Days Of Monitoring Research Articles

Capability of shallow open-water unit for emerging contaminants attenuation and ecological safety improvement in a treated effluent polishing process

Nature-based solutions of polishing treated effluent are drawing increased attention because of their potential to mitigate ecological risks, and the shallow open water unit (SOWU) process is one of the most promising options. In this study, a pilot experiment was conducted to assess the efficiency of SOWU for effluent quality polishing in a municipal wastewater treatment plant targeting 33 residual emerging contaminants (ECs) that were categorized into six groups, namely pharmaceuticals, sunscreens, bactericides, pesticides, flame retardants and phenols. In the 14-day monitoring period, each of the ECs decayed following a first order reaction, and about 61 % total ECs removal was achieved, indicating the remarkable photolysis effect of the SOWU under natural conditions. The significant removal of ECs, especially the very high removals of pharmaceuticals (76 %) and sunscreens (77 %), was associated with the attenuation of both the acute luminescent bacterial toxicity and genotoxicity. From the linear relationship between the acute toxicity and chromophoric dissolved organic matter and that between genotoxicity and UV absorbance at 254 nm, it was likely that the attenuation of biotoxicities resulted from the decay of chromophoric and aromatic compounds. By analyzing several reactive species, the excellent photoreactivity of the SOWU was further identified.

Effects of a simple cardiac rehabilitation program on improvement of self-reported physical activity in atrial fibrillation - Data from the RACE 3 study.

Background and aimPhysical inactivity is associated with an increased prevalence of atrial fibrillation (AF). We aim to evaluate whether cardiac rehabilitation (CR) motivates patients to become and stay physical active, and whether CR affects sinus rhythm maintenance and quality of life (QoL) in patients with persistent AF and moderate heart failure.MethodsIn the Routine versus Aggressive risk factor driven upstream rhythm Control for prevention of Early atrial fibrillation in heart failure study patients were randomized to conventional or targeted therapy. Targeted therapy contained next to optimal risk factor management a 3-month CR program, including self-reported physical activity and counseling. Successful physical activity was assessed in the targeted group, defined as activity of moderate intensity ≥ 150 min/week, or ≥ 75 min/week of vigorous intensity. AF was assessed at 1 year on 7-days Holter monitoring, QoL using general health, fatigue and AF symptom questionnaires.ResultsAll 119 patients within the targeted group participated in the CR program, 106 (89%) completed it. At baseline 80 (67%) patients were successfully physical active, 39 (33%) were not. NTproBNP was lower in active patients. During 1-year follow-up physical active patients stayed active: 72 (90%) at 12 weeks, 72 (90%) at 1 year. Inactive patients became active: at 12 weeks 25 (64%) patients and 30 (77%) at 1 year. No benefits were seen on sinus rhythm maintenance and QoL for successful physical active patients.ConclusionIn patients with persistent AF and moderate heart failure participation in CR contributes to improve and to maintain physical activity.

The relationship of sleep duration and quality to energy expenditure and physical activity in children.

Shorter sleep duration has been linked to the risk for obesity in children. The pathways linking sleep duration and quality to the risk of obesity are unclear, particularly the effect of sleep on energetics. We investigated the relationship between sleep duration, quality and timing in children, to the basal metabolic rate (BMR), total energy expenditure (TEE) and physical activity (PA). Fifty nine children in two age-groups (5-11 and 12-18 years) underwent evaluation of body composition (DXA), BMR in a room calorimeter, free-living TEE by doubly labelled water method, sleep and PA (7-day Actiheart monitor) during school break. Sleep duration contributed to the variance in BMR (β = 0.11, P = .009) after adjusting for age-group, sex, lean and fat mass, but not to the variance in TEE. Late sleep timing was related to lower PA. In the younger age-group, children who met recommended sleep duration on ≥50% of the 7 days had higher light PA (P = .03) and lower sedentary time (P = .009). Suboptimal sleep is associated with lower BMR, lower PA, and higher sedentary behaviours in young children. Prospective studies are needed to confirm if insufficient sleep duration or late sleep timing contribute to obesity risk by increasing sedentary behaviours and decreasing BMR.

Incidence and risk of short episodes of atrial fibrillation detected with 14 days of continuous electrocardiographic monitoring

Abstract Background There is widespread interest in population-based screening for atrial fibrillation (AF). However, there is debate regarding the optimal screening method and duration. Objectives To estimate the incidence of short-duration AF detected by a single continuous 14-day electrocardiographic (ECG) monitor in older individuals without prior AF and to estimate the risk of ischemic stroke or systemic embolism associated with these episodes. Methods Pacemaker and defibrillator electrograms were reviewed from a cohort of individuals ≥65 years old, with a history of hypertension, but no prior AF. For each participant, we simulated a continuous 14-day ECG monitor by randomly selecting a 14-day window in the 6 months following enrolment and measured the total AF burden during that period. We repeated random sampling 1000 times to ensure a robust estimate of the likelihood of capturing AF in a single 14-day period. We used Cox proportional hazards models adjusted for CHA2DS2-VASc score to estimate the risk of ischemic stroke or systemic embolism associated with different burdens of AF. Results Among 2470 participants with at least 6 months of follow-up, the mean CHA2DS2-VASc score was 4.0±1.3. The proportion of participants with an AF burden of >6 min on a single 14-day monitor was estimated as 3.1%, while the proportion with burdens of >15 min and >30 min were 2.9% and 2.6%, respectively. Over a mean follow-up of 2.5 years, 44 participants had an ischemic stroke or systemic embolism; the rate among patients with an AF burden ≤6 mins was 0.70%/year. An AF burden >6 min was associated with an increased risk of stroke or systemic embolism (2.2%/year, HR 3.0; 95% CI 1.3–5.7), as were burdens >15 min (2.4%/year; HR 3.3; 95% CI 1.4–6.4) and >30 min (2.6%/year HR 3.5; 95% CI 1.5–6.7). Conclusion Approximately 3% of individuals aged 65 years and older and with hypertension may have previously undiagnosed asymptomatic AF detected by a single 14-day continuous ECG monitor. As little as 6 minutes of AF may be associated with an increased risk of stroke. Randomized clinical trials are required to definitively assess screening in this population. Funding Acknowledgement Type of funding source: None

SARS-CoV-2 Exposure and Infection Among Health Care Personnel - Minnesota, March 6-July 11, 2020.

Health care personnel (HCP) are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), as a result of their exposure to patients or community contacts with COVID-19 (1,2). Since the first confirmed case of COVID-19 in Minnesota was reported on March 6, 2020, the Minnesota Department of Health (MDH) has required health care facilities* to report HCP† exposures to persons with confirmed COVID-19 for exposure risk assessment and to enroll HCP with higher-risk exposures into quarantine and symptom monitoring. During March 6-July 11, MDH and 1,217 partnering health care facilities assessed 21,406 HCP exposures; among these, 5,374 (25%) were classified as higher-risk§ (3). Higher-risk exposures involved direct patient care (66%) and nonpatient care interactions (e.g., with coworkers and social and household contacts) (34%). Within 14 days following a higher-risk exposure, nearly one third (31%) of HCP who were enrolled in monitoring reported COVID-19-like symptoms,¶ and more than one half (52%) of enrolled HCP with symptoms received positive SARS-CoV-2 test results. Among all HCP with higher-risk exposures, irrespective of monitoring enrollment, 7% received positive SARS-CoV-2 test results. Compared with HCP with higher-risk exposures working in acute care settings, those working in congregate living or long-term care settings more often returned to work (57%), worked while symptomatic (5%), and received a positive test result (10%) during 14-day postexposure monitoring than did HCP working outside of such settings. These data highlight the need for awareness of nonpatient care SARS-CoV-2 exposure risks and for targeted interventions to protect HCP, in addition to residents, in congregate living and long-term care settings. To minimize exposure risk among HCP, health care facilities need improved infection prevention and control, consistent personal protective equipment (PPE) availability and use, flexible sick leave, and SARS-CoV-2 testing access. All health care organizations and HCP should be aware of potential exposure risk from coworkers, household members, and social contacts.

Left Atrial Mechanics Assessed Early during Hospitalization for Cryptogenic Stroke Are Associated with Occult Atrial Fibrillation: A Speckle-Tracking Strain Echocardiography Study

Occult atrial fibrillation (AF) is an important contributor to cryptogenic stroke, yet remains difficult to unmask at presentation. This study investigated the predictive value of left atrial (LA) mechanics by strain echocardiography during stroke hospitalization for the presence of AF as detected on early 30-day monitoring and routine clinical follow-up. Left atrial mechanics were studied by strain echocardiography in a retrospective cohort of 191 patients with cryptogenic stroke and 30-day mobile cardiac outpatient telemetry poststroke to diagnose AF. After this, AF was diagnosed via routine clinical follow-up. The independent and incremental value of measures of LA size and mechanics (i.e., strain and strain rate in the reservoir, conduit, and booster pump phase) to predict AF on top of clinical characteristics was assessed. Of 191 patients, 15% (n=28) developed AF, of which 10 were observed during 30-day mobile cardiac outpatient telemetry and 18 were observed at a median follow-up of 25 (interquartile range, 10-43) months. Median time from embolic stroke to strain echocardiography was 1day (interquartile range, 1-2days). Left atrial mechanics were significantly worse in AF (P<.05 for all), despite largely similar baseline cardiovascular risk profile. Booster pump strain rate was the strongest predictor for AF, independent of age, LA volume index, E/e', and reservoir strain (odds ratio=2.88 per SD increase; 95% confidence interval, 1.29-6.41; P=.010). Adding LA strain reservoir strain and booster pump function significantly enhanced a multivariate model to predict AF. Freedom from AF was significantly lower in subjects with a booster pump strain rate (at stroke presentation) worse than -0.67sec-1, as derived from receiver operator curve analysis (P<.001). Left atrial mechanics and particularly the LA booster pump function assessed early during hospitalization for cryptogenic stroke can identify patients at greater likelihood of future diagnosis of AF. These findings could in part relate to LA mechanical stunning after spontaneous cardioversion, which-when identified by early strain echocardiography-can inform further risk stratification and decision-making.

Atrial fibrillation ablation success defined by duration of recurrence on cardiac implantable electronic devices.

Ablation for atrial fibrillation (AF) has emerged as an effective method of rhythm control. This exploratory analysis aimed to determine how various measures of recurrence would influence the definition of treatment success. Using an electronic health record data set from January 2007 to June 2019 linked with Medtronic cardiac implantable electronic device (CIED) data, patients who underwent a first AF ablation procedure following CIED implantation were identified. Data were analyzed for recurrence of AF stratified by varying definitions of successful ablation. The performance of various simulated external AF monitoring strategies was assessed. A total of 665 patients were analyzed including 248 with paroxysmal AF (mean age: 66.2 ± 9.3 years, 73.0% male) and 417 patients with persistent AF (mean age: 67.3 ± 9.0 years, 73.6% male). Among patients with paroxysmal AF, survival free from recurrence at 1 year ranged from 28.2% to 72.1% (>6 min and >23 h thresholds, respectively) with an overall median percentage of time in AF reduction of 99.6%. Among patients with persistent AF, survival free from recurrence at 1 year ranged from 24.9% to 60.0% (>6 min and 7 consecutive days > 23 h thresholds, respectively) with an overall median percentage of time in AF reduction of 99.3%. A single 7-day monitoring strategy had a sensitivity of less than 50% for detecting AF greater than 6 min in patients with paroxysmal and persistent AF. In this real-world data set of AF patients with CIEDs undergoing catheter ablation, treatment success varied substantially with different definitions of minimally required AF duration and is significantly impacted by the method of recurrence detection.

Effect of housewife's activity pattern on indoor particulate matter concentration: Ko-CHENS Mom study

Background/Aim Most housewives spend a lot of time at home and do housework such as cleaning and cooking. Low-cost sensors have advantage of being able to measure indoor particulate matter concentration in real time. Activities such as cooking, eating and cleaning can affect exposure patterns of indoor particulate matter. The purpose of this study was to identify changes in indoor particulate matter concentration according to the time-activity patterns of housewives. Methods We enrolled 306 participants in the study for the housewives located in Seoul and Ulsan, Korea. Housewives were measured their indoor exposures by low-cost sensor and completed time-activity diaries for a 7-days monitoring period. PM data is obtained every 5 minutes via Wi-Fi and cloud system connection. Participants self-reported their major activities every hour in their time-activity diary. The time activity diary provides hourly information on participants' activities and locations. Indoor PM concentrations over time were compared with participants' behavior patterns. We also performed the stratified analysis based on weekdays/weekends and seasons. The accuracy of the sensor measurment was evaluated by examining the correlation between the indoor PM measured by the sensor and the indoor PM measured by the GRIMM. Results During the study, the indoor occupancy rate of the participants was about 82%. The average age of the participants was 34 years. The time having highest average of indoor PM concentration was 10 am (PM2.5: 21.8 μg/m3, PM10: 26.3 μg/m3). Activity patterns related to cooking/eating, and cleaning influenced changes in indoor particulate matter concentrations. There was no difference in indoor PM concentration during weekdays/weekends. The correlation coefficients between concentrations measured by sensor and GRIMM were 0.9. Conclusion This study provides a comprehensive assessment of the variation in indoor particulate matter concentration associated with housewives’ time-activities. Our results found that indoor PM concentrations increased with indoor cooking /cleaning behavior.

First 100 Persons with COVID-19 - Zambia, March 18-April 28, 2020.

Zambia is a landlocked, lower-middle income country in southern Africa, with a population of 17 million (1). The first known cases of coronavirus disease 2019 (COVID-19) in Zambia occurred in a married couple who had traveled to France and were subject to port-of-entry surveillance and subsequent remote monitoring of travelers with a history of international travel for 14 days after arrival. They were identified as having suspected cases on March 18, 2020, and tested for COVID-19 after developing respiratory symptoms during the 14-day monitoring period. In March 2020, the Zambia National Public Health Institute (ZNPHI) defined a suspected case of COVID-19 as 1) an acute respiratory illness in a person with a history of international travel during the 14 days preceding symptom onset; or 2) acute respiratory illness in a person with a history of contact with a person with laboratory-confirmed COVID-19 in the 14 days preceding symptom onset; or 3) severe acute respiratory illness requiring hospitalization; or 4) being a household or close contact of a patient with laboratory-confirmed COVID-19. This definition was adapted from World Health Organization (WHO) interim guidance issued March 20, 2020, on global surveillance for COVID-19 (2) to also include asymptomatic contacts of persons with confirmed COVID-19. Persons with suspected COVID-19 were identified through various mechanisms, including port-of-entry surveillance, contact tracing, health care worker (HCW) testing, facility-based inpatient screening, community-based screening, and calls from the public into a national hotline administered by the Disaster Management and Mitigation Unit and ZNPHI. Port-of-entry surveillance included an arrival screen consisting of a temperature scan, report of symptoms during the preceding 14 days, and collection of a history of travel and contact with persons with confirmed COVID-19 in the 14 days before arrival in Zambia, followed by daily remote telephone monitoring for 14 days. Travelers were tested for SARS-CoV-2, the virus that causes COVID-19, if they were symptomatic upon arrival or developed symptoms during the 14-day monitoring period. Persons with suspected COVID-19 were tested as soon as possible after evaluation for respiratory symptoms or within 7 days of last known exposure (i.e., travel or contact with a confirmed case). All COVID-19 diagnoses were confirmed using real-time reverse transcription-polymerase chain reaction (RT-PCR) testing (SARS-CoV-2 Nucleic Acid Detection Kit, Maccura) of nasopharyngeal specimens; all patients with confirmed COVID-19 were admitted into institutional isolation at the time of laboratory confirmation, which was generally within 36 hours. COVID-19 patients were deemed recovered and released from isolation after two consecutive PCR-negative test results ≥24 hours apart. A Ministry of Health memorandum was released on April 13, 2020, mandating testing in public facilities of 1) all persons admitted to medical and pediatric wards regardless of symptoms; 2) all patients being admitted to surgical and obstetric wards, regardless of symptoms; 3) any outpatient with fever, cough, or shortness of breath; and 4) any facility or community death in a person with respiratory symptoms, and 5) biweekly screening of all HCWs in isolation centers and health facilities where persons with COVID-19 had been evaluated. This report describes the first 100 COVID-19 cases reported in Zambia, during March 18-April 28, 2020.

Complications associated with a flash glucose monitoring system in diabetic cats.

Glucose monitoring is an integral part of diabetes management. Interstitial glucose monitoring systems are increasingly commonly being used for this purpose in dogs and cats, including the use of a flash glucose monitoring system (FGMS). The aim of this study was to describe the incidence and nature of complications associated with the use of an FGMS in diabetic cats. The medical records of all cats that had placement of a 14-day FGMS during a 1-year period were retrospectively reviewed. Data retrieved included the number of days the sensor remained attached and functional, location of sensor placement and complications associated with the sensor. Complications were defined as early sensor detachment, sensor failure prior to the end of the 14-day monitoring period and dermatologic changes at the sensor site. Descriptive statistics were used to characterize the data. Twenty cats had a total of 33 FGMSs placed. The majority (30/33 [91%]) of sensors were placed over the dorsolateral aspect of the thorax just caudal to the scapula. Twenty (61%) FGMSs remained attached and functional for the full 14 days. The overall incidence of complications associated with FGMS use was 10/33 (30%). The most frequent complication was early sensor detachment (n = 5/33 [15%]). Mild dermatologic changes (erythema, crusts) were noted with 4/33 (12%) FGMSs. More serious complications (skin erosions, abscess formation) were noted with 2/33 (6%) FGMSs. The use of the FGMS is relatively safe in cats, although there are potential complications that owners should be made aware of.

S1459 Immune Checkpoint Inhibitor-Induced Pancreatic Injury: An Atypical Presentation

INTRODUCTION: Immune checkpoint inhibitors (ICI) are effective in the treatment of several advanced cancer types. ICI-pancreatic injury (ICI-PI) is uncommon and often asymptomatic with incidentally elevated pancreatic enzymes. We present a case of ICI-PI mimicking autoimmune pancreatitis (AIP) with obstructive jaundice. CASE DESCRIPTION/METHODS: A 60-year-old male with acral melanoma metastatic to the liver was treated with four cycles of nivolumab and ipilimumab. After three cycles of maintenance nivolumab, surveillance positron emission tomography (PET) revealed diffuse fluorodeoxyglucose (FDG)-avidity of the pancreas with peripancreatic fat stranding (Image 1). He endorsed mild abdominal discomfort with an elevated lipase 10x the upper limit of normal (Table 1). He had no gallstones on imaging and socially drank alcohol. ANA was negative with normal IgG4. He was given a diagnosis of ICI-PI and treated with intravenous fluids and discharged on a 14-day steroid taper and lab monitoring. Three weeks after completing the steroid taper, he presented with worsening abdominal pain and gray colored stool. Labs showed elevated liver tests consistent with a cholestatic obstructive pattern. Computed tomography (CT) revealed diffuse mild enlargement of the pancreas. MRCP showed dilated extrahepatic bile duct up to 11mm with an intrapancreatic stricture. Endoscopic ultrasound (EUS) showed diffusely lobular pancreas with hypoechoic areas and intervening hyperechoic standing. The pancreatic duct was not dilated. The bile duct was dilated and abruptly narrowed as it entered the pancreatic head. Fine needle aspiration (FNA) of the pancreatic head with 25G needle revealed pancreatic acini and focal findings suggestive of chronic pancreatitis without metastatic melanoma (Image 2). A diagnosis of ICI-PI mimicking AIP was made. He received high dose oral steroids with a long taper. His liver enzymes normalized. Repeat PET showed interval resolution of pancreatic FDG-avidity and peripancreatic fat stranding with continued remission of melanoma. DISCUSSION: This is a unique case of ICI-PI evolving into obstructive jaundice and resolving with steroids. Although he had negative serologies, his imaging and clinical course mimicked AIP. Both ICI related adverse events and AIP are T-cell driven processes suggesting a possible similar pathogenesis. The incidence of ICI-PI will likely rise with the increasing use of ICIs; thus, awareness of ICI-PI and its variable presentation are clinically salient.Table 1.: Liver enzymes, total bilirubin and lipase from the last cycle of nivolumab therapy through both hospitalizations. Normal aspartate aminotransferase (AST) is 0–40 IU/L. Normal alanine aminotransferase (ALT) is 0-32 IU/L. Normal alkaline phosphatase (ALP) is 39-117 IU/L. Normal total bilirubin is 0–1.2 mg/dL. Upper limit of normal lipase is 51 U/LFigure 1.: Image 1. Positron emission tomography (PET) imaging. A. Prior to nivolumab therapy. B. After three cycles of maintenance nivolumab. C. After high dose oral steroids and normalization of liver enzymes.Figure 2.: Image 2. Biopsy obtained during endoscopic ultrasound (EUS). A. Benign pancreatic acini and focal findings suggestive of chronic pancreatitis on hematoxylin and eosin (H&E) stain. B. SOX10 stain with control. SOX10 is a melanoma marker and thus no metastatic melanoma identified.

Objective measurement of physical activity in a random sample of Saint-Petersburg inhabitants

Background: World Health Organization (WHO) experts listed physical inactivity in leading risk factors for global mortality. Current research shows that only objective measurement of physical activity may provide accurate information on this parameter. The aim of our study was to assess the 7-day physical activity monitoring using triaxial accelerometers in a random sample of Saint-Petersburg inhabitants. Material and methods: As a part of all-Russian epidemiology survey ESSE-RF there was involved random sampling of 1600 Saint-Petersburg inhabitants (25–65 years) stratified by age and sex. After that a random sub-population of 100 subjects was selected. All subjects filled in questionnaire regarding physical activity, occupation, education and nutrition. Anthropometry (weight, height with body-mass index calculation, waist circumference) was performed. Actigraph GT3X+ (Actigraph LLC, USA) accelerometer and physical activity diary were used in order to evaluate physical activity monitoring for 7 days. Adequate levels of physical activity (PA) were defined as more than 10 000 steps/day and at least 150 minutes/week of moderate and vigorous physical activity (MVPA) in bouts of 10 minutes or more. Results: 1/2 of subjects were physically active according to steps, and 1/3 according to MVPA time criteria. No gender, occupation or body composition differences were revealed in physically active and inactive subjects. Almost 50% of physically active subjects had balanced workweek-weekend PA profile, and the same criterion is true only for 13% of subjects in inactive group. In both groups the same peaks of MVPA were revealed — at 8.00–9.00 and 18.00–19.00, which are typical transportation time, but in active group these peaks were significantly higher. According to PA diaries, in most of cases physical inactivity was related to the usage of private or public transport. Conclusion: Triaxial PA-monitoring shows, that 40–60% of subjects were physically inactive, and 150-min MVPA goal can easily be achieved by only increasing walking time during transportation peaks. The physical inactivity was not determined by the type of occupation, sex or age, instead it was mainly influenced by the usage of cars in the morning and evening transportation time, rather than walking.

Abstract IA05: Incorporating mobile health technology into a prospective cohort study to measure environment, physical activity, and sleep

Abstract Obesity is an established driver of cancer risk, and substantial evidence has identified inadequate physical activity and sleep as common risk factors. Inadequate physical activity contributes to over 12% of breast and colon cancers each year in the U.S. Furthermore, 10-20% of the general population experiences curtailed sleep and/or sleep disturbances, which have been associated with higher risk of breast, colon, prostate, and endometrial cancers. Geographic contextual measures, including neighborhood walkability and access to green space, have been demonstrated to affect physical activity, sleep patterns, and obesity. Both behaviors and environmental influences are most commonly measured with questionnaires, which almost certainly have substantial error, but this error has not been quantified. Novel mobile health technologies (mHealth), such as global positioning systems (GPS)-enabled smartphones and consumer-wearable accelerometry devices, can provide efficient, rigorous, and objective measures of geographic context, physical activity, and sleep with high spatio-temporal resolution. However, managing, processing, and analyzing streaming high-dimensional data has presented significant logistical and analytical challenges, especially when linking these data to existing data from large prospective cohorts. In this talk, I will discuss how we are measuring the interdependent relationships between geographic context, physical activity, sleep, and obesity by deploying smartphone applications and wearable devices within a subsample (n=500) of the Nurses’ Health Study 3 (NHS3). NHS3 is a web-based, nationwide, prospective open cohort with a current enrollment of ~46,000 male and female nurses aged 19-46 years old, a critical period for behaviors that influence cancer etiology. We are using mHealth approaches to collect streaming, high spatio-temporal resolution measures of geographic context (walkability and green space) based on smartphone GPS, physical activity, and sleep (based on Fitbit wearable devices) over a 7-day monitoring period, four times over one year. We are developing statistical methods to examine the interrelationships between these high-dimensional, intensive measures of context and behavior. Our long-term goal is to assess the effect of minute-to-minute exposure to geographic context on objective measures of physical activity and sleep, as well as subsequent obesity and cancer risk, within the full NHS3 cohort. This study is enabling us to rigorously quantify contextual exposures, physical activity, and sleep, and to identify the influence of geographic contextual factors on these interdependent behavioral risk factors for cancer and obesity. As we are advancing research on the objective measurement of geographic context, physical activity, and sleep through mHealth technology, we are bridging the gap between precise studies with small sample sizes and large prospective studies with abundant error. The approaches discussed here will aid in advancing epidemiologic research to better evaluate causal mechanisms between geographic context and behavioral risk factors for cancer. Citation Format: Peter James. Incorporating mobile health technology into a prospective cohort study to measure environment, physical activity, and sleep [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr IA05.

Carbonaceous inserts from lignocellulosic and non-lignocellulosic sources in cement mortar: Preparation conditions and its effect on hydration kinetics and physical properties

Landfilling and open burning of biomass wastes lead to adverse environmental impacts. A potential means to valorize such wastes can be achieved through thermal conversion to biochar, and applying the produced biochar as admixture in cementitious construction materials. This article aims to investigate the influence of biochar from different lignocellulsic wastes, including sorghum, cotton stalk, wood and dairy manure, and non-lignocellulosic algae waste on hydration, mechanical and permeability properties of cement mortar. Performance of biochar-mortar composites were compared with mortar prepared with three different commercial biochar with relatively high carbon content and surface area. The findings suggest that biochar with higher surace area and pore volume, for instance, wood biochar, tend to increase hydration, while biochar with high ash content, for instance dairy manure biochar in this case, reduce peak hydration heat and negatively affect the overall hydration over 7-day monitoring period. Strength results suggest that depending on elemental carbon content and surface area, addition of biochar from different lignocellulosic biomass increases compressive strength, elastic modulus and fracture toughness by 10–12%, 16–20% and 30–40% respectively at 2 years compared to control. Among lignocellulosic biochars, only wood biochar prepared at 500 ˚C led to slight increase (7%) in 28-day strength compared to control, while non-lignocellulosic algae biochar reduced strength of mortar by 15%. Depending on feedstock and production condition, addition of lignocellulosic and non-lignocellulosic biochar led to 10–50% reduction in permeability at 28-day age, measured by water absorption through capillary action. The findings suggest that addition of biochar from horticultural, agricultural and forest waste may be a sustainable means to improve physical properties of construction materials while reducing the need for incineration and landfilling.

Fiber-shaped organic electrochemical transistors for biochemical detections with high sensitivity and stability

Precise and continuous monitoring of biochemicals by biosensors assists to understand physiological functions for various diagnostics and therapeutic applications. For implanted biosensors, small size and flexibility are essential for minimizing tissue damage and achieving accurate detection. However, the active surface area of sensor decreases as the sensor becomes smaller, which will increase the impedance and decrease the signal to noise ratio, resulting in a poor detection limit. Taking advantages of local amplification effect, organic electrochemical transistors (OECTs) constitute promising candidates for high-sensitive monitoring. However, their detections in deep tissues are rarely reported. Herein, we report a family of implantable, fiber-shaped all-in-one OECTs based on carbon nanotube fibers for versatile biochemical detection including H2O2, glucose, dopamine and glutamate. These fiber-shaped OECTs demonstrated high sensitivity, dynamical stability in physiological environment and anti-interference capability. After implantation in mouse brain, 7-day dopamine monitoring in vivo was realized for the first time. These fiber-shaped OECTs could be great additions to the “life science” tool box and represent promising avenue for biomedical monitoring.

Assessment of patients who tested positive for COVID-19 after recovery

Assessment of patients who tested positive for COVID-19 after recovery

Severe Acute Respiratory Syndrome Coronavirus 2 Infection among Returnees to Japan from Wuhan, China, 2020.

In early 2020, Japan repatriated 566 nationals from China. Universal laboratory testing and 14-day monitoring of returnees detected 12 cases of severe acute respiratory syndrome coronavirus 2 infection; initial screening results were negative for 5. Common outcomes were remaining asymptomatic (n = 4) and pneumonia (n = 6). Overall, screening performed poorly.

Cost-Effectiveness of Extended Electrocardiogram Monitoring for Atrial Fibrillation After Stroke: A Systematic Review.

Management of cryptogenic stroke involves the identification of modifiable risk factors, such as atrial fibrillation (AF). Extended rhythm monitoring increases AF detection rates but at an increased device cost compared with conventional Holter monitoring. The objective of the study was to identify and synthesize the existing literature on the cost-effectiveness of prolonged rhythm monitoring devices for AF detection in cryptogenic stroke. We conducted a systematic review of available economic evaluations of prolonged ECG monitoring for AF detection following cryptogenic stroke compared with standard care. Of the 530 unique citations, 8 studies assessed the cost-utility of prolonged ECG monitoring compared with standard care following cryptogenic stroke. The prolonged ECG monitoring strategies included 7-day ambulatory monitoring, 30-day external loop recorders or intermittent ECG monitoring, and implantable loop recorders. The majority of cost-utility analyses reported incremental cost-effectiveness ratios below $50 000 per QALY gained; and two studies reported a cost-savings. There is limited economic literature on the cost-effectiveness of extended ECG monitoring devices for detection of atrial fibrillation in cryptogenic stroke. In patients with cryptogenic stroke, extended ECG monitoring for AF detection may be economically attractive when traditional willingness-to-pay thresholds are adopted. However, there was substantial variation in the reported ICERs. The direct comparison of cost-effectiveness across technologies is limited by heterogeneity in modeling assumptions.

116-LB: Evaluating the Impact of Glucommander on Improvement in Time-in-Range (TIR) in Type 2 Diabetes Using Continuous Glucose Monitoring

A proof of concept single center prospective study aimed at evaluating the safety and efficacy of utilizing Glucommander outpatient insulin dosing software to assist providers in titrating basal bolus insulin doses, using Abbott Freestyle Libre 14-day glucose monitoring system. A total of 25 adults (18-80), having T2D and an A1C &amp;gt; 8%, were enrolled. A nurse educator provided patient education on insulin administration, meal planning and use of the glucose sensor. Baseline CGM data was collected during week 1, after which time participants insulin doses were titrated weekly for the next 4 weeks. Data was collected on initial HbA1C, days of CGM wear, time in range (TIR), and time in hypoglycemia. Use of Glucommander significantly improved TIR from a baseline of 48.02% during the initial week to 73.84% during the final week of treatment (p&amp;lt;0.00001). Time in hypoglycemia (BG &amp;lt; 54 mg/dl) decreased from 0.37% during the initial week to 0.33% during the final week of treatment (p&amp;gt;0.557). % Changes in insulin: %Change(Basal) = 10.5%, %Change(Total Boluses)= 19.7%, %Change(TDD)= 15.1%. Disclosure B.W. Bode: Advisory Panel; Self; Medtronic, Novo Nordisk A/S. Consultant; Self; Eli Lilly and Company, Medtronic, Novo Nordisk A/S. Research Support; Self; Abbott, Advance, Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Janssen Pharmaceuticals, Inc., MannKind Corporation, Medtronic, National Institutes of Health, Nova Biomedical, Novo Nordisk A/S, Provention Bio, Inc., Sanofi, Senseonics. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., MannKind Corporation, Medtronic, Novo Nordisk A/S, Sanofi, Senseonics. Stock/Shareholder; Self; Aseko. J.G. Clarke: Employee; Self; Glytec. Stock/Shareholder; Self; Glytec. Funding Glytec, LLC

Microbiota in vitro modulated with polyphenols shows decreased colonization resistance against Clostridioides difficile but can neutralize cytotoxicity

While the knowledge on gut microbiota - C. difficile interactions has improved over the years, the understanding of the underlying mechanisms providing colonization resistance as well as preventative measures against the infection remain incomplete. In this study the antibiotic clindamycin and polyphenol extracts from pomegranate and blueberries were used individually and in combination to modulate fecal microbial communities in minibioreactor arrays (MBRA). Modulated communities were inoculated with C. difficile (ribotype 027). Subsequent 7-day periodical monitoring included evaluation of C. difficile growth and activity of toxins TcdA and TcdB as well as analysis of MBRA bacterial community structure (V3V4 16 S metagenomics). Polyphenols affected multiple commensal bacterial groups and showed different synergistic and antagonistic effects in combination with clindamycin. Exposure to either clindamycin or polyphenols led to the loss of colonization resistance against C. difficile. The successful growth of C. difficile was most significantly correlated with the decrease in Collinsella and Lachnospiraceae. Additionally, we demonstrated that Clostridium sporogenes decreased the activity of both C. difficile toxins TcdA and TcdB. The feature was shown to be common among distinct C. sporogenes strains and could potentially be applicable as a non-antibiotic agent for the alleviation of C. difficile infection.