To the best of our knowledge, there are no published data on the historical and recent use of CGM in clinical trials of pharmacological agents used in the treatment of diabetes. We analyzed 2,032 clinical trials of 40 antihyperglycemic therapies currently on the market with a study start date between 1 January 2000 and 31 December 2019. According to ClinicalTrials.gov, 119 (5.9%) of these trials used CGM. CGM usage in clinical trials has increased over time, rising from <5% before 2005 to 12.5% in 2019. However, it is still low given its inclusion in the American Diabetes Association’s latest guidelines and known limitations of A1C for assessing ongoing diabetes care.

Collective migration underlies key developmental and disease processes in vertebrates. Mathematical models describing collective migration can shed light on emergent patterns arising from simple mechanisms. In this paper, a mathematical model for collective migration is given for arbitrary numbers and types of individuals using principles outlined as a set of assumptions, such as the assumed preference for individuals to be “close but not too close" to others. The model is then specified to the case of two species with arbitrary numbers of individuals in each species. A particular form of signal response is used that may be parameterized based on experiments involving two or three agents. In its simplest form, the model describes two species of individuals that emit distinct signals, distinguishes between them, and exhibits responses unique to the type by moving according to signal gradients in various planar regions, a situation described as "mixotaxis". Beyond this simple form, initial conditions and boundary conditions are altered to simulate specific, additional in vitro as well as in vivo dynamics. The behaviors that were specifically accounted for include motility, directed migration, and a functional response to a signal. Ultimately, the paper’s results highlight the ability of a single framework for signal and response to account for patterns seen in multi-species systems, in particular the emergent self-organization seen in the embryonic development of placodal cells, which display chase-and-run behavior, flocking behavior, herding behavior, and the splitting of a herd, depending on initial conditions. Numerical experiments focus around the primary example of neural crest and placodal cell “chase-and-run” and “flocking” behaviors; the model reproduces the separation of placodal cells into distinct clumps, as described in the literature for neural crest and placodal cell development. This model was developed to describe a heterogeneous environment and can be expanded to capture other biological systems with one or more distinct species.

Background/Objectives: While robot-assisted radical prostatectomy (RARP) is the standard surgical treatment for localized prostate cancer, patients with marked prostatomegaly may experience worse outcomes. The current literature lacks generalizable, multi-surgeon data examining surgical complications in this population. Methods: We conducted a retrospective cohort study of 2030 patients who underwent RARP at a tertiary academic referral center. Perioperative complications and oncologic outcomes were compared between patients with marked prostatomegaly (defined as a prostate volume >100 grams (g)) and those with average-sized glands (<100 g). Logistic regression was used to compare groups. Results: Patients with marked prostatomegaly had a lower PSA density (0.10 vs. 0.20, p < 0.001), but there were no significant differences in pathologic NCCN grade groups, margin status, or lymph node involvement between groups. Patients with marked prostatomegaly had 60% higher odds of experiencing perioperative complications (OR 1.60, 95% CI 1.25–2.07, p < 0.0003) and were over twice as likely to have an ED visit or hospital readmission following surgery (OR 2.16, 95% CI 1.79–2.61, p < 0.001). They were also 25% more likely to undergo non-nerve-sparing or unilateral nerve-sparing procedures (OR 1.25, 95% CI 1.11–1.42, p < 0.001). Conclusions: Marked prostatomegaly is associated with higher rates of perioperative complications following RARP, with more frequent emergency room visits and readmissions. While nerve-sparing procedures were less commonly performed, oncologic outcomes remained comparable. Further prospective, multicenter studies are warranted to validate these results, which impact preoperative counseling.

Objective: This scoping review evaluated the impact of social determinants of health (SDOH) on health care delivery and access for US children with cerebral palsy (CP). Method: A comprehensive literature search was conducted using Medline, Embase, CINAHL Complete, and Scopus. Studies lacking extractable data or published before 2010 or outside the United States were excluded. Two independent investigators screened abstracts and a third resolved disagreements. Selected manuscripts underwent full-text review and data extraction for thematic and comparative analysis. Descriptive statistics were calculated in Excel. Results: In total, 6482 articles were identified and 146 underwent full-text review. Ultimately, 9 studies were included. The 3 main themes discussed were race (n = 6), economic standing (n = 5), and insurance status (n = 3). Three articles examined multiple themes. Black and multiracial individuals had significantly higher postoperative complication rates and unmet care coordination needs, and lower rates of receiving special services (e.g., physical therapy). Higher economic status was associated with greater health care expenses and service access. Public insurance was associated with insufficient care coordination, decreased special service utilization, and increased rates of readmission and inpatient complications. Conclusion: Included articles demonstrate that race, insurance status, and economic standing are significantly associated with unequal health care access and outcomes for US children with CP. Future efforts should prioritize standardization of reported metrics for SDOH and investigation into systemic inequalities in health care access.

1. Spinal fusion surgery is one of the most common and resource‑intensive procedures performed for degenerative conditions of the spine, with nearly 200,000 surgeries performed within the United St...