Best practice advice for asthma exacerbation prevention and management in primary care: an international expert consensus.

Primary care clinicians play a key role in asthma and asthma exacerbation management worldwide because most patients with asthma are treated in primary care settings. The high burden of asthma exacerbations persists and important practice gaps remain, despite continual advances in asthma care. Lack of primary care-specific guidance, uncontrolled asthma, incomplete assessment of exacerbation and asthma control history, and reliance on systemic corticosteroids or short-acting beta-agonist-only therapy are challenges clinicians face today with asthma care.

Lagrangian gradient regression for the detection of coherent structures from sparse trajectory data.

Complex flows are often characterized using the theory of Lagrangian coherent structures (LCS), which leverages the motion of flow-embedded tracers to highlight features of interest. LCS are commonly employed to study fluid mechanical systems where flow tracers are readily observed, but they are broadly applicable to dynamical systems in general. A prevailing class of LCS analyses depends on reliable computation of flow gradients.

Nonlinear parametric models of viscoelastic fluid flows.

Reduced-order models (ROMs) have been widely adopted in fluid mechanics, particularly in the context of Newtonian fluid flows. These models offer the ability to predict complex dynamics, such as instabilities and oscillations, at a considerably reduced computational cost. In contrast, the reduced-order modelling of non-Newtonian viscoelastic fluid flows remains relatively unexplored.

Long-acting muscarinic antagonist and long-acting β-agonist combination for the treatment of maintenance therapy-naïve patients with chronic obstructive pulmonary disease: a narrative review.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Faster lung function impairment occurs earlier in the disease, particularly in mild-to-moderate COPD, highlighting the need for early and effective targeted interventions. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 report recommends initial pharmacologic treatment with a long-acting muscarinic antagonist (LAMA) and long-acting β-agonist (LABA) combination in group B (0 or 1 moderate exacerbation not leading to hospitalization, modified Medical Research Council score of ⩾2, and COPD Assessment Test™ score of ⩾10) and E (⩾2 moderate exacerbations or ⩾1 exacerbation leading to hospitalization and blood eosinophil count <300 cells/µL) patients.

Promising directions of machine learning for partial differential equations.

Partial differential equations (PDEs) are among the most universal and parsimonious descriptions of natural physical laws, capturing a rich variety of phenomenology and multiscale physics in a compact and symbolic representation. Here, we examine several promising avenues of PDE research that are being advanced by machine learning, including (1) discovering new governing PDEs and coarse-grained approximations for complex natural and engineered systems, (2) learning effective coordinate systems and reduced-order models to make PDEs more amenable to analysis, and (3) representing solution operators and improving traditional numerical algorithms. In each of these fields, we summarize key advances, ongoing challenges, and opportunities for further development.

Mobile Sensor Path Planning for Kalman Filter Spatiotemporal Estimation.

The estimation of spatiotemporal data from limited sensor measurements is a required task across many scientific disciplines. In this paper, we consider the use of mobile sensors for estimating spatiotemporal data via Kalman filtering. The sensor selection problem, which aims to optimize the placement of sensors, leverages innovations in greedy algorithms and low-rank subspace projection to provide model-free, data-driven estimates.

Towards extending the aircraft flight envelope by mitigating transonic airfoil buffet.

In the age of globalization, commercial aviation plays a central role in maintaining our international connectivity by providing fast air transport services for passengers and freight. However, the upper limit of the aircraft flight envelope, i.e.

Sensorimotor delays constrain robust locomotion in a 3D kinematic model of fly walking.

Walking animals must maintain stability in the presence of external perturbations, despite significant temporal delays in neural signaling and muscle actuation. Here, we develop a 3D kinematic model with a layered control architecture to investigate how sensorimotor delays constrain robustness of walking behavior in the fruit fly, . Motivated by the anatomical architecture of insect locomotor control circuits, our model consists of three component layers: a neural network that generates realistic 3D joint kinematics for each leg, an optimal controller that executes the joint kinematics while accounting for delays, and an inter-leg coordinator.

Arousal as a universal embedding for spatiotemporal brain dynamics.

Neural activity in awake organisms shows widespread and spatiotemporally diverse correlations with behavioral and physiological measurements. We propose that this covariation reflects in part the dynamics of a unified, arousal-related process that regulates brain-wide physiology on the timescale of seconds. Taken together with theoretical foundations in dynamical systems, this interpretation leads us to a surprising prediction: that a single, scalar measurement of arousal (e.

Overuse of long-acting β-agonist/inhaled corticosteroids in patients with chronic obstructive pulmonary disease: time to rethink prescribing patterns.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality globally. In the major revision of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report, the scientific committee concluded that the use of long-acting β-agonist/inhaled corticosteroids (LABA/ICS) is not encouraged in patients with COPD. However, current prescribing patterns reveal significant use of LABA/ICS.

Sodium-glucose cotransporter-2 inhibition for heart failure with preserved ejection fraction and chronic kidney disease with or without type 2 diabetes mellitus: a narrative review.

Background: Heart failure (HF), chronic kidney disease (CKD), and type 2 diabetes mellitus (T2DM) are common and interrelated conditions, each with a significant burden of disease. HF and kidney disease progress through pathophysiologic pathways that culminate in end-stage disease, for which T2DM is a major risk factor. Intervention within these pathways can disrupt disease processes and improve patient outcomes.

Understanding the role of psychiatrists in the diagnosis and management of mild cognitive impairment and mild Alzheimer's disease dementia: a cross-sectional survey.

Background: Alzheimer's disease (AD) is a progressive neurological disorder and the most common cause of dementia. The clinical continuum of AD ranges from asymptomatic disease to mild cognitive impairment (MCI), followed by AD dementia, categorized as mild, moderate, or severe. Almost one-third of patients suspected of having MCI or mild AD dementia are referred to specialists including psychiatrists.

The experimental multi-arm pendulum on a cart: A benchmark system for chaos, learning, and control.

The single, double, and triple pendulum has served as an illustrative experimental benchmark system for scientists to study dynamical behavior for more than four centuries. The pendulum system exhibits a wide range of interesting behaviors, from simple harmonic motion in the single pendulum to chaotic dynamics in multi-arm pendulums. Under forcing, even the single pendulum may exhibit chaos, providing a simple example of a damped-driven system.

New Paradigms for CKD Management in Patients With T2D.

At the end of the activity, participants will be able to: Identify the risks of kidney disease and their consequences in patients with type 2 diabetes (T2D). Appropriately screen for the presence of chronic kidney disease (CKD) in patients with T2D. Initiate evidence-based therapy to slow the progression of kidney disease in patients with T2D and CKD.

Implementing an Evidence-Based COPD Hospital Discharge Protocol: A Narrative Review and Expert Recommendations.

Discharge bundles, comprising evidence-based practices to be implemented prior to discharge, aim to optimise patient outcomes. They have been recommended to address high readmission rates in patients who have been hospitalised for an exacerbation of chronic obstructive pulmonary disease (COPD). Hospital readmission is associated with increased morbidity and healthcare resource utilisation, contributing substantially to the economic burden of COPD.

Perspectives of patients, care partners, and primary care physicians on management of mild cognitive impairment and mild Alzheimer's disease dementia.

Objectives: Early diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia is crucial for effective disease management and optimizing patient outcomes. We sought to better understand the MCI and mild AD dementia medical journey from the perspective of patients, care partners, and physicians.

Methods: We conducted online surveys in the United States among patients/care partners and physicians in 2021.

Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer's Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists.

Background: Alzheimer's disease (AD) is a progressive, neurodegenerative disease presenting along a continuum ranging from asymptomatic disease to mild cognitive impairment (MCI), followed by dementia characterized as mild, moderate, or severe.

Objectives: To better understand the medical journey of patients with all-cause MCI or mild AD dementia from the perspective of patients, care partners, and physicians.

Design: Cross-sectional study.

Beyond Blood Glucose and Blood Pressure Control in Type 2 Diabetes: Alternative Management Strategies to Prevent the Development and Progression of CKD.

Chronic kidney disease associated with Type 2 diabetes is linked to significant increase in morbidity, reduced quality of life, and early death. Current guidelines recommend targets for the management of hyperglycemia, hypertension, and dyslipidemia but there remains a residual risk of chronic kidney disease progression and adverse cardiovascular outcomes in patients with Type 2 diabetes. The 2022 consensus report from the American Diabetes Association and Kidney Disease: Improving Global Outcomes support the use of sodium-glucose co-transporter 2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists to improve kidney and cardiovascular outcomes.