Effectiveness of the 5As Model-Based Transitional Care Program among Chinese Patients with Type B Aortic Dissection Post-TEVAR: A Randomized Controlled Trial.

Background: Thoracic aortic endovascular repair (TEVAR) is the primary treatment for Stanford type B aortic dissection (type B AD). However, patients often encounter significant difficulties post-TEVAR that endanger their safety when transitioning from hospital- to home-based care. Moreover, information on the ideal transitional care for patients with type B AD post-TEVAR is scarce in China. This single-masked randomized clinical trial aimed to assess the effectiveness of the Assess, Advise, Agree, Assist, and Arrange (5As) model-based transitional care in improving discharge preparation level and transitional care quality post-TEVAR among patients with type B AD in China. Methods: This study was conducted at a hospital in China between January 2021 and October 2021. Patients with type B AD were randomly divided into intervention and control groups. Participants in the intervention group received the 5As model-based transitional nursing care. The 5As model is an evidence-based intervention strategy comprising: (1) Assess: assessing the preoperative cardiovascular risk behavior of patients with AD. (2) Advise: making suggestions according to the risk behaviors of the patients. (3) Agree: reaching a consensus on goals and action plans by making decisions with the patients and their families. (4) Assist: assisting patients in solving obstacles to implementing health plans. (5) Arrange: arranging follow-up visits according to the actual situation of the patients and guiding them in adhering to a schedule. The control group received the usual nursing care for the same duration and number of follow-up visits. A trained research nurse collected all the baseline data of the patients on admission, assessed discharge readiness level (using the Readiness for Hospital Discharge Scale) on the day of discharge, and collected transitional quality of care (by the Care Transition Measure-15) data on day 30 after discharge. Results: Overall, 72 patients with type B AD were recruited. Discharge readiness level and transitional care quality in the intervention group were significantly superior to those in the control group. Conclusions: This study showed that the 5As model-based transitional care program can effectively promote discharge readiness and transitional care quality of patients with type B AD post-TEVAR. Clinical Trial Registration: The Chinese Clinical Trial Registry Center: ChiCTR2200060797 (https://www.chictr.org.cn/showproj.html?proj=167403).

The pediatric self-management model in asthma: A theory analysis and evaluation.

THEORETICAL PRINCIPLES: The Pediatric Self-management Model (PSMM) is a middle-range theory geared at understanding the relationship between factors influencing chronic illness management in children. PSMM is a family-centered model that focuses on the unique factors present in the pediatric population. PHENOMENA ADDRESSED: Pediatric asthma is a leading chronic respiratory illness in the United States, affecting over 4.6 million children in 2020. Over 40% of children with asthma will have at least one exacerbation per year. On average, a child with asthma will miss nine additional school days annually. Using the Walker and Avant framework for theory analysis, the PSMM is examined through the lens of pediatric asthma to evaluate its applicability to pediatric asthma shared management and adherence. RESEARCH LINKAGES: The PSMM has been used as a framework for understanding the roles of managing chronic illness in children, but it has yet to be applied to pediatric asthma. Asthma outcomes inherently depend on preventative medicine and home care strategies for symptom management and response outside the healthcare facility. The PSMM is a new framework for understanding barriers and facilitators within pediatric asthma management and highlights the importance of the dyadic relationship between child and parent to successfully share healthcare responsibility.

Pyrrolnitrin in Pseudomonas chlororaphis strain AFS009 metabolites reduces constitutive and DMI-induced MfCYP51 gene expression in Monilinia fructicola.

Brown rot, caused by Monilinia fructicola, is one of the most economically important diseases of peach. Demethylation inhibitor (DMI) fungicides play an important part in managing brown rot in the southeastern U.S., but over the last 20 years, reduced efficacy to DMIs has been reported in field isolates overexpressing the DMI target enzyme encoding MfCYP51 gene. Metabolites of the biocontrol agent (BCA) Pseudomonas chlororaphis strain AFS009 suppressed the MfCYP51 gene in sensitive and resistant M. fructicola isolates previousely, but it is not known what molecule was responsible. The goals of this study were to determine the presence and role of pyrrolnitrin (PRN), a common metabolite of P. chlororaphis and chemical analogue to fludioxonil with antifungal activity, in the suppression of the MfCYP51 gene and to investigate if MfCYP51 expression can also be suppressed by Bacillus subtilis. High-performance liquid chromatography (HPLC) detected pyrrolnitrin at 1.75 µg/mg in P. chlororaphis metabolites formulated as Howler EVO (Howler). PRN at 0.1 µg/ml, fludioxonil at 0.1 µg/ml, and Howler applied at a dose that contained 0.1 µg/ml PRN significantly reduced the MfCYP51 gene expression at similar levels in DMI-resistant isolates. Furthermore, MfCYP51 expression in DMI-sensitive and three DMI-resistant isolates treated with Howler (88.1 µg/ml), Theia (209.5 µg/ml), propiconazole (0.3 µg/ml), or the mixture of either Howler or Theia + propiconazole revealed that Howler significantly reduced the MfCYP51 target gene expression in two of three sensitive and all three resistant M. fructicola isolates. On the other hand, Theia showed no suppressive effect and even increased the MfCYP51 gene expression level in two of three resistant isolates. In detached fruit assays on apple with a DMI resistant isolate, only the mixture of Howler + 50 µg/ml propiconazole resulted in synergism. The results indicate that suppression of MfCYP51 target gene is BCA-dependent and can be induced by pyrrolnitrin.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery.

BACKGROUND: Esophageal cancer is one of the most common malignant tumors. The three-dimensional quality structure model is a quality assessment theory that includes three dimensions: Structure, process, and results. AIM: To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery. METHODS: In this prospective study, the control group received routine nursing, and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care. Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale (GSES) and Exercise of Self-Care Agency scale, respectively. IBM SPSS Statistics for Windows, version 17.0, was used for the data processing. RESULTS: This study recruited 112 patients who were assigned to the control and experimental groups (n = 56 per group). Before the intervention, there was no significant difference in GSES scores between the two groups (P > 0.05). After the intervention, the GSES scores of both groups increased, with the experimental group showing higher values (P < 0.05). At the time of discharge and three months after discharge, the scores for positive attitudes, self-stress reduction, and total score of health promotion in the experimental group were higher than those in the control group (P < 0.05). CONCLUSION: The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

Patients with diabetes struggling to afford food and control their HbA1c in food-insecure areas in Bronx, NY.

OBJECTIVE: To characterise the association between risk of poor glycaemic control and self-reported and area-level food insecurity among adult patients with type 2 diabetes. DESIGN: We performed a retrospective, observational analysis of cross-sectional data routinely collected within a health system. Logistic regressions estimated the association between glycaemic control and the dual effect of self-reported and area-level measures of food insecurity. SETTING: The health system included a network of ambulatory primary and speciality care sites and hospitals in Bronx County, NY. PARTICIPANTS: Patients diagnosed with type 2 diabetes who completed a health-related social need (HRSN) assessment between April 2018 and December 2019. RESULTS: 5500 patients with type 2 diabetes were assessed for HRSN with 7·1 % reporting an unmet food need. Patients with self-reported food needs demonstrated higher odds of having poor glycaemic control compared with those without food needs (adjusted OR (aOR): 1·59, 95 % CI: 1·26, 2·00). However, there was no conclusive evidence that area-level food insecurity alone was a significant predictor of glycaemic control (aOR: 1·15, 95 % CI: 0·96, 1·39). Patients with self-reported food needs residing in food-secure (aOR: 1·83, 95 % CI: 1·22, 2·74) and food-insecure (aOR: 1·72, 95 % CI: 1·25, 2·37) areas showed higher odds of poor glycaemic control than those without self-reported food needs residing in food-secure areas. CONCLUSIONS: These findings highlight the importance of utilising patient- and area-level social needs data to identify individuals for targeted interventions with increased risk of adverse health outcomes.

Chemical management strategies for halo blight of hop and in vitro sensitivity of Diaporthe humulicola populations to various fungicide classes.

Halo blight of hop, caused by Diaporthe humulicola, has increased in eastern North America since 2018. When left untreated, the disease can cause yield loss ranging from 17-56%. Currently, there are no fungicides registered for use on halo blight of hop. From 2020 to 2022 field trials were conducted using 10 fungicides registered for use on powdery and downy mildew of hop to determine their efficacy against halo blight. To validate field results, the EC50 value was determined for each active ingredient including flutriafol, tebuconazole + fluopyram, cyflufenamid, and trifloxystrobin + salicylhydroxamic acid (SHAM). Each fungicide tested had an EC50 value less than 50 ppm. A discriminatory dose was used to test the sensitivity of 206 D. humulicola isolates collected from the eastern U.S. and Canada in a poison agar assay. Results showed that tebuconazole + fluopyram decreased the incidence and severity of halo blight in the field. Also, this fungicide combination had EC50 values of 2.26 x 10-1 ppm and significantly reduced the growth of most of the isolates tested. Trifloxystrobin + SHAM decreased the presence of halo blight in the field tiral, but some isolates were less sensitive in discriminatory dose testing. Our results show that fungicides in FRAC groups 3, 7, and 11 were the most effective to control halo blight. Analyses of field trials showed a positive correlation between the severity of early season downy mildew infections and late season halo blight infections.

Serum-derived bovine immunoglobulin treatment in COVID-19 is associated with faster resolution of symptoms: A randomized pilot clinical trial.

Effective treatment to prevent hospitalization and death in people with COVID-19 exists, but people still need interventions that alleviate symptoms without drug interactions. Oral serum-derived bovine immunoglobulins (SBI) may reduce symptoms and time-to-improvement in people with mild-to-moderate COVID-19. In this randomized, open-label, single-site study, participants with mild-to-moderate COVID-19 received SBI 5.0 g bis in die (BID) + Standard of Care (SOC) or SOC alone (2:1) for 2 weeks. After 2 weeks, 78.8% of hospitalized participants on SBI + SOC improved by World Health Organization (WHO) scale of ≥3 compared to 61.1% on SOC alone (odds ratio: OR = 2.4; p = 0.0663), with older participants (>57 years) showing more significant differences between the arms (OR = 6.1; p = 0.0109). Further, more participants on SBI + SOC reported absence of COVID-19 symptoms at Week 2 (74.2%) compared to SOC alone (43.6%; OR = 3.7; p = 0.0031), most notably the absence of dyspnea on exertion (OR = 4.4; p = 0.0047), with women exhibiting the most significant eradication of all symptoms (OR = 5.8; p = 0.0080). No difference in change of IL-6 between arms was observed. Overall, participants with mild-to-moderate COVID-19 on SBI + SOC had a shorter time-to-recovery than on SOC alone, with a significantly higher rate of complete resolution of symptoms. Dyspnea on exertion was the symptom most significantly impacted. For people with mild-to-moderate COVID-19, oral SBI could be a safe and effective intervention, devoid of drug interactions.

The Swedish sleep apnea registry (SESAR) cohort - "Real world data" on a national level.

INTRODUCTION: The Swedish Sleep Apnea Registry (SESAR) collects clinical data from individual obstructive sleep apnea (OSA) patients since 2010. SESAR has recently been integrated with additional national healthcare data. The current analysis presents the SESAR structure and representative clinical data of a national sleep apnea cohort. METHODS: Clinical data from unselected patients with a diagnosis of OSA are submitted to the SESAR registry. 48 sleep centers report data from diagnosis, treatment starts with Continuous Positive Airway Pressure (CPAP), oral devices (OD), and Upper Airway Surgery (UAS). Data from follow-up are included. SESAR is linked to mandatory national healthcare data (mortality, comorbidities, procedures, prescriptions) and diagnosis-specific quality registries (e.g. stroke, heart failure, diabetes) within the DISCOVERY project. RESULTS: 83,404 OSA patients have been reported during the diagnostic workup (age 55.4 ± 14.1 years, BMI 30.8 ± 6.5 kg/m2, AHI 25.8 ± 21.6n/h, respectively). At least one cardiometabolic and respiratory comorbidity is recognized in 57 % of female and 53 % of male OSA patients with a linear increase across OSA severity. In 54,468, 7,797, and 390 patients, start of CPAP, OD or UAS treatment is reported, respectively. OD patients have 4 units lower BMI and 10 units lower AHI compared to patients started on CPAP. UAS patients are characterized by 10 years lower age. The degree of daytime sleepiness is comparable between treatment groups with mean Epworth Sleepiness Scale Scores between 9 and 10. CONCLUSION: SESAR is introduced as a large national registry of OSA patients. SESAR provides a useful tool to highlight OSA management and to perform relevant outcome research.

Bacterial diseases in Siniperca chuatsi: status and therapeutic strategies.

Mandarin fish (Siniperca chuatsi) is a prominent freshwater species with significant economic value in China, while disease poses a major hindrance to the advancement of mandarin fish aquaculture. To date, the understanding of the prevention and management of bacterial disease in mandarin fish remains incomplete. Therefore, there is a need for more comprehensive insights into the preventive and curative strategies to address these bacterial infections. In this review, we summarize the information pertaining to the predominant bacterial pathogens such as Aeromonas spp., Flavobacterium columnare, Edwardsiella tarda, Streptococcus uberis and Vibrio cholerae in the mandarin fish aquaculture, and point out the current strategies for diagnosis and combating these bacterial pathogens, as well as deliberate on the prospective alternative treatments such as vaccines, herbal remedies, and phage therapy for the prevention and control of these bacterial diseases. Furthermore, we also highlights the importance to implement an integrated bacterial disease management (IBDM) approach for the prevention and control of these pathogenic bacteria in aquaculture.

First Report of Rhizopus arrhizusi causing rot of Dictyophora rubrovolvata in China.

Dictyophora rubrovolvata, as an edible fungus with high medicinal value, is widely cultivated in several provinces in China (Hang et al. 2012). However, between December 2023 and March 2024, a rot disease occurred in the main production area in Fengxian District, Shanghai, China (N30°93', E121°49'). The disease incidence was 25% in the affected 1.33-ha growing area. High temperatures (>25℃) and poor ventilation provide favorable conditions for the spread of this disease. The disease mainly occurs at the stage of fruiting bodies formation of D. rubrovolvata. When the epidermis is damaged and broken, it becomes infested with mold, which then produces a layer of moldy rot with pus. The infected D. rubrovolvata tissues at the edge of the lesions were isolated, surface sterilized and cultured on potato dextrose agar (PDA) at 30 ℃ under dark conditions. Pure cultures were obtained by single-spore isolation. After 3 days, isolates were transferred to Czapek Yeast agar (CYA) (Samson et al, 2014). On CYA, the fungal colony consisted of white flocculent hyphae. Scanning electron microscopy analysis showed that the mycelium was white, and the internodes of the stolons formed characteristic pseudoroots, from which upwardly clustered erect, unbranched sporocarp peduncles expanded apically to form rounded sporocarp sacs, within which sporocarp spores were produced. (Hariprasath P, 2019). To confirm the identity of the pathogen, the genomic fragments for the internal transcribed spacer (ITS) and intergenic spacer (IGS) gene of the isolate were amplified by PCR (White et al. 1990; Liu XY. 2008). The resulting sequence was deposited in GenBank with accession PP951880 and PQ001670, respectively. PCR results and morphological observations indicated the isolated strain was a pure culture and the strain was designated as DIC01. Comparative results showed that the sequences with accession numbers MT603964.1 and DQ990323.1 showed high homology of 99.15% and 98.96% to the ITS and IGS sequences of Rhizopus arrhizusi DIC01, respectively. Phylogenetic analysis with ITS and IGS genes of the isolated strain and 7 Rhizopus spp. strains were performed using MEGAX with Neighbor-Joining (NJ) method. Based on the results of growth habits, morphological observations, and phylogenetic analysis, the pathogen was identified as R. arrhizusi. A spore suspension of the R. arrhizusi DIC01 (1 x107 conidia/mL) was inoculated back to healthy D. rubrovolvata. Five healthy fruit bodies of D. rubrovolvata were injected, and another five healthy morels were treated with potato dextrose broth (PDB) as controls. D. rubrovolvata was incubated at 25°C and 90% relative humidity without ventilation for 5 days. The pathogen successfully infected the D. rubrovolvata, which developed white moldy lesions similar to those of natural diseases. The controls remained healthy without any symptoms. The pathogen was reisolated from the affected lesions and identified as R. arrhizusi DIC01 based on its morphological characteristics and phylogenetic marker genes. R. arrhizusi has been reported to cause endothelial cell damage and mycelial invasion into blood vessels, leading to thrombosis and tissue necrosis. (Hariprasath P, 2019). To our knowledge, this is the first report of R. arrhizusi causing rot disease of D. rubrovolvata. This study confirmed that R. arrhizusi is the pathogenic fungus responsible for rotting disease in D. rubrovolvata farms in Fengxian, Shanghai.

Effects of home disease management strategies based on the dyadic illness management theory on elderly patients with chronic heart failure and informal caregivers' physical and psychological outcomes: protocol of a randomized controlled trial.

BACKGROUND: Currently, most elderly chronic heart failure (CHF) patients go home for rehabilitation after certain treatment in hospitals. However, the results of their rehabilitation at home are not satisfactory. According to studies, dyadic treatments can increase the efficiency of home rehabilitation, enhance both partners' quality of life, lessen the caregiver's load of care, and alleviate the strain of medical resources. Thus, the aim of our research is to design a study protocol that included elderly CHF patients and their informal caregivers as an intervention unit and to explore the impact of the protocol on their health and physical outcomes. METHODS: This is a prospective randomized controlled trial conducted in a triple-A hospital. In total, 80 elderly CHF patients and informal caregivers (80 dyads) will be recruited with informed consent. Based on the randomized numbers, they are divided into a control group (40 dyads) and an intervention group (40 dyads), subjects in the control group will receive usual care, and subjects in the intervention group will receive a home-based disease management program based on the Theory of Dyadic Illness Management on the basis of the control group. The duration of the intervention is 3 months, and the follow-up is 6 months. Data is collected at enrolment, 3 months after the intervention, and 3 months after the end of the intervention. The primary outcome is patients' quality of life and readmission. Secondary outcomes include patients' self-management behaviors, anxiety, and depression and caregivers' quality of life and care burden. DISCUSSION: This study focuses on whether this home-based disease management program can improve the quality of life of elderly patients with CHF, reduce the readmission rate, enhance their self-management capacity, reduce negative emotions, and reduce the burden of informal caregivers. It can provide a new perspective on home management and cardiac rehabilitation of heart failure disease in the elderly, as well as alleviate problems such as the burden of healthcare resources. TRIAL REGISTRATION: Chinese Clinical Trials Registry ChiCRT2300068026. Registered on 3 February 2023, manuscript Version: 1.0,  https://www.chictr.org.cn/ .

Pre-Plant Soil Treatments Influence Tree Performance and Nematode Dynamics in Replanted Cherry Orchards.

In this two-year field study, the impacts of pre-plant soil management strategies, including soil fumigation, nematicide application, and organic amendments, on the growth and nematode community dynamics on cherry cultivars 'Emperor Francis' and 'Ulster' grafted to 'Mahaleb' rootstock were investigated in a replanted orchard site. In the first year, fumigation with 1,3-dichloropropene - chloropicrin mixture (Telone C-35) led to significantly increased trunk cross-sectional area and canopy height in both cultivars. Pratylenchus penetrans population densities were suppressed only short-term. Plots treated with the fungicide/nematicide fluopyram (Velum® Prime) had P. penetrans reproduction factors below one throughout both years independent of the scion. Additionally, the combined application of Seed Starter 101®, Dairy Doo® compost, and straw mulch reduced the reproduction factor of P. penetrans to below one in the first year. In the same time period, this combinatory treatment had the highest reproduction factor for bacterivore and fungivore nematodes. Based on results of this study, fumigation with Telone® C-35 resulted in improvement of tree establishment and provided effective short-term suppression of P. penetrans. Velum® Prime exhibited longer-term efficacy for the suppression of P. penetrans.

Application of Alfalfa App in the management of oral anticoagulation in patients with atrial fibrillation: a multicenter randomized controlled trial.

BACKGROUND: In recent years, mobile medical technology has made great progress in chronic disease management, but its application in patients with atrial fibrillation (AF) still needs to be clarified. OBJECTIVE: This study aims to determine whether the newly developed smartphone app for patients with AF (Alfalfa App) can improve anticoagulation knowledge, drug treatment compliance, and satisfaction of AF patients. METHODS: Alfalfa App integrates the functions of patient education, remote consultation, and medication reminder through a simple user interface. From June 2020 to December 2020, patients with AF were recruited in five large tertiary hospitals in China. Patients were randomly divided into the Alfalfa App or routine nursing groups. Patients' knowledge, medication adherence, and satisfaction with anticoagulation were assessed using validated questionnaires at baseline, 1 month, and 3 months. RESULTS: In this randomized controlled trial, 113 patients with AF were included, 57 patients were randomly assigned to the Alfalfa App group, and 56 patients were randomly assigned to the routine nursing group. Forty-eight patients in the Alfalfa App group completed a three-month follow-up, and 48 patients in the routine nursing group completed a three-month follow-up. Basic demographic data were comparable between the two groups. The average age of AF patients was 61.65 ± 11.01 years old, and 61.5% of them were male. With time (baseline to 3 months), the knowledge scores of the Alfalfa App group (P<.001) and the routine nursing group (P = .002) were significantly improved, the compliance scores of the routine nursing group(P<.001) and Alfalfa App group(P<.001) significantly improved. Compared with the routine nursing group, patients' knowledge level and medication compliance using the Alfalfa App at 1 month and 3 months were significantly higher (all P < .05). There were significant differences in knowledge and compliance scores between the two groups with time (all P < .05). The satisfaction degree of drug treatment in the Alfalfa App group was significantly better than that in the routine nursing group (all P < .05). CONCLUSIONS: Alfalfa App significantly improved the anticoagulation knowledge, drug treatment compliance, and satisfaction of AF patients. In oral anticoagulation management for AF patients, mobile medical technology that integrates the functions of patient education, remote consultation, and medication reminder may be helpful. TRIAL REGISTRATION: Registration number, ChiCTR1900024455. Registered on July 12, 2019.

Role of Trifarotene in the Management of Acne in Indian Patients: Insights From an Indian Dermatology Experts' Meeting.

Acne vulgaris, a prevalent inflammatory skin condition, significantly impacts individuals worldwide, particularly adolescents and adults. Its chronic nature, associated sequelae, and psychosocial impact underscore the substantial burden it poses. Current treatment guidelines primarily address facial acne, with limited guidance on managing truncal acne. Personalized approaches are increasingly recognized as essential for tailoring treatments to individual patient needs. This review integrates insights from an Indian Dermatology Experts' Meeting, featuring perspectives from nine leading dermatologists. Discussions centered on analyzing acne's burden, its effects on quality of life (QoL), unmet needs in management, trifarotene's role in Indian therapy, anticipated challenges, and the importance of ancillary care. The experts highlighted acne's profound impact on patients' QoL and identified gaps in current management guidelines, especially concerning truncal acne. Trifarotene, a fourth-generation topical retinoid approved by the FDA and Drug Controller General of India (DCGI) for facial and truncal acne, demonstrated safety and efficacy across age groups. This synthesis of expert perspectives underscores the need for personalized acne management. Trifarotene emerges as a promising therapeutic option but challenges remain, particularly in optimizing ancillary care to minimize treatment-related adverse effects. Addressing these issues will enhance treatment outcomes and patient satisfaction in acne management, emphasizing the importance of tailored approaches in clinical practice.

Psychosocial profiles and blood pressure control: results from the multi-ethnic study of atherosclerosis (MESA).

Growing research shows psychosocial factors are associated with blood pressure (BP) control among individuals with hypertension. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing profiles among individuals with hypertension. The association of psychosocial profiles and BP control remains unknown. To characterize the psychosocial profiles of individuals with hypertension and assess whether they are associated with BP control over 14 years. We included 2,665 MESA participants with prevalent hypertension in 2002-2004. Nine psychosocial variables representing individual, interpersonal, and neighborhood factors were included. BP control was achieved if systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 9090 mmHg. Latent profile analysis (LPA) revealed an optimal model of three psychosocial profile groups (AIC 121,229; entropy = .88) "Healthy", "Psychosocially Distressed" and "Discriminated Against". Overall, there were no significant differences in systolic and diastolic BP control combined, across the profiles. Participants in the "Discriminated Against" profile group were significantly less likely [OR= 0.60; 95% CI: 0.43, 0.84] to have their DBP < 9090 mmHg as compared to the "Healthy" profile, but this was attenuated with full covariate adjustment. Discrete psychosocial profiles exist among individuals with hypertension but were not associated with BP control after full covariate adjustment.

Geographical Differences in the Perspective of Osteoarthritis Care Management: A Cross-Sectional Study in Italy, Sweden and Russia.

BACKGROUND: This study aimed to explore the awareness, experiences, and beliefs of individuals with osteoarthritis (OA) regarding their healthcare management, along with assessing their overall satisfaction levels. METHODS: A cross-sectional online survey was conducted in Italy, Sweden, and Russia, rigorously developed based on OA international guidelines in collaboration with healthcare professionals and individuals with OA. Participants over 40 years of age with self-reported hip and/or knee OA were eligible. The analytical framework included descriptive analysis (assessment of awareness levels for 'recommended', 'optional', and 'not recommended' treatments), analysis of suggested treatments and taken treatments, exploration of beliefs, barriers and satisfaction analysis (0-100 scale). RESULTS: A total of 401 participants (mean age: 59.7, 78.3% female, 28% Italian, 49% Swedish, 23% Russian) contributed to the study. In Sweden, 57%-72% accurately identified recommended treatments, while in Russia, the range was 34%-91%, and in Italy, it was 35%-73%. The predominant suggested and taken treatments were oral anti-inflammatory drugs in Italy (87/81%) and Russia (97/97%) and specific exercise in Sweden (84/79%). Notably, only Sweden reached a consensus on the effectiveness of exercise for everyone, while Russia and Italy insisted on radiographic findings as a prerequisite for exercise. Mean satisfaction levels were 59.7 (Italy), 47.4 (Sweden), and 35.2 (Russia). CONCLUSIONS: This study uncovered variations in awareness, treatment preferences, and beliefs among the three countries, underscoring the necessity for tailored education on OA management that accounts for regional differences across Europe.

Exploring the Frontier of Wheat Rust Resistance: Latest Approaches, Mechanisms, and Novel Insights.

Wheat rusts, including leaf, stripe, and stem rust, have been a threat to global food security due to their devastating impact on wheat yields. In recent years, significant strides have been made in understanding wheat rusts, focusing on disease spread mechanisms, the discovery of new host resistance genes, and the molecular basis of rust pathogenesis. This review summarizes the latest approaches and studies in wheat rust research that provide a comprehensive understanding of disease mechanisms and new insights into control strategies. Recent advances in genetic resistance using modern genomics techniques, as well as molecular mechanisms of rust pathogenesis and host resistance, are discussed. In addition, innovative management strategies, including the use of fungicides and biological control agents, are reviewed, highlighting their role in combating wheat rust. This review also emphasizes the impact of climate change on rust epidemiology and underscores the importance of developing resistant wheat varieties along with adaptive management practices. Finally, gaps in knowledge are identified and suggestions for future research are made. This review aims to inform researchers, agronomists, and policy makers, and to contribute to the development of more effective and sustainable wheat rust control strategies.

Psychological Well-Being of Children with Asthma and Their Parents.

Background/Objectives: The literature reports that emotional disorders in asthmatic children and their parents may affect asthma control. This research explores the baseline psychological well-being of asthmatic children and their mothers' and fathers' psychological functioning, focusing on the influence of the parents' anxiety and separation anxiety on children's asthma. Methods: In this cross-sectional study, we enrolled children with non-severe asthma and their parents, and a group of healthy children and their parents. The asthmatic children underwent anamnestic investigation, including asthma control and spirometry. Then, both the asthmatic and control triads filled a survey assessing their psychological functioning. Results: Among the 40 asthmatic children enrolled (8-18 years old), most had good clinical control maintained with GINA (Global Initiative for Asthma) therapy step 1-2 (14 patients, 35%) or step 3-4 (26 patients, 65%); 12 patients (30%) had at least one steroid course in the year before enrollment. They exhibited normal psychological adjustment but elevated levels of general (U = 179,500; p < 0.001) and state anxiety (U = 170,000; p < 0.001) compared to healthy peers. Additionally, the asthmatic children's mothers displayed higher levels of separation anxiety compared to the fathers (t = -2.865, p = 0.006). Increased separation anxiety in the mothers corresponded to a history of at least one exacerbation in the previous year. Conclusions: The asthmatic children exhibited normal psychological adjustment with higher general and state anxiety. Also, their mothers showed greater levels of separation anxiety compared to their fathers. Lastly, higher mothers' separation anxiety corresponded to a history of at least one exacerbation in the previous year. The influence of the parents' psychological well-being on the children's asthma control was previously unexplored.

The burden of allergic rhinitis is undermanaged in a large proportion of Chinese young adults from Singapore.

Background: Allergic rhinitis (AR) is a nasal disorder characterized by the simultaneous manifestation of at least 2 out of 4 possible symptoms: rhinorrhea, nasal itching, nasal pruritus, and sneezing. Presently, among Chinese young adults from Singapore, we characterised AR phenotypes, established Total Nasal Symptom Score (TNSS) baselines, and examined the management of AR. Methods: Participants completed an investigator-administered International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and underwent a skin prick test (SPT). Individuals exhibiting sensitization during the SPT while having at least 2 rhinitis symptoms were identified as AR cases, then categorized into Allergic Rhinitis in Asthma (ARIA) classifications. Results: There were 9323 subjects analyzed. AR prevalence was estimated at 35.4%. Rhinorrhea was perceived as the most severe (mean Nasal Symptom Score (mNSS) ± SD: 1.42 ± 0.74), while nasal pruritus was the least severe (mNSS ± SD: 1.24 ± 0.68). Among moderate-severe AR (68.1%), most were affected by either troublesome symptoms (27.7%) or sleep disturbances (18.4%). By ARIA classes, 26.6% were mild intermittent, 5.4% were mild persistent, 50.3% were moderate-severe intermittent, and 17.6% were moderate-severe persistent. The mean TNSS (mTNSS) of AR cases was 4.43 (SD = 2.49) and between AR classifications, the mTNSS was significantly different. Notably, a large proportion of AR cases remained undiagnosed (85.2%), untreated (72.5%), or both (65.4%); 19.8% self-medicated for AR. Conclusions: There was a significant difference in TNSS of the AR phenotypes, and among phenotypes with a higher mTNSS, a large proportion remained untreated, undiagnosed, or both. The evidence indicates an existing burden of AR among Chinese young adults in Singapore which is notably undermanaged.

The direct cost of chronic kidney disease (CKD) reported in Asian countries; a systematic literature review.

BACKGROUND: The direct and indirect costs of chronic kidney disease (CKD) are substantial and increase over time. Concerns regarding our capacity to manage the financial burden that CKD) places on patients, caregivers, and society are raised by its increasing prevalence and progression. Lack of awareness of CKD's economic effects is a major reason that lawmakers and administrators pay little attention to this chronic illness. OBJECTIVE: We aimed to analyze the direct burden of CKD across Asian countries and evaluate the main cost drivers among all mentioned cost centers in previous studies. METHODOLOGY: Related works evaluating the expenditures of CKD from the perspective of the patient were interpreted by a thorough search of PUBMED and GOOGLE SCHOLAR. RESULTS: Country-wise, in Asia, the direct mean average medical costs in RRT patients were reported in 8 studies as $4574, $18668, $2901, $6848, $16669, $3489, $5945, and $6344 in Singapore, Korea, Taiwan, China, Jordan, Vietnam, Lebanon, and India respectively and the direct mean average medical costs in non-RRT patients were reported in six studies as $3412, $2241, $4534, $290 and $1500 in Singapore, Japan, China, Vietnam, and India respectively. CONCLUSION: Hemodialysis is the main cost driver having an average mean cost of $23,358 per patient per year while the average mean cost of disease management is $4977 per patient per year. More research is needed to understand the specific economic challenges disadvantaged populations face, including the impact of income, education, and access to healthcare resources on the financial burden of CKD.