Poor Control Research Articles

Demographic and Metabolic Risk Factors Associated with Development of Diabetic Macular Edema among Persons with Diabetes Mellitus

PurposeDiabetic macular edema (DME), a leading cause of visual impairment, can occur regardless of diabetic retinopathy (DR) stage. Poor metabolic control is hypothesized to contribute to DME development though large-scale studies have yet to identify such an association. This study aims to determine whether measurable markers of dysmetabolism associate with DME development in persons with diabetes. DesignRetrospective cohort study ParticipantsUsing data from the Sight Outcomes Research Collaborative (SOURCE) repository, patients with diabetes mellitus (DM) and no pre-existing DME were identified and followed over time to see what factors associated with DME development. MethodsCox proportional hazard modeling was used to assess the relationship between demographic variables, diabetes type, smoking history, baseline DR status, blood pressure (BP), lipid profile, body mass index (BMI), hemoglobin A1C (HbA1C) and new onset of DME. Main Outcome MeasuredAdjusted Hazard Ratio (HR) of developing DME with 95% confidence intervals. ResultsOf 47,509 eligible patients from 10 SOURCE sites (mean age 63±12 years, 58% female sex, 48% white race), 3633 (7.6%) developed DME in the study period. The mean±standard deviation time to DME was 875±684 days (∼2.4 years) with those with baseline NPDR (HR 3.67 95% [confidence interval (CI]):3.41-3.95) and PDR (HR 5.19 95% [CI]:4.61-5.85) more likely to develop DME. There was no difference in DME risk between type 1 and type 2 patients, however Black race was associated with a 40% increase in DME risk (HR 1.40 95% [CI]:1.30-1.51). Every one unit increase in HbA1C had a 15% increased risk of DME (HR 1.15 95% [CI]:1.13-1.17) and each 10 mmHg increase in systolic blood pressure associated with a 6% increased DME risk (HR 1.06 95% [CI]:1.02-1.09). No association was identified between DME development and BMI, triglyceride levels, or high-density lipoprotein levels. ConclusionsThese findings suggest that in patients with diabetes modifiable risk factors such as elevated HbA1C and blood pressure confer a higher risk for DME development, however other modifiable systemic markers of dysmetabolism such as obesity and dyslipidemia did not. Further work is needed to identify the underlying contributions of race in DME.

The pursuit of welfare efficiency: when institutional structures turn ‘less’ into ‘more’

Addressing current socio-economic crises strains public budgets and may threaten fiscal sustainability. Particularly in the welfare sector, where high expenditures meet poor controllability, efficient resource usage is essential to ensure future governments’ capability to act while alleviating current problems. Consequently, this paper asks: why are some countries more efficient in translating social expenditure into welfare outcomes? To answer this question, it is argued that efficiency is a matter of institutional structures and their vertical policy-process integration (VPI): efficiency depends on institutional structures’ capability to (1) ensure policymakers’ responsibility and to (2) provide coordinated feedback, thus pushing for considerate and informed resource use. Analysing the effect of VPI on the relationship between welfare efforts and social outcomes in 21 OECD countries over three decades, the results show that VPI can not only turn ‘less’ into ‘more’, but it also compensates for performance losses in the face of spending cuts.

#1430 Acid excretion is disturbed in calcium oxalate and calcium phosphate stone formers in the Swiss kidney stone cohort

Abstract Background and Aims Kidney stone is a highly prevalent disease worldwide that causes high morbidity and may increase the risk for chronic kidney disease. Urine pH influences the crystallization of some types of kidney stones, such as calcium phosphate and uric acid. This study aimed to identify whether other acid-base parameters are associated with stone formation in the Swiss kidney stone cohort. Method Urinary, serum, clinical, and anthropomorphic baseline data were obtained from the Swiss Kidney Stone Cohort, a prospective, longitudinal, and multi-centric observational study. We included 200 non-stone formers (NSF, determined by CT scan), and 265 calcium oxalate (CaOx) and 113 calcium phosphate (CaP) stone formers with complete data for urine pH (collected under oil). Titratable acids were calculated based on urine phosphate and creatinine levels and urine bicarbonate based on urine pH. Net acid excretion (NAE) was calculated and NAE capacity (NAEC), the NAE for a given urine pH, which reveals the ability of kidneys to excrete acids, was calculated from the residuals of the relation between urine pH and NAE. Logistic regression analyses were used to estimate the potential contributions of various acid-base variables to the occurrence of CaOx or CaP kidney stones. Odds ratio (OR) are reported as “OR [95% confidence interval]” Results CaOx stone formers were slightly older than NSF individuals and CaP stone formers (NSF = 42.9 ± 13.6 y.o., CaOx = 47.3 ± 14.3 y.o., CaP = 43.3 ± 12.9 y.o.), slightly more overweight (NSF = 25.0 ± 4.15, CaOx = 27.1 ± 4.72, CaP = 25.9 ± 4.55), and had a higher prevalence of males (NSF = 56.0%, CaOx= 72.1%, CaP = 59.3%), but had similar baseline estimated glomerular filtration rate (NSF = 97.1 ± 16.5, CaOx = 96.3 ± 18.3, CaP = 99.5 ± 18.0 ml/min/1.73 m2). Hypertension, type 2 diabetes, pyelonephritis, and nephrocalcinosis were more prevalent among people with either type of kidney stones in comparison with NSFs, while inflammatory bowel disease was more common among CaOx stone formers in comparison with NSF individuals. CaOx and CaP stone formers showed disturbed capacity of excreting acids in relation to NSF (NAEC NSF = 1.81 ± 8.21 µmol/min; CaOx = −1.35 ± 8.45, P < .001; CaP = −0.89 ± 7.66, P = .016) and lower 24 h urine excretion of ammonium (NSF = 19.8 ± 8.70 µmol/min; CaOx = 17.4 ± 8.54, P = .012; CaP = 16.5 ± 8.23, P = .005), but also of citrate, oxalate, and potassium (Table 1). In addition, CaOx exhibited a lower urine volume. In contrast, both CaOx and CaP excreted more calcium (NSF = 3.12 ± 1.85 µmol/min; CaOx = 3.82 ± 1.91 p <0.001; CaP = 4.63 ± 2.27, p <0.001). Urine pH was more acidic in CaOx (p < 0.001) in comparison with NSFs and CaP (P = .004), NSF = 6.05 ± 0.51; CaOx = 5.86 ± 0.53; CaP = 6.16 ± 0.62. The correlations between urine pH and both urine calcium and ammonium were disturbed in CaOx stone formers and shifted in CaP stone formers (Fig. 1). Logistic models including urine ammonium, pH, citrate, phosphate, potassium, calcium, magnesium, oxalate, protein, and volume showed that ammonium is negatively associated with both CaOx and CaP stone formation (unadjusted model OR 0.41[0.26-0.57], p< 0.001 for CaOx and OR 0.42[0.26–0.67], P < .001 for CaP) and urine calcium is positively associated with kidney stones (OR 2.37 [1.72-3.43], P < .001 for CaOx and OR 5.82 [3.6–10.1], P < .001 for CaP). Similar results were obtained after adjustment for age, sex, and BMI. Removing urine ammonium, pH, and phosphate from our logistic model and adding NAEC rendered comparable goodness of fit and model complexity. Holding all other independent variables constant, the odds of CaOx associated with NAEC were 0.45 [0.33–0.61], P < .001 and with calcium of 2.6 [1.91–3.64], P < .001. For CaP, NAEC was still associated with it, but urine magnesium showed a lower odds ratio value (0.44 [0.27–0.72], P = .001 vs 0.54 [0.36–0.80], P = .003). Urine citrate was only associated with CaOx stones. Conclusion Baseline urine ammonium and net acid excretion capacity are strongly associated with the occurrence of CaOx and CaP kidney stones. Reduced NAEC indicates that poor control of ammonium excretion is a hallmark of both types of kidney stones, although more strongly apparent in CaOx.

Study on electromagnetic stirring–braking structure layout design and its synergistic mechanism in electromagnetic metallurgy

During the continuous casting process, electromagnetic stirring (EMS) can control the flow pattern of the molten steel on the meniscus in the slab mould, while it is difficult to effectively control the entire molten steel. To this end, a novel composite magnetic field structure of EMS and electromagnetic braking (EMBr) is proposed, and the EMS–EMBr synergistic mechanism is analysed. The flow field of molten steel without a magnetic field is analysed. The magnetic field regulation strategy required to control the molten steel is clarified. The coil core structure layout of existing EMS is analysed. The action mechanism of EMS is studied through simulation, revealing the poor control effect of EMS on the molten steel under high casting speeds. Thus, a novel EMS–EMBr structure layout is proposed to enable the braking magnetic field to cover the key areas within the slab mould, ensuring that the main flow is effectively suppressed. On this basis, the effects of EMS–EMBr synergy and different process parameters on the flow pattern of molten steel are studied. The results indicate that the EMS–EMBr composite magnetic field structure proposed can more effectively control the molten steel, providing technical support for the development of electromagnetic metallurgical equipment.

Psychiatric implications of anti-seizure medications in epileptic population

Background and objectiveEpilepsy is a prevalent neurological disorder that affects a significant number of individuals globally. This condition is associated with a high occurrence of psychiatric comorbidities, which can significantly affect the quality of life of individuals affected. The aim of this study was to investigate the association between antiseizure therapies and the likelihood of psychiatric comorbidities in individuals with epilepsy.MethodologyData for this study was gathered from the Neurology referral center in Islamabad, Pakistan. A standardized questionnaire was utilized to gather data from 120 individuals diagnosed with epilepsy. The survey consisted of inquiries regarding the management of seizures, the utilization of anti-seizure medications, and the presence of psychiatric comorbidities. The data was analyzed using the Statistical Package for the Social Sciences (SPSS).ResultsThe findings indicated that individuals who were using multiple antiseizure medications had a notably higher likelihood of having psychiatric comorbidities in comparison to those who were on mono therapy (p = 0.010). suggests that patients with unsuccessful seizure control are more probable to have psychiatric comorbidities as compared to those with good seizure control (p = 0.029).ConclusionTo conclude poor seizure control and poly therapy are associated with increased risk of psychiatric comorbidities.

Effects of robot-assisted walking training on balance, motor function, and ADL depending on severity levels in stroke patients.

Despite the explosive increase in interest regarding Robot-Assisted Walking Training (RAWT) for stroke patients, very few studies have divided groups according to the severity levels of patients and conducted studies on the effects of RAWT. The purpose of this study was to present a definite basis for physical therapy using the robot-assisted walking device through a more detailed comparison and analysis and to select the optimal target of RAWT. This study was designed as a prospective and randomized controlled trial to investigate the effect of RAWT on balance, motor function, and Activities of Daily Living (ADL) depending on severity levels in stroke patients. 100 participants were randomly divided into study and control groups in equal numbers. The study group was 49 and the control group was 47. One from the study group and three from the control group were eliminated. The study period is four weeks in total, and RAWT is performed five times a week for 40 minutes only for study group. During the same period, all group members had 30 minutes of Conventional Physiotherapy (CP) five times a week. The results of this study clearly confirmed that RAWT combined with CP produces more significant improvement in patients with stroke than the CP alone. And they indicated that RAWT had a more considerable effect in the poor or fair trunk control group for trunk balance and in the high fall risk group for balance. In motor function, RAWT showed its value in the severe and marked motor impairment group. The total or severe dependence group in ADL experienced more improvements for RAWT. This study can be concluded that the lower the level of physical functions, the more effective it responds to RAWT. As demonstrated in the results of this study, the potential of current robotic technology appears to be greatest at very low functional levels of stroke patients. Patients with low functional levels among stroke patients may benefit from robot rehabilitation.

Nurses in Iraq Show Alarmingly Low Infection Control Adherence

This study assesses nurses' adherence to standard precautions and infection management at the Republican Hospital in Basrah through a descriptive cross-sectional survey of 50 nurses, using a WHO-guideline-based questionnaire. The results indicate poor practice among 86% of nurses, with significant differences in adherence across age groups and workplace settings. The findings highlight the necessity for regular, targeted education to improve infection control practices, thus enhancing patient safety and care quality. Highlights: High Non-Adherence: 86% of nurses show poor infection control practices. Demographic Differences: Age, workplace impact standard precaution adherence. Need for Education: Targeted training essential to enhance safety. Keywords: Nurses’ Commitment, Health Guidelines, Infection Control, Standard Precautions, Healthcare Safety

Disease Control and Treatment Satisfaction in Patients with Chronic Spontaneous Urticaria in Japan.

Background: Chronic spontaneous urticaria (CSU), characterized by the recurrence of pruritic hives and/or angioedema for >6 weeks with no identifiable trigger, has a negative impact on health-related quality of life (HRQoL). Methods: The objective of this web-based cross-sectional study was to evaluate disease control, disease burden, and treatment satisfaction in Japanese adults with CSU using the Urticaria Control Test (UCT), HRQoL outcomes, and the Treatment Satisfaction Questionnaire for Medication-9 items (TSQM-9). Results: In total, 529 adults were included in the analysis (59.9% female), with a mean ± standard deviation (SD) in CSU duration of 13.2 ± 13.0 years. Based on UCT scores, two-thirds of patients had poor (score of 0-7; 23.6%) or insufficient (score of 8-11; 43.3%) symptom control, and one-third had good control (score of 12-16; 33.1%). Overall treatment satisfaction was not high, with mean ± SD TSQM-9 scores of 55.5 ± 17.6% for effectiveness, 68.2 ± 18.8% for convenience, and 59.2 ± 18.4% for global satisfaction. No apparent differences in TSQM-9 scores were observed between patients receiving different medications. HRQoL outcomes were worse among patients with poor/insufficient symptom control. Conclusions: Japanese adults with CSU have a high disease burden, and better treatment options are needed to increase treatment satisfaction.

Enterprise Digital Transformation: The Engine of New Quality Productivity Growth

In the digital age, digitalization has become an important force driving economic growth and social progress. Under the guidance of new quality productivity, future economic and social development will pay more attention to the improvement of quality and efficiency, as well as the comprehensive development of people. This article is based on data from Chinese A-share listed companies from 2012 to 2022, and explores the impact and mechanism of digital transformation on new quality productivity. The results show that digital transformation can effectively improve new quality productivity, and the conclusion has withstood a series of robustness tests. In further mechanism analysis, it is understood that digital transformation enhances new quality productivity by improving enterprise innovation efficiency and reducing information asymmetry. In addition, heterogeneity testing found that the improvement effect of enterprise digital transformation on new quality productivity is more significant in state-owned enterprises with poor internal control, loose financing constraints, and property rights attributes, providing useful insights for improving new quality productivity.

Biodegradable tracheal stents: our ten-year experience with adult patients

BackgroundBiodegradable (BD) stents made from polydioxanone have been used only in human airways. These stents combine the advantages of classical tracheal stents, and fewer side effects are expected due to their biocompatibility and their time-limited presence in airways. However, new clinical consequences have arisen. Here, the authors share their experiences with BD stents for tracheal indications, focusing on their safety and efficacy.MethodsThis was a retrospective review of a collected database of adult patients who underwent implantation of biodegradable tracheal stents between September 2013 and December 2022 at the Department of Respiratory Medicine of the 1st Faculty of Medicine in Prague and Thomayer University Hospital. The indications included functionally significant nonmalignant tracheal stenosis and tracheomalacia. Self-expandable, biodegradable, polydioxanone tracheal stents manufactured by ELLA-CS Ltd. (Hradec Kralove, Czech Republic) were implanted during rigid bronchoscopy under general anaesthesia. All patients were followed up in the department and were provided with the necessary care. The main efficacy and safety parameters and relationships were analysed using descriptive statistics and Fisher´s exact, Wilcoxon and Kruskal‒Wallis tests.ResultsA total of 65 stents were implanted in 47 adult patients. During the first two months after implantation, when adequate function was expected, the stent was found to be effective in 26 out of 39 patients who completed this period (66.7%). The clinical effectiveness reached 89.7%, as early restenoses were mostly mild and necessitated treatment in only 4 patients. The frequencies of significant mucostasis, migration and granulation tissue growth were 2.6%, 7.5% and 23.1%, respectively, during this period. Thirty-four participants completed the half-year follow-up period after the first or second stent insertion, and some were followed up beyond this period. Poor control of symptoms, the development of restenosis and the need for interventions were characteristic of this period as the stents degraded. Twenty-two patients who experienced remodelling or stabilization of the tracheal lumen achieved a stent-free state. Seven patients underwent subsequent surgical treatment.ConclusionsBD stents are safe and provide adequate tracheal support until they begin to degrade. The use of BD stents necessitates close monitoring of patients and accurate treatment of possible restenosis.Trial registrationBased on project NT14146 – Biodegradable stents in the management of the large airways (2013–2015, MZ0/NT), registered on May 1, 2013, in the Research and Development and Innovation Information System of the Czech Republic and at ClinicalTrials.gov (reg. no. NCT02620319, December 2, 2015).

Impact of HbA1c control and type 2 diabetes mellitus exposure on the oral microbiome profile in the elderly population

ABSTRACT Objective To investigate the associations of the oral microbiome status with diabetes characteristics in elderly patients with type 2 diabetes mellitus. Methods A questionnaire was used to assess age, sex, smoking status, drinking status, flossing frequency, T2DM duration and complications, and a blood test was used to determine the glycated haemoglobin (HbA1c) level. Sequencing of the V3-V4 region of the 16S rRNA gene from saliva samples was used to analyze the oral microbiome. Results Differential analysis revealed that Streptococcus and Weissella were significantly enriched in the late-stage group, and Capnocytophaga was significantly enriched in the early-stage group. Correlation analysis revealed that diabetes duration was positively correlated with the abundance of Streptococcus (r= 0.369, p= 0.007) and negatively correlated with the abundance of Cardiobacterium (r= -0.337, p= 0.014), and the level of HbA1c was not significantly correlated with the oral microbiome. Network analysis suggested that the poor control group had a more complex microbial network than the control group, a pattern that was similar for diabetes duration. In addition, Streptococcus has a low correlation with other microorganisms. Conclusion In elderly individuals, Streptococcus emerges as a potential biomarker linked to diabetes, exhibiting elevated abundance in diabetic patients influenced by disease exposure and limited bacterial interactions.

Enzyme-assisted high throughput sequencing of an expanded genetic alphabet at single base resolution

With just four building blocks, low sequence information density, few functional groups, poor control over folding, and difficulties in forming compact folds, natural DNA and RNA have been disappointing platforms from which to evolve receptors, ligands, and catalysts. Accordingly, synthetic biology has created “artificially expanded genetic information systems” (AEGIS) to add nucleotides, functionality, and information density. With the expected improvements seen in AegisBodies and AegisZymes, the task for synthetic biologists shifts to developing for expanded DNA the same analytical tools available to natural DNA. Here we report one of these, an enzyme-assisted sequencing of expanded genetic alphabet (ESEGA) method to sequence six-letter AEGIS DNA. We show how ESEGA analyses this DNA at single base resolution, and applies it to optimized conditions for six-nucleotide PCR, assessing the fidelity of various DNA polymerases, and extending this to AEGIS components with functional groups. This supports the renewed exploitation of expanded DNA alphabets in biotechnology.

Laser‐Annealed SiO2/Si1−xGex Scaffolds for Nanoscaled Devices, Synergy of Experiment, and Computation

Laser‐Annealed SiO₂/Si_1−<i>x</i>Ge_<i>x</i> Scaffolds for Nanoscaled Devices, Synergy of Experiment, and Computation

The socio-economic burden of H1-antihistamine-refractory chronic spontaneous urticaria in Germany.

Data from the AWARE study (A Worldwide Antihistamine-Refractory chronic urticaria patient Evaluation) illustrate a substantial disease burden in German patients with H1-antihistamine (-H1-AH)-refractory chronic spontaneous urticaria (CSU). Detrimental effects on patients' quality of life, poor disease control and impairment in the ability to work and perform other daily activities are reported. Based on these findings, this study aims to quantify the epidemiological and socio-economic burden of H1-AH-refractory CSU in Germany. To determine the epidemiological burden of H1-AH-refractory CSU, the age- and gender-specific prevalence of CSU and the proportion of H1-AH-refractory patients in Germany anonymized data from the InGef research database have been used. In a second step, the socio-economic burden in terms of lost numbers of hours in paid and unpaid work was calculated by extrapolating the age- and gender-specific work productivity and activity impairment (WPAI) observed in AWARE to the H1-AH-refractory CSU population in Germany. Finally, productivity losses in paid and unpaid work were monetized using the human capital and the friction cost approach respectively. Moreover, socio-economic burden was calculated depending on symptom control of the patients (measured by urticaria control test [UCT]). In Germany, over 203,000 patients (20 years or older) had H1-AH-refractory CSU in 2018. The avoided lost paid and unpaid work hours attributable to H1-AH-refractory CSU summed up to over 100 million. Overall, the socio-economic burden of H1-AH-refractory CSU in monetary terms was evaluated at € 2.2 billion and the majority of this was due to unpaid work loss. Patients with poor disease control, as indicated by UCT score < 12, were more likely to suffer from high impairment than patients with controlled disease, resulting in a higher socio-economic burden. The results of our analyses picture the substantial socio-economic burden of H1-AH-refractory CSU and therefore the tremendous impact it has on daily lives of individuals and society overall.

Stride width and postural stability in frontal gait disorders and Parkinson's disease.

Older adults, as well as those with certain neurological disorders, may compensate for poor neural control of postural stability by widening their base of foot support while walking. However, the extent to which this wide-based gait improves postural stability or affects postural control strategies has not been explored. People with idiopathic Parkinson's disease (iPD, n = 72), frontal gait disorders (FGD, n = 16), and healthy older adults (n = 32) performed walking trials at their preferred speed over an 8-m-long, instrumented walkway. People with iPD were tested in their OFF medication state. Analyses of covariance were performed to determine the associations between stride width and measures of lateral stability control. People with FGD exhibited a wide-based gait compared to both healthy older adults and iPD. An increased stride width was associated with an increase in lateral margin of stability in FGD. Unlike healthy older adults or iPD, people with FGD did not externally rotate their feet (toe-out angle) or shift their center of pressure laterally to aid lateral dynamic stability during walking but slowed their gait instead to increase stability. By adopting a slow, wide-based gait, people with FGD take advantage of the passive, pendular mechanics of walking.

The burden of atopic dermatitis in Australia: Medical care, treatment satisfaction, financial impact, long-term control and quality of life.

Atopic dermatitis patients and caregivers experience a high physical, mental and financial burden in Australia. We outline how the current care model impacts disease management and patients' quality of life via a survey of 265 Australian patients and caregivers to capture the experience of managing atopic dermatitis (AD) in Australia. Patients report an unsatisfactory quality of life and a high burden of disease with poor long-term control and low treatment satisfaction. They also reported changing spending and saving patterns to fund medical care. Patient experience improves with more specialised care that incorporates shared decision-making and patient/caregiver training beyond the clinic visit. These results highlight the need for improved general practitioner (GP) education, expedited access to medical specialists, greater patient involvement in treatment choices and more financial assistance to improve the experience of Australian patients and caregivers.

Resistance patterns and molecular basis to ACCase-inhibiting herbicides

Abstract Digitaria ciliaris var. chrysoblephara (Fig. &amp; De Not.) R.R. Stewart is an annual xeromorphic weed that severely infests direct-seeded rice fields in China. Herbicide resistance is emerging in D. ciliaris var. chrysoblephara owing to extensive and recurrent use of the acetyl-CoA carboxylase (ACCase)-inhibiting herbicide metamifop. In this study, a total of 53 D. ciliaris var. chrysoblephara populations randomly sampled from direct-seeded rice fields across Jiangsu Province were investigated for metamifop resistance and potential resistance-endowing mutations. Single-dose assays revealed that 17 (32.1%) populations evolved resistance to metamifop and 5 (9.4%) populations were in the process of developing resistance. The resistance index (RI) of metamifop-resistant populations ranged from 2.7 to 32.1. Amino acid substitutions (Ile-1781-Leu, Trp-2027-Cys/Ser, and Ile-2041-Asn) in ACCase genes were detected in resistant D. ciliaris var. chrysoblephara plants and caused various cross-resistance patterns to ACCase-inhibiting herbicides. All of four resistant populations (YC07, YZ09, SQ03, and HA06), with different ACCase mutations, exhibited cross-resistance to the aryloxyphenoxypropionate (APP) herbicides cyhalofop-butyl (RI values: 10.0 to 19.9), fenoxaprop-P-ethyl (RI values: 53.7 to 132.8), and haloxyfop-P-methyl (RI values: 6.2 to 62.6), and the phenylpyrazoline (DEN) pinoxaden (RI values: 2.3 to 5.4), but responded differently to the cyclohexanedione (CHD) herbicides clethodim and sethoxydim. It is noteworthy that four postemergence herbicides used for rice cropping, including bispyribac-sodium, pyraclonil, quinclorac, and anilofos, showed poor control effect against D. ciliaris var. chrysoblephara, suggesting few alternations for managing this weed in rice fields except ACCase inhibitors. In conclusion, this work demonstrated that the D. ciliaris var. chrysoblephara had developed resistance to ACCase-inhibiting herbicides in rice cultivation of China, and target-site amino acid substitutions in ACCase were primarily responsible for metamifop resistance.

Course of coronavirus infection in patients with type 2 diabetes mellitus

The coronavirus infection (COVID-19) pandemic remains a hot topic of study to this day. According to studies, mortality in patients with COVID-19 and a history of diabetes mellitus (DM) is 2-3 times higher than in patients without DM.The purpose of the study is to analyze the course of coronavirus infection in patients with T2DM.Material and methods: A prospective observation of 381 patients with T2DM and COVID-19 in the intensive care unit was carried out in 2020-2021. 2 groups were formed: Group I (comparison group) – patients with a fatal outcome, Group II (control group) – patients discharged from the hospital with an improvement in their condition. An assessment was made of changes in the dynamics of clinical and laboratory parameters upon admission and before discharge in both groups.Results and discussion: Patients with a fatal outcome were more often admitted in a serious condition (75% vs. 12.7% at p ≤ 0.0001). Significantly more often than aches (92.5% vs. 69.58%, p=0.0044), shortness of breath on exertion (92.5% vs. 75.17%, p=0.0245), grade 3 DN (62.5%, p&lt;0.0001), the need for non-invasive lung ventilation (28.95% versus 1.39%, p &lt;0.0001) artificial lung ventilation (81.1% versus 1.75% ( p&lt;0.0001) was noted in group I. In the comparison group, the Charlson comorbidity index was higher: 6.0 [5.0;7.0] versus 4 [4; 4], at p&lt;0.0001. In the group of patients who were discharged with improvement, they more often took metformin and sulfonylureas, in the group of patients who died, they were more often on insulin therapy. In dynamics, the levels of intracellular enzymes such as alkaline phosphatase, creatine phosphokinase, lactate dehydrogenase in the group with an unfavorable outcome significantly increased, in contrast to the group with a positive outcome. Also, in a fatal outcome, there is a deterioration in kidney function, laboratory characterized by an increase in the level of creatinine and urea, a decrease in the glomerular filtration rate and blood albumin. Despite the ongoing anticoagulant therapy, patients with a fatal outcome showed pronounced signs of activation of the hemostasis system, which are characterized by an increase in INR, prolongation of prothrombin time and aPTT, and thrombocytopenia.Conclusion. The risk of death from coronavirus infection in people with diabetes increases with age. DM 2 is a comorbid disease and acute multiple organ disorders develop with the addition of a coronavirus infection. Coronavirus-induced coagulopathy in patients with DM2 and COVID-19 with a fatal outcome is characterized by poor controllability and low efficacy of anticoagulant therapy.

Bacterial etiologies, antimicrobial susceptibility pattern and associated factors among patients suspected sterile body site infections at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

Sterile body locations are usually associated with clinical urgency and life-threatening illnesses, and they are typically contaminated with diverse bacterial etiologies. If the bacteria acquire resistance to antimicrobial drugs, the public health crisis will only worsen. In developing countries, drug-resistant bacteria are common because of poor surveillance, diagnostic capacity, and control measures. Early diagnosis, and assessing the drug resistance and factors associated with infection are important to combat the drug resistance and treatment. This study aimed to assess the bacterial etiologies, antimicrobial susceptibility pattern, and possible associated factors among patients suspected of sterile body sites. A hospital-based cross-sectional study was conducted from June 2022 to August 2022 at Debre Markos Comprehensive Specialized Hospital in Amhara regional state, Ethiopia. One hundred seven study participants were selected using consecutive convenient sampling techniques. A structured questionnaire was used to collect socio-demographic and clinical data. Gram stain was done for a preliminary report and inoculated into blood agar, MacConkey agar, and chocolate agar and incubated aerobically and micro aerobically at 37°C for 24 h. Antimicrobial susceptibility testing was done by the modified Kirby Bauer's disk diffusion method. Data were analyzed using bivariate and multivariate logistic regression was used. A p-value less than 0.05 is considered as statistically significant. The overall magnitude of sterile body site infection among study participants was 7.5% (14/187). The majority of the isolates were Gram-negative bacteria with the predominant species Enterobacter cloacae accounting for 28.57% (4/14). Among isolates 78.57%(11/14) of them were multidrug-resistant isolates. Being inpatient, co-morbidity, and alcohol consumption were significantly associated with sterile body site infection. In our study, Gram-negative bacteria were the predominant bacteria that infects sterile body fluid. The prevalence of multi-drug resistance bacteria isolates was significantly high. Therefore, before prescribing an empirical treatment, a medical professional should identify the bacterial etiology of sterile body fluids and the susceptibility of microbes to the drug.

Application of histogram of oriented gradient features and support vector machine models in stage lighting control in drama

SummaryThe lighting control of the theatrical stage is directly related to the presentation effect of the program and the audience's experience. With the development of intelligent control technology, the control of lighting effects has been continuously improved. However, the existing stage lighting control lacks intelligence, resulting in poor control effect and weak energy‐saving performance. Based on this, a human contour image classification model using support vector machines (SVM) based on histogram of oriented gradient (HOG) feature extraction method is constructed to achieve stage lighting control. The results show that the revised HOG feature extraction approach achieves recognition performance of 99.6% when the ratio is 0.8. The HOG‐SVM model proposed in the study has the best recognition performance, reaching 99.6%. This indicates that the stage lighting control system based on HOG‐SVM feature extraction constructed in the research can meet the actual needs of stage program performance, which can be applied to stage lighting control to effectively reduce energy consumption.