Search

Objective: Time in range (TIR) is an important metric to measure variability of blood glucose levels. The aim is to quantify the long-term health benefits and economic return associated with improved TIR for individuals with type 2 diabetes (T2D)., Method: A Markov model with three states (T2D, T2D with cardiovascular disease (CVD) and death) estimated 20-year medical costs, quality-adjusted life-years (QALY) gained and CVD risk under four TIR scenarios: >85%, 71%-85%, 51%-70% and ≤50%. The T2D population was identified using the National Health and Nutrition Examination Survey, and model parameters were sourced from literature. Costs were estimated from a healthcare sector perspective and standardized to 2021 US dollars. Cost ceilings were determined using three willingness-to-pay (WTP) thresholds: $100 000/QALY, $50 000/QALY and $0/QALY (cost-saving)., Results: Compared to TIR <50%, improving TIR to 51%-70% resulted in a 0.79 QALY increase and 4.91% CVD risk reduction; to 71%-85%, a 0.95 QALY increase and 6.24% CVD risk reduction; to >85%, a 1.18 QALY increase and 8.75% CVD risk reduction. To be cost-effective at $100 000/QALY, annual costs for TIR improvements from <50% to 51%-70%, 71%-85% and >85% should be <$1148, $4200 and $7252, respectively. To be cost-saving, these costs should be <$612, $2816 and $5021., Conclusion: Improving TIR yields significant health benefits. We calculated feasible medical cost allocations for TIR improvements, informing the implementation of interventions like continuous glucose monitoring devices., (© 2025 John Wiley & Sons Ltd.)

Objectives: This study aimed to quantify the additional cardioprotective effects of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) beyond the traditional risk factors control in individuals with type 2 diabetes. This helps calibrate the Building, Relating, Assessing, and Validating Outcomes (BRAVO) diabetes simulation model to capture the total cardiovascular benefits of new diabetes medications accurately., Methods: We extracted patient characteristics and treatment efficacy data from 4 cardiovascular outcome trials (CVOTs) of SGLT2is and 4 CVOTs of GLP-1RAs completed before May 2023. Using the BRAVO diabetes simulation model, we translated reductions in traditional risk factors (ie, glycated hemoglobin, systolic blood pressure, low-density lipids, and body mass index) from the newer drugs into risk reductions in cardiovascular outcomes (ie, myocardial infarction [MI], stroke, congestive heart failure [CHF], and mortality), assuming that the drug-associated risk reductions were only driven by traditional risk factors. Then, we compared the simulated risk-factor-driven risk reductions of cardiovascular outcomes with observed risk reductions from the trials and calculated drug-specific incremental benefits (DIB)., Results: After accounting for the cardiovascular effects from traditional risk factors control, SGLT2is was associated with an additional 19% risk reduction in CHF (DIB: 0.81, 95% CI 0.72-0.90). Furthermore, the uncalibrated model predicted a risk reduction in stroke with SGLT2is, which was not observed in CVOTs. This discrepancy highlights the need for an SGLT2i-specific calibrator to align the simulation results with the observed outcomes. In contrast, no additional cardiovascular benefit was associated with GLP-1RAs after controlling for traditional risk factors., Conclusions: Our study revealed that SGLT2is could further reduce CHF risk beyond the control of traditional risk factors but may offer additional pathways to offset the overall benefits of traditional risk factor control in stroke risk. No additional cardiovascular benefits were observed for GLP-1RAs beyond traditional risk factor control. The BRAVO model calibration enhances cardiovascular outcome prediction with these newer antidiabetic therapies., Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section. Dr Shi is an editor of Value in Health and had no role in the peer-review process of this article., (Copyright © 2025. Published by Elsevier Inc.)

Robots need to adapt to the complexities of acting in unstructured environments. Robotic systems need more awareness of the environment to adapt to uncertainty and variability. Although cameras have been predominantly used in robotic tasks, the limitations that come with them, such as occlusion, visibility, and lack of information, have diverted some focus to tactile sensing. Extensive datasets of the physical interactions between tactile-enabled robots are required to investigate and develop methods for performing manipulation and object exploration tasks. Therefore, this motivates us to compose a dataset of signals from Bioin-Tacto modules mounted on a robotic gripper performing extraction tasks. An operator controls a robotic gripper to extract three pegs of various complexities from their corresponding holes. This dataset contains angular velocity, linear acceleration, magnetic field intensity and direction, and pressure exerted on two tactile modules embedded in the compliant structure of the sensing module. The dataset comprises 96 extraction episodes, including data collected from a reinforcement learning agent. The dataset can be used to pre-train a reinforcement machine learning model to perform peg-in-hole tasks and to study how pretraining affects a manipulator's ability to infer tactile signals and improve the success rates of the manipulator., (© 2025 The Author(s).)

Effective human-like manipulation in robots depends on their capacity to recognize and identify textures in different environments. In unpredictable environments, robots with tactile sensors will have to identify textures through touch-related features. To advance research in texture classification, a comprehensive dataset capturing the physical interactions between a tactile-enabled robotic probe and various textures is necessary. As a result, we are driven to create a dataset from the signals collected by a bioinspired multimodal tactile sensing module, as a robotic probe dynamically makes contact with 12 different tactile textures. This dataset includes signals for pressure, acceleration, angular rate, and magnetic field variations, all captured by sensors embedded within the flexible structure of the sensing module. The pressure signals and the signals from the other sensors were sampled at a rate of 130 Hz. Each texture was explored 25 times, with each exploration involving a sliding motion along the uneven surface, tangential to the surface where the texture was bonded. The dataset comprises a total of 300 exploratory episodes. The tactile texture dataset applies to various projects in object recognition and robotic manipulation, making it particularly valuable for tasks involving tactile texture reconstruction and recognition. Additionally, this dataset offers opportunities to study time series properties generated by the robotic sliding motions during tactile texture exploration., (© 2025 The Author(s).)

Importance: A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain., Objective: To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection., Design, Setting, and Participants: This cohort study used data from the National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER)-Adult cohort, which consists of individuals enrolled in and prospectively followed up at 83 sites in 33 US states plus Washington, DC, and Puerto Rico. Data were examined from all participants enrolled between October 29, 2021, and July 5, 2024, who had a qualifying study visit 6 months or more after their initial SARS-CoV-2 infection., Exposure: Self-reported sex (male, female) assigned at birth., Main Outcomes and Measures: Development of long COVID, measured using a self-reported symptom-based questionnaire and scoring guideline at the first study visit that occurred at least 6 months after infection. Propensity score matching was used to estimate risk ratios (RRs) and risk differences (95% CIs). The full model included demographic and clinical characteristics and social determinants of health, and the reduced model included only age, race, and ethnicity., Results: Among 12 276 participants who had experienced SARS-CoV-2 infection (8969 [73%] female; mean [SD] age at infection, 46 [15] years), female sex was associated with higher risk of long COVID in the primary full (RR, 1.31; 95% CI, 1.06-1.62) and reduced (RR, 1.44; 95% CI, 1.17-1.77) models. This finding was observed across all age groups except 18 to 39 years (RR, 1.04; 95% CI, 0.72-1.49). Female sex was associated with significantly higher overall long COVID risk when the analysis was restricted to nonpregnant participants (RR, 1.50; 95%: CI, 1.27-1.77). Among participants aged 40 to 54 years, the risk ratio was 1.42 (95% CI, 0.99-2.03) in menopausal female participants and 1.45 (95% CI, 1.15-1.83) in nonmenopausal female participants compared with male participants., Conclusions and Relevance: In this prospective cohort study of the NIH RECOVER-Adult cohort, female sex was associated with an increased risk of long COVID compared with male sex, and this association was age, pregnancy, and menopausal status dependent. These findings highlight the need to identify biological mechanisms contributing to sex specificity to facilitate risk stratification, targeted drug development, and improved management of long COVID.

Background: Basilar invagination (BI) is a prolapse of the odontoid process cranially and posteriorly towards the foramen magnum. Several surgical treatment options are available for this condition. Herein, we describe a stress maneuver technique for BI reduction using a single-stage posterior approach., Methods: We described the case of a 56-year-old male diagnosed with type A BI and brainstem compression, who was treated with posterior fossa decompression and occipitocervical fusion. The BI was reduced intraoperatively using a stress maneuver, and cranial traction or atlantoaxial joint distraction was not necessary., Results: Postoperative imaging revealed a reduction of the odontoid process and adequate brainstem decompression. The patient showed progressive improvement of his symptoms., Conclusions: In selected cases, stress maneuvers for BI reduction can be a less morbid, easier, and replicable option within the already existing technical arsenal., (Copyright © 2024. Published by Elsevier Inc.)