Hepatitis C virus testing, liver disease assessment and treatment uptake among people who inject drugs pre- and post-universal access to direct-acting antiviral treatment in Australia: The LiveRLife study.

Gaps in hepatitis C virus (HCV) testing, diagnosis, liver disease assessment and treatment uptake among people who inject drugs (PWID) persist. We aimed to describe the cascade of HCV care among PWID in Australia, prior to and following unrestricted access to direct-acting antiviral (DAA) treatment. Participants enrolled in an observational cohort study between 2014 and 2018 provided fingerstick whole-blood samples for dried blood spot, Xpert HCV Viral Load and venepuncture samples. Participants underwent transient elastography and clinical assessment by a nurse or general practitioner. Among 839 participants (mean age 43 years), 66% were male (n = 550), 64% (n = 537) injected drugs in the previous month, and 67% (n = 560) reported currently receiving opioid substitution therapy. Overall, 45% (n = 380) had detectable HCV RNA, of whom 23% (n = 86) received HCV treatment within 12 months of enrolment. HCV treatment uptake increased from 2% in the pre-DAA era to 38% in the DAA era. Significant liver fibrosis (F2-F4) was more common in participants with HCV infection (38%) than those without (19%). Age 50 years or older (aOR, 2.88; 95% CI, 1.18-7.04) and attending a clinical follow-up with nurse (aOR, 3.19; 95% CI, 1.61-6.32) or physician (aOR, 11.83; 95% CI, 4.89-28.59) were associated with HCV treatment uptake. Recent injection drug use and unstable housing were not associated with HCV treatment uptake. HCV treatment uptake among PWID has increased markedly in the DAA era. Evaluation of innovative and simplified models of care is required to further enhance treatment uptake.

Effects of Intravenous Golimumab on Health-Related Quality of Life in Patients with Ankylosing Spondylitis: 28-Week Results of the GO-ALIVE Trial.

OBJECTIVE: Evaluate the effect of intravenous golimumab on health-related quality of life (HRQoL) in patients with ankylosing spondylitis (AS) through week 28 of the phase III, multicenter, randomized, double-blind, placebo-controlled GO-ALIVE study. METHODS: Adult patients (n = 208) were randomized to IV golimumab 2 mg/kg (n = 105) at weeks 0, 4, and 12 and every 8 weeks or placebo (n = 103) at weeks 0, 4, and 12, with crossover to golimumab 2mg/kg at weeks 16, 20, and every 8 weeks. General HRQoL was evaluated using the Short Form Health Survey (SF-36) Physical Component Summary/Mental Component Summary (PCS/MCS), and the EQ VAS, and AS disease-specific HRQoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) instrument. RESULTS: Mean improvements from baseline in SF-36 PCS were greater in the golimumab group versus the placebo group at weeks 8 and 16 (6.8 vs 2.1 and 8.5 vs 2.9, respectively; P < .001); similar results were observed for SF-36 MCS (5.6 vs 1.7 and 6.5 vs 0.8, respectively; P < .001). Mean improvement in each of 8 subscale scores of the SF-36 were also greater for golimumab-treated patients versus placebo at weeks 8 and 16. Mean improvements in EQ VAS and ASQoL were greater in the golimumab group versus placebo at week 8 and week 16. Greater proportions of golimumab-treated patients had clinically meaningful improvement in SF-36 PCS, SF-36 MCS, EQ VAS, and ASQoL at weeks 8 and 16; improvements in SF-36 PCS/MCS, EQ VAS, and ASQoL were maintained through week 28. CONCLUSIONS: Golimumab-treated patients had greater mean improvements in HRQoL measures compared with placebo through week 16. Clinically meaningful improvements were observed as early as week 8 and continued through week 28.

Effects of Intravenous Golimumab on Health-Related Quality of Life in Patients With Psoriatic Arthritis: 24-Week Results of the GO-VIBRANT Trial.

OBJECTIVES: Evaluate the effects of intravenous golimumab 2 mg/kg on multiple domains of health-related quality of life (HRQoL) in adult patients with active psoriatic arthritis (PsA). METHODS: In this phase III, randomized, double-blinded, placebo-controlled study, adults with active PsA were randomized in a 1:1 ratio to receive intravenous (IV) infusions of placebo (n = 239) or golimumab 2 mg/kg (n = 241) at weeks 0, 4, 12, and 20. Physical function was assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI). HRQoL was assessed using the 36-item Short-Form Health Survey Physical and Mental Component Summary (SF-36 PCS/MCS) scores, the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue, EQ VAS, and the Dermatology Life Quality Index (DLQI). RESULTS: Patients in the golimumab group had greater mean changes from baseline in HAQ-DI compared with placebo at weeks 8 (-0.52 vs -0.10), 14 (-0.60 vs -0.12), and 24 (-0.63 vs -0.14). Mean improvements from baseline in SF-36 PCS (8.0 vs 1.7), SF-36 MCS (5.0 vs 1.2), EQ VAS (17.2 vs 3.7), FACIT-Fatigue (7.9 vs 2.0), and DLQI (-7.2 vs -1.7) were also greater in the golimumab group versus placebo at week 8 and were maintained or increased through week 24. Greater proportions of golimumab-treated patients had improvements greater than or equal to the minimal clinically important difference (MCID) for HAQ-DI, SF-36 PCS/MCS, EQ VAS, FACIT-Fatigue, and DLQI scores at weeks 14 and 24. CONCLUSION: Improvements in HRQoL were greater in the IV golimumab group compared with placebo and were evident at week 8 and sustained through week 24.

Group-level cortical and muscular connectivity during perturbations to walking and standing balance.

Maintaining balance is a complex process requiring multisensory processing and coordinated muscle activation. Previous studies have indicated that the cortex is directly involved in balance control, but less information is known about cortical flow of signals for balance. We studied source-localized electrocortical effective connectivity dynamics of healthy young subjects (29 subjects: 14 male and 15 female) walking and standing with both visual and physical perturbations to their balance. The goal of this study was to quantify differences in group-level corticomuscular connectivity responses to sensorimotor perturbations during walking and standing. We hypothesized that perturbed visual input during balance would transiently decrease connectivity between occipital and parietal areas due to disruptive visual input during sensory processing. We also hypothesized that physical pull perturbations would increase cortical connections to central sensorimotor areas because of higher sensorimotor integration demands. Our findings show decreased occipito-parietal connectivity during visual rotations and widespread increases in connectivity during pull perturbations focused on central areas, as expected. We also found evidence for communication from cortex to muscles during perturbed balance. These results show that sensorimotor perturbations to balance alter cortical networks and can be quantified using effective connectivity estimation.

Transient visual perturbations boost short-term balance learning in virtual reality by modulating electrocortical activity.

Immersive virtual reality can expose humans to novel training and sensory environments, but motor training with virtual reality has not been able to improve motor performance as much as motor training in real-world conditions. An advantage of immersive virtual reality that has not been fully leveraged is that it can introduce transient visual perturbations on top of the visual environment being displayed. The goal of this study was to determine whether transient visual perturbations introduced in immersive virtual reality modify electrocortical activity and behavioral outcomes in human subjects practicing a novel balancing task during walking. We studied three groups of healthy young adults (5 male and 5 female for each) while they learned a balance beam walking task for 30 min under different conditions. Two groups trained while wearing a virtual reality headset, and one of those groups also had half-second visual rotation perturbations lasting ~10% of the training time. The third group trained without virtual reality. We recorded high-density electroencephalography (EEG) and movement kinematics. We hypothesized that virtual reality training with perturbations would increase electrocortical activity and improve balance performance compared with virtual reality training without perturbations. Our results confirmed the hypothesis. Brief visual perturbations induced increased theta spectral power and decreased alpha spectral power in parietal and occipital regions and improved balance performance in posttesting. Our findings indicate that transient visual perturbations during immersive virtual reality training can boost short-term motor learning by inducing a cognitive change, minimizing the negative effects of virtual reality on motor training. NEW & NOTEWORTHY We found that transient visual perturbations in virtual reality during balance training can boost short-term motor learning by inducing a cognitive change, overcoming the negative effects of immersive virtual reality. As a result, subjects training in immersive virtual reality with visual perturbations have equivalent performance improvement as training in real-world conditions. Visual perturbations elicited cortical responses in occipital and parietal regions and may have improved the brain's ability to adapt to variations in sensory input.

Management of fingertip amputations.

Injuries to the fingertips are among the most common injuries to the hand and result in approximately 4.8 million emergency department visits per year. Most injuries are lacerations or crushes; amputations represent a small but complex spectrum of injury. Treatments available cover a broad range of techniques with no single recommended reference standard for treatment. Although there is no consensus on how these injuries should be treated, the goals of treatment should include minimization of pain, optimization of healing time, preservation of sensibility and length, prevention of painful neuromas, avoidance or limiting of nail deformity, minimization of time lost from work, and provision of an acceptable cosmetic appearance. In this review we present a variety of options in caring for these injuries to help achieve these goals, and the available data that support the various treatment plans.

Structure and functionality of surface-active amylose-fatty amine salt inclusion complexes.

Novel value-added starch-based materials can be produced by forming amylose inclusion complexes (AIC) with hydrophobic compounds. There is currently little research on AIC use as polymeric emulsifiers, particularly for AIC with fatty amine salt ligands. This work evaluated AIC emulsifiers by studying the structure and functionality of AIC composed of high amylose corn starch and fatty amine salts (10-18 carbons, including a mixture simulating vegetable oil composition) produced via steam jet cooking. X-ray scattering verified successful AIC formation, with peaks located near 7.0°, 12.8° and 19.9° 2θ. AIC were easily dispersed in water (80-85 °C) and remained in suspension at room temperature for weeks, unlike the uncomplexed ligands or starch. AIC were highly effective emulsifying agents, with emulsifying activity indexes of 213-229 m2g-1 at pH 5, and zeta potentials, a measure of electrostatic repulsion, as high as 43.4 mV. AIC dispersions had surface tension ranging from 24 to 41 mN/m and displayed surface-active properties superior to amylose complexes formed from fatty acid salts and competitive with common starch-based emulsifiers. These findings demonstrate that fatty amine salt AIC are effective emulsifiers that can be made from low-cost sources of fatty amine salts, such as vegetable oil derivatives.

Work Productivity and General Health Through 2 Years of Guselkumab Treatment in a Phase 3 Randomized Trial of Patients With Active Psoriatic Arthritis.

INTRODUCTION: To evaluate the effect of guselkumab on work productivity and nonwork daily activity impairment and general health status through 2 years in patients who were biologic-naïve with active psoriatic arthritis (PsA) in the phase 3 DISCOVER-2 clinical trial. METHODS: Adult patients with PsA were randomized to subcutaneous injections of guselkumab 100 mg every 4 weeks (Q4W); at weeks 0, 4, then every 8 weeks (Q8W); or placebo (through week 24 with crossover to guselkumab Q4W). Work productivity and nonwork daily activity impairment were assessed using the Work Productivity and Activity Impairment Questionnaire for PsA (WPAI-PsA) and patient-reported general health status using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Index and EQ-Visual Analog Scale (EQ-VAS). Least-squares (LS) mean changes from baseline in WPAI-PsA domains and EQ-5D-5L/EQ-VAS were assessed through week 100. Changes in employment status were utilized to estimate potential indirect savings from improved work productivity. RESULTS: Of 739 randomized patients, 738 had available baseline data for the analyses (Q4W 245; Q8W 248; placebo 245). At week 24, greater improvements in work productivity, nonwork daily activity, and EQ-5D-5L/EQ-VAS were observed in the Q4W and Q8W groups versus the placebo group. At week 100, LS mean reductions in work productivity impairment (- 23.8% to - 28.0%) and nonwork daily activity impairment (- 26.6% to - 29.2%) and improvements in EQ-5D-5L/EQ-VAS (0.14 to 0.15/21.2 to 25.0) were maintained in patients receiving guselkumab. Among patients employed at baseline, 12.1-16.4% were not employed at week 100, and 20.0-25.3% shifted from not employed at baseline to employed at week 100. Potential yearly indirect cost savings (USD) from improved work productivity at week 100 ranged from $16,529 to $19,409. CONCLUSION: Patients with active PsA treated with guselkumab demonstrated reduced impairment in work productivity and nonwork daily activity, together with improvement in general health status and substantial potential cost savings, over a 2-year period. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT03158285.

Preoperative A1c and Postoperative Infection in Elective Hand Surgery.

Diabetes mellitus affects 10.5% of the US population. Numerous studies have documented increased risk of complications for patients with diabetes after different types of surgery, including hand surgery. By aiming for a preoperative target hemoglobin A1c (A1c), the risk of surgical complications following elective hand surgery may be reduced for patients with diabetes. This literature review was conducted to evaluate the association between diabetes mellitus and surgical site infections and, more specifically, to determine whether there is any association between preoperative A1c level and postoperative infections in hand surgery. The risk for surgical site infections and wound complications appears to be higher for patients with insulin-dependent diabetes mellitus, but not necessarily for patients with noninsulin-dependent diabetes mellitus, when compared with patients without diabetes. The role of prophylactic antibiotics for patients with diabetes undergoing elective hand surgery was also considered. Prophylactic antibiotics have not been shown to be beneficial for healthy patients undergoing clean, elective hand surgery. However, preoperative antibiotics may have a protective role for some patients with poorly controlled hyperglycemia.

Assessment of the Environmental Impacts of a Localized Food System and Food Waste Reduction in a Water-Scarce Region Using Diet Optimization Models.

Despite growing interest in fresh local produce across the United States, scaling up local agricultural development might impose new environmental pressures on increasingly scarce water and land resources in specific localities. Drawing upon the case of the Palouse of the US Inland Northwest, this study evaluates land and water footprints of local foods along with food waste reduction in a water-scarce region. We used both non-robust and robust diet-optimization techniques to estimate the minimum amounts of irrigation water necessary to grow foods locally and to satisfy the local population's caloric or nutrition needs. Our modeling results indicate that, on an annual basis, an increase of less than 5% of the current freshwater withdrawal on the Palouse could satisfy 10% of the local population's aspirational demand for locally grown food products, while more than 35% of local foods (by mass) may be wasted. Furthermore, reducing food waste by 50% could simultaneously reduce water use by up to 24%, cropland use by 13%, and pastureland use by 20%. Our findings not only provide intriguing information for access to local food but could also be used to stimulate new efforts to increase consumers' and retailers' awareness of environmental benefits associated with food waste reduction.

Impact of key manifestations of psoriatic arthritis on patient quality of life, functional status, and work productivity: Findings from a real-world study in the United States and Europe.

OBJECTIVES: To determine the individual impact of key manifestations of psoriatic arthritis (PsA) on quality of life (QoL), physical function, and work disability. METHODS: Data from the Adelphi 2018 PsA Disease-Specific Programme, a multinational, cross-sectional study of PsA patients, were used. PsA manifestations included peripheral arthritis (number of joints affected), psoriasis (body surface area [BSA]), axial involvement (inflammatory back pain [IBP] and sacroiliitis) enthesitis, and dactylitis. General, and disease-specific QoL, physical function, and work disability were measured with EQ-5D-5L, PsAID-12, HAQ-DI, and WPAI, respectively. Multivariate regression adjusting for potential confounders evaluated the independent effect of PsA manifestations on each outcome. RESULTS: Among the 2222 PsA patients analysed, 77.0% had active psoriasis and 64.4% had peripheral arthritis; 5.9%, 6.8%, 10.2%, and 3.6% had enthesitis, dactylitis, IBP, or sacroiliitis, respectively. Mean EQ VAS scores were significantly poorer in patients with vs. without enthesitis (59.9 vs. 75.6), dactylitis (63.6 vs. 75.4), and with greater peripheral joint involvement (none: 82.5; 1-2 affected joints: 74.1; 3-6 joints: 74.2; >6 joints: 65.0). Significantly worse mean PsAID-12 scores were associated with vs. without enthesitis (4.39 vs. 2.34) or dactylitis (4.30 vs. 2.32), and with greater peripheral joint involvement (none: 1.21; 1-2 joints: 2.36; 3-6 joints: 2.74; >6 joints: 3.92), and BSA (none: 1.49; >3-10%: 2.96; >10%: 3.43). Similar patterns were observed with HAQ-DI and WPAI scores. CONCLUSION: Most PsA manifestations were independently associated with worse general, and PsA-specific QoL, physical function, and work disability, highlighting the need for treatments targeting the full spectrum of PsA symptoms to lower the burden of disease.

Learning neural decoders without labels using multiple data streams.

Objective.Recent advances in neural decoding have accelerated the development of brain-computer interfaces aimed at assisting users with everyday tasks such as speaking, walking, and manipulating objects. However, current approaches for training neural decoders commonly require large quantities of labeled data, which can be laborious or infeasible to obtain in real-world settings. Alternatively, self-supervised models that share self-generated pseudo-labels between two data streams have shown exceptional performance on unlabeled audio and video data, but it remains unclear how well they extend to neural decoding.Approach.We learn neural decoders without labels by leveraging multiple simultaneously recorded data streams, including neural, kinematic, and physiological signals. Specifically, we apply cross-modal, self-supervised deep clustering to train decoders that can classify movements from brain recordings. After training, we then isolate the decoders for each input data stream and compare the accuracy of decoders trained using cross-modal deep clustering against supervised and unimodal, self-supervised models.Main results.We find that sharing pseudo-labels between two data streams during training substantially increases decoding performance compared to unimodal, self-supervised models, with accuracies approaching those of supervised decoders trained on labeled data. Next, we extend cross-modal decoder training to three or more modalities, achieving state-of-the-art neural decoding accuracy that matches or slightly exceeds the performance of supervised models.Significance.We demonstrate that cross-modal, self-supervised decoding can be applied to train neural decoders when few or no labels are available and extend the cross-modal framework to share information among three or more data streams, further improving self-supervised training.

Characterization and properties of starch-dicarboxylic acid inclusion complexes prepared by excess steam jet cooking.

A series of dicarboxylic-amylose inclusion complexes (AIC) were prepared by excess steam jet-cooking high amylose corn starch with linear C10, C12, C14, and C16 dicarboxylic acids to examine the influence of two polar head groups on complex formation. The C12, C14, and C16 dicarboxylic acid AIC were prepared in 48-63 % yields and contained 8.9-11.8 % diacid while the C10 AIC gave 30 % and contained 2.6 % diacid. These AIC had V6 helical amylose structures by XRD and complexation was further confirmed by DSC, FTIR, and TGA. SEM of the C12-C16 AIC revealed micron-sized toroidal spherulites while the C10 AIC was predominantly amorphous. DSC showed two AIC related transitions. This work provides a better understanding of the formation and physicochemical properties of these diacid AIC. Preparation by excess steam jet cooking demonstrates practical and commercial utility to prepare AIC as off-the-shelf materials for food and nonfood applications.

AJILE12: Long-term naturalistic human intracranial neural recordings and pose.

Understanding the neural basis of human movement in naturalistic scenarios is critical for expanding neuroscience research beyond constrained laboratory paradigms. Here, we describe our Annotated Joints in Long-term Electrocorticography for 12 human participants (AJILE12) dataset, the largest human neurobehavioral dataset that is publicly available; the dataset was recorded opportunistically during passive clinical epilepsy monitoring. AJILE12 includes synchronized intracranial neural recordings and upper body pose trajectories across 55 semi-continuous days of naturalistic movements, along with relevant metadata, including thousands of wrist movement events and annotated behavioral states. Neural recordings are available at 500 Hz from at least 64 electrodes per participant, for a total of 1280 hours. Pose trajectories at 9 upper-body keypoints were estimated from 118 million video frames. To facilitate data exploration and reuse, we have shared AJILE12 on The DANDI Archive in the Neurodata Without Borders (NWB) data standard and developed a browser-based dashboard.

Antimony(+5) ion induced tunable intramolecular charge transfer in hypervalent antimony(V) porphyrins.

The +5 oxidation state of antimony induced push-pull style intramolecular charge transfer in an elegantly designed axial dimethoxyantimony(V) porphyrin series: SbP(OMe)2·PF6, SbMP(OMe)2·PF6, SbDMP(OMe)2·PF6, SbTMP(OMe)2·PF6 with phenyl (P), 4-methoxyphenyl (MP), 3,5-dimethoxyphenyl (DMP), and 3,4,5-trimethoxyphenyl (TMP) units, respectively, in its meso positions. The Sb(+5) made the porphyrin ring electron-poor, whereas the methoxy groups on the phenyl unit produced electron-rich sites within the molecule. The presence of electron-poor and electron-rich parts in the same molecule resulted in a push-pull type intramolecular charge transfer (ICT). However, the ICT is strongly dependent on the position of the methoxy groups on the phenyl ring. The charge transfer character is more pronounced in meta-methoxy substituted antimony(V) derivatives (SbDMP(OMe)2·PF6, SbTMP(OMe)2·PF6) than the para-methoxy or no-methoxy substituted antimony(V) derivatives (SbP(OMe)2·PF6, SbMP(OMe)2·PF6). Steady-state and transient spectroscopic techniques, as well as solvatochromism techniques, were employed to establish the tunable ICT. Additionally, time-dependant density functional theory (TD-DFT) calculations were used to complement the experimental results. The systematic study of antimony(V) porphyrins, especially the tunable push-pull nature could play an important role in instigating high yield charge-separated states in multi-modular donor-acceptor systems for solar energy conversion and molecular electronic and photonic applications.

The Effect of Guselkumab on General Health State in Biologic-Naïve Patients with Active Psoriatic Arthritis Through Week 52 of the Phase 3, Randomized, Placebo-Controlled DISCOVER-2 Trial.

INTRODUCTION: In DISCOVER-2, guselkumab, an interleukin-23 p19 subunit inhibitor, was efficacious in biologic-naïve psoriatic arthritis (PsA) patients. We report the effect of guselkumab on health-related quality of life (HRQoL) using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Index and Visual Analog Scale (EQ-VAS) through Week 52. METHODS: Adults with active PsA were randomized to guselkumab 100 mg every 4 weeks (Q4W) or Weeks 0, 4, then every 8 weeks (Q8W), or placebo (crossover to guselkumab Q4W at Week 24). Least squares (LS) mean changes in EQ-5D-5L Index (0-1, US-based value set) and EQ-VAS (0-100) from baseline through Week 52 were assessed. Proportions of patients achieving minimally important differences (MIDs) were assessed through Week 52. Associations between patient clinical features and EQ-5D-5L Index and EQ-VAS scores were examined cross-sectionally with pooled data through Week 24. RESULTS: The analysis included 738 patients (Q4W n = 245; Q8W n = 248; placebo n = 245). At Week 24, LS mean changes from baseline in the Q4W, Q8W, and placebo groups were 0.12, 0.12, and 0.05, respectively, for EQ-5D-5L Index, and 18.2, 18.4, and 6.8, respectively, for EQ-VAS. At Week 52, improvement was maintained in the guselkumab groups and increased in the placebo crossover group. EQ-5D-5L Index MID was achieved by 56.0% in each guselkumab group at Week 24 and 66.2% in Q4W, 68.5% in Q8W, and 66.1% in placebo crossover group at Week 52. Higher C-reactive protein level, Psoriasis Area and Severity Index score, fatigue, and pain were correlated with worse EQ-5D-5L Index and EQ-VAS, based on pooled data through Week 24. Higher tender joint count was correlated with worse EQ-5D-5L, while higher swollen joint count was correlated with worse EQ-VAS. CONCLUSIONS: Guselkumab improved HRQoL through 52 weeks in patients with active PsA. Impairment in HRQoL was correlated with increased inflammation, fatigue, pain, and measures of skin and joint symptom severity. CLINICALTRIALS: GOV: NCT03158285.

The Effect of Guselkumab on Work Productivity in Biologic-Naïve Patients with Active Psoriatic Arthritis Through Week 52 of the Phase 3, Randomized, Placebo-Controlled DISCOVER-2 Trial.

INTRODUCTION: The phase 3 DISCOVER-2 trial evaluated the effect of guselkumab on impaired work productivity and nonwork activity in biologic-naïve patients with psoriatic arthritis (PsA). METHODS: Adults with active PsA were randomized (1:1:1) to guselkumab 100 mg every 4 weeks (Q4W), guselkumab 100 mg at weeks 0 and 4 and then every 8 weeks (Q8W), or placebo (with crossover to guselkumab Q4W at week 24). Least squares mean change from baseline in Work Productivity and Activity Impairment Questionnaire for PsA (WPAI-PsA) domains and employment were assessed by treatment group. Multivariate analysis of data from weeks 0 through 24 assessed independent associations between PsA clinical features and WPAI-PsA domains. RESULTS: In total, 738 patients were evaluated (guselkumab Q4W n = 245; guselkumab Q8W n = 248; placebo n = 245). At week 24, improvements (reduced impairment) in presenteeism (Q4W -20.1%, Q8W -19.6%, placebo -10.5%), work productivity (Q4W -20.1%, Q8W -19.2%, placebo -10.6%), and nonwork activity (Q4W -20.5%, Q8W -21.2%, placebo -9.9%) were greater in guselkumab-treated versus placebo-treated patients. At week 52, following placebo crossover at week 24, improvements were similar among groups. Baseline absenteeism was minimal and did not change in any group. By week 52, 23.1-25.9% of guselkumab-treated patients who were unemployed at baseline were employed. All WPAI-PsA domains were positively associated with C-reactive protein level, fatigue, and pain. All domains except absenteeism were positively associated with enthesitis and Psoriasis Area and Severity Index score. Age was negatively associated with presenteeism and work productivity loss, female sex and tender joint count were positively associated with nonwork activity impairment, and dactylitis was positively associated with presenteeism. CONCLUSION: Both guselkumab regimens reduced work productivity loss and nonwork activity impairment in patients with active PsA. Association of work productivity loss and nonwork activity impairment with PsA joint and skin features suggests that improvement in both features is beneficial for optimizing improved work productivity loss and nonwork activity impairment. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03158285.

Shoulder and upper arm muscle architecture.

PURPOSE: To examine the architecture of the shoulder and upper arm muscles and generate data that could serve as a guide for comparison, compatibility, and relative performance among these muscles for use in transfer. METHOD: Eleven shoulder and arm muscles were dissected bilaterally in 5 fresh cadavers. Of these 110 potentially available muscles, 107 were suitable for evaluation and were grouped according to similarities in architecture. Resting muscle length, required excursion, muscle fiber length, pennation angle, and mass were determined. Physiologic cross-sectional area (PCSA) was then calculated from these parameters using a standard formula. RESULTS: Based on the gross appearance of muscle fiber orientation, the 11 muscles were subdivided into 3 groups. Required excursion was found to be less than fiber length in all muscles except for the teres major and middle deltoid with abduction. The middle deltoid muscle was found to have a short fiber length, complex multipennate structure, and high PCSA. Comparison showed the biceps and posterior deltoid to have fiber lengths greater than any portion of the triceps; however, neither demonstrated architectural features that would generate the force (represented by PCSA) determined for the combined triceps. CONCLUSIONS: Data presented in this study offer the opportunity for direct comparison of architectural features of select shoulder and arm musculature.

Human electrocortical, electromyographical, ocular, and kinematic data during perturbed walking and standing.

Active balance control is critical for performing many of our everyday activities. Our nervous systems rely on multiple sensory inputs to inform cortical processing, leading to coordinated muscle actions that maintain balance. However, such cortical processing can be challenging to record during mobile balance tasks due to limitations in noninvasive neuroimaging and motion artifact contamination. Here, we present a synchronized, multi-modal dataset from 30 healthy, young human participants during standing and walking while undergoing brief sensorimotor perturbations. Our dataset includes 20 total hours of high-density electroencephalography (EEG) recorded from 128 scalp electrodes, along with surface electromyography (EMG) from 10 neck and leg electrodes, electrooculography (EOG) recorded from 3 electrodes, and 3D body position from 2 sensors. In addition, we include ∼ 18000 total balance perturbation events across participants. To facilitate data reuse, we share this dataset in the Brain Imaging Data Structure (BIDS) data standard and publicly release code that replicates our previous event-related findings.

Generalized neural decoders for transfer learning across participants and recording modalities.

Objective. Advances in neural decoding have enabled brain-computer interfaces to perform increasingly complex and clinically-relevant tasks. However, such decoders are often tailored to specific participants, days, and recording sites, limiting their practical long-term usage. Therefore, a fundamental challenge is to develop neural decoders that can robustly train on pooled, multi-participant data and generalize to new participants.Approach. We introduce a new decoder, HTNet, which uses a convolutional neural network with two innovations: (a) a Hilbert transform that computes spectral power at data-driven frequencies and (b) a layer that projects electrode-level data onto predefined brain regions. The projection layer critically enables applications with intracranial electrocorticography (ECoG), where electrode locations are not standardized and vary widely across participants. We trained HTNet to decode arm movements using pooled ECoG data from 11 of 12 participants and tested performance on unseen ECoG or electroencephalography (EEG) participants; these pretrained models were also subsequently fine-tuned to each test participant.Main results. HTNet outperformed state-of-the-art decoders when tested on unseen participants, even when a different recording modality was used. By fine-tuning these generalized HTNet decoders, we achieved performance approaching the best tailored decoders with as few as 50 ECoG or 20 EEG events. We were also able to interpret HTNet's trained weights and demonstrate its ability to extract physiologically-relevant features.Significance. By generalizing to new participants and recording modalities, robustly handling variations in electrode placement, and allowing participant-specific fine-tuning with minimal data, HTNet is applicable across a broader range of neural decoding applications compared to current state-of-the-art decoders.