Maintenance Rate Research Articles

Helping the Noncompliant Child and Child Behavior Outcomes: An Exploratory Examination of Financial Strain.

Theoretical models and empirical research have highlighted the impact of economic disadvantage on children's psychosocial development broadly and the onset, maintenance, and treatment of early-onset (3-8 years) behavior disorders (BDs) more specifically. In the context of intervention, evidence suggests that economic disadvantage may pose risk for diminished parent-mediated treatment efficacy (e.g., Behavioral Parent Training [BPT]) given its impact on salient factors in the family system. Though, studies have shown significant variability in BPT outcomes within families experiencing economic disadvantage, suggesting that additional influences may further contribute to disparities in the trajectory of treatment and maintenance of treatment gains for this population. To address this gap in existing knowledge, financial strain, or the inability to meet financial needs, was examined in families (N = 54) of young children (3-8 years old) with low-income and clinically elevated behavior problems participating in one BPT program, Helping the Noncompliant Child (HNC). Results demonstrated that families who experienced greater levels of financial strain prior to engaging in HNC exhibited diminished maintenance of parent reported child behavior gains following treatment. Financial strain did not significantly influence rate of change or maintenance of treatment gains for HNC clinician-coded child compliance. Clinical implications and directions for future research are discussed. ClinicalTrials.gov Identifier: NCT02191956, registered on 6/18/2014.

Optimum source, rate, timing, and placement of phosphorus fertilizer for Illinois soybean

AbstractConsistent increases in soybean (Glycine max L.) grain yields over the past decades in Illinois have co‐increased P demand, but—as for many US Midwest states—P fertilizer recommendations are outdated. We evaluated soybean grain yield, P uptake and removal with grain harvest, and P use efficiency in 4 site‐years of field trials on Argiudolls‐Endoaquolls and Fragiudalfs‐Hapludalfs under annual P application treatments of source (monoammonium phosphate [MAP], diammonium phosphate [DAP], triple superphosphate [TSP]), rate (partial vs. full maintenance rate), and timing–placement combination (fall and spring broadcast, spring banding). Substituting ammonium phosphate fertilizers, the most commonly used P fertilizers in the US Midwest, with N‐free TSP supported similar yields and resulted in similar P removal as hypothesized, while avoiding co‐applied N that can be subject to losses primarily via leaching. Soybean yield and grain P removal were unresponsive to rate, timing, and placement even at the partial rate, although banding and spring application may have reduced N loss risk for MAP and DAP. Given the challenges in accurately estimating P removal rate by grain harvest due to the variability in yield and grain P concentrations across years, assessment of P use efficiency should focus on long‐term balance between fertilization (input) and crop removal (output).

Growth, Morphology and Respiratory Cost Responses to Salinity in the Mangrove Plant Rhizophora Stylosa Depend on Growth Temperature.

Mangrove plants, which have evolved to inhabit tidal flats, may adjust their physiological and morphological traits to optimize their growth in saline habitats. Furthermore, the confined distribution of mangroves within warm regions suggests that warm temperature is advantageous to their growth in saline environments. We analyzed growth, morphology and respiratory responses to moderate salinity and temperature in a mangrove species, Rhizophora stylosa. The growth of R. stylosa was accelerated in moderate salinity compared with its growth in fresh water. Under warm conditions, the increased growth is accompanied by increased specific leaf area (SLA) and specific root length. Low temperature resulted in a low relative growth rate due to a low leaf area ratio and small SLA, regardless of salinity. Salinity lowered the ratio of the amounts of alternative oxidase to cytochrome c oxidase in the mitochondrial respiratory chain in leaves. Salinity enhanced the leaf respiration rate for maintenance, but under warm conditions this enhancement was compensated by a low leaf respiration rate for growth. In contrast, salinity enhanced overall leaf respiration rates at low temperature. Our results indicate that under moderate saline conditions R. stylosa leaves require warm temperatures to grow with a high rate of resource acquisition without enhancing respiratory cost.

Arbuscular mycorrhizal fungus activates wheat physiology for higher reproductive allocation under drought stress in primitive and modern wheat

Arbuscular mycorrhizal fungus (AMF) can mediate physiological adaptation of higher plants to drought stress, including wheat. Yet, it is unclear how AMF affects reproductive output via mediating crop physiological vitality at the evolutionary scale. To clarify this issue, a growth environment-controlled experiment was conducted using four primitive wheat genotypes and four modern ones with or without AMF (Funneliformis mosseae) inoculation. Two water regimes (80 % and 40 % field water capacity, FWC80 (well-watered) and FWC40 (drought stress)) were included. The data indicated that AMF inoculation significantly improved leaf area, photosynthetic rate, stomatal conductance and water use efficiency under drought stress, compared to the non-AMF group (CK). Regardless of soil moisture, the relationship between reproductive biomass vs. vegetative biomass (R-V), and between leaf biomass vs. shoot biomass, all fell into a typical allometric pattern (α>1, P<0.001) in primitive wheat. In contrast, in modern wheat, the R-V relationship tended to an isometric pattern (α≈1, P<0.001), showing lower α values in all treatments relative to primitive ones. Furthermore, AMF inoculation significantly promoted the maintenance rate of yield and biomass under drought stress, suggesting greater drought tolerance as induced by AMF in modern wheat compared to primitive ones. These findings illuminated a key evolutionary strategy to enhance reproductive allocation via activating physiological activities under drought stress from primitive to modern wheat.

Long-term safety and efficacy of ropeginterferon alfa-2b in Japanese patients with polycythemia vera.

Ropeginterferon alfa-2b (ropegIFN), a new-generation interferon-based agent, has been approved in Japan for patients with polycythemia vera (PV) who are ineligible for or respond inadequately to conventional treatment. However, long-term outcomes with ropegIFN in Japanese patients have not been reported. This extension of a phase2 study of ropegIFN in Japanese patients with PV aimed to determine its long-term safety/efficacy, and changes over time in JAK2 V617F allele burden. Here, we report data from the phase2 study and subsequent extension over a period of 36months. The primary endpoint was the complete hematologic response (CHR) maintenance rate without phlebotomy (hematocrit value < 45% without phlebotomy during the previous 12weeks, platelet count ≤ 400 × 109/L, and white blood cell count ≤ 10 × 109/L). The CHR maintenance rates were 8/27 (29.6%), 18/27 (66.7%), and 22/27 (81.5%) at 12, 24, and 36months, respectively. No thrombotic or hemorrhagic events occurred. The median allele burden change from baseline was - 74.8% at 36months. All patients experienced adverse events; 25/27 (92.6%) experienced adverse drug reactions (ADRs), but no serious ADRs or deaths occurred. This interim analysis demonstrated the safety and efficacy of ropegIFN over 36months in Japanese patients with PV.

Placebo rates in Crohn’s disease randomized clinical trials: An individual patient data meta-analysis

Understanding placebo rates is critical for efficient clinical trial design. We assessed placebo rates and associated factors using individual patient data (IPD) from Crohn's disease (CD) trials. We conducted a meta-analysis of phase 2/3 placebo-controlled trials evaluating advanced therapies in moderate-to-severe CD (2010-2021). Deidentified IPD were obtained through Vivli Inc. and Yale University Open Data Access Project. Primary outcomes were clinical response and remission. Pooled placebo rates and 95% confidence intervals (CIs) were estimated using one- and two-stage meta-analytical approaches. Regression analyses identified patient-level factors associated with placebo rates. Using IPD from eight induction (n=1147) and four maintenance (n=524) trials, overall placebo clinical response and remission rates for induction were 27% (95%CI=23-32%) and 10% (95%CI=8-14%) respectively, and 32% (95%CI=23-42%) and 22% (95%CI=14-33%) for maintenance, respectively. Among bio-naïve patients, placebo response and remission rates during induction were 29% (95%CI=24-35%) and 11% (95%CI=8-15%) respectively, and 26% (95% CI=20-33%) and 10% (95% CI=8-14%) for bio-exposed, respectively. During maintenance, bio-naïve response and remission rates were 41% (95%CI=34-48%) and 32% (95%CI=24-40%), respectively, and 29% (95%CI=24-34%) and 16% (95%CI=13-21%) for bio-exposed, respectively. Higher baseline C-reactive protein concentration predicted lower placebo rates, while higher baseline albumin levels and body mass index increased the odds of placebo outcomes. Increased baseline Crohn's Disease Activity Index and 2-item patient-reported outcome scores predicted higher response rates in induction, lower response rates in maintenance, and lower remission rates in induction and maintenance. Patient- and trial-level characteristics influence placebo rates in CD trials. Careful implementation of eligibility criteria, outcome definitions, and patient stratification may reduce placebo rates.

Integrated optimization for X-bar control chart, preventive maintenance and production rate

There are close relationships among statistical process control, maintenance, and production that have not fully explored in existing studies. In this study, we propose an economic model for jointly optimizing the X-bar control chart, preventive maintenance, and production rate. Unlike conventional studies relying on known failure rate functions, we employ a Gamma process to describe the system's deterioration. This approach allows us to consider not only the relationship between the production rate and the deterioration rate but also a broad range of deterioration scenarios and failure modes in the integrated optimization. After calculating the failure probability at each time point, we propose a recursive method to derive the production revenue, process control costs, and quality losses. This approach explores the close inner relationship between the production rate, deterioration, process monitoring and maintenance. Subsequently, we establish an optimization model aimed at maximizing the profit rate within a renewal cycle. The decision variables of this model include the production rate, control chart coefficient, sample size, length of the first sampling interval, and number of sampling intervals. Finally, we use a case study to illustrate the effectiveness and validity of our proposed model by identifying and explaining the interactions between production rate, deterioration, process control and maintenance.

The long-lasting maintenance of the pore structure achieves the stability of lithium metal batteries

The separator is considered critical to the safety and performance of lithium metal batteries (LMBs), however, the separator structure fails under high temperature conditions due to damage resulting in decreased mechanical strength, which causes short-circuiting of the battery. This paper describes a novel process to prepare stable and uniform dispersions of aramid nanofibers (ANFs) by bottom-up low-temperature polymerization, and then crosslink the ANFs with N2 plasma-treated polypropylene (PP) separator through capping isocyanate crosslinkers. The composite separator not only has excellent mechanical properties with hardness and modulus of elasticity up to 0.35 and 2.26 GPa, which is three times higher than the PP separator, but also has high-temperature thermal stability, the size maintenance rate reaches 99.8 % at 200 °C. Meanwhile, real-time monitoring of the pore size at different temperatures by synchrotron radiation small-angle X-ray scattering (SR-SAXS) showed that the pore radius of gyration was kept at 8.81 nm and the size change rate was only 22.8 % at 200 °C, which demonstrated that the composite separator had an outstanding ability to maintain the pore structure to ensure the stability of the ionic transport channel. Therefore, the crosslinked composite separator has greater potential for improving the performance and safety of LMBs in extreme high-temperature environments.

A Portable Fluid Administration System for Prolonged Intravenous Fluid Administration in Subadult and Adult White Rhinoceroses (Ceratotherium simum).

While translocations of white rhinoceroses have become an important conservation tool, dehydration during long-distance transports has been identified as a welfare concern. Intravenous (iv) fluid administration might therefore be useful to mitigate dehydration; however, special requirements need to be met to make iv fluid administration suitable for large, wild rhinoceroses during transport. Requirements include a portable and robust system that is capable of delivering high flow rates, is easy to set up, and remains patent and operating for long periods of time while allowing the animals to freely stand or lay down in the transport crates. Due to the lack of suitable fluid administration systems, we developed a custom-made system consisting of 8 L drip bags, a three-part, 4.4-m-long, large bore and partially coiled administration set, and a robust, battery-operated infusion pump, which allowed us to successfully administer iv fluids at a maintenance rate of 1-2 mL/kg/h to eight rhinoceroses for 24 h during a mock transport. While iv fluid administration in transported rhinoceroses is time intensive and the large amount of drip bags required during lengthy transports might pose a limitation, the developed system may be useful for the long-distance transport of small groups of rhinoceroses. Furthermore, this system would be of value for injured or sick rhinoceroses, which require parenteral fluid therapy when commercially available infusion pumps cannot provide the large fluid volumes needed.

Endoscopic hand suturing has the potential to reduce bleeding after gastric endoscopic submucosal dissection in patients on antithrombotic agents: Multicenter phase II study.

The risk of postoperative bleeding is high after gastric endoscopic submucosal dissection (ESD) in patients continuously treated with antithrombotic agents (ATAs). The effectiveness of endoscopic hand suturing (EHS) on bleeding after gastric ESD was investigated in patients at high risk of delayed bleeding. Patients with neoplasms ≤2 cm who underwent gastric ESD and continued to receive perioperative ATAs were enrolled in this multicenter phase II study. The mucosal defect was closed with EHS after removing the lesion. Postoperative bleeding rate was assessed for 3-4 postoperative weeks as a primary outcome measure. The technical success of EHS and adverse events were also assessed. Based on expected and threshold postoperative bleeding rates of 10% and 25%, respectively, we aimed to include 48 patients in the study. A total of 49 patients were enrolled in the study, and 43 patients were finally registered as the per-protocol set. The postoperative bleeding rate was 7.0% (3/43 patients; the upper limit of one-sided 95% confidence interval [CI], 17.1% and 97.5% CI, 19.1%). The upper limits of the CI were below the threshold value (25%), and the postoperative bleeding rate was below the expected value (10%). The technical EHS success rate, closure maintenance rate on postoperative day 3, and postoperative subclinical bleeding rate were 100%, 83%, and 2%, respectively. No severe adverse events related to EHS were observed. Endoscopic hand suturing may prevent postoperative bleeding in patients undergoing gastric ESD while being treated continuously with ATAs (UMIN000038140).

Evaluation of the management of a first crisis of atrial fibrillation in a group of Cameroon’s urban setting subjects

BackgroundAtrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. When atrial fibrillation is first diagnosed, it tends to be permanent and associated with significant morbidity and mortality. We aimed to study the management of a first episode of atrial fibrillation in a group of patients in Yaounde, Cameroon.MethodsWe conducted a retrospective study with data collected from the Cardiology department of Yaounde Central Hospital and the internal medicine department of Yaounde General Hospital over five years (January 2017 to December 2021), for a duration of 4 months, from February 2022 to May 2022. All patients older than 15 years with a first episode of atrial fibrillation were included, and all patients with incomplete medical records were excluded. The association between different variables was assessed using a χ² test and logistic regression method with a significance threshold of p < 0.05.ResultsOf the 141 patients recruited, the mean age was 68.5 ± 10.6 years. The sex ratio (M/F) was 0.7. The main associated factors and co-morbidities were hypertension in 70.2% (99) patients, heart failure in 36.9% (52) patients and a sedentary lifestyle in 33.3% (47) patients. The most common anticoagulant treatment was AntiVitamin K, used in 64.5% (91) of patients. Heart rate control was the most commonly used symptom control strategy in 85.1% (120) patients, mainly with beta-blockers in 52.5% (74). We found 1.4% (2) participants who were not treated with antithrombotics as recommended. Treatment of arrhythmia due to co-morbidities was not always recommended. The complication rate was 94.3% (133) patients. Control of the bleeding risk due to antithrombotic therapy and monitoring of anticoagulant therapy were not optimal. The heart rate control strategy had a higher success rate, and the sinus rhythm maintenance rate at one year was 61.7% (37) participants.ConclusionThe management of a first episode of atrial fibrillation at Yaoundé’s Central and General Hospitals is not always performed according to current recommendations and is far from optimal. However, nearly two out of three patients maintained sinus rhythm for one year.

How do plateau pikas use burrows during population reestablishment?

The construction of burrow systems is one of the most important challenges for burrowing animals, especially during population reestablishment. Efficient use of the existing resources could help improve the survival chances. To explore the strategies burrowing animals take in using the burrow resources, we conducted monthly field monitoring of the four features (Active burrows (AcB), abandoned burrows (AbB), latrine pits (LP), and shallow duck holes (SDH)) of plateau pika (Ochotona curzoniae) burrow systems after population extermination. The results indicated that the existing burrows were largely utilized in rebuilding their new burrow systems. The use rates of the four features were in the order of AcBs > AbBs > LPs > SDHs. More energy-saving measures were taken in using the existing burrows during population reestablishment than in the undisturbed natural ecosystems, including higher maintenance rates, higher transformation rates to AcBs, lower disappearing rates and new adding rates, especially in short time intervals; and burrows at the early breeding season are used more stable than at other times. Our study has implications for the population reestablishment of endangered burrowing animals.

Research on accident early warning of metallurgical enterprises based on grey DEMATEL/ISM and Bayesian network

To clarify the complex relationship between the factors causing safety accidents in metallurgical enterprises and predict the risk of accidents in enterprises, a correlation analysis model of the factors causing safety accidents in metallurgical enterprises based on grey Decision-Making Trial and Evaluation Laboratory/Interpretative Structural Modeling (DEMATEL/ISM) was established, and a Bayesian network early warning model was constructed on this basis. The relationship and action path of accident-causing factors in metallurgical enterprises were clarified. The factors were hierarchically divided and a multi-layer hierarchical structure model was established to obtain the neighboring cause, transitional cause, and essential cause of the accident. The results showed that the employee violation rate, the hazardous substances reserves, the toxic gas and dust pollution control compliance rate, the pass rate for equipment maintenance, and the qualification rate of special equipment were the neighboring causes of the accident. The perfection of the safety production management system was the essential cause. The Bayesian network early warning model was applied to the Fuxin Jiuxing Titanium work site. The expected risk probability of an accident was 17.9%, which was in a comparatively safe state (State2). The results obtained by the Bayesian model are consistent with those obtained by AHP and fuzzy comprehensive evaluation method, which proved the accuracy of the early warning model. The Bayesian model can give the risk probability value of the accident and the risk probability value of the accident cause factors at the same time, and include the causal relationship and conditional correlation relationship among the indicator variables in the reasoning process, which can provide targeted technical support for the construction of the emergency system of risk classification management and control.

Therapeutic Maintenance of Janus Kinase Inhibitors in Real Life for Rheumatoid Arthritis: Retrospective Study.

Background/Objectives: Janus kinase inhibitors (JAKis) belong to a new class of targeted oral drugs that have been added to the therapeutic arsenal for rheumatoid arthritis (RA). The aim of this study was to evaluate the efficacy and safety profiles of these four available molecules (tofacitinib, baricitinib, filgotinib, and upadacitinib) in real life. Methods: A retrospective, single-center observational study including all patients treated with JAKis for RA from 1 October 2017 to 1 December 2023. We assessed the maintenance rate at 24 months, which is an indirect reflection of the clinical and biological safety and efficacy profiles. Results: The 76 patients in our study were thus treated for the first time with anti-JAK, including 55 patients with baricitinib (BAR), 9 patients with tofacitinib (TOF), 4 patients with upadacitinib (UPA), and 8 patients with filgotinib (FIL). The majority of our patients had BAR introduced as the first intention. The therapeutic maintenance at 2 years for all our patients was 50%. The average maintenance duration was 8.6 months and was similar in all the groups. Of the 76 patients included in this study treated with Baricitinib (72.3%), 38 (50%) discontinued their treatment after two years of follow-up. Conclusions: Although this retrospective study is subject to various biases, it shows that the persistence rates of the four JAKi molecules in daily practice did not differ significantly, thus confirming the long-term efficacy of these drugs.

CRP improves the survival and competitive fitness of Salmonella Typhimurium under starvation by controlling the cellular maintenance rate.

Catabolite repression is a mechanism of selectively utilizing preferred nutrient sources by redirecting the metabolic pathways. Therefore, it prevents non-essential energy expenditure by repressing the genes and proteins involved in the metabolism of other less favored nutrient sources. Catabolite repressor protein (CRP) is a chief mediator of catabolite repression in microorganisms. In this context, we investigated the role of CRP in starvation tolerance, at both cell physiology and molecular level, by comparing the growth, survival, competitive fitness, maintenance rate, and gene and protein expression of wild type (WT) and ∆crp of Salmonella Typhimurium, under nutrient-rich and minimal medium condition. The ∆crp shows slow growth upon the arrival of nutrient-limiting conditions, poor survival under prolong-starvation, and inability to compete with its counterpart WT strain in nutrient-rich [Luria broth (LB)] and glucose-supplemented M9 minimal medium. Surprisingly, we observed that the survival and competitive fitness of ∆crp are influenced by the composition of the growth medium. Consequently, compared to the glucose-supplemented M9 medium, ∆crp shows faster death and a higher maintenance rate in the LB medium. The comparative gene and protein expression studies of WT and ∆crp in LB medium show that ∆crp has partial or complete loss of repression from CRP-controlled genes, resulting in a high abundance of hundreds of proteins in ∆crp compared to WT. Subsequently, the addition of metabolizable sugar or fresh nutrients to the competing culture showed extended survival of ∆crp. Therefore, our results suggest that CRP-mediated gene repression improves starvation tolerance and competitive fitness of Salmonella Typhimurium by adapting its cellular maintenance rate to environmental conditions.IMPORTANCESalmonella Typhimurium is a master at adapting to chronic starvation conditions. However, the molecular mechanisms to adapt to such conditions are still unknown. In this context, we have evaluated the role of catabolite repressor protein (CRP), a dual transcriptional regulator, in providing survival and competitive fitness under starvation conditions. Also, it showed an association between CRP and nutrient composition. We observed that Δcrp growing on alternate carbon sources has lower survival and competitive fitness than Δcrp growing on glucose as a carbon source. We observed that this is due to the loss of repression from the glucose and CRP-controlled genes, resulting in elevated cellular metabolism (a high maintenance rate) of the Δcrp during growth in a medium having a carbon source other than glucose (e.g., Luria broth medium).

Comparison of the inter-laminar approach and laminotomy open approach for filum terminale lipoma: A retrospective analysis.

Filum terminale lipoma (FTL) causes spinal-cord tethering and is associated with tethered-cord syndrome, which is treated by dissection of the entrapment. The conventional treatment for FTL involves dissection of the spinal cord through a laminotomy open approach (LOA). However, in recent years, the interlaminar approach (ILA) has gained popularity as a minimally invasive surgery. This study compares the effectiveness of the minimally invasive ILA with the conventional LOA in treating FTL. We retrospectively evaluated data on the ILA and LOA for FTL at our center. In total, 103 participants were enrolled, including 55 in the ILA group and 48 in the LOA group. The ILA required significantly less surgical time and resulted in less blood loss. The improvement rate of symptoms in symptomatic patients was 84%, and for urinary symptoms and abnormal urodynamic study findings, it was 77%. The postoperative maintenance rate for asymptomatic patients was 100%. Postoperative complications of ILA included delayed wound healing in two patients (3.6%). Compared with LOA, ILA offers advantages in terms of shorter operative time and less blood loss, with no significant difference in long-term symptom-improvement rates between the groups.

Radiofrequency Catheter Ablation for Atrial Fibrillation Patients on Hemodialysis (From the Kansai Plus Atrial Fibrillation Registry) - Clinical Impact of Early Recurrence.

Catheter ablation (CA) for atrial fibrillation (AF) in patients on hemodialysis (HD) is reported to have a high risk of late recurrence (LR). However, the relationship between early recurrence (ER) within a 90-day blanking period after CA in AF patients and LR in HD patients remains unclear.Methods and Results: Of the 5,010 patients in the Kansai Plus Atrial Fibrillation Registry, 5,009 were included in the present study. Of these patients, 4,942 were not on HD (non-HD group) and 67 were on HD (HD group). HD was an independent risk factor for LR after the initial CA (adjusted hazard ratio 1.6; 95% confidence interval 1.1-2.2; P=0.01). In patients with ER, the rate of sinus rhythm maintenance at 3 years after the initial CA was significantly lower in the HD than non-HD group (11.4% vs. 35.4%, respectively; log-rank P=0.004). However, in patients without ER, there was no significant difference in the rate of sinus rhythm maintenance at 3 years between the HD and non-HD groups (67.7% vs. 74.5%, respectively; log-rank P=0.62). ER in HD patients was a strong risk factor for LR. However, even HD patients could expect a good outcome without ER after the initial CA.

Improvement and Maintenance of Clinical Outcomes in a Digital Mental Health Platform: Findings From a Longitudinal Observational Real-World Study.

Digital mental health services are increasingly being provided by employers as health benefit programs that can improve access to and remove barriers to mental health care. Stratified care models, in particular, offer personalized care recommendations that can offer clinically effective interventions while conserving resources. Nonetheless, clinical evaluation is needed to understand their benefits for mental health and their use in a real-world setting. This study aimed to examine the changes in clinical outcomes (ie, depressive and anxiety symptoms and well-being) and to evaluate the use of stratified blended care among members of an employer-sponsored digital mental health benefit. In a large prospective observational study, we examined the changes in depressive symptoms (9-item Patient Health Questionnaire), anxiety symptoms (7-item Generalized Anxiety Disorder scale), and well-being (5-item World Health Organization Well-Being Index) for 3 months in 509 participants (mean age 33.9, SD 8.7 years; women: n=312, 61.3%; men: n=175, 34.4%; nonbinary: n=22, 4.3%) who were newly enrolled and engaged in care with an employer-sponsored digital mental health platform (Modern Health Inc). We also investigated the extent to which participants followed the recommendations provided to them through a stratified blended care model. Participants with elevated baseline symptoms of depression and anxiety exhibited significant symptom improvements, with a 37% score improvement in depression and a 29% score improvement in anxiety (P values <.001). Participants with baseline scores indicative of poorer well-being also improved over the study period (90% score improvement; P=.002). Furthermore, over half exhibited clinical improvement or recovery for depressive symptoms (n=122, 65.2%), anxiety symptoms (n=127, 59.1%), and low well-being (n=82, 64.6%). Among participants with mild or no baseline symptoms, we found high rates of maintenance for low depressive (n=297, 92.2%) and anxiety (n=255, 86.7%) symptoms and high well-being (n=344, 90.1%). In total, two-thirds of the participants (n=343, 67.4%) used their recommended care, 16.9% (n=86) intensified their care beyond their initial recommendation, and 15.7% (n=80) of participants underused care by not engaging with the highest level of care recommended to them. Participants with elevated baseline depressive or anxiety symptoms improved their mental health significantly from baseline to follow-up, and most participants without symptoms or with mild symptoms at baseline maintained their mental health over time. In addition, engagement patterns indicate that the stratified blended care model was efficient in matching individuals with the most effective and least costly care while also allowing them to self-determine their care and use combinations of services that best fit their needs. Overall, the results of this study support the clinical effectiveness of the platform for improving and preserving mental health and support the utility and effectiveness of stratified blended care models to improve access to and use of digitally delivered mental health services.

P‐168: Development of Conformal Anti‐diffraction Transparent LTPS TFT Pixel Arrays on Two‐axis Surface

This study shows the electrical and optical results of anti‐diffraction and high aperture ratio low‐temperature poly‐silicon (LTPS) TFT on bending surface. The resistance maintenance rate of the signal metal wiring is up to 90.4%. Our work gives rise to the results of stretchable LTPS TFT device, and indicates the excellent electrical maintenance stability of the metal wiring on a two‐axis bending surface with radius of Rx/Ry=600 mm/800 mm. The results also imply the high‐transparent anti‐diffraction pixel design on two‐axis surface could show clearer background image than traditional pixel design, which can be used as a basis for future development of different applications with conformal stretchable transparent displays.

Behavioural change for Parkinson’s Disease: A randomised controlled feasibility study to promote physical activity and exercise adherence among people with Parkinson’s: study protocol

Background Parkinson’s is a common progressive neurological condition characterized by motor and non-motor deficits. Physical activity and exercise can improve health, but many people with Parkinson’s (PwP) have trouble reaching the recommended dosage. Our recent literature review found improvements in exercise adherence with behavioural change interventions, but it remains unclear which are most effective. Further qualitative research and patient and public involvement has informed a novel behavioural change intervention to be tested alongside an existing exercise program. Objective To examine the feasibility of behavioural change techniques delivered alongside an exercise programme to improve physical activity, function, and self-efficacy in PwP (and study procedures) to inform a future pilot RCT trial. Methods A parallel-arm single blinded randomised feasibility study. Twenty participants with Parkinson’s (Hoehn and Yahr stage 1-3) will be recruited from a physiotherapy primary-care waiting list. Following written consent, and baseline assessment, the participants will be randomly allocated to the intervention (n=10) or the control group (n=10). Both groups will receive usual care, which includes a weekly program of a multidisciplinary education, a supervised exercise class and a prescribed home exercise program. The intervention group will receive additional behavioural change techniques, targeting behaviour regulation, belief about capabilities and social influences. Class and home exercise adherence, behavioural component uptake and adherence, and negative events will be recorded. Outcomes will include enrolment and maintenance rates, physical function, falls, physical activity, and exercise self-efficacy measured pre- and post- the 12-week program (in-person). Surveys will be used to compare experiences and satisfaction between groups. Exit interviews will be completed with the intervention group only, exploring their experience of the behavioural change techniques. Discussion The results will help inform a future pilot RCT, based on the intervention acceptability, consent rate, maintenance, and protocol integrity. Trial Registration ClincialTrials.gov NCT06192628