Time Of Data Collection Research Articles

A quick response data collection and management system for digital twin production line based on cloud-fog-edge computing collaboration

Background A production line is the basic unit of smart factories and smart manufacturing. However, owing to the development of the industrial Internet of Things, sensors, and other technologies, more data are being collected, leading to a data explosion, and the heterogeneous nature of multiple sources makes it difficult to manage data in a unified manner. Methods A production line data collection, storage, and management system based on cloud-fog-edge computing collaboration and a digital twin was designed. Multi-source heterogeneous data were collected and transmitted based on the OPC UA, and an information model of the production line was established. Modules for data mapping, publishing, and receiving were developed to achieve unified data collection and transmission. The data storage and management platform was constructed by front-end and back-end separation technologies. Results The developed data collection and management system was verified for functionality and performance on a digital twin production line. Functional tests show that the system has the functions of data acquisition and transmission, device addition and viewing, device data querying and downloading, data and model visualization, and user rights setting. The average time for edge data collection and transmission is 183.6ms. The average response time of the cloud for fog requests is less than 1s. This shows that the system can satisfy the real-time requirements of a digital twin production line. Conclusions The proposed system is real-time and stable, providing support for big data and virtual-reality interaction in digital twins.

A Study to Evaluate the Effectiveness of Educational Intervention on Knowledge regarding Self Care Practices among Adult Asthmatics in selected hospital at Ahmedabad

Bronchial asthma remains a most common human and economic burden, despite recent challenge in detecting the optimal management of asthma and renewed efforts from guidelines developers to help physicians integrate the recommendations in to current care. More than 300 million persons all over the world are affected by bronchial asthma, with mortality about 250,000 annually. The objectives of the study were to assess the level of knowledge regarding self care practices among adult asthmatics. b) To evaluate the effectiveness of educational intervention on knowledge regarding self care practices among adult asthmatics. c) To find out the association between selected demographic variables and Pre test level of knowledge regarding self care practices among adult asthmatics. The research approach selected for the study was quantitative research approach and pre-experimental research – one group pre-test post-test design. The study was conducted at selected hospital at Ahmadabad. Total 30 samples were selected from patients attending OPD & admitted in wards. Patients who are willing to participate in the study. Patients who are present at the time of data collection. Age of patient between 20-60 years. A formal prior permission was obtained from the Hospital, at Ahmadabad. The study was conducted for a period of a week 30 samples were selected based on the criteria for sample selection. The collected data were analyzed by using inferential statistical method. t- test was used to evaluate the effectiveness of A. Findings related to demographic variables of the study.1. The majority of 18(60%) sample’s age is between 50-60years. The majority of 21 (70%) the sample’s sex were male. The majority of 14 (47%) the sample’s education status is secondary. The majority of 21 (70%) samples are belongs from middle class. The majority of 23(90%) samples are not having past surgical history. The majority of 24(80 %) samples are having no family history. The majority of 23(76%) samples are having no previous hospitalization. significant p<0.05 level. Hence their findings of the study revealed that the Structured Teaching Programme was effective in knowledge regarding adult asthmatics

Durable ventricular assist devices for patients with advanced heart failure: the New Zealand experience.

The prevalence of heart failure in New Zealand is increasing. A small number of select patients with predicted poor short-term survival are candidates for advanced heart failure therapies such as transplantation and durable mechanical circulatory support (MCS). The aim of our study was to introduce left ventricular assist devices (LVADs) to the wider clinicians and highlight their role in managing patients with advanced heart failure in New Zealand. A retrospective audit of all ventricular assist device (VAD) recipients from January 2005 to December 2022 was conducted. Data were collated using electronic medical and paper records. The primary outcome was survival to transplantation or successful explant of VAD. Thirty-nine patients received VADs; 32 were male and seven female. Mean age was 45 years (range 10-64 years). Most recipients were NZ European (25), six were Māori, four were Pacific peoples and four were of other ethnicities. The majority of LVADs were implanted for those with dilated cardiomyopathy (67%). At the time of data collection, 24 (62%) had survived to heart transplantation, seven (18%) died while on VAD support, five from right ventricular failure and two from strokes, one patient had their VAD explanted due to recovery and seven (18%) VAD recipients continue on support awaiting transplant. This audit has provided an opportunity to inform New Zealand clinicians of our durable MCS programme and the expanding role of VAD support in patients with advanced heart failure. The programme will need to continue to audit and report its practice in order to provide equitable allocation of this very limited resource to a growing population in need.

Analyzing the Performance and Resilience of Neeraj Chopra Through the Lens of Theory of Threat and Challenge States in Athletes Authors

The present study aimed to analyze Neeraj Chopra’s performance and resilience with the help of the theory of threat and challenge states in athletes (TCTSA). Multiple quantitative and qualitative data sources, such as media bites, newspaper articles, interviews from various print and digital media, and online sites, were employed in the current study. The data collection time frame was limited to 2018 to 2021. Furthermore, the concept of resilience has been discovered and encouraged by utilizing the Theory of Challenge and Threat States in Athletes (TCTSA). In this article, we have taken the case of Neeraj Chopra and suggested that the hardship and adversities he has faced in the past can be ascribed to his resilience. His story helps us understand how important it is to expose athletes to adversities for their psychological development. This also implies that coaches should expose their trainees to stressful situations for mental growth and to build their confidence. Exposure to adversities and competition stress will help them to increase resilience. Developing a positive attitude towards adversity is also essential, as it will improve athletes’ perception of competition situations.

Non-excitation closed-loop identification based on hysteresis bias relay feedback

This paper proposes a closed-loop system identification method based on hysteresis loop bias relay feedback without using excitation. The method utilizes hysteresis loop bias relay instead of a controller to ensure the informativity of data without external excitation and with only noisy feedback. Additionally, this paper proposes a parameter scheme for the hysteresis loop bias relay to guide the selection of parameters more rationally, thus improving the accuracy of the identification model. Compared to recently proposed switching controller methods, the advantage of this method lies in the fact that it requires fewer samples and shortens data collection time. The method's effectiveness is verified through simulation comparisons with typical methods.

Advanced Ovarian Cancer Patients’ Experiences of Surgical Treatment: A Qualitative Analysis

ObjectivesRecommended treatment for advanced ovarian cancer involves a combination of debulking surgery and chemotherapy. Surgery places a significant burden on a patient's physical, social, sexual, and emotional wellbeing. Existing research exploring the impact of surgery is often limited to questionnaire administration with large gaps between data collection time points, missing key aspects of the perioperative period. Little is known of the experience of ovarian cancer surgical treatment from a patient perspective. This research aims to qualitatively explore advanced ovarian cancer patients’ experience of surgery and identify areas in which quality of life may be impacted. MethodsSemi-structured telephone or face-to-face interviews were conducted with patients who had undergone combined surgical and chemotherapy treatment. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using an inductive approach to thematic analysis. ResultsTwenty ovarian cancer patients who had undergone debulking surgery participated in interviews lasting between 33 and 68 minutes. Qualitative analysis generated five key themes: (1) care services; (2) experiences of a stoma; (3) preoperative experience; (4) impact of surgery; and (5) coping mechanisms. ConclusionsUnderstanding the patient experience of surgical treatment for advanced ovarian cancer can help inform and improve future care. This research explored the ways in which a patient's quality of life is impacted by surgery and highlights areas in which further support may be needed. Knowledge of the patient experience may also aid decision-making for both clinicians and patients when considering different treatment pathways. Implications for Nursing PracticeResults highlighted two crucial points in the surgical pathway where patients' need for emotional support was significant: during pre-op and recovering from surgery as an inpatient. Nursing staff are key to providing reassurance during this time. Specialized stoma nurses were also essential for supporting patients to adapt to their stomas both physically and psychologically.

Above-ankle Reamputation and Mortality following Transmetatarsal Amputation in Diabetic and Nondiabetic Peripheral Artery Disease

The risk of above-ankle reamputation following a transmetatarsal amputation is around 30%. Patient selection may be crucial to achieve good outcomes, and to avoid futile operations and suffering. We are aware of no previous comparison between the two largest patient groups that undergo lower extremity amputations: patients with diabetes, and patients with non-diabetic peripheral artery disease. Patients with diabetes or non-diabetic peripheral artery disease who had undergone a transmetatarsal amputation from 2004 through 2018 at our institution were included. Patient characteristics and peri-operative details were analyzed retrospectively. Subjects with diabetes were compared with subjects with non-diabetic peripheral artery disease regarding above-ankle reamputation, reamputation level, and mortality. Five-hundred-and-sixty transmetatarsal amputations in 513 subjects were included. The majority of transmetatarsal amputations (86%) occurred in diabetic subjects. Subjects with non-diabetic PAD had a higher risk of above-ankle reamputation (p = .008), and death (p < .001). At the time of data collection, only multiple-ray amputation (vs. single-ray) was an independent risk factor for above-ankle reamputation. Only age, medical comorbidity in general, and chronic heart failure were independent risk factors of death. To our knowledge, this study is the first to report marked differences in above-ankle reamputation rates and mortality following transmetatarsal amputation, comparing diabetics with non-diabetic patients with peripheral artery disease. However, the differences may be attributed to non-diabetics being older, having more medical comorbidities, and having more advanced foot ulcers at the time of transmetatarsal amputation. In patients exhibiting several of these risk factors, transmetatarsal amputation may be futile. Level of Clinical EvidencePrognostic Level 2: Retrospective study.

Participation for learners with cognitive disabilities in class activities during the pandemic in UAE: issues and barriers

The study examines issues related to achieving meaningful participation in class activities as an element of social inclusion of learners with cognitive disabilities aged 14–19 years that are enrolled in educational institutions (schools/centres) during COVID-19 in United Arab Emirates. The paper relied on a qualitative approach with 5 sessions of virtual observation and 18 semi-structured virtual interviews with learners themselves and their care givers/parents as the main methodological tool given lack of access to physical means at the time of data collection during the global pandemic (2021–22). The analysis was thematic, focusing on explored and extracted main issues that impact one important aspect of the social inclusion of such learners, which is their active participation during a difficult time. The results showed that learners with cognitive disabilities faced additional several issues in addition to what members of the surrounding community dealt with during the disaster. Data revealed that they were immensely affected by the pandemic, with another layer of social isolation, lack of peer interaction as well as family restriction that is directed at them with additional measures than everyone in the household. It also showed that despite the efforts and programmes designed by schools/institutes that were in place to support their engagement in academic and social activities, participation as an important social aspect of their school lives was badly impacted. Despite calls for prioritizing such learners, the study revealed that learners with cognitive disability were constructed as ‘last on the list’ among class community members in terms of their participation and active engagement in different class activities. The data were purposefully collected at a time that is unlikely to be replicated for many years to come (a global pandemic), the purpose was to give a reflection on the status allocated to such individuals during hard, unusual and/or difficult times for any future practice. The paper forwards recommendations to support educational institutions to promote active participation of learners with cognitive disabilities.

A Systematic Review of Outdoor Thermal Comfort Studies for the Urban (Re)Design of City Squares

In the upcoming period, city squares’ urban redesign will be crucial in achieving sustainable development goals. This study presents a systematic review of OTC-related studies for the urban design of city squares using the PRISMA 2020 methodology. A review included a total of 173 papers from 2001 to 2023. The results identified five study types—clusters based on four pre-defined criteria: study approach, data collection methods, time duration, and primary objectives. The clusters indicate that more than half of all studies are related to the comparison of thermal comfort and heat mitigation measures. Most of the case studies were located in one of three climate zones: temperate oceanic (Cfb) (58 studies), hot summer Mediterranean (Csa) (40 studies), or humid subtropical (Cfa) (28 studies). The most common geometry of the analyzed urban square is medium-sized, is rectangular, and has dominant axel orientation south–north. Also, based on all five clusters, several research gaps were identified, appropriate for future research: the majority of studies related to the traditionally considered climate areas, no typology of urban square geometry configuration based on OTC assessment, and the lack of a local design model for assessing and improving the thermal comfort of city squares.

A systematic review and meta-analysis of the effectiveness of social support on turnover intention in clinical nurses.

Nurse turnover has become a salient issue in healthcare system worldwide and seriously compromises patient outcomes. Social support is considered an effective contributor to alleviate nurse turnover intention (TI). However, the degree of correlation between social support and nurse TI remains elusive. This study aims to evaluate the strength of the effectiveness of social support on TI among nurses as well as its potential moderators. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. To obtained qualified studies, two researchers searched Embase, PubMed, Web of science, CINAHL, CNKI, WanFang, and Chinese Medical Journal Full Text Database from inception to January 6, 2024. Meta-analysis, publication bias, and sensitivity analysis were carried out on the included studies using CMA 3.0 software, and the moderating effect was verified through meta-analysis of variance (ANOVA). A total of 38 studies were obtained, involving 63,989 clinical nurses. The comprehensive effect size of the random effect model showed a significant medium negative correlation between social support and TI among nurses (p < 0.001). The sample size and TI measurement tools significantly moderated the correlation between social support and TI (p < 0.050). However, nurse department, gender, data collection time, and social support measurement tools did not moderate the correlation between the two variables. Social support is negatively associated with TI in nurses. Nursing administrators and the medical community should fully recognize the importance of social support for nurses and take corresponding measures to enhance it, thereby reducing TI and ensuring the stability of the nursing team.

Peptide Drug Design Using Alchemical Free Energy Calculation: An Application and Validation on Agonists of Ghrelin Receptor.

With recent large-scale applications and validations, the relative binding free energy (RBFE) calculated using alchemical free energy methods has been proven to be an accurate measure to probe the binding of small-molecule drug candidates. On the other hand, given the flexibility of peptides, it is of great interest to find out whether sufficient sampling could be achieved within the typical time scale of such calculation, and a similar level of accuracy could be reached for peptide drugs. However, the systematic evaluation of such calculations on protein-peptide systems has been less reported. Most reported studies of peptides were restricted to a limited number of data points or lacking experimental support. To demonstrate the applicability of the alchemical free energy method for protein-peptide systems in a typical real-world drug discovery project, we report an application of the thermodynamic integration (TI) method to the RBFE calculation of ghrelin receptor and its peptide agonists. Along with the calculation, the synthesis and in vitro EC50 activity of relamorelin and 17 new peptide derivatives were also reported. A cost-effective criterion to determine the data collection time was proposed for peptides in the TI simulation. The average of three TI repeats yielded a mean absolute error of 0.98 kcal/mol and Pearson's correlation coefficient (R) of 0.77 against the experimental free energy derived from the in vitro EC50 activity, showing good repeatability of the proposed method and a slightly better agreement than the results obtained from the arbitrary time frames up to 20 ns. Although it is limited by having one target and a deduced binding pose, we hope that this study can add some insights into alchemical free energy calculation of protein-peptide systems, providing theoretical assistance to the development of peptide drugs.

Multifold enhancement of quantum SNR by using an EMCCD as a photon number resolving device

Electron multiplying charge-coupled devices (EMCCDs), owing to their high quantum efficiency and spatial resolution, are widely used to study typical quantum optical phenomena and related applications. Researchers have already developed a procedure that enables one to statistically determine whether a pixel detects a single photon, based on whether its output is higher or lower than the estimated noise level. However, these techniques are feasible at extremely low photon numbers (≈0.15 mean number of photons per pixel per exposure), allowing for at most one photon per pixel. This limitation necessitates a very large number of frames required for any study. In this work, we present a method to estimate the mean rate of photons per pixel per frame for arbitrary exposure time. Subsequently, we make a statistical estimate of the number of photons (≥ 1) incident on each pixel. This allows us to effectively use the EMCCD as a photon number resolving device. This immediately augments the acceptable light levels in the experiments, leading to significant reduction in the required experimentation time. As evidence of our approach, we quantify contrast in quantum correlation exhibited by a pair of spatially entangled photons generated by a spontaneous parametric down conversion process. In comparison with conventional methods, our method realizes an enhancement in the signal-to-noise ratio (SNR) by approximately a factor of 3 for half the data collection time. This SNR can be easily enhanced by minor modifications in experimental parameters such as exposure time, etc.

Abundance of Marine Debris on Satonda Island, West Nusa Tenggara, Indonesia

Abstract Macro-sized marine debris is found not only on the coasts of densely populated islands but also on the coasts of small islands. The presence of marine debris on this small island is because there are tourist attractions that attract people’s attention or because currents around it carry it away. Therefore, this research aims to determine the abundance of marine debris on Satonda Island (a small island in the eastern part of Sumbawa Island, West Nusa Tenggara Province, Indonesia). Even though it is small, this island is an attractive tourist destination because it has a lake formed from the eruption of Mount Tambora. Marine debris data was collected using the quadrant transect method, carried out randomly along the coastline. Data collection time was carried out at high and low tides, with the parameters recorded being the amount and type of waste, size and shape of rubbish, coordinate points, transect length, and data collection time. The research results show that the marine debris on Satonda Island is diverse (393 items), with a total weight of 16,665.45 g. At high tide, it is dominated by rubber marine debris, such as shoes and sandals weighing 1,457 g (33 items), while at low tide, it is dominated by hard plastic marine debris weighing 3,972 g (147 items).

Effectiveness of a Glyceryl Trinitrate (GTN) Patch in Preventing Amputation, Improving Pain Control and Reducing the Size of Tissue Loss for a Patient With Critical Limb-Threatening Ischaemia (CLTI).

Background Foot ulcer is a common complication of poorly controlled diabetes and peripheral vascular disease (PVD). The current standard of treatment for diabetic foot ulcers includes the management of underlying risk factors, wound debridement, use of antibiotics for infection, off-loading with cast, and revascularisation surgery. The glyceryl trinitrate (GTN) patch is currently off-licence in treating PVD or diabetic foot ulcers. This study aims to evaluate the effectiveness of the GTN patch in preventing amputation, improving pain control, and reducing the size of tissue loss (ulcer/gangrene) or localised ischaemic area. Method This is a pilot study of 30 patients who were started on the GTN patchfrom February 2020 to October 2021. Inclusion criteria were patients who have critical limb-threatening ischaemia (CLTI) and with no viable options or are at high risk for revascularisation, both endovascular and open surgery. Patients who were on a GTN patch for less than six weeks at the time of data collection or had unclear outcomes were excluded. The outcomes were retrospectively collected on prevention of amputation, improvement in pain control, and reduction in tissue loss (the size of ulcer/gangrene) or localised ischaemic area with the use of a GTN patch. The binomial test was used to compare the observed outcome of the GTN patch and the expected outcome, which was assumed to be 50% in this study. Results Ninety-three per cent (93%) of the patients who had GTN patches successfully avoided amputation (p<0.0001). Eighty-four per cent (84%) of patients reported better pain control (p=0.0022) and improvement in the size of ulcer/gangrene/localised ischaemic areas (p=0.0005). Conclusion The GTN patch is effective in preventing amputation, improving pain control, and reducing the size of ulcer/gangrene/localised ischaemic areas in patients who have end-stage CLTI and no viable options or who are at high risk for revascularisation surgery.

Pathological complete response rate to anthracycline versus non−anthracycline based chemotherapy regimens in localized and regional HER2 neu positive breast cancer.

e12632 Background: Debate over the need of anthracycline as part of neoadjuvant chemotherapy in HER2-neu early breast cancer was addressed in many trials with results favoring similar outcomes with or without anthracycline. This was not adopted fully in Saudi Arabia because of concern regarding ethnic differences in response to treatment. We conducted this retrospective analysis to evaluate if there is any difference in pathological complete response rate (PCR) in patients with early HER2-neu positive breast cancer depending on neoadjuvant chemotherapy regimen. Methods: Patients with HER2-neu positive early breast cancer who were treated with neoadjuvant chemotherapy at Johns Hopkins Aramco Healthcare (JHAH) facility between the year 2018 and 2022 were all evaluated for pathological subtype, HER2-neu status and type of neoadjuvant chemotherapy administered. Pathological response status was evaluated in all patients and PCR was measured to see if there was any difference depending on the use of anthracycline (AC) or non-anthracycline (non-AC) based chemotherapy regimen. Patient demographics, tumor characteristics, clinical stage, treatments and outcomes were collected via JHAH’s oncology registry. Categorical variables are reported as frequencies and percentages. The association between chemotherapy regimen AC vs non-AC based and PCR was analyzed using Fisher Exact Test. p-value &lt;0.05 was considered statistically significant. Analyses were conducted using JMP version 15. Results: In this study 59 HER2-neu positive early breast cancer patients were identified. We examined their clinical characteristics and treatment outcomes. Median age was 57. The most prevalent histology was invasive carcinoma of no special type (79.66%), Estrogen receptor positivity was observed in 72.88% of patients, while progesterone receptor positivity was seen in 62.71% of cases. Majority of patients were alive (96.61%) at the time of data collection. There was no significant difference in clinical stage in both groups. The association between chemotherapy type and pathological response was assessed. Among patients receiving AC chemotherapy (n=29), 55.17% achieved PCR, while for patients receiving Non-AC chemotherapy (n=30), the PCR rate was 50%. However, this difference was not statistically significant (p-value = 0.8). Conclusions: In our cohort of HER-neu positive early breast cancer patients who received neoadjuvant therapy there seems to be no significant difference in PCR with AC or Non-AC based chemotherapy regimens. This is concordant with the international trends.

Rodent anogenital distance recommendations.

Measurement of rat anogenital distance (AGD) dates to at least 1912. Increased interest in endocrine disrupting chemicals and the use of AGD as a biomarker for fetal androgen effects have increased the number of studies with this endpoint in recent decades. A literature review revealed different landmarks, methods of measurement, and methods to adjust for body weight differences. AGD is often reported to hundredths of millimeters and as such, deserves precision in all these aspects. This paper presents recommendations for the measurement and analysis of rodent AGD. Literature and regulatory guidance documents that mentioned or measured rodent AGD were reviewed. Four adjustment methods were evaluated using available online data from three rat studies each with two generations of offspring. Tabulation of studies reveals that species/stocks and time of data collection, but more importantly anatomical landmarks and methods of measurement have produced a variety of results which are difficult to compare. Not all studies have adjusted for test article effects on body weight (and thus size). The four adjustment methods were fairly comparable. Recommendations are as follows. A microscopic method should be used to measure AGD of late rodent fetuses and early postnatal pups. The caudal edge of the genital tubercle and the cranial edge of the anus are clear and identifiable landmarks. The simplest adjustment is to divide individual AGDs by the cube root of animals' body weight. These recommendations will help ensure data consistency and accuracy, and facilitate meaningful comparisons across laboratories and chemical classes.

Hereditary Cancer Screening and Outcomes at an Urban Safety-Net Hospital.

Patients with hereditary cancer syndromes (HCS) have a high lifetime risk of developing cancer. Historically underserved populations have lower rates of genetic evaluation. We sought to characterize demographic factors that are associated with undergoing HCS evaluation in an urban safety-net patient population. All patients who met inclusion criteria for this study from 2016 to 2021 at an urban safety-net hospital were included in this analysis. Inclusion criteria were pathologically confirmed breast, ovarian/fallopian tube, colon, pancreatic, and prostate cancers. Patients also qualified for hereditary breast and ovarian cancers or Lynch syndrome on the basis of National Comprehensive Cancer Network guidelines. Institutional review board approval was obtained. Demographic and oncologic data were collected through retrospective chart review. Univariable and multivariable logistic regression models were constructed. Of the 637 patients included, 40% underwent genetic testing. Variables associated with receiving genetic testing on univariable analysis included patients living at the time of data collection, female sex, Latinx ethnicity, Spanish language, family history of cancer, and referral for genetic testing. Patients identifying as Black, having Medicare, having pancreatic or prostate cancer, having stage IV disease, having Eastern Cooperative Oncology Group (ECOG) prognostic score ≥1, having medium or high Charlson comorbidity index, with current or previous cigarette use, and with previous alcohol use were negatively associated with testing. On multivariable modeling, family history of cancer was positively associated with testing. Patients identifying as Black, having colon or prostate cancer, and having ECOG score of 2 had significantly lower association with genetic testing. Uptake of HCS was lower in patients identifying as Black, those with colon or prostate cancer, and those with an ECOG score of 2. Efforts to increase HCS testing in these patients will be important to advance equitable cancer care.

Workforce evaluation in the field of radiation oncology: National data from a limited-resource setting.

e13576 Background: The workforce shortage in the field of radiation oncology is a critical challenge in developing countries. This study's main objective was to evaluate the workload of radiation oncologists (RO) in Armenia. Methods: In this cross-sectional study, the adapted questionnaire from Gunasekera et al. (2021) survey was used. The study setting was the only two RO centers operating in Armenia (public and private). For data collection purposes, census sampling was done and self-administered questionnaires were distributed. The data collection time frame was 15-25 July 2023. Descriptive statistics was done to analyze and present data through portions. Results: In total, data on 16 ROs and residents was collected. The ratio of ROs per million population was 6 in 2023, in Armenia. Primary consultations in median lasted 25 minutes (range: 10-40 mins). Similarly, consults of the patients on active treatment lasted in median of 12.5 minutes (min-60 mins). The median duration of follow-up oncology care consults was 7.5 minutes per day (range: 10- 40 mins). In terms of clinic hours, physicians in public settings reported spending a median of 50 hours per week. According to the respondents, on average radiation therapy specialists allocated 50% of their working time to providing direct patient care, 35% to fulfilling administrative responsibilities, 5% to educational and teaching endeavors, and 10% to conducting scientific research. The median radiation therapy delay was 1 week. Namely, treatment delay in the non-metastatic setting was 1․19, and in the metastatic setting 1 week. By the ROs, the most common barriers to delivering cancer care were treatment high cost (68%, n=11), lack of access to imaging (18.7%, n=3) and pathological (18.7%, n=3) diagnostic procedures, and lack of physicians' time to dedicate to patients (31%, n=5). Conclusions: Our study offers some insight into the radiation oncology workload in Armenia. From this research, we conclude that Armenian healthcare is understaffed in terms of radiation oncologists and medical physicists compared to other upper-middle-income and high-income income countries. Moreover, the median daily workload of the ROs exceeds the upper limit of the amount of consults suggested by the international societies. Hence, further research is required for a detailed evaluation of the RO workforce and specific intervention development that will be able to address this issue in Armenia and other resource-limited settings.

Real-world outcomes in patients with chronic spontaneous urticaria receiving omalizumab: insights from a clinical practice survey

Objective Chronic spontaneous urticaria (CSU) is a debilitating inflammatory skin condition, often impacting quality of life. International guidelines recommend omalizumab, an anti-immunoglobulin E antibody, for second-line treatment. Our objective was to understand patient characteristics associated with prescription of omalizumab, and assess real-world outcomes in patients with CSU treated with omalizumab. Methods We analyzed data from the Adelphi Real World CSU Disease Specific Programme, a cross-sectional survey with retrospective data collection (December 2020–October 2021) from physicians and patients with CSU in the United States. Results Data from allergists (n = 45), dermatologists (n = 51), and primary care physicians (PCPs; n = 20) were included. At the time of data collection, one-third of patients were receiving omalizumab (n = 220) and 67% were eligible for but not receiving omalizumab (n = 455). Using logistic regression, the odds of receiving omalizumab were higher in patients whose entire bodies were affected by hives [odds ratio (OR) = 2.551; 95% confidence interval (CI) 1.502–4.333; p < 0.001] or with deteriorating/unstable prognoses at treatment initiation [OR = 2.219; 95% CI 1.031–4.777; p = 0.042], and lower in patients managed by PCPs [OR = 0.276; 95% CI 0.130–0.584; p < 0.001]. Estimates from an inverse probability weighted regression adjustment model indicated that patients receiving omalizumab had higher treatment satisfaction, improvements in itching, hives, angioedema, insomnia, and anxiety, and lower impact on work productivity, compared with patients not receiving omalizumab. Conclusion Around two-thirds of patients with CSU considered eligible for omalizumab were not receiving the guideline-recommended therapy. Patients receiving omalizumab had better real-world outcomes compared with patients not receiving omalizumab. Ensuring patients receive the most appropriate treatment could benefit patients with CSU.

The impacts of packaging on preferences for cannabis edibles: A discrete choice experiment

BackgroundsCannabis edibles recently gained considerable market share in the United States. The tobacco and food literatures consistently suggest that product packaging regulations are crucial to substance control, but little is known about how product packaging may impact cannabis edible use. This study aims to estimate the impacts of packaging on individual preferences for cannabis edibles and explore heterogeneities in preferences by cannabis use status and use purposes. Methods1578 adults were recruited, who lived in 18 states and Washington D.C. in the United States that legalized recreational cannabis by the time of data collection in August and September of 2022. An online discrete choice experiment was conducted to elicit individual choices between cannabis edibles with variations in five packaging attributes: package style, health claim, potency indicator, warning label position, and warning label text. Mixed logit regressions were used to assess associations between package attributes and package choices. Subsample analysis was conducted by cannabis use status (users vs. nonusers) and use purposes (medical-only, recreational-only, and dual-purpose) to detect heterogeneities. ResultsAlmost all subsamples prefer branded packages to plain packages, any health claim to no health claim, and any potency indicator to no potency indicator. Cannabis users, particularly recreational-only users and dual-purpose users, also prefer youth-appealing packages to branded packages. Warning label position and text have limited impacts on choices. Overall, package style is perceived to be the most important attribute among the five (relative importance 33.2–50.8%), followed by health claim (relative importance 22.6–30.5%). ConclusionIn the United States, adults’ preferences for cannabis edibles are associated with packaging features. Policies requiring plain package and prohibiting youth-appealing package and unsubstantiated health claims may be effective methods of cannabis control.