Search Results (15)

Background: Intracranial pressure (ICP) monitoring is crucial in managing acute brain injury (ABI) to prevent secondary brain injury. While invasive techniques remain the gold standard, they can carry notable risks, such as infection and hemorrhage. Non-invasive techniques are increasingly used, but their inter-modality correlation and concordance have not been systematically evaluated. This study aimed to assess the correlation and concordance among four commonly used non-invasive neuromonitoring tools in patients with ABI undergoing invasive ICP monitoring. Methods: This was a secondary analysis of prospectively collected data from 100 adult patients admitted to the intensive care unit with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH) who underwent invasive ICP monitoring. Simultaneous assessments using optic nerve sheath diameter (ONSD), transcranial Doppler-derived pulsatility index (PI), estimated ICP (eICP), and the neurological pupil index (NPi) were performed. Correlation between modalities was assessed using Spearman’s correlation coefficient (ρ), and concordance was evaluated with Cohen’s kappa coefficient (k). Results: We found weak correlations between ONSD and PI (ρ = 0.29), ONSD and NPi (ρ = −0.33), and PI and NPi (ρ = −0.33); moderate correlations between ONSD and eICP (ρ = 0.54) and PI and eICP (ρ = 0.48); and a strong inverse correlation between eICP and NPi (ρ = −0.71; all p < 0.05). Concordance was generally low, with the highest agreement between PI and eICP (k = 0.69). Most other tool pairings showed poor-to-fair concordance (k ≤ 0.30). Conclusions: Non-invasive neuromonitoring tools show variable correlation and limited agreement, suggesting they are not interchangeable. Each modality captures different aspects of cerebral physiology, supporting the use of a multimodal approach to improve accuracy in ICP estimation. Full article

Left ventricular noncompaction (LVNC) is characterized by excessive trabeculation, which may impair left ventricular function over time. While cardiac magnetic resonance imaging (CMR) is considered the gold standard for evaluating LV morphology, the optimal modality for follow-up remains uncertain. This study aimed to assess the correlation and agreement among two-dimensional transthoracic echocardiography (2D_TTE), three-dimensional transthoracic echocardiography (3D_TTE), and CMR by comparing volumetric and strain parameters in LVNC patients and healthy individuals. Thirty-eight LVNC subjects with preserved ejection fraction and thirty-four healthy controls underwent all three imaging modalities. Indexed end-diastolic, end-systolic, and stroke volumes, ejection fraction, and global longitudinal and circumferential strains were evaluated using Pearson correlation and Bland–Altman analysis. In the healthy group, volumetric parameters showed strong correlation and good agreement across modalities, particularly between 3D_TTE and CMR. In contrast, agreement in the LVNC group was moderate, with lower correlation and higher percentage errors, especially for strain parameters. Functional data exhibited weak or no correlation, regardless of group. These findings suggest that while echocardiography may be suitable for volumetric follow-up in LVNC after baseline CMR, deformation parameters are not interchangeable between modalities, likely due to trabecular interference. Further studies are warranted to validate modality-specific strain assessment in hypertrabeculated hearts. Full article

Background/Objectives: Sensorineural hearing loss (HL) is a highly prevalent chronic health condition. It can be managed through hearing care, including the use of hearing aids (HAs). Still, a majority of individuals with HL remain undiagnosed or untreated. Virtual care delivery may support uptake and adherence to interventions. In blended care, individuals can choose interchangeably between in-person and virtual services. This study aimed to investigate how real-world individuals accessed blended hearing care (through in-person, virtual, or hybrid services), the amount of support they received, and their satisfaction with services and products. Methods: An exploratory, retrospective analysis was performed on longitudinal observational data collected through Australia’s longest-running blended hearing care model. A total of 25,058 appointment records were available, matched to HA purchase records and clinical notes where possible, as well as 916 satisfaction ratings. Results: The majority of individuals attended in-person appointments (75%); 25% were virtual or hybrid appointments. The number of appointments attended depended on how HAs were purchased (in-person, virtually, or hybrid), but all modalities were complemented by ample unscheduled email and telephone support. Of those who purchased HAs repeatedly, 49% changed preferred sales channel (in-person versus virtual) over time. Satisfaction ratings were highest for virtual services. Conclusions: This first report of real-world, longitudinal evidence on blended hearing care showed strong attendance of in-person appointments, while hybrid services—including informal; unscheduled support—may have responded to individuals’ changing needs and preferences over time. The findings offer practice-based evidence for blended care models and recommendations for further research. Full article

Given an untrimmed video and a natural language query, the video temporal grounding task aims to accurately locate the target segment within the video. Functioning as a critical conduit between computer vision and natural language processing, this task holds profound importance in advancing video comprehension. Current research predominantly centers on enhancing the performance of individual models, thereby overlooking the extensive possibilities afforded by multi-model synergy. While knowledge flow methods have been adopted for multi-model and cross-modal collaborative learning, several critical concerns persist, including the unidirectional transfer of knowledge, low-quality pseudo-label generation, and gradient conflicts inherent in cooperative training. To address these issues, this research proposes a Multi-Model Collaborative Learning (MMCL) framework. By incorporating a bidirectional knowledge transfer paradigm, the MMCL framework empowers models to engage in collaborative learning through the interchange of pseudo-labels. Concurrently, the mechanism for generating pseudo-labels is optimized using the CLIP model’s prior knowledge, bolstering both the accuracy and coherence of these labels while efficiently discarding extraneous temporal fragments. The framework also integrates an iterative training algorithm for multi-model collaboration, mitigating gradient conflicts through alternate optimization and achieving a dynamic balance between collaborative and independent learning. Empirical evaluations across multiple benchmark datasets indicate that the MMCL framework markedly elevates the performance of video temporal grounding models, exceeding existing state-of-the-art approaches in terms of mIoU and Rank@1. Concurrently, the framework accommodates both homogeneous and heterogeneous model configurations, demonstrating its broad versatility and adaptability. This investigation furnishes an effective avenue for multi-model collaborative learning in video temporal grounding, bolstering efficient knowledge dissemination and charting novel pathways in the domain of video comprehension. Full article

Background: Repeated sprint ability (RSA) is defined as the ability to recover and maintain maximal effort during repeated sprints, recognised as a crucial performance component in team sports. The exercise mode used to test RSA may influence performance and the contributions of different energy systems. The primary aim of this study is to address the critical gap between traditional cycling-based anaerobic tests, such as the Wingate test, and the practical, sport-specific demands of running in field-based team sports. Methods: This study involved 32 professional soccer players (age: 21.2 ± 1.3 years; height: 177.8 ± 4.3 cm; and mass: 71.3 ± 6.4 kg). They performed cycling- and running-based repeated sprint tests, with similar total sprint numbers, durations, and recovery times, on different days. Contributions from adenosine triphosphate-phosphocreatine (ATP-PCr), glycolytic, and oxidative systems were estimated through body weight, oxygen uptake (VO₂), blood lactate (BLa), and the fast component of excess post-exercise oxygen consumption (EPOC). The VO₂ levels and heart rate (HR) were monitored during the rest (10 min), exercise, and recovery (15 min) phases in a breath-by-breath mode using a portable gas exchange system. BLa was measured before (at rest) and 1, 3, 5, 7, and 10 min after the running and cycling tests using a handheld portable analyser. A mono-exponential model estimated the ATP-PCr system contribution, calculated using the fast component of EPOC following the final sprint and the sum of the VO₂-time integral during rest intervals. Results: The cycling tests demonstrated significantly higher values for the peak power (PP), mean power (MP), and rate of perceived exertion (RPE) (p < 0.05), while the heart rate peak and blood lactate responses were similar across all modalities. The fatigue index was notably higher in the running tests (p < 0.05). Furthermore, the running tests showed greater contributions in both the percentage and absolute terms from the adenosine triphosphate-phosphocreatine (ATP-PCr) system (p < 0.01), total energy demand (p < 0.05), and total energy expenditure (TEE) (p < 0.01). Notably, the running tests resulted in an increased phosphocreatine breakdown (p < 0.05) and rapid phosphocreatine replenishment (p < 0.01). A simple linear regression analysis highlighted a significant determination coefficient between these performance variables and the contributions of the energy systems, affirming the robustness of the results. The correlation heatmaps further illustrated these relationships, with higher correlations for the PP and MP across modalities (0.41), emphasising the moderate association between cycling and running tests in these metrics. Conclusions: This study elucidated the similarities and differences in energy system contributions and performance outcomes between a cycling and a running repeated sprint protocol, with a comparable total sprint time and work–rest ratio. The findings reveal that a running repeated sprint test elicits a higher energy demand and a higher contribution from the PCr energy system compared to cycling. Performance variables were not associated between running and cycling tests, suggesting those tests cannot be used interchangeably. Full article

Background: Despite a successful repair of tetralogy of Fallot (rToF) in childhood, residual lesions are common and can contribute to impaired exercise capacity. Although both cycle ergometer and treadmill protocols are often used interchangeably these approaches have not been directly compared. In this study we examined cardiopulmonary exercise test (CPET) measurements in rToF. Methods: Inclusion criteria were clinically stable rToF patients able to perform a cardiac magnetic resonance imaging (CMR) and two CPET studies, one on the treadmill (incremental Bruce protocol) and one on the cycle ergometer (ramped protocol), within 12 months. Demographic, surgical and clinical data; functional class; QRS duration; CMR measures; CPET data and international physical activity questionnaire (IPAQ) scores of patients were collected. Results: Fifty-seven patients were enrolled (53% male, 20.5 ± 7.8 years at CPET). CMR measurements included a right ventricle (RV) end-diastolic volume index of 119 ± 22 mL/m², a RV ejection fraction (EF) of 55 ± 6% and a left ventricular (LV) EF of 56 ± 5%. Peak oxygen consumption (VO₂)/Kg (25.5 ± 5.5 vs. 31.7 ± 6.9; p < 0.0001), VO₂ at anaerobic threshold (AT) (15.3 ± 3.9 vs. 22.0 ± 4.5; p < 0.0001), peak O₂ pulse (10.6 ± 3.0 vs. 12.1± 3.4; p = 0.0061) and oxygen uptake efficiency slope (OUES) (1932.2 ± 623.6 vs. 2292.0 ± 639.4; p < 0.001) were significantly lower on the cycle ergometer compared with the treadmill, differently from ventilatory efficiency (VE/VCO₂) max which was significantly higher on the cycle ergometer (32.2 ± 4.5 vs. 30.4 ± 5.4; p < 0.001). Only the VE/VCO₂ slope at the respiratory compensation point (RCP) was similar between the two methodologies (p = 0.150). Conclusions: The majority of CPET measurements differed according to the modality of testing, with the exception being the VE/VCO₂ slope at RCP. Our data suggest that CPET parameters should be interpreted according to test type; however, these findings should be validated in larger populations and in a variety of institutions. Full article

Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, in addition to PDAC, and to the other most common and well-known solid lesions, either related to benign conditions, such as pancreatitis, or not so benign, such as pancreatic neuroendocrine neoplasms (pNENs), there are solid pancreatic lesions considered rare due to their low incidence. These lesions may originate from a cell line with a differentiation other than exocrine/endocrine, such as from the nerve sheath as for pancreatic schwannoma or from mesenchymal cells as for solitary fibrous tumour. These rare solid pancreatic lesions may show a behaviour that ranges in a benign to highly aggressive malignant spectrum. This review includes cases of an intrapancreatic accessory spleen, pancreatic tuberculosis, solid serous cystadenoma, solid pseudopapillary tumour, pancreatic schwannoma, purely intraductal neuroendocrine tumour, pancreatic fibrous solitary tumour, acinar cell carcinoma, undifferentiated carcinoma with osteoclastic-like giant cells, adenosquamous carcinoma, colloid carcinoma of the pancreas, primary leiomyosarcoma of the pancreas, primary and secondary pancreatic lymphoma and metastases within the pancreas. Therefore, it is important to determine the correct diagnosis to ensure optimal patient management. Because of their rarity, their existence is less well known and, when depicted, in most cases incidentally, the correct diagnosis remains challenging. However, there are some typical imaging features present on cross-sectional imaging modalities that, taken into account with the clinical and biological context, contribute substantially to achieve the correct diagnosis. Full article

Boron-10-containing positron emission tomography (PET) radio-tracer, ¹⁸F-FBPA, has been used to evaluate the feasibility and treatment outcomes of Boron neutron capture therapy (BNCT). The clinical use of PET/MR is increasing and reveals its benefit in certain applications. However, the PET/CT is still the most widely used modality for daily PET practice due to its high quantitative accuracy and relatively low cost. Considering the different attenuation correction maps between PET/CT and PET/MR, comparison of derived image features from these two modalities is critical to identify quantitative imaging biomarkers for diagnosis and prognosis. This study aimed to investigate the comparability of image features extracted from ¹⁸F-FBPA PET/CT and PET/MR. A total of 15 patients with malignant brain tumor who underwent ¹⁸F-FBPA examinations using both PET/CT and PET/MR on the same day were retrospectively analyzed. Overall, four conventional imaging characteristics and 449 radiomic features were calculated from PET/CT and PET/MR, respectively. A linear regression model and intraclass correlation coefficient (ICC) were estimated to evaluate the comparability of derived features between two modalities. Features were classified into strong, moderate, and weak comparability based on coefficient of determination (r²) and ICC. All of the conventional features, 81.2% of histogram, 37.5% of geometry, 51.5% of texture, and 25% of wavelet-based features, showed strong comparability between PET/CT and PET/MR. With regard to the wavelet filtering, radiomic features without filtering (61.2%) or with low-pass filtering (59.2%) along three axes produced strong comparability between the two modalities. However, only 8.2% of the features with high-pass filtering showed strong comparability. The linear regression models were provided for the features with strong and moderate consensus to interchange the quantitative features between the PET/CT and the PET/MR. All of the conventional and 71% of the radiomic (mostly histogram and texture) features were sufficiently stable and could be interchanged between ¹⁸F-FBPA PET with different hybrid modalities using the proposed equations. Our findings suggested that the image features high interchangeability may facilitate future studies in comparing PET/CT and PET/MR. Full article

A finite element model of an aero-engine dual-rotor system with intermediate bearing supported by six bearings is set up. Three modes of non-concentricity caused by the assembly process are defined, namely parallel non-concentricity, front deflection angle non-concentricity and rear deflection angle non-concentricity. The influence of the non-concentricity on the vibration characteristics of the dual-rotor system is investigated in detail. The results show that the parallel non-concentricity and the front deflection angle non-concentricity have a significant influence on the bending vibration modals of the high-pressure rotor and the low-pressure rotor, but have little influence on the local vibration modals of the rotors. With the increase in the magnitude of the non-concentricity, the natural frequencies of the bending modals decrease continuously, and the mode shapes of bending modals and that of local modals may be interchanged, leading to the emergence of bending modals in advance. Therefore, the key parameters to be controlled in the assembly process are the parallel non-concentricity and the front deflection angle non-concentricity. In order to prevent the bending modal of the dual-rotor system from appearing in advance, it is necessary to control the parallel non-concentricity within 2 mm and the front deflection angle non-concentricity amount within 0.18°. Full article

In the last decades, car sharing has been a tool for city planners to reduce private car traffic and pollution in big urban areas. The emergence of the ICTs (Information and Communication Technologies), together with the development of the collaborative economy, has allowed for the birth of the new Free-Floating Carsharing (FFCS): A more flexible type of carsharing, in which electric cars can be used. Little research has been devoted using real FFCS flows data, to the FFCS impacts on user behavior and even on the public transport system thus far. Furthermore, in big metropolitan areas, central rail stations should promote modal interchanges, including new modes of electric FFCS systems. The aim of this paper is to design a web-based platform to collect and analyze FFCS demand on the surrounding areas of rail stations and makes a proposal to provide these systems with electrical recharging energy obtained from the regenerative braking of high-speed trains. This case study includes Atocha and Chamartín Central Stations in Madrid (Spain). Scientific evidence shows a high demand of FFCS cars at central rail stations and a trip profile with a short time duration linked to the closest districts of rail stations. Full article

Background: Observational research plays an important part in developmental research due to its noninvasiveness. However, it has been hardly applied to investigate efficacy of the child–therapist interaction in the context of naturalistic developmental behavioral interventions (NDBI). In particular, the characteristics of child–therapist interplay are thought to have a significant impact in NDBIs in children with autism spectrum disorder (ASD). Quantitative approaches may help to identify the key features of interaction during therapy and could be translated as instruments to monitor early interventions. Methods: n = 24 children with autism spectrum disorder (ASD) were monitored from the time of the diagnosis (T0) and after about one year of early intervention (T1). A novel observational coding system was applied to video recorded sessions of intervention to extract quantitative behavioral descriptors. We explored the coding scheme reliability together with its convergent and predictive validity. Further, we applied computational techniques to investigate changes and associations between interaction profiles and developmental outcomes. Results: Significant changes in interaction variables emerged with time, suggesting that a favorable outcome is associated with interactions characterized by increased synchrony, better therapist’s strategies to successfully engage the child and scaffold longer, more complex and engaging interchanges. Interestingly, data models linked interaction profiles, outcome measures and response trajectories. Conclusion: Current research stresses the need for process measures to understand the hows and the whys of ASD early intervention. Combining observational techniques with computational approaches may help in explaining interindividual variability. Further, it could disclose successful features of interaction associated with better response trajectories or to different ASD behavioral phenotypes that could require specific dyadic modalities. Full article

In the European Union, more than 70% of the population lives in urban areas. Achieving more efficient and low-carbon mobility is crucial to ensuring urban systems are sustainable and tackling important challenges, such as reduction of CO₂ emissions, air and noise pollution, and traffic congestion. Identifying effective strategies and design solutions that boost multimodal mobility and effective interchange among different sustainable means of transport can be a significant contribution in this area. This paper presents an easy-to-use methodology to assess the performance of policy measures and design solutions-oriented to foster modal interchange, with special regard to the configuration of the interchange hubs. The methodology is based on identifying key factors necessary to ensure an efficient multimodal interchange and the different types of interchanges that are frequently present in the urban realm. By grouping the key factors into nine different domains, and by weighing the key factors in relation to their importance, the methodology creates a decision support system to assess the performance of the current interchange, as well as of different planning and design scenarios. This methodology has been developed in the framework of the Interreg Europe MATCH-UP project and is conceived to support both designers and decision-makers whenever they have to reorganise existing transport hubs and policies, or design and plan new ones. Full article

The vasodilator-associated stimulated phosphoprotein (VASP) phosphorylation level is a highly specific method to assess P2Y12 receptor inhibition. Traditionally, VASP phosphorylation is analyzed by flow cytometry, which is laborious and restricted to specialized laboratories. Recently, a simple ELISA kit has been commercialized. The primary objective of this study was to compare the performance of VASP assessment by ELISA and flow cytometry in relation to functional platelet aggregation testing by Multiplate^® whole-blood aggregometry. Blood from 24 healthy volunteers was incubated with increasing concentration of a P2Y12 receptor inhibitor (AR-C 66096). Platelet function testing was carried out simultaneously by Multiplate^® aggregometry and by VASP assessment through ELISA and flow cytometry. As expected, increasing concentrations of the P2Y12 receptor inhibitor induced a proportional inhibition of platelet aggregation and P2Y12 receptor activation across the modalities. Platelet reactivity index values of both ELISA- and flow cytometry-based VASP assessment methods correlated strongly (r = 0.87, p < 0.0001) and showed minimal bias (1.05%). Correlation with Multiplate^® was slightly higher for the flow cytometry-based VASP assay (r = 0.79, p < 0.0001) than for the ELISA-based assay (r = 0.69, p < 0.0001). Intraclass correlation (ICC) was moderate for all the assays tested (ICC between 0.62 and 0.84). However, categorization into low, optimal, or high platelet reactivity based on these assays was strongly concordant (κ between 0.86 and 0.92). In conclusion, the consensus-recommended assays with their standardized cut-offs should not be used interchangeably in multi-center clinical studies but, rather, they should be standardized throughout sites. Full article

Grasping and manipulation with anthropomorphic robotic and prosthetic hands presents a scientific challenge regarding mechanical design, sensor system, and control. Apart from the mechanical design of such hands, embedding sensors needed for closed-loop control of grasping tasks remains a hard problem due to limited space and required high level of integration of different components. In this paper we present a scalable design model of artificial fingers, which combines mechanical design and embedded electronics with a sophisticated multi-modal sensor system consisting of sensors for sensing normal and shear force, distance, acceleration, temperature, and joint angles. The design is fully parametric, allowing automated scaling of the fingers to arbitrary dimensions in the human hand spectrum. To this end, the electronic parts are composed of interchangeable modules that facilitate the mechanical scaling of the fingers and are fully enclosed by the mechanical parts of the finger. The resulting design model allows deriving freely scalable and multimodally sensorised fingers for robotic and prosthetic hands. Four physical demonstrators are assembled and tested to evaluate the approach. Full article

Excess visceral adipose tissue (VAT) and VAT volume relative to subcutaneous adipose tissue (SAT) are associated with elevated health risks. This study compares fat measurements by dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). In total, 21 control subjects (Control) and 16 individuals with metabolic syndrome (MetSyn) were scanned by DXA and MRI. The region measured by MRI was matched to the android region defined by DXA, and MRI reproducibility was also evaluated. In addition, liver fat fraction was quantified via MRI and whole-body fat by DXA. VAT measurements are interchangeable between DXA and MRI in the Control (R = 0.946), MetSyn (R = 0.968), and combined cohort (R = 0.983). VAT/SAT ratio did not differ in the Control group (P = .10), but VAT/SAT ratio measured by DXA was significantly higher in the MetSyn group (P < .01) and the combined (P = .03) cohort. Intraobserver (ICC = 0.998) and interobserver (ICC = 0.977) reproducibility of MRI VAT measurements was excellent. Liver fat fraction by MRI was higher (P = .001) in MetSyn (12.4% ± 7.6%) than in controls (2.6% ± 2.2%), as was whole-body fat percentage by DXA (P = .001) between the MetSyn (42.0% ± 8.1%) and Control groups (26.7% ± 6.9%). DXA and MRI VAT are interchangeable when measured over an anatomically matched region of the abdomen, while SAT and VAT/SAT ratio differ between the 2 modalities. Full article