Primary Body Research Articles

Equilibrium points and Lyapunov families in the circular restricted three-body problem with an oblate primary and a synchronous rotating dipole secondary: Application to Luhman-16 binary system

We numerically study a version of the synchronous circular restricted three-body problem, where an infinitesimal mass body is moving under the Newtonian gravitational forces of two massive bodies. The primary body is an oblate spheroid while the secondary is an elongated asteroid of a combination of two equal masses forming a rotating dipole which is synchronous to the rotation of the primaries of the classic circular restricted three-body problem. In this paper, we systematically examine the existence, positions, and linear stability of the equilibrium points for various combinations of the model's parameters. We observe that the perturbing forces have significant effects on the positions and stability of the equilibrium points as well as the regions where the motion of the particle is allowed. The allowed regions of motion as determined by the zero-velocity surface and the corresponding isoenergetic curves as well as the positions of the equilibrium points are given. Finally, we numerically study the binary system Luhman-16 by computing the positions of the equilibria and their stability as well as the allowed regions of motion of the particle. The corresponding families of periodic orbits emanating from the collinear equilibrium points are computed along with their stability properties.

The Prognostic and Predictive Value of Human Gastrointestinal Microbiome and Exosomal mRNA Expression of PD-L1 and IFNγ for Immune Checkpoint Inhibitors Response in Metastatic Melanoma Patients: PROTOCOL TRIAL.

Immunotherapy has been successful in treating advanced melanoma, but a large proportion of patients do not respond to the treatment with immune checkpoint inhibitors (ICIs). Preclinical and small cohort studies suggest gastrointestinal microbiome composition and exosomal mRNA expression of PD-L1 and IFNγ from the primary tumor, stool and body fluids as potential biomarkers for response. Patients treated with immune checkpoint inhibitors as a first line treatment for metastatic melanoma are recruted to this prospective study. Stool samples are submitted before the start of treatment, at the 12th (+/-2) week and 28th (+/-2) week, and at the occurrence of event (suspected disease progression/hyperprogression, immune-related adverse event (irAE), deterioration). Peripheral venous blood samples are taken additionally at the same time points for cytologic and molecular tests. Histological material from the tumor tissue is obtained before the start of immunotherapy treatment. Primary objectives are to determine whether the human gastrointestinal microbiome (bacterial and viral) and the exosomal mRNA expression of PD-L1 and IFNγ and its dynamics predicts the response to treatment with PD-1 and CTLA-4 inhibitors and its association with the occurrence of irAE. The response is evaluated radiologically with imaging methods in accordance with the irRECIST criteria. This is the first study to combine and investigate multiple potential predictive and prognostic biomarkers and their dynamics in first line ICI in metastatic melanoma patients.

Ryugu’s Anhydrous Ingredients and Their Spectral Link to Primitive Dust from the Outer Solar System

Ryugu is a second-generation C-type asteroid formed by the reassembly of fragments of a previous larger body in the main asteroid belt. While the majority of Ryugu samples returned by Hayabusa2 are composed of a lithology dominated by aqueously altered minerals, clasts of pristine olivine and pyroxene remain in the least-altered lithologies. These clasts are objects of great interest for revealing the composition of the dust from which the original building blocks of Ryugu's parent asteroid formed. Here we show that some grains rich in olivine, pyroxene, and amorphous silicates discovered in one millimeter-sized stone of Ryugu have infrared spectra similar to the D-type asteroid Hektor (a Jupiter Trojan), to comet Hale–Bopp, and to some anhydrous interplanetary dust particles of probable cometary origin. This result indicates that Ryugu's primary parent body incorporated anhydrous ingredients similar to the building blocks of asteroids (and possibly some comets) formed in the outer solar system, and that Ryugu retained valuable information on the formation and evolution of planetesimals at different epochs of our solar system's history.

Optimization Design of Large-Aperture Primary Mirror for a Space Remote Camera

Lightweight, high stability, and high-temperature adaptability are the primary considerations when designing the primary mirror of a micro/nano satellite remote sensing camera. In this paper, the optimized design and experimental verification of the large-aperture primary mirror of the space camera with a diameter of Φ610 mm is carried out. First, the design performance index of the primary mirror was determined according to the coaxial tri-reflective optical imaging system. Then, SiC, with excellent comprehensive performance, was selected as the primary mirror material. The initial structural parameters of the primary mirror were obtained using the traditional empirical design method. Due to the improvement of SiC material casting complex structure reflector technology level, the initial structure of the primary mirror was improved by integrating the flange with the primary mirror body design. The support force acts directly on the flange, changing the transmission path of the traditional back plate support force, and has the advantage that the primary mirror surface shape accuracy can be maintained for a long time when subjected to shock, vibration, and temperature changes. Then, a parametric optimization algorithm based on the mathematical method of compromise programming was used to optimize the design of the initial structural parameters of the improved primary mirror and the flexible hinge, and finite element simulation was conducted on the optimally designed primary mirror assembly. Simulation results show that the root mean square (RMS) surface error is less than λ/50 (λ = 632.8 nm) under gravity, 4 °C temperature rise, and 0.01 mm assembly error. The mass of the primary mirror is 8.66 kg. The maximum displacement of the primary mirror assembly is less than 10 μm, and the maximum inclination angle is less than 5″. The fundamental frequency is 203.74 Hz. Finally, after the primary mirror assembly was precision manufactured and assembled, the surface shape accuracy of the primary mirror was tested by ZYGO interferometer, and the test value was 0.02 λ. The vibration test of the primary mirror assembly was conducted at a fundamental frequency of 208.25 Hz. This simulation and experimental results show that the optimized design of the primary mirror assembly meets the design requirements of the space camera.

Forum: Navigating the Global South Landscape: Insights and Implications for Representation and Inclusion in ISA Journals

Abstract The International Studies Association (ISA) is widely recognized as an American-European-centric professional organization, with Global South scholars traditionally representing a minority of its membership. This pattern largely reflects the development of the International Relations (IR) discipline and its publication trends. In this Forum, we examine the progress made in the representation of Global South scholars within the IR discipline over the past decade, specifically focusing on the ISA as the primary professional body for IR scholars. We tackle some issues the Global South Task Force (GSTF) highlighted to a more assertive representativeness of the Global South within the ISA. Our analysis concentrates on ISA's journals data tracking to capture the current state of affairs and foster dialogue on developing inventive solutions to enhance diversity, intellectual plurality, and scholarly cultures within the IR discipline. Rather than resorting to outright criticism, we adopt a constructive stance, discussing attempted solutions and proposing steps to advance the discipline.

Effect of Orbital Characteristic of Inclined Third-body on Motion of Secondary-body for a Hierarchical Triple Systems

The influence of a third-body’s orbital elements on the second-body’s motion in a hierarchical triple system is a crucial problem in astrophysics. Most prolonged evaluation studies have focused on a distant zero-inclined third-body. This study presents a new perspective on second-body motion equations that addresses a perturbing-body in an elliptic orbit derived with consideration of the axial-tilt (obliquity) of the primary. The proposed model is compared by the dual-averaged method and the N-body problem algorithm. After validation, a generalized three-body model is derived to investigate the effects of the third-body’s orbital elements on secondary-body motion behavior. The proposed model considers short-time oscillations that affect secular evaluation and applies to exoplanets with all the primary and third body eccentricities, inclinations, and mass ratios. It is shown that the obliquity of the primary (or third-body’s inclination) must be considered for precise long-term assessment, even in highly-hierarchical systems.

Computer assisted proofs for transverse collision and near collision orbits in the restricted three body problem

This paper considers two point boundary value problems for conservative systems defined in multiple coordinate systems, and develops a flexible a posteriori framework for computer assisted existence proofs. Our framework is applied to the study collision and near collision orbits in the circular restricted three body problem. In this case the coordinate systems are the standard rotating coordinates, and the two Levi-Civita coordinate systems regularizing collisions with each of the massive primaries. The proposed framework is used to prove the existence of a number of orbits which have long been studied numerically in the celestial mechanics literature, but for which there are no existing analytical proofs at the mass and energy values considered here. These include transverse ejection/collisions from one primary body to the other, Strömgren's asymptotic periodic orbits (transverse homoclinics for L4,5), families of periodic orbits passing through collision, and orbits connecting L4 to ejection or collision.

AL KALIMᾹT AL MUQTARADAH MIN AL LUGAH AL ‘ARABIYYAH ILᾹ AL LUGAH AL INDŪNISIYYAH FĪ IFTITᾹHI AL DUSTŪR AL INDŪNISIY AL‘ ᾹM 1945

<p style="text-align: justify;"><em>Loan words were foreign words used by a particular language to fill a linguistic gap, multiplying borrowed words in the target language. In addition to borrowing words from Sanskrit, Spanish, Portuguese, Dutch, and English, the Indonesian language also use many words from Arabic. As part of this research, the researchers attempted to determine which words were borrowed and to investigate the meaning of the Arabic borrowed words in the primary body of the Indonesian Constitution. The method used for this research was the qualitative descriptive method, and the approach used is a librarian and the procedure for data collection. The researcher used written documents and the method to analyze the data. The researcher used the comparative approach to define the change of meaning of Arabic borrowed words in the Indonesian language in the preamble of the Indonesian Constitution in 1945. The result of the research was the number of Arabic borrowed words at the opening of the Basic Constitution 19. The borrowed word the research is expected to add ınsıght and knowledge ın the field of langueage and can provıde ınformatıon and ınput.</em></p>

Hydrodynamics of body–body interactions in dense synchronous elongated fish schools

Mechanisms for hydrodynamic benefit via fluid interactions in large planar fish schools ( n ≥ 10) are investigated by two-dimensional numerical simulations of carangiform fish swimming. It is observed that the average swimming efficiency of the 10-fish school is increased by 30% over a single swimmer, along with a thrust production improvement of 114%. The performance and flow analyses characterize the associated hydrodynamic interaction mechanisms in large dense schools leading to enhanced performance. First, anterior body suction arises from the proximity of the suction side of the flapping tail to the head of the following fish. Next, the block effect is observed as another fish body blocks the flow behind a fish. Finally, the wall effect enhances the flow of momentum downstream where the body of a neighboring fish acts as a wall for the flapping of a fish tail moving toward it. Because these primary body–body interactions are based on the arrangement of surrounding fish, a classification of the individual fish within the school is presented based on the intra-fish interactions and is reflected in the performance of the individuals. It is shown that the school can be separated as front fish, middle fish, edge fish, and back fish based on the geometric position, performance, and wake characteristics. Finally, groupings and mechanisms observed are proven to be consistent over a range of Reynolds numbers and school arrangements.

Spatiotemporal Variability Comparisons of Water Quality and Escherichia coli in an Oklahoma Stream

AbstractFecal indicator bacteria, Escherichia coli, for primary body contact recreation (PBCR) in Oklahoma waterbodies, is defined as the geometric mean of 10 samples from the recreation season, May 1 to September 30, with an impairment threshold of 126 colony forming units (cfu) per 100 mL. However, the water quality standards provide limited guidance on spatiotemporal and environmental factors that could influence samples collected and analyzed. In this study, two stream cross sections under baseflow conditions in a central Oklahoma urban perennial stream, Spring Creek, were densely sampled to investigate temporal and spatial variability of E. coli concentrations and water quality parameters across the stream channel. Water quality parameters (specific conductivity, temperature, dissolved oxygen, pH, turbidity, and total suspended solids (TSS)), stream discharge, and bacteria samples were collected simultaneously at equal intervals across the two cross sections in the morning and afternoon during one summer day with sunny, dry, and hot weather conditions. Results indicate a significant difference between time‐of‐day samples and water quality parameters and E. coli concentrations. Strong correlations between temperature, dissolved oxygen, and time versus E. coli concentrations were observed, while location, turbidity, and TSS were not significant or correlated to measured values. Furthermore, E. coli concentrations were highly variable spatially across each stream cross section, regardless of time of day or location. Results from this study provide an initial indication that stream water quality, spatial cross section sample location, and diurnal variations may be influencing factors on bacteria concentrations.

Impact of TECAR therapy on post-natal rectus diastasis: A randomized trial

Background. Rectus diastasis is a common problem affecting postpartum mothers. It decreases the integrity as well as functional strength of the abdominal wall, and causes low back pain and pelvic instability Objective. To examine how TECAR therapy (monopolar capacitive resistance radiofrequency of 448 KHz) affects rectus diastasis in postpartum women. Design. A prospective randomized controlled trial. Setting. Outpatient physical therapy clinic, Kafr El Sheikh University. Methods. Forty postnatal women having diastasis recti abdominis (DRA) > 2.5 cm were recruited and randomized into two equal groups; the control group received a program of selected abdominal exercises and low caloric diet of 1200 kcal/ day for 4 weeks, and the study group received the same control group interventions in addition to TECAR application. DRA degree was the primary outcome, while weight and body mass index measures were the secondary outcomes. All variables were measured at the baseline and after 4 weeks of the intervention by rectus diastasis test, abdominal ultrasonography, and calibrated weight scale. Results. Analysis showed a significant reduction (P < .05) in weight, body mass index, rectus diastasis test, and ultrasound measures in both groups in favor of the study group Conclusion. Using TECAR with a standard program of abdominal exercises and low caloric diet has more beneficial effects on postnatal DRA than practicing the exercise program alone with the low-calorie diet.

European union crisis-induced institutional evolution. The effect of institutional entrepreneurship in the formation of EFSF

ABSTRACT This paper conducts an in-depth case study of the 2010 Greek entrepreneurship attempts that led to the EFSF's creation, aiming to theorise crisis-induced institutional change in the EU. This research aims to cover the theoretical gap left by existing literature by combining theoretical elements derived from historical institutionalism and institutional entrepreneurship. Crises function as critical junctures. During critical junctures, the structural grip of path dependency loosens; thus, a multitude of paths forward are available. The choice of a specific path, if any, heavily relies on the concept of institutional entrepreneur. In 2010 the Greek government was such an agent, with interest in altering EU institutional design to overcome its financial ordeal and with direct access to the EU Council, the primary decision-making body regarding institutional change. The entrepreneur triggers a process of institutional change through their proposal. Once the entrepreneur chooses a path forward, this is further moulded by path dependencies.

Periodic Orbits of Quantised Restricted Three-Body Problem

In this paper, perturbed third-body motion is considered under quantum corrections to analyse the existence of periodic orbits. These orbits are studied through two approaches to identify the first (second) periodic-orbit types. The essential conditions are given in order to prove that the circular (elliptical) periodic orbits of the rotating Kepler problem (RKP) can continue to the perturbed motion of the third body under quantum corrections where a massive primary body has excessive gravitational force over the smaller primary body. The primaries moved around each other in circular (elliptical) orbits, and the mass ratio was assumed to be sufficiently small. We prove the existence of the two types of orbits by using the terminologies of Poincaré for quantised perturbed motion.

Landing Simulation in the Full Two-Body Problem of Binary Asteroids

This paper investigates the motion of a lander in a fully coupled spin–orbit binary system. The full dynamical equations are established, including the states of the lander and the two small celestial bodies. The binary companions are represented by tetrahedral meshes when propagating their states; therefore, their irregular shapes are preserved. The mutual gravitational interactions between the two bodies and the attraction of the lander in this binary system are evaluated by the finite element method. The contact motion between the lander in arbitrary shapes/inertia and the asteroid surface is processed by the polygonal contact model. The resulting framework is applied to the binary asteroid system, 66391 Moshup. The deployment simulations of four typical initial positions near the secondary body suggest the lander release should avoid polar regions. The dynamical effect of the primary body on the lander is also investigated. The numerical results show that the accumulative effect of the weak tidal force from the primary body is nonnegligible. In addition, four different internal structures of the secondary body are constructed by operating the tetrahedron mesh. The touchdown positions and settling time of the landing trajectories on these four models are summarized and compared. The results indicate that variations of the internal structure have a nonnegligible effect on the local gravitational field around the secondary body, and therefore affect the locomotion of the lander.

Semi-Analytical Approach in BiER4BP for Exploring the Stable Positioning of the Elements of a Dyson Sphere

In this study, we present a new approach with semi-analytical and numerical findings for solving equations of motion of small orbiter m, which is moving under the combined gravitational attraction of three primaries, M1, M2, and M3, in case of the bi-elliptic restricted problem of four bodies (BiER4BP), where three such primaries, M1, M2, and M3, are moving on elliptic orbits with hierarchical configuration M3 << M2 << M1 within one plane as follows: third primary body M3 is moving on elliptical orbit around second M2, and second primary M2 is moving on elliptical orbit around first M1. Our aim for constructing the aforementioned quasi-planar motion of planetoid m is obtaining its coordinates supporting its orbit in a regime of close motion to the plane of orbiting the main bodies M1, M2, and M3. Meanwhile, the system of equations of motion was successfully numerically explored with respect to the existence and stable positioning of approximate solution for a Dyson sphere. As a result, the concept of the Dyson sphere for possible orbiting variety of solar energy absorbers was transformed to the elongated Dyson space net with respect to their trajectories for the successful process of absorbing the energy from the Sun; this can be recognized as symmetry reduction. We obtain the following: (1) the solution for coordinates {x, y} is described by the simplified system of two nonlinear ordinary differential equations of second order, depending on true anomaly f; (2) the expression for coordinate z is given by an equation of Riccati-type where small orbiter that quasi-oscillates close to the fixed plane {x,y,0}.

The sea spider Pycnogonum litorale overturns the paradigm of the absence of axial regeneration in molting animals

Regenerative abilities and their evolution in the different animal lineages have fascinated generations of biologists. While some taxa are capable of restoring entire individuals from small body fragments, others can regrow only specific structures or lack structural regeneration completely. In contrast to many other protostomes, including the segmented annelids, molting animals (Ecdysozoa) are commonly considered incapable of primary body axis regeneration, which has been hypothesized to be linked to the evolution of their protective cuticular exoskeleton. This holds also for the extraordinarily diverse, segmented arthropods. Contradicting this long-standing paradigm, we here show that immatures of the sea spider Pycnogonum litorale reestablish the posterior body pole after transverse amputation and can regrow almost complete segments and the terminal body region, including the hindgut, anus, and musculature. Depending on the amputation level, normal phenotypes or hypomeric six-legged forms develop. Remarkably, also the hypomeric animals regain reproductive functionality by ectopic formation of gonoducts and gonopores. The discovery of such complex regenerative patterns in an extant arthropod challenges the hitherto widely assumed evolutionary loss of axial regeneration during ecdysozoan evolution. Rather, the branching of sea spiders at the base of Chelicerata and their likely ancestral anamorphic development suggests that the arthropod stem species may have featured similar regenerative capabilities. Accordingly, our results provide an incentive for renewed comparative regeneration studies across ecdysozoans, with the aim to resolve whether this trait was potentially even inherited from the protostome ancestor.

Predictors of Adolescents' Response to a Web-Based Intervention to Improve Psychosocial Adjustment to Having an Appearance-Affecting Condition (Young Person's Face IT): Prospective Study.

Adolescents with a condition affecting their appearance that results in a visible difference can be at risk of psychosocial distress and impaired adjustment. Evidence for the effectiveness of existing interventions in improving psychosocial outcomes is limited, and relevant treatment can be difficult to access. Young Person's Face IT (YPF), a self-guided web-based intervention, has demonstrated potential in reducing social anxiety in adolescents with a visible difference. However, more knowledge is needed about the variables that contribute to variations in intervention effects to identify those who may benefit most from YPF. This study aimed to investigate demographic, psychosocial, and intervention-related variables as predictors of overall intervention effects after adolescents' use of YPF. We used longitudinal data collected as part of a larger, ongoing mixed methods project and randomized controlled trial (ClinicalTrials.gov NCT03165331) investigating the effectiveness of the Norwegian version of YPF. Participants were 71 adolescents (mean age 13.98, SD 1.74 years; range 11-18 years; 43/71, 61% girls) with a wide range of visible differences. The adolescents completed primary (body esteem and social anxiety symptoms) and secondary (perceived stigmatization, life disengagement, and self-rated health satisfaction) outcome measures at baseline and postintervention measurement. The predictor variables were demographic (age and gender), psychosocial (frequency of teasing experiences related to aspects of the body and appearance as well as depressive and anxiety symptoms), and intervention-related (time spent on YPF) variables. Two-thirds (47/71, 66%) of the adolescents completed all YPF sessions and spent an average of 265 (SD 125) minutes on the intervention. Backward multiple regression analyses with a 2-tailed P-value threshold of .20 revealed that several variables were retained in the final models and predicted postintervention outcome changes. Body esteem was predicted by age (P=.14) and frequency of teasing experiences (P=.09). Social anxiety symptoms were predicted by gender (P=.12), frequency of teasing experiences (P=.03), depressive and anxiety symptoms (P=.08), and time spent on YPF (P=.06). Perceived stigmatization was predicted by age (P=.09), gender (P=.09), frequency of teasing experiences (P=.19), and depressive and anxiety symptoms (P=.06). Life disengagement was predicted by gender (P=.03), depressive and anxiety symptoms (P=.001), and time spent on YPF (P=.14). Self-rated health satisfaction was predicted by age (P=.008). However, the results were limited by relatively low explained postintervention variance, ranging from 1.6% to 24.1%. This study suggests that adolescent boys, adolescents who experience higher levels of psychosocial distress related to their visible difference, and adolescents who spend sufficient time on YPF may obtain better overall intervention effects.

Influence of a corporal expression program on primary school children's body image

Este estudio pretendió observar el efecto de un programa de expresión corporal en la imagen corporal de alumnos de 12 años. El programa incluyó siete sesiones de 45 minutos de dramatización y baile. Se obtuvieron mediciones pre y post con 33 alumnos (n = 13 grupo control -GC-; n = 20 grupo experimental -GE-). Para conocer su imagen corporal se utilizó una escala de figuras corporales (Children’s Ten Bodies Scale). Los resultados revelaron mayor satisfacción corporal en el GE en comparación con el GC, aunque no hubo diferencias significativas tras la intervención y tampoco se encontraron diferencias por género. Sin embargo, las chicas del GE mostraron menos insatisfacción corporal en el post-test (M = -0,57) que en el pre-test (M = -2,37). Los resultados sugieren que las actividades expresivas podrían ayudar a mejorar la imagen corporal, especialmente en chicas.

Dynamical origin of Dimorphos from fast spinning Didymos

Didymos is a binary near-Earth asteroid. It is the target of the DART and HERA space missions. The primary body, Didymos, rotates close to the spin at which it is expected to shed mass. The secondary body, Dimorphos, is a 140 meters moon that orbits the primary body in about 12 h. Here we investigate the possible origin of Dimorphos. Using 1D models of ring/satellite interactions, we study the evolution of material lost from Didymos’ surface and deposited as a ring at its equator. We find that due to viscous spreading, the ring spreads outside the Didymos’ Roche limit forming moonlets. A fraction of the mass will form Dimorphos and a set of objects near the Roche limit, while most of the ring’s mass falls back on Didymos. To match the properties of today’s Dimorphos, the total mass that must be deposited in the ring is about 25% of Didymos’ mass. It is possible that a fraction of the material travelled several times between the ring and the surface of Didymos. The models produce an orbit similar to that observed for a Didymos tidal parameter k2/Q≤10−5. If the ring deposition timescale is long (≥102 yr) (so the material flux is small) Dimorphos could be irregularly shaped as it forms from the collision of similar-sized satellitesimals. However, the top-shape of Didymos is expected to be achieved due to a fast spin-up of the asteroid, which would result in a short deposition timescale (≲yr). In that case, the satellite would form from progressively accreting material at the Roche Limit, resulting in an ellipsoidal Dimorphos constructed of small pieces with sizes of the order of meters, which is apparently in agreement with the recent images of Dimorphos obtained by DART mission.

Initial observations of medically complex young adults transitioning to adult care: Revealing data regarding mental health, nutrition, and transition preparedness

BackgroundApproximately one million adolescents with medical complexity transition into adult healthcare each year. Pediatric and adult providers alike have identified several barriers to transition, including insufficient knowledge of community resources, a lack of reimbursement for providing transition services, and an overall shortage of medical providers. Because of these barriers, the healthcare needs and challenges of this population have been understudied. The purpose of this article is to describe findings regarding nutrition, mental health, transition readiness, and caregiver burnout in a patient population of medically complex young adults in the interdisciplinary STEP clinic in the state of Alabama. Through the establishment of streamlined transition programs such as STEP, providers can address the unique health care needs of this patient population, with particular emphasis on optimizing mental health and nutrition. MethodsAll patients seen at the STEP clinic from September 2020 to August 2021 (n = 169) were evaluated through pertinent validated assessments of transition readiness (TRAQ), and/or caregiver burden (ZBI), and/or mental health (PHQ9, GAD7). Additional variables collected from patient charts include age, race, diagnosis, primary insurance type, equipment dependence, and body mass index (BMI). ResultsThe average TRAQ score of patients included in this study is 3.57 ± 1.11. A TRAQ score of below 4.0 suggests that the patient is not yet ready to transition from pediatric to adult care. The average ZBI score of caregivers is 20.97 ± 12.59, which indicates mild to moderate caregiver burden. 33% of patients were found to have moderate to severe anxiety, and 28% were found to have moderate to severe depression. Only 3.6% of patients seen at the STEP clinic have a BMI within normal limits. 113 of our patients have ongoing use of medical technology, and 49% are wheelchair users. ConclusionsThe need for organized transition care for medically complex young adults is apparent and growing. This patient population faces unique challenges in navigating the adult healthcare system, and patients are often unprepared for the transition. It is crucial that multidisciplinary clinics in which mental health and nutrition are addressed become accessible to all patients within this high-risk population.