Changes In Frequency Research Articles

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort.

This study aimed to test the hypothesis that being pregnant and delivering during the coronavirus disease 2019 (COVID-19) pandemic was associated with changes in gestational weight gain (GWG) or frequency of small- (SGA) or large-for-gestational-age (LGA) neonates. Secondary analysis of a multicenter observational cohort comparing pregnant people who delivered during the COVID-19 pandemic (June-December 2020) to people who delivered prior to the pandemic (March-December 2019). Those with multiple gestations, fetuses with major congenital anomalies, implausible GWG values, unavailable body mass index (BMI), or who were severe acute respiratory syndrome coronavirus-2-positive were excluded. The primary outcome was frequency of optimal recommended GWG based on prepregnancy BMI. Neonatal outcomes included birth weight, ponderal index, and frequency of SGA, LGA, and small head circumference for live births. Multivariable regression analysis was used to assess associations between exposure to the pandemic and outcomes. A total of 10,717 pregnant people were included in our analysis. A total of 4,225 pregnant people were exposed to the pandemic and 6,492 pregnant people delivered prior to the COVID-19 pandemic. Pregnant people exposed to the pandemic were older and more likely to have gestational diabetes. The frequency of appropriate GWG was 28.0% during the pandemic and 27.6% before the pandemic (adjusted odds ratio [aOR]: 1.02, 95% confidence interval [CI]: 0.93-1.11). Excessive GWG was more likely (54.9 vs. 53.1%; aOR: 1.08, 95% CI: 1.001-1.17), and inadequate GWG was less likely during the pandemic (17.0 vs. 19.3%; aOR: 0.86, 95% CI: 0.77-0.95). The frequency of SGA was 5.4% during the pandemic and 6.1% before the pandemic (aOR: 0.90, 95% CI: 0.76-1.06), and the frequency of LGA was 16.0% during the pandemic versus 15.0% before the pandemic (aOR: 1.06, 95% CI: 0.95-1.18). Other neonatal outcomes including birth weight percentile (62.1 [35.8-83.2] vs. 60.2 [34.4-82.2]; adjusted mean difference (aMD) = 1.50, 95% CI: -0.28 to 3.29), ponderal index (2.6 g/cm3 [2.4-2.8] in both groups; aMD = 0.01, 95% CI: 0.00-0.02), and small head circumference for livebirths (<10th percentile [8.2 vs. 8.1%; aOR: 1.03, 95% CI: 0.89-1.19], <3rd percentile [3.5 vs. 3.1%; aOR: 1.16, 95% CI: 0.93-1.44]) were similar between groups as well. Being pregnant and delivering during the COVID-19 pandemic was associated with a higher likelihood of excessive GWG and a lower likelihood of inadequate GWG. · Delivering during the COVID-19 pandemic was associated with higher likelihood of excessive GWG.. · Delivering during the COVID-19 pandemic was associated with lower likelihood of inadequate GWG.. · COVID-19 pandemic was not associated with changes in frequency of SGA or LGA..

Detection of adulterants in rice grains by the characteristics of reflection coefficient of the incident microwave signal

Detection of food quality by identifying different adulterants in food products is a grave requirement for the food industry. Various methods of food analysis have been evolved to identify the quality and quantity of impurities but those methods are time-consuming, expensive and laborious. Our research aims at reducing the challenges experienced in these existing methods. Our procedure is to detect food adulterants using a microwave signal and observe the change in reflection coefficient and resonant frequency of the reflected microwave signal. The property of modification of reflection coefficient and resonant frequency of reflected microwave signal from pure rice grains in the presence of adulterants like small stones/pebbles and broken rice is exploited. In this work, the detection and proportion of adulterants, such as stones and low-quality broken rice in fresh rice in varying proportions, have been determined. Adulterants as low as 2% weight of rice are highly detectable utilizing microwave.

Ecotoxicological assessment of UV filters benzophenone-3 and TiO2 nanoparticles, isolated and in a mixture, in developing zebrafish (Danio rerio)

ABSTRACT The increasing use of UV filters, such as benzophenone-3 (BP-3) and titanium dioxide nanoparticles (TiO2 NPs), has raised concerns regarding their ecotoxicological effects on the aquatic environment. The aim of the present study was to examine the embryo-larval toxicity attributed to BP-3 or TiO2 NPs, either alone or in a mixture, utilizing zebrafish (Danio rerio) as a model after exposure to environmentally relevant concentrations of these compounds. Zebrafish embryos were exposed to BP-3 (10, 100, or 1000 ng/L) or TiO2 NPs (1000 ng/L) alone or in a mixture (BP-3 10, 100, or 1000 ng/L plus 1000 ng/L of TiO2 NPs) under static conditions for 144 hr. After exposure, BP-3 levels were determined by high-performance liquid chromatography (HPLC). BP-3 levels increased in the presence of TiO2 NPs, indicating that the BP-3 degradation decreased in the presence of the NPs. In addition, in the presence of zebrafish, BP-3 levels in water decreased, indicating that zebrafish embryos and larvae might absorb BP-3. Data demonstrated that, in general, environmentally relevant concentrations of BP-3 and TiO2 NPs, either alone or in a mixture, did not significantly induce changes in heart and spontaneous contractions frequencies, levels of reactive oxygen species (ROS), morphological and morphometric parameters as well as mortality rates during 144 hr exposure. However, the groups exposed to TiO2 NPs alone and in a mixture with BP-3 at 10 ng/L exhibited an earlier significant hatching rate than the controls. Altogether, the data indicates that a potential ecotoxicological impact on the aquatic environment exists.

Ih Block Reveals Separation of Timescales in Pyloric Rhythm Response to Temperature Changes in Cancer borealis.

Motor systems operate over a range of frequencies and relative timing (phase). We studied the contribution of the hyperpolarization-activated inward current (Ih) to frequency and phase in the pyloric rhythm of the stomatogastric ganglion (STG) of the crab, Cancer borealis as temperature was altered from 11°C to 21°C. Under control conditions, the frequency of the rhythm increased monotonically with temperature, while the phases of the pyloric dilator (PD), lateral pyloric (LP), and pyloric (PY) neurons remained constant. When we blocked Ih with cesium (Cs+) PD offset, LP onset, and LP offset were all phase advanced in Cs+ at 11°C, and the latter two further advanced as temperature increased. In Cs+ the steady state increase in pyloric frequency with temperature diminished and the Q10 of the pyloric frequency dropped from ~1.75 to ~1.35. Unexpectedly in Cs+, the frequency displayed non-monotonic dynamics during temperature transitions; the frequency initially dropped as temperature increased, then rose once temperature stabilized, creating a characteristic "jag". Interestingly, these jags were still present during temperature transitions in Cs+ when the pacemaker was isolated by picrotoxin, although the temperature-induced change in frequency recovered to control levels. Overall, these data suggest that Ih plays an important role in the ability of this circuit to produce smooth transitory responses and persistent frequency increases by different mechanisms during temperature fluctuations.

Melatonin as an add-on anti-seizure medication in children with epilepsy: An open-label randomized controlled trial

Objectives: The primary objective of this study is to measure the effect of melatonin in decreasing seizure frequency in intervention group as compared to controls in children with drug-resistant epilepsy. Materials and Methods: An open-label randomized controlled trial was conducted from July 2020 to June 2022 in children between 2 and 14 years with drug-resistant epilepsy attending Pediatric and Neurology outpatient department and inpatient department. After noting down baseline seizure frequency, children were randomized into the melatonin group and control group. In the melatonin group, add-on melatonin was added to the existing ASM, and in the control group, ASMs were continued. The primary and secondary outcomes were measured after 3 months of follow-up. Results: The percentage change in the seizure frequency between both groups at the end of 3 months of follow-up was not statistically significant, but the percentage reduction of seizure frequency was more than 50% in the melatonin group. Melatonin was well tolerated in our children except for 4 (22%) who developed minor adverse effects. Conclusion: Add-on melatonin decreases seizure frequency to some extent which was not statistically significant with no major side effects. Further studies are needed to assess add-on melatonin’s long-term effectiveness and safety in children with drug-resistant epilepsy.

Optimization of battery/ultra‐capacitor hybrid energy storage system for frequency response support in low‐inertia microgrid

AbstractModern power system networks are under statutory obligations to integrate renewable energy sources (RES). The primary reason is to meet ever‐increasing energy demand and also to curtail environmental pollution by greenhouse gases. However, the higher penetration of RES has the tendency of reducing inertia of overall power system network. Consequently, frequency stability is affected and deviates beyond allowable permissible limits leading to power blackouts, load shedding, and even total system failure. To address the issues associated with reduced inertia, an optimal control of hybrid energy storage system (HESS) has been proposed. HESS is basically a combination of battery and ultracapacitor, where ultracapacitor addresses rapidly varying power component by mimicking inertia while the battery compensates long‐term power variations. Thus, the HESS is effectively controlled to compensate the loss of inertia by regulating its energy flow. For the purpose of improved efficiency and better power management of the HESS, an improvised particle swarm optimization (MPSO)‐based virtual inertia control design has been proposed. The proposed MPSO is utilized to tune the gains of bidirectional dc–dc converter in such a way that improves frequency nadir with faster response to transient disturbances. This proposed method is simulated in MATLAB and its merits are validated in real time using hardware in loop. On analysing of the results, it can be observed that frequency nadir is improved by 48.96% with significant reduction in rate of change of frequency in comparison to conventional particle swarm optimization.

Suggested mechanism of CCR5Δ32, CCR2-64I and SDF 1-3'A allele frequency change in Polish and Lithuanian gene pools from the perspective of passing time.

The study aimed to determine the frequency of the alleles associated with hereditary immune response in 16 historical populations and assess which evolutionary forces may have contributed to the observed frequency fluctuation. The analysed polymorphic sites are located in three genes - CCR5, CCR2 and SDF 1 (CXCL12). Protein products are involved in the innate immune response and are also involved in various types of infections, autoimmune diseases and tumours. The frequency of the alleles found in the DNA of the studied individuals was determined by the Sanger methodology and was compared with the data obtained for modern populations. To confirm the authenticity of the obtained results, mtDNA HVRI haplotypes of all the studied samples were obtained and compared with the genetic database of the laboratory personnel who came into contact with the studied material. Based on the variability of allele frequency, advanced biostatistical analysis was used to distinguish the effect of natural selection from genetic drift, i.e. the forces operating on the polymorphic sites studied. All procedures were performed according to the guidelines for working with ancient DNA to avoid contamination with modern DNA molecules. 681 samples from 39 archaeological sites in Poland and Lithuania dated to the 40th century BC and the 19th century were studied. The biostatistical analysis showed that the fluctuations in the frequency of CCR5Δ32 in the analysed time interval could be mainly the effect of genetic drift. Nevertheless, for CCR2-64I and SDF 1-3'A, the results confirm the suggestion of negative selection as the mechanism involved. Since all the polymorphic sites encode the elements of innate immune response that are indirectly associated with the process of an HPV infection and the development of cervical cancer, the human papillomavirus may be a good candidate for a selection coefficient affecting the frequency of CCR2-64I and SDF 1-3'A. However, for CCR5Δ32, selection was not detected despite its proven role in the molecular mechanism involved in the response to an HPV infection. The presented work seems to be the first in which the problem of the pattern of CCR5Δ32, CCR2-64I and SDF 1-3'A frequency fluctuations in a temporal perspective was discussed, proposing HPV as a factor influencing the occurrence of the CCR2 and SDF1 alleles.

Intensification and Poleward Shift of Compound Wind and Precipitation Extremes in a Warmer Climate

AbstractCompound wind and precipitation extremes (CWPEs) can severely impact natural and socioeconomic systems. However, our understanding of CWPE future changes, drivers, and uncertainties under a warmer climate is limited. Here, by analyzing the event both on oceans and landmasses via state‐of‐the‐art climate model simulations, we reveal a poleward shift of CWPE occurrences by the late 21st century, with notable increases at latitudes exceeding 50° in both hemispheres and decreases in the subtropics around 25°. CWPE intensification occurs across approximately 90% of global landmasses, and is most pronounced under a high‐emission scenario. Most changes in CWPE frequency and intensity (about 70% and 80%, respectively) stem from changes in precipitation extremes. We further identify large uncertainties in CWPE changes, which can be understood at the regional level by considering climate model differences in trends of CWPE drivers. These results provide insights into understanding CWPE changes under a warmer climate, aiding robust regional adaptation strategy development.

Historical museum samples reveal signals of selection and drift in response to changing insecticide use in an agricultural pest moth.

In response to environmental and human-imposed selective pressures, agroecosystem pests frequently undergo rapid evolution, with some species having a remarkable capacity to rapidly develop pesticide resistance. Temporal sampling of genomic data can comprehensively capture such adaptive changes over time, for example, by elucidating allele frequency shifts in pesticide resistance loci in response to different pesticides. Here, we leveraged museum specimens spanning over a century of collections to generate temporal contrasts between pre- and post-insecticide populations of an agricultural pest moth, Helicoverpa armigera. We used targeted exon sequencing of 254 samples collected across Australia from the pre-1950s (prior to insecticide introduction) to the 1990s, encompassing decades of changing insecticide use. Our sequencing approach focused on genes that are known to be involved in insecticide resistance, environmental sensation, and stress tolerance. We found an overall lack of spatial and temporal population structure change across Australia. In some decades (e.g., 1960s and 1970s), we found a moderate reduction of genetic diversity, implying stochasticity in evolutionary trajectories due to genetic drift. Temporal genome scans showed extensive evidence of selection following insecticide use, although the majority of selected variants were low impact, and alternating trajectories of allele frequency change were suggestive of potential antagonistic pleiotropy. Our results provide new insights into recent evolutionary responses in an agricultural pest and show how temporal contrasts using museum specimens can improve mechanistic understanding of rapid evolution.

Vibration analysis of a partially submerged structure using the DIC technique

The continuous expansion of offshore wind turbine sites has been garnering increasing attention, particularly in countries where available land is limited. Nevertheless, efficiently allocating resources for the maintenance and repair of offshore wind turbines presents a formidable challenge. This challenge is compounded by the complex and often unpredictable weather conditions, as well as various business-related issues specific to the offshore environment. To tackle these challenges, one effective solution is to implement vibration analysis through the use of digital image correlation (DIC) methods. This approach has a well-established theoretic background dating back to approximately 2008 and has demonstrated its effectiveness in the realm of structural health monitoring for large structures like bridges and towers. Relevant information on the upper structure of the wind turbines has been obtained using numerical models in our previous work. Changes in the structural feature frequencies of wind turbines are the primary focus in vibration analysis. However, changes in feature frequencies can occur for various reasons, and relying solely on frequency shifts can make it challenging to pinpoint the precise areas of damage within wind turbine structures, especially without the benefit of long-term observations. In this study, the DIC method is employed on scaled cylindrical models to gain insights into the frequency variations stemming from the erosion of non-cohesive soils beneath offshore wind turbine foundations. Changes in modal curvature within the upper structure of the wind turbine will also be analyzed. This additional investigation will enable a clear differentiation between defects in the upper structure and frequency shifts resulting from erosion or problems with the underwater foundation.

Association of characteristics of cancer, patient, and county with telemedicine services use: Impact of the waiver of reimbursement restrictions on telemedicine.

11058 Background: Telemedicine services have great potential to improve access to care of cancer patients who are vulnerable in health status and may experience financial hardship due to the cost of their care. However, very little is known about how the Centers for Medicare and Medicaid Services’ waiver of reimbursement restrictions on telemedicine and characteristics of cancer affected their use of telemedicine services. We examined the changes in frequency of telemedicine use before and after the waiver and, after the waiver, the determinants of telemedicine use across medical provider types. Methods: We used the 5% Surveillance, Epidemiology and End Results registry file linked to Medicare data among patients who had a newly diagnosed cancer in 2019 and were enrolled in Medicare Parts A and B during 2019-2020, and Area Health Resources File. Our outcomes were binary variables of telemedicine services use in outpatient (OP), office-based clinics (OB), and emergency department (ED), respectively, and for detailed provider types in OB. Primary independent variables included the ten most frequently observed cancer sites (reference: all other sites), sequence of cancer, stage of diagnosis, and quarter of diagnosis in 2019. Analysis was by a multilevel mixed effects logistic regression model, adjusting characteristics of cancer, patient and county. Results: Among eligible patients (n = 14,226), telemedicine services use for all provider types increased from 4.3% in pre-waiver period to 40.3% (5.2% in OP, 39.3% in OB, and 0.2% in ED) in post-waiver period. Telemedicine services use varied by primary cancer site, but was higher for those with a cancer recurrence (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.16-1.60) and advanced cancer stage (OR 1.24, 95% CI 1.03-1.48). For visits to oncologists, cancer characteristics such as recurrence (OR 1.67, 95% CI 1.34-2.08), advanced stage (OR 5.52, 95% CI 4.12-7.40) and diagnosis in the last quarter in 2019 (OR 1.39, 95% CI 1.20-1.61) were associated with greater use of telemedicine. Patients of older age and minority race/ethnicity and in non-Northeast regions were less likely to use telemedicine, while women, patients with dual eligibility for Medicaid, and those living in a county with high median household income and high availability of hospital beds were more likely to use telemedicine. Conclusions: Cancer patients used telemedicine services more frequently after the waiver and their cancer characteristics were most strongly associated with that use, implying their greater need for, and benefit from, telemedicine. Disparities in telemedicine use related to individual and county-level socio-demographics and medical supply suggest health policy changes to improve equitable access to telemedicine and efficient cancer care planning.

South China Sea Typhoon Hagibis enhanced Xinfengjiang Reservoir seismicity

There was an evident increase in the number of earthquakes in the Xinfengjiang Reservoir from June to July 2014 after the landing of Typhoon Hagibis. To understand the spatial and temporal evolution of this microseismicity, we built a high-precision earthquake catalog for 2014 and relocated 2275 events using recently developed methods for event picking and catalog construction. Seismicity occurred in the southeastern part of the reservoir, with the preferred fault plane orientation aligned along the Heyuan Fault. The total seismic energy peaked when the typhoon passed through the reservoir, and seismicity correlated with typhoon energy. In contrast, a limited seismic response was observed during the later Typhoon Rammasun. Combining data regarding the water level in the Xinfengjiang Reservoir and seismicity frequency changes in the Taiwan region during these two typhoon events, we suggest that typhoon activity may increase microseism energy by impacting fault stability around the Xinfengjiang Reservoir. Whether a fault can be activated also depends on how close the stress accumulation is to its failure point.

Development of Environmental Monitoring Sensor for Steel Corrosion in Concrete based on Micro-Electro-Mechanical Systems (MEMS)

Many bridges located near marine environments usually have high risk to lose their structural performance due to corrosion of reinforcing bars with chloride attack. While a huge amount of budget to maintain may be consumed for the structural maintenance methodologies, an efficient monitoring system for Reinforced Concrete (RC) structures in the corrosive environment is strongly demanded. Thus, structural health monitoring in real situations is significant for bridge asset management. The alternative way for preventing severe damage propagation is proactively monitoring the environmental condition containing chloride ion and its effect on the durability of concrete structures, for which numerous methods have been conventionally suggested such as dry gauze method to capture chlorides in air. In this study, Micro Energy Harvester (MEH) based on Micro-Electro-Mechanical Systems (MEMS) is technically applied to develop a sensor to identify the corrosion environment with chlorides in the exposure condition. MEMS is a rapidly evolving device, which enables to monitor the changes in natural frequency and amplitude at nodal locations of the targeting structure due to vibration-based electrostatic power generation induced by the corrosive environment. The purpose of this research is to develop a system for detecting the high corrosion-prone areas and finding the suitable metal sheet material for various chloride ion conditions, using the metal sheet as a cantilever structure for the MEMS device. 4 types of metal, aluminium, copper, iron and zinc are considered for the parametric experiments. Several scenarios are considered including chloride ion concentration, temperatures, and wet and dry conditions to compare the dominant frequency changes of each metal sheet and determine their sensitivity to corrosion environment. From the preliminary results, iron and zinc have a significant drop in frequency with the elapsed exposure period, which indicates that they are highly sensitive to the external chloride ion environment. These results offer an innovative and proactive approach to structural health monitoring for further developed applications. It enables prompt maintenance and early detection of potential issues for corrosion of steel bars in concrete, ensuring the longevity and safety of RC bridge structures.

Pancreatic-enzyme replacement therapy with pancrelipase plus chemotherapy for patients with pancreatic adenocarcinoma with cachexia and exocrine pancreatic insufficiency (PANCAX-3).

e24059 Background: Pancreatic-enzyme replacement therapy (PERT) is the standard of care to prevent maldigestion, malnutrition, and excessive weight loss in patients with exocrine pancreatic insufficiency (EPI). The utility of this therapy for patients with EPI in the setting of pancreatic ductal adenocarcinoma (PDAC) is unclear. We report results of a single site phase 2 trial for PERT with Pancreaze® plus standard of care (SOC) chemotherapy in PDAC patients with cachexia and EPI. The primary outcome measure was to assess feasibility of completing PERT during the first 8 weeks of treatment. Secondary outcome measures included weight stability, mean change in stool frequency, stool consistency from Cycle 1 (C1) to Cycle 3 (C3) (after 8 weeks of PERT), mean change in serum levels of fat soluble vitamins (A, D, E, K) from baseline to end of study, functional activity, and safety. Methods: Feasibility was defined as adherence to therapy of ≥50% of the needed total lipase units in the first 8 weeks of treatment (84,000 IU lipase units per meal, 42,000 IU lipase units per snack). Data are presented as frequencies (%) for categorical variables and means ± standard deviation for continuous variables. Weight stability, stool frequency, fat soluble vitamin levels, walk speed, and hand grip strength compared using two-sample paired t-tests. Stool consistency (Bristol stool type) compared using Fisher’s exact test. Results: Of 36 patients enrolled, 30 were evaluable for primary endpoint. Median age was 70. 73.3% (22/30) were female. 33.3% (10/30) were borderline resectable, 33.3% (10/30) locally advanced, and 33.3% (10/30) advanced/metastatic. 30 patients completed 8 weeks of PERT and 96.7% (29/30) were compliant. Efficacy results include PR (6.7%, 2/30), SD (66.7%, 20/30) and PD (23.3%, 7/30). Imaging not available for 1 patient. 6 patients experienced grade 1/2 GI toxicities (nausea, bloating, diarrhea, abdominal pain) deemed possibly/probably related to PERT. Grade 3/4 AEs included fatigue, infection, and hematologic toxicities deemed unrelated to PERT. Among evaluable patients, weight remained stable (-0.01±0.07 kg/BMI, p = 0.511) and there was a trend toward reduced stool frequency (p = 0.052) from C1 to C3. Stool consistency from C1 to C3 showed significant association (p = 0.035). Serum fat soluble vitamins, functional activity by walk speed and hand grip strength were also explored and no statistically significant differences were observed from C1 to C3 among the evaluable patients. Conclusions: PERT plus SOC chemotherapy for PDAC patients with cachexia and EPI is feasible and well-tolerated. Patients taking PERT experienced weight stability. PERT may aid in reducing stool frequency and further analysis is warranted into how PERT affects stool consistency. Clinical trial information: NCT04098237 .

Continuous Wave Ultrasound Testing Techniques

Currently, the primary method employed for ultrasound inspection is based on sending and detecting ultrasound pulses. Typically, pulse-based methods are essentially time-domain back-reflection methods, and the time-of-flight is the main measured parameter. Recently, continuous-wave methods have been developed in the radar and the fiber-optics fields, which demonstrate significantly better spatial resolution, higher signal-to-noise ratio, and ability to detect reflecting objects at very short distances. It is proposed to use the same approach to develop continuous-wave ultrasound inspection systems. The two main differences between the proposed continuous-wave ultrasonic testing and the classical pulsed ultrasound inspection method are: (i) in the continuous-wave ultrasonic testing method, the transmitted and received signals overlap in the time domain, while in the pulsed ultrasound inspection method the transmitted and received signals are separated in the time; and (ii) in the pulsed ultrasound inspection method the most important parameter is the time delay between the transmitted and received signals, while in the continuous-wave ultrasonic testing method the most informative parameters are the frequency and phase changes in the received signal in respect to modulated transmitted signal. This allows for additional flexibility in the continuous-wave ultrasonic measurements, through control of the frequency modulation. Also, the continuous-wave ultrasonic method potentially offers improved detection range and resolution; improved signal-to-noise ratio due to better energy efficiency and easier filtering; and reduced requirements on the voltage applied to the transducer, which in turn allows the use of simplified low-cost electronics. The theoretical basis of several continuous-wave ultrasound inspection technique is explained, and their advantages and limitations are discussed. Implementation of several prototype continuous-wave ultrasound testing systems is presented. Examples of the use of the systems for non-destructive testing are described.

Digital health program for patients with cancer to support self-management: A retrospective real-world analysis.

1570 Background: Sidekick Health’s 13-week digital health program was built to support cancer self-management. It was available free of charge to US-based cancer patients through commercial health insurance. The program includes disease education, mindfulness, medication adherence support, and asynchronous messaging with a care manager. We hypothesized that highly engaged users had reduced symptom frequency and severity, and improved quality of life (QoL) outcomes. Methods: In-app data were analyzed for registrations Aug 2021-Jan 2024: n(registered)=1286; n(retained ≥7 days)=795; n(QoL/symptoms)=284. QoL was defined as self-reported sleep quality, energy and stress (10-point scale, ≤4x/week). Symptoms were also self-reported (10-point scale, ≤7x/week). Generalized linear mixed models for repeated measures were used to investigate QoL, symptom frequency and severity changes over the program. Subgroup analysis: weekly iterative k-means clustering into highly- and less-engaged (based on total active days) to mitigate survival bias. Results: Diverse patients from 37 states engaged: mean age 58.0 years (SD=10.5), 71% female; 49% diagnosed &lt;6 months ago, 36% ≥12 months ago; 23% early-stage disease, 26% stable disease, 6% in remission and 2% terminal; 60% received chemotherapy, 24% radiation therapy, and 21% immunotherapy. Most (61%) registered users were active after 7 days and 29% after 90 days. Less-engaged users reported higher mean baseline weight (85.3kg (SD=26.7)) vs highly engaged (76.9kg (SD=18.3); p=0.010) but were otherwise similar (age, gender, height, time since diagnosis and treatment: p&gt;0.05). For QoL, highly engaged users had improved energy (p=0.013) and sleep (p=0.002), but not stress (p=0.164) vs less engaged. A significant time-group interaction for sleep (p&lt;0.001) showed highly engaged users had better sleep, and larger improvements over time vs less-engaged. Overall, users reported fewer symptoms over the program (IRR (95% CI)=0.965 (0.953, 0.978), p&lt;0.001). Symptom frequency decreased significantly for stress (p=0.034) and nausea (p=0.003), but not numbness (p=0.320) or fatigue (p=0.530). Highly engaged users’ symptom severity had a downward trajectory, compared with less-engaged, for fatigue (p=0.044) and nausea (p=0.001), but not stress (p=0.234) or numbness (p=0.680). Conclusions: Theprogram was accessed by a broad patient group and retention was high. Highly engaged users reported improved QoL (energy, sleep) and reduced symptom severity (fatigue, nausea). Total symptom frequency was reduced over the program, as well as for stress and nausea specifically. These findings indicate digital self-management is not only achievable for patients with cancer, but that higher engagement may improve patient-reported outcomes.

Load frequency control of interconnected power system using cuckoo search algorithm

This paper presents a new time-domain multi-objective function approach for solving load frequency control issue in an interconnected power system. The performance of interconnected power system in each area is validated for overshoot and settling time values of frequency change and tie-line power exchange. An objective function is created with the goal of enhancing proportional integral derivative (PID) controller settings by reducing overshoot and achieving faster time-domain settling times. The efficiency of the proposed time-domain multi-objective function is evaluated in a two-area thermal power plant using a nature-inspired cuckoo search optimization (CSA) technique. By comparing the time-domain simulation results of the test system with the existing integral error-based objective functions IAE, ISE, ITAE, and ITSE, the proposed objective function is validated. Further, a sensitivity analysis were carried out to analyze the robustness of the proposed multi-objective function under various uncertain conditions.

Design of osteosynthesis plate for detecting bone union using wire natural frequency

We have developed a novel osteosynthesis plate with bone union detection using a wire's natural frequency (BUDWF) to provide the quantitative result of bone union detection. The concept for detecting bone union is measuring the rate of frequency change. The frequency is measured from sound generated from the wire attached to a modified plate. The plate is modified from a Syncera ADLER B0409.10 and attached with 0.3 mm diameter 316L stainless steel wire. The sound generation mechanism was created by PEEK and installed on the plate to generate the sound. The preliminary experiments were conducted on a Sawbones tibia composite mimic. We used the cut Sawbones to create fracture samples with a 0, 0.5, 1-, 2-, and 5-mm gap representing the fractured bone with different gap sizes and prepared uncut Sawbones as a union sample. These samples were tested five times, and the sound was recorded from a condenser microphone and analyzed. We found that the BUDWF can differentiate samples with a fracture gap above 2 mm from the union sample, as the differences in the rates of frequency change between samples with a fracture gap above 2 mm and union samples were statistically significant. However, there was a limitation that the BUDWF plate was still unable to differentiate the 0 mm fracture gap and the union sample in this study.

Ethnic diversity and divergent perceptions of climate change: a case study in Southwest China

Understanding divergent perceptions of ethnic groups to climate change in mountainous regions home to multi-ethnic cultures and the factors influencing these perceptions is crucial for policymakers to predict the trending impacts of climate change and make long-term decisions. Based on the case of Southwest China, 1216 households were interviewed by questionnaire surveys to gain insight into the perceptions of local people on the dynamic evolution characteristics of climate events in the uplands of Yunnan, China, which is an area home to rich ethnic diversity, and also to determine the factors that influence these perceptions. Results indicated that climate events have now become important events for farmers’ livelihoods, ranking only after family diseases and livestock diseases. Drought, long-term drought, and erratic rainfall are the three kinds of climatic events with the most significant increase in frequency and severity in mountainous areas. Farmers’ perceptions on whether drought, long-term drought, and erratic rainfall occurred 10 years ago as well as changes in frequency and severity are significantly influenced by characteristics of respondents, ethnic culture, geographical environment of farmer residences, farmland characteristics, and sources of livelihood. Ultimately, taking ethnic differences into consideration for long-term planning will be an important part of the local response to climate change in the future.

Spectrum of Resistance Mechanisms to ALK TKIs in NSCLC: Largest Single-Center Experience from India

Abstract Introduction Anaplastic lymphoma kinase (ALK) rearranged non-small cell lung carcinoma (NSCLC) has emerged as a distinct entity with growing number of potent ALK tyrosine kinase inhibitors (TKIs). Despite showing durable responses and promising survival rates, resistance to these ensue. This is the largest series of repeat biopsies from patients of ALK-positive NSCLC progressing on ALK-directed therapy from this part of the world. Using a combinatorial approach of genomics and histology, we describe the spectrum of various resistance mechanisms encountered. Methods This is a cross-sectional study recruiting ALK-positive NSCLC cases who have progressed on any line ALK TKI and have undergone repeated biopsies followed by genomic sequencing by next-generation sequencing (NGS). Results Thirty-two ALK-positive NSCLC patients progressed on TKI were enrolled. Median age was 53 years (range: 36–75 years) with a male predilection (male:female 1.3:1). Twenty-seven (84.4%) cases harbored an additional resistance mechanism. Eighteen of these harbored an on-target ALK alteration, with L1196M gatekeeper mutation being the most common, in 11 cases, and G1202 alteration in 3 cases. In 9 cases an off-target alteration was detected, the most frequent being TP53 mutation in 8 cases, KRAS mutation in 4 cases and MET amplification in 3 cases. Four patients underwent sequential NGS testing and allele frequency changes in ALK fusion and resistance mechanisms were demonstrated. Sixteen patients have been offered lorlatinib therapy, the median progression-free survival of which has not yet been reached. Conclusion This is the largest series depicting ALK resistance mechanisms from a single center to date. The SPACEWALK study which demonstrated ALK TKI resistance mechanisms using plasma-based genotyping was a multicentric study. The spectrum encountered in this study is distinct from the rest of the world, thus highlighting heterogeneity within ALK-rearranged tumors. Comprehensive clinical evaluation at disease progression coupled with NGS-based genotyping will pave the way for lucid understanding of disease biology, thus aiding in the institution of optimal therapy.