Gastrointestinal Perforations Associated With JAK Inhibitors: A Disproportionality Analysis of the FDA Adverse Event Reporting System.

Background: Gastrointestinal perforations have been reported in a small number of rheumatoid arthritis (RA) patients treated with Janus kinase (JAK) inhibitors in clinical trials. However, large-scale postmarketing data repositories are needed to further investigate this potentially rare but serious adverse event.

Methods: A retrospective, pharmacovigilance study of the FDA adverse event reporting system (July 2014 to September 2023) assessing the reporting of gastrointestinal perforations following JAK inhibitors compared to biological disease-modifying antirheumatic drugs (bDMARDs) in RA patients.

Epilepsy Therapies Symposium | Do We Really "Outgrow" Seizures?

Initiation and maintenance of antiseizure therapy can be relatively straightforward in most patients. Depending on epilepsy type, patients may be more or less likely to enter remission or a resolution of their epilepsy and the International League Against Epilepsy developed clinically guiding definitions in this regard. The mechanisms by which resolution or remission are achieved are poorly understood which complicates clinical decision making and risk estimate for future seizure relapse.

A comparison between lipid-based vs. glycemic-based insulin sensitivity indices for the association with abnormal ECG findings and 20-year mortality among older adults.

Background: A direct comparison between glycemic-based and lipid-based insulin sensitivity indices (ISIs) for ECG findings and all-cause and cardiovascular mortality is lacking.

Methods: 963 community-dwelling older adults, examined as part of the third phase of the Glucose intolerance, Obesity, and Hypertension study between 1999 and 2008, were followed until December 2016 and December 2019 for cardiovascular and all-cause mortality, respectively. Eleven different ISIs were calculated and evaluated against ECG findings, all-cause, and cardiovascular mortality with multivariable regression models.

A systematic review on revision total hip arthroplasty employing the direct anterior approach.

Introduction: The increased use of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) has extended to revision THA. This systematic review evaluated studies reporting both the utility and clinical outcomes of revision THA using DAA, focusing on studies comparing revision approaches.

Materials And Methods: A review of the Cochrane Library, EMBASE, and MEDLINE databases identified 577 publications.

Spontaneous and induced degradation of dermal fillers: A review.

Dermal fillers are among the most versatile tools in esthetic medicine. A broad range of temporary, semipermanent, and permanent filler products are on the market. We performed a narrative review on spontaneous and induced degradation of dermal fillers and .

Using high-frequency oscillations from brief intraoperative neural recordings to predict the seizure onset zone.

Background: While high-frequency oscillations (HFOs) and their stereotyped clusters (sHFOs) have emerged as potential neuro-biomarkers for the rapid localization of the seizure onset zone (SOZ) in epilepsy, their clinical application is hindered by the challenge of automated elimination of pseudo-HFOs originating from artifacts in heavily corrupted intraoperative neural recordings. This limitation has led to a reliance on semi-automated detectors, coupled with manual visual artifact rejection, impeding the translation of findings into clinical practice.

Methods: In response, we have developed a computational framework that integrates sparse signal processing and ensemble learning to automatically detect genuine HFOs of intracranial EEG data.

Predictors and implications of renal injury after CD19 chimeric antigen receptor T-cell therapy.

Chimeric Antigen Receptor (CAR) T cells targeting CD19 induce durable remissions in patients with relapsed or refractory non-Hodgkin lymphoma (NHL), but many patients experience treatmentrelated toxicity. Cytokine release syndrome and immune effector cell-associated neurologic syndrome are extensively characterized. However, limited data exist on the burden, predictors, and implications of acute kidney injury (AKI) after CAR T cell therapy.

A functional microbiome catalogue crowdsourced from North American rivers.

Predicting elemental cycles and maintaining water quality under increasing anthropogenic influence requires knowledge of the spatial drivers of river microbiomes. However, understanding of the core microbial processes governing river biogeochemistry is hindered by a lack of genome-resolved functional insights and sampling across multiple rivers. Here we used a community science effort to accelerate the sampling, sequencing and genome-resolved analyses of river microbiomes to create the Genome Resolved Open Watersheds database (GROWdb).

Improving Residency Training in Refugee and Immigrant Health Care at an Urban Academic Family Medicine Residency.

As a safety net hospital, Boston Medical Center (BMC) serves a global community of patients and is welcoming new refugee and immigrant patients at an unprecedented rate. Many of these patients are cared for by Family Medicine residents and faculty in both inpatient and outpatient settings. Currently, the care delivered by Family Medicine residents lacks uniformity due to lack of familiarity with the U.

The Fundamentals of Antiseizure Medications: A Through Z.

Since bromides were first used in 1857 to treat epilepsy, numerous antiseizure medications (ASM) have been developed. Many of these are available for the treatment of epilepsy and status epilepticus today. With so many ASM available, questions arise as to whether all of these medications are needed and when should they be used.

Using Urine Output Trending for the Management of Acute Cardiorenal Syndrome.

Background: One-third of patients with acute decompensated heart failure (ADHF) develop worsening kidney function, known as type I cardiorenal syndrome (CRS). CRS is linked to higher mortality rates, prolonged hospital stays, and increased readmissions.

Objectives: To explore the impact of real-time monitoring of urinary output (UO) trends on personalized pharmacologic management, fluid balance, and clinical outcomes of patients with ADHF admitted to a cardiac intensive care unit.

All in the family? Understanding differences in the kin-centricity of older US adults' core discussion networks from classic age, period, and cohort table estimates.

Panel data have generated several insights about changes in kin relationships, yet few studies examine these shifts across multiple dimensions of time simultaneously. In this paper, we use data from the National Social Life, Health, and Aging Project (N=5,269) in classic lexis tables to examine age, period, and cohort differences in the kin-centricity of older adults' core discussion networks. We estimate population averages in discussion network size, range, kin composition, and kin co-residency across ages and periods.

The inferior sacral iliac line as a horizontal reference plane in paediatric pelvic radiographs.

Background: While often used, Hilgenreiner's line may not always be a reliable reference plane following triple innominate pelvic osteotomy or trauma to the triradiate cartilage. The inferior sacral-iliac line is a horizontal line connecting the sclerotic corners of the inferior sacral-iliac joints. This is a consistent landmark in the ossifying infant pelvis as well as the fully developed adult pelvis.

Utilization of tissue-free minimal residual disease testing in colorectal cancer patients from Asia and Middle East.

Introduction: The presence of minimal residual disease (MRD) after curative-intent surgery for early-stage cancers is associated with disease recurrence. Circulating tumour deoxyribonucleic acid (ctDNA) has emerged as a promising biomarker for MRD assessment in patients with colorectal cancer (CRC) who have undergone surgery or completed adjuvant therapy. MRD tests are already available for use in clinics; however, treatment decisions following MRD results obtained in routine practice are infrequently described.

Fine-Tuning Large Language Models to Enhance Programmatic Assessment in Graduate Medical Education.

Background: Natural language processing is a collection of techniques designed to empower computer systems to comprehend and/or produce human language. The purpose of this investigation was to train several large language models (LLMs) to explore the tradeoff between model complexity and performance while classifying narrative feedback on trainees into the Accreditation Council for Graduate Medical Education subcompetencies. We hypothesized that classification accuracy would increase with model complexity.

The very early evolution of biological complexity.

All extant life is descended from a common ancestor, which, despite being very ancient, appears to have been a complex cellular organism. A new study by Moody et al. shows that this ancestor was not only a complex cell, but also lived within a microbial ecology likely inhabited by other complex cells.

Introduction to the Special Issue on Early Evolution and the Last Common Ancestor.

The early evolution of life spans an extensive period preceding the emergence of the first eukaryotic cell. This epoch, which transpired from 4.5 to 2.

The Relationship Between Age and 30-Day Outcomes Following Unicompartmental Versus Total Knee Arthroplasty.

Background: Understanding the short-term complication profile following unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA) can improve surgical decision-making and patient outcomes. This study aimed to determine if the difference in risk of 30-day morbidity and mortality between UKA and TKA varied based on patient age.

Methods: This retrospective study of a national quality improvement database using data from 2014 to 2020 included 403,342 patients undergoing UKA (n = 12,324) or TKA (n = 391,018).

Massachusetts Medicaid ACO Program May Have Improved Care Use And Quality For Pregnant And Postpartum Enrollees.

Value-based care models, such as Medicaid accountable care organizations (ACOs), have the potential to improve access to and quality of care for pregnant and postpartum Medicaid enrollees. We leveraged a natural experiment in Massachusetts to evaluate the effects of Medicaid ACOs on quality-of-care-sensitive measures and care use across the prenatal, delivery, and postpartum periods. Using all-payer claims data on Medicaid-covered live deliveries in Massachusetts, we used a difference-in-differences approach to compare measures before (the first quarter of 2016 through the fourth quarter of 2017) and after (the third quarter of 2018 through the fourth quarter of 2020) Medicaid ACO implementation among ACO and non-ACO patients.