High Rate Of Change Research Articles

Sleep/wake rhythm modifications in the Italian population during SARS-CoV2 pandemic: a web-based cross-sectional survey.

The study aims to investigate in a representative sample of the Italian population whether the SARS-CoV2 pandemic and the subsequent home isolation had repercussion on the daily sleep/wake cycling and habits. A web-based cross-sectional survey consisted of various multiple-choice questions concerning demographic characteristics, sleep habits, and sleep-related problems was broadcast through mainstream social-media. Individuals were randomly allowed to participate from April 29th to May 17th, namely 50 days after the lockdown imposition and the day before its abrogation. 58.84% of respondents experienced a change in their sleep habits. 71% of those whose sleep changed showed a delayed sleep pattern. Overall, a two-fold risk of delayed sleep pattern without any change in total sleep time emerged during the investigation period. Females emerged almost 2 times more likely to modify their sleep habits than males. Youths were also more likely to experience modifications than old people, who conversely appeared protected. A significant improvement in daytime sleepiness occurred during the home isolation which additionally correlated with delayed bedtime and less sleep time. A high rate of change in sleep habits, especially among youths and females, occurred in Italian population during the home isolation to limit the SARS-CoV2 pandemic. Moreover, self-reported daytime sleepiness decreased in severity.

Radical hysterectomy practice patterns for early-stage cervical cancer: a cross-sectional survey of gynecologic oncologists

Objectives: In this study, we evaluated current practice patterns related to radical hysterectomies for early stage cervical cancer and how they have changed since new literature was released in 2018. Methods: This study was a cross-sectional survey of current gynecologic oncologists. The primary outcome assessed was performance of primarily open radical hysterectomies for FIGO Stages IA1, IA2, IB1, and IB2 cervical carcinoma. A secondary outcome assessed was a change in surgical practice. Multivariable logistic regression analyses were completed to assess for associations of demographic and surgical experience predictors. Additional descriptive analyses were performed to evaluate reasons physicians would consider a minimally invasive radical hysterectomy, specific changes made to surgical technique, concerns regarding the 2018 NEJM trials, and beliefs about the role of future clinical trials. Results: Of 1309 SGO members invited to participate, 249 responded (19.0%) and 218 (87.6%) complete responses were analyzed. Performance of primarily open radical hysterectomies was reported in 61.6%, 80.2%, and 88.9% of Stage IA2, IB1, and IB2 cancers, respectively. For Stage IA2 cancer, the age group of 40-49 was associated with 73% lower odds of performing primarily open hysterectomies compared to the reference group of ages 30-39 (OR 0.27, p=0.01). Female gender was associated with greater odds of performing primarily open radical hysterectomies (OR 2.03, p=0.04 for IA2, OR 3.25, p=0.01 for IB1). For Stage IB2 cancers, no demographic or surgical experience factors were statistically associated with performance of open surgery. Change from minimally invasive to open surgery was reported in 52.3%, 68.4%, and 71.1% of Stage IA2, IB1, and IB2 cancers, respectively. Change in minimally invasive technique was reported in 5.5%, 6.42%, and 5.96% of Stage IA2, IB1, and IB2 cancers, respectively. For Stage IA2 cancer, each decrease of 1 year in practice (i.e. since fellowship graduation) was associated with 10% greater odds of changing surgical route or technique. Time since fellowship graduation was associated with 23% greater odds of a change for Stage IB2 cancers. For Stage IB1 cancer, each increase in case volume by 1 radical hysterectomy annually was associated with 6% lower odds of changing surgical route or technique. Most (66.7%) physicians reported they would consider a minimally invasive hysterectomy for one or more reasons. The majority of respondents (84.7%) reported believing there is a role for additional studies evaluating the topic of route of surgery for early stage cervical cancer. Download : Download high-res image (239KB) Download : Download full-size image Conclusions: Despite emerging research demonstrating worse oncologic outcomes for minimally invasive radical hysterectomies in early stage cervical cancer, our research shows that current practices remain heterogeneous. In this study, female surgeons had greater odds of performing open surgery compared to their male colleagues for Stage IA2 and IB1 cancers. The odds for performing open surgery were lower in middle age surgeons compared to younger physicians. More recent fellowship graduation was associated with greater odds of change, indicating that more senior surgeons reported being less likely to change practice. Many individuals reported feeling there is room for additional randomized clinical trials to inform evidence-based practices. Given the high rates of practice change reported, there will also be a role for future epidemiologic studies to evaluate oncologic outcomes in the current practice environment.

Multiple paths to morphological diversification during the origin of amniotes.

Early terrestrial vertebrates (amniotes) provide a classic example of diversification following adaptive zone invasion. The initial terrestrialization of vertebrates was closely followed by dietary diversification, as evidenced by a proliferation of craniomandibular and dental adaptations. However, morphological evolution of early amniotes has received limited study, in analyses with restricted taxonomic scope, leaving substantial questions about the dynamics of this important terrestrial radiation. We use novel analyses of discrete characters to quantify variation in evolutionary rates and constraints during diversification of the amniote feeding apparatus. We find evidence for an early burst, comprising high rates of anatomical change that decelerated through time, giving way to a background of saturated morphological evolution. Subsequent expansions of phenotypic diversity were not associated with increased evolutionary rates. Instead, variation in the mode of evolution became important, with groups representing independent origins of herbivory evolving distinctive, group-specific morphologies and thereby exploring novel character-state spaces. Our findings indicate the importance of plant-animal interactions in structuring the earliest radiation of amniotes and demonstrate the importance of variation in modes of phenotypic divergence during a major evolutionary radiation.

High rates of therapeutic changes in patients with psoriatic arthritis receiving treatment with disease-modifying antirheumatic drugs: A cross-sectional study

Objectives To characterize treatment patterns for patients with psoriatic arthritis (PsA) currently receiving any disease-modifying antirheumatic drug (DMARD). Methods The Strategy for Psoriatic Arthritis In Germany (SPAIG) study was a retrospective observational study conducted from May to November 2017 at 46 rheumatology centers. Current and previous treatment data were collected at a single visit from adult patients with PsA and psoriasis who received DMARD treatment for ≥6 of the previous 12 months. The primary outcome was the proportion of patients receiving a biologic DMARD (bDMARD). Multinomial logistic regression analysis was used to evaluate associations between current characteristics and initial choice of therapy. Results Mean age of the 316 patients was 55.1 years and mean PsA disease duration was 9.9 years. PsA activity was generally comparable across treatment groups. In this cohort, 57.3% of patients were currently treated with bDMARDs, 37.7% with conventional synthetic DMARDs, and 4.4% with targeted synthetic DMARDs. Almost half (48.4%) of patients reported DMARD modifications in the previous 12 months. Specific comorbidities and patient/disease characteristics were associated with initial therapy. Conclusion DMARD treatment of PsA is frequently modified, suggesting the need for more effective therapies and assessment tools.

A Rare Case of Ileocecal Intussusception in an Adult

Question: A 91-year-old woman with ulcerative colitis in clinical and endoscopic remission on mesalazine presented with a 2-day history of severe right lower abdominal pain, nausea, and vomiting. Physical examination showed abdominal distention and tenderness in the right side of the abdomen. A computed tomography scan of the abdomen showed dilated small bowel loops and a typical target sign (Figure A, arrow), suggesting colonic intussusception and a lead point intussusception with invaginated mesenteric fat and vessels (Figure B, arrow). Colonoscopy revealed the invagination of the terminal ileum (intussusceptum) into the ascending colon (Figure C) and localized marked edematous swelling of the ileocecal valve as the lead point. The ileocecal region showed no mucosal changes suggestive of ischemia. What is the most likely diagnosis? How should the patient be managed? See the Gastroenterology website (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and images in GI. The swollen ileocecal valve was punctured with an endoscopic needle knife, causing clear fluid to leak out (Figure D, E). The submucosa was confirmed to be highly edematous and filled with fluid. The swollen mucosa then became completely deflated, and the intussusception was immediately resolved (Figure F, Video). Histologic findings of the biopsy specimens revealed no pathological findings other than edema in the submucosa and the lamina propria. No malignant cells were found in the examined fluid. There was no evidence of a causal factor of intussusception, such as bowel ischemia, inflammation, diverticulum, lesions that were either benign or malignant, or any other pathological trigger. The cause of the localized edema of the ileocecal valve was unknown. Based on these findings, the diagnosis of adult idiopathic ileocecal intussusception was made. The patient completely recovered and was discharged without procedure-related complications. No recurrence of intussusception occurred over a 3-year follow-up period. Adult intussusception represents 5% of all cases of intussusception and accounts for only 1%–5% of bowel obstructions in adults, and most cases involve identifiable etiologies such as benign or malignant tumors.1Azar T. Berger D.L. Adult intussusception.Ann Surg. 1997; 226: 134-138Crossref PubMed Scopus (677) Google Scholar In contrast, idiopathic intussusception is frequent in children, but rare in adults. Owing to the high rate of malignancy or other structural change causing adult intussusception, a surgical approach has been served as the treatment of choice.1Azar T. Berger D.L. Adult intussusception.Ann Surg. 1997; 226: 134-138Crossref PubMed Scopus (677) Google Scholar,2Lindor R.A. Bellolio M.F. Sadosty A.T. et al.Adult intussusception: presentation, management, and outcomes of 148 patients.J Emerg Med. 2012; 43: 1-6Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar However, intestinal resection surgery may be overly invasive when the intussusception does not involve neoplastic lesions.3Imasato M. Kim H.M. Higashi S. et al.Laparoscopic surgery for idiopathic adult intussusception successfully reduced by colonoscopy.J Anus Rectum Colon. 2019; 3: 49-52Crossref PubMed Google Scholar If endoscopic reduction is possible, as in our case, emergency surgery can be avoided and appropriate treatment can be performed. Therefore, a nonoperative approach with endoscopic reduction should be attempted when the lead point is thought to be benign or idiopathic. https://www.gastrojournal.org/cms/asset/f81955b8-fb7a-47f7-b5b2-a48da942c0eb/mmc1.mp4Loading ... Download .mp4 (45.01 MB) Help with .mp4 files Supplementary Video

Survey on what COVID-19 pandemic changed in pediatric urology.

We aimed to conduct a survey to see how the patient management of pediatric urologists has changed during the COVID-19 pandemic in daily practice and its compliance with the guidelines that aim to minimize the harm to the patient and healthcare professionals. A questionnaire was prepared to be asked to physicians via Microsoft Forms dealing with pediatric urology for this purpose, and a link was shared in social media groups of doctors managing pediatric urology patients. A total of 58 (46 males and 12 females) doctors participated in the survey. Participants stated that they made a very high rate of change in their clinical routine; the most preferred approach for the prevention in the operating room was reducing the number of the working staff, and the second most frequent was performing a preoperative COVID-19 screening. Elective surgeries (ie, inguinoscrotal pathologies) were delayed by the majority. However, the majority of the surgeons did not delay surgeries for ureteropelvic junction obstruction or urinary stones. Ninety-five percent of the participants stated that the number of patients was decreased in the outpatient clinics, which was mainly due to the hospital and government policies. The most used method to communicate with patients during the pandemic was phone calls, and there was a 52% increase in the WhatsApp messenger application before the pandemic. Our survey provided us with an opinion about how our colleagues' lives changed during the pandemic and showed us the importance of a well-established telemedicine system.

PV/Wind-Integrated Low-Inertia System Frequency Control: PSO-Optimized Fractional-Order PI-Based SMES Approach

A paradigm shift in power engineering transforms conventional fossil fuel-based power systems gradually into more sustainable and environmentally friendly systems due to more renewable energy source (RES) integration. However, the control structure of high-level RES integrated system becomes complex, and the total system inertia is reduced due to the removal of conventional synchronous generators. Thus, such a system poses serious frequency instabilities due to the high rate of change of frequency (RoCoF). To handle this frequency instability issue, this work proposes an optimized fractional-order proportional integral (FOPI) controller-based superconducting magnetic energy storage (SMES) approach. The proposed FOPI-based SMES technique to support virtual inertia is superior to and more robust than the conventional technique. The FOPI parameters are optimized using the particle swarm optimization (PSO) technique. The SMES is modeled and integrated into the optimally designed FOPI to support the virtual inertia of the system. Fluctuating RESs are considered to show the effectiveness of the proposed approach. Extensive time-domain simulations were carried out in MATLAB Simulink with different load and generation mismatch levels. Systems with different inertia levels were simulated to guarantee the frequency stability of the system with the proposed FOPI-based SMES control technique. Several performance indices, such as overshoot, undershoot, and settling time, were considered in the analysis.

Performance of Asbestos Enclosure Ventilation: Laboratory Evaluation of Complex Configuration.

The aim of the study was to find out good practices for effective air distribution inside a complex shaped asbestos enclosure and for control of pressure differences between the enclosure and the surroundings. In addition, sufficient pressure difference for asbestos containment was tested. The effect of air distribution was studied in laboratory conditions by constructing an L-shaped asbestos enclosure and connecting it to a negative pressure unit. The efficiency of six different ventilation configurations was compared using a tracer decay method and the local air change indexes as the performance indicator. The sufficient negative pressure for containment was assessed by simulating person traffic to and from the enclosure and recording the pressure difference continuously. The effect of a pressure controller unit in maintaining the target pressure difference was also tested by simulating filter loadings of the negative pressure unit causing changes in the air flow rate. The results showed that high nominal air change rates alone do not guarantee good air distribution. Effective air distribution within an asbestos enclosure can be arranged by locating additional air supply openings far away from the air exhaustion point, using recirculation air with a pressure controller, or extending the exhaust location to the poorly ventilated areas. A pressure difference of at least −10 Pa is recommended to ensure a sufficient margin of safety in practical situations.

A retrospective analysis of changes in lymphocyte levels in patients with multiple sclerosis during and after Tecfidera® treatment.

BackgroundThere are currently no best practice recommendations for lymphocyte subset monitoring for patients with multiple sclerosis (pwMS) on disease-modifying therapies including Tecfidera® (dimethyl fumarate, DMF). However, there have been several cases of pwMS on DMF without severe lymphopenia who had high CD4:CD8 T cell ratios and went on to develop progressive multifocal leukoencephalopathy.ObjectiveOur objective was to characterize the changes in immune profile during and after DMF treatment in pwMS.MethodsA retrospective analysis of longitudinal data from 299 pwMS who have been treated with DMF at the Fraser Health Multiple Sclerosis Clinic in British Columbia, Canada. The blood test results were taken from January 1, 2013 to April 1, 2020.ResultsOur results suggest that CD8+ T cells had the highest proportional decrease compared to other lymphocyte subset populations and overall lymphocyte count in response to DMF treatment. CD56+ Natural Killer cells were similarly decreased in response to DMF treatment. CD4:CD8 T cell ratio was the measurement that had the highest rate of change in response to DMF initiation and discontinuation.ConclusionCD8+ T cell count and CD4:CD8 T cell ratio may be a more sensitive measurement of the immune landscape of patients with MS on DMF.

The Impact of Sudden Commencements on Ground Magnetic Field Variability: Immediate and Delayed Consequences

AbstractWe examine how Sudden Commencements (SCs) and Storm Sudden Commencements (SSCs) influence the occurrence of high rates of change of the magnetic field (R) as a function of geomagnetic latitude. These rapid, high amplitude variations in the ground‐level geomagnetic field pose a significant risk to ground infrastructure, such as power networks, as the drivers of geomagnetically induced currents. We find that rates of change of ∼30 nT min−1 at near‐equatorial stations are up to 700 times more likely in an SC than in any random interval. This factor decreases with geomagnetic latitude such that rates of change around 30 nT min−1 are only up to 10 times more likely by 65°. At equatorial latitudes we find that 25% of all R in excess of 50 nT min−1 occurs during SCs. This percentage also decreases with geomagnetic latitude, reaching ≤1% by 55°. However, the time period from the SC to 3 days afterward accounts for ≥90% of geomagnetic field fluctuations over 50 nT min−1, up to ∼60° latitude. Above 60°, other phenomena such as isolated substorms account for the majority of large R. Furthermore, the elevated rates of change observed during and after SCs are solely due to those classified as SSCs. These results show that SSCs are the predominant risk events for large R at mid and low latitudes, but that the risk from the SC itself decreases with latitude.

Conceptualization of the efficiency model of the institution of social protection of population (Part 2)

Today we are faced with the coronavirus (COVID-19) pandemic, which directly or indirectly has affected all countries and regions of the world. The state policy of all countries is aimed at containing the spread of the virus and meeting the basic needs of people in forced isolation. This situation has once again proved the importance of the institution of social protection of population (hereinafter—ISPP) and the need to ensure the efficiency of its functioning. The high growth rates of social changes, in turn, cause a certain lagging behind the process of their scientific comprehension — piling up issues unresolved by means of sociological science. Thus, the current system for assessing the ISPP functioning in terms of the actually obtained result against the normative/planned one, as well as the system for estimating economic costs, do not meet the challenges that modern science and management face. Many problems related to assessment of the ISPP functioning remain unresolved. In particular, the entire range of difficulties faced by consumers of social services has not been fully disclosed; the issues of achieving a consistently high satisfaction of vulnerable population groups with various quantitative and qualitative parameters of service provision are acute. The article discusses the scientific concepts and approaches to assessing effectiveness of the social protection of population used in domestic and foreign social science and practice. It outlines the authors' model for assessing effectiveness of the ISPP functioning on the example of the Republic of Tatarstan, which is based on an integrated approach that consists in fixing the temporal and spatial aspects of assessing effectiveness of the ISPP functioning.

Proteomic and Biological Analysis of an In Vitro Human Endothelial System in Response to Drug Anaphylaxis.

Anaphylaxis is a life-threatening systemic hypersensitivity reaction. During anaphylaxis, mediator release by effector cells causes endothelial barrier breakdown, increasing vascular permeability and leakage of fluids, which may lead to tissue edema. Although endothelial cells (ECs) are key players in this context, scant attention has been paid to the molecular analysis of the vascular system, and further analyses of this cell type are necessary, especially in humans. The protein expression pattern of human microvascular ECs was analyzed in response to sera from anaphylactic patients (EC-anaphylaxis) and sera from non-allergic subjects (EC-control) after 2 hours of contact. Firstly, a differential quantitative proteomic analysis of the protein extracts was performed by mass spectrometry using an isobaric labeling method. Second, the coordinated behavior of the identified proteins was analyzed using systems biology analysis (SBA). The proteome of the EC-anaphylaxis system showed 7,707 proteins, of which 1,069 were found to be significantly altered between the EC-control and EC-anaphylaxis groups (p-value < 0.05). Among them, a subproteome of 47 proteins presented a high rate of change (|ΔZq| ≥ 3). This panel offers an endothelial snapshot of the anaphylactic reaction. Those proteins with the highest individual changes in abundance were hemoglobin subunits and structural support proteins. The interacting network analysis of this altered subproteome revealed that the coagulation and complement systems are the main biological processes altered in the EC-anaphylactic system. The comprehensive SBA resulted in 5,512 functional subcategories (biological processes), 57 of which were significantly altered between EC-control and EC-anaphylaxis. The complement system, once again, was observed as the main process altered in the EC system created with serum from anaphylactic patients. Findings of the current study further our understanding of the underlying pathophysiological mechanisms operating in anaphylactic reactions. New target proteins and relevant signaling pathways operating in the in vitro endothelial-serum system have been identified. Interestingly, our results offer a protein overview of the micro-EC-anaphylaxis environment. The relevance of the coagulation, fibrinolytic, contact and complement systems in human anaphylaxis is described. Additionally, the untargeted high-throughput analysis used here is a novel approach that reveals new pathways in the study of the endothelial niche in anaphylaxis.

Improving Indoor Air Quality in Classrooms via Wind-Induced Natural Ventilation

Student performance in classrooms is related to the indoor environmental quality. High air change rates are necessary to secure an acceptable level of indoor air quality and provide fresh air, which require large amounts of energy and technical installations. Mostly, mechanically supplied air is partially mixed with the return air. In warm climates, the capacity for natural ventilation is not fully exploited in modern buildings. During periods of acceptable outdoor temperatures, buildings need to adapt and employ available free renewable resources, such as wind. In this context, the building form, orientation, and envelope openings are crucial to enable an increased air change rate, user satisfaction, and energy savings. Owing to the difficulty of providing cross-ventilation in buildings with double-loaded corridors, single-sided ventilation is the most common approach. This study investigates the methods to improve the wind-driven air exchange of classrooms in warm climates, where naturally ventilated corridors help increase air movement. This study examines the potential of a set of alternatives within the context of a generic model regarding the pressure distribution, thermal sensation, air velocity, and air change rate. The study suggests that no single opening scenario can be applied to all façades at any time. Each façade requires special treatment. Decisions on natural ventilation need to be made during the early design stages for each façade. It was found that with the aid of low-tech modifications, remarkable increases in air change rates, in some cases up to 14.5 times that of the typical single-sided ventilation case, could be achieved.

Dynamics of humoral response to coronavirus antigens among employees of a designated COVID‑19 hospital: an observational study.

During the COVID‑19 pandemic studies on workplace safety of hospital staff taking care of patients with this disease are a high priority. We decided to analyze the results of opportunistic screening for anti-SARS‑CoV-2 antibodies among employees of a designated COVID-19 center. The aim of the study was to investigate whether potential exposition to SARS‑CoV-2 antigens is reflected in the results of serological studies. Every employee who performed at least a single test between April 21 and July 20, 2020 was included in the study. The tests assessed the levels of immunoglobulin (Ig) G and IgM+IgA. Employees working in direct contact with COVID‑19 patients and those participating in aerosol‑generating procedures were identified. The results of 2455 tests taken by 1572 employees were analyzed. A total of 357 participants (22.7%) had at least 1 positive or equivocal result during the study period. Linear mixed models revealed gradual increases in mean levels of both IgG and IgM+IgA antibodies among employees with all negative results. The rate of change was higher among persons who had direct contact with COVID‑19 patients and the highest rate of change was observed among individuals participating in aerosol‑generating procedures. We detected developing humoral immune response to a new set of coronavirus antigens among the study group. It is possible that employees of designated COVID‑19 centers are regularly exposed to noninfectious doses of SARS‑CoV-2 or its antigens.

Establishing Continuous App Improvement by Considering Heterogenous Data Sources

&lt;p class="0abstract"&gt;&lt;span lang="EN-US"&gt;Mobile apps have penetrated the market and are being used every­where. Companies developing apps face increasing challenges such as short time to market or demand for high quality. Furthermore, the success of an app also depends on how users perceive its quality. Feedback provided by users influences other potential users and provides new opportunities for identifying features. Consequently, it is a valuable source of input for app developers with respect to product improvements. One form is textual feedback. This kind of feedback is usually distributed across various data sources. Therefore, it must be captured from these sources and put into one single pool of data before it can be analyzed. The analysis must take into account the peculiarities of the short release cycles and high change rate of features for mobile apps. In this article, we present User Echo Service (UES), which was built to address heterogeneous data sources. The aim of UES is to allow product managers to be able to be always up to date with the latest feedback data. Therefore, we have created an extensible architecture aimed at supporting different data sources and present the feedback collection scheduling system. This forms the prerequisite for subsequent analyses of the collected data. We discuss our solution and provide ideas for future development.&lt;/span&gt;&lt;/p&gt;

The impact of spatial variation of inertial response and flexible inter-area allocation of fast frequency response on power system scheduling

The impact of the spatial variation of inertial response and fast frequency services has not been fully investigated in power system scheduling models incorporating constraints on network security. This paper demonstrates the importance of acknowledging the variety of local frequency dynamics in the aftermath of a generation loss. It proposes a novel scheduling methodology that enables the system security in all areas of the system thus preventing potential tripping of distributed generation triggered by locally-measured high rates of change of frequency. The proposed methodology highlights the positive contribution to local frequency dynamics from an HVDC link, whose capacity is optimally dispatched to allocate power flow and fast-frequency services. The novel power system scheduling model is applied to analyze a typical 2030 GB low-carbon scenario. Results show that there are changes in the commitment decisions compared to the solution obtained with a one-area formulation when local security is taken into account. These changes translate into additional operational cost.

PSMA-PET/CT Registry for Recurrent Prostate Cancer (PREP): Initial findings from a single center.

5064 Background: Several lesion-targeted therapies exist for locally recurrent or limited stage metastatic prostate cancer (PCa) post-radiotherapy (RT) and radical prostatectomy (RP). However, detection of disease sites is limited using conventional imaging (CI) including computed tomography (CT) and bone scan. Prostate specific membrane antigen (PSMA) targeting PET radiopharmaceuticals like [18F]DCFPyL may help detect disease not seen on CI. Our objective was to assess the ability of PSMA targeted PET/CT to detect sites of disease recurrence and impact on patient management. Methods: This multi-center prospective registry study included six Ontario centers. Eligible patients in 1 of 7 clinical cohorts (Table) were identified and approved by Cancer Care Ontario (CCO) to have restaging with PSMA targeted PET/CT. Referring physicians were asked to complete a form indicating whether a change in management strategy would occur based on the PET/CT results. At 6 months post-PET/CT, actual patient management will be confirmed via provincial registries. These interim results are from a single center. Results: 253 patients were enrolled and had a PSMA targeted PET/CT. At baseline, median age was 71 years (range 50-102 years) and median PSA was 2.7 ng/mL (range 0.04-134.0 ng/mL). The majority of patients (n=59; 23.3%) were in cohort 2 (biochemical failure post-RP). In patients with negative CI, PSMA targeted PET/CT detected disease sites in 68.5% (170/248), resulting in a change in management for 67.8% (137/202) overall and 72.1% and 64.3% post-RT and post-RP, respectively. Conclusions: PSMA targeted PET/CT detected occult lesions on CI in the majority of patients enrolled, leading to a high rate of change in management. Our institutional results are in keeping with preliminary results reported for the provincial cohort. Clinical trial information: NCT03718260. [Table: see text]

Effect of Different Binder Proportions on Properties of Silicon-based Anode Materials

With the development of lithium-ion battery technology, silicon anode is deemed as an ideal next-generation anode materials by virtue of its extremely high specific capacity. Nevertheless, higher requirements are raised for the properties of the binder owing to the high volume change rate of silicon anode during charging and discharging and the thickening of SEI film. In respect of the binders such as polyacrylic acid (PAA), polyvinyl alcohol (PVA), sodium alginate (Alginate), sodium carboxymethylcellulose (CMC) in possession of large-scale application value, this paper studies the effects of different binders and mixed binders with different ratios on the properties of silicon anode materials. As a result, it is suggested that the binders acquired when PAA:PVA=9:1 can render it possible for the electrode to be provided with better charge-discharge cyclic performance.

Effect of Different Binder Proportions on Properties of Silicon-based Anode Materials

With the development of lithium-ion battery technology, silicon anode is deemed as an ideal next-generation anode materials by virtue of its extremely high specific capacity. Nevertheless, higher requirements are raised for the properties of the binder owing to the high volume change rate of silicon anode during charging and discharging and the thickening of SEI film. In respect of the binders such as polyacrylic acid (PAA), polyvinyl alcohol (PVA), sodium alginate (Alginate), sodium carboxymethylcellulose (CMC) in possession of large-scale application value, this paper studies the effects of different binders and mixed binders with different ratios on the properties of silicon anode materials. As a result, it is suggested that the binders acquired when PAA:PVA=9:1 can render it possible for the electrode to be provided with better charge-discharge cyclic performance.

Perfluoroalkyl and polyfluoroalkyl substances and body size and composition trajectories in midlife women: the study of women's health across the nation 1999-2018.

Background/Objectives:Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been suggested as obesogens but epidemiologic evidence is limited. We examined associations of serum PFAS concentrations with longitudinal trajectories of weight, waist circumference (WC), fat mass and proportion fat in midlife women.Subjects/Methods:This study included 1,381 midlife women, with a total of 15,000 repeated measures from the multi-racial/ethnic Study of Women’s Health Across the Nation between 1999 and 2018. The average follow-up was 14.9 (range: 0–18.6) years. Body size (objectively measured weight and WC) and body composition from dual-energy X-ray absorptiometry were assessed at near-annual visits. Linear mixed models with piecewise linear splines were utilized to model non-linear trajectories of body size and composition.Results:After multivariable adjustment, PFAS concentrations were positively associated with weight, WC, fat mass, and proportion fat at baseline and during follow-up. Comparing the highest to the lowest tertiles of PFAS concentrations, adjusted geometric mean weight was 73.9 kg vs. 69.6 kg for PFOS (P<0.0001), and 74.0 vs. 69.4 kg for linear PFOA (P<0.0001) at baseline. Women with the highest tertile of PFOS had an annual increase rate of 0.33% (95% CI: 0.27%, 0.40%) in weight, compared to the lowest tertile with 0.10% (95% CI: 0.04%, 0.17%) (P<0.0001). PFOS was also significantly related to higher increase rates in WC (difference=0.12% per year, P=0.002) and fat mass (difference=0.25% per year, P=0.0002). EtFOSAA and MeFOSAA showed similar effects to PFOS. Although PFHxS was not related to body size or fat at baseline, PFHxS was significantly associated with accelerated increases in weight (P<0.0001), WC (P=0.003), fat mass (P<0.0001), and proportion fat (P=0.0009). No significant results were found for PFNA.Conclusions:Certain PFAS were positively associated with greater body size and body fat, and higher rates of change over time. PFAS may be an underappreciated contributing factor to obesity risk.