Multiple Model Optimal Sampling Promotes Accurate Vancomycin Area-Under-the-Curve Estimation Using a Single Sample in Critically Ill Children.

Background: Area-under-the-curve (AUC)-directed vancomycin therapy is recommended; however, AUC estimation in critically ill children is difficult owing to the need for multiple samples and lack of informative models.

Methods: The authors prospectively enrolled critically ill children receiving intravenous (IV) vancomycin for suspected infection and evaluated the accuracy of Bayesian estimation of AUC from a single, optimally timed sample. During the dosing interval, when clinical therapeutic drug monitoring was performed, an optimally timed sample was collected, which was determined for each subject using an established population pharmacokinetic model and the multiple model optimal function of Pmetrics, a nonparametric population pharmacokinetic modeling software.

Long-term safety and efficacy of ritlecitinib in adults and adolescents with alopecia areata and at least 25% scalp hair loss: Results from the ALLEGRO-LT phase 3, open-label study.

Background: ALLEGRO-LT is an ongoing, long-term, open-label, multicentre, phase 3 study of ritlecitinib in adults and adolescents with alopecia areata (AA).

Objectives: To evaluate ritlecitinib safety and efficacy through Month 24 in patients with AA and ≥25% scalp hair loss.

Methods: ALLEGRO-LT enrolled rollover patients who previously received study intervention in either ALLEGRO phase 2a or 2b/3 studies and de novo patients who had not received treatment in either study.

Inflammation in atherosclerosis: a Big Idea that has underperformed so far.

Purpose Of Review: For many years, inflammation has been a major concept in basic research on atherosclerosis and in the development of potential diagnostic tools and treatments. The purpose of this review is to assess the performance of this concept with an emphasis on recent clinical trials. In addition, contemporary literature may help identify new therapeutic targets, particularly in the context of the treatment of early, rather than end-stage, arterial disease.

Synergistic Effects of Extra X Chromosome on Development of Systemic Lupus Erythematosus and Sjögren Disease in Klinefelter and Triple X Syndrome: A Retrospective Cohort Study.

Objective: Systemic lupus erythematosus (SLE) and Sjögren disease (SjD) are autoimmune diseases with significant female predominance. The prevalence of SLE is increased in Klinefelter syndrome (KS) compared with the general male population. Our study investigates the dose effects of extra X chromosomes on the development of SLE and SjD in KS and triple X syndrome compared with the general population.

Concurrent Perioperative Benzodiazepine and Opioid Utilization in Opioid-Naive Patients Undergoing Soft Tissue Hand Surgery.

Background: While concomitant opioid and benzodiazepine use is discouraged due to an increased risk of sedation/overdose, the extent of perioperative opioid utilization in hand surgery patients already using benzodiazepines is unknown.

Methods: Using an administrative claims database, we identified adults undergoing carpal tunnel, DeQuervain, or trigger finger release, palmar fasciectomies, ganglion/mucoid cyst removals, and hand/wrist soft tissue mass excisions from 2011 to 2021. We identified opioid-naive patients with a benzodiazepine prescription within 90 days before surgery.

Exploring the presence and roles of humility when experiencing situations of uncertainty.

Background: Uncertainty is a pervasive challenge in clinical practice. Whereas the importance of humility in navigating uncertainty has been discussed, empirical research on how humility is practiced or expressed (i.e.

High-grade liver injury: outcomes with a trauma surgery-liver surgery collaborative approach.

Background: Operative mortality for high-grade liver injury (HGLI) remains 42% to 66%, with near-universal mortality after retrohepatic caval injury. The objective of this study was to evaluate mortality and complications of operative and nonoperative management (OM and NOM) of HGLI at our institution, characterized by a trauma surgery-liver surgery collaborative approach to trauma care.

Methods: This was an observational cohort study of adult patients (age ≥16) with HGLI (The American Association for Surgery of Trauma (AAST) grades IV and V) admitted to an urban level I trauma center from January 2010 to November 2021.

Types and cost of wellness services provided by a neighborhood-based academic nursing center.

Background: Despite increased insurance coverage since 2010, racial and ethnic minorities in the United States still receive less medical care than White counterparts. The Johns Hopkins School of Nursing's Center for Community Programs, Innovation, and Scholarship (COMPASS Center) provides free wellness services, aiming to address healthcare disparities in the neighborhoods.

Objective: To delineate the types and cost of wellness services provided by the COMPASS Center.

Assessing self-determined motivation for drinking alcohol via the Comprehensive Relative Autonomy Index for Drinking.

Introduction: Self-Determination Theory (SDT) examines human motivation in multiple domains; however, the only existing measure assessing SDT-informed behavioral regulations for drinking focuses on responsible drinker behaviors, rather than drinking , which is important given the alignment between SDT and harm reduction approaches to alcohol use. The aim of this study was to test the structural validity of the SDT-informed Comprehensive Relative Autonomy Index for Drinking (CRAI-Drinking) among college students.

Methods: Participants included two convenience samples with a total of 630 adult drinkers (M = 21.

Principal investigator gender and clinical trial success: analysis of over 3000 obstetrics and gynecology trials.

Background: In obstetrics and gynecology (OBGYN) research, gender disparities permeate through leadership, funding, promotion, mentorship, publishing, compensation, and publicity. Few studies have investigated OBGYN clinical trial leadership as it relates to investigator gender. Thus, we undertook an investigation of principal investigator (PI) gender and clinical trial success.

Exploring the association between emergency hospital services and homicide incidents in Pennsylvania.

Homicide is a significant measure of quality of life and serves as a reference point for a comparison between neighborhoods. Despite its unique relevance to homicide, the role of medical resources, specifically emergency hospital services, has been underexplored in the literature. This study addresses this gap by examining the relationship between emergency hospital availability and homicide rates across counties in Pennsylvania, using advanced spatiotemporal modeling techniques.

Optimizing brain mapping: integrating real-time neuropsychological assessment in awake craniotomy.

Intraoperative neuropsychological testing (IONT) is a sophisticated method of cognitive mapping during the resection of brain tumors in eloquent areas. Direct electrical stimulation during awake craniotomy is routinely utilized for mapping basic language and sensorimotor function, but the utilization of IONT offers an individualized approach that can yield real-time, comprehensive feedback on various cognitive functions, allowing for a tailored and more extensive tumor resection. In this video, the authors present the case of a 41-year-old male undergoing re-resection for a recurrent right temporal astrocytoma in which IONT played a crucial role.

Therapeutic Levels of Acetaminophen Causing AKI: A Case Report and Literature Review.

Our case highlights the importance of being aware of the potential renal complications that can occur with acetaminophen, even when used at dosages slightly above the recommended therapeutic dose.

Efferent compared to afferent neural substrates of the vergence eye movement system evoked via fMRI.

Introduction: The vergence neural system was stimulated to dissect the afferent and efferent components of symmetrical vergence eye movement step responses. The hypothesis tested was whether the afferent regions of interest would differ from the efferent regions to serve as comparative data for future clinical patient population studies.

Methods: Thirty binocularly normal participants participated in an oculomotor symmetrical vergence step block task within a functional MRI experiment compared to a similar sensory task where the participants did not elicit vergence eye movements.

Advancements and Future Directions of Dual-Target Chimeric Antigen Receptor T-Cell Therapy in Preclinical and Clinical Studies.

In recent years, chimeric antigen receptor T-cell (CAR-T) therapy has made groundbreaking progress in the treatment of various cancer types, particularly hematological malignancies. In the meantime, various preclinical and clinical studies have extensively explored dual-target CAR-T therapies which can be designed to recognize two antigens simultaneously based on the immunophenotype of tumor cells. Compared with single-target CAR-T approach, dual-target CAR-T therapies demonstrate varying degrees of superior antitumor CAR effects, prevent antigen escape and relapse, reduce on-target off-tumor effects, and ensure durable responses in different types of cancer.

Partial Avulsion Patterns in the Pediatric Humeral Medial Epicondyle.

Background: The anterior oblique bundle of the medial ulnar collateral ligament (UCL) inserts on the anteroinferior aspect of the humeral medial epicondyle, while the flexor pronator mass (FPM) originates superficial and proximal to the UCL. With valgus stress, these distinct footprints may produce injury patterns that affect only focal areas of the medial epicondyle.

Hypothesis: The proximal UCL can act on the medial epicondyle either in isolation or in conjunction with the FPM to form partial avulsion fracture patterns within the pediatric medial epicondyle, and the predominant pattern involves only the proximal UCL footprint.

Access to CARe: A Narrative of Real-World Medical Decision-Making to Access Chimeric Antigen Receptor (CAR) T-Cell Therapy in Children, Adolescents, and Young Adults.

Chimeric antigen receptor (CAR) T-cell therapy is a potentially life-saving treatment for children with relapsed/refractory B-cell hematologic malignancies, and remains an important investigational therapy for other childhood cancers. Yet, access to this class of therapies remains suboptimal through both commercial use and clinical trials, especially in children, adolescents, and young adults. Using a series of case-based discussions, we outline guidance on real-world medical decision-making, and offer potential solutions to enhancing access to CAR T-cell therapy as a treatment modality.

Know Your ABCs: Discovery, Differentiation, and Targeting of T-Bet+ B Cells.

Since their first description in 2008, T-bet+ B cells have emerged as a clinically important B cell subset. Now commonly known as ABCs (Age-associated B Cells), they are uniquely characterized by their expression of the transcription factor T-bet. Indeed, this singular factor defines this B cell subset.

Coping is a moderator of relationships between cognitive fatigue and cognitive variability in multiple sclerosis.

Objective: Mean levels of cognitive functioning typically do not show an association with self-reported cognitive fatigue in persons with multiple sclerosis (PwMS), but some studies indicate that has an association with cognitive fatigue. Additionally, coping has been shown to be a powerful moderator of some outcomes in multiple sclerosis (MS). To date, however, coping has not been considered as a possible moderator of the relationship between cognitive fatigue and cognitive in MS.

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.

Quantification of NAD T and T Relaxation Times Using Downfield H MRS at 7 T in Human Brain In Vivo.

The purpose of this study was to measure T and T relaxation times of NAD proton resonances in the downfield H MRS spectrum in human brain at 7 T in vivo and to assess the propagation of relaxation time uncertainty in NAD quantification. Downfield spectra from eight healthy volunteers were acquired at multiple echo times to measure T relaxation times, and saturation recovery data were acquired to measure T relaxation times. The downfield acquisition used a spectrally selective 90° sinc pulse for excitation centered at 9.