Management Approach Research Articles

Renal nutcracker syndrome presenting with varicocele: A case series

Introduction and importanceNutcracker syndrome (NCS) is a rare condition characterized by left renal vein compression and presents with diverse clinical manifestations. This case series study aims to evaluate the clinical presentations and outcomes of patients with NCS and varicocele. Case presentationWe reviewed the cases of four male patients, aged 15 to 19 years, who presented with recurrent and grade 3 varicocele after varicocelectomy. All patients reported pain in the hypogastric, flank, or groin areas. Despite the absence of hematuria, NCS was diagnosed based on duplex ultrasound and contrast-enhanced computed tomography (CT) scans. Patients underwent open surgical interventions, including gonadal vein transposition or saphenous vein bypass. Clinical discussionThe absence of hematuria in these cases poses a diagnostic challenge, as current diagnostic criteria for NCS relies on its presence. Our findings underscore the need to consider NCS in patients with varicocele, even in the absence of hematuria. Surgical interventions were effective in resolving the symptoms. After NCS surgery, the varicocele in one patient resolved, and three patients underwent varicocelectomy successfully without recurrence throughout the recovery period. ConclusionThis case series highlights the diagnosis of NCS presenting with varicocele and local pain without hematuria, emphasizing the need for improved diagnostic and management approaches.

3D Printed Personalized Colon-targeted Tablets: A Novel Approach in Ulcerative Colitis Management.

Ulcerative colitis (UC) and Crohn's disease (CD) are two types of idiopathic inflammatory bowel disease (IBD) that are increasing in frequency and incidence worldwide, particularly in highly industrialized countries. Conventional tablets struggle to effectively deliver anti-inflammatory drugs since the inflammation is localized in different areas of the colon in each patient. The goal of 3D printing technology in pharmaceutics is to create personalized drug delivery systems (DDS) that are tailored to each individual's specific needs. This review provides an overview of existing 3D printing processes, with a focus on extrusion-based technologies, which have received the most attention. Personalized pharmaceutical products offer numerous benefits to patients worldwide, and 3D printing technology is becoming more affordable every day. Custom manufacturing of 3D printed tablets provides innovative ideas for developing a tailored colon DDS. In the future, 3D printing could be used to manufacture personalized tablets for UC patients based on the location of inflammation in the colon, resulting in improved therapeutic outcomes and a better quality of life.

Application of Box-Behnken design in the optimization and development of albendazole-loaded zein nanoparticles as a drug repurposing approach for colorectal cancer management

Colorectal cancer (CRC) is the second cancer worldwide representing a major global health challenge. Numerous effective anticancer drugs have been developed in the last decade, yet the problem remains due to their low therapeutic index and nonspecificity. A new anticancer therapeutic paradigm is based on repurposing and nanoformulating drugs. Albendazole (ALB), a popular anthelmintic agent, was recently repurposed against CRC cells. In this study zein, an amphiphilic protein, was used to formulate nanoparticles (NPs) loaded with ALB. Box-Behnken design was selected to optimize the loaded NPs, the concentrations of polyvinyl alcohol, acetic acid, and the weight of zein were the independent variables. The dependent variables were the particle size, polydispersity index, and zeta potential. The optimized formula displayed a size of 84.3 ± 0.41 nm, PDI 0.13 ± 0.012, and a zeta potential of 42.5 ± 2.35 mV. ALB was successfully encapsulated into zein NPs and the release study revealed a desirable pH-responsive drug release behavior, that was negligible discharge during the first 2 h at pH 1.2 and progressive in the simulated colon environment reaching 71.1 ± 0.34 % at 6 h and 92.4 ± 1.11 % at 24 h. The anticancer effect of the loaded NPs on the human HCT116 cells showed favorable effects at 1 μM concentrations with a significant decrease in the IC50 at days 2 and 3 upon loading albendazole into zein NPs. ZNPs proved to be prospective nanocarriers that could be used for the delivery of repurposed drugs in CRC treatment.

Therapeutic strategies to modulate gut microbial health: Approaches for sarcopenia management.

Sarcopenia is a progressive and generalized loss of skeletal muscle and functions associated with ageing with currently no definitive treatment. Alterations in gut microbial composition have emerged as a significant contributor to the pathophysiology of multiple diseases. Recently, its association with muscle health has pointed to its potential role in mediating sarcopenia. The current review focuses on the association of gut microbiota and mediators of muscle health, connecting the dots between the influence of gut microbiota and their metabolites on biomarkers of sarcopenia. It further delineates the mechanism by which the gut microbiota affects muscle health with progressing age, aiding the formulation of a multi-modal treatment plan involving nutritional supplements and pharmacological interventions along with lifestyle changes compiled in the review. Nutritional supplements containing proteins, vitamin D, omega-3 fatty acids, creatine, curcumin, kefir, and ursolic acid positively impact the gut microbiome. Dietary fibres foster a conducive environment for the growth of beneficial microbes such as Bifidobacterium, Faecalibacterium, Ruminococcus, and Lactobacillus. Probiotics and prebiotics act by protecting against reactive oxygen species (ROS) and inflammatory cytokines. They also increase the production of gut microbiota metabolites like short-chain fatty acids (SCFAs), which aid in improving muscle health. Foods rich in polyphenols are anti-inflammatory and have an antioxidant effect, contributing to a healthier gut. Pharmacological interventions like faecal microbiota transplantation (FMT), non-steroidal anti-inflammatory drugs (NSAIDs), ghrelin mimetics, angiotensin-converting enzyme inhibitors (ACEIs), and butyrate precursors lead to the production of anti-inflammatory fatty acids and regulate appetite, gut motility, and microbial impact on gut health. Further research is warranted to deepen our understanding of the interaction between gut microbiota and muscle health for developing therapeutic strategies for ameliorating sarcopenic muscle loss.

Management strategies of translocated pondweed Monochoria hastata and its ecological and economic impacts

Understanding the impacts of, and options for, controlling invasive species is crucial to their management. Wetlands are a widely invaded ecosystem, since dispersal of aquatic species is facilitated by seasonal flooding. This study evaluated the effects of the translocated pondweed Monochoria hastata on fish and rice production in two wetlands of Bangladesh over six years (2017-2022). Fish and rice production were compared between control (negligible M. hastata) and three treatments under different M. hastata management methods comprising manual-, herbicide- and mechanical-treatment. Density of M. hastata increased significantly in all treatment groups over time in both wet and dry seasons. However, M. hastata density was lower by 270% in the dry season than the wet season. For fishes, a negative relationship between M. hastata density and fish production was recorded for snakeheads and catfishes, the most saleable fishes, whereas a mixed pattern was recorded for barbs and minnows across treatments. A positive relationship occurred between the density of M. hastata and production of the most common fish, mud eel, and therefore, the overall fish production increased in all treatment groups. Compared to control plots, rice production was lower in M. hastata infested plot groups. Among the M. hastata infested plot groups, rice production in herbicide-and mechanical-treatment groups was similar but lower than the manual-treatment group. Although manual-treatment plots yielded greater rice production, the weed management cost was also higher. This study provides evidence that translocated M. hastata can be of an invasive nature and impact rice production, not only by reducing yield but also by increasing the production costs through additional management for M. hastata control. Its presence in wetlands in Bangladesh can increase overall fish production due to the overriding influence of increased mud eel yield which has little demand locally but can decrease the species of high demand (e.g. snakehead and catfish). None of the existing control measures are effective in controlling M. hastata. Further research is needed on better management approaches for both agricultural and fish production in areas invaded by M. hastata.

A Systematic Review on the Potential Applications of Theranostic Nanoparticles in Diabetes and its Associated Complication Diabetic Neuropathy

Background: Diabetes neuropathy is a frequent ailment that has a substantial impact on patients by increasing the risk of falls and causing discomfort. The lower extremities are where diabetic neuropathy patients first feel pain. This discomfort could seem like a pinprick, an electric shock, or something else. Objective: Here, we give a comprehensive overview of this quickly developing theranostic appli-cation that includes all relevant imaging, diagnostic, therapeutic, and monitoring elements for the management of diabetes and diabetes neuropathy. Methods: The data for the current study was gathered by searching PubMed and Google Scholar. Several research and review publications from various publishers, including Springer Nature, Bentham Science, PLOS one, MDPI, and ACS Publishing Centre, were evaluated to compile the data. Result: Recent developments in theranostics have shown promise as alternate management ap-proaches for diabetes and ailments linked to diabetes. Numerous nanotechnology-built biosen-sors, including multiwalled carbon nanotubes, copper nanowires, zinc oxide tetrapods, and nano-particle-embedded contact lenses, offer benefits in monitoring diabetic neuropathy. Conclusion: The potency, usability, and dependability of insulin substitutes have been demon-strated by a variety of innovative methods for the management of diabetes, which includes nano-technology approaches using Gene-Based Nanoparticles (siRNA), Liposomes, Exo-somes/Extracellular Vesicles, Neuromodulation, and Inhalable Nanoparticles. Over the past few years, the development of various theranostic nanoparticles for Diabetic neuropathy has experi-enced an unprecedented expansion. Even though much work needs to be done to precisely evalu-ate the genuine benefits provided by these particles, such as issues with nanotoxicity, theranostic nanoparticles will have a significant impact on the field of nanomedicine.

Promoting multidisciplinary pain management in low- and middle-income countries—challenges and achievements

Abstract The burden of pain in low- and middle income countries (LMICs) is high and expected to rise further with their ageing populations. Multidisciplinary pain management approaches based on the biopsychosocial model of pain have been shown to be effective in reducing pain-related distress and disability, but these approaches are still lacking in many LMICs due to various factors, including low levels of awareness about the role of multidisciplinary pain clinics, lack of prioritisation for pain services, and lack of healthcare professionals trained in pain management. The International Association for the Study of Pain (IASP) has several educational programs to promote multidisciplinary pain management in LMICs, in the form of education grants, pain fellowships, pain camps and, most recently, the development of a Multidisciplinary Pain Centre Toolkit. This article describes the various educational programs, focusing on Southeast Asia, that demonstrate how targeted educational programs which include skills training, follow-up and mentorship, can translate into the formation of new multidisciplinary pain management services in settings with limited resources.

I'm in Charge, But Not Always in Control: A Qualitative Exploration of Female's Beliefs and Knowledge About Their Pelvic Pain.

Beliefs and knowledge about pain can influence how an individual approaches pain management. At present, there have been no investigations into the beliefs and knowledge that females hold about their pelvic pain; therefore, pain intervention approaches may not be targeted at current patient understandings. Exploring beliefs and knowledge may help inform and subsequently improve pain intervention outcomes for pelvic pain by allowing more tailored content to be delivered. This study aimed to identify beliefs and knowledge that females hold about their pelvic pain. Semi-structured interviews (n=12) were conducted. Based on the Common Sense Model, interview questions investigated participants' beliefs and knowledge related to the identity (diagnostic labels), cause, consequence, control, and timeline of their pelvic pain. Transcribed interviews were analysed using an Interpretive Description Framework. Participants reported holding biopsychosocial understandings of pain; however, many described their own pain experience in a way that was more aligned with the biomedical model of pain, suggesting incongruence in pain understandings. Participants valued their ability to take charge of their pain management, highlighting bodily autonomy and being proactive in pain management approaches. This approach to management did not provide total control over participants' pelvic pain. Pelvic pain was perceived as disruptive of life, both at present and into the future, with predictability of pain varying over time. This study provides insight into the perspectives of females with pelvic pain. Recommendations for clinicians are provided with a focus on delivering targeted education and equipping patients with helpful representations of their pain.

Suggestions on Grassroots Fire Safety Management for Smart City Construction

In this context, China has proposed "adhering to the overall concept of national security" and "adhering to the positive interaction between high-quality development and high-level security" to ensure the safety of life and property of the people in their pursuit of a better life. In the field of safety in China, fire safety has always been the top priority, and its impact has been widely reflected in the social, scientific and technological and economic fields, but there are still large shortcomings in the grass-roots fire safety management in China, so it is particularly important to find a suitable management approach. Based on this, this paper synthesizes the views of various scholars, summarizes and analyzes the exploration of grass-roots fire safety governance and the existing problems, and finds the appropriate governance approach, in order to provide a certain reference for China's grass-roots fire safety governance

Development and evaluation of mucoadhesive buccal films for the sustained release of diclofenac sodium: An innovative approach for pain management

The research explores the development and evaluation of mucoadhesive buccal films for the sustained release of diclofenac sodium, a widely used non-steroidal anti-inflammatory drug (NSAID) for pain relief. Mucoadhesive buccal films are an innovative drug delivery system designed to adhere to the mucous membrane in the oral cavity, enabling the controlled release of drugs directly into the bloodstream, bypassing first-pass metabolism and improving therapeutic outcomes. These films provide sustained release, localized action, and improved compliance, making them more convenient for patients. Mucus membranes, which are moist surfaces lining body cavities, are the main components of mucus gels. The wetting theory applies to mucoadhesion, which involves the release of mucus from the mucosal surface into the bloodstream. The study aims to develop a more efficient and effective method for the controlled release of diclofenac sodium, a potent anti-inflammatory and analgesic drug.

Mathematical approaches to fisheries quota management: ensuring sustainable practices in U.S. commercial fishing

Fisheries quota management plays a critical role in ensuring the sustainability of commercial fishing practices, particularly in the United States, where overfishing and resource depletion pose significant challenges to marine ecosystems. This review explores the mathematical approaches utilized to manage fisheries quotas effectively and sustainably. The paper examines key mathematical models, including population dynamics, bioeconomic models, game theory, and Catch-per-Unit-Effort (CPUE) models, highlighting their role in maintaining fish stock levels and regulating fishing activities. Through case studies from U.S. fisheries, such as the New England groundfish and Alaska pollock fisheries, the review assesses the effectiveness of these models in real-world applications. Additionally, it explores how advances in technology, such as satellite tracking, big data, and artificial intelligence, are enhancing the accuracy and adaptability of fisheries management models. The review concludes with insights into future directions for mathematical approaches in fisheries management, emphasizing the need for continuous innovation to support sustainable commercial fishing practices. By integrating advanced mathematical techniques and data-driven models, this paper aims to provide a pathway for policymakers and fisheries managers to achieve long-term sustainability in U.S. commercial fisheries.

Revolutionizing inventory management: A comprehensive automated data-driven model using power BI incorporating industry 4.0

This is a study on advanced inventory management approaches in the mechanical industry using data-driven models, accompanied by Power BI analytics. Drawing insights from broad collaboration with relevant industrial expertise at different organizational scales, our research work addresses the intricacies and challenges in maintaining optimal inventory levels concerning growing industries and operational risks. In this global mechanical firm, we analyzed historical data using descriptive and predictive analytics to understand the trends of the past and to forecast future inventory needs. Descriptive analytics provided base insights about the present status of inventory, while predictive analytics helped proactive management of stock levels classified into on-hand and critical level categories for greater efficiency in strategies related to planning at the coordination end with its suppliers and mitigating risks. Core to our methodology will be the implementation of an automated data-driven machine-learning approach that brings minimal intervention from humans to solve some of the most critical problems in inventory management. One major contribution this study adds is a major product: a Power BI dashboard that visualizes critical part numbers falling below threshold values and recognizes suppliers with historical shipment shortages. Armed with this intuitive dashboard, supplier-coordinating engineers are better placed to take proactive action on inventory shortages, greatly improving operational efficiency in supply chain resilience.

The impact of climate change on the ecology, reproduction and distribution of marine mammals and the possible legislation, conservation and management approaches to protect these marine mammal species: A systematic review

The impact of climate change on the ecology, reproduction and distribution of marine mammals and the possible legislation, conservation and management approaches to protect these marine mammal species: A systematic review

Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center

BackgroundThe management of infants at risk of neonatal abstinence syndrome (NAS) remains challenging. In 2000 Maternidade Bissaya Barreto implemented a strategy based on the qualitative assessment of neonates and in 2018 the Eat, Sleep, Console (ESC) approach, a tool based on similar concepts, was created. The aim is to assess the efficacy of a qualitative assessment of infants at risk, compare it with the ESC approach and report temporal trends of NAS in a European hospital.MethodsRetrospective cohort study of all infants of mothers with a history of drug abuse during pregnancy admitted to a tertiary European centre between January 2010 and December 2021. The therapeutical decision was guided by a qualitative assessment of the newborn’s well-being. The ESC approach was retrospectively determined. Pharmacologic treatment was used as a last resort. The clinical outcomes and therapeutic strategies employed were evaluated. Statistical association was evaluated. The incidence rate per 1000 births was calculated and temporal trend differences were identified.ResultsA total of 79 neonates at risk were included, of whom 40 (50.6%) developed NAS. Consolability was the most affected criterion (35.0%), followed by feeding difficulties (12.5%). Sleep was affected less frequently (5.0%). Overall, 37.5% of infants failed to meet at least one of the criteria. All neonates with a positive ESC failed the qualitative assessment (p = 1.000) After optimization of nonpharmacologic measures, drug therapy was still necessary in four cases (10.0% of infants with the syndrome). The incidence rate of NAS decreased from 3.9 per 1000 births in 2010 to 0.0 per 1000 births in 2021 (p = 0.025).ConclusionThe qualitative assessment of the infant based on the ability to feed, sleep and be consoled correctly identified neonates at risk and led to a significant reduction in the use of drug therapy. The incidence rate of NAS decreased during the study period.

Lessons learned from implementing a digital rehabilitation care planning platform to improve care access for patients with work disability: qualitative process evaluation of the RehaPro-SERVE study

BackgroundInpatient rehabilitation therapies can be applied for in Germany by patients of working age to support their return to work. However, there are some problems that impede an easy and uncomplicated application process. An interdisciplinary case management approach for rehabilitation care planning was developed to facilitate the access to rehabilitation. Case conferences (CCs) were held with relevant stakeholders and took place on a digital communication platform. We conducted a qualitative process evaluation to understand the implementation of the intervention and to identify contextual factors as well as mechanisms for a successful implementation in the context of primary care.MethodsThe process evaluation included interviews with primary care physicians (PCPs), patients and stakeholders involved in the intervention process. Reflexive thematic analysis was used to analyse the data. Emerging themes were structured according to the Donabedian framework of structure, process and outcomes.ResultsA total of 18 interviews were conducted. Important results included the desire for more patient involvement and case management. Patients especially valued the opportunity to receive support from a social worker. Limitations of the platform related to usability and limited opportunities for stakeholder communication. Despite training for PCPs, several problems arose regarding the clarity of the intervention process. Patients were satisfied with their application process and the treatments offered, while PCPs reported an increase in workload.ConclusionsA digitalisation of the application procedure for rehabilitation and further treatment options is acceptable to patients and personal support of a social worker is particularly valued. However, patients should be included in the CC in terms of a shared decision-making process. The digital platform requires sufficient training and adjustments have to be made to enhance usability and to improve the efficiency of the process for PCPs. Overall, the exchange between the various stakeholders in the CC is considered particularly useful in more complex cases.Trial registrationDRKS German Clinical Trials Register, DRKS0 00242 07. Registered on 22 March 2021.

Investigating Transmission Patterns and Genome Sequencing of SARS-CoV-2 in University College Dublin

Abstract Background This study describes the investigation and management of multiple outbreaks of SARS-Cov2 during the second and third wave of the pandemic at University College Dublin, Ireland from September 2020 to September 2021. Methods Relevant data were gathered as part of the public health outbreak investigations led by the UCD Internal Covid Control Team (ICCT) in collaboration with the public health teams of the Health Service Executive (HSE). Results are presented for PCR (polymerase chain reaction) confirmed cases and their close contacts, reported to the UCD ICCT between September 2020 to September 2021. Results There were 214 cases notified to ICCT. Among these, 153 cases were in residence on-campus cases. 73 epidemiologically linked clusters identified, where the number of cases linked with each cluster varied between 1 to 27. Additional cases during this period had no obvious epidemiological link to the identified clusters. Of 902 close contacts with PCR test results, 31.5% (n = 284) tested positive. 77% (n = 219) self-reported with mild to moderately symptoms while 23% (n = 65) self-reported as asymptomatic. Retrospective Whole Genome Sequence (WGS) analysis was undertaken after the outbreaks had subsided. The test positive cases were grouped into 6 clusters, and it was shown that many of the apparent sporadic cases were included in these clusters. Conclusions The proportion of close contacts testing positive varied significantly throughout the pandemic, with testing policy and type of exposure having the greatest impact. Whole genome sequencing can give a better understanding of webs of transmission to complement epidemiological investigations. It is now possible to undertake sequencing in real time where it can make a contribution to outbreak control and resolution. Public Health professionals should become familiar with WGS and bioinformatics as useful tools in their armory for the control of all communicable diseases not only SARS-CoV-2. Key messages • Combined epidemiological investigations and Whole Genome Sequencing (WGS) provide crucial insights into campus COVID-19 outbreaks, guiding effective control measures. • WGS integration enhances understanding of transmission patterns, identifies clusters, and equips public health professionals with data-driven approaches for outbreak management beyond SARS-CoV-2.

Bi-Directional Charging with V2L Integration for Optimal Energy Management in Electric Vehicles

Electric vehicles (EVs) are becoming increasingly popular as an efficient transportation solution but they also present unique challenges for energy management. Bi-directional charging (BDC) is a solution that allows EVs to not only consume energy from the grid but also supply energy back to the grid. This facilitates vehicle-to-load (V2L) integration, where EVs can act as mobile power sources for homes, buildings, and the grid. V2L enables better energy management by utilizing EVs as a flexible resource to balance grid demand and supply in the proposed system. This is achieved through intelligent coordination between the EVs, charging stations, and the grid, using smart meters and communication networks. Integration of BDC and V2L also enables EVs to provide backup power during grid outages, reduce the need for costly grid infrastructure, and support renewable energy integration. BDC with V2L integration is a promising approach for optimal energy management in EVs and can play a significant role in the future of sustainable transportation and energy systems. The proposed model reached 95.13% charging efficiency, 95.03% energy management, 95.69% power rating, 96.28% voltage support and 87.99% temperature management.

Long-term facial nerve outcome in surgically treated petrous bone cholesteatoma patients.

The term petrous bone cholesteatoma (PBC) represents a slow-growing epidermal lesion arising from the petrous part of the temporal bone. It is a rare incidence accounting for only 4-9% of all petrous bone lesions. PBC represents a real surgical challenge due to its complex relationship with critical neurovascular structures. To demonstrate our experience in using various options of facial nerve (FN) management during surgical treatment of PBC and analyze the long-term facial function outcomes. Retrospective medical record review in a quaternary skull-base center. Medical records of 298 PBC cases operated between the years 1983 and 2024 were thoroughly evaluated. Sanna's classification scheme was used to classify cases into the appropriate class and the House-Brackmann (HB) grading system of the FN was used to assess the facial function pre- and postoperatively. A total of 298 PBC cases were surgically treated at our center. Males constitute 68% (n = 203) of total operated PBC patients while the rest 32% (95) were females, making the male-to-female ratio 2.2:1. The age in this series ranged from 9 to 85. According to updated Sanna's PBC classification, 44% were supralabyrinthine, 33% were massive, 9% were infralabyrinthine-apical, 8% were infralabyrinthine, and 5% were apical. On preoperative FN function examination, 45% (n = 133) of patients had various degrees of paresis and complete paralysis whereas 55% (n = 165) had normal FN function. The commonest degree of paresis observed was HB-III (18.5%) followed by HB-IV (5.7%). A total of 40(13.4%) patients, however, had complete facial paralysis at the initial presentation. The facial function was compromised more frequently in supralabyrinthine and massive PBCs. Among the total patients who had an abnormal facial function at presentation, 52% had paresis/paralysis for less than a year whereas 48% had FN paresis/paralysis for greater than one year. The most commonly used surgical approaches at our center were transotic (TO), modified transcochlear type A (MTCA) with rerouting of the FN, and translabyrinthine (TLAB) with external auditory canal (EAC) closure. Intraoperatively an intact fallopian canal was found only in 33% (n = 99) cases whereas the rest 67% (n = 199) had erosion of the fallopian canal either with intact (n = 24) or infiltrated FN (n = 175). The FN was maintained in the bony fallopian canal in 35% (n = 104) cases. An active form of FN management, however, was required in 65% (n = 194) of cases either intraoperatively or as a second-stage procedure. Factors affecting postoperative FN function include age, preoperative FN function (HB), duration of paralysis, class of PBC, surgical approach, and method of active FN management. PBCs represent diagnostically and surgically challenging lesions of temporal bone which are usually frustrating to the treating surgeon. Preoperative anatomic classification of the lesion enables the physician to choose the appropriate surgical approach. Sanna's classification is the most widely accepted system used to classify PBC. This classification is based on the relation of the lesion to the labyrinthine block. Active FN management, including rerouting, end-to-end anastomosis, cable nerve grafting, and masseteric-to-FN anastomosis routinely come into play in the surgical management of PBCs, and the postoperative FN results after such interventions can be satisfactory in most cases.

Strategic genetic insights and integrated approaches for successful management of blackleg in canola/rapeseed farming

AbstractThis review describes a triumphant narrative in the battle against the devastating plant pathogen complex, Leptosphaeria maculans and L. biglobosa, and the success of the world's second‐largest oilseed crop, canola/oilseed rape. Emphasizing global collaborations, the article explores successfully mitigating this destructive disease in canola/rapeseed production across Australia, Canada and Europe. It highlights how strategies may vary between continents to adapt to specific contexts. While initial resistance (R) genes proved effective, the evolution of the pathogen under crop‐induced disease pressure led to the breakdown of these genes. Now, growers in these regions have been equipped with new tools, allowing them to make informed decisions that help to keep the disease at generally low levels. A pivotal factor in this success has been a deepened understanding of the intricate science underlying the host–pathogen interaction. Concerted efforts of individual laboratories and collaborative initiatives have played an essential role in this success, including novel methods for disease control based on extensive research that has translated into developing highly resistant varieties, enhanced pathogen monitoring, improved cultivar recommendation and integrated management strategies. The review showcases many milestone advancements, including the cloning of numerous avirulence genes within the pathogen, characterization of specific R genes, the development of various molecular tools for monitoring both pathogen and host, the introduction of groundbreaking disease management strategies such as R gene labelling, rotation and stacking, and establishment of a universal pathogen isolate collection that facilitates the exchange of information among multiple laboratories and adds a new dimension to this triumph.

Culinary medicine in type 2 diabetes management: co-designing the Cook2DIAbeat training program

Abstract Background Type 2 diabetes (hereinafter diabetes) stands among the top ten drivers of disease burden. Globally, more than 59 million adults are living with diabetes with a projection of 15% increase by 2045. The Cook2DIAbeat project aims to develop a tailor-made nutrition training program based on culinary medicine, for patients with diabetes to achieve lifelong dietary changes. The aim of the present work was to reveal potential drivers and barriers related to lifelong dietary modifications. Methods The study was implemented in February-July 2023 in Spain, Belgium, Greece, and Cyprus. A mixed-method co-design methodology was conducted: co-creation sessions with individuals with diabetes, family members, and healthcare professionals, and an online survey with patients with diabetes. Results In total, 23 health professionals and 25 patients and family members participated in the co-creation sessions, and 212 patients in the online survey. Patients and health professionals recognized the added value of the culinary approach for diabetes management. The main perceived barriers for changing dietary habits included difficulties accessing reliable and non-conflicting information, lack of time, emotional and psychological issues, and limited social support. Individuals at an advanced age and of low socioeconomic status seem to demand specific educational approaches addressing the actual challenges of their daily life. Conclusions The study indicated that training should provide reliable information and address psychosocial aspects. The translation of the dietary guidelines through the culinary medicine approach seems to be well-received by the target group. Last, the content needs to be tailored to suit the specific age group and socioeconomic background of the patients. Key messages • Reliability, practicability are three key characteristics of a nutrition training program in diabetes management. • Cultural and socioeconomic barriers needs to be taken into consideration.