Poor Control Research Articles

Association between the rs1800624 and rs80096349 SNPs and diabetic retinopathy: a pilot study

ABSTRACT Background One of the conditions that might harm your eyesight is diabetic retinopathy (DR), DR may set in slowly but surely for those with long-term diabetes and poor glucose control. ‎ Objective To establish a connection between the various genotypes of the rs1800624 SNP and the rs80096349 SNP located in the AGER gene and DR patients. ‎ Methods The current case-control research examined one hundred thirty-four individuals diagnosed with type 2 diabetes and thirty-six healthy individuals who did not have DM. These samples were obtained from Amir Al-Muminin, a private hospital in Najaf, Iraq. The tetra primers ARMS-PCR method was utilized to determine the genotype of rs1800624 SNP of the AGER gene. Results A significant association was found between genotypes (AA, AG, and GG) and DR subgroups (NPDR & PDR) in patients (p = 0.001). The AG genotype of rs1800624 SNP is associated with a lowering the risk of developing NPDR (OR = 0.30; 95% CI = 0.12-0.74; p = 0.009 between controls and NPDR, OR = 0.36; 95% CI = 0.14-0.90; p = 0.029 between NDR and NPDR). HRM analysis verified the presence of only two genotypes in the samples: wild type (GG) and a heterozygous mutant (GA). However, a significant association between genotypes was observed when comparing DR status with controls and NDR (p = 0.031). Conclusion The rs1800624 SNP of the AGER gene is associated with the risk of NPDR and PDR in T2DM, and the polymorphism of the rs80096349 may be associated with retinopathy in the Iraqi population.

Drooling in developmentally normal children: a review.

Drooling or saliva spillage has been explored widely among children with neurodevelopmental conditions. Yet, the approach to drooling in an otherwise developmentally normal child remains unexplored, as it is regarded as self-limiting. Nonetheless, drooling beyond age 4 in the awake stage should raise concern. This narrative review aims to shed light on drooling in developmentally normal children, also known as 'healthy droolers', and the available evidence on its management. Most notable factors causing saliva spillage include poor oral-motor control and impaired oral sensation. Delayed saliva acquisition may be an early indicator of developmental or intellectual delay. Drooling impairs both the children's and parents' overall quality of life significantly. Healthy droolers can be managed by simple behavioural therapy and reassurance.

Prevalence and Determinants of Complementary and Alternative Medicine Use among Children living with Epilepsy in Port Harcourt, Nigeria

Introduction: Epilepsy is a common neurologic disorder in children with its management centered on the use of anti-seizure medications (ASM). However, many children do not achieve seizure control despite being on the appropriate ASM. Hence, caregivers may seek complementary and alternative medicines (CAMs) therapies. The aim of this study is to investigate the prevalence and types of CAM used by children with epilepsy in a tertiary hospital in Port Harcourt, Nigeria, and the factors that determines their use. Methods: A descriptive cross-sectional study was conducted among children diagnosed with epilepsy and their caregivers. Participants were recruited using a convenient sampling method, a structured questionnaire was used to collect data. Descriptive statistic was performed using IBM SPSS while Pearson’s chi-square test was used to identify significant associations. Results: The prevalence of CAM use was found to be 84.3%, the use of CAM is a risk for poor adherence to ASM. Family members were the main influencers in the decision to use CAM, and the majority of parents/caregivers did not consult their children’s healthcare providers before incorporating these therapies. Significant factors influencing the use of CAM includes: being a male (P=0.01), higher seizure frequency (P=0.002), multiple ASM use (P=0.01), and the presence of comorbidities (P=0.04). The most common CAMs used were prayers, kernel or crude oil and scarifications. Conclusion: CAM use among children with epilepsy is common and is a cause of poor adherence to ASMs with its untoward effects. It is crucial for healthcare providers to proactively inquire about the use of CAM with caregivers during the management of childhood epilepsy and to educate them on the possible risks specifically regarding drug adherence, compliance and poor seizure control.

Recent advances in bioactive wound dressings.

Traditional wound dressings, despite their widespread use, face limitations, such as poor infection control and insufficient healing promotion. To address these challenges, bioactive materials have emerged as a promising solution in wound care. This comprehensive review explores the latest developments in wound healing technologies, starting with an overview of the importance of effective wound management, emphasising the need for advanced bioactive wound dressings. The review further explores various bioactive materials, defining their characteristics. It covers a wide range of natural and synthetic biopolymers used to develop bioactive wound dressings. Next, the paper discusses the incorporation of bioactive agents into wound dressings, including antimicrobial and anti-inflammatory agents, alongside regenerative components like growth factors, platelet-rich plasma, platelet-rich fibrin and stem cells. The review also covers fabrication techniques for bioactive wound dressings, highlighting techniques like electrospinning, which facilitated the production of nanofibre-based dressings with controlled porosity, the sol-gel method for developing bioactive glass-based dressings, and 3D bioprinting for customised, patient-specific dressings. The review concludes by addressing the challenges and future perspectives in bioactive wound dressing development. It includes regulatory considerations, clinical efficacy, patient care protocol integration and wound healing progress monitoring. Furthermore, the review considers emerging trends such as smart materials, sensors and personalised medicine approaches, offering insights into the future direction of bioactive wound dressing research.

Dynamic neuromuscular stabilization and its efficiency on sports performance

Neuromuscular stability is necessary for optimal sport performance. Stability is not achieved only by abdominal muscles, spine extensors and gluteals, but it is accomplished by precise coordination of these muscles and intra-abdominal pressure by the central nervous system. A primary role of the core muscles stability is to raise the intra-abdominal pressure and to increase the tension in the thoracolumbar fascia. Postural core instability is associated with poor dynamic balance control and with a high risk of injury or fall. Dynamic neuromuscular stabilization (DNS) is a rehabilitative approach to optimize the movement system based upon the scientific principles of developmental kinesiology and provides an effective tool in rehabilitation of sport injuries.

Prognostic impact of the metabolic syndrome and its components in acute type a aortic dissection after surgery: a retrospective study.

This study aimed to explore whether metabolic syndrome (MetS) and its components are associated with poor outcomes in patients with acute type A aortic dissection (ATAAD) after surgery. This study included 353 patients who had undergone surgery. Demographic and clinical characteristics of the patients were collected. Subgroup, mixed-model regression, score systems, and receiver operating characteristic curve (ROC) analyses were performed. Overall, 353 inpatients were assigned to the poor outcome group (n = 69) and control group (n = 284) with or without MetS. Compared to the control group, the incidence of MetS was higher in the poor outcome group. Poor outcomes were present in 0%, 4.4%, 12.3%, 47.6%, 71.4%, and 100% of the six groups who met the diagnostic criteria for MetS 0, 1, 2, 3, 4, and 5 times, respectively. For multivariable logistic regression, Body mass index (BMI) quartiles remained risk factors for poor outcomes after adjustment for other risk factors. After adjusting for potential confounding factors, the MetS was found to be an independent risk factor in several models. Assigning a score of one for each component, the AUC was 0.877 (95%CI: 0.823-0.923) in all patients, 0.864 (95%CI: 0.7945-0.935) in MetS, and 0.700 (95%CI: 0.567-0.833) in non-MetS by receiver operating characteristic. MetS, especially BMI, confer a greater risk of poor outcomes in ATAAD after surgery during the 3-year follow-up.

Abstract 4141496: Methylation changes in monocytes of type 2 diabetes patients with cardiovascular disease are associated with apoptosis and inflammation pathways.

Background: Monocytes have been implicated in the initiation and progression of cardiovascular (CV) complications of type 2 diabetes (T2D). Aim: We investigated diabetes-induced methylation changes and enriched pathways in circulating monocytes of T2D patients. We compared T2D vs. non-T2D participants and analyzed T2D patients according to diabetes control. Further, we assessed methylation changes in a subset of patients with poor diabetes control and high CV risk following a 6-month treatment intensification. Methods: We recruited consecutively 200 participants, 160 with T2D and 40 non-diabetes controls. Circulating monocytes were sorted using the FACSAria2 ™ cell sorter. Samples were sequenced using enhanced reduced representation bisulfite sequencing. Methylation data was processed with Lumi and limma R packages to obtain batch and covariate corrected differential expression values for the indicated comparisons. Ingenuity Pathway Analysis (Qiagen) was used to identify enriched pathways for each tested condition. Differentially methylated genes used for pathway analysis were those with a p-value < 0.05 and an absolute logFC value ≥ 0.5. Results: There were 1122 differentially methylated genes when comparing T2D to non-T2D patients. Among the top five enriched canonical pathways, apoptosis signaling was predicted to be activated, while the RHO GTPase cycle and LPS-stimulated MAPK signaling pathways were predicted to be inhibited. Within patients with diabetes, there were 1670 differentially methylated genes comparing those with poor control (HbA1c ≥ 7%) vs. good control (HbA1c<7%). Among the top five enriched pathways, synthesis of DNA, DNA replication signaling, and cell cycle checkpoints were activated while inhibition of ARE-mediated mRNA degradation pathway was inhibited. In patients who responded to treatment intensification (Δ HbA1c = -1.5%, p= 0.02), 1377 differentially methylated genes and differentially inhibited pathways such as non-homologous end-joining and cellular response to heat stress were identified. In non-responders, we identified 1582 differentially methylated genes and activated pathways, including inhibition of mRNA degradation pathways and p14/p19 ARF signaling. Conclusion: Treatment intensification in T2D patients with CVD and poor control showed the presence of differentially methylated genes affecting pathways regulating cell proliferation and inflammation and are known to be associated with diabetic CVD complications.

Enlarged Frontal Sinusotomy and Chronic Rhinosinusitis with Nasal Polyps: An Effective Strategy to Control the Disease.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a disease with a strong impact on the quality of life (QoL) which treatment is based on local intranasal corticosteroids (ICS) and iterative courses of systemic corticosteroids (SCS) in case of relapse. When medical treatment is insufficient, surgery is indicated. We investigated the impact of enlarged frontal sinusotomies (EFS: Draf IIb or Draf III) on QoL and annual SCS consumption of patients with severe uncontrolled CRSwNP. This is a retrospective cohort study of 38 patients, who underwent EFS at Lariboisière University Hospital (CHU) in Paris, France, between 2006 and 2020. All patients were asked to complete SNOT-22 questionnaires concerning pre- and post-op status. Patients' medical and sinus surgery history as well as the number of SCS treatments per year before and after surgery were also collected. Of the 38 patients, 33 underwent a Draf III procedure and 5 a Draf IIb, with no major complications reported. Surgery resulted in a significant improvement in SNOT-22 scores (-32.7 ± 19.3, P < 0.001), with 19/22 items improving significantly. The number of annual SCS treatments decreased significantly from a mean of 4.8 ± 4.3 to 0.6 ± 1.2 (P < 0.001). During the follow-up (mean 88 months), 95% of our patients showed a satisfying disease control and only 2 patients required revision surgery for poor disease control 5 years after EFS. EFS appears to be an effective and durable therapeutic option to improve the QoL of patients with severe CRSwNP and to reduce their SCS consumption without major complications.

Evaluate the Differential Effectiveness of the Case Management and Primary Nursing Models in the Implementation of Discharge Planning.

This study aims to compare the effectiveness of the case management model and the primary nursing care model by focusing on hospital stay length, readmission, follow-up resource utilisation and survival. To improve patient continuity of care, a discharge planning team has been established at the hospital to implement the service concept of long-term medical care. The team works with a multidisciplinary medical team to provide case management, which ensures high-quality patient care. Retrospective case-control study. This study collected data from the medical record information system database and the Ministry of Health and Welfare's care service management information system to explore medical and follow-up care utilisation of patients discharged between 2017 and 2018. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, with the checklist used to ensure transparent and complete reporting of the methodology and results. To ensure comparability between the case management model group and the primary nursing model group, propensity score matching was used. After matching, 660 individuals from the case management model group and 2876 individuals from the primary nursing model group were selected for further analysis. In this study, patients were primarily involved in the research as participants, providing data through their medical records for analysis. However, no direct involvement from the public or patients was used in the planning or design stages of the research. The study found that factors such as activities of daily living (ADL) score ≤ 60 points, catheterisation, poor chronic disease control and inadequate primary caregiver capacity can lead to longer hospitalisations. Males and patients with catheters have a higher risk of readmission within 30 days, and men, those aged ≥ 75 years, those with ADL score ≤ 60, catheterisation, pressure sores or unclean wounds, financial problems, insufficient primary caregiver capacity and those readmitted within 14 days after discharge had significantly increased mortality after discharge. Although the case management model group had higher hospitalisation days, they had lower readmission rates and higher survival rates than the primary nursing model group. Early consultation with the case manager for discharge planning can help patients to continue to receive care and utilise relevant resources after returning home. Identifying and addressing patient-specific factors can significantly improve patient outcomes by reducing hospitalizations and readmissions, and lowering mortality rates. The case management model is more effective than the primary nursing care model in reducing readmission rates and increasing survival rates. Early consultation with case managers for discharge planning is crucial to ensuring patient care continuity and resource utilization.

EXTH-51. ENHANCING GLIOBLASTOMA TREATMENT: ALLOGENEIC CAR-T CELLS OVERCOMES FUNCTIONAL DEFICITS OF PATIENT-DERIVED AUTOLOGOUS PRODUCTS

Abstract Glioblastoma (GBM) is the most common primary brain malignancy in adults, with a dismal prognosis despite an intensive standard of care. Recently, chimeric antigen receptor T-cell (CAR-T) therapy has shown promising outcomes in treating liquid malignancies. However, clinical trials targeting various tumor antigens in GBM failed to show durable clinical benefit. Though this may stem from various tumor-intrinsic immune evasion strategies typical of GBM, there has been little work investigating whether the problem lies in the quality of the CAR-T products treatment itself. Currently, CAR-T cells for clinical studies are produced in an autologous setting, where T-cells are extracted from patients, engineered ex-vivo, and then re-infused. However, peripheral T-cells taken from GBM patients have shown qualitative and functional deficits, which may contribute to suboptimal treatment outcomes. Thus, we aimed to explore whether CAR-Ts generated from GBM patients had any functional deficits in comparison to healthy donors, utilizing our previously validated CD133 CAR-T. In this study, we show pre-treatment exhaustion, poor tumor control, and reduced survival advantage in autologous, patient-derived CD133-targeting CAR-T cell products using an orthotopic xenograft model of human GBM. To address the functional and logistical considerations of autologous therapy, we also sought to generate an “off-the-shelf” allogeneic CD133 CAR-T. Using CRISPR gene editing technology, we generated TCR-knockout CAR-T cells with comparable pre-clinical efficacy to our healthy donor derived autologous models. Ultimately, this work highlights the need to reevaluate autologous CAR-T therapy for GBM and consider allogeneic approaches as biologically-informed therapeutic alternatives.

Integration of in-wheel motor sensorless systems and hierarchical direct yaw moment control for distributed drive electric vehicles

Ensuring robust and reliable control of distributed vehicles powered by in-wheel motor systems poses a significant challenge due to the harsh operating environments and high costs of such motor systems. Poor motor control, parameter variations, and sensor malfunction under these conditions can compromise the vehicle yaw stability. Integrating permanent magnet synchronous motor (PMSM) sensorless systems with vehicle yaw moment control offers a cost-effective solution for this issue without wheel angular speed sensors while enhancing yaw stability. In this paper, a composite nonlinear feedback sliding mode controller that can enhance the PMSM speed response is proposed. The proposed scheme exhibits a rotor speed overshoot and transient time of only 0.64% and 0.07s, respectively, which are smaller and shorter compared with other methods under motor parameter changes. Subsequently, the key states and tire-road friction coefficients required for vehicle control were estimated using sensorless rotor speeds and unscented Kalman filters, enabling the integration of the PMSM sensorless system with the vehicle yaw moment control. Additionally, a fuzzy adaptive hybrid sliding mode method is presented for yaw moment control enhancement. This method maintained the smallest sideslip angle root mean square error during double lane changes (0.4192 deg) compared with other methods. Analysis results show that different motor controllers and parameter changes significantly affect the vehicle dynamics performance. The proposed integrated scheme is feasible and effectively enhances the yaw moment control via high-performance sensorless PMSM systems.

Twisted-Planar Molecular Engineering with Sonication-Induced J-Aggregation to Design Near-Infrared J-Aggregates for Enhanced Phototherapy.

J-aggregates show great promise in phototherapy, but are limited to specific molecular skeletons and poor molecular self-assembly controllability. Herein, we report a twisted-planar molecular strategy with sonication-induced J-aggregation to develop donor-acceptor (D-A) type J-aggregates for phototherapy. With propeller aggregation-induced emission (AIE) moieties as the twisted subunits and thiophene as the planar π-bridge, the optimal twisted-planar π-interaction in MTSIC induces appropriate slip angle and J-aggregates formation, red-shifting the absorption from 624 to 790 nm. In contrast, shorter π-planarity results in amorphous aggregates, and elongation promotes charge transfer (CT) coupled J-aggregates. Sonication was demonstrated to be effective in controlling self-assembly behaviors of MTSIC, which enables the transformation from amorphous aggregates to H-intermediates, and finally to stable J-aggregates. After encapsulation with lipid-PEG, the resultant J-dots show enhanced phototherapeutic effects over amorphous dots, including brightness, reactive oxygen species (ROS) generation, and photothermal conversion, delivering superior cancer phototherapy performance. This work not only advances D-A type J-aggregates design but also provides a promising strategy for supramolecular assembly development.

The prevalence of chronic traumatic encephalopathy in a historical epilepsy post-mortem collection.

Previous post-mortem epilepsy series showed phosphorylated tau (pTau) accumulation in relation to traumatic brain injury (TBI) rather than driven by seizure frequency. The Corsellis Epilepsy Collection, established in the mid-20th century, represents brain samples collected from patients living with a range of epilepsies from the 1880s to 1990s. Our aim was to interrogate this historical archive to explore relationships between epilepsy, trauma and tau pathology. AT8 immunohistochemistry for pTau was carried out in 102 cases (55% male, with mean age at death of 62 years) on frontal, temporal, amygdala, hippocampal and lesional cortical regions and evaluated using current NINDS criteria for chronic traumatic encephalopathy (CTE) and Braak staging with beta-amyloid, AT8-GFAP and other pTau markers (CP13, PHF1, AT100, AT180) in selected cases. CTE-neuropathologic change (CTE-NC) was identified in 15.7% and was associated with the presence of astroglial tau, a younger age of onset of epilepsy, evidence of TBI and institutionalisation for epilepsy compared to cases without CTE-NC, but not for seizure type or frequency. Memory impairment was noted in 43% of cases with CTE-NC, and a significantly younger age of death; more frequent reports of sudden and unexpected death (p <0.05-0.001) were noted in cases with CTE-NC. In contrast, a higher Braak stage was associated with late-onset epilepsy and cognitive decline. Of note, 9% of cases showed no pTau, including cases with long epilepsy duration, poor seizure control and a history of prior TBI. In summary, this cohort includes patients with more severe and diverse forms of epilepsy, with CTE-NC observed more frequently than reported in non-epilepsy community-based studies (0%-8%) but lower than published series from contact sports participants (32%-87%). Although the literature does not report increased epilepsy occurring in CTE syndrome, our findings support an increased risk of CTE in epilepsy syndromes, likely primarily related to increased TBI.

Supplemental Material for Why Multiple Hypothesis Test Corrections Provide Poor Control of False Positives in the Real World

Supplemental Material for Why Multiple Hypothesis Test Corrections Provide Poor Control of False Positives in the Real World

Pigtail Catheter Compared to Formal Intercostal Catheter for the Management of Isolated Traumatic Pneumothorax: A Systematic Review and Meta-Analysis

(1) Background: The optimal management approach for adults with traumatic pneumothorax without haemothorax remains an area of debate. Specifically, there is lack of consensus as to whether insertion of a pigtail catheter is superior to a formal intercostal catheter in improving complication rates. (2) Methods: Medline, EMBASE, Cochrane Central, and the World Health Organisation International Clinical Trials Registry Platform databases were systematically searched for studies evaluating pigtail catheters compared to formal intercostal catheters for the management of traumatic pneumothorax. Investigative outcomes of interest included pain, duration management, failure, need for formal thoracoscopic surgery, need for supplemental oxygen, length of stay, infection and overall total complications. (3) Results: Three studies evaluating 280 patients were included in this analysis. There was no significant difference in total complications, rates of failure, length of stay or duration of management between pigtail catheters and formal intercostal catheters. This evidence was based on studies of low to moderate risk of bias with poor control for confounding factors. (4) Conclusions: This systematic review and meta-analysis demonstrates lack of evidence to suggest pigtail catheters are superior to formal intercostal catheter for traumatic pneumothorax. These findings may reflect a true absence of effect between either approach for this patient cohort or non-committal findings in light of limitations of the underlying evidence. Further prospective trials with larger sample sizes and control for confounders are required to validate the outcomes between these two modalities of treatment.

The Influencing Factors of Psychological Causes of Violent Crime

Violent crimes not only can cause significant economic losses, but also affect people's mental health. This passage discusses the various psychology factors that form violent crimes in combination with literature. The group of violent criminals usually has cognitive defects, which are manifested in poor judgment, serious distortion of values and morals, and are easily influenced by wrong ideas. In addition, this type of criminals are also generally emotionally unstable, vulnerable to emotional frustration, and often dominated by strong negative emotions such as anger and resentment. Thirdly, in terms of personal quality, the violent criminal group also has defects, that is, the criminals have poor self-regulation and control ability, and are prone to lose control or over-suppress emotions. Finally, from the analysis of personality and personality psychological factors, it is pointed out that violent criminals usually have obvious negative personality traits, such as impulsiveness, lack of responsibility and sympathy, and excessive expansion of self-awareness. These personality defects may be the root cause of their violent means. In general, these different psychological factors interact with each other and jointly influence and form the psychological mechanism of violent crime. This article can provide some support for understanding the causes and prevention of violent crimes.

Chemical Control of the Invasive Tree Ailanthus altissima

Many natural areas are colonised by the invasive species Ailanthus altissima (Mill.) Swingle. Its presence in natural ecosystems damages the ecological richness while competing with native flora. A. altissima is one of the most widespread weed species in natural areas of temperate regions such as conservation parks, archaeological sites and communication corridors. Not many active ingredients are available to control this weed since the most popular, glyphosate, has been banned by many municipalities. To test the efficacy of alternative herbicides, naturally occurring populations in Collserola Conservation Park in Barcelona (Catalonia, Spain) were treated with different herbicides using three different techniques. Aclonifen, metribuzin, flazasulfuron, metsulfuron-methyl, fluroxypyr, isoxaflutole + thiencarbazone-methyl and triclopyr mixed with 2.4-D, fluroxypyr, aminopyralid and clopyralid were applied by stem injection, cut stump injection or basal bark techniques to trees of about 5 cm diameter. Cut stump and stem injection both gave almost total control of the trees while basal bark showed more varied results depending on the herbicide. The best control was achieved when flazasulfuron or triclopyr were present as active ingredients and poorer control was observed when using metsulfuron-methyl or isoxaflutole + thiencarbazone-methyl. Aclonifen showed no damage to the trees. Metribuzin worked better if the cut stump injection technique was used. These results showed that several alternatives are available to the use of glyphosate, which has been banned for some uses due to environmental concerns.

CONTExT-RA—a cross-sectional study evaluating disease activity, quality of life and the socio-demographic profile of Irish patients with rheumatoid arthritis

Abstract Objectives CONTExT-RA is a cross-sectional, non-interventional multicentre study which enrolled patients diagnosed with rheumatoid arthritis (RA) and receiving disease-modifying anti-rheumatic drug (DMARD) treatment in a secondary care setting. The study evaluated disease control and associated disease burden amongst this Irish population. Methods Patients with RA attending six Irish rheumatology centres, were invited to participate. Each consented patient attended a single routine study visit. Disease activity was assessed using Clinical Disease Activity Index (CDAI). The primary endpoint was EuroQol-5 dimensions (EQ-5D-5L) stratified by CDAI, compared using a non-parametric Wilcoxon Rank-Sum test. Results 130 patients were included. Using CDAI, 34 (26.2%) patients were in clinical remission (CR), 42 (32.3%) had low disease activity (LDA), 41 (31.5%) had moderate disease activity (MDA) and 13 (10.0%) had high disease activity (HDA). QoL (EQ-5D-5L index (median)) scores were significantly (p &amp;lt; 0.001) greater for patients in CR or CR/LDA than for those with MDA/HDA, 0.866 (0.920), 0.777 (0.822) vs 0.578 (0.691), respectively. Patients in CR reported higher levels of work productivity, mean (SD) rating of 1.7 (2.52) vs those in MDA/HDA of 4.2 (3.28) (higher rating indicates greater impairment). Similar findings were observed for non-work-related activities. Conclusion Disease control for many patients with RA, treated in secondary care in Ireland, is sub-optimal with only 1 in 4 in CDAI remission. The impact of poor disease control on QoL is significant, and the superior outcomes for patients in CR provide compelling evidence that by achieving greater disease control, the burden of disease on patients can be greatly reduced.

Impact of Fruit Order on Cucurbits Yield Components: A Case of Lagenaria siceraria (Molina) Standl

Lagenaria siceraria is a trendy plant in Ivory Coast for its seeds. However, production of this plant remains relatively low. One of the underlying reasons for poor yields is poor control of crop techniques. This study is part of the improvement of L. siceraria production. It was conducted on the experimental farm of Nangui Abrogoua University in Abidjan. The study focused on the effect of fruit order on agronomic parameters related to fruits and seeds. To this end, a series of experiments was conducted. Fruits formed on the same plant were classified into three groups: J0 for the first generation, J8 for the second and J15 for the third generation. The results obtained indicate that for all agronomic parameters, the weight of the fruit (PoFr), the volume of the fruit (VoFr), the volume of the seed lodge (VLGr), the number of seeds per fruit (NoGr), the weight of 100 seeds (P100), the highest values are obtained for fruits of the first generation of fruit (J0). Thus, the fruits that appear first have a better agronomic quality. Farmers should use seeds from first-generation fruits for planting.

Remote Foot Temperature Monitoring Among Veterans: Large Observational Study of Noncompliance and Its Correlates.

In-home remote foot temperature monitoring (RTM) holds promise as a method to reduce foot ulceration in high-risk patients with diabetes. Few studies have evaluated adherence to this method or evaluated the factors associated with noncompliance. The aims of this study were to estimate noncompliance in patients who were enrolled in RTM nationwide across Department of Veterans Affairs (VA) and to evaluate characteristics associated with noncompliance. We conducted an observational study including 1137 patients in the VA who were enrolled in RTM between January 2019 and June 2021, with follow-up through October 2021. Patient information was obtained from the VA's electronic health record and RTM use was obtained from the company. Noncompliance was defined as using the mat <2 days per week for ≥4 of the 12 months of follow-up. Using a multivariable model, we calculated odds ratios (ORs) and 95% CIs for associations between various factors and noncompliance and compared using Akaike information criterion statistics, a measure of model fit. The sample was predominantly male (n=1125, 98.94%) ; 21.1% (n=230) were Black and 75.7% (n=825) were White. Overall, 37.6% (428/1137) of patients were classified as noncompliant. In the multivariable model, an intermediate area deprivation index was statistically significantly and inversely associated with noncompliance (area deprivation index 50-74 vs 1-24; OR 0.56, 95% CI 0.35-0.89); factors significantly and positively associated with noncompliance included recent history of osteomyelitis (OR 1.44, 95% CI 1.06-1.97), Gagne comorbidity index score ≥4 (vs ≤0; OR 1.81, 95% CI 1.15-2.83), telehealth encounters (28+ vs <6; OR 1.70, 95% CI 1.02-2.84), hemoglobin A1c≥10 (vs <5.7; OR 2.67, 95% CI 1.27-5.58), and current smoking (OR 2.06, 95% CI 1.32-3.20). Based on Akaike information criterion differences, the strongest factors associated with noncompliance were behavioral factors (poor glucose control [as measured by hemoglobin A1c] and smoking), and to a lesser extent, factors such as a recent history of osteomyelitis and an elevated Gagne comorbidity index, indicating a high comorbidity burden. To reduce the risk of ulcer recurrence and amputation, proactively providing additional support for self-monitoring to patients with characteristics identified in this study (poor glucose control, current smoking, high comorbidity burden) may be helpful. Furthermore, research is needed to better understand barriers to use, and whether the addition of design features, reminders, or incentives may reduce noncompliance and the risk of foot ulcers.