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OBJECTIVE: Quality of care (QoC) delivery in rheumatoid arthritis (RA) continues to suffer from various challenges (eg, delay in diagnosis and referral) that can lead to poor patient outcomes. This study aimed to identify good practice interventions that address these challenges in RA care in North America. METHODS: The study was conducted in three steps: (1) literature review of existing publications and guidelines (April 2005 to April 2021) on QoC in RA; (2) in-person visits to >50 individual specialists and health care professionals across nine rheumatology centers in the United States and Canada to identify challenges in RA care and any corresponding good practice interventions; and (3) collation and organization of findings of the two previous methods by commonalities to identify key good practice interventions, followed by further review by RA experts to ensure key challenges and gaps in RA care were captured. RESULTS: Several challenges and eight good practice interventions were identified in RA care. The interventions were prioritized based on the perceived positive impact on the challenges in care and ease of implementation. High-priority interventions included the use of technology to improve care, streamlining specialist treatment, and facilitating comorbidity assessment and care. Other interventions included enabling patient access to optimal medication regimens and improving patient self-management strategies. CONCLUSION: Learnings from the study can be implemented in other rheumatology centers throughout North America to improve RA care. Although the study was completed before the COVID-19 pandemic, the findings remain relevant.

Extensive reading (ER) research has suggested that completing the equivalent of 7,200 standard words of extensive reading per week facilitates substantial reading rate gains. Research has also suggested that 100 minutes per week is sufficient to complete this goal for most English language learners (Beglar & Hunt, 2014). However, experimental and quantitative studies have yet to fully investigate the feasibility of such large amounts of ER in a limited amount of time for learners of languages other than English. The goal of this study was to investigate the feasibility of a 7,200- standard-word (12,000-character) per week reading goal for intermediate-level learners of Japanese as a foreign language (JFL). Another aim was to ascertain learner perceptions of ER that followed strict adherence to ER principles. Using a quantitative single-subject study and observation design, I monitored eight intermediate-level learners of Japanese engaging in ER for over two and a half to four months. Results indicated that given 100 minutes per week, a reading goal of 12,000 characters (7,200 standard words) is likely feasible for most intermediate JFL learners and that participants had overwhelmingly positive attitudes toward ER.

This study's goal was to determine if appropriately designed, completely virtual formats of language courses are able to engender in students speaking ability progress comparable to that fostered within traditional face-to-face (F2F) classrooms. The study further sought to clarify language learners' perceptions of online Japanese courses. The speaking ability of all participants was assessed at the beginning and end of their Japanese language course. A mixed-design analysis of variance was conducted to analyze the effect of course type on speaking ability. Results showed that participant speaking ability improved significantly over time regardless of course type (online or F2F). This study also revealed that the majority of participants were able to use online tools with ease and found the online format to be an effective method of learning Japanese. Two principal reasons for studying Japanese online are reported. Implications and suggestions are discussed.

In recent years there has been an increased recognition of the need for learners to understand language as social action. However, language learners are often left on their own to develop the ability to adapt to the unanticipated demands of real-world interaction. To encourage this development, attention is turning toward the notion of interactional competence (IC). The present study contributes to efforts to better understand Japanese learners' IC. Specifically, this study aims to better understand how learners naturally accomplish compliment and consolation speech acts and for what social purposes, including how learners adapt linguistic forms to do acts that go beyond the act most commonly associated with those forms. Conversation analysis of foreign language housing mealtime conversations revealed two core observations. First, based on preempirical descriptions, compliments occur with more frequency than consolations. Compliments also tend to be deployed as the first part of a compliment-response pair, while consolations tend to be deployed as a response to the public exposure of a challenge or a troubling emotional state. Second, when looking instead at how participants use turns that are construed as compliments regardless of linguistic form, we find that compliments are also used to do activities other than what their surface formulation suggests. A discussion of what these results mean for developing deeper understandings of IC in speech acts performed by language learners is provided. [ABSTRACT FROM AUTHOR]

Objective: To assess efficacy, safety, pharmacokinetics, and immunogenicity of pegloticase plus methotrexate (MTX) versus pegloticase plus placebo cotreatment for uncontrolled gout in a randomized, placebo‐controlled, double‐blind trial. Methods: This study included adults with uncontrolled gout, defined as serum urate ≥7 mg/dl, oral urate‐lowering therapy failure or intolerance, and presence of ongoing gout symptoms including ≥1 tophus, ≥2 flares in the past 12 months, or gouty arthritis. Key exclusion criteria included MTX contraindication, current immunosuppressant use, G6PDH deficiency, and estimated glomerular filtration rate <40 ml/minute/1.73 m2. Patients were randomized 2:1 to 52 weeks of pegloticase (8 mg biweekly) with either oral MTX (15 mg/week) or placebo. The primary end point was the proportion of treatment responders during month 6 (defined as serum urate <6 mg/dl for ≥80% of visits during weeks 20–24). Efficacy was evaluated in all randomized patients (intent‐to‐treat population), and safety was evaluated in all patients receiving ≥1 blinded MTX or placebo dose. Results: A total of 152 patients were randomized, 100 to receive pegloticase plus MTX, 52 to receive pegloticase plus placebo. Significantly higher treatment response occurred during month 6 in the MTX group versus the placebo group (71.0% [71 of 100 patients] versus 38.5% [20 of 52 patients], respectively; between‐group difference 32.3% [95% confidence interval 16.3%, 48.3%]) (P < 0.0001 for between‐group difference). During the first 6 months of pegloticase plus MTX or pegloticase plus placebo treatment, 78 (81.3%) of 96 MTX patients versus 47 (95.9%) of 49 placebo patients experienced ≥1 adverse event (AE), most commonly gout flare (64 [66.7%] of 96 MTX patients and 34 [69.4%] of 49 placebo patients). Reports of AEs and serious AEs were comparable between groups, but the infusion reaction rate was considerably lower with MTX cotherapy (4.2% [4 of 96 MTX patients, including 1 patient who had anaphylaxis]) than with placebo cotherapy (30.6% [15 of 49 placebo patients, 0 who had anaphylaxis]) (P < 0.001). Antidrug antibody positivity was also lower in the MTX group. Conclusion: MTX cotherapy markedly increased pegloticase response rate over placebo (71.0% versus 38.5%) during month 6 with no new safety signals. These findings verify higher treatment response rate, lower infusion reaction incidence, and lower immunogenicity when pegloticase is coadministered with MTX. [ABSTRACT FROM AUTHOR]

A large variety of techniques are used to understand the thermodynamic stability, in addition to the electrical and physical characteristics of high permittivity hafnium titanate thin films that are commonly used as gate insulators. The studies show that the increase in the Ti content also increases the permittivity of the films, whereas the temperature dependence highly depends on the Hf content of the films linearly.

The details of promotion competency model developed by the General Mills, which includes in-house promotional function, are discussed. The creativity, which is important aspect of nine competencies, is emphasized.

Vertical transport in metal-polar heterostructure junction is examined. The fixed polar charge causes band bending that requires doping.

Plasma enhanced chemical vapor deposition (PECVD) technique was used to fabricate properly functioning pn junction diodes. Plasma clean is not required in low temperature growth of Si thin films.

A fully atomistic modeling scheme was used to diffuse x-ray scattering patterns form 311 defects. Results suggest how both defect width and length can be derived from the scattering.

Blue and green light emitting lithium zinc gallate thin-film phosphors were grown. This was done using pulsed laser deposition.