Approaches and outcomes of adalimumab discontinuation in patients with well-controlled inflammatory arthritis: a systematic search and review.

Objective: This systematic search and review aimed to evaluate the available literature on discontinuation of adalimumab and other tumor necrosis factor inhibitors (TNFi) for patients with well-controlled chronic inflammatory arthritides.

Methods: We conducted a publication search on adalimumab discontinuation from 2000-2023 using PubMed, CINAHL, EMBASE, and Cochrane Library. Included studies evaluated adalimumab discontinuation approaches, tapering schemes, and outcomes including successful discontinuation and recapture after flare, in patients with well-controlled disease.

Takayasu arteritis in an adolescent with untreated Crohn's disease: A case report.

Extraintestinal manifestations in inflammatory bowel disease (IBD) most frequently involve the joints, skin, and organs such as the liver and pancreas. Inflammation of the aorta is less commonly described in pediatrics, although it has been described in adults. We report a case of an adolescent female with Crohn's disease who presented with worsening diarrhea, vomiting, and weight loss, found to have aortitis on imaging.

Persistent plastic: Insights from seawater weathering and simulated whale gut.

Single-use plastics make up 60-95 % of marine plastic pollution, including common commodity films used for packaging and bags. Plastic film breaks down as a function of environmental variables like wave action, wind, temperature, and UV radiation. Here, we focus on how films degrade in cold waters across depths, time, and simulated mammal digestion.

The Association Between C-Reactive Protein Levels and Pediatric Appendicitis Score and the Severity of Appendicitis in Children.

Background: Acute appendicitis is a common cause of abdominal pain leading to emergent abdominal surgery in children. C-reactive protein (CRP), an inflammatory marker typically elevated in acute appendicitis, and Pediatric Appendicitis Score (PAS), a clinical scoring system used for the diagnosis of appendicitis, have the potential to predict the severity of inflammation of the appendix. This may be useful in helping the physician make a treatment plan prior to surgery.

Increased rates of invasive bacterial disease in late 2022.

Invasive bacterial disease is associated with significant morbidity and mortality. In winter 2022, there was an apparent increased rate of invasive bacterial disease compared to preceding years. Cross-site retrospective analysis of the three Children's Health Ireland (CHI) hospitals looking at children admitted between 1st October 2022-31st December 2022 (Q4) with community-acquired invasive bacterial disease, defined as an abscess in a normally sterile site in the head, neck and chest or isolation or PCR detection of Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus pyogenes (Group A streptococcus) or Haemophilus influenzae from a normally sterile site.

HUG: A Compassionate Approach to Designing for Wellbeing in Dementia Care.

Design can improve the quality of life of people living with dementia but creating successful design solutions is not simple, due to the complexity of the medical condition, and the ethical considerations of including those affected in design research and evaluation. This article describes research involving an interactive product, 'HUG', developed from academic research, to support the wellbeing of people living with advanced dementia, which is now commercially available. People affected by dementia were included at every stage in the design research process.

Ocean acidification, warming and feeding impacts on biomineralization pathways and shell material properties of Magallana gigas and Mytilus spp.

Molluscs are among the organisms affected by ocean acidification (OA), relying on carbon for shell biomineralization. Metabolic and environmental sourcing are two pathways potentially affected by OA, but the circumstances and patterns by which they are altered are poorly understood. From previous studies, mollusc shells grown under OA appear smaller in size, brittle and thinner, suggesting an important alteration in carbon sequestration.

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment.

Vascular pathologies associated with SARS-CoV-2 infection are poorly understood. Color and sensory changes to the extremities, often referred to as "COVID toes" or chilblains-like lesions, have been widely reported in children and adolescents since the onset of the pandemic, raising the concern that they could be a vasculitis secondary to the infection. However, it is unclear if the lesions are a result of the infection or an epiphenomenon.

Hybridization decreases native cutthroat trout reproductive fitness.

Examining natural selection in wild populations is challenging, but crucial to understanding many ecological and evolutionary processes. Additionally, in hybridizing populations, natural selection may be an important determinant of the eventual outcome of hybridization. We characterized several components of relative fitness in hybridizing populations of Yellowstone cutthroat trout and rainbow trout in an effort to better understand the prolonged persistence of both parental species despite predictions of extirpation.

Optimization of hippocampus sparing during whole brain radiation therapy with simultaneous integrated boost-tutorial and efficacy of complete directional hippocampal blocking.

Purpose: Hippocampus-avoidance whole brain radiotherapy with simultaneous integrated boost (HA-WBRT+SIB) is a complex treatment option for patients with multiple brain metastases, aiming to prevent neurocognitive decline and simultaneously increase tumor control. Achieving efficient hippocampal dose reduction in this context can be challenging. The aim of the current study is to present and analyze the efficacy of complete directional hippocampal blocking in reducing the hippocampal dose during HA-WBRT+SIB.

Essential nutrient element profiles in rice types: a risk-benefit assessment including inorganic arsenic.

Rice is consumed by nearly half of the global population and a significant source of energy and nutrients. However, rice consumption can also be a significant pathway of inorganic arsenic (iAs) exposure, thus requiring a risk-benefit assessment. This study assessed nutrient element (NE) densities in fifty-five rice types (white, brown and wild rice) marketed in the UK.

Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation-results from a prospective pilot trial.

Purpose: Intratumoral hypoxia increases resistance of head-and-neck squamous cell carcinoma (HNSCC) to radiotherapy. [F]FMISO PET imaging enables noninvasive hypoxia monitoring, though requiring complex logistical efforts. We investigated the role of plasma interleukin-6 (IL-6) as potential surrogate parameter for intratumoral hypoxia in HNSCC using [F]FMISO PET/CT as reference.

The Magnetic Electron Ion Spectrometer: A Review of On-Orbit Sensor Performance, Data, Operations, and Science.

Unlabelled: Measurements from NASA's Van Allen Probes have transformed our understanding of the dynamics of Earth's geomagnetically-trapped, charged particle radiation. The Van Allen Probes were equipped with the Magnetic Electron Ion Spectrometers (MagEIS) that measured energetic and relativistic electrons, along with energetic ions, in the radiation belts. Accurate and routine measurement of these particles was of fundamental importance towards achieving the scientific goals of the mission.

Hippocampus-Avoidance Whole-Brain Radiation Therapy Is Efficient in the Long-Term Preservation of Hippocampal Volume.

Background And Purpose: With improved life expectancy, preventing neurocognitive decline after cerebral radiotherapy is gaining more importance. Hippocampal damage has been considered the main culprit for cognitive deficits following conventional whole-brain radiation therapy (WBRT). Here, we aimed to determine to which extent hippocampus-avoidance WBRT (HA-WBRT) can prevent hippocampal atrophy compared to conventional WBRT.

The Camouflage Machine: Optimizing protective coloration using deep learning with genetic algorithms.

Evolutionary biologists frequently wish to measure the fitness of alternative phenotypes using behavioral experiments. However, many phenotypes are complex. One example is coloration: camouflage aims to make detection harder, while conspicuous signals (e.

New understanding of the direct effects of spectral balance on behaviour in Myzus persicae.

The study of insect responses to colour has mainly focused on flying species and morphs, however colour cues are likely to be important for insect positioning within the canopy. We examine the role of illumination colour in canopy positioning of apterous Myzus persicae (Sulzer) using both a field experiment, utilising various UV-manipulating optical filters, and a laboratory experiment using video tracking of individuals illuminated by a variable intensity UVA-Blue-Green LED-array. In the field experiment, approximately twice as many aphids were located on exposed leaf surfaces under UV-deficient environments compared to UV-rich environments.

Empirically Estimated Electron Lifetimes in the Earth's Radiation Belts: Comparison With Theory.

We compute quasilinear diffusion rates due to pitch angle scattering by various mechanisms in the Earth's electron radiation belts. The calculated theoretical lifetimes are compared with observed decay rates, and we find excellent qualitative agreement between the two. The overall structure of the observed lifetime profiles as a function of energy and is largely due to plasmaspheric hiss and Coulomb scattering.

Empirically Estimated Electron Lifetimes in the Earth's Radiation Belts: Van Allen Probe Observations.

We use measurements from NASA's Van Allen Probes to calculate the decay time constants for electrons over a wide range of energies (30 keV to 4 MeV) and values ( = 1.3-6.0) in the Earth's radiation belts.

Molecular Imaging in Photon Radiotherapy.

Nowadays, more than ever before, the treatment of cancer patients requires an interdisciplinary approach more than ever. Radiation therapy (RT) has become an indispensable pillar of cancer treatment early on, offering a local, curative treatment option and symptom control in palliative cases.

Whole-brain irradiation with hippocampal sparing and dose escalation on metastases: neurocognitive testing and biological imaging (HIPPORAD) - a phase II prospective randomized multicenter trial (NOA-14, ARO 2015-3, DKTK-ROG).

Background: Whole brain radiation therapy (WBRT) is the standard therapy for multiple brain metastases. However, WBRT has a poor local tumor control and is associated with a decline in neurocognitive function (NCF). Aim of this trial is to assess the efficacy and safety of a new treatment method, the WBRT with hippocampus avoidance (HA) combined with the simultaneous integrated boost (SIB) on metastases/resection cavities (HA-WBRT+SIB).

Interacting with Members of the Public to Discuss the Impact of Food Choices on Climate Change-Experiences from Two UK Public Engagement Events.

Food systems contribute to up to 37% of global greenhouse gas emissions, and emissions are increasing. Since the emissions vary greatly between different foods, citizens' choices can make a big difference to climate change. Public engagement events are opportunities to communicate these complex issues: to raise awareness about the impact of citizens' own food choices on climate change and to generate support for changes in all food system activities, the food environment and food policy.

Pediatric Heatstroke Fatalities Caused by Being Left in Motor Vehicles.

Objectives: Fatalities due to being left in motor vehicles is an important cause of pediatric mortality. Few studies in the medical literature focus on this topic. This study aims to describe the circumstances surrounding these deaths, to determine their geographic distribution, and to evaluate the legal consequences for those responsible.

Hippocampus-avoidance whole-brain radiation therapy with a simultaneous integrated boost for multiple brain metastases.

Background: The current study was aimed at investigating the feasibility of hippocampus-avoidance whole-brain radiation therapy with a simultaneous integrated boost (HA-WBRT+SIB) for metastases and at assessing tumor control in comparison with conventional whole-brain radiation therapy (WBRT) in patients with multiple brain metastases.

Methods: Between August 2012 and December 2016, 66 patients were treated within a monocentric feasibility trial with HA-WBRT+SIB: hippocampus-avoidance WBRT (30 Gy in 12 fractions, dose to 98% of the hippocampal volume ≤ 9 Gy) and a simultaneous integrated boost (51 or 42 Gy in 12 fractions) for metastases/resection cavities. Intracranial tumor control, hippocampal failure, and survival were subsequently compared with a retrospective cohort treated with WBRT via propensity score matching analysis.

Observational Evidence for Stochastic Shock Drift Acceleration of Electrons at the Earth's Bow Shock.

The first-order Fermi acceleration of electrons requires an injection of electrons into a mildly relativistic energy range. However, the mechanism of injection has remained a puzzle both in theory and observation. We present direct evidence for a novel stochastic shock drift acceleration theory for the injection obtained with Magnetospheric Multiscale observations at the Earth's bow shock.