Real-World Treatment and Care Patterns in Patients With Rheumatoid Arthritis Initiating First-Line Tumor Necrosis Factor Inhibitor Therapy in the United States.

Objective: Treatment guidelines for rheumatoid arthritis (RA) recommend targeting low disease activity or remission and switching therapies for patients not reaching those targets. We evaluated real-world use of disease activity measures, treatment discontinuation, and switching patterns among patients with RA initiating a first-line tumor necrosis factor inhibitor (TNFi).

Methods: Data from adult patients with RA initiating a first-line TNFi were collected from the American Rheumatology Network (January 2014-August 2021).

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Objective: To develop updated guidelines for the pharmacologic management of rheumatoid arthritis.

Methods: We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence.

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Objective: To develop updated guidelines for the pharmacologic management of rheumatoid arthritis.

Methods: We developed clinically relevant population, intervention, comparator, and outcomes (PICO) questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence.

Forward Flux Sampling of Polymer Desorption Paths from a Solid Surface into Dilute Solution.

We compute desorption rates for isolated polymers adsorbed to a solid wall with a rare event sampling technique called multilevel splitting, also known as forward flux sampling. We interpret computed rates with theories based on the conjecture that the product tdesDRg2 of the desorption time tdes and diffusivity D divided by squared radius of gyration Rg scales with exp() where is the equilibrium ratio of adsorbed surface concentration of polymer Γ to bulk concentration of polymer c. As the polymer-wall interaction energy is increased, the slope of lntdesDRg2 vs.

Utility of Point-of-Care Ultrasound for the Diagnosis of Hill-Sachs Deformity in the Pediatric Emergency Department.

We report a case of a 20-year-old man presenting to our pediatric emergency department with an anterior shoulder dislocation. Point-of-care ultrasound demonstrated a Hill-Sachs deformity. The potential role of ultrasound and the clinical importance of identifying patients with Hill-Sachs deformities are discussed.

Search for the Source of an Apparent Interfacial Resistance To Mass Transfer of CnEm Surfactants To the Water/Oil Interface.

Experiments have shown that relaxation of oil/water interfacial tension by adsorption of alkyl ethoxylate surfactants from water onto an oil droplet is delayed relative to diffusion-controlled adsorption. We examine possible causes of this delay, and we show that several are implausible. We find that redissolution of the surfactant in the oil droplet cannot explain the apparent interfacial resistance at short times because the interface will preferentially fill before any such redissolution occurs.

Evaluation of the Schöttle Technique in the Pediatric Knee.

Background: The Schöttle point is commonly used for anatomic femoral tunnel placement during medial patellofemoral ligament (MPFL) reconstruction. This technique has not been previously validated in the skeletally immature patient, in whom femoral tunnel placement may put the distal femoral physis at risk of iatrogenic injury.

Hypothesis: Interobserver reliability for femoral tunnel placement will be higher in adult knees compared with pediatric knees.

MACRA: A New Age for Physician Payments.

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 introduced a new system of physician payments in the United States. This legislation and the complex rules written to enact the law intend to force a shift away from volume-based payments and into so called value-based payments. Physicians and other clinicians will be graded via quality and cost metrics and payments will be adjusted based on performance.

Reversible and Irreversible Adsorption Energetics of Poly(ethylene glycol) and Sorbitan Poly(ethoxylate) at a Water/Alkane Interface.

We simulate poly(ethylene glycol) (PEG) oligomers and model Tween 80 (polyoxyethylene sorbitan monooleate) molecules at water/alkane interfaces. Using the weighted histogram analysis method (WHAM), including an extension of WHAM to two reaction coordinates to remove hysteresis, we calculate interfacial potentials of mean force (PMFs) for PEG and Tween 80 using three force fields: the atomistic GROMOS 53a6OXY+D and two coarse-grained (CG) MARTINI force fields. Because the force fields have not yet been validated for PEO adsorption to hydrophobic interfaces, we calculate PMFs for alcohol ethoxylates C12E2 and C12E8 and find that they agree with semiempirical results of Mulqueen and Blankschtein [Langmuir 2002, 18 (2), 365-376] for the GROMOS 53a6OXY+D force field, whereas for both MARTINI force fields, PEO adsorbs too weakly to a clean hydrophobic interface.

A Simple Radiographic Sign of Vertical Anterior Cruciate Ligament Tunnel Placement.

The purpose of this study is to describe a novel radiographic sign indicative of vertical tunnel placement following anterior cruciate ligament (ACL) reconstruction. We reviewed 190 consecutive ACL reconstructions. Operative records, patient charts, arthroscopic images, and preoperative and postoperative orthogonal plain radiographic images were reviewed.

Molecular dynamics simulations of structure-property relationships of Tween 80 surfactants in water and at interfaces.

We build a united atom model for Tween 80 (polyoxyethylene sorbitan oleates), based on the GROMOS53A6(OXY+D) force field, and apply it to two stereoisomers, three constitutional isomers, and three structures with one, two, and three tails, to represent components in the Tween 80 commercial mixture. In a preassembled micelle containing 60 molecules, the distribution of Tween tail and ethylene oxide head groups is found to be insensitive to stereoisomerization but sensitive to changes in relative lengths of the four polyoxyethylene head groups. At the air-water and oil-water interfaces, the interfacial tension is significantly lower for the constitutional isomer with a shorter W headgroup, which attaches the tail to the sorbitan ring, and for Tween 80 isomers with more than one tail group.

The role of magnetic resonance imaging in a Division I university sports medicine program.

Objective: To prospectively document musculoskeletal magnetic resonance imaging (MRI) use and how it affects diagnosis, playing status, and treatment of Division I university athletes. We hypothesized that MRI often has little or no effect on the diagnosis or treatment plan.

Design: Cross-sectional study.

Quadriceps and hamstrings muscle control in athletic males and females.

The aim of this study was to investigate whether athletic males and females have differences in their quadriceps and hamstrings muscle control strategies. Twenty-four people (12 males, 12 females) active in level I activities volunteered to participate. The subjects' muscle control strategies were studied using electromyography and a target matching protocol that assesses one's ability to produce force with control.

The ultrasonographic appearance of ovarian ectopic pregnancies.

Objective: To evaluate the ultrasonographic findings of ovarian ectopic pregnancies.

Methods: The ultrasonographic reports, videotapes, medical records, and operative summaries were reviewed for all women with a confirmed diagnosis of an ovarian ectopic pregnancy. Examinations were personally conducted by a physician who was either a radiologist-obstetrician or an obstetrician-maternal-fetal medicine specialist.

Targeting acute ischemic stroke with a calcium-sensitive opener of maxi-K potassium channels.

During ischemic stroke, neurons at risk are exposed to pathologically high levels of intracellular calcium (Ca++), initiating a fatal biochemical cascade. To protect these neurons, we have developed openers of large-conductance, Ca++-activated (maxi-K or BK) potassium channels, thereby augmenting an endogenous mechanism for regulating Ca++ entry and membrane potential. The novel fluoro-oxindoles BMS-204352 and racemic compound 1 are potent, effective and uniquely Ca++-sensitive openers of maxi-K channels.

Hereditary syndactyly in Angus cattle.

Twenty-five syndactylous Angus cattle, characterized pathologically, were reported from 16 herds in 10 states from 1979 to 1994. Twenty-one (84%) had all 4 legs syndactylous, 3 (12%) had 3 legs syndactylous, and 1 (4%) had 2 legs syndactylous. All syndactylous cattle walked with considerable difficulty.

1-Phenyl-3-(aminomethyl)pyrroles as potential antipsychotic agents. Synthesis and dopamine receptor binding.

A series of 1-phenyl-3-(aminomethyl)pyrroles were prepared in two steps from aniline and their affinities for D2, D3, and D4 dopamine receptor subtypes determined. A 15-fold selectivity for cloned human D4 receptors over cloned African Green monkey D2 receptors was observed with 1-(2-pyridyl)-4-[[3-(1-phenylpyrrolyl)]methyl]piperazine.

2-Phenyl-4-(aminomethyl)imidazoles as potential antipsychotic agents. Synthesis and dopamine D2 receptor binding.

A series of 2-phenyl-4-(aminomethyl)imidazoles were designed as conformationally restricted analogs of the dopamine D2 selective benzamide antipsychotics. The title compounds were synthesized and tested for blockade of [3H]YM-09151 binding in cloned African green monkey dopamine D2 receptor preparations. The binding affinity data thus obtained were compared against that of the benzamides and a previously described series of 2-phenyl-5-(aminomethyl)-pyrroles.

Experimental allergic encephalomyelitis. T cell trafficking to the central nervous system in a resistant Thy-1 congenic mouse strain.

Background: The understanding of recognition events that underlie the migration of antigen-specific T cells to a target organ during immune-mediated damage will be integral to the therapy of a number of human conditions of proven or suspected autoimmune etiology. In experimental allergic encephalomyelitis (EAE), the laboratory model of the human demyelinating disease, multiple sclerosis, previous studies have concentrated on susceptible strains and have shown that myelin-specific T cells play an early, key role in central nervous system (CNS), lesion formation. Not known in this model is whether in EAE-resistant strains, similar antigen-specific T cells possess the ability to recognize CNS endothelium and infiltrate the CNS.

Heritability and diagnosis of congenital abnormalities in food animals.

The heritability and diagnosis of congenital abnormalities in food animals have been reviewed from the viewpoint of practitioners, clinicians, and researchers. At least 632 putative mutant genes have been cataloged and listed according to the principal body system affected and mode of inheritance (see Tables 1 and 2). Implications of recent advances in genetic methodology are noted.