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Is there an association between HPV vaccination and anti-NMDA receptor encephalitis?

Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute autoimmune disorder that develops both neurological symptoms and psychiatric symptoms,…

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Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute
autoimmune disorder that develops both neurological symptoms and psychiatric
symptoms, including hallucination, cognitive disturbance, epilepsy, movement
disorder, and impaired consciousness. This disease may be misdiagnosed at the early
stage as a psychosis disease because of primary psychiatric symptoms. The
misdiagnosis may delay appropriate therapeutic intervention. Most patients with
anti-NMDA receptor encephalitis respond to immunotherapy [1, 2].
The pathology of this disease is an autoimmunity reaction that anti-NMDA
antibodies attack patients’ brains. Tumors might induce anti-NMDA receptor
immune responses due to cross-reactivity with NMDA receptors in teratomas
containing brain cells. Ovarian teratomas could trigger anti-NMDA receptor
encephalitis, and other tumors including neuroendocrine tumors, mediastinal
teratomas, testicular teratomas, and small-cell lung carcinoma have been reported
to be associated with anti-NMDA antibodies [3]. Recently, it was reported that stress
might cause this disease, and stress management may prevent relapse.
In addition to tumors and stress, other types of encephalitis or vaccinations may
trigger anti-NMDA receptor encephalitis [4-7]. Japanese encephalitis (JE) and herpes
simplex virus (HSV) encephalitis might induce anti-NMDA receptor encephalitis.
Several anti-NMDA receptor encephalitis cases have been reported to be associated
with vaccination, including JE, influenza A virus subtype H1N1,
odiphtheria/pertussis/tetanus/poliomyelitis vaccination or coronavirus disease 2019
(COVID-19) vaccinations.
In addition to these vaccines, cases of papillomavirus (HPV) vaccination triggering
anti-NMDA receptor encephalitis have been reported, but the underlying mechanism
has not been explored. HPV vaccination prevents infections with HPV, which can
cause cervical cancer (CC). CC is one of the most common cancers threatening
women's health that develops in a woman's cervix. Cases of adverse events related

Credit: Image Rights belong to Bentham Science

Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute
autoimmune disorder that develops both neurological symptoms and psychiatric
symptoms, including hallucination, cognitive disturbance, epilepsy, movement
disorder, and impaired consciousness. This disease may be misdiagnosed at the early
stage as a psychosis disease because of primary psychiatric symptoms. The
misdiagnosis may delay appropriate therapeutic intervention. Most patients with
anti-NMDA receptor encephalitis respond to immunotherapy [1, 2].
The pathology of this disease is an autoimmunity reaction that anti-NMDA
antibodies attack patients’ brains. Tumors might induce anti-NMDA receptor
immune responses due to cross-reactivity with NMDA receptors in teratomas
containing brain cells. Ovarian teratomas could trigger anti-NMDA receptor
encephalitis, and other tumors including neuroendocrine tumors, mediastinal
teratomas, testicular teratomas, and small-cell lung carcinoma have been reported
to be associated with anti-NMDA antibodies [3]. Recently, it was reported that stress
might cause this disease, and stress management may prevent relapse.
In addition to tumors and stress, other types of encephalitis or vaccinations may
trigger anti-NMDA receptor encephalitis [4-7]. Japanese encephalitis (JE) and herpes
simplex virus (HSV) encephalitis might induce anti-NMDA receptor encephalitis.
Several anti-NMDA receptor encephalitis cases have been reported to be associated
with vaccination, including JE, influenza A virus subtype H1N1,
odiphtheria/pertussis/tetanus/poliomyelitis vaccination or coronavirus disease 2019
(COVID-19) vaccinations.
In addition to these vaccines, cases of papillomavirus (HPV) vaccination triggering
anti-NMDA receptor encephalitis have been reported, but the underlying mechanism
has not been explored. HPV vaccination prevents infections with HPV, which can
cause cervical cancer (CC). CC is one of the most common cancers threatening
women's health that develops in a woman's cervix. Cases of adverse events related

to HPV vaccination including chronic fatigue syndrome, postural orthostatic
tachycardia syndrome (POTS), orthostatic intolerance, and complex regional pain
syndrome have been reported. Compared to these adverse events, only a few
studies reported anti-NMDA receptor encephalitis cases that were associated with
HPV vaccination. Since cases of HPV vaccination triggering anti-NMDA receptor
encephalitis have been reported, this study investigates the underlying mechanism
from a molecular perspective. The method is based on the phylogenetic analyses of
microRNA (miRNA) biomarkers. miRNA biomarkers have been used to explore the
relationship between anti-NMDA receptor encephalitis and vaccination (or tumors).
In addition, it is worth mentioning that HPV can cause cancers, and anti-NMDA
receptor encephalitis is associated with tumors. Ovarian teratomas were the most
commonly reported anti-NMDA receptor encephalitis-associated tumor in females.
Testicular teratomas were reported to be associated with anti-NMDA receptor
encephalitis in males. HPV might induce CC and cancers of the vulva, the vagina, the
penis, and the anus. Both HPV and anti-NMDA receptor encephalitis have been
associated with tumors or cancers of the male and female reproductive systems. This
may shed light on investigating the mechanism of the association between HPV
vaccination and anti-NMDA receptor encephalitis.

While the risk of HPV triggering encephalitis appears low, the study emphasizes the
need for vigilance. Those who develop psychiatric or neurological symptoms
following HPV vaccination should undergo an evaluation for anti-NMDA receptor
encephalitis, with a thorough examination to rule out other potential complications.

References
1. Wang, H.* (2016). Efficacies of treatments for anti-NMDA receptor encephalitis,
Frontiers in Bioscience-Landmark, 21:651-63.
2. Wang, H.* (2020). Anti-NMDA Receptor Encephalitis: Efficacy of Treatment for
Male Patients and miRNA Biomarker, Current Medicinal Chemistry, 27(24):4138-
4151.
3. Wang, H.* (2019). Phylogenetic Analysis to Explore the Association Between Anti-
NMDA Receptor Encephalitis and Tumors Based on microRNA Biomarkers,
Biomolecules, 9(10), 572.
4. Wang, H.* (2017). Anti-NMDA Receptor Encephalitis and Vaccination,
International Journal of Molecular Sciences, 18, 193.
5. Wang, H.* (2018). A protocol for investigating the association of vaccination and
anti-NMDA receptor encephalitis. Frontiers in Bioscience (Scholar Edition), 10:229-
237. 6. Wang, H.* (2019). Anti-NMDA Receptor Encephalitis, Vaccination and
Viruses. Current Pharmaceutical Design, 25(43),4579-88.
7. Wang, H.* (2022). COVID-19, Anti-NMDA Receptor Encephalitis and MicroRNA.
Fronters in Immunology, 13:825103.


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The National Park Service warns of this problem around a popular park

The agency is warning of traffic delays related to constructions around the road leading to the park.

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While they have been "a thing" ever since Teddy Roosevelt first started designating certain forests as national parks in the 1900s, national park use has been at record-high since the pandemic period in which many people started looking more closely at the treasures they have closer to home.

The flip side of this type of exploration is the overcrowding that comes with greater numbers of visitors. Mount Rainier in Washington state, Zion in Utah and Yosemite in California have all looked at different ways of combating the problem — from raising entry prices to requiring visitors to register their entry time ahead of time.

Related: Another National Park just made it more difficult for you to visit

This month, the National Park Service (NPS) is also warning of traffic delays at Yellowstone National Park spanning Wyoming, Montana and Idaho. Along with growing numbers of visitors as the summer season nears, two road construction projects are expected to cause delays of up to 30 minutes at entrances to the park.

Yellowstone is one of the country's most beloved national parks.

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NPS reminds visitors to 'plan accordingly for these delays'

"The Lewis River Bridge and Yellowstone River Bridge projects will cause traffic delays," the NPS said in its announcement. "It’s important that visitors plan accordingly for these delays located along the park's southern and northern road corridors."

More Travel:

From the start of May to the end of October, 10 miles around the Lewis River Bridge as well as the South Entrance on South Entrance Road will see delays of up to 20 minutes while the road around Near Tower Junction along the Northeast Entrance Road will see delays of up to 30 minutes. 

While the main road will remain open to wheeled cars with delays, the pullout roads and trail to Lewis River Falls will also be closed during the construction period.

'Enlarged to accommodate increased visitor use'

The two construction projects began in the last two years but will be reaching their most active period during the coming months. Both are also expected to be finished by the end of 2024.

"A new 1,285-foot-long, 175-foot-high steel girder bridge upstream will replace the existing 604-foot-long bridge to preserve year-round access to/from the Northeast Entrance and communities of Silver Gate and Cooke City, Montana," the NPS said further. "New pullouts, paved parking areas, and dedicated route across the new bridge will increase access to trails, fishing and viewpoints. The Yellowstone River Picnic Area will be enlarged to accommodate increased visitor use."

Earlier this month, the NPS also announced that the Ramsay Cascades Trail to see a waterfall at Great Smoky Mountains National Park at the border of Tennessee and South Carolina will be closed most days of the week until the fall for a similar road restoration project.

To ensure that those who want to hike it can still do so, it will be opened in a staggered schedule that grants access on Fridays and the weekends as well as whatever national holidays fall between now and the start of November.

“Trail crews will repair tread surfaces, improve drainages, construct trail structures such as staircases, turnpikes, and retaining walls and remove trip hazards like exposed roots and rocks," the NPS said in a statement. "The rehabilitation will improve overall trail safety and protect the park’s natural resources."

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Got stocks? Don’t panic

Stocks took a beating last week amid inflation and Middle East worries. Now they face a big week of earnings. And maybe a rally.

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It was startling this past week to see many of the hottest stocks stagger around and then fall down like drunken sailors in a dodgy street.

This is April, after all, and April has been one of the top months for investors since 1950. 

But stagger stocks did. The Standard & Poor's 500 Index finished below 5,000 for the first time since Feb. 21. The Nasdaq Composite dropped 5.5%, its worst weekly loss since its 5.65% fall during the week of Oct. 31, 2022.

The Dow Jones Industrial Average ended flat. 

Interest rates moved mostly higher, and so did mortgage rates.  

And now investors face a big week with some of the first quarter's most important earnings reports due from Tesla  (TSLA) , Meta Platforms  (META) , Microsoft  (MSFT)  and Exxon Mobil  (XOM)

Related: Wall Street faces make-or-break week with Tesla, GDP, inflation on deck

Plus two important economic reports: the first look at the U.S. Gross Domestic Product for the first quarter and the March report of the Federal Reserve's favorite inflation measure, the Personal Consumption Expenditures Index.

It sounds dangerous, but here are two bits of good news to consider:

  • A big shooting war in the Middle East has NOT erupted.
  • Early futures trading on Sunday suggests lower oil prices and hints that a short-term rally in stocks is forming. 

The big market challenges, part 1 

The shock that professionals and retail investors have been feeling of late starts with this challenge:

The market opened 2024 with most of Wall Street expecting inflation to fall and, with it, multiple interest-rate cuts from the Federal Reserve. 

But inflation hasn't fallen enough to satisfy Fed officials, and this past week, Fed Chairman Jerome Powell conceded what market veterans had expected: There may be one rate cut, maybe two in 2024 — if only inflation will cooperate.

Traders work on the floor of the New York Stock Exchange earlier in April. 

Michael M. Santiago/Getty Images

The 10-year Treasury yield ended the week at 4.63%, up from 4.53% a week before and up 19% from the 3.88% at the end of 2023. 

Mortgage rates had fallen from about 8% in early October to the 6.5% range on a 30-year fixed-rate loan in January, giving hope to home buyers, sellers of existing homes,  and small homebuilders. Now, the rate is above 7%. The rising-rate trend hit the recent report on existing home sales.

The big market challenges, part 2

The big tech stocks that have led the big rally since the end of October have lost their mojo as the hype about artificial intelligence has faded. 

It feels somewhat like the hype around the Internet in early 2000 and the resulting dot.com bust. Just not as crazy.

Yes, AI is a powerful technology. How that technology gets used — and truly used profitably — by customers is not yet clear.  

Nvidia  (NVDA) , up nearly 83% in the first quarter, fell 11% last week and is off 15.7% so far in April. Chip designer Arm Holdings  (ARM) , up 66.3% in the first quarter, is down 30% just in April. 

More on markets

Microsoft, up nearly 12% in the first quarter, is down 5.1% at $399.12 this month. It no longer sports a market capitalization above $3 trillion. 

Tesla, up nearly 102% in 2023, has struggled all year with a glutted electric-vehicle market and well-publicized manufacturing problems. It is down 41% year to date.

In fact, the real stress in the market was concentrated in technology, discretionary and communication services stocks. These include Ford  (F) , General Motors  (GM) , Home Depot  (HD)  and Starbucks  (SBUX)

Consumer staples, financial and utilities stocks moved higher.

Meanwhile, United Airlines  (UAL)  was up 22% after a blowout earnings report. Also rising this past week: Goldman Sachs  (GS) , up 3.7%, PepsiCo  (PEP) , up 3.6%, and Nike  (NKE) , 2.8%.

The strength in financial stocks in particular suggests investors aren't that worried about the economy. They are, however, moving money away from technology,  wrote market watcher Jon Markman this week.

How to handle this market 

Markets move up and down. A 5%-to-10% rundown is a given once or twice in a normal year, defined for our purposes as not battered by a pandemic or something like the 2008-2009 market crash. 

The S&P 500, in fact, fell 10.3% between July 31, 2023 and the market bottom of 4,119.37 on Oct. 27, 2023. 

The index still finished the year up 24%. 

As of April 19, the S&P 500 is down 5.5% from its record close of 5,254.35 reached on Feb. 28. 

So the question is how to handle this downturn. And one should start with these questions: Why am I in the market? When do I need the money? 

If the answer to the second question is soon, then think about getting some advice to protect yourself. 

If you have time, you consider at least three options. 

  • Move investments around to safe havens like bonds you can hold to maturity. The downside is it entails costs and, more importantly, more risk than you expect. 
  • Buy into the lower prices. That's a different way to describe dollar-cost averaging. That's a strategy that works with mutual funds and exchange-traded funds. For the same cash, you're getting more shares. And it sets your investments up for a gain when the turn comes.  
  • Do nothing. Market downturns usually turn around if you have the time to wait. The S&P 500 has weathered two serious selloffs starting in late 2007. It's up 657% since the bottom of the 2008-09 crash. 

What's ahead this week

Some 667 public-traded U.S. companies report quarterly reports this week. Of that total, 158 are components of the S&P 500. 

The big reports to watch: 

Monday (April 22): German software giant SAP  (SAP) , telecom giant Verizon  (VZ) , and grocery giant Albertsons  (ACI) .

Tuesday (April 23): Visa  (V) , Tesla, General Electric Aerospace  (GE)  (the survivor from breaking the old General Electric into three pieces), Texas Instruments  (TXN)  and United Parcel Service  (UPS) .

Wednesday (April 24): Meta Platforms  (META) , IBM  (IBM) , AT&T  (T)  and Boeing  (BA)

Thursday (April 25): Microsoft, Google parent Alphabet  (GOOG) , T-Mobile  (TMUS) , Caterpillar  (CAT) , Intel  (INTC)  and Southwest Airlines  (LUV)

Friday (April 26): Oil giants Exxon Mobil and Chevron  (CVX) , pharmaceutical giant AbbVie  (ABBV) , Colgate-Palmolive  (CL)  and Phillips 66  (PSX)

Related: Veteran fund manager picks favorite stocks for 2024

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Closed Las Vegas Strip hotel gets new life, casino appears dead

One long-delayed hotel project has new life while a stalled Las Vegas Strip resort casino has not shown any signs of life.

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Sometimes plans get shared for Las Vegas Strip resorts, casinos, restaurants, and retail stores that never actually come to be. It's challenging to build in Las Vegas — it is a desert that has few raw materials where the weather can be punishing — and many projects never get off the ground.

In many cases, there are billion-dollar projects that kick off with great fanfare, which never even start. That's the case with the All-Net Arena planned by former NBA player Jackie Robinson on the north end of the Strip.

Related: Iconic Las Vegas Strip venue has last act before implosion

Plans have been filed, and ground was broken back in 2014, but numerous funding plans for the project have either fallen through or they were never real in the first place. It's a tantalizing dream as Las Vegas hopes to land and NBA expansion team, but Robinson's group has not moved past the announcement and theater stage of the project.

That's not uncommon on the Strip but long delays don't always mean a project has died. Another North Strip property, Fontainebleau Las Vegas, recently opened after a 20-year odyssey that included multiple stops and starts as well as several owners.

Now, another Las Vegas Strip project — one first made public in 2019 — appears to be back from the dead.

People walk through Las Vegas' Harry Reid International Airport.

Image source: Shutterstock

Long-closed Las Vegas Strip property may make a comeback

The former Atrium Hotel first went bankrupt back in 2008 during the housing crisis when a lot of businesses struggled due to failing consumer demand. Siegel Group, a Las Vegas real estate developer bought the property for $4.2 million in 2012 and shared plans to rebuild it in 2019.

Those plans never actually happened, likely due to concerns about the Covid pandemic, but now the company which owns Las Vegas' Gold Spike Hotel & Casino, has new plans for the Atrium site. 

"The Siegel Group is in its 'final stages' to get permits to move forward with plans to demolish the Atrium Hotel and build a 480-unit flexible-stay apartment complex," said Siegel Group CEO Stephen Siegel, the Las Vegas Review-Journal reported.

No start date has been shared, but Siegel Group has asked Clark County to make some improvements to the area around the site including closing off a tunnel and widening "the stretch of Paradise Road between Harmon Avenue and Sands/Twain Avenue," the paper reported.

Another Las Vegas Strip project remains stalled

When construction on the Dream Hotel and Casino stopped in March 2023 over unpaid bills, the project's owner, Shopoff Realty Investments, said the pause would be short. It promised that new funding was coming, but construction on the property remains stopped.

The boutique hotel sits near the Harry Reid International Airport 5051 South Las Vegas Boulevard.

"According to developers, the new resort is expected to be 20 stories tall with 531 guestrooms and suites as well as dining and nightlife venues, a pool deck, a bar, and a lounge space on the gaming floor and on-site parking," KTNV Las Vegas reported.

The project, which was supposed to open in Fall 2024, was supposed to become a 531-room lifestyle hotel and casino with seven experiential dining and nightlife venues, 12,000 square feet of meeting and event space, and a 20,000-square-foot casino.

Construction stopped when the developer fell millions of dollars behind in paying its building partners. After sharing plans for new funding that would have led to a January 2024 restart, the developer has been silent about the future of the Dream Hotel and Casino.

"This project represents a new type of Vegas hotel experience, offering tourists and locals alike a unique boutique hotel option on the Las Vegas Strip. We are thrilled to break ground on Dream Las Vegas and watch as it energizes the southern end of the Strip, while providing countless jobs and revenue for local government," explained Shopoff Realty Investments CEO William Shopoff at the time.

 

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