Comparing Glucose Outcomes Following Face-to-Face and Remote Initiation of Flash Glucose Monitoring in People Living With Diabetes.

Background: When launched, FreeStyle Libre (FSL; a flash glucose monitor) onboarding was mainly conducted face-to-face. The COVID-19 pandemic accelerated a change to online starts with patients directed to online videos such as Diabetes Technology Network UK for education. We conducted an audit to evaluate glycemic outcomes in people who were onboarded face-to-face versus those who were onboarded remotely and to determine the impact of ethnicity and deprivation on those outcomes. Methods: People living with diabetes who started using FSL between January 2019 and April 2022, had their mode of onboarding recorded and had at least 90 days of data in LibreView with >70% data completion were included in the audit. Glucose metrics (percent time in ranges) and engagement statistics (previous 90-day averages) were obtained from LibreView. Differences between glucose variables and onboarding methods were compared using linear models, adjusting for ethnicity, deprivation, sex, age, percent active (where appropriate), and duration of FSL use. Results: In total, 935 participants (face-to-face 44% [n = 413]; online 56% [n = 522]) were included. There were no significant differences in glycemic or engagement indices between onboarding methods and ethnicities, but the most deprived quintile had significantly lower percent active time (b = −9.20, P = .002) than the least deprived quintile. Conclusions: Online videos as an onboarding method can be used without significant differences in glucose and engagement metrics. The most deprived group within the audit population had lower engagement metrics, but this did not translate into differences in glucose metrics.</p

Additional file 3: of Workflow standardization of a novel team care model to improve chronic care: a quasi-experimental study

Clinical Outcomes for Patients with Clinical Outcomes above the HEDIS Threshold at the time of the Office Visit. This file includes the results of Tables 3, 4 and 5 for those patients with poor biometric control at the time of the primary care provider office visit. (PDF 819 kb

Additional file 1: of Optimising recruitment and informed consent in randomised controlled trials: the development and implementation of the Quintet Recruitment Intervention (QRI)

Contains details of ethical approvals for the RCTs and ProtecT trial registrations. (DOCX 45 kb

Clinicians’ individual perceptions of equipoise, based on interview accounts.

<p>Clinicians’ individual perceptions of equipoise, based on interview accounts.</p

Clinicians’ descriptions of the concept of equipoise to patients during RCT recruitment appointments.

<p>Clinicians’ descriptions of the concept of equipoise to patients during RCT recruitment appointments.</p

RCT details and associated number of appointments recorded (shown by participating clinician).

<p>RCT details and associated number of appointments recorded (shown by participating clinician).</p

Volcano plots of acrosome, capacitation and motility assays.

Upper panel indicates 10 μM, lower plot panels indicate 30 μM. Incubation times for assays are 3h with compound for Acrosome 2 assay and Motility (non-capacitating) (PM = progressive motility), and 30 min for the Capacitation assay (HA = hyperactive motility, PM = progressive motility). Dotted line indicates significance levels of 0.05. Any point above dotted line is indicated in magenta. Buffer conditions are indicated below Plot title (capacitating vs. non-capacitating). (TIF)</p

Sperm Toolbox compounds.

Male contraceptive options and infertility treatments are limited, and almost all innovation has been limited to updates to medically assisted reproduction protocols and methods. To accelerate the development of drugs that can either improve or inhibit fertility, we established a small molecule library as a toolbox for assay development and screening campaigns using human spermatozoa. We have profiled all compounds in the Sperm Toolbox in several automated high-throughput assays that measure stimulation or inhibition of sperm motility or the acrosome reaction. We have assayed motility under non-capacitating and capacitating conditions to distinguish between pathways operating under these different physiological states. We also assayed cell viability to ensure any effects on sperm function are specific. A key advantage of our studies is that all compounds are assayed together in the same experimental conditions, which allows quantitative comparisons of their effects in complementary functional assays. We have combined the resulting datasets to generate fingerprints of the Sperm Toolbox compounds on sperm function. The data are included in an on-line R-based app for convenient querying.</div

STB assay protocols.

(a) Diagram showing sperm motility assays run on high-content microscope with compound incubation time/read-out time. Motility assays were run under non-capacitating conditions, with a 1 hour recovery phase after preparation of spermatozoa. Capacitation assays were run under capacitating conditions. Spermatozoa are capacitated for 30 min prior to compound incubation. (b) Diagram showing assays run on high-throughput flow cytometer to measure acrosome status and sperm viability. Incubation time with compound, agonist and read-out times are indicated. Acrosome assays run under capacitating conditions. Sperm viability assay run under non-capacitating condition. (c) Additional assays performed on sperm toolbox compounds. (TIF)</p

Visualization of assay results on STB compounds.

(A) Heatmap showing standardized results (z-score) for every Toolbox compound screened at 30 μM in selected assays: Acrosome 2 (3h with compound then induction with acrosome reaction using an agonist mix), Motility Hyperactive (30 min capacitation then 30 min incubation with compound), Motility Progressive (3h incubation with compounds under non-capacitating conditions), Motility Total (3h incubation with compound under non-capacitating conditions)), Solubility (aqueous solubility of compounds after 24h incubation), Sperm viability (3h with compound then propidium iodide assay), Toxicity HeLa (24h compound incubation then cell painting assay), Toxicity HepG2 (70h incubation with compound then resaruzin based assay). Heatmap color indicates decrease (blue) or increase (red). (B) UMAP plot showing groups of compounds with similar assay profile. Color indicates annotated sperm function. (C) Structures and zoom-in of three compounds with related structures described to modulate LRRK2 kinase but appear to have different effects on sperm function.</p