Eli Lilly (Canada)

High-density and high-quality inductive passives are a key requirement to improve the efficiency of high-speed and high-frequency integrated circuits. With the rise of compute-intensive and high-frequency applications, such as machine learning and 6G communication, significant improvements in terms of inductance density and quality of integrated inductors are still required. Shoelace, a novel integrated solenoid inductor structure, is proposed in this paper. The proposed inductive topology, theoretical models, and simulation of key performance parameters are presented. From the simulation result, the shoelace inductor exhibits 28% improvement in inductance density as compared to conventional integrated solenoid inductors. Furthermore, two variations of the baseline TSV-based shoelace inductor, namely the nested shoelace and the magnetic core shoelace, exhibit inductance density of, respectively, 238.81 nH/mm<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> and 228.32 nH/mm<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup>. In addition, the package-level integration of the proposed inductors is also discussed.

Abstract Background Mirikizumab is approved for adults with moderate-to-severe ulcerative colitis (UC) based on evidence from randomised clinical trials.1 However, real-world evidence on treatment persistence and clinical outcomes in routine practice is limited. This analysis evaluated treatment persistence and effectiveness among patients with UC receiving mirikizumab in a Canadian real-world setting. Methods Adults (≥18 years) with moderate-to-severe UC enrolled in the LillyPlus® Patient Support Program in Canada who received at least 1 dose of mirikizumab (index date) between 26 October 2023 and 28 April 2025 were included. Persistence was defined as continuous mirikizumab treatment until reported discontinuation.2 Clinical outcomes assessed included bowel urgency (BU; scored 0-10), rectal bleeding (RB; scored 0-3), and stool frequency (SF; scored 0-3), with higher scores indicating more severe symptoms/higher symptom severity. Scores were collected at baseline and at weeks 4, 12, and 24 (+4-week window after each touchpoint). Persistence and clinical outcomes were evaluated up to 24 weeks post-index by prior advanced therapy (AT) subgroup (AT-naïve and AT-experienced) using descriptive statistics. Results The cohort (N = 774) was 51.9% female with a mean (standard deviation [SD]) age of 46.5 (17.4) years, and 87.0% of participants were AT-experienced. Treatment persistence rates were 98.0%, 92.6%, and 80.9% at 4, 12, and 24 weeks, respectively (Figure 1). Persistence rates trended higher in AT-naïve than in AT-experienced patients at week 24. At baseline, the overall mean (SD) BU, RB, and SF scores were 6.83 (2.90), 1.41 (1.08), and 2.22 (1.05), respectively (Figure 2). Changes to outcome scores were observed as early as week 4. By week 24, the overall mean (SD) BU, RB, and SF scores had decreased to 2.98 (2.67), 0.44 (0.72), and 0.86 (0.92), respectively. Conclusion In this real-world setting, which included a high proportion of AT-experienced participants (87.0%), mirikizumab demonstrated treatment persistence through 24 weeks of initial treatment. Improvements in BU, RB, and SF scores were observed as early as 4 weeks and continued over 24 weeks in both AT-naïve and AT-experienced patients.

ABSTRACTObjectivePeople with early‐onset obesity (diagnosed at age < 25 years) may present with more cardiometabolic abnormalities and obesity‐related complications. This post hoc analysis assessed baseline characteristics and body weight (BW) changes with tirzepatide in people with early‐ versus later‐onset obesity.MethodsParticipants (N = 3782) from SURMOUNT‐1, SURMOUNT‐3, and SURMOUNT‐4 randomized to tirzepatide or placebo were included. Baseline characteristics and changes in BW and cardiometabolic risk factors at 72/88 weeks were assessed.ResultsIn SURMOUNT‐1, participants with early‐ versus later‐onset obesity had longer mean obesity duration (20 ± 12 vs. 11 ± 8 years), higher BMI (40 ± 7 vs. 37 ± 6 kg/m2) and waist circumference (WC, 118 ± 16 vs. 112 ± 14 cm), and lower HbA1c (5.48% ± 0.4% vs. 5.60% ± 0.4%), triglycerides (median 120 vs. 130 mg/dL), and systolic blood pressure (SBP; 121 ± 13 vs. 125 ± 13 mmHg) at baseline (all p ≤ 0.004). At 72 weeks, improvements with tirzepatide in BW (−23% vs. −22%), WC (−22 vs. −19 cm), HbA1c (−0.51% vs. −0.52%), triglycerides (−32% vs. −31%), and SBP (−8 vs. −8 mmHg) were similar between subgroups. Similar improvements were observed in SURMOUNT‐3 and SURMOUNT‐4.ConclusionsIn this post hoc analysis, participants with early‐ versus later‐onset obesity exhibited a mixed profile of metabolic health at baseline, including a higher degree of central adiposity and lower HbA1c and SBP. Improvements in BW and cardiometabolic markers with tirzepatide were similar between subgroups.Trial RegistrationClinicalTrials.gov identifiers: NCT04184622, NCT04657016, NCT04660643

Introduction: Moderate-to-severe ulcerative colitis (UC) can be associated with impaired quality of life. The Communicating Needs and Features of IBD Experiences (CONFIDE) study aims to increase understanding of patients’ experiences and the impact of IBD on their lives and elucidate any communication gaps between healthcare professionals (HCPs) and patients with moderate-to-severe UC in the United States, Europe, Japan, and Canada. These data focus on Canadian patients and HCPs. Methods: Online, quantitative, cross-sectional survey was conducted (panel recruitment) between February and April 2023 with patients diagnosed with moderate-to-severe UC and gastroenterologists (GIs) in Canada. Active disease of at least moderate severity defined using criteria based on previous treatment, steroid use, and/or hospitalization. HCPs were GIs responsible for making prescribing decisions for patients with moderate-to-severe UC. Results summarised descriptively. Results: Survey completed by 82 (373 contacted) patients (65% male, mean age 43.5 years (SD 12.6), mean time since diagnosis 6.3 years (SD 7.6, range 1-33 years)) and 53 GIs (70 contacted). The top 3 patient-reported symptoms experienced in the past month were diarrhea (39%, n=32), bowel urgency (BU, 30%, n=25), and fatigue/tiredness (29%, n=24). Among patients currently experiencing BU, 36% (n=9) discussed this at every appointment, of those that did not (n=16), 88% would like to discuss this more. 22% of patients (n=10) who have ever suffered from BU did not feel comfortable reporting BU to their GI. 85% (n=45) GIs reported they proactively discuss BU at routine appointments; 73% (n=39) thought their patients were comfortable reporting BU. GIs who reported that they do not proactively discuss BU (15%, n=8) cited the main reasons as expectation for the patient to bring it up and insufficient time (both 62%, n=5). Conclusion: A communication gap related to BU exists between patients and GIs. Most GIs report they proactively discuss BU routinely, but the majority of patients experiencing this would like to discuss it more. Among GIs that do not routinely proactively discuss BU, most believe their patients are comfortable reporting it. Patients who do not routinely discuss it would like to do so more frequently, but do not feel comfortable reporting it to their GI.

Immigrants to Western countries tend to have darker skin than native-born populations. We examined the relationship between skin melanin and serum vitamin D (vitD) [S-25(OH)D] levels and explored whether melanin levels explained S-25(OH)D variations between immigrants and native-born Canadians. This study offers novel findings as no such study has been conducted. We used a national cross-sectional population-based design with data from the Canadian Health Measures Survey (CHMS). Skin melanin levels among first-generation immigrants based on their ethnicity and origin/country of birth were compared with white and native-born populations. We assessed the association between S-25(OH)D and melanin after adjusting for independent variables related to S-25(OH)D, melanin level, and immigration status. Of 11,579 participants, 21.9% were immigrants aged 3-79 years (mean age 39.23 years). Compared with non-immigrants, immigrants had lower S-25(OH)D levels (mean: 51.23 vs. 62.72; 95% CI: 8.37, 14.62; P < 0.001) but higher melanin levels (mean [SE]: 17.08 [0.25] vs. 16.29 [0.29]; 95% CI: -1.29, -0.281; P = 0.004). Melanin did not differ by length of stay in Canada but was weakly positively correlated (r = 0.088, P < 0.001) with S-25(OH)D. Sex (male), age (≥18 years), summer/fall seasons, sunlight exposure, sunscreen non-use, smoking, and alcohol consumption were associated with higher melanin levels, whereas indoor tanning use was not. Skin melanin levels were associated with sociodemographic and behavioral characteristics. Immigrants had higher melanin levels, but melanin did not differ by length of stay in Canada. The weak positive correlation between melanin and S-25(OH)D suggested confounding factors may impact the relationship between melanin levels, S-25(OH)D, and immigration status.

IntroductionPatients with psoriasis (PsO) should adhere to and be persistent with treatment to maintain disease control. Patient support programs (PSPs) are useful to support patients with disease management. We aimed to understand the real-world patient profile and persistence of ixekizumab-initiating Canadian patients with moderate-to-severe PsO using PSP data.MethodsThis retrospective observational study was conducted utilizing a Canadian PSP database (May 2016 to March 2020). Inclusion criteria were: age ≥ 18 years with moderate-to-severe PsO, initiated ixekizumab, enrolled in the PSP for ≥ 6 months, and provided informed consent. Psoriasis Area Severity Index (PASI), body surface area (BSA) involvement, and Dermatology Life Quality Index (DLQI) were collected at PSP entry. Adherence [using the proportion of days covered (PDC)] and persistence (using Kaplan–Meier curves) were assessed after 1-year and 2-year follow-ups. Differences in persistence between biologic-naïve and biologic-experienced patients were compared using Cox proportional hazards model after adjusting baseline parameters.ResultsIn total, 1891 ixekizumab-treated moderate-to-severe patients with PsO were included. The mean [standard deviation (SD)] age was 52.3 (13.3) years; 51.1% of patients were 45–65 years old and 61.4% were male. At baseline, the mean (SD) PASI score was 14.3 (8.1), the DLQI score was 16.5 (7.7), and BSA % was 17.4 (15.1). PsO lesions were commonly located on the hands (33.4%), face (28.6%), and feet (23.8%). Ixekizumab-treated patients were highly adherent [PDC ≥ 80%: 1-year (92.0%), 2-year (87.7%)] and persistent [1-year (90.4%), 2-year (85.6%)]. Biologic-naïve patients were more adherent (1-year, 94.6% versus 87.3%; 2-year, 90.3% versus 83.5%) than biologic-experienced patients. Significantly higher persistence in biologic-naïve versus biologic-experienced patients for 1-year (p < 0.01) and 2-year (p = 0.010) follow-up periods was observed after adjusting for baseline parameters.ConclusionPatients with moderate-to-severe PsO overwhelmingly remained on ixekizumab treatment for more than 2 years while participating in a PSP.

We thank Dr. Tchetina for their interest in our article,1 and we appreciate the opportunity to respond to their Letter to the Editor.2 In the letter and their recent publication, Tchetina et al describe the utility of gene expression analyses using peripheral blood mononuclear cells (PBMCs) from patients with rheumatoid arthritis (RA) to predict clinical response to tofacitinib (TOF).2,3.

To generate initial data on the frequency and effect of symptomatic adverse events (AEs) associated with rheumatoid arthritis (RA) drug therapy from the patient perspective. We conducted an exploratory online survey asking patients with RA to indicate whether they currently or had ever experienced the 80 different symptomatic AEs included in the Patient-Reported Outcomes of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Results were summarized to report their frequency, and regression models were used to estimate their associations with RA medication use and overall bother. The 560 patients who completed the survey and reported taking ≥ 1 RA medication (disease-modifying antirheumatic drugs [DMARDs], steroids, nonsteroidal antiinflammatory drugs [NSAIDs]), had a mean disease duration of 8 years, and were on a wide range of DMARDs. The number of symptomatic AEs experienced in the past 7 days was none (6%), 1-10 (28%), 11-20 (28%), and &gt; 20 (38%). Overall, most participants reported that side effects bothered them somewhat (28%), quite a bit (24%), or very much (15%). In multivariable regression analyses, current prednisone and NSAID use were associated with the greatest number of current side effects (26 and 22, respectively). Many of the strongest associations between current symptomatic AEs and medication use aligned with known side effect profiles. In this exploratory online survey, patients with RA reported frequent symptomatic AEs with their medications that are bothersome. Further work is needed to develop and validate a measure for use in patients with rheumatic disease.

ObjectivesThe association of obesity and family history of type 2 diabetes mellitus (T2DM) provides an opportunity for risk stratification and prevention, as these two conditions are the most well-known risk factors for T2DM. We aimed to test the feasibility and effects of a diabetes mellitus prevention education program designed for overweight and obese Emirati people with at least one parent with T2DM.MethodsWe conducted a pilot study using a pre-post design without a control arm at the Diabetes Center at Tawam Hospital in Al Ain, UAE. Overweight and obese subjects with at least one parent with T2DM were invited to participate. Three study assessments were conducted at baseline, three months, and six months including a questionnaire, anthropometry, and laboratory assessments. Interventions included three individualized or family-engaged counseling sessions based on the DiAlert protocol. The study outcomes included awareness of risks and prevention opportunities to T2DM, behavior changes in nutrition and exercise, decreased waist-circumference, and clinical/metabolic/inflammatory markers. Pre-post changes were analyzed using repeated-measures analysis of variance.ResultsOne hundred twenty-two overweight or obese individuals were approached. Forty-four individuals met the eligibility criteria, and 32 individuals (35.0±9.0 years; 75.0% female) completed the study. At six months, there were significant improvements in the glycated hemoglobin levels (p = 0.007), high-density lipoprotein (p < 0.049), serum creatinine (p < 0.025), estimated glomerular filtration rate (p = 0.009), and adiponectin levels (p < 0.024). Sixteen of 32 participants had ≥ 2 cm reduction in waist circumference. They demonstrated notable physical and laboratory improvements in moderate-vigorous activity, average activity counts per day, tumor necrosis factor-alpha, and interleukin-6 total cholesterol, triglyceride, and low-density lipoprotein.ConclusionsOffering family-oriented diabetes education to people at risk for T2DM is well received and has favorable effects on relevant risk factors. Better testing with large-scale randomized controlled studies is needed, and implementing similar educational programs for the Emirati population seems warranted.