ObjectiveTo investigate whether antidrug antibodies and/or drug non‐trough levels predict the long‐term treatment response in a large cohort of patients with rheumatoid arthritis (RA) treated with adalimumab or etanercept and to identify factors influencing antidrug antibody and drug levels to optimize future treatment decisions.MethodsA total of 331 patients from an observational prospective cohort were selected (160 patients treated with adalimumab and 171 treated with etanercept). Antidrug antibody levels were measured by radioimmunoassay, and drug levels were measured by enzyme‐linked immunosorbent assay in 835 serial serum samples obtained 3, 6, and 12 months after initiation of therapy. The association between antidrug antibodies and drug non‐trough levels and the treatment response (change in the Disease Activity Score in 28 joints) was evaluated.ResultsAmong patients who completed 12 months of followup, antidrug antibodies were detected in 24.8% of those receiving adalimumab (31 of 125) and in none of those receiving etanercept. At 3 months, antidrug antibody formation and low adalimumab levels were significant predictors of no response according to the European League Against Rheumatism (EULAR) criteria at 12 months (area under the receiver operating characteristic curve 0.71 [95% confidence interval (95% CI) 0.57, 0.85]). Antidrug antibody–positive patients received lower median dosages of methotrexate compared with antidrug antibody–negative patients (15 mg/week versus 20 mg/week; P = 0.01) and had a longer disease duration (14.0 versus 7.7 years; P = 0.03). The adalimumab level was the best predictor of change in the DAS28 at 12 months, after adjustment for confounders (regression coefficient 0.060 [95% CI 0.015, 0.10], P = 0.009). Etanercept levels were associated with the EULAR response at 12 months (regression coefficient 0.088 [95% CI 0.019, 0.16], P = 0.012); however, this difference was not significant after adjustment. A body mass index of ≥30 kg/m2 and poor adherence were associated with lower drug levels.ConclusionPharmacologic testing in anti–tumor necrosis factor–treated patients is clinically useful even in the absence of trough levels. At 3 months, antidrug antibodies and low adalimumab levels are significant predictors of no response according to the EULAR criteria at 12 months.

Abstract

The important issue for Designing architecture isthe evolution of Artificial Neural Network (ANN). There is no systematic method to design a near-optimal architecture for a given application or task. The pattern classification methods are used to design the neural network architectures and efforts towards the automatic design of network topologies, constructive and destructive algorithms can be used. In the proposed work the optimization of architectures and connection weights uses the evolutionary process. A singlepoint crossover is applied with selective schemas on the network space and evolution is introduced in the mutation stage so that an optimized ANNs are achieved.

In Wideband code-division multiple-access (WCDMA) systems, all users share the same time and frequency resources and may lead to near far problem, where power control forms an effective solution. A power control algorithm aims to reduce transmission power and interference level, and to maximize system capacity. In this paper, we propose an adaptive power control mechanism for multimedia traffic in WCDMA networks. The proposed algorithm uses two most recent Transmit Power Control (TPC) commands to compute the Adaptive Factor (AF) based on a predefined Adaptive Control Factor (ACF). We introduce another parameter, Power Determining Factor (PDF) based on the data traffic rate to determine the power. Based on this parameter, the power is increased or decreased. Depending on the traffic rate, the PDF factor is updated i.e., if the observed traffic rate is high, then it will increase the parameter and subsequently increases the power and if it is low, then the parameter will be decreased and correspondingly the power also. By simulation results, we show that the proposed power control algorithm reduces the power consumption of multimedia traffic.

Ahstract-This paper describes the High capacity energy efficient Dynamic MAC protocol (HCEEDMAC) for WCDMA wireless multimedia networks to allocate system resources to multimedia users for QoS provisioning and for high resource utilization. The protocol is designed to support high capacity, Energy efficient and high throughput by using interference control and congestion control. High throughput is achieved by Dynamic MAC protocol (DMAC) using contention based scheduling. High capacity and Energy efficiency are achieved by using Adaptive Power Control technique (APC) which reduces the interference level and Adaptive Call Admission control (ACA) mechanism which controls the congestion by reducing the call blocking probability. By simulation results, we show that our proposed HCEEDMAC protocol achieves high capacity, Energy efficient and high throughput for multimedia data transmission.