐free survival (PFS) (hazard ratio [HR] = 0.80, 95% confidence interval [CI]: 0.67 to 0.94), but not in overall survival (OS) (HR = 0.89, 95% CI: 0.78 to 1.02). Further sensitivity analysis indicated that adding anti‐EGFR MoAbs to FOLFOLX regimen as a first‐line treatment showed benefits in both PFS and OS (PFS: HR = 0.74, 95% CI: 0.64 to 0.84; OS: HR = 0.83, 95% CI: 0.73 to 0.95, respectively). Comparing with irinotecan‐based chemotherapy or best supportive care, adding anti‐EGFR MoAbs revealed an improvement in both PFS (HR = 0.77, 95% CI: 0.69 to 0.86; HR = 0.46, 95% CI: 0.40 to 0.54, respectively) and OS (HR = 0.89, 95% CI: 0.80 to 0.98; HR = 0.65, 95% CI: 0.54 to 0.78, respectively). Conclusion: Anti‐EGFR MoAbs as a monotherapy or in combination with either irinotecan‐based chemotherapy or FOLFOX in patients with RAS wild‐type mCRC have better response and survival outcome, whereas OS does not benefit from adding anti‐EGFR MoAbs to another oxaliplatin‐based regimen. Anti‐EGFR MoAbs have increased the risk of adverse effects than chemotherapy alone. More high‐quality randomized controlled trials for RAS wild type are necessary. [ABSTRACT FROM AUTHOR]

We develop a model and a genetic algorithm for determining an optimal replacement policy for power equipment subject to Poisson shocks. If the time interval of two consecutive shocks is less than a threshold value, the failed equipment can be repaired. We assume that the operating time after repair is stochastically nonincreasing and the repair time is exponentially distributed with a geometric increasing mean. Our objective is to minimize the expected average cost under an availability requirement. Based on this average cost function, we propose the genetic algorithm to locate the optimal replacement policy N to minimize the average cost rate. The results show that the GA is effective and efficient in finding the optimal solutions. The availability of equipment has significance effect on the optimal replacement policy. Many practical systems fit the model developed in this paper. [ABSTRACT FROM AUTHOR]