Long-term Control Research Articles

Efficacy and predictors of response to somatostatin analogues in patients with ectopic ACTH syndrome

Aim. To study the immediate efficacy, tolerability and predictors of response to prolonged-acting somatostatin analogues (SSAs) in patients with ectopic ACTH syndrome (EAS). Materials and methods. A multicenter, observational study with a retrospective analysis. The effectiveness of treatment was evaluated every 12–24 weeks by the activity of hypercortisolism, clinical symptoms of the disease, control of tumor growth. Patients were conditionally divided into “responders” and “non-responders” at time points of 6, 12 and 24 months. Radiological efficacy was performed according to the RECIST 1.1. Statistical data processing was carried out by using IBM SPSS Statistics 23. Results. The study included 46 patients (26 women, 20 men). The median follow-up period was 71 months [32; 122]. Localized tumor process (T1-3N0M0) – in 19 (41.3%) patients, locally widespread (T1-3N1M0, T4N0-1M0) – in 15 (32.6%), generalized (T1-4N0-1M1) – in 12 (26.1%) cases. Surgical treatment was performed in 33 (71.7%) patients. SSAs were the first-line therapy for all 46 patients. The average duration of SSAs use was 34 months (Me 27.5 [13.8; 41]). Dose escalation was required in 39.4% cases, the period before the first dose escalation was on average 9 months. 13 (48.1%) patients achieved drug-induced remission of the disease. Normalization of cortisol in 24hUFC or its decrease ≥50% from the baseline level by the 6th month of treatment was achieved in 46.4%, by the 12th month – in 61.9%, “eluding” from the effect of therapy was observed in 3 patients. Objective response was evaluated in 30 patients. There was no complete response to the treatment. In 4 (13.3%) cases – a partial response, in 15 (50%) – disease stabilization, in 11 (36.7%) – disease progression. The best therapeutic efficacy of SSAs is associated with bronchial NET (HR 0.078, 95% CI 0.010–0.633; p=0.017), and resistance to treatment is associated with negative expression of SSTR5 (HR 6.532, 95% CI 1.019–41.878; p=0.048). Conclusion. SSAs are the drugs of choice for the first-line treatment of patients with EAS, allowing for long-term effective control of hypercortisolism and tumor progression in more than 60% of patients. Significant factors determining the response to SSAs after 6 months of treatment are expression status of SSTR5 and NET localization.

Malignant Degeneration of a Peripheral Nerve Sheath Tumor in the Neck Region.

Background: Malignant transformation of neurofibromas into malignant peripheral nerve sheath tumors (MPNST) is a rare but aggressive phenomenon, particularly in the head and neck region, and is associated with a poor prognosis. The primary treatment modality is surgical excision, often followed by radiotherapy. This is a case report of MPNST in the neck, with long-term follow-up. Case Presentation: A 26-year-old woman presented with a history of multiple progressively enlarging neck swellings for 8 years. The swellings were associated with mild pain and occasional bleeding. The patient had undergone 3 prior surgical excisions, with a fourth recurrence leading to complete excision and split-thickness skin grafting due to extensive raw surface area. Histopathological examination confirmed the diagnosis of MPNST. The patient subsequently received adjuvant chemoradiotherapy due to the aggressive nature of the pathology. Results: The patient has been under regular follow-up for 36 months, with no evidence of local, regional, or distant metastasis. Conclusion: Malignant transformation of neurofibromas is a rare entity, particularly in the head and neck. Early surgical intervention followed by adjuvant chemoradiotherapy provides effective long-term control of the disease and improved survival.

Long-term tumor control following repeat gamma-knife radiosurgery of growing pituitary adenomas: a population-based cohort study

BackgroundGamma Knife radiosurgery (GKRS) is a well-established treatment for residual or growing pituitary adenomas (PAs) post-partial resection. However, some PAs grow even after initial GKRS, for which the efficacy of repeat GKRS is unclear. The primary objective of this study was to determine long-term progression-free survival (PFS) following repeated GKRS in patients with PA. The secondary objective was to determine predictors of tumor progression in these patients.MethodsSingle-center, population-based consecutive cohort study of patients with recurrent PAs treated with repeated GKRS due to tumor progression between 1999 and 2022 at the Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. PFS and predictors of tumor growth were assessed.Results23 patients were included, with a median follow-up time of 6.3 years. The 5-year PFS rate was 57%, and the median duration from repeat GKRS to tumor progression was 2.6 years. Tumor growth after repeat GKRS occurred exclusively within the first three years post-treatment. Older age at the time of repeat GKRS was a significant predictor of continued tumor growth (OR 1.09, p = 0.036).ConclusionRepeat GKRS is a feasible treatment alternative for PAs that exhibit growth following initial GKRS.

Trigeminal neuralgia in multiple sclerosis: proposal of surgical flowchart and long-term outcome evaluation in a mono-istitutional cohort.

Trigeminal neuralgia (TN) is a chronic pain syndrome more prevalent in patients with multiple sclerosis (MS), often presenting with earlier onset and more intense pain compared to non-MS patients. The management of TN in MS is complex due to the interaction between demyelination and neurovascular factors. A retrospective analysis of 35 MS patients treated for TN with 65 procedures between 2010 and 2023 was conducted. Patients underwent surgical treatments guided by a flowchart and based on the presence of NVC and patient risk factors. Procedures included MVD, PBC, SRS and TRZ. Outcomes were assessed using BNI pain and hypoesthesia scales, focusing on pain recurrence and changes in antineuralgic medication. After first treatment, MVD (13 procedures) achieved a 100% success rate with a mean pain-free interval of 59.4 months, and 77% of patients reduced or stopped medication. PBC (16) had a 93.8% success rate and a recurrence time of 34 months. SRS showed an 80% success rate with a recurrence time of 7.4 months, while TRZ had a 50% success rate with 24 months of pain-free duration. After the first surgical intervention, 30.5% of patients were pain-free, increasing to 40% after the third treatment. At last follow-up (77,0 ± 68.7months) it was demonstrated high pain-free rates (61.1%) and good long-term pain control. The use of a tailored flowchart significantly improves outcomes in TN-MS patients. MVD provides the longest pain-free intervals when NVC is present, while PBC, SRS, and TRZ remain viable alternatives for those with contraindications. Personalized approaches enhance pain control and reduce recurrence.

Topical therapy for psoriasis: algorithms for the use of activated zinc pyrithione

Treatment of any type of psoriasis involves the use of external therapy. Recommended topical preparations include: corticosteroids, calcipotriol in combination with corticosteroids, zinc pyrithione, keratolytics, tar. A special place in the therapy of psoriasis is occupied by a drug containing activated zinc pyrithione (Skin-cap), due to its effectiveness, safety and the availability of various forms (aerosol, cream, shampoo), which allows it to be used in both short-term and long-term therapy at different stages of the disease. Complex treatment, including the use of topical forms containing activated zinc pyrithione, is a highly effective, safe, pathogenetically substantiated method of treating various forms of psoriasis, allowing to achieve rapid regression of rashes, minimize the risk of adverse effects and achieve long-term control over the disease, which significantly improves the quality of life of patients

Seizure outcomes and associated factors in adults with unilateral mesial temporal lobe epilepsy undergoing surgery

ObjectiveTo analyze postoperative seizure outcomes and factors associated with unfavorable seizure control (Engel III-IV) in adults with drug-resistant unilateral mesial temporal epilepsy who underwent temporal lobectomy. MethodsThis was an observational, longitudinal, and retrospective study. A descriptive analysis of sociodemographic, clinical, and paraclinical characteristics was performed. The incidence rate of inadequate seizure control was calculated, and a Kaplan-Meier curve was reported. Cox regression analysis was conducted to identify factors associated with unfavorable outcomes. ResultsA total of 285 patients were included, 56.4% were women, and 49.12% underwent standard temporal lobectomy. Engel I were achieved in 70.87% of patients, while 6.31% experienced postsurgical complications. The estimated incidence rate of unfavorable outcomes was 3.87 cases per 100 person-years (95% CI: 3.51-4.27). Cox regression analysis indicated that patients with a temporal functional deficit zone, as identified by neuropsychological testing, had a 55.34% lower risk of an unfavorable outcome (adjusted HR: 0.4466, 95% CI: 0.236-0.854) compared to those with non-conclusive or extratemporal deficits. Concordance between video-electroencephalogram and brain magnetic resonance imaging findings in patients with right-sided lesions was also a protective factor (adjusted HR: 0.1868, 95% CI: 0.06-0.578). Discontinuation of anti-seizure treatment significantly increased the risk of an unfavorable outcome (adjusted HR: 6.718, 95% CI: 3.309-13.64). ConclusionTemporal lobe epilepsy surgery can achieve long-term seizure control in a significant proportion of patients. Neuropsychological assessment and concordance between MRI and video-EEG are essential presurgical factors for favorable outcomes. Additionally, patients should continue with antiepileptic treatment post-surgery to prevent seizure recurrence.

Identification of Causal Genes and Potential Drug Targets for Restless Legs Syndrome: A Comprehensive Mendelian Randomization Study

Background: Restless legs syndrome (RLS) is a common sensorimotor sleep disorder that affects sleep quality of life. Much effort has been made to make progress in RLS pharmacotherapy; however, patients with RLS still report poor long-term symptom control. Methods: Comprehensive Mendelian randomization (MR) was performed to search for potential causal genes and drug targets using the cis-pQTL and RLS GWAS data. Robustness was validated using the summary-based Mendelian randomization (SMR) method and co-localization analysis. Further evidence of pleiotropy of the target genes and their potential side effects was provided by phenome-wide MR analysis (MR-PheWAS). Finally, molecular docking simulations were conducted on drug candidates corresponding to these targets, which revealed promising binding affinities and interaction patterns and underscored the druggable potential of the target gene. All of the analyses above were conducted in the context of Homo sapiens. Results: MAN1A2 showed a statistically significant result in the MR analysis, which was validated through SMR and co-localization analysis. The MR-PheWAS showed a low probability of pleiotropy and prospective side effects. Molecular docking was used to visualize the binding structure and fine affinity for MAN1A2 and the drugs predicted by DSigDB. Conclusions: Our study provides comprehensive evidence supporting MAN1A2 as a promising causal gene and therapeutic target for RLS, offering insights into the underlying molecular mechanisms and paving the way for future drug development efforts.

Epidemiological Trends of HIV/AIDS in Sub-Saharan Africa: A 2024 Perspective

The HIV/AIDS epidemic in Sub-Saharan Africa remains a major public health challenge, with the region accounting for approximately 68% of the global population living with HIV. This review explores the current epidemiological trends in 2024, highlighting the demographic shifts, socioeconomic factors, and public health interventions shaping the epidemic. Despite progress in reducing new infections and expanding antiretroviral therapy (ART) coverage, significant challenges remain, particularly among vulnerable populations such as women, adolescents, and key populations like men who have sex with men (MSM) and sex workers. The review also discusses the impact of public health interventions, such as the prevention of mother-to-child transmission (PMTCT) and the integration of HIV services with other health programs. Socioeconomic barriers, stigma, and disparities in healthcare access are critical issues that must be addressed to achieve long-term control of the epidemic. The evolving landscape of HIV/AIDS, including emerging issues like aging populations and co-infection with tuberculosis, requires innovative approaches to prevention and treatment. Keywords: HIV/AIDS, Sub-Saharan Africa, epidemiological trends, antiretroviral therapy (ART), mother-to-child transmission (MTCT).

Comparative Evaluation of Glycemic and Glycation Markers in Type I, Type II, and Gestational Diabetes Mellitus in Choba, Rivers State

Diabetes Mellitus is a leading global cause of death, highlighting the need for accurate diagnostic and management markers. This study aimed to assess various diabetes indicators and glycation markers related to glycemic status. Conducted in Rivers State (Choba), the study included 90 participants diagnosed with Gestational, Type I, and Type II diabetes, with 30 individuals in each group. Blood samples were collected after fasting to measure Insulin (INS), Fasting Blood Glucose (FBG), Glycated Hemoglobin (A1c), Glycated Albumin (GA), Fructosamine (FA), and 1,5-anhydroglucitol (1,5-AG). Results showed no significant differences in FBG levels across the groups (F-value = 2.14, P = 0.12). However, INS levels were significantly higher in all groups (F-value = 16.1, P < 0.05). Other markers, including FA, GA, A1c, and 1,5-AG, did not differ significantly between the groups. Correlation analysis revealed significant relationships between A1c, GA, and FA with FBG. Notably, the correlation between FBG and A1c was strongest in Type II (r² = 0.99) and Gestational diabetes (r² = 0.99), while it was weaker in Type I (r² = 0.56). Overall, A1c emerged as the most reliable marker of glycemic status, providing valuable insights for the diagnosis and management of diabetes. HbA1c remains the gold standard for long-term glycemic control, alternative biomarkers such as fructosamine, GA, and 1,5-AG are gaining recognition for their clinical utility in managing diabetes.

Race and Appointment Availability Influence Continuity of Care for Chronic Inflammatory Skin Disease: A Cross-Sectional Study of United States Practice Data

BackgroundIn the management of chronic inflammatory skin disease (CISD), continuity of care may influence the achievement of long-term disease control. Barriers to care have been identified in this population, which may leave some patients more vulnerable to loss of follow-up. ObjectiveWe aim to identify predictors of continuity of care for CISD patients across demographic groups and healthcare practice types in the United States (US). MethodsA cross-sectional study of National Ambulatory Medical Care Survey (NAMCS) data was conducted on US outpatient CISD visits between 2011 and 2019 including a primary diagnosis of psoriasis, atopic dermatitis, acne, or rosacea. ResultsA total of 2,747 visits, estimating 75.4 (95% CI 70.9-79.9) million CISD encounters were identified during the period. Multivariate regression showed that Black patients had lower odds of establishing continuity of care relative to White patients (p<0.01). Practices offering same-day visits had greater odds for patients with continuity (p<0.05). Conversely, practices with lower overall wait times (≤ 1 month) were less likely to be associated with continuity of care (p<0.01). LimitationsDisease severity data was unavailable. ConclusionBoth patient race and appointment availability predict differences in continuity of care, suggesting vulnerabilities may exist for some CISD patients requiring follow-up.

Long-Term Seizure Outcome With or Without Vagal Nerve Stimulation Therapy.

To compare long-term seizure control in patients with long-term VNS (vagal nerve stimulator) stimulation (VNS-on) with those who discontinued VNS after >3 years (VNS-off). Patients with refractory epilepsy with VNS therapy for >3 years (and follow-up for >2 years after VNS discontinuation for VNS-off patients) were included. Patients with brain surgery <3 years after VNS were excluded. We compared the percentage of patients with ≥50% seizure reduction (50% responder rate) and change in seizure frequency within and between groups in follow-up. Thirty-three VNS-on and 16 VNS-off patients were evaluated. VNS-on patients underwent stimulation for 9.7 years (mean). VNS-off patients had VNS treatment for 6.5 years (mean), discontinued treatment, then had additional 8.0 years (mean) follow-up. 50% responder rates were similar between groups (VNS-on: 54.5% vs VNS-off at last-on: 37.5%, p = 0.26; vs VNS-off at the last follow-up: 62.5%, p = 0.60). VNS-on patients had a significant reduction in seizure frequency at the last follow-up compared with baseline (median [Mdn] = -4.5 seizures/month, interquartile range [IQR] = 14.0, 56% reduction, p = 0.013). VNS-off patients also showed significant seizure reduction while still continuing VNS therapy (Mdn = -1.0 seizures/month, IQR = 13.0, 35% reduction, p = 0.020) and, after discontinuing therapy, at the last follow-up compared with baseline (Mdn = -3.2, IQR = 11.0, 52% reduction, p = 0.020). The 2 groups were comparable in seizure frequency change both at the last-on visit (absolute change, p = 0.62; relative change, p = 0.50) at the last follow-up (absolute change, p = 0.67; relative change, p = 0.76). Patients who discontinued VNS therapy and those who continued therapy had similar response during active treatment and similar long-term outcomes, suggesting that factors such as the natural disease course and/or medication treatment strongly affect long-term outcomes.

Parental Psychological Control and Interpersonal Trust in Junior High School Students: Serial Mediating Roles of Shyness and Interpersonal Self-Support.

Long-term parental psychological control tends to cause adolescents to become oversensitive in interpersonal relationships, and there is a gap in the mechanism of action between parental psychological control and the interpersonal trust of junior high school students. This study intends to analyze the relationship between parental psychological control and interpersonal trust in middle school students and explore the sequential mediation role of shyness and interpersonal self-support. Based on self-determination theory and object-relations theory, this study administered questionnaires to 542 Chinese junior high school students using the Psychological Control Scale, Interpersonal Trust Scale, Shyness Scale, and Interpersonal Self-support Scale. Afterwards, structural equation modelling was used for testing. The findings revealed that (1) parental psychological control significantly and negatively predicted interpersonal trust and that (2) shyness and interpersonal self-support sequentially mediated the association between parental psychological control and interpersonal trust. The findings suggest that parental psychological control can not only directly influence the interpersonal trust of junior high school students but also indirectly act on interpersonal trust through shyness and interpersonal self-support. This study contributes to an in-depth understanding of the relationship between parental psychological control and the interpersonal trust of junior high school students, which is important for increasing the level of interpersonal trust of junior high school students.

Long-term tumor control following gamma-knife radiosurgery of recurrent or residual pituitary adenomas: a population-based cohort study

BackgroundPituitary adenomas (PAs) often require adjuvant Gamma Knife radiosurgery (GKRS) due to partial resection or postoperative recurrence. The purpose of this study was to evaluate the long-term efficacy of GKRS for such cases.MethodsPopulation-based, observational cohort study of patients who underwent GKRS for postoperative residual or recurrent PAs between 1999 and 2020. We assessed long-term progression-free survival (PFS), identified predictors of tumor growth, and documented adverse radiation events (AREs).Results147 patients were included, with a median follow-up time of 8.1 years. Following GKRS, the 5-year and 10-year PFS was 86% and 68%, respectively, with a median PFS of 18.7 years. Somatotrophic adenomas showed a significantly lower risk of tumor progression in the regression analysis (OR 0.11, p = 0.003). Hypopituitarism was the most common ARE, affecting 32% of patients.ConclusionGKRS is an effective treatment option for recurrent or residual PAs, offering substantial long-term control. However, the risk for AREs, particularly hypopituitarism, is not negligeable.

Control of Cucumber Powdery Mildew Using Resistant Cultivars and Organic Agricultural Materials.

This study evaluated the efficacy of various inorganic materials, biological control agents, organic agricultural materials (OAMs), and essential oils for controlling cucumber powdery mildew (CPM) under greenhouse conditions. Treatments included silicate, bicarbonate, copper sulfate, sulfurbased compounds, Bacillus subtilis KB-401, Bacillus amyloliquefaciens M27, Bordeaux mixtures, chitosan combined with oxidated copper salt, chitooligosaccharides, and essential oils such as castor and rapeseed oil with lecithin. Results demonstrated that Bordeaux mixtures, particularly Bordeaux Mixture I, and sulfur-based compounds provided the most reliable CPM control among inorganic materials. Bacillus strains KB-401 and M27 achieved sustained disease suppression, suggesting their value in integrated pest management (IPM). Chitosan combined with oxidated copper salt showed high efficacy, making it a promising candidate for long-term control. Among OAMs, loess-sulfur mixtures proved especially effective in preventive applications, achieving comparable results to resistant cultivar 'Saronsamcheok'. Essential oils, including castor and rapeseed oil, also exhibited significant CPM suppression potential, although repeated applications may be necessary for sustained control. These findings highlight the potential of these environmentally friendly treatments as viable components of an IPM strategy for managing CPM in cucumber crops. Further studies are recommended to optimize combinations and application timing for enhanced efficacy.

Flexible scan statistic with a restricted likelihood ratio for optimized COVID-19 surveillance.

Disease surveillance remains important for early detection of new COVID-19 variants. For this purpose, the World Health Organization (WHO) recommends integrating of COVID-19 surveillance with other respiratory diseases. This requires knowledge of areas with elevated risk, which in developing countries is lacking from the routine analyses. Focusing on Ghana, this study employed scan-statistic cluster analysis to uncover the spatial patterns of incidence and Case Fatality Rates (CFR) of COVID-19 based on reports covering the four pandemic waves in Ghana between 12 March 2020 and 28 February 2022. Applying flexible spatial scan statistic with restricted likelihood ratio, we examined the incidence and CFR clusters before and after adjustment for covariates. We used distance to the epicentre, proportion of the population aged ≥ 65, male proportion of the population and urban proportion of the population as the covariates. We identified 56 significant spatial clusters for incidence and 26 for CFR for all four waves of the pandemic. The Most Likely Clusters (MLCs) of incidence occurred in the districts in south-eastern Ghana, while the CFR ones occurred in districts in the central and the northeastern parts of the country. These districts could serve as sites for sentinel or genomic surveillance. Spatial relationships were identified between COVID-19 incidence covariates and the CFR. We observed closeness to the epicentre and high proportions of urban populations increased COVID-19 incidence, whiles high proportions of those aged ≥ 65 years increased the CFR. Accounting for the covariates resulted in changes in the distribution of the clusters. Both incidence and CFR due to COVID-19 were spatially clustered, and these clusters were affected by high proportions of the urban population, high proportions of the male population, high proportions of the population aged ≥ 65 years and closeness to the epicentre. Surveillance should target districts with elevated risk. Long-term control measures for COVID-19 and other contagious diseases should consider improving quality healthcare access and measures to reduce growth rates of urban populations.

Supportive care in myeloma-when treating the clone alone is not enough.

The overall survival in patients with multiple myeloma has increased over recent decades. This trend is anticipated to further advance with the emergence of T-cell-redirecting therapies, including chimeric antigen receptor T-cell (CAR T) therapy and T-cell-engaging bispecific antibodies. Despite these therapeutic improvements, treatment-related adverse events impede quality of life. This underscores the imperative of optimizing supportive care strategies to maximize treatment outcomes. Such optimization is crucial not only for patient well-being but also for treatment adherence, which may translate into long-term disease control. We here describe a) how to prevent bone disease, b) a risk-adapted thrombosis prophylaxis approach, c) the management of on-target, off-tumor toxicity of G-protein-coupled receptor class C group 5 member D-targeting T-cell-redirecting therapies, and d) infectious prophylaxis, with a focus on infections during T-cell-redirecting therapies.

Regional differences in the effects of atmospheric moisture residence time on precipitation isotopes over Eurasia

Regional variations in atmospheric moisture residence time (RT) highlight the need to obtain independent observation indexes to constrain different model-based estimates. Stable isotopes of oxygen and hydrogen naturally exist in water molecules that can provide such observational constraints. We analyzed the relationship between RT and precipitation isotopes (δ2H and δ18O) across different climatic zones in Eurasia from 1980 to 2020. Our analysis reveals that: (1) Both precipitation isotopes and RT showed significant increasing trends during 1980–2020. The increase in RT corresponds to weakened net isotopic distillation over Eurasia, suggesting reduced atmospheric circulation intensity under warming conditions. (2) The spatial patterns of RT and precipitation isotopes vary significantly among different moisture source regions, reflecting distinct moisture transport and precipitation formation processes. (3) On long-term scales, RT generally shows positive correlations with precipitation isotopes, except in plateau regions. The RT-δ18O relationship exhibits latitude-dependent variations, with similar slopes in regions sharing common moisture sources. These findings enhance our understanding of the long-term controls on precipitation isotopic composition and atmospheric moisture cycling patterns across Eurasia.

Haemoglobin types and variant interference with HbA1c and its association with uncontrolled HbA1c in type 2 diabetes mellitus

Diabetes mellitus is among the leading global health concerns, causing over 1.5 million deaths alongside other significant comorbidities and complications. Conventional diagnosis involves estimating fasting, random blood glucose levels and glucose tolerance test. For monitoring purposes, long-term glycaemic control has been achieved through the measurement of glycated haemoglobin (HbA1c) which is considered reliable and preferred tool. However, its estimation could be affected by haemoglobin types like HbA0, HbA2, and HbF concentrations whose magnitude remains unclear as well as other haematological parameters. As such, the current study determined the association between HbA1c and haemoglobin types and determined correlation between haemoglobin types and haematological parameters among patients with type 2 diabetes mellitus (T2DM) compared to healthy non-diabetic participants. In this cross-sectional study, participants [n = 144 (72 per group), ages 23–80 years] were recruited and the desired parameter measured. HbA1c and other Haemoglobin variants were measured using ion-exchange high-performance liquid chromatography (HPLC) by the Bio-Rad D-10 machine (Bio-Rad Laboratories, Inc). Haematological parameters were measured using the Celtac G MEK-i machine (Nihon Kohden Europe). SPSS version 27 (IBM Corporation, Chicago, Illinois, United States) was used for the analysis. Chi-square (χ2) analysis, Mann-Whitney U test, Binary logistic regression and Pearson correlation were used to determine the differences between proportions, compare laboratory characteristics, associations and correlations respectively. With non-diabetics as the reference group, HbA1c was associated with increased HbA0 [OR = 1.509, 95% CI = 1.020–1.099, p = 0.003] and increased HbA2 [OR = 3.893, 95% CI = 2.161–7.014, p = 0.001]. However, there was no significant association between HbA1c and HbF [OR = 2.062, 95% CI = 0.873–4.875, p = 0.099]. Further, haematocrit (HCT) had a negative correlation with HbAO and a positive correlation with HbAS in participants with controlled diabetes. Mean cell volume (MCV) and mean cell haemoglobin (MCH) had a negative correlation with HbF. MCHC (mean cell haemoglobin concentration) had a negative correlation with HbA2 in participant with uncontrolled diabetes. The study concluded that levels of various haemoglobin types should be considered while monitoring glycaemic control through HbA1c. Additionally, MCHC should be considered in individuals with high concentration of HbA2 among T2DM patients while interpretating results for HbA1c.

Projecting the Potential Global Distribution of Sweetgum Inscriber, Acanthotomicus suncei (Coleoptera: Curculionidae: Scolytinae) Concerning the Host Liquidambar styraciflua Under Climate Change Scenarios.

Acanthotomicus suncei is a newly discovered bark beetle in China that significantly threatens the American sweetgum Liquidambar styraciflua. In recent years, this pest has spread from its original habitat to many surrounding cities, causing substantial economic and ecological losses. Considering the wide global distribution of its host, Liquidambar styraciflua, this pest is likely to continue to spread and expand. Once the pest colonizes a new climatically suitable area, the consequences could be severe. Therefore, we employed the CLIMEX and Random Forests model to predict the potential suitable distribution of A. suncei globally. The results showed that A. suncei was mainly distributed in Southern China, in South Hokkaido in Japan, Southern USA, the La Plata Plain in South America, southeastern Australia, and the northern Mediterranean; these areas are located in subtropical monsoon, monsoonal humid climates, or Mediterranean climate zones. Seasonal rainfall, especially in winter, is a key environmental factor that affects the suitable distribution of A. suncei. Under future climates, the total suitable area of A. suncei is projected to decrease to a certain extent. However, changes in its original habitat require serious attention. We found that A. suncei exhibited a spreading trend in Southwest, Central, and Northeast China. Suitable areas in some countries in Southeast and South Asia bordering China are also expected to show an increased distribution. The outward spread of this pest via sea transportation cannot be ignored. Hence, quarantine efforts should be concentrated in high-suitability regions determined in this study to protect against the occurrence of hosts that may contain A. suncei, thereby avoiding its long-distance spread. Long-term sentinel surveillance and control measures should be carried out as soon as A. suncei is detected, especially in regions with high suitability. Thus, our findings establish a theoretical foundation for quarantine and control measures targeting A. suncei.

Long-Term Maintenance of Optimal Treatment Targets for Skin and Itch Outcomes With Upadacitinib in Moderate-to-Severe Atopic Dermatitis: 140-Week Results From the Phase 3 Measure Up 1 and 2 Studies

Introduction: Despite undergoing prolonged systemic therapy, many patients with moderate-to-severe atopic dermatitis (AD) do not achieve optimal targets for skin and itch outcomes as defined by Aiming High in Eczema/AD (AHEAD) recommendations (eg, ≥90% improvement from baseline in Eczema Area and Severity Index [EASI 90] and Worst Pruritus Numerical Rating Scale [WP-NRS] score of 0/1 [no/minimal itch]). We evaluated long-term maintenance of optimal treatment targets with upadacitinib, an oral selective JAK inhibitor approved for moderate-to-severe AD in adolescents and adults. Methods: This 140-week interim analysis included adolescents and adults with moderate-to-severe AD who were randomized at baseline to upadacitinib 15 mg (UPA15) or 30 mg (UPA30) in the ongoing, phase 3, double-blind Measure Up 1 and 2 studies. Assessments included the proportion of patients (at the population level) who maintained EASI 90, WP-NRS 0/1, or simultaneous achievement of EASI 90 + WP-NRS 0/1 responses from week 16 (end of the placebo-controlled period) onwards. Data are reported as observed cases with no imputation for missing data. Results: Among patients who achieved EASI 90 at week 16 (UPA15, n=298; UPA30, n=384), EASI 90 was maintained by 79.8% (UPA15) and 83.7% (UPA30) at week 52, 76.7% (UPA15) and 83.0% (UPA30) at week 100, and 74.0% (UPA15) and 84.2% (UPA30) at week 140. Of patients achieving WP-NRS 0/1 at week 16 (UPA15, n=193; UPA30, n=281), WP-NRS 0/1 was maintained by 69.4% (UPA15) and 72.0% (UPA30) at week 52, 65.6% (UPA15) and 68.4% (UPA30) at week 100, and 62.3% (UPA15) and 66.0% (UPA30) at week 140. Of patients simultaneously achieving EASI 90 + WP-NRS 0/1 at week 16 (UPA15, n=156; UPA30, n=243), maintenance was achieved by 68.1% (UPA15) and 70.8% (UPA30) at week 52, 62.7% (UPA15) and 66.5% (UPA30) at week 100, and 58.7% (UPA15) and 64.4% (UPA30) at week 140. Among patients who did not maintain optimal outcomes, most still achieved clinically meaningful responses. Conclusion: Most patients maintained optimal skin and itch outcomes through 140 weeks of upadacitinib treatment, demonstrating its potential to provide sustained long-term disease control in atopic dermatitis.