Gastric teratoma with predominant nephroblastic elements

Gastric teratoma is an uncommon neoplasm in infancy. Most of the gastric teratomas described have mature elements while some have immature elements. Occurrence of nephroblastic rests in gastric teratoma has not been described in available literature earlier.     

Alcohol Quantity and Type on Risk of Recurrent Gout Attacks: An Internet-based Case-crossover Study

Objectives

Although beer and liquor have been associated with risk of incident gout, wine has not. Yet anecdotally, wine is thought to trigger gout attacks. Further, how much alcohol intake is needed to increase the risk of gout attack is not known. We examined the quantity and type of alcohol consumed on risk of recurrent gout attacks.

Methods

We conducted a prospective Internet-based case-crossover study in the US among participants with gout and who had at least one attack during the 1 year of follow-up. We evaluated the association of alcohol intake over the prior 24 hours as well as the type of alcoholic beverage with risk of recurrent gout attack, adjusting for potential time-varying confounders.

Results

This study included 724 participants with gout (78% men, mean age 54 years). There was a significant dose-response relationship between amount of alcohol consumption and risk of recurrent gout attacks (P <.001 for trend). The risk of recurrent gout attack was 1.36 (95% confidence interval [CI], 1.00-1.88) and 1.51 (95% CI, 1.09-2.09) times higher for >1-2 and >2-4 alcoholic beverages, respectively, compared with no alcohol consumption in the prior 24 hours. Consuming wine, beer, or liquor was each associated with an increased risk of gout attack.

Conclusions

Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Individuals with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.     

Plasmon-Induced Enhanced Light Emission and Ultrafast Carrier Dynamics in a Tunable Molybdenum Disulfide-Gallium Nitride Heterostructure

The effect of localized plasmon on the photoemission and absorption in hybrid molybdenum disulfide-Gallium nitride (MoS₂-GaN) heterostructure has been studied. Localized plasmon induced by platinum nanoparticles was resonantly coupled to the bandedge states of GaN to enhance the UV emission from the hybrid semiconductor system. The presence of the platinum nanoparticles also increases the effective absorption and the transient gain of the excitonic absorption in MoS₂. Localized plasmons were also resonantly coupled to the defect states of GaN and the exciton states using gold nanoparticles. The transfer of hot carriers from Au plasmons to the conduction band of MoS₂ and the trapping of excited carriers in MoS₂ within GaN defects results in transient plasmon-induced transparency at ~1.28 ps. Selective optical excitation of the specific resonances in the presence of the localized plasmons can be used to tune the absorption or emission properties of this layered 2D-3D semiconductor material system.     

Development of the American College of Rheumatology Electronic Clinical Quality Measures for Gout

Objective

Electronic clinical quality measures (eCQMs) are increasingly used by health registries and third parties to evaluate and improve the quality of health care. To complete these eCQMs, data are extracted from electronic health records (EHRs). The treatment of gout has been an area identified with gaps in quality of care. On behalf of the American College of Rheumatology (ACR), we sought to develop and test eCQMs to evaluate gout care.

Methods

Drawing from the 2012 ACR gout guidelines, a working group developed candidate gout process measures that were evaluated by an interdisciplinary panel of health care stakeholders, the ACR Quality Measures Subcommittee (QMS), and ultimately the ACR Board of Directors for formal validity testing. For each of the selected gout eCQMs, 3 clinical sites using different EHR systems tested the scientific feasibility and validity of the measures. Measures appropriate for accountability were presented for national endorsement.

Results

Of the 10 proposed eCQMs, 4 were endorsed by the ACR QMS, 3 were incorporated into the ACR's Rheumatology Informatics System for Effectiveness (RISE) Registry, and 2 were endorsed by the National Quality Forum. The 3 eCQMs incorporated into RISE (evaluating indications for urate‐lowering therapy [ULT]), monitoring serum urate, and treat‐to‐target outcome) demonstrated high validity and reliability. Proportions of patients passing these 3 eCQMs in RISE and at the 3 clinical testing sites ranged between 32% and 58%, indicating significant room for improvement in care.

Conclusion

Three eCQMs have been validated and implemented into RISE. Two of these measures (evaluating indications for ULT and monitoring serum urate) are available for use in federal quality reporting programs. Performance on these measures suggests there is significant room for improvement in the management of gout.