Search Results (16)

Background: Rehabilitation after stroke often employs Robots and Allied Digital Technologies (RADTs). However, evidence of their effectiveness remains inconclusive due to study heterogeneity and limited sample sizes. Methods: This is a protocol of a pragmatic multicentre, multimodal, randomised, controlled, parallel-group (1:1) interventional study with blinded assessors aimed at assessing the effectiveness and sustainability of RADT-mediated rehabilitation compared to traditional rehabilitation. The trial will recruit 596 adult subacute post-stroke patients. Participants will be randomised into either the experimental group (using RADTs and two therapists supervising four to six patients) or the control group (individual traditional rehabilitation). Patients in both groups will undergo a comprehensive rehabilitation treatment, targeting (a) upper limb sensorimotor abilities; (b) lower limb sensorimotor abilities and gait; (c) balance; and (d) cognitive abilities. Patients will undergo 25 sessions, each lasting 45 min, with a frequency of 5 (inpatients) or 3 (outpatients) times a week. The primary endpoint is the non-inferiority of RADTs in the recovery of the activities of daily living (ADL) using the modified Barthel Index. If non-inferiority is established, the study will evaluate the superiority. Secondary endpoints will analyse the improvements in the aforementioned domains, as well as changes in neural plasticity and biochemical aspects. Upper limb dexterity and gait recovery rates during treatment will be monitored. The study will also evaluate ADL and quality of life during a six-month follow-up period. Acceptability and usability of integrated RADTs-based rehabilitation for patients, families, and healthcare providers, along with economic and organisational sustainability for patients, payers, and society, will also be assessed. Conclusions: This study aims to establish stronger evidence on the effectiveness of RADTs in post-stroke patients. Trial registration number: NCT06547827. Full article

Background/Objectives: The COVID-19 pandemic underscored the urgent need for rapid, efficient testing methods at large-scale events to control virus spread. This study leverages queueing theory to explore how different floor plan configurations affect the efficiency of Rapid Antigen Diagnostic Test (RADT) centers at mass gatherings, aiming to enhance throughput and minimize wait times. Methods: Employing the MAP/PH/c model (Markovian Arrival Process/phase-type service distribution with c servers), this study compared the operational efficiency of RADT centers using U-shaped and straight-line floor plans. The research involved 500 healthy participants, who underwent the RADT process, including queue number issuance, registration, sample collection, sample mixing, and results dissemination. Agile management techniques were implemented to optimize operations. Results: The findings demonstrated that the U-shaped layout was more efficient than the straight-line configuration, reducing the average time from sample collection to results acquisition—1.6 minutes in the U-shaped layout versus 1.8 minutes in the straight-line layout. The efficiency of the U-shaped layout was particularly notable at the results stage, with statistically significant differences (p < 0.05) in reducing congestion and improving resource allocation. Conclusions: The study confirms the feasibility of implementing RADT procedures at mass gatherings and identifies the U-shaped floor plan as the optimal configuration. This layout significantly enhances testing efficiency and effectiveness, suggesting its suitability for future large-scale testing scenarios. The research contributes to optimizing mass testing strategies, vital for public health emergency management during pandemics. Full article

(1) Background: Group A Streptococcal (GAS) pharyngitis is common, resulting in numerous ambulatory visits. Accurate diagnosis is challenging. This study evaluated the clinical utility, cost, and performance of a nucleic acid amplification test (NAAT) for GAS detection, comparing it to a rapid antigen detection test (RADT) and throat culture. Additionally, we assessed the diagnostic stewardship related to these testing methods to ensure appropriate antibiotic use in clinical practice. Methods: Between November 2022 and February 2023, 82 throat swabs were analyzed, with McIsaac clinical scores calculated for each. The Abbott ID NOW STREP A 2 NAAT and Sekisui Diagnostics’ OSOM^® STREP A RADT were performed, followed by bacterial culture. Diagnostic performance was compared using culture as the gold standard. Results: Of the 82 samples, 28 (34.14%) tested positive for pathogenic germs, primarily Streptococcus pyogenes (92.85%). RADTs showed a sensitivity of 80.76% and a specificity of 100%, while NAATs demonstrated a sensitivity of 100% and specificity of 96.42%. Cost analysis indicated the need for reimbursement adjustments to optimize NAAT’s economic benefits. Clinical data indicated that symptoms alone were insufficient for reliable diagnosis. Conclusions: This study confirmed the superior sensitivity of Abbott’s Strep A2 NAAT over RADT. Given the Belgian guidelines against routine antibiotic treatment for pharyngitis and considering local treatment recommendations and cost, implementing NAAT for GAS detection in Belgian laboratories is less beneficial. However, the role of NAAT in supporting antimicrobial stewardship by ensuring appropriate antibiotic use remains significant. Full article

(1) Background: The impact of SARS-CoV-2 has been variable over the time course of the pandemic and in different populations. The aim was to analyze the impact of COVID-19 infection in a known population of hemodialysis (HD) patients and professionals in Spain at different times of the pandemic. (2) Methods: We conducted an observational, descriptive study with a follow-up from 3 March 2020 to 23 April 2022 (776 days), using in average of 414 professionals and 1381 patients from 18 HD units in Spain. The data from the positive PCR or the rapid antigen detection test (RADT) subject were analyzed and segmented into six periods (waves). (3) Results: Of 703 positive COVID-19 tests, 524 were HD patients (74.5%), and 179 were HD professionals (25.5%). Overall, 38% of staff and 43% of patients were affected. Differences were observed in regard to incidence (21% vs. 13%), mortality (3.5% vs. 0%), and symptomatology between the patients and professionals and throughout the pandemic. (4) Conclusions: COVID-19 severity varied during different pandemic waves, with a greater impact seen in the first wave. HD professionals and patients had similar infection rates, but patients had higher mortality rates. Community transmission was the primary route of infection. Full article

To estimate rainfall from remote sensing data, three machine learning-based regression models, K-Nearest Neighbors Regression (K-NNR), Support Vector Regression (SVR), and Random Forest Regression (RFR), were implemented using MSG (Meteosat Second Generation) satellite data. Daytime and nighttime data from a rain gauge are used for model training and validation. To optimize the results, the outputs of the three models are combined using the weighted average. The combination of the three models (hereafter called Com-RSK) markedly improved the predictions. Indeed, the MAE, MBE, RMSE and correlation coefficient went from 23.6 mm, 10.0 mm, 40.6 mm and 89% for the SVR to 20.7 mm, 5.5 mm, 37.4 mm, and 94% when the models were combined, respectively. The Com-RSK is also compared to a few methods using the classification in the estimation, such as the ECST Enhanced Convective Stratiform Technique (ECST), the MMultic technique, and the Convective/Stratiform Rain Area Delineation Technique (CS-RADT). The Com-RSK show superior performance compared to ECST, MMultic and CS-RADT methods.The Com-RSK is also compared to the two products of satellite estimates, namely CMORPH and CHIRPS. The results indicate that Com-RSK performs better than CMORPH and CHIRPS according to MBE, RMSE and CC (coefficient correlation). A comparison with three types of satellite precipitation estimation products, such as global product, regional product, and near real-time product, is performed. Overall, the methodology developed here shows almost the same results as regional product methods and exhibits better results than near real-time and global product methods. Full article

In recent years, transparent terbium aluminum garnet (TAG) ceramics have attracted much attention for use in high-power Faraday isolators. Fine-grained ceramics usually possess better mechanical properties and accordingly better service performance. In this work, transparent TAG ceramics with fine grains were prepared using a two-step sintering procedure based on the low-temperature sintering process to suppress grain growth. The composition of TAG precursor and powders calcined at different temperatures was studied in detail. The microstructure and relative density of air pre-sintered TAG ceramics were studied to meet the requirements of hot isostatic pressing (HIP) post-treatment. Driven by the low pre-sintering temperature in air, the average grain sizes of the obtained TAG ceramics after HIP treatment are about 2.9–5.3 μm. The TAG ceramics (1.2 mm thick) pre-sintered at 1450 °C with HIP post-treatment at 1550 °C for 3 h under a 176 MPa Ar atmosphere possess the highest in-line transmittance of 80.3% at 1064 nm. The Verdet constant of the TAG ceramics at 632.8 nm is −180.5 rad·T⁻¹·m⁻¹ at room temperature, which is about 1.3 times larger than that of the commercial Tb₃Ga₅O₁₂ single crystals. Full article

In this paper, (Tb_0.7Lu_0.3)₂O₃ magneto-optical transparent ceramics with different ZrO₂ doping levels (0~5 at%) were prepared by hydrogen sintering and sequential HIP technique using ZrO₂ as a sintering aid. The effect of ZrO₂ doping content on the microstructure and optical properties of (Tb_0.7Lu_0.3)₂O₃ ceramics was analyzed. We found that the optimal doping content of ZrO₂ was 3 at%. The transmittance of 3 at% ZrO₂-doped (Tb_0.7Lu_0.3)₂O₃ ceramics at the wavelength of 1064 nm was 74.84 %, and the Verdet constant was approximately 275.28 rad·T⁻¹·m⁻¹ at the wavelength of 650 nm. Full article

Five species of Plasmodium cause malaria in humans and two of them, P. vivax and P. falciparum, pose the greatest threat. Rapid antigen detection tests (RADT) have been used for many years to diagnose and distinguish malaria caused by these two parasites. P. falciparum malaria can single-handedly be diagnosed using an RADT, which detects the unique P. falciparum specific histidine-rich protein 2 (HRP2). Unfortunately, there is no RADT that can single-handedly diagnose P. vivax malaria because no specific marker of this parasite has yet been described. Here, we report the discovery of a unique P. vivax protein (Vir14, NCBI Reference Sequence: XP_001612449.1) that has no sequence similarity with proteins of P. falciparum and no significant similarities with proteins of other species of Plasmodium. We propose that this protein could be an outstanding candidate molecule for the development of a promising RADT that can single-handedly and specifically diagnose P. vivax malaria. Full article

(1) Background: Endoscopy and morphological imaging are the mainstay of the diagnostic work up of laryngeal squamous cell carcinomas (LSCCs), which can be integrated in a multidisciplinary discussion to obtain a shared pretreatment staging. (2) Methods: A retrospective evaluation of patients, managed at a tertiary university hospital in Italy and submitted to major laryngeal surgery, has been performed. Four different stagings have been defined and compared: epTN (based on endoscopy and physical ENT examination); radTN (based on CT scan); cTN (based on multidisciplinary integration of the two above); pTN based on pathology on surgical samples. Oncological outcomes have been assessed. (3) Results: Three-year relapse free and disease specific survival were 88% and 92.5%, respectively, without significant differences between partial surgeries (n = 13) and total laryngectomies (n = 32). As for the pretreatment staging, and in particular the T classification, the cTN has been revealed as more reliable than epTN and radTN alone in predicting the final pT (Cohen kappa coefficient: 0.7 for cT, 0.44 for radT, 0.32 for epT). In the partial surgery group, we did not record any positive margin nor local recurrence, with a 100% overall and disease-specific survival. (4) Conclusions: The multidisciplinary approach is fundamental in the definition of the primary lesion in LSCC, in particular in order to safely perform surgical preservation of laryngeal function, which is associated with a higher laryngectomy-free survival than irradiation but to a lower salvageability in case of recurrence. Full article

The empirical or semi-empirical model is widely used for vehicle simulation because of its high accuracy but relies on massive experimental data of tire force and moment. Therefore, tire mechanical prediction is of great significance to improve tire modeling efficiency and to reduce costs. Typical prediction methods or models based on normalization presented by Pacejka and Radt assume that different loads could be close to one normalized curve, but it is not always accurate enough to predict tire force under pure slip conditions and there is no mention of friction prediction methods. In the paper, a theoretical model considering the deformation of belt/carcass is established, which lays the foundation for a normalization model. A method for separation of friction from test data and the proportional assumption of longitudinal and lateral peak friction coefficient between target tire and reference tire are proposed, and the experimental results show that this assumption is acceptable. Finally, according to the separation of friction method and assumption, a new prediction method for tire force under pure slip conditions is presented and validated by comparison with the experimental data. It shows that the proposed method has good prediction capability with satisfactory accuracy. Full article

As a result of preliminary air calcination and subsequent reduction in a flowing NH₃ atmosphere of the precursor from the liquid precipitation method for the first time, pure-phase Tb₂O₃ powder with an average particle size of 135 nm was prepared. The Tb₂O₃ magneto-optical transparent ceramics with the average grain size of 1.3 μm were successfully fabricated by vacuum pre-sintering and hot isostatic pressing post-treatment from the as-synthesized Tb₂O₃ powder. In-line transmittance values of Tb₂O₃ ceramics reach 70.3% at 633 nm, 78.1% at 1064 nm, and 79.4% at 1400 nm, respectively. Thanks to the high intrinsic concentration of Tb³⁺, Tb₂O₃ ceramics present high Verdet constants of −427.3 and −123.7 rad·T⁻¹·m⁻¹ at 633 and 1064 nm, which are about 3.1 and 3.4 times higher than those of commercial Tb₃Ga₅O₁₂ crystals, respectively. Due to the excellent magneto-optical properties, Tb₂O₃ ceramics are promising candidates for the development of Faraday isolator toward compaction used in visible and near-infrared bands. Full article

This study evaluates a population-based screening of asymptomatic people, using a rapid antigen diagnostic test (RADT), in areas of high transmission. To detect sources of SARS-CoV-2 infection, nasopharyngeal samples were taken and were tested using RADT. Confirmatory RT-qPCR tests were performed in both positive and negative cases. The internal validity of the RADT, the prevalence of infection, and the positive and negative predictive values (PPV and NPV) were estimated, based on the percentages of confirmed cases with 95% confidence interval. Of the 157,920 people registered, 50,492 participated in the screening; 50,052 were negative, and 440 were positive on the RADT (0.87%). A total of 221 positive RADT samples were reanalysed using RT-qPCR and 214 were confirmed as positive (96.8%; 95% CI: 93.5–98.7%), while 657 out of 660 negative RADT samples were confirmed as RT-qPCR negative (99.5%; 95% CI 98.7–99.9%). The sensitivity obtained was 65.1% (38.4–90.2%) and the specificity was 99.97% (99.94–99.99%). The prevalence of infection was 1.30% (0.95–2.13%). The PPVs were 95.4% (85.9–98.9%) and 97.9% (93.3–99.5%), respectively, while the NPVs were 99.7% (99.4–100%) and 99.2% (98.7–100%), respectively. The high specificity found allow us to report a high screening performance in asymptomatic patients, even in areas where the prevalence of infection was less than 2%. Full article

Group A streptococcus (GAS) is an important cause of acute pharyngitis. We investigated the positive rate of GAS tests and clinical viral features in children with acute pharyngitis. A retrospective review was conducted for patients <15 years old with both rapid antigen detection test (RADT) and throat culture results. Patients were excluded if they were diagnosed with influenza or had received antibiotics within two weeks before these tests. A total of 377 patients were eligible. The median age of patients was 3.5 years, and 45.4% of total patients were <3 years old. Among all patients, 68.7% had at least one viral feature, and 39% had more than two. The overall positiv rate for GAS was 11.4%. The GAS positive rate was significantly lower in patients <3 years old than in older patients (1.8% vs. 19.4%, p < 0.0001). The overall sensitivity and specificity of RADT were 75.0% (95% CI: 57.8–87.9) and 97.9% (95% CI: 95.8–99.2), respectively. The GAS positive rate was not significantly different between patients with and without viral features (12.4% vs. 9.3%, p = 0.4854). In patients aged 3–14 years, the GAS positive rate was not associated with the modified Centor score or the frequency of clinical viral features. Despite a low prevalence of GAS pharyngitis, testing for GAS was frequently performed in children <3 years old in this study. Appropriate use of laboratory testing for GAS pharyngitis and judicious prescription of antibiotics were imperative. Full article

High-quality magneto-optical ceramics (Tb_xY_1−x)₂O₃ (x = 0.5–1.0) with a Bixbyite structure were extensively investigated for the first time. The total performances of these ceramics were far superior to those of commercial TGG (Tb₃Ga₅O₁₂) crystal, which is regarded as the highest class of Faraday rotator material. In particular, the Verdet constant of Tb₂O₃ (when x = 1.0) ceramic was the largest—495 to 154 rad·T⁻¹·m⁻¹ in the wavelength range of 633 to 1064 nm, respectively. It was possible to further minimize the Faraday isolator device. The insertion loss of this ceramic was equivalent to that of the commercial TGG single crystal (0.04 dB), and its extinction ratio reached more than 42 dB, which is higher than the value for TGG crystal (35 dB). The thermal lens effect (1/f) was as small as 0.40 m⁻¹ as measured by a 50 W fiber laser. The laser damage threshold of this ceramic was 18 J/cm², which is 1.8 times larger than that of TGG, and it was not damaged during a power handling test using a pulsed laser (pulse width 50 ps, power density 78 MW/cm²) irradiated at 2 MHz for 7000 h. Full article

Meningitis is commonly caused by infection with a variety of bacterial or viral pathogens. Acute bacterial meningitis (ABM) can cause severe disease, which can progress rapidly to a critical life-threatening condition. Rapid diagnosis of ABM is critical, as this is most commonly associated with severe sequelae with associated high mortality and morbidity rates compared to viral meningitis, which is less severe and self-limiting. We have designed a microarray for detection and diagnosis of ABM. This has been validated using randomly amplified DNA targets (RADT), comparing buffers with or without formamide, in glass slide format or on the Alere ArrayTube^TM (Alere Technologies GmbH) microarray platform. Pathogen-specific signals were observed using purified bacterial nucleic acids and to a lesser extent using patient cerebral spinal fluid (CSF) samples, with some technical issues observed using RADT and glass slides. Repurposing the array onto the Alere ArrayTube^TM platform and using a targeted amplification system increased specific and reduced nonspecific hybridization signals using both pathogen nucleic and patient CSF DNA targets, better revealing pathogen-specific signals although sensitivity was still reduced in the latter. This diagnostic microarray is useful as a laboratory diagnostic tool for species and strain designation for ABM, rather than for primary diagnosis. Full article