Time Gap Research Articles

Retreatment of Multiple Myeloma with Previously Refractory Drugs.

As patients with relapsed/refractory multiple myeloma (RRMM) continue to live longer, they might get exposed to most available drugs and drug classes during the disease course. For such late line RRMM or among patients without access to novel therapies, retreatment with a drug that the disease had previously been refractory to might be one option. In this retrospective study, we describe 315 patients with RRMM at our institution that were retreated with a drug that the disease had been previously refractory to. We found an overall response rate of 56.2%, and a median progression free survival (PFS) of 11 months with retreatment. Patients with a longer time on initial therapy with the index drug (>28.4 months) had a superior PFS with retreatment (median PFS 16.9 months vs 8.1 months, p<0.001). Similarly, patients with a longer time gap between the initial line of therapy with index drug and retreatment with index drug (>46.1 months) had a better PFS with retreatment (28.2 vs 8.9 months, p=0.016). In conclusion, retreatment with a previously refractory drug is a viable therapeutic option for RRMM, with the most significant benefit derived in disease demonstrating sensitivity to initial drug exposure, and among those with a longer gap between initial drug exposure and retreatment.

Excess mortality and life-years lost in people diagnosed with depression: A 20-year population-based cohort study of 126,573 depressed individuals followed for 1,139,073 persons-years

Depression is associated with premature mortality, but evidence is mainly derived from Western countries. Very limited research has evaluated shortened lifespan in depression using life-years-lost (LYLs), a recently developed mortality metric taking into account the illness onset for life expectancy estimation. Temporal trends of differential mortality gap are understudied. This population-based cohort study, which utilized a territory-wide medical-record database of public inpatient and outpatient healthcare services in Hong Kong, evaluated the extent of premature mortality in 126,573 individuals with depression (persons-years=1,139,073) between January 2002 and December 2021 regarding the standardized mortality ratio (SMR) and excess LYLs. Trends in annual SMRs over 20 years were assessed by joinpoint analyses. The results showed that individuals with depression exhibited significantly higher all-cause (SMR=1.84 [95% CI=1.82–1.88]), natural-cause (1.69 [1.66–1.72]), and unnatural-cause (5.24 [4.97–5.51]) mortality rates than the general population. Suicide-specific SMR was markedly elevated (7.92 [7.47–8.38]), particularly in the 15–34 year-olds (12.75 [10.87–14.79]). Respiratory diseases, cardiovascular diseases and cancers accounted for the majority of deaths. Excess LYLs extended to men (5.67 years, 95% CI = 5.45–5.90) and women (4.06 years, 95% CI = 3.89–4.23). Overall and natural-cause mortality rates improved over time, but unnatural-cause and suicide-related mortality gaps persisted. Taken together, this study indicates that depression is associated with increased premature mortality and reduced lifespan in a predominantly Chinese population, mainly attributed to natural causes. Relative suicide-specific mortality is substantially elevated, especially among young people. The pronounced mortality gap underscores an urgent need for effective interventions targeting improved physical health and suicide risk reduction in individuals with depression.

Impact of solar-wind turbulence on a planetary bow shock. A global 3D simulation

The interaction of the solar-wind plasma with a magnetized planet generates a bow-shaped shock ahead of the wind. Over recent decades, near-Earth spacecraft observations have provided insights into the physics of the bow shock, and the findings suggest that solar-wind intrinsic turbulence influences the bow shock dynamics. On the other hand, theoretical studies, primarily based on global numerical simulations, have not yet investigated the global three-dimensional (3D) interaction between a turbulent solar wind and a planetary magnetosphere. This paper addresses this gap for the first time by presenting an investigation of the global dynamics of this interaction that provides new perspectives on the underlying physical processes. We use the newly developed numerical code Menura to examine how the turbulent nature of the solar wind influences the 3D structure and dynamics of magnetized planetary environments, such as those of Mercury, Earth, and magnetized Earth-like exoplanets. We used the hybrid particle-in-cell (PIC) code Menura to conduct 3D simulations of the turbulent solar wind and its interaction with an Earth-like magnetized planet through global numerical simulations of the magnetosphere and its surroundings. Menura runs in parallel on graphics processing units (GPUs), enabling efficient and self-consistent modeling of turbulence. By comparison with a case in which the solar wind is laminar, we show that solar-wind turbulence globally influences the shape and dynamics of the bow shock, the magnetosheath structures, and the ion foreshock dynamics. Also, a turbulent solar wind disrupts the coherence of foreshock fluctuations, induces large fluctuations on the quasi-perpendicular surface of the bow shock, facilitates the formation of bubble-like structures near the nose of the bow shock, and modifies the properties of the magnetosheath region. The turbulent nature of the solar wind impacts the 3D shape and dynamics of the bow shock, magnetosheath, and ion foreshock region. This influence should be taken into account when studying solar-wind--planet interactions in both observations and simulations. We discuss the relevance of our findings for current and future missions launched into the heliosphere.

Washback in English Education:

Testing is a crucial aspect of language teaching and learning, as it helps determine a learner’s proficiency. This study aims to identify the effects of ninth-grade students’ final examinations on their learning and to suggest procedures for both teachers and students to mitigate negative washback. Data were collected using a test and a questionnaire, and the results were analyzed quantitatively. The findings showed that students significantly improved their scores from the pretest to the post-test (final test). However, they received low scores on the final test due to the time gap between the preparation course and the final test, leading to a loss of motivation and intention. Additionally, most students agreed that thorough preparation before the final examination helped them better understand the test techniques and format. The researcher compared the students’ pretest and post-test results with their final test scores, revealing considerable improvement during the preparation course but negative washback in the final test. Based on these results, the study provides suggestions for further research and implications for language educators in Libya and beyond..

НОРМАТИВНО-ПРАВОВЕ ЗАБЕЗПЕЧЕННЯ ОБЛІКУ ТА КОНТРОЛЮ РОЗРАХУНКІВ З ПОСТАЧАЛЬНИКАМИ ТА ПІДРЯДНИКАМИ

Annotation. The organization of accounting for accounts payable at any enterprise is quite important, because it contributes to the reliability, correctness and transparency of the display of data from settlement transactions with suppliers and contractors. The article discusses the peculiarities of accounting for payments with suppliers and contractors. The purpose of the article is to clarify the economic meaning of the terms "supplier", "contractor", "creditor debt" and to reveal their role in the country's economy. It was determined that accounts payable is the organization's debt to other legal entities and individuals, which appears as a result of a time gap between the provision of goods and materials, the receipt of goods and services, the provision of services, the receipt of a preliminary cash advance and the date of their actual payment and fulfillment of obligations to third parties. The current legal acts regulating the accounting of settlements with suppliers and contractors were analyzed; the theoretical aspects of their accounting and analytical support are systematized, as well as the documentation of transactions with these counterparties is displayed. Ways and directions for further improvement of accounts payable management are proposed. It was revealed that with the help of keeping analytical documentation, accounts payable will be improved, namely, control of the timeliness of payments with each supplier or contractor for the delivered values ​​will be improved, and as a result, this will have a positive impact on the company's financial condition. It was identified that the main methods of managing payables are: control over the ratio of payables; assessment of accounts payable; analysis of settlements with creditors, their registration.

AI in Hidradenitis Suppurativa: Expert Evaluation of Patient-Facing Information.

This study investigates the accuracy of Artificial Intelligence (AI) chatbots, ChatGPT and Bard, in providing information on Hidradenitis Suppurativa (HS), aiming to explore their potential in assisting HS patients by offering insights into symptoms, thus possibly reducing the diagnostic and treatment time gap. Using questions formulated with the help of HS patient associations, both ChatGPT and Bard were assessed. Responses to these questions were evaluated by 18hS experts. ChatGPT's responses were considered accurate in 86% of cases, significantly outperforming Bard, which only achieved 14% accuracy. Despite the general efficacy of ChatGPT in providing relevant information across a range of HS-related queries, both AI systems showed limitations in offering adequate advice on treatments. The study identifies a significant difference in the performance of the two AIs, emphasizing the need for improvement in AI-driven medical advice, particularly regarding treatment options. The study highlights the potential of AI chatbots, particularly ChatGPT, in supporting HS patients by improving symptom understanding and potentially reducing the time to diagnosis and treatment. AI chatbots, while promising, cannot yet substitute for professional medical diagnosis and treatment, indicating the importance of enhancing AI capabilities for more accurate and reliable medical information dissemination.

In-situ zircon and cassiterite LA-ICP-MS geochronology and implications for granite-hosted Sn deposit models and exploration: Insights from the Cameroon Line

Abstract Tin mineralization of significant economic importance occurs across the continental portion of the Cameroon Line (CL). Tin deposits therein occur as both primary and secondary (residual and alluvial) ore. Though the temporal and, by inference, the genetic link between Sn mineralization and the host granite had long been modeled and widely accepted worldwide, in the CL, however, the age of the granite hosting cassiterite is poorly constrained, preventing a robust assessment of the temporal and genetic relationship between the Sn mineralization and its host rock. Here, we present in-situ zircon and cassiterite laser ablation inductively coupled mass spectrometry (LA-ICP-MS) U-Pb data in order not only to constrain the age of the granitic rock hosting the primary Sn ore but also to bracket the time frame of Sn mineralization, with respect to the magmatic-hydrothermal evolution of the parental magma of the host granite. Zircon from two greisen-altered, cassiterite-bearing granite samples yield overlapping and concordant ages of 64.21 ± 0.59 Ma and 65.46 ± 0.95 Ma, respectively, which are also overlapping with regional granite magmatism in the CL (ca. 65–30 Ma). On the other hand, cassiterite, which is spatially associated with the Paleocene zircon, yields Lower Eocene ages of 54.99 ± 0.35 Ma and 56.08 ± 0.46 Ma. The ca. 10 Myr time gap between zircon and cassiterite suggests that the granite is a passive host not genetically related to the Sn mineralization, which may be linked to a younger, concealed intrusion of ca. 55 Ma. This finding contrasts with the most widely accepted petrogenetic model of tin granite, according to which Sn mineralization and the host granite are cogenetic.

Advancing Marine Surveillance: A Hybrid Approach of Physics Infused Neural Network for Enhanced Vessel Tracking Using Automatic Identification System Data

In the domain of maritime surveillance, the continuous tracking and monitoring of vessels are imperative for the early detection of potential threats. The Automatic Identification System (AIS) database, which collects vessel movement data over time, including timestamps and other motion details, plays a crucial role in real-time maritime monitoring. However, it frequently exhibits irregular intervals of data collection and intricate, intersecting trajectories, underscoring the importance of analyzing long-term temporal patterns for effective vessel tracking. While Kalman Filters and other physics-based models have been employed to tackle these issues, their effectiveness is limited by their inability to capture long-term dependence and non-linearity in the historical data. This paper introduces a novel approach that leverages Long Short-Term Memory (LSTM), a type of recurrent neural network, renowned for its proficiency in recognizing patterns over extended periods. Recognizing the strengths and limitations of the LSTM model, we propose a hybrid machine-learning algorithm that integrates LSTM with a physics-based model. This combination harnesses the physical laws governing vessel movements alongside data driven pattern mining, thereby enhancing the predictive accuracy of vessel locations. To assess the performance of standalone and hybrid models, various scenarios with different levels of complexity are generated. Furthermore, to simulate real-world data loss conditions often encountered in maritime tracking, temporal data gaps are randomly introduced into the scenarios. The competing approaches are then evaluated using both with time gap and without time gap conditions. Our results show that, although the LSTM model performs better than the physics-based model, the hybrid model consistently outperforms both standalone models across all scenarios. Furthermore, while data gaps negatively impact the accuracy of all models, the performance reduction is minimal for the physics-infused model. In summary, this study not only demonstrates the potential of combining data-driven and physics-based approaches but also sets a new benchmark for maritime vessel tracking.

A gender gap in the manuscript review time of Turkish national journals?

A gender gap in the manuscript review time of Turkish national journals?

A novel tapered quartz tuning fork-based laser spectroscopy sensing

A novel tapered quartz tuning fork (QTF) was designed to enhance its stress magnitude and charge distribution in QTF-based laser spectroscopy, which had a low resonant frequency of 7.83 kHz and a wide fork gap for long energy accumulation time and easy optical alignment. Compared to the reported rectangular QTF, this tapered QTF transfers the maximum stress position from the root to the middle to improve its sensing performance. Furthermore, the unique design eliminates the 90° right angles typically found in standard QTFs, which often lead to undesired “webs” and “facets” during the etching process. This design minimizes performance degradation by reducing the presence of residual unexpected materials. QTF-based laser spectroscopy of quartz-enhanced photoacoustic spectroscopy (QEPAS) and light-induced thermoelastic spectroscopy (LITES) were adopted to verify its performance. Compared with the widely used standard QTF, the total surface charge of the tapered QTF was improved 5.08 times and 5.69 times in QEPAS and LITES simulations, respectively. Experiments revealed that this tapered QTF-based QEPAS sensor had a 3.02 times improvement in signal-to-noise-ratio (SNR) compared to the standard QTF-based system. Adding an acoustic micro-resonator to this tapered QTF-based QEPAS sensor improved the signal level by 97.20 times. The minimum detection limit (MDL) for acetylene (C2H2) detection was determined to be 16.45 ppbv. In the LITES technique, compared to the standard QTF, this tapered QTF-based sensor had a 3.60 times improvement in SNR. The MDL for C2H2 detection was determined to be 146.39 ppbv.

A NIR light activated self‐reporting carbon dots assembly as phototheranostics for tumor photodynamic therapy

AbstractPhotodynamic therapy (PDT) has emerged as a promising protocol for cancer therapy. However, real‐time monitoring of PDT progress and accurate determination of the optimal treatment timing remain challenges. In this work, we selected carbon dots (CDs) and new indocyanine green (IR820) as building units to fabricate a smart nanotheranostics (CDs‐IR820 assembly) with the characteristics of controlled release and real‐time imaging to solve the time gap between diagnosis and treatment. The fabricated CDs‐IR820 assembly locked the photosensitivity of the CDs and could degrade under 750 nm laser irradiation to achieve controlled release of the CDs, thus used for cell imaging and producing single oxygen under the white light. Besides, the released CDs could migrate from the mitochondria to the nucleus during the PDT process, indicating the cell activity, which facilitated the regulation of treatment parameters to achieve the precise PDT for cancer.

Two-stage group-sequential designs with delayed responses – what is the point of applying corresponding methods?

BackgroundIn group-sequential designs, it is typically assumed that there is no time gap between patient enrollment and outcome measurement in clinical trials. However, in practice, there is usually a lag between the two time points. This can affect the statistical analysis of the data, especially in trials with interim analyses. One approach to address delayed responses has been introduced by Hampson and Jennison (J R Stat Soc Ser B Stat Methodol 75:3-54, 2013), who proposed the use of error-spending stopping boundaries for patient enrollment, followed by critical values to reject the null hypothesis if the stopping boundaries are crossed beforehand. Regarding the choice of a trial design, it is important to consider the efficiency of trial designs, e.g. in terms of the probability of trial success (power) and required resources (sample size and time).MethodsThis article aims to shed more light on the performance comparison of group sequential clinical trial designs that account for delayed responses and designs that do not. Suitable performance measures are described and designs are evaluated using the R package rpact. By doing so, we provide insight into global performance measures, discuss the applicability of conditional performance characteristics, and finally whether performance gain justifies the use of complex trial designs that incorporate delayed responses.ResultsWe investigated how the delayed response group sequential test (DR-GSD) design proposed by Hampson and Jennison (J R Stat Soc Ser B Stat Methodol 75:3-54, 2013) can be extended to include nonbinding lower recruitment stopping boundaries, illustrating that their original design framework can accommodate both binding and nonbinding rules when additional constraints are imposed. Our findings indicate that the performance enhancements from methods incorporating delayed responses heavily rely on the sample size at interim and the volume of data in the pipeline, with overall performance gains being limited.ConclusionThis research extends existing literature on group-sequential designs by offering insights into differences in performance. We conclude that, given the overall marginal differences, discussions regarding appropriate trial designs can pivot towards practical considerations of operational feasibility.

Effect of Pre-Analytical Line Settings on Artefactually Elevated Anion Gap Results

Abstract Introduction When the core lab at a large tertiary care hospital introduced an automated laboratory system from a major manufacturer, the automated line aliquoted patient serum into open cups for all chemistry testing. It was subsequently discovered that if sample testing was delayed, electrolyte abnormalities could be introduced from evaporation, resulting in an increased anion gap (presumably due to a loss of bicarbonate with evaporation of carbon dioxide). To address this issue, the core lab changed the sample processing protocol in April 2023 from an open cup system to testing primary tubes on the analyzers. The purpose of this study was to evaluate the impact of switching to a primary tube testing system on artefactually elevated anion gap results. Methods Equivalent ten-week blocks of anion gap, creatinine and sample turnaround time (from receipt on the line to analyzer perform time) results from pre- to post-primary tube conversion were collected from the laboratory information system. Data from weekend testing and from repeat samples from the same patient were excluded. Data was cleaned and analyzed using R. Results Multivariable linear regression showed that when adjusted for the turnaround time and creatinine result, the open cup system was significantly associated (p&amp;lt;0.0001) with a 0.95 [95% CI 0.69-1.21] increase in anion gap. There was a positive relationship between turnaround time and anion gap, with a slope of 0.017 (i.e., a 0.017 increase in anion gap per minute delay; p&amp;lt;0.0001). Overall, the proportion of abnormal results (defined as anion gap &amp;gt;=16) decreased from 26% to 10% after switching to a primary tube testing system. Furthermore, there was an association between the times of day in which the lines were overloaded with specimens, turnaround time, and an increase in abnormal anion gap results. Overall, the mean anion gap decreased by 1 with a turnaround time of one hour and 2 after two hours by switching to the primary tube system. This trend in anion gap was largely driven by a corresponding decrease in bicarbonate. Sodium and chloride levels did not show any relationship with turnaround time. Conclusions Using an open cup system for electrolyte testing can cause spuriously elevated anion gap levels, especially with testing delays. Switching to a primary tube testing system largely resolved the issue; however, the data still showed a weakly positive relationship between turnaround time and anion gap for the primary tube testing system, so additional work is needed to identify potential causes of this relationship.

ANALYSING THE RATE OF RECURRENCE AND LEPTOMENINGEAL DISEASE IN POSTERIOR FOSSA BRAIN METASTASES FOLLOWING POSTOPERATIVE RADIOTHERAPY- SINGLE CENTRE EXPERIENCE

Abstract AIMS The management of posterior fossa brain metastases is complex and necessitates a multidisciplinary approach involving neurosurgeons and oncologists. Post-operative radiotherapy (PORT) to surgical cavity has demonstrated positive oncologic outcomes as well as preserving cognitive function when compared to conventional whole brain radiation therapy. However, larger post-operative volumes in posterior fossa and greater target volume uncertainty due to presence of pseudomeningocele may result in an increased risk of local recurrence (LR) and leptomeningeal disease (LMD). The aim of this retrospective single centre study was to determine the rates of LR and LMD in patients with posterior fossa metastases who underwent PORT to surgical cavity. METHOD Retrospective analysis of data of patient who underwent PORT in between 2017-2022, for posterior fossa brain metastases at our centre. Clinical, imaging and radiotherapy data was collected from electronic medical records. Statistical analysis was performed using SPSS Statistics version 28.0.1. RESULTS We identified 42 patients meeting the study criteria. The median age of the patients was 60.5 years. 71.4% of patients were females, while 28.6% were males. 52.4% of patients had pseudomeningocoele on their radiotherapy planning scans. The median time gap between the date of surgery and initiation of radiotherapy was 34.5 days. 20 out of 42 (47.6%) patients had local recurrence of a posterior fossa brain metastasis and 7 out of 42 (16.7%) patients developed LMD. Out of 7 patients with LMD, 4 patients had pseudomeningocoele present at the time of PORT. The timing of radiotherapy after surgery (≤4 weeks or &amp;gt;4 weeks) showed no statistically significant impact on LR (p-value: 0.413, log-rank test). CONCLUSION The risk of LR remains high despite PORT. This study highlights the challenges in management of posterior fossa metastases. High LR and LMD rates underscore the need for improved treatment strategies.

Overtaking risk assessment based on extreme value theory and intelligent network information

In order to evaluate the overtaking risk level of intelligent connected vehicles when providing different connected information, and to make up for the neglect of driver factors in traditional risk assessment and the inadequate evaluation of complex traffic scenarios by a single traffic conflict indicator, this paper introduces the Block maxima (BM) and Peak over threshold (POT) methods to fit the extreme value distribution for two conflict scenarios involved in overtaking events (following vehicle conflict and frontal vehicle conflict), so as to evaluate the risk of following vehicle accidents and frontal collision accidents during overtaking. In each conflict scenario, a non-stationary extreme value model considering driver factors and a binary extreme value model considering different traffic conflict indicators are constructed, and the model is verified by the overtaking test data of intelligent connected vehicles in a two-way two-lane vehicle. Overtaking events were extracted from the original test data and conflict indicators were calculated: including the collision time GAP with the front vehicle at the beginning of the overtaking event, the collision time TTC_t1 with the oncoming vehicle, the deceleration DRAC, and the collision time TTC with the oncoming vehicle and the headway time THW with the front vehicle at the end of the overtaking event. The probability of the event with a negative time conflict indicator or DRAC greater than MADR was used to characterize the degree of collision risk. The results show that in the following vehicle conflict scenario, the binary extreme value model constructed with different conflict indicators has different error results, among which the binary extreme value model constructed with THW&amp;DRAC has the most accurate evaluation result (standard error MAE = 0.00028); in the front vehicle conflict scenario, the binary extreme value model constructed with TTC&amp;DRAC has the most accurate evaluation result ( MAE = 0.006 ). In different conflict scenarios, the non- stationary extreme value model considering the driver factor significantly improves the risk assessment accuracy compared with the model without considering the driver factor (small AIC and BIC values). In addition, different intelligent network information (real-time distance, overtaking advice, speed advice) brings different overtaking risks, and when the intelligent network information is speed advice, the vehicle's overtaking risk is the lowest. Therefore, the non- stationary extreme value model and binary extreme value model considering driver factors proposed in this paper can effectively evaluate driving risks through traffic conflict indicators. Secondly, the experimental data of intelligent networked vehicles show that the extreme value theory model proposed in this paper can accurately evaluate the overtaking risk level of intelligent networked vehicles when providing different network information.

State of Charge Estimation for Lithium-Ion Batteries Using Optimized Model Based on Optimal HPPC Conditions Created Using Taguchi Method and Multi-Objective Optimization

This study proposes a comprehensive methodology for accurate State of Charge (SOC) estimation in lithium-ion batteries by optimizing equivalent circuit model (ECM) parameters under varying temperature conditions using the Taguchi method. Analysis of Variance (ANOVA) was employed to evaluate the influence of these parameters on ECM accuracy. Experiments were conducted at −10 °C, 25 °C, and 40 °C to evaluate the effects of pulse time gap, discharge pulse time, and C-rate on SOC estimation accuracy. A genetic algorithm-based multi-objective optimization technique was employed to minimize RMSE in the extended Kalman filter (EKF) SOC estimation process. The results showed that temperature significantly impacts SOC prediction, with deviations most pronounced at low (−10 °C) and high (40 °C) temperatures. When assessments are conducted for different SOC levels (SOC90, SOC50, SOC30), the key results highlight the substantial influence of pulse time gap and discharge pulse time on model accuracy. Also, it was observed that there is a significant reduction in RMSE, indicating improved performance under optimized conditions. The findings are particularly relevant for real-time applications, such as electric vehicles, where accurate SOC estimation is crucial for battery management.

Assessment of Constraints and Suggestion Insights from Beneficiaries of Centrally Sponsored Agricultural Schemes: A study of PKVY, PMKSY and SHC in Vidarbha Region of Maharashtra, India

The present study focused on assessing the constraints faced by the beneficiaries of centrally sponsored agricultural schemes namely Paramparagat Krishi Vikas Yojana (PKVY), Pradhan Mantri Krishi Sinchayee Yojana (PMKSY), and the Soil Health Card Scheme (SHC) and invited suggestions from them to overcome the constraints. For the proposed study, 60 beneficiary farmers were selected from Amravati districts and 60 beneficiary farmers were selected from Buldhana districts in Vidarbha region of Maharashtra for each scheme. Thus, for the three schemes, a total of 360 beneficiary farmers were selected. In the case of PKVY beneficiaries, the major constraints faced were lack of proper marketing channel for organic produce, lack of sustainability in the reduction of cost of organic cultivation and reduced productivity of organic farm produce even after conversion period. Whereas, in the case of constraint faced by PMKSY beneficiaries, the first constraint faced by the beneficiary was longer time for getting the subsidy credited, followed by lack of increase in the sources of irrigation and load shedding of electricity. In the case SHC beneficiaries, the major constraint faced were long time gap between soil sample collection and issuing SHC, difficulty to comprehend the information and follow the recommendations provided in SHC and lack of effective training and demonstrations provided to farmers about soil health. In the case of PKVY beneficiaries, majority of them (74.17%) gave the suggestion for establishment of proper marketing channel for organic produce, followed by 34.17 per cent of them suggested the strengthening of farmer groups and developing them into Farmer Producer Organizations (FPOs). Whereas in the case of PMKSY beneficiaries, 84.17 per cent of them suggested to ensure timely crediting of subsidies, followed by expansion of irrigation infrastructure through the construction of water harvesting structures such as check dams, farm ponds, tanks and bore wells (59.16%). In the case of SHC beneficiaries, majority of them (85.83%) gave the suggestion to speed up the process of issuing Soil Health Cards and 71.66 per cent suggested for training programs and field level demonstrations focused on soil health and the practical application of SHC recommendations to improve farmers' knowledge and skills.

Comparison of 4-week versus 8-week dietitian-led FODMAP diet group education sessions in tertiary care clinical practice for irritable bowel syndrome: A service evaluation.

The implementation of the fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet for irritable bowel syndrome (IBS) can be effectively delivered by dietitians in group settings. The initial FODMAP restriction phase is recommended to be followed for 4 weeks; however, limited efficacy data exist for 4-week FODMAP restriction in group education clinical practice. We aimed to compare 4-week versus 8-week FODMAP group treatment pathways on clinical outcomes using a prospective service evaluation design of IBS patients attending FODMAP restriction (baseline) and reintroduction (follow-up) group sessions (between 2015 and 2019). Clinical outcomes included global symptom question (GSQ) measuring satisfactory relief, gastrointestinal symptom rating scale (GSRS), stool frequency (SF), stool consistency using Bristol stool form scale (BSFS), diet acceptability, patient satisfaction with group sessions and dietary adherence. Logistic regression was used to test for differences in treatment effects when clinical outcomes were compared between groups. Patients (n = 284) included were aged 18 to 86 years (mean ± SD [standard deviation], 44.6 ± 15.5), 80% female, and were split into 4-week (41%, 117/284) versus 8-week (59%, 167/284) pathways with no differences in baseline characteristics. Mean ± SD time gap between baseline and follow-up was 4.6 ± 0.9 weeks in the 4-week pathway and 9.6 ± 3.3 weeks in the 8-week pathway. When groups were compared at follow-up, no statistical differences were observed in any measures (GSQ, GSRS, SF, BSFS, dietary adherence, diet acceptability and patient satisfaction). A 4-week dietitian-led group FODMAP treatment pathway is as clinically effective and maintains patient acceptability when compared to 8-weeks and should be considered as part of routine clinical practice.

A-337 The Utility of Urinary Human Chorionic Gonadotropin Testing in the Emergency Department

Abstract Background Human chorionic gonadotropin (hCG) levels are measured in both urine and blood as an indication of suspected pregnancy, and assessment of progress of conception. It is also measured in the investigation of patients presenting with acute abdomen and suspected of ectopic or molar pregnancy. This study reviewed the utility of urine pregnancy test in a large university teaching hospital. Methods Results of all urinary hCG tests (using hCG Combo Pregnancy kit, MEDLINE, IL) performed as point of care in the emergency department during the year 2023 were obtained. Corresponding plasma hcG levels performed (Total β-HCG Alinity immunoassay, Abbott Diagnostics, IL) were also obtained. Analysis of hCG testing outcomes were assessed. Results A total of 2848 urinary hCG tests were performed during the study period. The majority 2113 (74.2%) of samples were negative for hCG whereas 835 samples (29.3) were positive. Among the positive hCG urine samples, 401 patients (48%) had plasma hCG requested and performed. Plasma hCG values ranged from &amp;lt; 2.4 (26.5) to 219,462.5 mIU/mL (median 16,872.35 mIU/mL). One plasma sample with corresponding positive urinary hCG result had plasma hCG level &amp;lt;2.4 mIU/mL which is below the detection limit of the assay suggesting a false positive urinary hCG result. Among the 13 patients with serial plasma hCG values, only one patient exhibited doubling (48 hours) hCG values when less than 13,000 mIU/mL. One patient had a declining serial hCG plasma values suggesting failing conception. The remaining patients with consecutive plasma hCG values cannot be assessed as either the time gap was excessive or hCG values were markedly elevated (&amp;gt; 30,000 mIU/mL). Conclusions Although the utility of urinary hCG testing in the emergency department appeared appropriate, unnecessary repeat analysis with appropriate plasma request represented 3.2%. An electronic test request duplicate notification may help resolve this unnecessary repeat.

The Trauma of Emigration: Language Change (B. Stanišić, V. Čolić, A. Mahmutović, A. Božičević, N. Kulidžan)

The article is devoted to the problem of choosing a language among modern writers – immigrants from the countries of the former Yugoslavia and it presents four options for «life in another language». A number of authors continue to write in their native language, their works, however, are published, more often in translation into the language of the country of residence, the second category of authors are those who have completely changed their native language to the language of the country of residence, and still others begin their literary career in a non-native, acquired language – the language of the country residence, the last group, the smallest, are authors who began their literary career in a non-native language and, at the same time, not in the language of the country of residence. Loss of home, severance of ties with the homeland, isolation from «one’s own» culture and language are perhaps the most common motives in the texts of migrant authors. Creativity becomes for them a way to reflect on the events of the past (the trauma of war, loss of home) and the present (attempts to adapt to new conditions), which can be interpreted in terms of the therapeutic function of writing as an attempt to overcome trauma. The new space and time gap create a distance that allows one to turn to the inexpressible experience and try to narrativize it. Choosing a non-native language can also create (additional) distance, a mask.