Margin Index Research Articles

Comarca Lagunera: Between the socioeconomic characterization and the availability of piped water

Objective: This research aims to describe with sociodemographic features the municipalities that make up theComarca Lagunera. They are located in the states of Coahuila and Durango. In Coahuila, they are: FranciscoI. Madero, Matamoros, San Pedro, Torreón and Viesca; and in Durango: Gómez Palacio, Lerdo, Mapimí andTlahualilo.Design/methodology/approach: The methodological strategy is quantitative, using descriptive statistics asanalysis technique to incorporate synthetic measures (such as indices) and proportions. The information sourcescome from different instances (CONEVAL, CONAPO and INEGI). In all cases, the level of disaggregationis municipal and the moment of information collection corresponds to 2020. The population volume of themunicipality is described, as well as its proportion with regards to the number of inhabitants in the state. Later,the results from the Gini index, marginalization index, proportion of occupied population devoted to primaryactivities, and proportion of private households without access to piped water are incorporated.Results: The municipalities that had the highest values for each of the variables are presented. In Mapimí theGini index is 0.54; in Viesca, 36.2% of the population is dedicated to primary activities; in Tlahualilo, 4.13% ofhouseholds lack piped water; and the index of marginalization in Torreón is 0.62.Limitations on study/implications: It was not possible to present the information with a higher level ofdisaggregation because the chosen variables only have data available up to the municipal level.Findings/conclusions: The use of indices allows to carry out a very useful characterization and can bestrengthened by the inclusion of specific variables that account for the municipal situation.

A systematic approach for risk assessment and mitigation of wind integrated electricity markets

A risk-based double auction mechanism with dispatchable loads is one of the most cost-efficient trading mechanisms in the modern real-time electricity markets. Risks in the system due to various uncertainties, such as line failure, generator failure, load changes and other severe contingencies causes non-systematic execution of real-time electricity markets. This paper presents a simple and systematic procedure for reducing system risks in deregulated power markets considering wind power integrations. For maximizing the considerable system social welfare and minimizing the system’s economic risk, the optimal placement and operation of wind power producers (WPP) have been suggested. The critical buses have been identified by accessing the different assessment tools e.g., Value at Risk (VaR), Conditional Value at Risk (CVaR), and locational marginal pricing (LMP) based Marginal Pricing Index (MPI). The presented approach has been evaluated and validated on modified IEEE 30-bus system.

Estimation of HbA1c for DMT2 risk prediction on the Mexican population based in Artificial Neural Networks

In this paper, the main objective is to estimate the percentage of glycosylated hemoglobin through an easily accessible computational platform to estimate the risk of generating type 2 diabetes mellitus in the Mexican population. The estimation of the computational tool is developed through an artificial neural network model, which was trained and validated according to a population sample of 1120 Mexican people between 18 and 59 years old. The model inputs were gender, age, body mass index, waist circumference, weekly food consumption, family history, and whether the person suffers from any chronic degenerative disease other than T2DM. We used the percentage of glycosylated hemoglobin as output, estimated according to a dynamic glucose model. The estimation results present a coefficient of determination of 99 %, demonstrating an acceptable performance of the neural network model. The developed platform is an aid tool for health personnel, which seeks to generate a first approximation to the glycemic status of those communities with a high marginalization index for generating disease prevention strategies.

Factors influencing the technical efficiency of diabetes care at primary care level in Mexico.

Diabetes prevalence is rising globally, especially in low- and middle-income countries like Mexico, posing challenges for healthcare systems that require efficient primary care to manage the disease. However, healthcare efficiency is influenced by factors beyond decision-makers, including socioeconomic and political conditions. This study aims to evaluate the technical efficiency of primary healthcare for diabetes patients in Mexico over a 12-year period and explore the impact of contextual variables on efficiency. A longitudinal analysis was conducted using administrative and socio-demographic data from 242 health jurisdictions between 2009 and 2020. Data envelopment analysis with bootstrapping and output orientation was used to measure the technical efficiency; health resources in infrastructure and human resources were used as inputs. As outcome, the number of patients receiving treatment for diabetes and the number of patients with controlled diabetes were considered. Machine learning algorithms were employed to analyse multiple factors affecting the provision of diabetes health services and assess heterogeneity and trends in efficiency across different health jurisdictions. The average technical efficiency in primary healthcare for diabetes patients was 0.44 (CI: 0.41-0.46) in 2009, reaching a peak of 0.71 (CI: 0.69-0.72) in 2016, and moderately declining to 0.60 (CI: 0.57-0.62) in 2020; these differences were statistically significant. The random forest analysis identified the marginalization index, primary healthcare coverage, proportion of indigenous population and demand for health services as the most influential variables in predicting efficiency levels. This research underscores the crucial need for the formulation of targeted public policies aimed at extending the scope of primary healthcare services, with a particular focus on addressing the unique challenges faced by marginalized and indigenous populations. According to our results, it is necessary that medical care management adjust to the specific demands and needs of these populations to guarantee equitable care in Mexico.

Determining of the degree of geographical marginality of settlements in Međimurje using GIS and exploratory factor analysis

The research topic is geographical marginality, and the main aim of the research is to develop a methodology for identifying, analyzing and determining marginal areas of Međimurje on the spatial level of settlement. Exploratory factor analysis was used in the research via GIS methods. The 30 selected variables were used for exploratory factor analysis. The suitability of the variables was tested using the Kaiser-Meyer-Olkin test and Bartlett’s test. Free, open source R, JASP and QGIS software were used. In the analysis, six factors were identified, by which the characteristic types of settlements in Međimurje were identified: 1) Spatial concentration and economic dynamics; 2) Demographic dynamics and population aging; 3) Education and economic diversification; 4) Availability of central functions; 5) Traditional extensive agricultural production; and 6) Stationary work contingent focused on primary activities. Based on the factor scores, a Međimurje index of marginalization of settlements (MIMaNa) was calculated. Based on this index, the degree of geographical marginality of settlements in Međimurje was determined.

Rates of pediatric emergency department visits vary according to neighborhood marginalization in Ottawa, Canada.

To determine the association between neighborhood marginalization and rates of pediatric ED visits in Ottawa, Ontario. Secondary objectives investigated if the association between neighborhood marginalization and rates varied by year, acuity, and distance to hospital. We calculated rates of pediatric ED visits per 1000 person-years for census dissemination areas within 100km of the Children's Hospital of Eastern Ontario for patients < 18years old from January 2018 through December 2020. The 2016 Ontario Marginalization Index categorized neighborhoods along quintiles of residential instability, material deprivation, ethnic concentration, and dependency. Generalized mixed-effects models determined the incidence rate ratios of pediatric ED visits for each quintile of marginalization; multivariate models were used to control for year of presentation and distance to hospital. Analysis was repeated for low versus high acuity ED visits. There were 154,146 ED visits from patients in 2055 census dissemination areas within 100km of CHEO from 2018 to 2020. After controlling for year and distance from hospital in multivariate analyses, there were higher rates of pediatric ED visits for dissemination areas with high residential instability, high material deprivation, and low ethnic concentration. These findings did not change according to visit acuity. Neighborhood residential instability and material deprivation should be considered when locating alternatives to emergency care.

Spatial and temporal variability of precipitation based on marginal and apportionment entropy disorder indices in Iran

Spatial and temporal variability of precipitation based on marginal and apportionment entropy disorder indices in Iran

Study on the Fluctuation Spillover Effect between China's Carbon Market and New Energy Market

This project analyzes the volatility spillover effect of China's carbon market and new energy market, which is crucial to effectively prevent Systematic risk, promote low-carbon transformation of the energy market and ensure stable economic growth. Firstly, based on the spillover index model, we examine the dynamic interdependence between China's carbon market and the new energy market; Secondly, in order to capture market asymmetry, this project decomposes the total volatility into good volatility and bad volatility based on the GJR-GARCH model, and further explores the asymmetric spillover effects between these two types of markets. Finally, the marginal net spillover index (MNS) method is used to explore the main sources and paths of risk transmission in China's carbon market and new energy market under the impact of major events such as the China–United States trade war, the COVID-19 and the Russia-Ukraine conflict. Therefore, this project has important practical significance in promoting the establishment of a national carbon market, low-carbon transformation of the energy system, and improving macro risk prevention measures.

Urbanization in the Mexico City Metropolitan Area 1900–2020: Urban Dynamics and Driving Factors

The variability of urban growth in the Mexico City conurbation reflects the complexity of changes and uncertainty experienced in many urban areas. The goal of this project is to identify how the urban expansion of the Mexico City conurbation reflects the changes in socioeconomic variables of the region over recent decades. The authors first spatially quantified the rate of urban growth from 1990 to 2020 using Landsat data and then identified the socioeconomic variables associated with this urban expansion. Results showed a progressive loss in vegetated land and an increase in urban land. The population’s access to roads and the marginalization index had the highest positive correlation with the observed urban growth. Although these variables were highly correlated with each other, access to roads was not found to be a variable of importance for projecting urban growth. Finally, two distinct zones of urban growth were determined using cluster statistics; the first showed no growth, which corresponded with more established, older municipalities closer to the city centre, and the second zone had significant growth, which corresponded to municipalities away from the centre, coinciding with urban decentralization and new lifestyle patterns. The identification of urban growth zones and socioeconomic variables associated with that growth will assist with effective planning, infrastructure development, and resource management.

Impact of the coronavirus disease 2019 pandemic on equity of access to hip and knee replacements: a population-level study.

The COVID-19 pandemic had innumerable impacts on healthcare delivery. In Canada, this included limitations on inpatient capacity, which resulted in an increased focus on outpatient surgery for non-emergent cases such as joint replacements. The objective of this study was to assess whether the pandemic and the shift towards outpatient surgery had an impact on access to joint replacement for marginalized patients. Data from Ontario's administrative healthcare databases were obtained for all patients undergoing an elective hip or knee replacement between January 1, 2018 and August 31, 2021. All surgeries performed before March 15, 2020 were classified as "pre-COVID," while all procedures performed after that date were classified as "post-COVID." The Ontario Marginalization Index domains were used to analyze proportion of marginalized patients undergoing surgery pre- and post-COVID. A total of 102,743 patients were included-42,812 hip replacements and 59,931 knee replacements. There was a significant shift towards outpatient surgery during the post-COVID period (1.1% of all cases pre-COVID to 13.2% post-COVID, p < 0.001). In the post-COVID cohort, there were significantly fewer patients from some marginalized groups, as well as fewer patients with certain co-morbidities, such as congestive heart failure and chronic obstructive pulmonary disease. The most important finding of this population-level database study is that, compared to before the COVID-19 pandemic, there has been a change in the profile of patients undergoing hip and knee replacements in Ontario, specifically across a range of indicators. Fewer marginalized patients are undergoing joint replacement surgery since the COVID-19 pandemic. Further monitoring of access to joint replacement surgery is required in order to ensure that surgery is provided to those who are most in need.

Assessing the Impact of Marginalization on Survival for Patients Undergoing Autologous Stem Cell Transplant in Ontario, Canada

Background Autologous hematopoietic stem cell transplants (ASCT) are potentially life-saving interventions used to treat hematologic disorders. However, it is unclear if socioeconomic disparities impact the patient benefit from ASCT. Recent evidence suggests lower rates of ASCT for patients living in rural settings and for ethnic minority groups. Few population-based studies have assessed comprehensive indices of marginalization as predictors of outcomes after ASCT. In a publicly funded healthcare setting, it is crucial to understand if various aspects of marginalization interact to ultimately impact survival for patients undergoing ASCT. Methods We performed a retrospective population-based study using administrative healthcare databases from Ontario, Canada. Patients were included if they had undergone auto-SCT for lymphoma or myeloma between 2010 and 2022. The Ontario Marginalization Index (ON-Marg), created using Canadian census data, explores four key aspects of marginalization: residential instability (referring to housing instability), material deprivation (referring to individual and community abilities to access basic material needs), dependency (referring to lack of income from employment), and ethnic concentration (referring to individuals who are recent immigrants or belonging to a visible minority group). The primary outcome was 2-year overall survival (OS) from time of transplant to death or end of the study period stratified by ON-Marg quintiles. Multivariable Cox regression analyses were used to identify baseline characteristics associated with OS. Results A total of 1886 patients underwent ASCT for lymphoma and 2842 patients underwent ASCT for myeloma. The median age of patients undergoing ASCT for lymphoma was 56 years (IQR 44-63) and 64% of patients were male. 22% of patients had high aggregated diagnosis group (ADG) comorbidity scores and 15% had a prior history of cancer. 2-year OS for patients in the fifth quintile of marginalization of the ethnic concentration index was 80.4% (95% CI 75.9-84.1%), compared to 72.3% (95% CI 67.5-76.5%) in the first quintile ( Figure 1A). This survival advantage (HR 0.71, 95% CI 0.52-0.99) persisted after adjusting for age, comorbidity burden, and distance to hospital ( Table 1). Patients who lived 150-200 km from the transplant center had a lower risk of death compared to patients who lived within 50km of the hospital (HR 0.53, 95% CI 0.30-0.94). 2-year OS was not significantly different for patients in quintile 5 of marginalization of the dependency index compared to quintile 1 (HR 1.25, 95% CI 0.93-1.67), with similarly no significant difference across residential instability or material deprivation. The median age of patients undergoing ASCT for myeloma was 61 years (IQ 55-66), and 25% of patients had high ADG comorbidity scores. OS was not significantly different across all domains of marginalization, with a 2-year OS of 88.8% (95% CI 85.8-91.2%) in quintile 1 of ethnic deprivation and 87.5% (95% CI 84.7-89.8%) in quintile 5 ( Figure 1B). Higher comorbidity scores were associated with an increased risk of death compared to lower comorbidity scores (HR 2.17, 95% CI 1.58-2.98), as shown in Table 1. Living 150-200 km from the transplant center was associated with worse OS (HR 1.74, 95% CI 1.24-2.45). Conclusion This is one of the first studies to examine the effect of marginalization on outcomes after ASCT in a publicly-funded healthcare system. For patients undergoing ASCT for lymphoma, patients in quintile 5 of ethnic concentration had improved 2-year OS compared to patients in quintile 1. One possible explanation is the healthy immigrant effect, whereby immigrant patients are healthier than their Canadian-born counterparts. Cultural factors may also have a protective role. Patients undergoing ASCT for lymphoma who lived farther from the transplant center had a lower risk of death; these patients may be more highly selected based on fitness and disease biology to be referred for transplant compared to patients who live within close proximity. For patients undergoing ASCT for myeloma, 2-year OS was not affected by ethnic concentration quintile. The decision for referral for ASCT for myeloma is not as subjective, with ASCT commonly used in the first-line setting for eligible patients regardless of distance, which likely accounts for this difference. Further work is needed to ensure that all eligible patients receive ASCT.

Age and Growth of Shotted Halibut, Eopsetta grigorjewi (Herzenstein, 1890), in the West Sea of Korea

To investigate the age and growth characteristics of shotted halibut, Eopsetta grigorjewi, in the West Sea of Korea, the samples were collected using gill nets throughout 2019. A total of 861 specimens (693 females and 168 males) were analyzed. The BW-TL relations were BW = 0.0034TL3.3278 (R2 = 0.8716) for females and BW = 0.0031TL3.3359 (R2 = 0.8860) for males. This analysis revealed that males exhibited a larger growth rate than females (p &lt; 0.05). Notably, the anterior and posterior sections of the otolith displayed an elongated oval shape, exceeding the radius of the dorsal and ventral regions. By examining the correlation between radii in four directions and total length, the highest correlation was observed between the total length (TL) and the ventral radius (R). The evaluation of the relationship between the fish total length and the otolith ventral radiusresulted in an equation of TL = 14.657R + 9.1601 (R2 =0.7081) for females and TL = 15.037R + 5.0265 (R2 = 0.6992) for males (p &lt; 0.05). The formation of annuli occurred annually, consistently in January each year, as discerned through monthly changes in marginal index (MI) values. The von Bertalanffy growth equations from the relationship between the otolith annuli radius and the total length were Lt = 83.6 (1 − exp−0.046(t+4.70)) in females (n = 693, p &lt; 0.05) and Lt = 56.8 (1 − exp−0.078(t+2.16)) in males (n = 168, p &lt; 0.05).

Copula-based conditional tail indices

Consider a multivariate distribution of (X,Y), where X is a vector of predictor variables and Y is a response variable. Results are obtained for comparing the conditional and marginal tail indices, ξY|X(x) and ξY, based on conditional distributions {FY|X(⋅|x)} and marginal distribution FY, respectively. For a multivariate distribution based on a copula, the conditional tail index can be decomposed into a product of copula-based conditional tail indices and the marginal tail index. In some applications, one may want ξY|X(x) to be non-constant, and some new copula families are derived to facilitate this.

Oral hygiene condition in orthodontic patients treated with fixed appliance

ABSTRACT: The foundation of excellent oral health is proper oral hygiene, especially in patients with fixed orthodontic appliances (devices) where regular oral hygiene may be difficult to maintain due to the device. The objective of this study was to assess oral hygiene and gingival health in patients undergoing fixed orthodontic treatment at four different time points, with repeated oral hygiene guidance provided during each visit. In this prospective study, 41 patients between the ages of 18 and 22 were divided into two groups, one of which had just begun fixed orthodontic treatment (New) and the other have passed five months from the beginning of the treatment (Old). All patients got traditional oral hygiene training with oral hygiene kit and (SENSODYNE) toothpaste. The plaque index (PI) and Marginal bleeding index (MBI) were measured. Both groups showed increase in plaque values without statistical differences. Whereas MBI showed statistical differences (P=0.010) at new group only after 4 weeks. We think that oral hygiene enforcement at each visit not enough to improve oral hygiene status and need to seek for other strategies to enhance oral health like using software reminders.

Assessing the Impact of Marginalization on Survival for Patients Undergoing Allogeneic Stem Cell Transplant in Ontario, Canada

Background Allogeneic hematopoietic stem cell transplants (allo-SCT) are potentially life-saving interventions used to treat hematologic disorders. Recent studies have shown that living in rural areas may predict worse outcomes after allo-SCT. Marginalization, a term that encompasses social and health-related factors affecting individuals, is predictive of adverse health outcomes. The Ontario Marginalization Index (ON-Marg), an administrative index using variables obtained from census data, was used to identify marginalization status (quintile 1-least marginalized; quintile 5-most marginalized) encompassing four domains: residential instability (area-level concentrations of people who experience high rates of family or housing instability), material deprivation (area-level concentrations of inability for individuals and communities to access and attain basic material needs), dependency (area-level concentrations of people who do not have income from employment), and ethnic concentration (area-level concentrations of people who are recent immigrants and/or a visible minority). In a publicly-funded healthcare context, it is important to know how marginalization impacts survival for patients undergoing allo-SCT. Methods We performed a retrospective population-based study using administrative healthcare databases from Ontario, Canada. Patients were included if they were 18 years or older at the time of allo-SCT, and had undergone allo-SCT for acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) or acute lymphoblastic leukemia (ALL) between 2010 and 2022. Patients were excluded if they were a non-Ontario resident at the time of allo-SCT and as a result lacked ON-Marg data. Patients who received allo-SCT for a different indication were excluded. The primary outcome of this study was 2-year overall survival (OS) from time of transplant to death or end of the study period, based on ON-Marg quintiles. Multivariable Cox regression analysis was used to identify baseline characteristics associated with OS, with ON-Marg as the main exposure. Results A total of 1961 patients underwent allo-SCT for AML/MDS/ALL. The median age of patients undergoing allo-SCT was 55 years (IQR 43-63), and 55% of patients were male. 40% of patients had high aggregated diagnosis group (ADG) comorbidity burden, and a majority of patients (64%) lived within 50 kilometers (km) from the transplant center, with a mean distance of 33 km in the entire study population. The distribution of patients across each quintile of marginalization was not always uniform. For ethnic concentration, 24% of patients were in quintile 5, with 17% of patients in quintile 1. For dependency, 19% of patients were in quintile 5, and 25% of patients were in quintile 1. During the follow-up period, 43% of patients (n = 842) died. 2-year OS was not significantly different across all quintiles of the ethnic concentration domain of marginalization ( Figure 1A). 2-year OS was worse (HR 1.27, 95% CI 1.02-1.57) for patients in quintile 4 compared to quintile 1 of the dependency domain of marginalization ( Figure 1B). This effect persisted in multivariable logistic regression analyses accounting for other demographic variables ( Table 1). Increased age and a higher comorbidity index were significantly associated with worse survival across all domains. Patients with ALL had worse outcomes compared to patients with AML/MDS across all domains of marginalization. There was also a trend toward patients living &amp;gt;200 km from the transplant center having an increased risk of death compared to patients living less than 50 km from the center (HR 1.24, 95% CI 1.00-1.54). Conclusion This study shows that 2-year OS after allo-SCT for AML/MDS/ALL was not affected by marginalization quintile of ethnic concentration. This is in keeping with other published data suggesting that outcomes after allo-SCT are not impacted by socioeconomic factors such as race. Patients in quintile 4 of dependency had worse outcomes than patients in quintile 1, suggesting that employment and income support are crucial to successful patient outcomes. A majority of patients who underwent allo-SCT lived in close proximity to the transplant center. Transplant outcomes in general do not appear to vary based on marginalization status, and it is therefore crucial that all patients who may benefit receive allo-SCT regardless of demographics or distance to treatment centers.

Quality of colorectal and anal cancer care delivered during the COVID pandemic.

432 Background: Reports suggest that there have been significant impacts to the provision of cancer care with delays, interruptions and cancellations across all treatment modalities as a result of the COVID pandemic which have implications for the quality of care. We evaluated the impact of the early phase of the pandemic relative to the same period in the year prior using a panel of measures spanning the six domains of quality; 8 measures focused on pandemic-specific care modifications, and 16 established measures. Methods: The cohort consisted of all new patient consultations between 02/19 to 12/19 (comparator) or 02/20 to 12/20 (COVID) at Princess Margaret Cancer Centre (PM) in Toronto, Canada, who were &gt;18 years of age and newly diagnosed with colon, rectal or anal cancer. Chart abstraction data was linked to Census and the Ontario Marginalization Index datasets to derive additional population-weighted sociodemographic variables. A summary quality score across established measures was computed and a benchmark was set using the pared mean approach representing the top 10% of performers. Associations between achieving the quality benchmark and patient characteristics were evaluated using a multivariable logistic regression model. Results: Relative to the year prior, there was a 12.2% reduction new patient consultations (294 vs 335). Significant findings for individual indicators are summarized below. Relative to English-first language patients, those whose first language was not English were 7.4 times less likely to achieve the benchmark (OR 0.13; 95% CI 0.01-0.61). Compared to those with stage I disease, patients with stage IV disease at diagnosis were 6.5 times less likely to achieve the benchmark (OR: 0.15; 95% CI 0.02-0.78). Conclusions: While overall quality of care was poorer during the early phase of the pandemic, there was a reduction in the proportion of patients treated with systemic therapy within 30 days of death. This likely reflects efforts to prioritize fitter patients with curative disease for treatment and reduce avoidable healthcare utilization. Future work should focus on understanding the downstream impacts of these differences in care quality on clinical outcomes and optimizing preparedness for future disasters.[Table: see text]

A comparative study of voltage stability NVSI Index and load margin index

With the development of new energy generation technologies, photovoltaic (PV) power generation has gained widespread application as a clean and sustainable source of electricity. However, the intermittency and variability of PV generation pose new challenges to power system secure and stable operation. The WSCC 9-bus system is used in this paper to investigate the effect of PV integration on static voltage stability in power systems. An improved voltage stability index (NVSI) considering the new energy was used to measure the voltage stability of the access point of PV plant. Compared with the P-V curve and the classic load margin index (ILM), even if the index value is less than 0, the NVSI index has still a better measure effect on voltage stability.

THU132 Pediatric Diabetes Virtual Visit Quality And Outcome Not Associated With Social Determinants Of Health

Abstract Disclosure: L. Bastien: None. C. Zuijdwijk: None. E. Goldbloom: None. R. Webster: None. E. Sucha: None. Word count: 350 Title: Pediatric diabetes virtual visit quality and outcome not associated with social determinants of health Authors: Laurence Bastien, Ellen Goldboom, Ewa Sucha, Richard Webster, IvanTerekov, Caroline Zuijdwijk Objectives: Social determinants of health (SDH) impact diabetes short- and long-term outcomes. In response to COVID-19, virtual care has become a solution to ensure ongoing healthcare access. However, socially disadvantaged groups have less access and skills related to technology, leading to potential increases in health disparities. We aimed to determine the association between SDH and physician-perceived virtual visit quality and outcome in pediatric diabetes patients. Methods: Retrospective chart review of patients who attended a scheduled virtual diabetes follow-up visit at a pediatric tertiary care centre from December 1, 2020 to March 31, 2021. During this time, a quality improvement study required physicians to rate the quality (same/better or worse than in-person) and outcome (successfully replaced in-person visit or not) of each virtual visit. These data, along with patient characteristics, were extracted from the electronic health record. Institut national de santé public du Québec Material and Social Deprivation Index and the Ontario Marginalization Index (Ethnic Concentration) were used to determine SDH based on postal code. Statistical analysis tested for an association between deprivation index quintiles and virtual visit quality and outcome. Results: Data were obtained for 447 patients with mean age 12.7±3.8 years; 47.7% female; 93.1% type 1 diabetes; and mean glucose management indicator 7.96±1.41%. During the study period, 17.9% visits were evaluated as worse than in person, 13.1% visits were unsuccessful in replacing an in-person visit, and 20.7% were rated worse or unsuccessful. The odds of having a worse or unsuccessful visit were not different in those with the highest vs. lowest degree of material deprivation (odds ratio [OR] 1.59, 95% confidence interval [CI] 0.53, 4.76), social deprivation (OR 1.36, 95%CI 0.48, 3.83), or ethnic concentration (OR 0.30, 95%CI 0.30, 1.77). Conclusion: In our pediatric diabetes population, virtual visit quality and outcome were not associated with material or social deprivation. These results show promising success in equitable access and delivery of high quality virtual diabetes care for patients regardless of socioeconomic status, which is important in the context of the current pandemic and sustainable widespread integration of virtual care. Further studies are required to assess this association in other populations. Presentation: Thursday, June 15, 2023

Optimal allocation of distributed generation in active distribution power network considering HELM-based stability index

Traditionally, assessment of static voltage stability for distribution power networks with distributed generation (DG) utilizes the continuous power flow (CPF) method by calculating load margin index (LMI) at various load levels, which suffers from slow calculation speed and low accuracy when power flow calculation becomes ill-conditioned. To overcome this issue, this paper presents a novel holomorphic embedding load flow method (HELM)-based approach that calculates voltage stability indices for various types of nodes in a distribution network. Different orders of sensitivity information are calculated using the HELM method, and the criteria for assessing voltage stability are derived, which are used as constraints to optimize the location and capacity of DG. Such formulation of the optimization problem does not need to calculate the maximum load margin using CPF. Moreover, it can be effectively solved using the Genetic Algorithm and easily adaptable to various operating conditions of DG, which improve the calculation speed of the stability index. The effectiveness of the proposed approach is verified on IEEE 33-node and IEEE 69-node distribution power network models. Results show that considering the HELM VSI, the location, and capacity of DG in the distribution network can be better optimized. For the IEEE 33-node model, the total cost is reduced by approximately 2.33%, the network loss is reduced by 1.2%, and the HELM voltage stability criteria index is increased by about 4.23%; while for the IEEE 69-node system, the total cost is reduced by about 2.98%.

Quantitative Frequency Security Assessment of Modern Power System Considering All the Three Indicators in Primary Frequency Response

The primary frequency response scale is deteriorating in the modern power system due to the high penetration of different power devices. Frequency security assessments are essential for the operation or stability-checking of the power system. Firstly, this paper establishes the Unified Transfer Function Structure (UTFS) of power systems with highly penetrated wind turbines. Based on the UTFS, this paper analyzes the three indicators of the primary frequency responses. Secondly, to better assess the security of the frequency, the secondary frequency drop (SFD) is avoided, with the frequency response parameters of the wind turbines calculated. Moreover, considering all three indicators of the primary frequency response, this paper proposes a frequency security margin index (FSMI). The FSMI divides the system stability margin into three levels, quantitively and linearly representing the frequency response capability of different power devices. Finally, to show the effectiveness and practicability of the FSMI, this paper establishes a simulation model with high wind energy penetration, including four machines and four zones in DigSILENT. Based on the FSMI, the frequency stability margins in different typical operating scenarios are divided into three zones: “Absolut secure”, “Secure” and “Relative secure”. The FSMI also shows the dominant frequency stability problem and the risk of system frequency instability for each zone. Considering the checking principles, the frequency stability margin is equivalently expanded by calculating the energy storage’s minimum frequency response capacity.