Switching Pattern Research Articles

Switches between biologics in patients with moderate-to-severe psoriasis: results from the French cohort PSOBIOTEQ.

Biologics are the cornerstone of treatment of patients with moderate-to-severe plaque psoriasis and switches between biologics are frequently needed to maintain clinical improvement over time. The main purpose of this study was to describe precisely switches between biologics and how their pattern changed over time with the recent availability of new biologic agents. We included patients receiving a first biologic agent in the Psobioteq multicenter cohort of adults with moderate-to-severe psoriasis receiving systemic treatment. We described switches between biologics with chronograms, Sankey and Sunburst diagrams, assessed cumulative incidence of first switch by competing risks survival analysis and reasons for switching. We assessed the factors associated with the type of switch (intra-class - i.e. within the same therapeutic class - vs. inter-class) in patients switching from a TNF-alpha inhibitor using multivariate logistic regression. A total of 2153 patients was included. The cumulative incidence of switches from first biologic was 34% at 3 years. Adalimumab and ustekinumab were the most prescribed biologic agents as first and second lines of treatment. The main reason for switching was loss of efficacy (72%), followed by adverse events (11%). Patients receiving a TNF-alpha inhibitor before 2016 mostly switched to ustekinumab, whereas those switching in 2016 or after mostly switched to an IL-17 inhibitor. Patients switching from a first-line TNF-alpha inhibitor before 2016 were more likely to switch to another TNF-alpha inhibitor compared with patients switching since 2018. Patients switching from etanercept were more likely to receive another TNF-alpha inhibitor rather than another therapeutic class of bDMARD compared with patients switching from adalimumab. This study described the switching patterns of biologic treatments and showed how they changed over time, due to the availability of the new biologic agents primarily IL-17 inhibitors.

Effects of doping concentration and annealing temperatures on the ferroelectric memory properties of yttrium doped HfO2

HfO2 has been widely studied in nonvolatile memories owing to its advantages including wide bandgap, superior ferroelectricity, low power and high density. Herein, yttrium doped hafnium (Y: HfO2) films were fabricated on Si (100) substrate by chemical solution deposition method. Effect of Y contents on the structural and electrical performance of Y: HfO2 ferroelectric films was carefully investigated in the range of 0–10 mol%. Results revealed that Y: HfO2 was crystallized from m-phase to c/o-phase with the increase of Y contents which exhibited a strong dependence on the concentrations of oxygen vacancies. 7 mol% Y: HfO2 achieved the highest remnant polarization of 23.37 μC cm−2 after being annealed at 700 °C for 60 s in O2 atmosphere. Significant domain switching patterns could be written by piezoelectric force microscope indicating the good ferroelectricity in 7 mol% Y: HfO2. Lower and higher annealing temperatures were not beneficial for the improvement of ferroelectricity due to the large leakage current and over-crystallization, respectively. This work would provide useful guidance for HfO2-based films in future memories with great potential.

From “Latin” to the Vernacular: Latin-Romance Hybridity, Scribal Competence, and Social Transformation in Medieval Castile

This study presents an alternative interpretation of language represented in Latin-Romance hybrid documents of early-thirteenth-century Castile based on analysis of local legal documents produced by Nicholaus Martini, a scribe of the city of Burgos. Most scholars have attributed hybrid practices primarily to some kind of scribal ignorance of “Latin” norms. In contrast, we highlight evidence of scribal competence by focusing on the production of a single, typical scribe, arguing that he (and peers) worked within a monolingual culture characterized by spectroglossia. The patterns of switching, mixing, and blending of registers in Nicholaus’s texts cannot be accounted for primarily as a result of incompetence. Rather, they develop as conventions in response to larger sociocultural changes (e.g., urbanization, laicization) and a number of social and cultural factors that favored representation of “Latin,” representation of “Romance,” and representation of a hybrid register. In so doing, we also argue against an overemphasis on ease of comprehension as a factor shaping the design and reception of written texts and oral performances of them. The study suggests that this type of hybrid document corresponds to a period that set the stage for subsequent development of practices and conceptions that differentiated sharply between Latin and Romance(s) as separate languages.

A Simple SVM Technique on Three-Phase MPUC7 Inverter for Solar Photovoltaic System

In This paper, a simple single-dimension Space Vector Modulation (SVM) technique is introduced to implement on three-phase thirteen-level Modified Packed U-Cell (MPUC) inverter for photovoltaic system in which many DC sources are available. The three-phase thirteen-level converter consists of three single-phase seven-level MPUCs that each phase has six switches and two isolated DC sources. One major advantage of proposed method is to produce an output voltage with nearly constant amplitude in desired range in case of input DC voltage fluctuations, which is common in renewable sources like Photovoltaic Systems (PV). On the other hand, the conventional Pulse Width Modulation (PWM) strategies do not have such capability. Thus, the converter behavior is investigated for the proposed control method and Level Shift PWM (LS-PWM) and it is shown that the LS-PWM method does not function properly when the DC voltage varies. In order to produce an output voltage with seven equal levels, which results in reduction of the switching losses and Total Harmonic Distortion (THD), it is necessary to trigger switches in proper way. Consequently, two switching patterns are introduced and the significant decrease in power loss due to the second switching pattern is shown. Furthermore, it is investigated that in three-phase mode, the 3rd order line-voltage harmonics are eliminated well and the voltage and current THD are further improved by the proposed method. To validate the proposed SVM technique, MATLAB Simulink simulation results are presented and a comparative analysis is done between the proposed method and LS-PWM.

HSD33 Patient Utilization and Switching Patterns of Patient Assistance Programs (PAPs) for Monoclonal Antibodies Targeting the Calcitonin Gene-Related Peptide (CGRP) Pathway for Migraine Prevention: A Retrospective Cohort Study

Manufacturers offer PAPs (e.g. free trial program, bridge program, copay card, eVoucher, denial conversion) to reduce out of pocket costs for patients. This study describes utilization and switching patterns of PAPs among patients treated with anti-CGRP pathway monoclonal antibodies (mAbs) for migraine prevention.

Analyzing Trajectories of Acute Cigarette Reduction Post-Introduction of an E-Cigarette Using Ecological Momentary Assessment Data.

Electronic cigarettes (ECs) may hold great potential for helping smokers transition off combustible cigarettes (CCs); however, little is known about the patterns that smokers follow when using an EC as a CC-substitute in order to ultimately reduce and quit smoking. Our primary aim in this study was to evaluate whether common patterns of CC use exist amongst individuals asked to substitute an EC for at least half of the CCs they would normally smoke. These patterns may elucidate the immediate switching and reduction behaviors of individuals using ECs as a reduction/cessation tool. This analysis uses data from a randomized controlled trial of 84 adult smokers assigned to receive either 4.5% nicotine or placebo (0% nicotine) EC. Participants were advised to use the EC to help them reach a 50% reduction in cigarettes-per-day (CPD) within 3 weeks. Longitudinal trajectory analysis was used to identify CPD reduction classes amongst the sample; participants clustered into four distinct, linear trajectories based on daily CC use during the 3-week intervention. Higher readiness to quit smoking, prior successful quit attempts, and lower baseline CC consumption were associated with assignment into “more successful” CC reduction classes. ECs may be a useful mechanism to promote CC reduction. This study demonstrates that a fine-grained trajectory approach can be applied to examine switching patterns in the critical first weeks of an attempt.

A Desired Voltage Vector Based MPTC Strategy for PMSM With Optimized Switching Pattern

The main challenges for Finite Set-model Predictive Torque and Flux Control (MPTC) include huge calculation amount, large torque ripple, and the selection of weighting factor. To deal with these challenges and achieve the fastest torque response, a novel MPTC strategy with virtual voltage vector-based pattern is proposed in this paper. In each control period, a desired voltage vector is computed based on the maximum torque variation rate. The virtual desired voltage vector is combined by using basic voltage vectors with the minimum switching times. The switching pattern between two adjacent control periods is optimized by using a cost function in realtime. Compared with the traditional MPTC approach, the novel strategy has multifaceted improved performances: faster torque response, less calculation amount, lower switching frequency, reduced torque ripple, higher efficiency and no weighting factor. The proposed method is contrasted with traditional MPTC method and a well-known generalized multiple-vector-based MPC method via experiments.

Total Suppression of High-Frequency Transient Oscillations in Dual-Active-Bridge Series-Resonant Converter by Trajectory-Switching Modulation

Dual-active-bridge series-resonant converter (DABSRC) is increasingly used in many emerging power electronics applications requiring fast dynamic responses. However, under conventional transient phase-shift modulation strategy, DABSRC generally suffers from large-amplitude transient oscillations when its phase-shift angle is changed abruptly by a high-gain controller. These oscillations occur at the beat frequency, which results from the interaction between the switching-frequency and resonant-frequency components in the series-resonant tank during transient states. Besides incurring high voltage and current stresses on the power-stage devices, these transient oscillations also span many switching cycles between the original and new steady states and cause perturbations to the output voltage of DABSRC, thereby degrading its dynamic performance and output voltage quality. To mitigate these problems, a new transient modulation strategy, known as trajectory-switching modulation (TSM), is proposed for achieving an accurate and computationally efficient trajectory planning of the resonant voltages and currents of DABSRC during transient states, and its basic operation is to govern the transient switching patterns of the gating signals according to a simple set of closed-form equations. The proposed TSM strategy can guarantee convergence to the next new steady state within about one switching cycle and avoid needing costly sensors and complex computation for implementation, and it is inherently compatible with high-gain controllers for realizing oscillation-free fast dynamic responses.

Carbon nanotube logic gates: An interplay of spin and light

Carbon nanotubes (CNTs) are known to be the future of modern electronic devices due to their unique structure and extraordinary properties. In this paper, we modeled a first of its kind combinational carbon nanotube device consisting of a lanthanum strontium manganite molecule fused near the left CNT electrode and four-atom boron–nitrogen dopant atoms substituted near the right CNT electrode. Spin-resolved transport properties are studied using density functional theory. It is observed from the results that spin-resolved transport properties highly depend on the type of magnetic field applied and light conditions. The device shows efficient switching pattern and high spin filtration. The observations are made by calculating I–V characteristics, spin dependent transmission spectra, and molecular projected self-consistent Hamiltonian orbitals. Using light and spin polarization dependent properties, we have designed and realized the logic operations of and, or, and not gates. The study is useful to design a number of futuristic spin and light controlled electronic devices such as transistors, amplifiers, and oscillators.

An optimal zero‐sequence voltage injection‐based common‐mode voltage reduction pulse‐width modulation for the reduction of common‐mode voltages in both amplitude and third‐order component

An optimal zero-sequence voltage injection-based common-mode voltage reduction pulse-width modulation (CMVRPWM) for the reduction of common-mode voltages (CMVs) in both amplitude and third-order component is proposed in this paper. On the basis of general symmetrical switching patterns of CMVRPWM, a constrained mathematical programming model is established with the objective of optimizing the volt-second value of CMV in each switching period. By solving the mathematical model, the limitation of the CMV amplitude and the reduction of third-order harmonic in CMV can be achieved simultaneously, contributing to better CMV suppression and common-mode filter design in the applications of two-level voltage source inverters (2L-VSIs). The optimal zero-sequence voltage under the given target is obtained, and the calculation method of the switching pattern and modulation wave is studied. Simulation and experimental results show that the proposed method can restrict the CMV amplitude within one-sixth of the DC bus voltage, and the third-order component in CMV is effectively reduced compared with the conventional methods.

Changes in the association between overweight and depression across three major ethnic groups, 2005–2018

BackgroundThe relationship between body weight and depression may have changed along with the climbing trend of obesity prevalence, but most previous studies examined the association with a single cross-sectional survey. The present study assessed the change in the association between depression and body weight, measured and perceived from 2005 to 2018, among three major racial/ethnic groups. MethodsWe analyzed the data of 27,387 adults aged ≥18, collected in the National Health and Nutrition Examination Survey. Surveys from 2005 to 2010 were combined as the early period and the surveys from 2011 to 2018 as the recent period. ResultsA switching pattern was observed among white women. In the 2005–2010 survey period, only self-perceived overweight was significantly associated with depression [Odds ratio (OR) = 3.25 (95% confidence interval = 1.33, 7.90)]. However, in the 2011–2018 survey period, self-perceived overweight was not associated with depression anymore [1.32 (0.72, 2.41)], but obesity measured directly was significantly associated with depression [2.59 (1.04, 6.48)]. Among white men, self-perceived overweight and obesity measured directly were significantly associated with depression only in 2011–2018; [2.57 (1.18, 5.58)] and [0.29 (0.10, 0.80)], respectively. Obesity directly measured consistently associated with increased odds of depression among black men. No significant associations were observed in Hispanic and black women in any survey period. ConclusionSignificant gender and ethnic differences exist, and the associations between body weight and depression have evolved in sex-race-specific trajectories. The interventions must be consistently fine-tuned following the dynamics of the relationship between body weight and overall well-being.

A Study on Switching behavior of Smartphone users in India

In recent times smartphone have become an integral part of our day-to-day life. With the dramatic increase in smartphone usage in recent years the switching (existing smartphone users changing their smartphone) pattern of the customers has also changed. This study is an attempt to identify those factors those affect customers while switching from one smartphone to another. Target respondents were from emerging cities like Noida, Gurugram and Agra of diversified backgrounds like students, businessmen, servicemen, homemakers and smartphone retailers. The descriptive statistics and relevant inferential statistics were applied to test the hypotheses and extract the underlying factors affect switching behavior of smartphone users. The result shows that the change in five variables that are disposable income, lifestyle, new technology & features, functional conditions and physical damage have significant influence on switching behavior of smartphone user except one variable that is promotions & discounts that has no significant influence on the switching behavior of smartphones users.

High-Speed Searching of Optimum Switching Pattern for Digital Active Gate Drive to Adapt to Various Load Conditions

Digital active gate driving has been shown to effectively manage the switching performance for power devices with the adjustable driving waveforms. However, most of the studies are based on a dedicated test circuit rather than a practical inverter with the sinusoidal output current. In fact, it is the dependence on the load current that makes the design of the gate driving profiles a critical issue. To investigate the digital active gate driver in an inverter application, this article has applied optimal patterns adapting to time-varying output load current. Prior to the search of optimal patterns, the proper design of time slot is discussed with three different time resolutions. With the proper resolution determined for patterns, multiple optimizations are carried out for different current conditions. In this way, the search for optimal patterns can be completed in an efficient time. Next, a lookup table of optimal switching pattern in correspondence with each certain load current condition was built in advance. According to the output load current, the optimal pattern is selected based on the lookup table. Compared to conventional constant driving waveform, the power loss has been reduced by 7% with full optimal lookup table applied.

Phylogenetic analysis of migration, differentiation, and class switching in B cells.

B cells undergo rapid mutation and selection for antibody binding affinity when producing antibodies capable of neutralizing pathogens. This evolutionary process can be intermixed with migration between tissues, differentiation between cellular subsets, and switching between functional isotypes. B cell receptor (BCR) sequence data has the potential to elucidate important information about these processes. However, there is currently no robust, generalizable framework for making such inferences from BCR sequence data. To address this, we develop three parsimony-based summary statistics to characterize migration, differentiation, and isotype switching along B cell phylogenetic trees. We use simulations to demonstrate the effectiveness of this approach. We then use this framework to infer patterns of cellular differentiation and isotype switching from high throughput BCR sequence datasets obtained from patients in a study of HIV infection and a study of food allergy. These methods are implemented in the R package dowser, available at https://dowser.readthedocs.io.

First-line therapies for hepatitis B in the United States: A 3-year prospective and multicenter real-world study after approval of tenofovir alefenamide.

Real‐world data are limited on tenofovir alafenamide (TAF). We aimed to study TAF real‐world outcomes with other first‐line regimens for chronic hepatitis B (CHB). We enrolled patients with CHB from 10 centers retrospectively and followed them for 36 months prospectively. We analyzed switching patterns of antiviral therapy and treatment outcomes of TAF, tenofovir disoproxil fumarate (TDF), and entecavir therapy. For efficacy and safety, we analyzed a subset of patients with complete data at 24 months after switching to TAF or remaining on TDF or entecavir. Among 1037 enrollees, 889 patients were analyzed. The mean age was 52%, and 72% were hepatitis B e antigen–negative. After enrollment, shifts in therapies were mostly in reduced use of TDF from 63% to 30% due to switching to TAF. Clinical parameters were compared at enrollment or initiation to measures at 24 months for patients remaining on TAF (187), TDF (229), or entecavir (181). At 24 months, a significantly higher portion of patients on TAF achieved hepatitis B virus (HBV) DNA ≤ 20 IU/ml (93% vs. 86%; p = 0.012) and normalized alanine aminotransferase (ALT) (66% vs. 56%; p = 0.031) with stable estimated glomerular filtration rates (eGFRs). However, a higher percentage of the patient with eGFR < 60 ml/mi/1.7 m2 was observed in the TDF‐treated group (9% vs. 4%; p = 0.010). In patients who remained on entecavir or TDF for 24 months, ALT and HBV‐DNA results did not differ significantly from baseline. Treatment of CHB in the United States has significantly shifted from TDF to TAF. Our data suggest that switching from TDF or entecavir to TAF may result in increased frequency of ALT normalization and potential clearance of viremia at the 24‐month time point.

Effectiveness and Safety of Adalimumab, Etanercept and Ustekinumab for Severe Psoriasis in Children Under 12 Years of Age: A French-Italian Daily Practice Cohort (BiPe Jr).

Biological therapies are valuable treatments for severe psoriasis. Children aged under 12 years are underrepresented in therapeutic trials for these drugs. The objective of the 'BiPe Jr' cohort study was to evaluate the drug survival, effectiveness, tolerance and switching patterns of biological therapies in children under 12 years of age with psoriasis. We conducted a multicentre retrospective study of children with psoriasis who received at least one injection of a biological agent, even off-licence, before the age of 12 years in France and Italy, collecting the data betweenApril and August 2021. The data collected were from March 2012 up to August 2021. In total, 82 children (mean age: 9.1years; females: 61.0%) received 106 treatments. The drugs administered were adalimumab (n=49), etanercept (n=37), ustekinumab (n=15), anakinra (n=2), infliximab (n=2) and secukinumab (n=1). The most common form of psoriasis was plaque psoriasis (62.9%). The Physician Global Assessment and the Psoriasis Area Severity Index(PASI) scores decreased significantly from baseline to 3 months after treatment initiation for the three main biological drugs; PASI went from 14.1± 9.4 to 4.1± 11.3 for adalimumab (p=0.001), 14.9± 9.3 to 5.1± 4.0 for etanercept (p=0.002) and 11.6± 8.3 to 2.6± 2.2 for ustekinumab (p=0.007). A trend towards higher 2-year maintenance rates was observed for ustekinumab and adalimumab, compared with etanercept (p=0.06). 52 children discontinued their biological therapy, most frequently due to inefficacy (n=28) and remission (n=14). Seven serious adverse events (SAEs) were reported, including four severe infections. Our analyses of drug survival and treatment patterns, combined with those of previous studies conducted in older children, indicate that there is a trend towards higher 2-year survival rates of ustekinumab and adalimumab. The SAEs identified were rare, but highlight the need for increased vigilance concerning infections. Overall, the biological therapies showed good effectiveness and safety profiles when used in daily practice for the treatment of young children with psoriasis.

Retrospective Database Analysis to Explore Patterns and Economic Burden of Switchback to Brand After Generic or Authorized Generic Utilization.

BackgroundDespite demonstration of bioequivalence of generics to brands and the potential for reduced costs, some patients switch back from a generic to the brand. A prior retrospective analysis suggested that this switchback rate may be lower among patients that had initially switched to authorized generics (AG), often both produced and marketed by the brand company, compared to those initially switched to another generic.ObjectiveExplore switching patterns of brands, AGs, and generics, switchback rates, and the potential impact of switchbacks on healthcare costs.MethodsAn analysis of the Pharmetrics Plus™ database (2007–2019), a United States (US) payer administrative database, was conducted to examine the use of Upjohn medications available as AGs across multiple therapeutic areas. Patients initiating treatment with brand medication in the 6 months prior to generic market entry were identified and switch rates to generics and AGs, as well as switchback rates, were evaluated. Costs were descriptively compared between patients who switched back to brand and those who remained on any generic.ResultsAcross 14 brand medications, more than half of the patients initiating treatment with the brand medication were switched to a generic. Generally, switching to AG, which ranged from 0.5 to 39.6%, was lower than switching to non-AG generics (16.7–79.9%). The comparison of switchback rates from AGs to brand and non-AGs to brand showed similar results (AG:1.3–7.5%; non-AG:1.4–12.9%); however, the most substantial differences were observed where non-AG switchbacks were higher. Patients that switched back to brand remained on AG or generic for an average of 1–3 months (32–88 days). The analysis showed a tendency towards increased medical costs in the period immediately preceding switchback for all medications except sildenafil in both indications (erectile dysfunction and pulmonary arterial hypertension). For the remaining medications, medical costs ranged from $63 to $1544 higher for the switchback population. Pharmacy costs similarly tended to be higher for patients who had a switchback, with the exception of sildenafil for pulmonary arterial hypertension and sirolimus.ConclusionPatients receiving a brand medication are likely to be switched to a generic upon market availability. Some patients switch back to the brand medication, usually within 1–3 months; this may be associated with increased medical costs. Additional research is needed to understand switching, its potential disruption to patients, and the role of brands, generics, and AGs.

An H5-Bridge-Based Laddered $CLLC$ DCX With Variable DC Link for PEV Charging Applications

Plug-in electric vehicles’ charger is preferred to cover an ultrawide battery voltage range with the vehicle-to-grid capability. Conventional bidirectional resonant dc–dc converters suffer from the contradiction among wide voltage gain range, squeezed dc-link voltage span, and narrow switching frequency band. To solve the issue, this article proposes a novel H5-bridge-based bidirectional <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$CLLC$</tex-math></inline-formula> converter. By configuring the switch pattern, the H5-bridge can form the modes of single half-bridge, dual half-bridge, half full-bridge, and dual full-bridge, respectively. Correspondingly, six gain curves can be derived. Combined with the variable dc-link framework, the converter constrains the switching frequency in the vicinity of the resonant frequency with optimal efficiency. The converter achieves an ultrawide battery voltage range with a squeezed dc-link span. A bidirectionally synchronous rectification method is proposed to improve the efficiency further. To verify the proposed concept, a 1-kW rated prototype with a 320–420 V dc link is built and tested. It validates the battery voltage 55–420 V for charging and 230–420 V for discharging. Zero-voltage turn- <sc xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">on</small> and zero-current turn- <sc xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">off</small> are achieved in the rectifying <sc xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">mosfet</small> s. The prototype exhibits 98.04% peak efficiency and good overall efficiency performance.

21 LEVEL HYBRID SINGLE T TYPE DOUBLE HBRIDGE MULTILEVEL INVERTER TOPOLOGY

Inverters are the power electronic circuits which transfers power from direct current source to alternating current load. It manages voltage, current and frequency of the signal. Inverter comprises of various applications like adaptable velocity AC motor drives, uninterruptible power supply, running appliances of AC used in automobile battery, etc. The simulation of 21 level multilevel inverter is taken out using MATLAB/Simulink and the simulated circuit model is discussed. The input DC voltage sources for inverter are assigned with the magnitudes 96V, 96V and 96V satisfying the ratio 3:3:3 for the frequency of 50 Hz and the results analyzed for resistive load and inductive load with fundamental switching pattern. The circuit is simulated with half height method and fundamental equal phase angle method and the THD is calculated and compared.

Study on the CM EMI Generation Characteristics of the Si/SiC Hybrid Switch at Different Switching Patterns and Gate Resistors

The switching patterns and gate resistor of the Si/SiC hybrid switch are the key to realizing its own highly efficient and reliable operation. However, as an important performance indicator, the common mode (CM) electromagnetic interference (EMI) noise caused by the Si/SiC hybrid switch lacks comprehensive research, which means that it is not clear how the switching patterns and gate resistor affect CM EMI. In this paper, the Si/SiC hybrid switch-based boost converter is established at first. Then, by analyzing the spectral characteristics of the CM voltage of the Si/SiC hybrid switch, the CM EMI generation characteristics of the Si/SiC hybrid switch at different switching patterns and gate resistors are revealed. Furthermore, the analysis and experimental results can be used to comprehensively guide the design of the gate drive pattern, gate resistor, and EMI suppression strategy.