Advanced Options Research Articles

Are There Hidden Dangers Associated With Milk and Egg Dietary Advancement Therapy?

Dietary advancement therapies (DAT) constitute a continuum spanning extensively heated item ingestion, progressive milk/egg ladders, and oral immunotherapy (OIT). These represent an evolution in food allergy management from strict avoidance to an active therapy that may modulate the immune system to develop tolerance to particular forms of the allergen. Many egg or milk individuals are tolerant to baked egg/milk at baseline, and regular consumption (at home ingestion) of baked milk or egg is a safe process with potential quality of life and immunologic benefit. Milk and egg ladders, developed for non-IgE mediated allergy, are being increasingly adapted to IgE-mediated allergy as a potentially safe at-home option for gradual dietary advancement. However, data are limited regarding how safe and effective these approaches are, or what patient is best suited for which DAT. It is also unclear if extensively heated allergen consumption and ladders are susceptible to the same patient-specific factors which affect day-to-day tolerance and safety in OIT. Several recent events involving near-fatal or fatal reactions to milk or egg products (all amongst patients with asthma) have highlighted that DATs are not risk-free, and that physician guidance in these therapies is essential. Such guidance may include obtaining informed consent prior to starting any DAT, and instituting the same safe dosing rules for OIT across any form of DAT. This rostrum discusses practical concerns about the safety of DAT, and considerations how clinicians can maximize patient protection while defining the safety and efficacy of real-world implementation of these concepts.

Pediatric oncofertility care in limited versus optimum resource settings: results from 39 surveyed centers in Repro-Can-OPEN Study Part I & II.

As a secondary report to elucidate the diverse spectrum of oncofertility practices for childhood cancer around the globe, we present and discuss the comparisons of oncofertility practices for childhood cancer in limited versus optimum resource settings based on data collected in the Repro-Can-OPEN Study Part I & II. We surveyed 39 oncofertility centers including 14 in limited resource settings from Africa, Asia, and Latin America (Repro-Can-OPEN Study Part I), and 25 in optimum resource settings from the USA, Europe, Australia, and Japan (Repro-Can-OPEN Study Part II). Survey questions covered the availability of fertility preservation and restoration options offered in case of childhood cancer as well as their degree of utilization. In the Repro-Can-OPEN Study Part I & II, responses for childhood cancer and calculated oncofertility scores showed the following characteristics: (1) higher oncofertility scores in optimum resource settings than in limited resource settings for ovarian and testicular tissue cryopreservation; (2) frequent utilization of gonadal shielding, fractionation of anticancer therapy, oophoropexy, and GnRH analogs; (3) promising utilization of oocyte in vitro maturation (IVM); and (4) rare utilization of neoadjuvant cytoprotective pharmacotherapy, artificial ovary, in vitro spermatogenesis, and stem cells reproductive technology as they are still in preclinical or early clinical research settings. Based on Repro-Can-OPEN Study Part I & II, we presented a plausible oncofertility best practice model to help optimize care for children with cancer in various resource settings. Special ethical concerns should be considered when offering advanced and innovative oncofertility options to children.

Recent concept study for cryogenic fluid management to support opposition class crewed missions to Mars

NASA recently completed a mission concept study to evaluate the feasibility and propulsion technology development requirements for reduced travel duration crewed missions to Mars. A high-level goal of the study was to minimize the health impact on the crew caused by the space environment. This was implemented in the study by limiting the crew to a total of approximately-two years of in-space operations and travel time. For the initial mission, the crew would stay about 30 days on the Martian surface. The propulsive demands of such a mission are immense, and the study identified two advanced propulsion options with the potential to meet the mission requirements—both options rely on nuclear fission to provide efficient propulsive energy. One propulsion option was a nuclear electric propulsion (NEP)/Chem Hybrid, with a reactor and energy conversion system powering xenon propellant ion thrusters to provide an efficient, but lower-thrust, push for most of the mission duration. This concept also relied on a liquid oxygen/liquid methane (LO2/LCH4) chemical propulsion stage to provide high thrust for maneuvers while near the Earth and Mars. The second propulsion option was nuclear thermal propulsion (NTP), in which the reactor heats liquid hydrogen (LH2) propellant to expand through a nozzle for thrust at about twice the efficiency of the best chemical propulsion systems. Both vehicle concepts rely on storing large amounts of cryogenic propellant (either LO2/LCH4 or LH2) for multiple years in space without loss, far exceeding state-of-the-art capability. To enable this new capability, the team assumed the use of several advanced cryogenic fluid management (CFM) technologies and analyzed the integrated system performance. This included considering the vehicle-level effects of the size, mass, and power requirements of these CFM elements. Further, the team evaluated the development required to enable such a mission in the mid-2030 s and determined that it was feasible. The paper elaborates on the assumed CFM technologies, provides key analysis results, and illustrates the feasibility of technology development for the proposed solutions to the CFM challenges for each propulsion concept.

Evaluating cost per remission and cost of serious adverse events of advanced therapies for ulcerative colitis

BackgroundDetermining the relative cost-effectiveness between advanced therapeutic options for ulcerative colitis (UC) may optimize resource utilization. We evaluated total cost per response, cost per remission, and cost of safety events for patients with moderately-to-severely active UC after 52 weeks of treatment with advanced therapies at standard dosing.MethodsAn analytic model was developed to estimate costs from the US healthcare system perspective associated with achieving efficacy outcomes and managing safety outcomes for advanced therapies approved for the treatment of UC. Numbers needed to treat (NNT) for response and remission, and numbers needed to harm (NNH) for serious adverse events (SAEs) and serious infections (SIs) were derived from a network meta-analysis of pivotal trials. NNT for induction and maintenance were combined with drug regimen costs to calculate cost per clinical remission. Cost of managing AEs was calculated using NNH for safety outcomes and published costs of treating respective AEs.ResultsCosts per remission were $205,240, $249,417, $267,463, $365,050, $579,622, $750,200, and $787,998 for tofacitinib 10 mg, tofacitinib 5 mg, infliximab, vedolizumab, golimumab, adalimumab, and ustekinumab, respectively. Incremental costs of SAEs and SIs collectively were $136,390, $90,333, $31,888, $31,061, $20,049, $12,059, and $0 for tofacitinib 5 mg, golimumab, adalimumab, tofacitinib 10 mg, infliximab, ustekinumab, and vedolizumab (reference), respectively.ConclusionsTofacitinib was associated with the lowest cost per response and cost per remission, while vedolizumab had the lowest costs related to SAEs and SIs. Balancing efficacy versus safety is important when evaluating the costs associated with treatment of moderate-to-severe UC.

A Bibliometric Analysis of the Global Research in Odonata: Trends and Gaps

Insects of the order Odonata have been used as indicators of environmental quality in different aquatic systems around the world. In this context, we conducted a bibliometric analysis to understand the general patterns of research on Odonata published in the past decade (2012–2021). We extracted literature from the Web of Science (WoS) in the advanced search option and used search terms related to Odonata plus search strings for each term. A total of 2764 Odonata publications were identified. The journals with the most published articles on Odonata were Zootaxa, International Journal of Odonatology and Odonatologica. The countries with the most Odonata publications were the USA, Brazil and China. Most studies were conducted on streams, ponds and rivers. Ecology, taxonomy and behavior were the main study topics. Of the total articles on Odonata, 982 involved Zygoptera and 946 Anisoptera. Another 756 studies were focused on both suborders. The increase in ecological and taxonomic studies of Odonata reflects the dynamic characteristics of this order, and its relatively well-defined systematics, especially in the case of adults. Despite the recent increase in the number of publications, there are still many gaps related to topics such as biogeography, parasitism, competition within and between species, evolutionary and phylogenetic relationships, as well as studies of the eggs (e.g., their development) and larval exuviae (e.g., their morphological features).

Twitter and Communicating Stigma about Medications to Treat Obesity

ABSTRACT In North America, stigma remains a significant barrier to treating obesity. Many candidates for medical weight management do not seek treatment, possibly related to anticipated and internalized stigma and weight bias. Pharmacologic treatment of obesity remains highly stigmatized, despite advances in drug development and medical weight management programs. People contemplating medical weight management are likely to see information about “diet pills” on social media sites, such as Twitter. However, Twitter has been found to contain false and stigmatizing information. This study examines a sample of 2170 Tweets to better understand the content through the lens of obesity stigma. Tweets were collected over a seven-day period containing general terms such as “diet pills,” “weight loss pills,” or “fat burner” using the Twitter advanced search option. The analysis revealed that almost 50% of Tweets containing “diet pills” contained stigmatizing language. The most common elements of stigma communication were taking personal blame for obesity and the perils associated with taking medications for weight loss. Further analysis revealed sub-themes such as profiting from social pressures to lose weight, distrust of physicians and the practice of obesity medicine, lack of efficacy of medications, and the use of social media to disseminate stigma. Most Tweets were from personal accounts followed by direct sales of weight loss supplements. The findings have potential implications for medically supervised weight management programs and may drive the need for more evidence-based social media messaging around obesity related healthcare.

Abstract 15632: Rv Dysfunction and the Risk of Mortality in Cardiomyopathy Patients Who Suffered a Cardiac Arrest

Background: Right ventricular (RV) dysfunction has been associated with higher mortality in patients who suffer a cardiac arrest. However, the role of RV dysfunction in patients with known cardiomyopathy (CM) (EF<50%) who suffer cardiac arrest from a shockable rhythm is not well examined. Aim: To assess the relationship between RV dysfunction and mortality in patients with cardiac arrest from a shockable rhythm without an ICD. Methods: We included patients with CM of any etiology who were hospitalized for the first time with cardiac arrest at a tertiary care center between 2011 and 2017. We examined in-hospital as well as long-term mortality. RV dysfunction was defined based on standard echo parameters. Results: A total of 208 patients were admitted to the hospital with cardiac arrest from a shockable rhythm (VT/VfIb) and 139 of those had no ICD at the time of the cardiac arrest. Out of those 139 patients, 48 had RV dysfunction. Patients with RV dysfunction had higher in-hospital mortality (44.7% vs 15.1%, p<.001). Over a mean follow-up of 2.9±3.2 years, patients with RV dysfunction had higher long-term mortality rates (72.9 vs 53.8%, p=.029) as well as shorter mean survival time (33.2, CI [20.6-45.8], vs 66.0 [53-78.9] months, p=0.005, Figure). In a Cox regression model, patients with RV dysfunction had higher long-term mortality rates when adjusting for EF, initiation of new AAD, electrolyte abnormalities and new ischemia (HR 1.68, 95% CI [1.05-2.69], p=.028). During hospitalization, patients with RV dysfunction needed advanced HF treatment options (inotropes, OHT) more frequently compared to patients without RV dysfunction (70.8 vs 46.2%, p=.005). Conclusions: RV dysfunction is an independent predictor of mortality in patients with cardiac arrest from a shockable rhythm who do not have an ICD. Further studies should investigate whether the presence of RV dysfunction alone should be taken into consideration for decisions on ICD implantation in patients with CM.

Development of Innovative Biomaterials and Devices for the Treatment of Cardiovascular Diseases (Adv. Mater. 46/2022)

Cardiovascular Biomaterials and Devices In article number 2201971, Yunbing Wang and co-workers provide an overview of the challenges and research frontiers of innovative biomaterials and devices for the treatment of cardiovascular diseases, and their future development directions are discussed. With the development and improved performance of new cardiovascular biomaterials and devices, more advanced treatment options will be available to bring new hope to the cardiovascular patients.

A confluence of advanced treatment options for atopic dermatitis, eosinophilic lung diseases and chronic urticaria brought about by the revolutionary discovery of biologics and Janus kinase inhibitors.

A confluence of advanced treatment options for atopic dermatitis, eosinophilic lung diseases and chronic urticaria brought about by the revolutionary discovery of biologics and Janus kinase inhibitors.

Information retrieval linguistic instruments in e-catalogs of Russian large libraries

The article is based on the findings of the study of linguistic instruments of information search used in e-catalogs of Russian largest libraries. For the study, the libraries with the collections of over 4 million entries were sele cted. The authors analyze search types applicable to e-catalog search interface. They specify the following search types applied in the above libraries: single-line (simple) search, standard (basic), advanced and professional search. The advanced search options are discussed, namely refinement systems, ranking and sorting of search results; at least one of these options is used in the e-catalogs under study. The authors also analyze the systems of search dictionaries, guidelines and use characteristics. The popular information retrieval languages are discussed with the conclusion made that the e-catalogs under study offer search options for various sets of bibliographic elements, among them author, title, year of publication, and subject search based on verbal languages (every library under study) and classification languages (majority of the libraries). The authors formulate the common features inherent in the libraries' e-catalogs and information retrieval linguistic instruments. They also offer recommendations on how to develop and efficiently use these instruments for upgrading library e-catalogs.

Green synthesis and electrochemical properties of A3(PO4)2 (A = Mn, Zn, and Co) hydrates for supercapacitors with long-term cycling stability

Energy storage materials are currently considered to promote the development of life and economy in a society with high energy consumption. Particularly, supercapacitors play a significant role in providing a sustainable human society as a kind of green energy storage system. Recently, most researchers mainly focus on improving the electrochemical properties of electrode materials. In light of cost-effective and discharged pollutants, eco-friendly and simple-operated synthesis is an advanced option to fabricate high-energy storage electrode materials. Herein, a green one-step strategy is introduced to prepare a series of A3(PO4)2 (A = Mn, Zn, and Co) hydrates at room temperature along with the characterization in terms of their phase structure, morphology, and electrochemical properties for potential high-performance supercapacitor electrodes. Interestingly, the Co3(PO4)2·8H2O electrode delivers a good specific capacity value of 210.67 mAh g−1 (specific capacitance value of 1516.8 F g−1) with a high voltage of 0.5 V under the current density of 1 A g−1. Moreover, the constructed pouch-type device exhibits an outstanding cycling stability of ∼90.53% after the following 24000 cycles. In addition, the energy density of the fabricated device is estimated to be 33.44 Wh kg−1 while the maximum power density is found to be about 3750 W kg−1. This work suggests that the A3(PO4)2 hydrates are very promising as excellent electrodes for supercapacitors with ultra-long cycling stability through a simple and green strategy.

Treatment Patterns and Treatment Satisfaction Among Adults with Alopecia Areata in the United States.

Alopecia areata (AA), an autoimmune disease, is characterized by non-scarring hair loss involving the scalp, face, and/or body. Prior to 2022, no US Food and Drug Administration (FDA)-approved treatments for AA were available in the USA; existing treatment options had limited efficacy and durability and are often associated with side effects. This study aimed to evaluate the current AA treatment patterns and treatment satisfaction as reported by dermatologists. Real-world data from a 2019 cross-sectional survey of US dermatologists and their adult patients with AA were analyzed. Dermatologists provided comprehensive data on their patients with AA, including AA dermatologist-assessed severity, treatments, treatment duration, treatment satisfaction, and reasons for dissatisfaction. The switching patterns among the proportion of patients on each of the treatment groups at the time of survey and, for those with prescription history, were reported. A total of 442 patients with AA, treated by 90 dermatologists, were included in this analysis. At the time of survey, 45% of patients were being prescribed a combination of corticosteroids, 21% injectable corticosteroids, 11% topical corticosteroids/topical calcineurin inhibitor, and 10% immunomodulator as monotherapy or in combination. The majority (65%) of patients had no prior reported therapy. Among patients who were reported to have a prior therapy, frequent switching was to combination corticosteroids, injectable corticosteroids, and immunomodulators. Overall treatment dissatisfaction was high (24% dissatisfied and 29% neutral) and increased with AA severity. This analysis provides a snapshot of the different local and systemic treatment options currently being used in a real-world treatment setting. Unfortunately, none of these treatments provide a sustainable, safe, and relapse-free solution, which leads to high treatment dissatisfaction rates and hence indicates a significant unmet need for the new and advanced treatment options for patients with AA.

The case for global regulation of carbon capture and storage and artificial intelligence for climate change

This article investigates the trends in the global law-making process as it relates to carbon capture and storage (CCS) and associated technology. It detects regulatory deficiencies and makes a case favouring robust global regulation of such technology in realizing climate aspirations. CCS is recognized as an indispensable ally in the worldwide enterprise that seeks to limit carbon dioxide emissions. This article probes the relatively new and developing area of international regulation of the process of CCS and related technology, in particular Artificial Intelligence (AI), a dimension that promises noteworthy results on the climate change front. It presents a case for the broader deployment of the CCS technology – including more advanced AI options – to enhance in a more radical fashion the prospect of meeting global climate goals and thus stabilising global temperature (that is, achieving net zero CO2 emissions globally in the early 2050s), identifies the need for new and revised sets of rules to govern the development, design and deployment of such technology, and argues in favour of the applicability of existing general sustainable development principles.

Exploring Predictors of Development and Career Planning Among TVET Educators

Career planning and development a key factor that provides added value to career sustainability. Career development approaches have recently changed due to the fast-paced global change, competitive industry needs, demands, and global education trends. Traditionally, it was the responsibility of an institution to guarantee that its educators possessed the skills necessary to achieve its long-term objectives. Currently, however, educators should be accountable for their career growth. Therefore, a survey was conducted to discover predictors of development and career paling for TVET educators (n = 141). A multiple regression analysis was conducted for all sets of career planning variables such as career aspirations (88.48%), personal aspirations and drive (85.93%), current competency (86.00%), current learning and development opportunities (82.05%), and company support 87.45%) is measured. This study found changes in the predictor, personal aspirations and drive, current competency, current learning and development opportunities, and organization support are significantly associated with changes in career aspiration. This majority of TVET educators are aware and willing to improve their knowledge and skills to meet the standard of current changes in TVET education needs and demands. The finding indicated that a proven technique for meeting organizational and personnel demands includes creating career routes that allow TVET educators to comprehend their options for advancement within the institution and collecting information to assess their abilities for career relevancy and sustainability.

A Digitally Capable Mobile Health Clinic to Improve Rural Health Care in America: A Pilot Quality Improvement Study

ObjectiveTo address the problem of limited health care access for patients in rural southern Minnesota, a digitally capable mobile health clinic (MHC) quality improvement initiative was launched in a rural community-based health system. MethodsThis project was designed and implemented according to our institutional strategic plan, guiding principles for virtual community care, and existing approved standards of care. A quality improvement development and pilot implementation framework was rapidly developed using Agile methodology. ResultsThe resulting technology and equipment selection, overall clinic design, vehicle vendor selection, clinical schedule and workflows, staffing model, equipment and technology selection, and testing were achieved in 12 months. The pilot site communities were chosen on the basis of size, interest, and lack of existing access. Four underserved rural communities now have access to telehealth consultations, laboratory testing, and in-person primary care examinations. By April 30, 2022, the MHC had provided 1498 patient appointments while maintaining our standards of care. Newly established broadband internet access for these communities and their residents was a valuable secondary outcome. ConclusionBy designing and implementing an MHC quality improvement intervention that provides both in-person and advanced telehealth options for patients in rural communities, our institution rapidly provided a potential solution for the rural health care crisis. The MHC not only replaces traditional brick-and-mortar facilities but also expands service offerings and access to technology for rural communities and the people who live and work in them.

Paediatric Inflammatory Bowel Disease: A Multi-Stakeholder Perspective to Improve Development of Drugs for Children and Adolescents.

Despite recent approvals for new drugs to treat adults with Crohn's disease or ulcerative colitis, there are only two approved advanced treatment options [infliximab and adalimumab] for children with inflammatory bowel disease [IBD]. There are many potential new therapies being developed for adult and paediatric IBD. Moreover, regulatory agencies in both the European Union and USA have processes in place to support the early planning and initiation of paediatric studies. Nevertheless, unacceptable delays in approvals for use of drugs in children persist, with an average 7-year gap, or longer, between authorization of new IBD drugs for adults and children. A 2-day virtual meeting was held during April 14-15, 2021 for multi-stakeholders [clinical academics, patient community, pharmaceutical companies and regulators] to discuss their perspectives on paediatric drug development for IBD. The multi-stakeholder group presented, discussed and proposed actions to achieve expediting the approval of new drugs in development for paediatric IBD. Collaborative action points for all stakeholders are required to make progress and facilitate new drug development for children with IBD.

IGlarLixi versus basal plus Rapid-Acting insulin in adults with type 2 diabetes advancing from basal insulin therapy: The SoliSimplify Real-World study.

For people with suboptimally controlled type 2 diabetes (T2D) on basal insulin (BI), guidelines recommend several treatment advancement options. This study compared the clinical effectiveness of once-daily iGlarLixi versus a multiple-injection BI + rapid acting insulin (RAI) regimen in adults with T2D advancing from BI therapy in real-world clinical practice. Electronic medical records from the Observational Medical Outcomes Partnership (OMOP) database were analysed retrospectively using propensity score matching to compare therapy advancement with iGlarLixi or BI + RAI in US adults ≥18 years with T2D on BI who had ≥1 valid glycated haemoglobin (HbA1c) value at baseline and at the 6-month follow-up. The primary objective was non-inferiority of iGlarLixi to BI + RAI in HbA1c change from baseline to 6months (margin 0.3%). Propensity score matching generated cohorts with balanced baseline characteristics (N=814 in each group). HbA1c reduction from baseline to 6months with iGlarLixi was non-inferior to BI + RAI [mean difference (95% confidence interval): 0.1 (-0.1, 0.2)%; one-sided p=.0032]. At 6months, weight gain was significantly lower with iGlarLixi than with BI + RAI [-0.8 (-1.3, -0.2) kg; two-sided p=.0069]. Achievement of HbA1c <7% without hypoglycaemia and weight gain were similar between groups [odds ratio (95% confidence interval): 1.15 (0.81, 1.63); p=.4280]. Hypoglycaemia was low in both groups, probably because of underreporting. In real-world clinical practice, glycaemic outcomes 6months after treatment advancement from BI are similar for people with T2D using iGlarLixi versus BI + RAI, with iGlarLixi leading to less weight gain.

Towards 20 T Hybrid Accelerator Dipole Magnets

The most effective way to achieve very high collision energies in a circular particle accelerator is to maximize the field strength of the main bending dipoles. In dipole magnets using Nb-Ti superconductor the practical field limit is considered to be 8-9 T. When Nb <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> Sn superconductor material is utilized, a field level of 15-16 T can be achieved. To further push the magnetic field beyond the Nb <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> Sn limits, High Temperature Superconductors (HTS) need to be considered in the magnet design. The most promising HTS materials for particle accelerator magnets are Bi2212 and REBCO. However, their outstanding performance comes with a significantly higher cost. Therefore, an economically viable option towards 20 T dipole magnets could consist in an “hybrid” solution, where both HTS and Nb <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> Sn materials are used. We discuss in this paper preliminary conceptual designs of various 20 T hybrid magnet concepts. After the definition of the overall design criteria, the coil dimensions and parameters are investigated with finite element models based on simple sector coils. Preliminary 2D cross-section computation results are then presented and three main layouts compared: cos-theta, block, and common-coil. Both traditional designs and more advanced stress-management options are considered.

Hutchinson-Gilford Progeria Syndrome: A Literature Review.

Hutchinson-Gilford progeria syndrome (HGPS) is a premature aging condition that involves genetic mutations, resulting in debilitating phenotypic features. The present state of knowledge on the molecular pathways that contribute to the pathophysiology of HGPS and the techniques being tested in vitro and in vivo to combat progerin toxicity have been discussed here. Nuclear morphological abnormalities, dysregulated gene expression, DNA repair deficiencies, telomere shortening, and genomic instability are all caused by progerin accumulation, all of which impair cellular proliferative capability. In addition, HGPS cells and preclinical animal models have revealed new information about the disease's molecular and cellular pathways and putative mechanisms involved in normal aging. This article has discussed the understanding of the molecular pathways by which progerin expression leads to HGPS and how the advanced therapy options for HGPS patients can help us understand and treat the condition.

Improved patient-reported outcomes with iGlarLixi versus premix BIAsp 30 in people with type 2 diabetes in the SoliMix trial.

To assess patient-reported outcomes (PROs) in the SoliMix trial, which compared the efficacy and safety of iGlarLixi versus BIAsp 30 in people with type 2 diabetes (T2D). SoliMix (EudraCT: 2017-003370-13), a 26-week, open-label study, randomized (1:1) 887 adults with T2D and HbA1c≥7.5%-≤10.0% (≥58-≤86 mmol/mol) on basal insulin plus oral antihyperglycaemic drugs (OADs) to once-daily iGlarLixi or twice-daily premix insulin, BIAsp 30. PROs were assessed using the Treatment-Related Impact Measure Diabetes (TRIM-D) and Global Treatment Effectiveness Evaluation (GTEE) questionnaires. Over 26 weeks, iGlarLixi showed greater improvement from baseline versus BIAsp 30 in total TRIM-D score (least squares mean difference [95% confidence interval]: 5.08 [3.69, 6.47]; effect size: 0.32) and in each TRIM-D domain, with the greatest differences seen in diabetes management (8.47 [6.11, 10.84]) and treatment burden (6.95 [4.83, 9.07]). GTEE scores showed a greater proportion of participants and physicians rated a complete or marked improvement of diabetes control with iGlarLixi (80.5%, 82.8%) versus BIAsp 30 (63.3%, 65.1%) at week 26. Post hoc analyses showed that after adjusting for HbA1c, body weight and hypoglycaemia outcomes, iGlarLixi continued to show greater improvements in TRIM-D total scores versus BIAsp 30. In addition to better glycaemic control, weight benefit and less hypoglycaemia, once-daily iGlarLixi provided improved diabetes management, treatment burden and perceived effectiveness versus twice-daily premix BIAsp 30, further supporting iGlarLixi as an advanced treatment option in people with suboptimally controlled T2D on basal insulin plus OADs.