Number Of Contacts Research Articles

In silico evaluation of favipiravir-associated potential new drugs against polymerase enzyme of SARS-CoV-2

Millions of lives have been lost to the deadly SARS-CoV-2 virus. Vaccines and antiviral drugs are essential scientific tools in combating viral infections. This in silico study focused on the RdRp inhibitor favipiravir, exploring new analogs by substituting the fluorine atom on the pyrazine ring with both homocyclic and heterocyclic moieties. Initially, ADME and toxicity properties were assessed using SwissADME and ProTox-II online tools. Ligands L6 and L7 exhibited high bioavailability and drug-likeness compared to favipiravir. Subsequently, all new analogs were docked into the RdRp active site using AutoDock Vina, demonstrating high affinity compared to favipiravir. Based on optimal ADMET profiles and docking scores, ligands L4, L6, and L7 underwent 200 ns MDS using the CHAARM 36 force field in NAMD software to validate docking results. Various trajectory analyses, including RMSD, RMSF, histograms, total number of contacts, and ligand properties, were conducted to gain insights into the interaction patterns between ligands and RdRp. All protein-ligand complexes exhibited greater stability than favipiravir throughout simulations period. This theoretical study suggests that ligands L6 and L7 could serve as lead candidates for RdRp inhibition. Cell-Based SARS-CoV-2 RdRp Activity Assay is recommended to validate these in silico findings.

Computational Study of Molecular Mechanism for the Involvement of Human Serum Albumin in the Renin–Angiotensin–Aldosterone System

Human serum albumin (HSA) is an endogenous inhibitor of angiotensin I-converting enzyme (ACE) and, thus, plays a key role in the renin–angiotensin–aldosterone system (RAAS). However, little is known about the mechanism of interaction between these proteins, and the structure of the HSA–ACE complex has not yet been obtained experimentally. The purpose of the presented work is to apply computer modeling methods to study the interaction of HSA with ACE in order to obtain preliminary details about the mechanism of their interaction. Ten possible HSA–ACE complexes were obtained by the procedure of macromolecular docking. Based on the number of steric and polar contacts between the proteins, three leading complexes were selected, the stabilities of which were then tested by molecular dynamics (MD) simulation. Based on the results of MD simulation, the two most probable conformations of the HSA–ACE complex were selected. The analysis of these conformations revealed that the processes of oxidation of the thiol group of Cys34 of HSA and the binding of albumin to ACE can reciprocally affect each other. Known point mutations in the albumin molecules Glu82Lys, Arg114Gly, Glu505Lys, Glu565Lys and Lys573Glu can also affect the interaction with ACE. According to the result of MD simulation, the known ACE mutations, albeit associated with various diseases, do not affect the HSA–ACE interaction. A comparative analysis was performed of the resulting HSA–ACE complexes with those obtained by AlphaFold 3 as well as with the crystal structure of the HSA and the neonatal Fc receptor (FcRn) complex. It was found that domains DI and DIII of albumin are involved in binding both ACE and FcRn. The obtained results of molecular modeling outline the direction for further study of the mechanisms of HSA–ACE interaction in vitro. Information about these mechanisms will help in the design and improvement of pharmacotherapy aimed at modulation of the physiological activity of ACE.

Is adoption of modern dairy farming technologies interrelated? A case of smallholder dairy farmers in Meru county, Kenya

Attempts have been made to promote the adoption of modern dairy farming technologies (MDFT). However, the adoption of these technologies largely remains underutilized. This study aimed to analyze the determinants of the adoption of MDFTs in Meru County. Using purposive and proportionate sampling techniques from 355 smallholder dairy farmers in Meru County, Kenya, this study analyzed the factors that facilitate or impede the adoption of MDFTs. We use a Multivariate probit (MVP) to evaluate adoption decisions by dairy farm households facing multiple MDFTs. The results reveal a significant correlation among the eight MDFTs suggesting that modern technologies are interrelated. The MVP model results indicate that household income, education level, number of extension contacts, access to credit, farmer group membership, farming experience and livestock monetary value had positive effect on the adoption of MDFTs. Education level and extension contacts had a positive influence on the adoption of fodder establishment and preservation technologies. Farming experience in dairy farming had a positive effect on the adoption of well-structured and clean sleeping areas, and the growth of Rhodes grass. Household income had a positive effect on the growth of Rhodes grass and feed mixture. This work illustrates a need for a policy implication and insight into a need for the county government and private milk processing companies to increase extension frequency to enhance the adoption of MDFTs. Additionally, there is a need to increase access to affordable credit, this should be considered by the government by establishing strengthening a smallholder low-interest and efficient local credit schemes and institutions.

Trends in Contacts Made by Immigrants to the National Domestic Violence Hotline, Before and During the COVID-19 Pandemic.

Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic. This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as a barrier to accessing services (N = 49 817). We used joinpoint regressions to examine whether the rate of change differed significantly from 2016-2019 (before the pandemic) to 2019-2021 (during the pandemic). The number of immigrant contacts to NDVH peaked in 2017 (n = 9333) and declined 25% to 6946 in 2021. During 2016-2019, the percentage of contacts reporting the following increased significantly: technology-facilitated violence (+12.7 percentage points), economic/financial abuse (+10.8 percentage points), and involvement of firearms (+4.8 percentage points); during 2019-2021, these trends reversed. The percentage of contacts reporting separation or divorce was relatively flat until 2019 and then increased from 14.6% in 2019 to 19.9% in 2021 (+5.2 percentage points). Housing instability increased during 2017-2020 (+9.3 percentage points), but requests for shelters decreased (-4.5 percentage points). Immigration status and personal finances were commonly reported barriers to services; both decreased during 2016-2019 but then increased during 2019-2021. This study can inform prevention and response strategies relevant for immigrants experiencing or reporting IPV.

Novel 2D/2D/2D heterojunction of ZnIn2S4/g-C3N4/MoS2 for enhanced photocatalytic hydrogen evolution reaction

Photocatalysts for hydrogen evolution reaction (HER) have widely been explored but fine-tuning and engineering multiphase photocatalyst components are still challenging. Among catalysts, ZnIn2S4 has shown promise but maximizing the use of ZnIn2S4-photogenerated carriers and enhancing quantum yield still require further investigation. One way to achieve this is by enhancing the photon utilization and reducing the recombination of shallow carriers in ZnIn2S4. Accordingly, novel ZnIn2S4/g-C3N4/MoS2 type-II heterojunction composites with 2D/2D/2D structures (abbreviated ZIS/CN/MS) were synthesized in the present work by simple thermal condensation-solvothermal method. The optimized ZIS/CN/MS exhibited a photocatalytic hydrogen evolution rate of 13.6 mmol g−1 h−1 under visible light (λ ≥ 420 nm) irradiation, a value much higher than those of pure-phases ZIS and CN, as well as the binary composite of ZIS/CN. The apparent quantum efficiency of the optimized ZIS/CN/MS at a wavelength of 420 nm reached 27.0 % coupled with excellent cycling stability. The significantly improved photocatalytic performance and the excellent stability can mainly be attributed to the unique 2D/2D/2D arrangement of the ternary components of ZIS, CN, and MS in ZIS/CN/MS photocatalyst, providing a large number of close interfacial contacts between the components for shortened migration distance of photogenerated charges and more pathways for electron separation and transport in type-II heterostructures. Overall, the proposed methodology and ZIS/CN/MS composites with type-II heterojunction and 2D/2D/2D structures have great potential for use in solar-to-hydrogen energy conversion and can be extended to the preparation of other photocatalysts.

A descriptive study of the connections between social risk and healthcare utilization with supportive oncology care

Objective This study utilized social risk data in the electronic heath record collected as part of routine clinical practice and examined relationships with supportive oncology care contacts and healthcare utilization. Methods A total of 2,807 cancer patients were screened for four social determinants of health (SDOH) domains (financial resource strain, housing instability, food insecurity, and transportation need) and categorized to low or high risk SDOH groups. The number of patient contacts with supportive oncology was compared amongst the groups. The data were analyzed for demographic and outcome differences including emergency department visits, inpatient admissions, and appointment adherence. Results Heightened social risk was associated with more total contacts with supportive oncology care. Patients with high SDOH risk had more contacts across all outcomes examined including emergency department visits (M = 13), inpatient admissions (M = 14), and missed appointments (M = 11). Conclusions Patients with both greater social risks and acute care utilization are associated with more psychosocial interventions in supportive oncology follow-up. These findings highlight the need for comprehensive action to respond to social risk factors identified in SDOH screening.

Micro‐Mechanical Analysis for Residual Stresses and Shakedown of Cohesionless‐Frictional Particulate Materials Under Moving Surface Loads

AbstractResidual stresses and shakedown have been successfully presented by two‐dimensional numerical experiments based on the discrete element method (DEM), wherein a cohesionless‐frictional material under moving surface loads was replicated through irregular‐shaped particles. With surface loads below the shakedown limit, both permanent deformations and residual stresses cease to accumulate and the numerical structure shakes down after a number of load passes. Corresponding micro‐mechanical analyses indicate that strong forces and normal forces make a dominant contribution to residual stresses. Besides, averaged magnitudes of interparticle forces and corresponding total contact numbers initially change with load passes, and their final variation trends will differ as the structure shakes down or not. Furthermore, polar distributions of interparticle forces and contacts have been presented, and variations of their preferential orientations were emphasised. Lastly, the fabric tensor and anisotropy of resultant forces were studied, presenting the anisotropy weakening of macro‐stress fields, induced by developments of residual stresses.

Edge-functionalized graphene quantum dot as a nano-biosensor for simultaneous detection of glucose, galactose and lactose

The swift and accurate diagnosis of diseases, particularly diabetes, remains a pressing and critical concern in healthcare. Monitoring blood glucose levels is imperative for diabetic patients to manage their condition effectively. Addressing this necessity, developing non-invasive, simultaneous detection devices for sugars shows immense promise. Herein, we introduce the design of a novel nano-biosensor employing edge‐functionalized graphene quantum dots, enabling the concurrent detection of three pivotal sugars: glucose, galactose, and lactose. Through comprehensive molecular dynamics simulations, we demonstrate the feasibility and stability of the proposed biosensor. Our results show that the edge-functionalization of graphene quantum dots significantly enhances their binding affinity, with calculated average number of contacts of 2174 for glucose, 1085 for galactose, and 6274 for lactose. Furthermore, the radial distribution function analysis echoed these findings, highlighting lactose’s pronounced interaction with the biosensor, followed by glucose and then galactose. The detailed analysis reveals distinct and non-overlapping sugar bindings on the nano-biosensor surface, with lactose showing the highest affinity and interaction strength, followed by glucose and galactose. This innovative approach marks a significant stride forward in biosensor technology, providing a potential avenue for precise and dependable monitoring of blood sugar levels in diabetic patients.

Enhancing electrical conductivity of RuO2 nanosheet-coated films by enlarging the nanosheet area

This study focused on enhancing the electrical conductivity of metal oxide nanosheet films by increasing the size of the nanosheets to promote the electron flow in the desired in-plane direction. We developed a method for increasing the size of RuO2 metal oxide nanosheets, a 2D material, by controlling the heat-treatment process. The size of the RuO2 nanosheets increased from 0.7 to 3.5 μm by modifying the heat-treatment conditions of KxRuO2, which was used as the precursor material. As a consequence, the electrical conductivity of the large-sized-RuO2 nanosheet-coated films was eight times higher than that of their small-sized counterparts. This lower resistance was attributed to the minimal number of contacts required for electron flow; the contact resistance between the nanosheets being higher than the intrinsic resistance. The proposed approach for enhancing the conductivity of metal oxide 2D materials is very promising and is expected to significantly contribute to the development of advanced flexible electronic devices.

Recognition of schizophrenia and quality of treatment during the COVID-19 pandemic: A Danish nationwide study

BackgroundThe COVID-19 pandemic may have exacerbated the state of ill-health among patients with schizophrenia. We examined the number of patients diagnosed with schizophrenia, the number of hospital admissions and outpatient contacts and the quality of treatment during the pandemic in comparison with the previous years. MethodsWe identified patients ≥18 years old registered in the Danish Schizophrenia Registry from 2016 to 2022. Using a generalized linear model, we estimated prevalence ratios (PR) and 95 % confidence intervals (CI) for each variable of interest. ResultsA minor reduction in the number of new cases, admissions and outpatient contacts was seen during the first lockdown; however, there was no overall change across the pandemic period compared with the pre-pandemic period. We found no change in the proportion of patients who were interviewed using a diagnostic tool (37.0 % during pandemic vs 37.9 % pre-pandemic; PR = 0.87; 95 % CI 0.68–1.12) or received family intervention (57.7 % vs 57.1 %; PR = 0.97; 95 % CI 0.81–1.15), and no decrease was observed in the proportion of patients assessed for social support. Furthermore, no change in the proportion of patients re-admitted within 30 days (35.9 % vs 35.0 %; PR = 0.96; 95 % CI 0.88–1.07) or screened for suicide risk in relation to discharge (55.2 % vs 56.8 %; PR = 0.96; 95 % CI 0.97–1.09) was observed. ConclusionsRecognition and treatment of schizophrenia was minimally affected during the first lockdown, but across the pandemic period no overall change was observed. The quality of treatment of schizophrenia was unchanged.

The in- and outpatient health care use of patients with COPD before and after initiation of home care: a registry study from Norway

Objective Chronic obstructive pulmonary disease (COPD) is a common condition associated with age, multimorbidity and frequently involves the use of health care across levels. Understanding the factors associated with the initiation of long-term care is important when planning the future need for services. We describe healthcare use before and after the reception of any home care. We further studied the associations between healthcare use and first registered home care service and from first registered home care service to nursing home admission or death. Design and subjects Patients residing in Oslo or Trondheim at the time of first contact with a COPD primary diagnosis, 2009–2018. Patient data were linked across national and municipal registries, covering healthcare and sociodemographics. The sample consisted of 16,738 individuals. Results There was a marked increase in inpatient and outpatient hospital contacts in the years prior to and after the reception of any home care. Adjusted for comorbidities and sociodemographics, high numbers of GP consultations, and inpatient and outpatient hospital contacts for respiratory diagnoses were associated with a significantly higher likelihood of receiving home care the next year (hazard odds ratios > 1.3). Following the reception of home care, the type of home care service received (e.g. home nursing or short-term rehabilitation/treatment) was more important than outpatient services in predicting next-year nursing home admission or death. Conclusion Including data on prior outpatient care when predicting future need for home care is beneficial. A high frequency (top 10%) of yearly GP, in- or outpatient hospital contacts can imply that the patient may be in need of home care in the near future.

Hyperbranched Poly-l-Lysine Modified Titanium Surface With Enhanced Osseointegration, Bacteriostasis, and Anti-Inflammatory Properties for Implant Application: AnExperimental InVivo Study.

This study aimed to explore multiple effects of hyperbranched poly-l-lysine (HBPL) titanium (Ti) surfaces on osseointegration, bacteriostasis, and anti-inflammation across three different animal models. Ti surfaces were covalently modified with HBPL, with uncoated surfaces as controls. Characterization included scanning electron microscopy (SEM) and surface chemistry and elemental analysis (EDX). Ti and Ti-HBPL implants were placed in conventional canine edentulous sites, post-operative infection canine edentulous sites, and diabetic rat tibias. Implants from canine edentulous models were analyzed using micro-CT and histomorphometry to assess osseointegration at 8 weeks. Post-operative infection beagles were used to evaluate antibacterial efficacy through clinical parameters and bacterial cultures at 1 week. In diabetic rats, micro-CT and histomorphometry were performed at 8 weeks. HBPL was uniformly grafted on Ti-HBPL surfaces. Ti-HBPL surfaces showed higher bone volume/total volume (BV/TV, p < 0.001), bone-implant contact (BIC%, p < 0.001), and trabecular number (Tb.N, p < 0.01) in beagles. Besides, it displayed higher BIC% (p < 0.001) and bone area fraction occupancy (BAFO%, p < 0.01) in hard tissue sections. In an infected model, Ti-HBPL surfaces exhibited lower bleeding on probing (BOP, p < 0.001), and plaque index (DI, p < 0.01), with reduced bacterial colony formation (p < 0.001) compared to the control group. In diabetic rats, Ti-HBPL surfaces showed an increase in BV/TV (p < 0.01) and Tb.N (p < 0.001), downregulated TNF-α and IL-1β (p < 0.01), and upregulated IL-10 (p < 0.01) and osteocalcin (OCN) expression (p < 0.01). HBPL-Ti surfaces demonstrated enhanced osseointegration, bacteriostasis, and anti-inflammatory effects invivo.

Evaluation of a voluntary passive surveillance component in cattle through notification of excess mortality

Passive surveillance can be most effective in the early detection of disease outbreaks given that farmers observe their animals daily. The European Animal Health Law states that unexplained excess mortality should be reported to the veterinary authorities. In the Netherlands, in addition to notifications to the competent authority, Royal GD is commissioned a passive surveillance component that consists of a veterinary helpdesk and postmortem examination for early detection of emerging diseases. The aim of this study was to evaluate this voluntary passive surveillance component through excess mortality in cattle.Weekly on-farm mortality was calculated using the cattle Identification and Registration records. Mortality was assessed on regional level for dairy, veal and other beef cattle using a Generalized Linear Model (GLM) (log-link, negative binomial). We used a cumulative sum of the model residuals to identify periods of excess mortality. The mortality was defined as excessive when above five times the standard error. The analysis was also conducted on herd level, but these models did not converge.We checked for an association between the two passive surveillance components elements and excess mortality. A GLM (log-link, negative binomial) with the number of contacts or submissions per region as the dependent variables and excess mortality per region and year as independent variables was carried out.Overall, the models showed significantly higher use of passive surveillance components in periods of excess mortality compared to non-excess periods. In dairy cattle the odds for contact or submission were between 1.72 (1.59–1.86) and 2.02 (1.82–2.25). For veal calves we found the odds of 2.19 (1.18–4.04) and 2.24 (1.78–2.83) relative to periods without excess mortality. Beef cattle operations, other than veal, showed only an increased odds for postmortem submissions in calves of 3.71 (2.74–5.01), submissions for cattle and contact in general was not increased for this farm type.In conclusion, the voluntary passive surveillance component in the Netherlands is used more often in periods of excess mortality in cattle. The chance of getting a timely response is highest for dairy farms. For veal calf operations the chance of receiving a timely response is more likely for postmortem submissions. A comparison with passive surveillance for excess mortality in other countries was not possible because no literature could be found. However, the method of this study can be used by other countries to evaluate their passive surveillance. This would make comparison of the performance of passive surveillance in different countries possible.

Directly observed social contact patterns among school children in rural Gambia

IntroductionSchool-aged children play a major role in the transmission of many respiratory pathogens due to high rate of close contacts in schools. The validity and accuracy of proxy-reported contact data may be limited, particularly for children when attending school. We observed social contacts within schools and assessed the accuracy of proxy-reported versus observed physical contact data among students in rural Gambia. MethodsWe enrolled school children who had also been recruited to a survey of Streptococcus pneumoniae carriage and social contacts. We visited participants at school and observed their contact patterns within and outside the classroom for two hours. We recorded the contact type, gender and approximate age of the contactee, and class size. We calculated age-stratified contact matrices to determine in-school contact patterns. We compared proxy-reported estimated physical contacts for the subset of participants (18 %) randomised to be observed on the same day for which the parent or caregiver reported the school contacts. ResultsWe recorded 3822 contacts for 219 participants from 114 schools. The median number of contacts was 15 (IQR: 11–20). Contact patterns were strongly age-assortative, and mainly involved physical touch (67.5 %). Those aged 5–9 years had the highest mean number of contacts [19.0 (95 %CI: 16.7–21.3)] while the ≥ 15-year age group had fewer contacts [12.8 (95 %CI: 10.9–14.7)]. Forty (18 %) participants had their school-observed contact data collected on the same day as their caregiver reported their estimated physical contacts at school; only 22.5 % had agreement within ±2 contacts between the observed and reported contacts. Fifty-eight percent of proxy-reported contacts were under-estimates. ConclusionsSocial contact rates observed among pupils at schools in rural Gambia were high, strongly age-assortative, and physical. Reporting of school contacts by proxies may underestimate the effect of school-age children in modelling studies of transmission of infections. New approaches are needed to quantify contacts within schools.

Demographic and temporal trends in mental health and substance use services provided by primary care physicians in British Columbia, Canada

BackgroundAs the demand for mental health and substance use (MHSU) services increases, there will be an even greater need for health human resources to deliver this care. This study investigates how family physicians’ (FP) contact volume, and more specifically, MHSU contact volume, is shaped by demographic trends among FPs in British Columbia, Canada.MethodsWe used annual physician-level administrative billing data and demographic information on FPs in British Columbia between 1996 and 2017. This study analyzes trends in primary care service provision among graduating cohorts of FPs, FPs of different ages (as measured by years since graduation), and FPs practicing during different time periods. Additionally, analyses are stratified by FP sex to account for potential differences in labour supply patterns between male and female FPs.ResultsOur results show that while FPs’ overall contacts with patients decreased between 1996 and 2017, their annual number of MHSU contacts increased, which was largely driven by an increase in substance use visits. Demographically, the proportion of female FPs in the labour force rose over time. Observed trends were similar, though not identical in male and female FPs, as males tended to have higher overall contact volume (both total contacts and MHSU), but also steeper declines in contact volume in later careers. The number of contacts (both total and MHSU) changed across career stage - rising steadily from start to mid-career, peaking at 20–30 years in practice, and decreasing steadily thereafter. This was evident for all cohorts and consistent over the 21-year study period but flattened in amplitude over time. Our findings also point to potential cohort effects on labour supply. The inverse U-shaped career trend extended to MHSU contacts, but its peak seems to have shifted to a later career stage (peaking at 30–40 years of practice) over time.ConclusionsOur study shows changing dynamics in MHSU service delivery among FPs over time, across the life span and between FP sexes that are likely to influence access to care beyond simply the number of FPs. Given the healthcare needs of the population, these findings point to potential future changes in provision of MHSU services.

Changes in the Success and Characteristics of Tobacco Dependence Treatment before and during the COVID-19 Pandemic: Clinical Sample Comparisons.

Background and Objectives: There is little information on changes in the process and outcomes of intensive tobacco dependence treatment during the COVID-19 pandemic. The following characteristics were evaluated: interest in treatment, the number of face-to-face or telephone follow-ups, the duration of pharmacotherapy use, and the success rate. The aim of our study was to compare the number of patients who entered tobacco dependence treatment programmes and evaluate the one-year success rate in patients three years before and three years after the COVID-19 pandemic. Materials and Methods: A single-site retrospective cohort study using data from patients treated at the Centre for Tobacco Dependence in Prague, Czech Republic, between 2017 and 2022 (n = 2039) was performed. The one-year abstinence rate was validated by measuring carbon monoxide in exhaled air (6 ppm cut-off). Patients were divided into two groups: the group for which treatment was initiated in 2017-2019 (i.e., before the COVID-19 pandemic, BC; n= 1221) and the group for which treatment was initiated in 2020-2022 (i.e., during the COVID-19 pandemic, DC; n = 818). Results: No significant differences in the success rate of tobacco dependence treatment were found between the two groups (BC group, 40.5% (494/1221) vs. DC group, 42.2% (345/818)) (χ2 (1, N = 2.039) = 0.6, p = 0.440). Furthermore, differences were not found in sex, education level, age at first cigarette, the duration of pharmacotherapy use, or the number of in-person visits. In contrast, there was an increase in the number of telephone contacts between the groups (18.7% (SD = 17.5%) vs. 32.9% (SD = 18.2%), p < 0.001). Conclusions: The number of patients who started treatment during the COVID-19 pandemic decreased by one-third compared to that during the 3-year period before the pandemic. The overall treatment success rate did not change significantly even with the increase in the number of telephone visits with the therapist.

Fusion Dynamics and Size-Dependence of Droplet Microstructure in ssDNA-Mediated Protein Phase Separation.

Biomolecular condensation involving proteins and nucleic acids has been recognized to play crucial roles in genome organization and transcriptional regulation. However, the biophysical mechanisms underlying the droplet fusion dynamics and microstructure evolution during the early stage of liquid-liquid phase separation (LLPS) remain elusive. In this work, we study the phase separation of linker histone H1, which is among the most abundant chromatin proteins, in the presence of single-stranded DNA (ssDNA) capable of forming a G-quadruplex by using molecular simulations and experimental characterization. We found that droplet fusion is a rather stochastic and kinetically controlled process. Productive fusion events are triggered by the formation of ssDNA-mediated electrostatic bridges within the droplet contacting zone. The droplet microstructure is size-dependent and evolves driven by maximizing the number of electrostatic contacts. We also showed that the folding of ssDNA to the G-quadruplex promotes LLPS by increasing the multivalency and strength of protein-DNA interactions. These findings provide deep mechanistic insights into the growth dynamics of biomolecular droplets and highlight the key role of kinetic control during the early stage of ssDNA-protein condensation.

P044 TEAM-BASED CARE TO MANAGE COMPLEX CASES OF HYPERTENSION

Background and Objectives: Team-based care that uses home blood pressure (BP) telemonitoring to facilitate hypertension management is safe and effective in lowering BP in routine primary care. However, its usefulness to manage more complex cases of hypertension is uncertain. This 6-month study explores its use in such patients attending a hypertension clinic. Methods: BP telemonitoring consisted of smartphone with BP app paired with wireless home BP device to transmit BP readings to a central server, accessible to patients and clinic staff. Patients were asked to contact the clinic about worrisome home BP readings, treatment problems and technical issues. Home readings were integrated into clinical decision-making. Outcomes were patients’ experience and clinical measures. Results: Of 90 enrolled patients, 38% had grade 3 or 4 chronic kidney disease, 23% diabetes, 31% heart disease, 12% stroke and 12% aortic dissection. Mean number (standard deviation) of co-morbid conditions was 4.2 (2.0). Most patients were at very high (30%) or high risk (50%) for a cardiovascular event. During follow-up, one patient died and one dropped-out of care. Mean number of in-person and virtual assessments by a physician were 1.6 (0.6) and 2.0 (1.8), respectively. Eighty-three percent (n=75) contacted clinic staff. Mean number of contacts for technical reasons was 1.2 (1.8), treatment-related issues 0.5 (1.0) and personal support 4.2 (5.9). From baseline to exit mean automated office BP fell (p&lt;0.001), BP control improved (p&lt;0.001) and mean number of antihypertensive drug classes increased (p=0.049). Most patients, 91% (80/88), felt BP telemonitoring to be a valuable tool for managing their hypertension. Nonetheless, 38% also considered cost to be potentially a barrier to long-term use. Only 6% had data security concerns. Conclusions: Team-based care was highly rated by patients to manage their hypertension and may account for the low drop-out rate, high number of patient-provider contacts, good patient acceptance of more intensified pharmacological treatment and better BP control. However, cost potentially may be a barrier for long-term use.

FIXEL: TOPSIS-Driven Mobile Application for Roadside Assistance Provider Decision Making

Many drivers have faced the struggle of getting help when their vehicle breaks down on the road. This difficult situation is extremely stressful because there are limitations to seeking help, such as the service provider being too far away or the service provider's contact number being unavailable. The complication of deciding to choose a service provider is also occurring because of the eagerness to fulfil different kinds of aspects, such as the lowest price of the services and the shortest distance from the service provider. From the service provider’s perspective, it has become a challenge to get new customers when they are unfamiliar with their surroundings. Usually, the drivers will choose the most popular service provider, which may be far away from them. These issues sparked the motivation for this study, which aims to assist drivers and service providers through the mobile platform. One of the multi-criteria decision-making methods was employed to enhance the quality of choosing the right service provider based on the criteria involved, which are service availability, prices, distances and ratings. The result of this study would benefit drivers and service providers by improving decision-making, enhancing the customer experience, optimizing resource utilization and reducing cost.

Do time preferences predict diabetes outcomes? A combined survey and register-based study.

Identifying determinants of heterogeneity in health outcomes continues to be a focus in the health economic literature. In this study, we analyze whether time preferences predict health outcomes in individuals with type 1 diabetes (T1D) who use insulin pump therapy to manage their condition. We collect data on time preferences using a hypothetical matching task and estimate aggregate as well as individual-level discounting parameters using the exponential, hyperbolic, and quasi-hyperbolic discounting models. These parameters are then regressed against essential diabetes-related health outcomes obtained from registries and medical records, including glycemic control, kidney function, BMI, and number of hospital contacts. Our analyses indicate that all three discounting models fit the data equally well. Except for hospital contacts, we find robust evidence that impatience, as reflected by higher discounting, predicts worse health outcomes. Additionally, present bias is associated with worse kidney function. Our findings suggest that time preferences can explain some of the heterogeneity in health among individuals with T1D and call for increased attention on the role of time preferences in the design of disease management programs for individuals with chronic conditions.