Q & T Research

Rhythmic auditory cueing (RAC) improves spatiotemporal gait parameters in older adults, often using isochronous rhythmic cues (i.e., with constant inter-beat-intervals). However, healthy gait contains fractal-like variability, (i.e., with persistent long-range correlations; LRC) which is disturbed when walking to isochronous cues. Embedding auditory cues with a fractal structure increases LRC in gait among young and older adults, though middle-aged adults are under researched. Walking requires greater cognitive resources with increased age, though how different cue-types interact with attentional load during RAC is under researched. This may depend on beat perception, as those with better beat perception benefit more from RAC. The aim of this study was to investigate the optimal parameters for RAC across the adult lifespan. We predicted that 1) walking to fractal cues would increase LRC in gait across the adult lifespan; 2) increasing attentional load would decrease LRC in gait, particularly for older adults. Moderating effects of beat perception on the impact of cue-type on LRC were also explored. Young, middle-aged, and older adults (n = 62) walked around an elliptical track in silence and in three cued walking conditions of increasing attentional load. Tones were presented in isochronous and fractal rhythms. Fractal cues increased LRC in gait, with qualitatively greater increase among middle-aged adults. Attentional load had no effect on LRC in gait. Isochronous cues resulted in decreased LRC in gait, particularly for those with better beat perception. The optimal parameters of RAC therefore depend on age, beat perception, and the target gait parameter.

Abstract Background Patients with inflammatory bowel disease (IBD) have a high prevalence of mental health disorders which are associated with worse disease outcomes. Additionally, the global COVID-19 pandemic has led to an increased incidence of mental health challenges in the general population. Aims This study aims to assess the prevalence of anxiety and depression in a cohort of patients with IBD following the COVID-19 pandemic. Methods The prevalence of anxiety and depression was assessed in IBD outpatients, either in person or via virtual visits, using the validated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Patients’ demographics, disease characteristics, and treatment history were collected through retrospective chart reviews. Multivariable analysis was performed to identify factors associated with depression and anxiety. Results A total of 199 patients (59.3% female, mean age 47) completed the questionnaires. Of these, 130 (65.3%) were treated with advanced therapies. 15.1% met the criteria for depression and/or anxiety. The prevalence of depression was 13% while anxiety was observed in 7.5% of patients. 11 patients (5.5%) met the criteria for both diagnoses, see table 1. A total of 41 patients (20.6%) were receiving treatment for depression or anxiety. Hospitalization since 2020 (32 patients) was the only factor significantly associated with both depression and anxiety (p = 0.0001; 95% CI: 2.48–12.92). Corticosteroid therapy (p = 0.063; 95% CI 0.94–4.74) and disease activity (p = 0.127; 95% CI 0.72–14.02) appeared to increase risk, while treatment changes (p = 0.626; 95% CI 0.55–2.66) were not associated with mental health symptoms. Most patients (77.9%) were satisfied with their gastroenterologist’s attention to mental health, and 68.8% wanted integration of mental health services into their IBD care. Conclusions A substantial proportion of IBD patients in out cohort experience depression and anxiety, with recent hospitalization as a key risk factor. Most patients desire improved access to mental health resources, supporting the integration of these services into IBD clinics and post-hospitalization care. Funding Agencies None

In future operations on the lunar surface, automated vehicles will be required to transport cargo between known locations. Such vehicles must be able to navigate precisely in safe regions to avoid natural hazards, human-constructed infrastructure, and dangerous dark shadows. Rovers must be able to park their cargo autonomously within a small tolerance to achieve a successful pickup and delivery. In this field test, Lidar Teach and Repeat provides an ideal autonomy solution for transporting cargo in this way. A one-tonne path-to-flight rover was driven in a semi-autonomous remote-control mode to create a network of safe paths. Once the route was taught, the rover immediately repeated the entire network of paths autonomously while carrying cargo. The closed-loop performance is accurate enough to align the vehicle to the cargo and pick it up. This field report describes a two-week deployment at the Canadian Space Agency’s Analogue Terrain, culminating in a simulated lunar operation to evaluate the system’s capabilities. Successful cargo collection and delivery were demonstrated in harsh environmental conditions.

The intricate interaction between bacteria and surfaces, coupled with the complexity of biofilm formation, poses significant challenges in understanding and controlling microbial behaviour. To combat pathogen contamination and proliferation, bioinspired nanostructures as antimicrobial surfaces have gained prominence over the past decade. However, conflicting theoretical studies and experimental results have made it difficult to draw general conclusions about antibacterial mechanisms. To address these challenges, we have adopted an approach that provides access to deeper insights to characterize the performance of surfaces, by taking into account different modes of antibacterial action. To demonstrate the applicability of this strategy, nanostructured materials mimicking dragonfly wing, were evaluated. A gold electrodeposition process was optimized to create large-area, uniform nanospike arrays, ranging in height from 70 to 570 nm. Large sample area (12 cm²) was critical for ensuring statistically significant results in the analysis of antibacterial effects. Model surfaces with ∼150 nm high spikes were tested, demonstrating significant efficacy in reducing bacterial proliferation for Escherichia coli and Staphylococcus epidermidis . Moreover, striking differences between strains were observed in biofouling (surface detachment and release of bacteria). These findings underscore the relevance of such a protocol in precisely characterizing bacterial interactions with antimicrobial materials. By providing a standardized characterization method, this study aims to facilitate a deeper understanding of antimicrobial surface interactions with bacteria and contributes to the development of more effective antibacterial surfaces.

Background/Objectives: Currently, treatments for age-related macular degeneration (AMD) consist of regular intravitreal injections that exert significant pressure on healthcare systems via their high labor costs and economic burden. To address this, our study's goal is to propose new treatment protocols by comparing the efficacy of bimonthly fixed dosing aflibercept injections versus the treat-and-extend (T&E) approach for wet AMD. Secondary objectives included categorical best-corrected visual acuity (BCVA) changes, anatomical outcomes, treatment intervals, and adverse events. Methods: This study is a 1-year randomized, open-label, prospective trial that included 44 eyes from 44 patients, 32 in the T&E arm and 12 in the bimonthly arm. Treatment-naïve AMD patients with neovascularization were randomized to a bimonthly fixed dosing group or a T&E group after receiving 3 consecutive monthly aflibercept injections. Following the induction doses, retreatment intervals for patients in the T&E arm were adjusted based on a predetermined algorithm. Results: Over 12 months, mean BCVA improvements were 5.0 letters in the bimonthly group and 4.1 in the T&E group (p = 0.096 for non-inferiority test). On average, T&E patients received 9.6 injections compared to 7.7 for those in the fixed dosing group (p < 0.001). Anatomical outcomes were comparable in both treatment arms. Conclusions: In our trial, the T&E approach provided significant visual improvements, but did not meet the threshold for non-inferiority when compared to fixed bimonthly dosing. It was also unable to minimize treatment burden over the course of the first year of injections. Further research is required to optimize the T&E algorithm with aflibercept.

<bold>Background:</bold> Evaluation of multiple endpoints in clinical trials is often limited by endpoints of lower clinical importance. Win ratios are used to categorize multiple outcomes by clinical importance. <bold>Aims & Objectives:</bold> This post hoc analysis uses win ratios to compare dupilumab efficacy vs placebo in BOREAS and NOTUS. <bold>Methods:</bold> BOREAS (<ext-link>NCT03930732</ext-link>) and NOTUS (<ext-link>NCT04456673</ext-link>), phase 3 randomized, double-blind, placebo-controlled trials, enrolled patients with COPD, and type 2 inflammation (screening blood eosinophil count ≥300 cells/µL) on LABA/LAMA/ICS. Patients received add-on dupilumab 300 mg or placebo q2w for 52 weeks. Win ratio analysis compared each patient on dupilumab to each patient on placebo for time-to-event and occurrence-of-event. Endpoints were ordered based on clinical priority. <bold>Results:</bold> Evaluation of the pooled population (dupilumab n=938; placebo n=934) across multiple endpoints for occurrence-of-event showed patients receiving dupilumab being 32% more likely to avoid hierarchically important clinical deterioration compared with placebo (1.32; 95% CI 1.17, 1.49]) (<bold>Figure</bold>). Similar findings were seen for the time-to-event endpoints (win ratio 1.26; 95% CI 1.13, 1.40). <bold>Conclusions:</bold> Dupilumab vs placebo increased the odds of avoiding hierarchically worse clinical outcomes by 32% in patients with COPD and type 2 inflammation. <fig><object-id>erj;66/suppl_69/PA4572/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

The management and survival outcomes of patients with Merkel cell carcinoma (MCC) in Canada are currently unknown. The objective of this study was to investigate the management and outcomes of patients diagnosed with MCC in Canada from 2000 to 2018. This retrospective cohort study evaluates management and temporal survival differences among patients diagnosed with MCC in ten large urban university centers in three provinces during three periods: 2000-2005, 2006-2011, and 2012-2018. There were 899 patients included with a median follow-up of 22.8 months. There were no significant changes in patient and tumor characteristics between the three periods. There were increases in the use of radiologic staging (2000-2005, 53.4%; 2006-2011, 73.7%; 2012-2018, 78.1%; p < 0.01), surgery as the sole treatment (2000-2005, 25.7%; 2006-2011, 34.0%; 2012-2018, 31.8%; p = 0.02), and surgery with adjuvant radiation (2000-2005, 37.2%; 2006-2011, 36.2%; 2012-2018, 43.7%; p =0.02) during the study period. Between 2000 and 2018, the 5-year median overall survival (OS) was 47.9% (95% confidence interval (CI) 43.2-55.8%), disease-free survival was (DFS) 48.9% (95% CI 42.4-55.1%), and cancer-specific survival (CSS) was 49.7% (95% CI 43.2-55.8%). There were no significant differences in OS and DFS between the three periods on multivariable analysis. Compared with 2000-2005, there was no significant difference in CSS from 2006 to 2011 (hazard ratio (HR) 1.02 95% CI 0.66-1.62, p = 0.9), but there was a significant improvement in CSS from 2012 to 2018 (HR 0.57 95% CI 0.34-0.97, p = 0.04). Despite changes in the utilization of staging, surgery, and radiation, the prognosis of patients with MCC in Canada remains poor, highlighting the need for improved management strategies.

The LabPET II modular technology was identified as a promising platform for a new generation of Ultra-High Resolution (UHR) brain PET scanners. Scaling up from preclinical systems to achieve a human brain field-of-view introduces significant challenges that require high-density, low-noise detection modules capable of dissipating over 1.1 kW of heat within a confined volume. To address these constraints, a new UHR detection module, referred to as the UHR-DM, was developed based on a 2.5D stacked PCB architecture. This design embeds two readout ASICs between two circuit boards to enhance thermal management, mechanical alignment, and electrical performance, while preserving full backward compatibility with the existing LabPET II platform. This paper presents a detailed comparison between the UHR-DM and the original LabPET II detection module (LP2-DM). Key improvements include improved heat extraction through direct conduction, reduced parasitic capacitance via shorter and more uniform trace routing, and enhanced noise immunity enabled by embedded shielding. A dedicated testbench was used to evaluate thermal performance, baseline stability, noise characteristics, intrinsic and full-system coincidence time resolution (CTR), and time-over-threshold (ToT) energy resolution. Results show that the UHR-DM design reduces ASIC operating temperature by up to 43%, lowers noise by 60% when using high electronic gains, and improves channel-to-channel noise uniformity. It also achieves more consistent CTR and energy resolution without compromising any performance aspect of the original design. These enhancements will facilitate the upcoming integration all 129 024 individual channels required by the UHR brain PET scanner to achieve a spatial resolution of 1.25 mm at the center of the field of view.

Abstract This paper aims at presenting the results of the CleanSky 2 European project IMPACT (GA no. 885052), granted under the Large Passenger Aircraft Integrated Technology Demonstrator (LPA-ITD), aiming at optimizing the rear-end design for the next generation Short and Medium Range (SMR) A320-like aircraft. Specifically, the project has investigated a Forward Swept Horizontal Tail Plane (FSHTP) enhanced with a Leading-Edge eXtension (LeX) device. The activities have focused on the optimisation of the horizontal stabilizer, accounting for the coupled aerodynamic, aeroelastic and, for the first time, icing behaviour. The optimal solution provides significantly better lift performance of the tailplane (i.e. up to 12.4% increase in CL), limiting the drag penalty to below 1.0% in cruise condition (i.e. between 0 and 2 degrees of Angle of Attack).

<bold>Background:</bold> The prevalence of clinical remission in severe asthma is poorly studied. This study aims to assess the prevalence and characteristics of asthma remission based on the Canadian Severe Asthma Registry (CSAR) dataset. <bold>Methods:</bold> A retrospective review was performed using CSAR cohort data from November 2018 to June 2023. Baseline demographics, asthma medications, and comorbidities were collected. Eligible patients were ≥18 years old, had uncontrolled asthma Global Initiative for Asthma (GINA) step 4 or 5, who were followed for at least 12 months. Three remission criteria were assessed, including rate of asthma exacerbations, use of systemic oral corticosteroid (OCS) and asthma control status. <bold>Results:</bold> 182 patients met at least one remission criteria, only 58 patients had data for the 3 remission criteria at baselineand 51 patients post-biologics (Bx). Patients started Bx therapy as follows: 36 (20%) on Anti-IgE, 133 (73%) on Anti-IL5/5R, and 13 (7%) on Anti-IL4/13. Compared to pre-Bx period, those who initiated Bx had fewer exacerbations (42% vs 12%), significant reduction in long-term OCS (24% vs 15%) and improvement in asthma control (55% vs 60%). Overall, 27 out of 58 patients met 3 criteria for remission, of which 4 without Bx (6.9%) and 23 with Bx (45%). Increase in remission rates were seen for both Anti-IgE and Anti-IL5/5R. No difference with Anti-IL4/IL13 due to limited sample size. <bold>Conclusion:</bold> Our CSAR retrospective study demonstrates that biologics therapy enhanced clinical remission up to 45% and led to better outcomes. Nevertheless, further studies are required to investigate the impact of different biological agents and patient characteristics on remission.