ic activity by 6.2% and 12.8% at low temperature. The goal of this study was the assessment of long-term outcome of dorsal capsular imbrication of the distal radioulnar joint (DRUJ) in dorsal instability. The study included ten patients (mean 38.7years of age) with a mean follow-up time of 11.2years (9.3years to 14.3years). Examination parameters included Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, modified Mayo Wrist Score (MMWS), determination of range of motion in comparison with the healthy extremity, pre- and post-operative pain level assessment, and examination of DRUJ stability. Eight of ten DRUJs proved to be stable after the above-mentioned follow-up. Mean MMWS was 92.5 (65-100; SD 11.1). Mean DASH Score was 8.8 (0-60; SD 18.4). Grip strength reached 93.5% of the contralateral unaffected hand. Range of motion did not differ significantly in comparison with the healthy contralateral extremity. Nine of ten patients regarded pain level reduction as excellent. Eight of ten patients regarded DRUJ stability as excellent after surgery. Dorsal capsular imbrication of the DRUJ is an efficacious surgical technique for post-traumatic dorsal instability in the long-term.Dorsal capsular imbrication of the DRUJ is an efficacious surgical technique for post-traumatic dorsal instability in the long-term. Testing is required in medical education. The large number of exams that students face requires effective learning strategies. Various methods of improving knowledge retention and recall have been discussed, two of the most widely evaluated of which are test-enhanced learning and pause procedures. This study investigated the effect of voluntary multiple-choice questions on students' performance. In a prospective study from April 2013 to March 2015, 721 students were randomly assigned to receive supplementary online material only (control group) or additional multiple-choice questions (investigative group) accompanying lectures. Their performance in the final exam was evaluated. A total of 675 students were ultimately included, with 299 randomly assigned to the investigative group and 376 to the control group. Students in the investigative group scored significantly better in relation to grades and points (2.11 vs. 2.49; 33 vs 31.31; p < 0.05). The effect declined over time. This is the first study of the use of voluntary multiple-choice questions to improve medical students' performance. The results support test-enhanced learning and the feasibility of implementing multiple-choice questions in lectures.This is the first study of the use of voluntary multiple-choice questions to improve medical students' performance. The results support test-enhanced learning and the feasibility of implementing multiple-choice questions in lectures.Lenalidomide (Len) and dexamethasone (dex) therapy is a standard therapy in patients with multiple myeloma. Elderly or unfit patients may reduce Len or dex doses to prevent toxicities that lead to treatment discontinuation. However, there have been few studies evaluating the efficacy and safety of lower doses of Len and dex. We conducted a phase II study of 1.5-year low-dose Len and dex therapy following melphalan and prednisolone (MP), the number of which cycles was determined by a response within 9 cycles. The Len dose was 10 mg daily and the dex dose was 20 mg weekly, which were continued for 1.5 years. Twenty-one patients were enrolled. The median number of cycles of MP was 3 (range, 2-9). The overall response rate was 81% and a very good partial response or better was achieved in 33.3% of patients. selleck The median follow-up time for survivors was 70.5 months (range, 42-83 months), the median progression-free survival (PFS) was 27 months (95% CI, 21-33 months), and the median overall survival was not reached. Grade 3 or 4 adverse events were observed in 28.6% of patients. In conclusion, the low-dose Len and dex therapy safely achieved comparable efficacies to the standard-dose regimen in elderly patients with newly diagnosed multiple myeloma. UMIN000007889.Adoptive transfer of Bispecific antibody Armed activated T cells (BATs) showed promising anti-tumor activity in clinical trials in solid tumors. The cytotoxic activity of BATs occurs upon engagement with tumor cells via the bispecific antibody (BiAb) bridge, which stimulates BATs to release cytotoxic molecules, cytokines, chemokines, and other signaling molecules extracellularly. We hypothesized that the release of BATs Induced Tumor-Targeting Effectors (TITE) by this complex interaction of T cells, bispecific antibody, and tumor cells may serve as a potent anti-tumor and immune-activating immunotherapeutic approach. In a 3D tumorsphere model, TITE showed potent cytotoxic activity against multiple breast cancer cell lines compared to control conditioned media (CM) Tumor-CM (T-CM), BATs-CM (B-CM), BiAb Armed PBMC-CM (BAP-CM) or PBMC-CM (P-CM). Multiplex cytokine analysis showed high levels of Th1 cytokines and chemokines; phospho-protein signaling array data suggest that the prominent JAK1/STAT1 pathway may be responsible for the induction and release of Th1 cytokines/chemokines in TITE. In xenograft breast cancer models, IV injections of 10× concentrated TITE (3×/week for 3 weeks; 150 μl TITE/injection) was able to inhibit tumor growth significantly (ICR/scid, p  less then  0.003; NSG p  less then  0.008) compared to the control mice. We tested the key components of the TITE for immune activating and anti-tumor activity individually and in combinations, the combination of IFN-γ, TNF-α and MIP-1β recapitulates the key activities of the TITE. In summary, master mix of active components of BATs-Tumor complex-derived TITE can provide a clinically controllable cell-free platform to target various tumor types regardless of the heterogeneous nature of the tumor cells and mutational tumor.Maintaining balance during quiet standing is a challenging task for the neural control mechanisms due to the inherent instabilities involved in the task. The feedback latencies and the lowpass characteristics of skeletal muscle add to the difficulty of regulating postural dynamics in real-time. Inverted-pendulum (IP) type robotic models have served as a popular paradigm to investigate control of postural balance. In this study, an in-depth neuromechanical postural control model is developed from physiological principles. The model comprises a single-segment IP robotic model, Hill-type muscle model, and proprioceptive feedback from the muscle spindle (MS) and golgi tendon organ (GTO). An optimal proportional-integral-derivative (PID) controller is proposed to realize effective postural control amid latencies in sensory feedback. The neural commands for postural stabilization are generated by a time-varying PID controller, tuned using linear quadratic regulator (LQR) principles. Computer simulations are used to assess the efficacy of the tuned PID-LQR controller.