Pegloticase and Methotrexate Cotherapy in Patients With Uncontrolled Gout With Prior Pegloticase Monotherapy Failure: Findings of an Open-Label Trial.

Objective: Patients with uncontrolled gout have few treatment options. Pegloticase lowers serum urate (SU) levels, but antidrug antibodies limit SU-lowering response and increase infusion reaction (IR) risk. Methotrexate (MTX) cotherapy increases pegloticase response rates and lowers IR risk in pegloticase-naïve patients.

Quantifying the Impact of State Health Policy on State Population Health Outcomes.

Thirty-five years after the Institute of Medicine report, (1988), multiple authors have considered what needs to be achieved to build a robust public health system that improves health for all. A central theme is the renewed emphasis on the role of evidence-based policy. This study provides clear evidence using a ranking methodology of how important policy is to achieving better health outcomes across the United States.

Opportunities for Improving the Long-term Management of Keratoconus Patients.

Background And Objective: This study determined whether practitioners specializing in keratoconus (KC) adhere to published guidelines for disease management and to what extent comorbid conditions of dry eye, contact lens tolerance, and psychological consequences of KC are formally assessed as part of long-term management.

Materials And Methods: This cross-sectional study used an IRB-approved, Internet-based, REDCap platform. Descriptive statistics are presented.

Altered Oscillatory Neural Dynamics Related to Word Prediction in Older Adult Readers.

The engagement of predictive mechanisms during language comprehension can facilitate processing and modulate neural oscillatory activity. These modulations include alpha-band activity decreases prior to expected words, reflecting anticipatory preparation, and frontal theta-band activity following unexpected words, reflecting engagement of cognitive control. It remains unknown how these oscillatory dynamics are impacted by aging.

Surgical risks and care trends: A cross sectional study of people experiencing homelessness presenting at a free clinic care in Miami-Dade County.

Background: The effects of housing insecurity on surgical care are under researched and largely unknown. Thus far, studies on surgery outcomes of people experiencing homelessness either focus on shelter-based patients or do not differentiate whether patients are sheltered or unsheltered, despite significant differences in care needs and health risks. Herein we provide the first report on surgical care trends of people experiencing unsheltered homelessness.

Comparison of Glenoid Bone Loss After Unidirectional Versus Combined Shoulder Instability in a Military Population.

Background: While glenoid bone loss (GBL) after anterior shoulder instability correlates with poor functional outcomes, the specific effects of GBL in posterior and combined-type shoulder instability remain poorly characterized, especially in a high-risk military population.

Purpose/hypothesis: The purpose of this study was to compare GBL between unidirectional anterior or posterior instability versus combined-type instability in active-duty servicemembers. It was hypothesized that total GBL and GBL in the direction of instability would be greater in those with combined-type instability compared with unidirectional instability.

The 2022 ADEA Climate Study in U.S. and Canadian Dental Schools and Allied Dental Programs: Methodological Considerations.

Objectives: From January 2020 to the end of August 2020, preliminary research gathered data about the need for and the feasibility of an ADEA-led joint Climate Study of dental schools and allied dental programs in the United States and Canada. Informed by these findings, the first ever ADEA-led joint Climate Study took place in 2022. The objectives of this manuscript were to describe the timeline of this climate study and provide information about its methodology, specifically about (a) who participated in this research, (b) what was assessed, (c) how the study was conducted, and (d) how the results were communicated.

Lymph Node Staging and Treatment in Pediatric Patients With Soft Tissue Sarcomas: A Consensus Opinion from the Children's Oncology Group, European paediatric Soft tissue sarcoma Study Group, and the Cooperative Weichteilsarkom Studiengruppe.

Accurate staging of nodal involvement in pediatric sarcoma patients is important to determine correct systemic and local therapy, with the goal to reduce subsequent recurrences. However, differences in lymph node staging strategies, definitions, and treatment protocols between the Children's Oncology Group (COG), European paediatric Soft tissue sarcoma Study Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS) complicate comparisons. In this article, we aim to establish internationally recognized recommendations for lymph node assessment and treatment of children and adolescents diagnosed with rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) according to the Consensus Conference Standard Operating Procedure methodology.

The Call to Increase Adoption of Family-Based Interventions in Global Mental Health Programming.

Family-based intervention approaches hold tremendous promise for improving mental health in scalable and relevant ways that address social determinants of health, yet family-focused prevention and care interventions are underused in global mental health. This article provides a brief overview of the evidence and types of programs. It then outlines five future directions for family-focused global mental health interventions: integrating implementation science into family-focused programs, expanding research on family-focused work to other populations and different modalities, encouraging transdisciplinary learning from other fields, understanding what works for whom and where, and disseminating family interventions grounded in locally derived theoretical frameworks.

Electrochemical and spectroelectrochemical investigation of Ru(por)(NO)(OAr) derivatives (por = octaethylporphyrin, tetraanisolylporphyrin; Ar = Ph, CH-2-NHC(O)CF; CH-2,6-(NHC(O)CF)).

The electrochemistry and spectroelectrochemistry of Ru(porphyrin)(NO)(phenoxide) complexes Ru(por)(NO)(OPh) (por = OEP, 1a; TAP, 2a; Ph = CH), Ru(por)(NO)(OAr) (por = OEP, 1b; TAP, 2b; OAr = -OCH-(2-NHC(O)CF)), Ru(por)(NO)(OAr) (por = OEP, 1c; TAP, 2c; OAr = OCH-(2,6-NHC(O)CF); OEP = octaethylporphyrinato dianion, TAP = tetraanisolylporphyrinato dianion) indicate that initial one-electron oxidation results in structure-dependent net reactivity at the phenoxide ligand. Oxidation of 1a generates 1a+, which undergoes a relatively slow rate-limiting second-order follow-up reaction. In contrast, 2a undergoes a diffusion-limited follow-up reaction after oxidation.

Putting seedlings on the map: Trade-offs in demographic rates between ontogenetic size classes in five tropical forests.

All species must partition resources among the processes that underly growth, survival, and reproduction. The resulting demographic trade-offs constrain the range of viable life-history strategies and are hypothesized to promote local coexistence. Tropical forests pose ideal systems to study demographic trade-offs as they have a high diversity of coexisting tree species whose life-history strategies tend to align along two orthogonal axes of variation: a growth-survival trade-off that separates species with fast growth from species with high survival and a stature-recruitment trade-off that separates species that achieve large stature from species with high recruitment.

Exploring the Intersection of Gender Diversity and Intellectual Disability: A Scoping Review With a Focus on Clinical Care.

Background: Little research has been conducted solely exploring gender diversity in people with intellectual disabilities. This review explores the literature, discusses the prevalence, and identifies clinical best practices for people at the intersection of gender diversity and intellectual disability.

Method: A scoping review was conducted utilising PRISMA methodology of the following databases: PubMed, CINAHL Complete (EBSCO), Cochrane Library (Wiley), Dissertations & Theses Global (ProQuest), PsycInfo (EBSCO), Scopus and Web of Science.

Creating the 5A Nursing Response Model for the Emerging Pandemic: A Qualitative, Theory-Generating Study.

Aim: The aim of this qualitative exploratory study aimed was to explore how nurses experienced and responded to the COVID-19 pandemic crisis in clinical settings to develop a response model.

Design: Focus group interviews.

Methods: Thirteen focus group interviews (n = 50) with nurses and nurse leaders practicing in diverse clinical settings were conducted between May and July of 2021 in South Korea.

Efficacy and Safety Results With Rilzabrutinib, an Oral Bruton Tyrosine Kinase Inhibitor, in Patients With Immune Thrombocytopenia: Phase 2 Part B Study.

Current treatments for persistent or chronic immune thrombocytopenia (ITP) are limited by inadequate response, toxicity, and impaired quality of life. The Bruton tyrosine kinase inhibitor rilzabrutinib was evaluated to further characterize safety and durability of platelet response. LUNA2 Part B is a multicenter, phase 1/2 study in adults with ITP (≥ 3 months duration, platelet count < 30 × 10/L) who failed ≥ 1 ITP therapy (NCT03395210, EudraCT 2017-004012-19).

Young mothers' prenatal attachment and later attachment-related representations of their young children.

Although mother-to-infant attachment begins during pregnancy, few studies have explored correlates of prenatal attachment and associations with later measures of attachment representations. This study explored whether prenatal attachment is related to attachment representations during toddlerhood and whether associations between them reflect the broader quality of mothers' relationships. Young, ethnically/racially diverse, low-income American women (n = 160) were followed from pregnancy through 30 months postpartum.

Sleep quality and cognitive functioning among Chinese older adults living in the US: a mixed-effects model analysis.

Background: Racial and ethnic disparities in sleep quality and cognitive health are increasingly recognized, yet little is understood about their associations among Chinese older adults living in the United States. This study aims to examine the relationships between sleep health and cognitive functioning in this population, utilizing data from the Population Study of Chinese Elderly in Chicago (PINE).

Methods: This observational study utilized a two-wave panel design as part of the PINE, including 2,228 participants aged 65 years or older who self-identified as Chinese.

Insulin degludec 100 U/mL for treatment of spontaneous diabetes mellitus in dogs.

Background: The advantages of insulin degludec 100 U/mL (IDeg100) in the treatment of diabetes mellitus (DM) include consistent release, predictable glucose-lowering effect, and minimal day-to-day variability.

Hypothesis/objectives: To describe the use of IDeg100 in dogs with DM, level of diabetic control and adverse effects.

Animals: Thirty-three client-owned dogs with DM.

Commentary on: "Text-to-Video Models and Sora in Plastic Surgery: Pearls, Pitfalls, and Prospectives".

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.

Evolution of intrinsic disorder in the structural domains of viral and cellular proteomes.

Intrinsically disordered regions are flexible regions that complement the typical structured regions of proteins. Little is known however about their evolution. Here we leverage a comparative and evolutionary genomics approach to analyze intrinsic disorder in the structural domains of thousands of proteomes.

An Exploratory Investigation of Heritage and Educational Language Exposures as Factors in Medical Student Spanish Language Proficiency.

Background: Prior to enrolling in medical Spanish courses, students typically acquire their Spanish skills either through formal second language education only (L2 learners) or by being exposed to Spanish during childhood at home (heritage learners).

Objective: To categorize the language exposures of medical students who participated in a medical Spanish course and explore the associations of exposures with their medical language proficiency score on the Physician Oral Language Observation Matrix (POLOM).

Setting And Participants: Forty-one fourth-year medical students (2021-2022) self-reported demographics and prior language exposures and participated in videorecorded POLOM-rated Spanish standardized patient encounters.

Distributed training of foundation models for ophthalmic diagnosis.

Vision impairment affects nearly 2.2 billion people globally, and nearly half of these cases could be prevented with early diagnosis and intervention-underscoring the urgent need for reliable and scalable detection methods for conditions like diabetic retinopathy and age-related macular degeneration. Here we propose a distributed deep learning framework that integrates self-supervised and domain-adaptive federated learning to enhance the detection of eye diseases from optical coherence tomography images.

The effect of midazolam co-induction on cardiorespiratory variables, myoclonus and etomidate dose requirements in healthy cats.

Objective: To evaluate dose requirements of etomidate for endotracheal intubation, with or without midazolam co-induction, and to describe induction quality and associated cardiorespiratory variables in healthy cats.

Study Design: Randomized prospective experimental study.

Animals: A group of 24 adult neutered cats (17 females, seven males).

N SABRE-SHEATH and NMR/DFT Characterization of Amino-Metronidazole, a Metabolic Product of the Antibiotic and Prospective Hypoxia Contrast Agent Metronidazole.

The antibiotic metronidazole (MNZ) has gained interest as a potential MRI contrast agent for imaging hypoxia. N-labeled MNZ can be efficiently hyperpolarized via SABRE-SHEATH (Signal Amplification By Reversible Exchange in SHield Enables Alignment Transfer to Heteronuclei), but the envisioned MRI approach requires that MNZ rapidly undergoes structural changes in hypoxic environments with significant N frequency differences manifested in its downstream metabolic products. We have performed NMR studies of the anticipated metabolic product amino-MNZ (despite anticipated stability concerns) accompanied by computational density functional theory (DFT) studies to predict the N chemical shifts of different relevant species.