Guillain–Barré syndrome (GBS) is an immune–mediated neuropathy that causes acute flaccid paralysis. Immunoglobulin and plasma exchange are established treatments for GBS ; however, a substantial number of patients, particularly those with severe disease, have poor recovery and residual deficits. Recent studies suggest that complement activation plays a pivotal role in GBS–associated axonal degeneration, and eculizumab is a humanized monoclonal antibody that specifically binds to complement component 5 and potently inhibits complement activation.

This clinical trial aims to evaluate the efficacy and safety of eculizumab for treatment of GBS.

The Japanese Eculizumab Trial for GBS (JET–GBS) is a prospective, multicenter, placebo–controlled, double–blind, randomized phase II study conducted at 13 tertiary neurology centers and is funded by the Japan Agency for Medical Research and Development. A total of 34 GBS patients unable to walk independently within 2 weeks from symptom onset (Hughes functional grade 3–5) were randomized at a 2 : 1 ratio to receive either intravenous eculizumab (900mg/day) or placebo once weekly for 4 weeks, followed by 20 weeks of follow–up. The primary endpoint for efficacy is the proportion of patients who regain their ability to walk without aid at 4 weeks after the first dose of the study treatment, while primary safety outcomes are the incidence of adverse events and serious adverse events during the trial. Enrollment for the trial began in August 2015, and follow–up of the last patient was completed in October 2016. This study is the first to investigate the efficacy and safety of eculizumab for GBS. In case of a positive result, we will plan a phase III trial to investigate this issue in a larger number of patients.

Registered with CLINICALTRIAL : UMIN Clinical Trials Registry UMIN 000018171 ; https:/upload.umin.ac.jp/cgi–open–bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&language=J&recptno=R000020978 (Archived by

A new wood-inhabiting fungal species, Xylodon kunmingensis, is proposed based on morphological and molecular evidences. The species is characterized by an annual growth habit, resupinate basidiocarps with cream to buff hymenial, odontioid surface, a monomitic hyphal system with generative hyphae bearing clamp connections and oblong-ellipsoid, hyaline, thin-walled, smooth, inamyloid and indextrinoid, acyanophilous basidiospores, 5–5.8 × 2.8–3.5 μm. The phylogenetic analyses based on molecular data of ITS sequences showed that X. kunmingensis belongs to the genus Xylodon and formed a single group with a high support (100% BS, 100% BP, 1.00 BPP) and grouped with the related species X. astrocystidiatus, X. crystalliger and X. paradoxus. Both morphological and molecular evidences confirmed the placement of the new species in Xylodon.

Two new wood-inhabiting fungal species, Tubulicrinis xantha and T. yunnanensis spp. nov., are described based on morphological and molecular characters. Tubulicrinis xantha is characterized by resupinate, furfuraceous basidiomata with buff to yellowish hymenial surface, amyloid lyocystidia and cylindrical to allantoid, hyaline, thin-walled, smooth basidiospores (5.3–6.3 × 1.2–1.6 μm). Tubulicrinis yunnanensis is characterized by pruinose basidiomata with primrose to olivaceous hymenial surface and encrusted lyocystidia and cylindrical, hyaline, thin-walled, smooth basidiospores (4.2–6.2 × 1.2–2 μm). Sequences of ITS and LSU nrRNA gene regions of the studied samples were generated, and phylogenetic analyses were performed with maximum likelihood, maximum parsimony and bayesian inference methods. The phylogenetic analyses based on molecular data of ITS and ITS + nLSU sequences showed that T. xantha grouped with T. martinicensis, and T. yunnanensis grouped with T. glebulosus.

Two new species, Hyphoderma fissuratum and H. mopanshanense spp. nov., are proposed based on morphological and molecular evidences. Hyphoderma fissuratum is characterized by resupinate basidiomata with cracking hymenial surface, a monomitic hyphal system with generative hyphae bearing clamp connections, IKI–, CB–, and cylindrical, colorless, thin-walled, smooth basidiospores measuring (8.5–10.3 × 3–4 µm). Hyphoderma mopanshanense is characterized by an annual growth habit, slight gray to cream hymenial surface, and fusiform, thick-walled cystidia apically encrusted with crystal. Sequences of ITS and LSU nrRNA gene regions of the studied samples were generated, and phylogenetic analyses were performed with maximum likelihood, maximum parsimony and Bayesian inference methods. These phylogenetic analyses based on molecular data of ITS and nLSU sequences showed that two Hyphoderma new species formed a well supported monophyletic lineage distinct from other related species and then H. fissuratum grouped with H. medioburiense and H. roseocremeum. Hyphoderma mopanshanense grouped with H. setigerum.

Wood-rotting fungi are important components of woody plant ecosystems and play an active role in the decomposition and turnover of nutrients from wood, and are among the major groups of Basidiomycota. In this study, a new species of wood-rotting fungus, Sistotrema yunnanense, was proposed based on morphological characteristics and molecular evidence. It is characterized by resupinate basidiomata, a monomitic hyphal system having generative hyphae with clamp connections, suburniform to urniform basidia, and short-cylindrical to oblong ellipsoid basidiospores (4.5-6.5 × 3-4 µm). Phylogenetic analyses performed using the large subunit nuc rDNA indicated that S. yunnanense was nested within the genus Sistotrema s.l. of the family Hydnaceae, within the order Cantharellales.

Two new wood-inhabiting fungal species, Steccherinum hirsutum and S. yunnanense spp. nov., are proposed based on a combination of morphological features and molecular evidence. Sequences of internal transcribed spacer and large subunit region of nuculear ribosomal RNA gene of the studied samples were generated, and phylogenetic analyses were performed using maximum likelihood, maximum parsimony and bayesian inference methods. Steccherinum hirsutum is characterized by an annual growth habit, stipitate basidiocarps with scarlet to red, odontioid hymenial surface, a dimitic hyphal system with clamped generative hyphae negative in Melzer's reaction, and acyanophilous basidiospores measuring 2.5-3.5 × 1.5-2.5 µm. Steccherinum yunnanense is distinguished by resupinate basidiomata with odontioid hymenial surface, a dimitic hyphal system with clamped generative hyphae, strongly encrusted cystidia and ellipsoid, hyaline, thin-walled, smooth basidiospores (3.5-4.5 × 2-3.5 µm). The phylogenetic analyses comfirmed that two new species nest in Steccherinum, in the residual polyporoid clade.

Aims: Employers in the United States incur substantial costs associated with substance use disorders. Our goal was to examine the effectiveness of employer-led interventions to reduce the adverse effects of drug misuse in the workplace.

Methods: We conducted a systematic review of studies that evaluated the effectiveness of recommended workplace interventions for opioids and related drugs: employee education, drug testing, employee assistance programs, supervisor training, written workplace drug-free policy, and restructuring employee health benefit plans. We searched PubMed MEDLINE, EMBASE (embase.com), PsycINFO (Ebsco), ABI Inform Global, Business Source Premier, EconLit, CENTRAL, Web of Science (Thomson Reuters), Scopus (Elsevier), Proquest Dissertations, and Epistemonikos from inception through May 8, 2019, with no date or language restrictions. We included randomized controlled trials, quasi-experimental studies, and cross-sectional studies with no language or date restrictions. The Downs and Black questionnaire was used to assess the quality of included studies. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results: In all, 27 studies met our inclusion criteria and were included in the systematic review. Results were mixed, with each intervention shown to be effective in at least one study, but none showing effectiveness in over 50% of studies. Studies examining the impact of interventions on workplace injuries or accidents were more commonly reported to be effective. Although four studies were randomized controlled trials, the quality of all included studies was “fair” or “poor.”

Conclusions: Despite the opioid epidemic, high-quality studies evaluating the effectiveness of employer-led interventions to prevent or reduce the adverse effects of substance use are lacking. Higher quality and mixed methods studies are needed to determine whether any of the interventions are generalizable and whether contextual adaptations are needed. In the meantime, there is a reason to believe that commonly recommended, employer-led interventions may be effective in some environments.