Robust Error Research Articles

Robust logarithmic hyperbolic cosine adaptive filtering over graph signals

Graph signal processing (GSP) has two methods including graph Fourier transform (GFT) and graph shift-operator (GSO) for dealing with the graph signal used for adaptive filtering (AF). However, in order to perform feature decomposition, GFT requires the availability of a band-limited graph signal with a known bandwidth in advance. Therefore, a general model based on GSO is then derived for AF by introducing a mixture coefficient to combine the advantages of different GSOs, comprehensively. Since the existing algorithms using the mean square error and other robust error criteria in GSP cannot effectively fight against non-Gaussian noises, a robust logarithmic hyperbolic cosine adaptive filter over graph (GLHCAF) algorithm is proposed by applying the logarithmic hyperbolic cosine loss function to the designed general model. The significant performance improvement of GLHCAF in non-Gaussian noises is obtained by simply controlling the scaling parameter. To avoid the parameter selections including scaling parameter and step size, the adaptive GLHCAF (AGLHCAF) algorithm is therefore proposed to further improve the performance of GLHCAF. Moreover, the mean square performance analysis of GLHCAF is given. Simulations in the real-world data are provided to assess the reliability and accuracy for theoretical analysis, the universality of the designed general model, and superiorities of proposed algorithms.

Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75.

Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup. Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors. Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (≥58) compared to younger participants (<58). Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.

Profile of a large cohort of children with persistent fetal vasculature and their predictors of poor visual outcome in a tertiary eye hospital in Saudi Arabia.

To present the profile of a large cohort of children with persistent fetal vasculature (PFV) and identify their predictors of poor visual outcome in a tertiary eye hospital in Saudi Arabia. This was a single-center study. Medical records of children diagnosed with persistent fetal vasculature between January 1990 and January 2020 at King Khaled Eye Specialist Hospital (KKESH), Riyadh, were reviewed. Data were collected on PFV type, presenting features, management, and visual acuity. Poisson regression with robust error variance was used to identify the predictors of poor visual outcome. Data of 175 eyes of 170 children with PFV were analyzed. Most had unilateral disease (n = 165, 96.2%), and over half of them (57.1%) were males. The main presenting complaints were leukocoria (n = 126, 72.0%), followed by smaller eye (n = 36, 20.6%), poor vision (n = 15, 8.6%), and strabismus (n = 13, 7.4%). Anterior, posterior, and combined PFV were present in 30.9%, 10.9%, and 58.3% eyes, respectively. In eyes with measurable visual acuity (n = 124), BCVA at the last follow-up was ≥20/100, <20/100-20/400, CF/HM and LP/NLP in 11 (8.9%), 32 (25.8%), 43 (34.7%), and 38 (30.6%) eyes, respectively. In the multivariable poisson regression analysis, eyes with posterior PFV were approximately two times more likely to have a BCVA of CF or worse than those with anterior PFV (Adjusted incidence ratio: 1.82 (95%: 1.23, 2.70; P = 0.003). Compared with eyes with primary or secondary IOL implantation, aphakic eyes or those with no cataract surgery were significantly more likely to have BCVA of CF or worse (adjusted incidence ratio: 1.84 [95%: 1.18, 2.86], p = 0.007 and adjusted incidence ratio: 1.64 [95%: 1.08, 2.50], p = 0.020, respectively). The prognosis of PFV varies depending on the severity of the disease. Patients with posterior PFV had worse visual outcome than anterior or combined type. Whether primary or secondary, IOL implantation increases the probability of having BCVA better than CF.

When to Transfer: Predictors of Pediatric High Flow Nasal Cannula Failure at a Community Hospital.

To identify risk factors of high flow nasal cannula (HFNC) failure at a US pediatric hospital without a co-located ICU. Retrospective cohort study of patients aged 0 to 18 years who were started on HFNC in the emergency department or inpatient unit at a community hospital over a 16-month period. Children with chronic medical conditions were excluded. Outcome was HFNC failure, defined as HFNC need greater than floor limit, noninvasive positive pressure, or mechanical ventilation. In bivariate analysis, we compared demographic and clinical factors between those with and without failure. We included variables in a multivariable model on the basis of statistical significance. We used Poisson regression with robust error variance to calculate the adjusted relative risk (aRR) of failure for each variable. Of 195 children, 51% had HFNC failure. In adjusted analysis, failure was higher in all age groups <12 months as compared with older children. For example, children aged 3 to 5 months had a higher risk of failure compared with patients 12 months or older (aRR 1.85, confidence interval [CI] 1.34-2.54). Patients with an asthma exacerbation had a higher risk of failure (aRR 1.39, CI 1.03-1.88). Patients whose respiratory rate or heart rate did not improve also had a higher risk of failure (aRR 1.73, CI 1.24-2.41; aRR 1.47, CI 1.14-1.90). Patients who were younger, had asthma, and did not have improved respiratory rate or heart rate after HFNC were more likely to experience HFNC failure.

SuperAdjoint: Super-resolution neural networks in adjoint-based error estimation

Numerical simulations and optimisation methods, such as mesh adaptation, rely on the accurate and inexpensive use of error estimation methods. Adjoint-based error estimation is the most accurate method, and generally the most costly. A strong contributor to this cost is the need to compute a higher resolution adjoint solution. Here, it is proposed to use super-resolution neural networks to super-resolve a fine adjoint solution from a lower-cost coarse adjoint solution: a superAdjoint. The method is compared to reference error estimators on an unsteady Burgers’ equation using the method of manufactured solutions. Two forms of the superAdjoint were implemented, a twice and a four times refining super-resolution neural network. These were used to demonstrate both the computational cost reduction and the potential for the reduction of the storage footprint of the primal problem. The first, referred to as 2×CNN, was able to reconstruct the spatially enriched adjoint solution, thus providing a robust and inexpensive local output error. The second, the 4×CNN, was able to demonstrate the reconstruction ability of super-resolution neural networks for higher upscaling factors. This was leveraged in order to subsample the primal solution in space, thus reducing substantially the storage footprint of the discrete primal solution. Both superAdjoints could achieve the desired level of accuracy when compared to the reconstruction of the refined adjoint-based error estimate. Moreover, superAdjoint was shown to be able to generalise to a new QoI that was untrained for. This gives great confidence in the use of super-resolution neural networks for the reduction of both computational cost and storage requirements of adjoint-based error estimation, and goal-oriented mesh adaptation.

Thermal error modeling of servo axis based on optimized LSSVM with gray wolf optimizer algorithm

Thermal error of a CNC machine tool has a serious effect on its machining accuracy. In order to reduce the thermal error, establishing an accurate and robust thermal error model is necessary. A new data-driven thermal error model is proposed based on gray wolf optimizer (GWO) and least squares support vector machine (LSSVM). While, three temperature-sensitivity points (TSPs) were picked by grouping search method. With optimizing the hyperparameters γ and σ2 by GWO algorithm, LSSVM is applied to thermal error modeling, which has advantages in dealing with small samples and nonlinear data. The experiments were conducted, and the results showed that the error prediction model constructed by GWO-LSSVM achieved an accuracy of 94.39 % meeting the requirements for error compensation. Then, the stability of the proposed error model is verified. Finally, the LSSVM model is compared with MLR and BP models commonly used in error modeling, and the advantages and applicable occasions are analyzed through experiments.

Associations between weekly gestational exposure of fine particulate matter, ozone, and nitrogen dioxide and preterm birth in a North Carolina Birth Cohort, 2003-2015.

Preterm birth (PTB; <37 weeks completed gestation) is associated with exposure to air pollution, though variability in association magnitude and direction across exposure windows exists. We evaluated associations between weekly gestational exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with PTB in a North Carolina Birth Cohort from 2003 to 2015 (N = 1,367,517). Daily average PM2.5 and daily 8-hour maximum NO2 concentration estimates were obtained from a hybrid ensemble model with a spatial resolution of 1 km2. Daily 8-hour maximum census tract-level concentration estimates for O3 were obtained from the EPA's Fused Air Quality Surface Using Downscaling model. Air pollutant concentrations were linked by census tract to residential address at delivery and averaged across each week of pregnancy. Modified Poisson regression models with robust errors were used to estimate risk differences (RD [95% confidence intervals (CI)]) for an interquartile range increase in pollutants per 10,000 births, adjusted for potential confounders. Associations were similar in magnitude across weeks. We observed positive associations for PM2.5 and O3 exposures, but generally null associations with NO2. RDs ranged from 15 (95% CI = 11, 18) to 32 (27, 37) per 10,000 births for PM2.5; from -7 (-14, -1) to 0 (-5, 4) for NO2; and from 4 (1, 7) to 13 (10, 16) for O3. Our results show that increased PM2.5 exposure is associated with an increased risk of PTB across gestational weeks, and these associations persist in multipollutant models with NO2 and/or O3.

Prenatal exposure to Per- and polyfluoroalkyl substances and adiposity measures of children at 4 and 6 years: A prospective birth cohort in China

There is growing evidence that prenatal exposure to Per- and polyfluoroalkyl substances (PFAS) was associated with childhood obesity, but evidence on multiple adiposity measures including arm circumference (AC), and waist circumference (WC) among Chinese children is limited. We investigated the associations of prenatal exposure to PFAS with adiposity measures of children at 4 and 6 years of age in the Shanghai-Minhang Birth Cohort Study. A total of 573 mother-child pairs with maternal PFAS concentrations and at least one measurement of adiposity measures of children were included in the present study. Eleven PFAS were assessed in maternal fasting blood samples. Information on children's weight, height, AC, and WC was collected at follow-ups. Weight for age Z score (WAZ), body mass index for age Z score (BMIz), and children overweight were calculated based on the World Health Organization Child Growth Standards. Multivariate linear regression, Poisson regression with robust error variance, and Bayesian Kernel Machine Regression (BKMR) models were used to examine the associations of prenatal exposure to PFAS with children's adiposity measures. Eight PFAS with detection rates above 85 % were included in the analyses. In the multivariate linear regression models, maternal PFNA concentrations were associated with a greater AC (β = 0.29, 95 % Confidence Interval (CI): 0.04–0.55) in 4-year-old children and with an increase in WAZ (β = 0.26, 95 % CI: 0.06–0.46), BMIz (β = 0.31, 95 % CI: 0.09–0.53), AC (β = 0.49, 95 % CI: 0.08–0.90), and WC (β = 1.47, 95 % CI: 0.41–2.52) in 6-year-old children. We also observed the associations of maternal concentrations of PFOS, PFNA, PFUdA, and PFTrDA with the increased risk of children overweight in 6-year-old children. BKMR models further supported the findings from multivariate linear regression and Poisson regression models, and identified PFNA as the most important contributor. Moreover, the associations described above were generally more pronounced in girls. In conclusion, prenatal exposure to PFAS was associated with an increased risk of children's adiposity with a sex-specific manner, and PFNA contributed most to the associations after controlling for the effect of co-exposure to other PFAS compounds, especially among girls at 6 years of age.

Maternal education and its association with maternal and neonatal adverse outcomes in live births conceived using medically assisted reproduction (MAR)

BackgroundTo examine the association between maternal education and adverse maternal and neonatal outcomes in women who conceived using medically assisted reproduction, which included fertility medications, intrauterine insemination, or in vitro fertilization.MethodsWe conducted a retrospective cohort study utilizing the US Vital Statistics data set on national birth certificates from 2016 to 2020. Women with live, non-anomalous singletons who conceived using MAR and had education status of the birthing female partner recorded were included. Patients were stratified into two groups: bachelor’s degree or higher, or less than a bachelor’s degree. The primary outcome was a composite of maternal adverse outcomes: intensive care unit (ICU) admission, uterine rupture, unplanned hysterectomy, or blood transfusion. The secondary outcome was a composite of neonatal adverse outcomes: neonatal ICU admission, ventilator support, or seizure. Multivariable modified Poisson regression models with robust error variance adjusted for maternal age, race, marital status, prenatal care, smoking during pregnancy, neonatal sex, and birth year estimated the relative risk (RR) of outcomes with a 95% confidence interval (CI).Results190,444 patients met the inclusion criteria: 142,943 had a bachelor’s degree or higher and 47,501 were without a bachelor’s degree. Composite maternal adverse outcomes were similar among patients with a bachelor’s degree (10.1 per 1,000 live births) and those without a bachelor’s degree (9.4 per 1,000 live births); ARR 1.05, 95% CI (0.94–1.17). However, composite adverse neonatal outcomes were significantly lower in women with a bachelor’s degree or higher (94.1 per 1,000 live births) compared to women without a bachelor’s degree (105.9 per 1,000 live births); ARR 0.91, 95% CI (0.88–0.94).ConclusionsOur study demonstrated that lower maternal education level was not associated with maternal adverse outcomes in patients who conceived using MAR but was associated with increased rates of neonatal adverse outcomes. As access to infertility care increases, patients who conceive with MAR may be counseled that education level is not associated with maternal morbidity. Further research into the association between maternal education level and neonatal morbidity is indicated.

Investigating inequalities in cancer staging and survival for adults with intellectual or developmental disabilities and cancer: A population-based study in Manitoba, Canada

BackgroundCancer is a leading cause of death among adults living with intellectual or developmental disabilities (IDD). However, few epidemiological studies exist worldwide quantifying inequalities in cancer stage at diagnosis and survival for people with IDD relative to those without IDD. MethodsA population-based, retrospective cohort study was conducted using provincial health and social administrative data in Manitoba, Canada. Adults (≥18 years) with a cancer diagnosis between 2004 and 2017 were included. Lifetime IDD was identified before the cancer diagnosis using an established algorithm. Modified Poisson regression with robust error variance was used to estimate the association between IDD status and metastatic cancer at diagnosis. Multivariable Cox proportional hazards analyses were used to the effect of IDD on overall survival following the cancer diagnosis. ResultsThe staging and prognosis cohorts included 62,886 (n = 473 with IDD) and 74,143 (n = 592 with IDD) cancer patients, respectively. People living with IDD were significantly more likely to be diagnosed with metastatic cancer and die following their cancer diagnosis compared to those without IDD (RR=1.20; 95 % CI 1.05–1.38; HR= 1.53; 95 % CI 1.38–1.71). Significant heterogeneity by sex was identified for cancer survival (p = 0.005). DiscussionPeople with IDD had more advanced cancer stage at diagnosis and worse survival relative to those without IDD. Identifying and developing strategies to address the factors responsible that contribute to these disparities is required for improving patient-centred cancer care for adults with IDD.

Spinal Hypotension and Time from Spinal-to-Delivery in Scheduled Cesarean Deliveries: Association with Neonatal Acidosis.

This work aimed to study the effect of sustained hypotension after spinal on neonatal acidosis and adverse outcomes in those undergoing scheduled cesarean delivery (CD) with universal prophylactic vasopressor exposure and to examine differences in spinal-to-delivery time by neonatal acidosis status. This retrospective cohort study conducted at a quaternary care center from January 2019 to December 2021 included singleton, term, nonanomalous pregnancies, with scheduled CD under spinal anesthesia. Hypotension was defined as a systolic blood pressure (SYS-BP) < 100 mm Hg (SYS-BP100) or a >20% drop from baseline blood pressure (SYS-BP20). Both the occurrence of hypotension and its magnitude and duration were studied; the latter through the development of a hypotension index. The 90th and 95th percentiles of the hypotension index for SYS-BP20 and SYS-BP100, respectively, were used to define sustained hypotension. The primary outcome was neonatal acidosis (umbilical artery pH ≤ 7.1 or base excess ≤ -12 mmol). Secondary outcomes were composites of neonatal (CNAO) and maternal (CMAO) adverse outcomes. Multivariable Poisson regression models with robust error variance analysis was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs). Our study included 332 individuals who underwent scheduled CD; among them 330 (99.4%) received prophylactic vasopressors. The rate of neonatal acidosis was 4.2%. Sustained hypotension after spinal anesthesia, which occurred in 12.3% of the cohort, was associated with increased risk for neonatal acidosis (aRR 3.96, 95% CI 1.21-12.98), but was not associated with CNAO or CMAO. Time from spinal-to-delivery was not different in those with and without neonatal acidosis. Despite universal exposure to prophylactic vasopressors, sustained hypotension after spinal anesthesia was still associated with neonatal acidosis, but no other adverse perinatal outcomes. Our findings may provide additional support for the adoption of prophylactic vasopressors to reduce spinal hypotension and downstream effects on the neonate from intraoperative hemodynamic instability. · Despite prophylactic vasopressors during scheduled CD, neonatal acidosis occurred in 4% of subjects.. · Sustained hypotension after spinal anesthesia was associated with neonatal acidosis, but not adverse neonatal outcomes.. · Spinal-to-delivery time was not associated with neonatal acidosis in scheduled CD..

First VLTI/GRAVITY Observations of HIP 65426 b: Evidence for a Low or Moderate Orbital Eccentricity

Giant exoplanets have been directly imaged over orders of magnitude of orbital separations, prompting theoretical and observational investigations of their formation pathways. In this paper, we present new VLTI/GRAVITY astrometric data of HIP 65426 b, a cold, giant exoplanet which is a particular challenge for most formation theories at a projected separation of 92 au from its primary. Leveraging GRAVITY’s astrometric precision, we present an updated eccentricity posterior that disfavors large eccentricities. The eccentricity posterior is still prior dependent, and we extensively interpret and discuss the limits of the posterior constraints presented here. We also perform updated spectral comparisons with self-consistent forward-modeled spectra, finding a best-fit ExoREM model with solar metallicity and C/O = 0.6. An important caveat is that it is difficult to estimate robust errors on these values, which are subject to interpolation errors as well as potentially missing model physics. Taken together, the orbital and atmospheric constraints paint a preliminary picture of formation inconsistent with scattering after disk dispersal. Further work is needed to validate this interpretation. Analysis code used to perform this work is available on GitHub: https://github.com/sblunt/hip65426.

Distributed adaptive event-triggered asymptotic tracking control of linear uncertain multiagent systems by using output only

For the robust tracking control problem of multiagent systems with linear uncertainties, most of the existing studies require full state feedback. Moreover, the designed control strategy also uses global information, such as the number of agents or the eigenvalues of the Laplacian matrix, which does not satisfy the distributed requirement for multiagent design. To address these problems, first, a Luenburger observer is designed to observe the full state of the system by using the output information. Second, the constant gain in the traditional distributed observer for estimating exosystem state information is replaced with a time-varying gain that comes from the output of a newly designed filter, which avoids the use of the global information mentioned above. Finally, based on the above observer and adaptive dynamic feedback, an event-triggered output feedback control strategy is given. This control strategy is not only piecewise constant, which is easy to implement, but also makes the robust tracking control error converge asymptotically to zero. Furthermore, it is theoretically proven that each agent does not have Zeno behaviour, and the effectiveness of the designed control strategy is verified with a simulation example.

The Influence of Adiposity Levels on the Relation between Perfluoroalkyl Substances and High Depressive Symptom Scores in Czech Adults.

The extensive use and bioaccumulation of Perfluoroalkyl Substances (PFAS) over time raise concerns about their impact on health, including mental issues such as depression. This study aims to evaluate the association between PFAS and depression. In addition, considering the importance of PFAS as an endocrine disruptor and in adipogenesis, the analyses will also be stratified by body fat status. A cross-sectional study with 479 subjects (56.4% women, 25-89 years) was conducted. Four PFAS were measured: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctane sulfonate (PFOS). The Poisson regression model was applied using robust error variances. The fully adjusted model included age, sex, educational level, income, smoking, physical activity, body fat percentage, and the questionnaire to assess depression. The prevalence of depression and high body fat was 7.9% and 41.1%, respectively. Only PFOA was significantly associated with depression in the entire sample (prevalence rate (PR): 1.91; confidence interval (CI95%): 1.01-3.65). However, in the group with normal adiposity, PFOA (3.20, CI95%: 1.46-7.01), PFNA (2.54, CI95%: 1.29-5.00), and PFDA (2.09, CI95%: 1.09-4.00) were also significant. Future research should investigate the role of obesity as well as the biological plausibility and possible mechanisms increasing the limited number of evidences between PFAS and depression.

Prevalence and changes of intimate partner violence against women aged 15 to 49 years in 53 low-income and middle-income countries from 2000 to 2021: a secondary analysis of population-based surveys

In low-income and middle-income countries (LMICs), intimate partner violence poses a substantial barrier to accomplishing target 5.2 of the Sustainable Development Goals: to eliminate all forms of violence against women and girls. Our study aimed to assess the prevalence and changes of intimate partner violence against women in LMICs. We also explored the association between women's empowerment and intimate partner violence. In this secondary analysis of population-based surveys, we obtained data from the nationally representative Demographic and Health Surveys conducted in LMICs between 2000 and 2021. We selected countries with available data on the domestic violence module, and women aged 15 to 49 years who currently or formerly had a husband or partner, and who had provided information about intimate partner violence, were included in the analysis. We first estimated the weighted prevalence of intimate partner violence in LMICs with available data, and then we assessed the average annual rate of change using Poisson regression with robust error variance in a subset of countries with at least two surveys. We used multilevel analysis to investigate the association between intimate partner violence and women's empowerment measured at both the country and individual levels. Country-level empowerment was measured by gender inequality index, while individual-level empowerment considered social independence, decision making, and attitude to violence. A total of 359 479 women aged 15 to 49 years were included from 53 LMICs. 336 811 women from 21 countries with two surveys provided data for assessing the trends of intimate partner violence. The weighted prevalence of any type of intimate partner violence was 37·2% (95% CI 36·6 to 37·8). A significant overall decline in the prevalence of any type of intimate partner violence was observed with an average annual rate of change of -0·2% (95% CI -0·4 to -0·03); however six countries showed significant increasing trends, with average annual rates of change ranging from 1·2% (95% CI 0·7 to 1·7) in Nigeria to 6·6% (5·3 to 7·8) in Sierra Leone. Notably, the prevalence of psychological intimate partner violence has risen (average annual rate of change, 2·3% [95% CI 2·1 to 2·6]), reflected in increased rates across eight countries. Higher levels of country-level women's empowerment were associated with a lower risk of intimate partner violence: women from countries with the highest tertile of gender inequality index had an increased odds of any type of intimate partner violence (odds ratio 1·58 [95% CI 1·12 to 2·23]). Similarly, better individual-level women's empowerment also showed significant associations with a lower risk of intimate partner violence. The prevalence of intimate partner violence remains high, and some countries have shown an increasing trend. The strong relationship between both country-level and individual-level women's empowerment and the prevalence of intimate partner violence suggests that accelerating women's empowerment could be one strategy to further reduce intimate partner violence against women. National Natural Science Foundation; Vanke School of Public Health, Tsinghua University; and Sanming Project of Medicine in Shenzhen.

The effects of periodic and noisy tendon vibration on a kinesthetic targeting task.

Tendon vibration is used extensively to assess the role of peripheral mechanoreceptors in motor control, specifically, the muscle spindles. Periodic tendon vibration is known to activate muscle spindles and induce a kinesthetic illusion that the vibrated muscle is longer than it actually is. Noisy tendon vibration has been used to assess the frequency characteristics of proprioceptive reflex pathways during standing; however, it is unknown if it induces the same kinesthetic illusions as periodic vibration. The purpose of the current study was to assess the effects of both periodic and noisy tendon vibration in a kinesthetic targeting task. Participants (N = 15) made wrist extension movements to a series of visual targets without vision of the limb, while their wrist flexors were either vibrated with periodic vibration (20, 40, 60, 80, and 100Hz), or with noisy vibration which consisted of filtered white noise with power between ~ 20 and 100Hz. Overall, our results indicate that both periodic and noisy vibration can induce robust targeting errors during a wrist targeting task. Specifically, the vibration resulted in an undershooting error when moving to the target. The findings from this study have important implications for the use of noisy tendon vibration to assess proprioceptive reflex pathways and should be considered when designing future studies using noisy vibration.

The Impact of Lifetime Traumatic Brain Injury (TBI) on Mental Health Symptoms among Service Members in Interdisciplinary TBI Programs.

Traumatic brain injury (TBI) is highly prevalent among active duty service members (ADSMs) and imposes a significant health burden, particularly on mental health (e.g., post-traumatic stress disorder [PTSD] and depressive symptoms). Little is known about how TBI setting characteristics impact PTSD and depressive symptom expression in service members undergoing interdisciplinary TBI care. The study included 455 patients enrolled in interdisciplinary, outpatient TBI programs within the military health system. Using Poisson regression with robust error variance, TBI injury setting characteristics (i.e., before military service, during military training, and during noncombat/combat deployment) were evaluated against clinically-elevated PTSD (PTSD Checklist, DSM-5 score ≥ 33) and depressive (Patient Health Questionnaire-8 score ≥ 15) symptoms. In adjusted models, TBI sustained before military service was associated with less likelihood for clinically-elevated PTSD symptoms at pretreatment (prevalence ratio [PR] = 0.76, confidence interval [CI] = 0.60-0.96) and post-treatment (PR = 0.67, CI = 0.52-0.87). TBI sustained during combat deployment, however, resulted in the greatest impact on clinically-elevated pretreatment PTSD (PR = 1.49, CI = 1.16-1.91) and depressive (PR = 1.47, CI = 1.06-2.03) symptoms. Null results were found between military training/noncombat deployment and mental health symptoms. Regardless of the TBI setting, following TBI treatment, there remained 37.5% (n = 180) and 24.8% (n = 108) with clinically-elevated PTSD and depressive symptoms, respectively. There was a differential impact of TBI settings, particularly between TBI sustained before military service and that from combat deployment among ADSMs enrolled in outpatient TBI programs. This may be indicative of differences in the characteristics of these environments (e.g., injury severity) or the impact of such an event during recovery from current TBIs. The large percentage of ADSMs who present with clinically-elevated mental health symptoms after treatment may suggest the need for additional resources to address mental health needs before, during, and after treatment in TBI programs.

Abstract 11599: High-Density Lipoprotein Cholesterol and Statin Use for Primary Prevention Among US Adults With Intermediate 10-year Predicted ASCVD Risk

Introduction: Although there is no strong evidence of a causal relationship between high-density lipoprotein cholesterol (HDL-C) with atherosclerotic cardiovascular disease (ASCVD), HDL-C is considered “good cholesterol” by many which may impact decision making around statin use. We determined if statin use for primary prevention differed by HDL-C levels among adults without ASCVD, diabetes mellitus (DM), or low-density lipoprotein cholesterol (LDL-C) &gt;190 mg/dL but an intermediate 10-year predicted ASCVD risk. Methods: National Health and Nutrition Examination Surveys (NHANES) participants who were non-pregnant, 40-75 years with a 10-year ASCVD risk 7.5-&lt;20% and fasting lipids, and without ASCVD, DM, LDL-C &gt; 190 mg/dL, or triglycerides ≥500 mg/dL from 2013-2020 were included. Multivariable Poisson regression with robust error variance estimated adjusted prevalence and prevalence ratios (PRs) and 95% confidence intervals (CIs) for statin use associated with HDL-C levels (low [&lt;40 mg/dL], normal [40-60 mg/dL], high [ &gt; 60 mg/dL]). Models were adjusted for age, race, ethnicity, sex, education, healthcare access within 12 months, routine location for health care, health insurance, LDL-C, and body mass index. Results: Among 999 included US adults (representing 23.7 million adults) with a 10-year predicted ASCVD risk 7.5-&lt;20%, the multivariable adjusted prevalence of statin use was 32.5%, 28.6%, and 24.4% among adults with low HDL-C, normal HDL-C, and high HDL-C, respectively. After adjustment, the PR for statin use among adults with low HDL-C was 1.14 (95% CI 1.01,1.18) and high HDL-C was 0.85 (95% 0.83,0.88) vs. adults with normal HDL-C (Figure 1). Discussion In the current analysis, adults with high HDL-C were less likely to be taking a statin, while adults with low HDL-C were more likely. HDL-C may influence the decision to use statin medication among adults with intermediate 10-year ASCVD risk despite evidence that HDL-C level is not causally related to ASCVD.

Abstract 13622: Association Between Self-Reported Medication Adherence and Therapeutic Inertia in Hypertension: A Secondary Analysis of the Systolic Blood Pressure Intervention Trial (SPRINT)

Introduction: Therapeutic inertia (TI), the failure to intensify antihypertensive medication when blood pressure (BP) is above goal, remains highly prevalent in hypertension management. The degree to which self-reported antihypertensive adherence is associated with TI when targeting intensive BP goals remains unclear. Methods: Cross-sectional analysis of the 12-month visit of participants randomized to the intensive systolic BP (SBP) arm of the SBP Intervention Trial (SPRINT), which randomized adults at high cardiovascular disease risk to an intensive (&lt;120 mm Hg) vs. standard (&lt;140 mm Hg) SBP treatment group. TI was defined as no change in the antihypertensive medication regimen intensity score, which incorporates the medication number and dose, when the SBP &gt;120 mm Hg. Self-reported medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (&lt;6), medium (6 to &lt;8), and high (8). Poisson regression models with robust error variance estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for TI associated with MMAS-8 category. Results: Among 1,009 intensive arm participants with SBP &gt;120 mm Hg at the 12-month visit (mean age 69.6 years, 35.2% female, 28.8% non-Hispanic Black), TI occurred in 50.8% of participants. Participants with low self-reported adherence (vs. high) were younger and more likely to be non-Hispanic Black or current smokers. The prevalence of TI among low, medium, and high adherence was 45.0%, 53.5%, and 50.4%, respectively. After adjustment, neither low nor medium adherence (vs. high) were associated with TI (PR 1.11; 95% CI 0.87,1.42, PR 1.08; 95% CI 0.84,1.38, respectively). Conclusion: Although clinician uncertainty about medication adherence is often cited as a reason for why antihypertensive intensification is withheld when the BP is above goal, we observed no evidence of an association between self-reported adherence to antihypertensive medication and TI.

Dynamic boundary layer super‐twisting sliding mode control algorithm based on RBF neural networks for a class of leader‐follower multi‐agent systems

AbstractIn this paper, the consensus problem of robust sliding mode fault tolerance for a class of leader‐follower multi‐agent systems is discussed. Aiming at a second‐order multi‐agent system with unknown model uncertainty and external disturbance, a new super‐twisting sliding mode control method based on a dynamic boundary layer and neural network is proposed. Firstly, the super‐twisting controller is designed by introducing two new variables, the convergence speed of the control system is greatly improved, and the symbolic function is replaced by an improved dynamic boundary layer, which will be continuously adjusted with the system states, the tracking accuracy of the system is improved, and the chattering problem caused by symbolic function is overcome effectively. Secondly, an radial basis function neural network is used to realize the adaptive approximation to the completely unknown model, so that the controller does not need to depend on the precise mathematical model of the controlled system, and the stability of the closed‐loop system is ensured by adjusting the adaptiveweight. Thirdly, the stability of the whole system is analyzed by the Lyapunov method, and the upper bound of robust consensus error is given by constructing an equivalence relation, meanwhile, the upper bound of the final convergence of the sliding variable in the dynamic boundary layer is analyzed. Finally, the simulation results for a second‐order system show the superior performance of the proposed control algorithm, then it is extended to a class of application systems, and the same conclusion is obtained.