Articles: ninos.
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Randomized Controlled Trial Multicenter Study Comparative Study
Adjuvant Pembrolizumab versus Observation in Muscle-Invasive Urothelial Carcinoma.
Muscle-invasive urothelial carcinoma is an aggressive disease with high rates of relapse. Whether pembrolizumab as adjuvant therapy would be effective in patients with high-risk muscle-invasive urothelial carcinoma after radical surgery is unknown. ⋯ Among patients with high-risk muscle-invasive urothelial carcinoma after radical surgery, disease-free survival was significantly longer with adjuvant pembrolizumab than with observation. (Funded by the National Cancer Institute of the National Institutes of Health and others; Alliance A031501 AMBASSADOR ClinicalTrials.gov number, NCT03244384.).
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Multicenter Study
Asundexian versus Apixaban in Patients with Atrial Fibrillation.
Stroke prevention with direct-acting oral anticoagulant agents in patients with atrial fibrillation confers a risk of bleeding and limits their use. Asundexian, an activated factor XI (XIa) inhibitor, is an oral anticoagulant that may prevent strokes with less bleeding. ⋯ Among patients with atrial fibrillation at risk for stroke, treatment with asundexian at a dose of 50 mg once daily was associated with a higher incidence of stroke or systemic embolism than treatment with apixaban in the period before the trial was stopped prematurely. There were fewer major bleeding events with asundexian than with apixaban during this time. (Funded by Bayer; OCEANIC-AF ClinicalTrials.gov number, NCT05643573; EudraCT number, 2022-000758-28.).
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Randomized Controlled Trial Multicenter Study
In T1D, weekly efsitora was noninferior to daily degludec for reducing HbA1c but increased severe hypoglycemia at 26 wk.
Endocrinology: [Formula: see text].
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Randomized Controlled Trial Multicenter Study
In insulin-naive T2D, weekly efsitora was noninferior to daily degludec for reducing HbA1c at 52 wk.
GIM/FP/GP: [Formula: see text] Endocrinology: [Formula: see text].
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Multicenter Study
What are the challenges to quality in modern, hybrid general practice? A multi-site longitudinal study.
Since 2022, general practice has shifted from responding to the acute challenges of COVID-19 to restoring full services using a hybrid of remote, digital, and in-person care. ⋯ Contemporary hybrid general practice features changes (digitalisation, physical distancing, extension of roles, and protocolisation) that have had the unintended effect of dehumanising, compromising, and fragmenting care. Policymakers and practices should urgently address the risks to patients and the traditional core values of general practice should be urgently addressed.