Search Results (3,341)

In our previous work, we developed a neuromorphic decoder of intended movements of tetraplegic patients using ECoG recordings from the brain motor cortex, called Motor Control Decoder (MCD). Even though the training data are labeled based on the desired movement, there is no guarantee that the patient is satisfied by the action of the effectors. Hence, the need for the classification of brain signals as satisfactory/unsatisfactory is obvious. Based on previous work, we upgrade our neuromorphic MCD with a Neural Response Decoder (NRD) that is intended to predict whether ECoG data are satisfactory or not in order to improve MCD accuracy. The main aim is to design an actor–critic structure able to adapt via reinforcement learning the MCD (actor) based on NRD (critic) predictions. For this aim, NRD was trained using not only an ECoG signal but also the MCD prediction or prescribed intended movement of the patient. The achieved accuracy of the trained NRD is satisfactory and contributes to improved MCD performance. However, further work has to be carried out to fully utilize the NRD for MCD performance optimization in an on-line manner. Possibility to include feedback from the patient would allow for further improvement of MCD-NRD accuracy. Full article

In the digital age, online teacher professional development (TPD) has become a key strategy for enhancing instructional quality and ensuring equitable access to continuous learning. This research compares and analyzes Chinese online teacher professional development (TPD) with the United States over a period of ten years, from 2014 to 2024. This study uses a mixed-methods approach based on policy documents, structured surveys, and interviews to investigate how governance regimes influence TPD outcomes for fair education. Both countries experienced a massive expansion of web-based TPD access and engagement, with participation rates over 75% and effectiveness scores over 4.3 by 2024. China focused on fast scaling by way of centralized mandates and investments in infrastructure, while the United States emphasized gradual expansion through decentralized, locally appropriate models. Most indicators had converged by the end of the period, even with these different approaches. Yet, qualitative evidence reveals persisting gaps in functional access and contextual appropriateness, especially in rural settings. Equality frameworks with attention to teacher agency, policy implementation, and digital usability must supplant weak access metrics. A hybrid paradigm presents itself as an attractive means toward building equitable and productive digital TPD environments through the symbiotic integration of China’s successful scalability and the United States’ professional autonomy. Full article

Background/Objectives: Mild Cognitive Impairment (MCI), a condition between normal aging and dementia, is characterized by cognitive changes that do not significantly affect instrumental activities of daily living. The Memory Support System (MSS), an evidence-based behavioral intervention developed by the Mayo Clinic, has been shown to aid those living with MCI and their support partners in coping with cognitive challenges. However, the MSS has not been offered clinically within the Canadian context. Therefore, we conducted a study assessing the feasibility of the MSS from the perspectives of individuals living with MCI and their support partners. Methods: Participants from an institutional registry of research participants, patients, and support partners at a memory clinic, as well as members of a local Dementia Society, were approached to complete an online or paper version of a survey assessing feasibility dimensions. Responses were compared between and within groups for differences in mean scores and associations between linked binary choice response questions. Results: A total of 77 responses were received; 39 surveys were completed by participants with MCI, and 38 by support partners. Respondents found the MSS to be acceptable and practical. On average, participants thought it would be more difficult to train in using the MSS than support partners. Both groups expressed interest in the intervention. On average, participants with MCI and support partners preferred virtual MSS training to in-person and indicated more interest in participating in training over six weeks as compared to two weeks. Conclusions: Flexibility in duration and format when offering the MSS are important considerations when offering the intervention as part of a clinical program. Future research should evaluate cost-effectiveness (e.g., financial, staff resources, etc.) of the MSS approach if it were to be institutionalized in the Ontario healthcare system. Full article

Background/Objectives: Health education plays a vital role in training health professionals and caregivers, supporting both prevention and the promotion of self-care. In this context, technology serves as a valuable ally by enabling continuous and flexible learning. Among the various domains of health education, nutrition stands out as a key element in the management of Amyotrophic Lateral Sclerosis (ALS), helping to prevent malnutrition and enhance patient well-being. Accordingly, this study aimed to evaluate the effectiveness of the teaching and learning processes within a learning pathway focused on food and nutrition in the context of ALS. Methods: This study adopted a longitudinal, quantitative design. The learning pathway, titled “Food and Nutrition in ALS,” consisted of four self-paced and self-instructional Massive Open Online Courses (MOOCs), offered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). Participants included health professionals, caregivers, and patients from all five regions of Brazil. Participants had the autonomy to complete the courses in any order, with no prerequisites for enrollment. Results: Out of 14,263 participants enrolled nationwide, 182 were included in this study after signing the Informed Consent Form. Of these, 142 (78%) completed at least one course and participated in the educational intervention. A significant increase in knowledge was observed, with mean pre-test scores rising from 7.3 (SD = 1.8) to 9.6 (SD = 0.9) on the post-test across all courses (p < 0.001). Conclusions: The self-instructional, technology-mediated continuing education model proved effective in improving participants’ knowledge about nutrition in ALS. Future studies should explore knowledge retention, behavior change, and the impact of such interventions on clinical outcomes, especially in multidisciplinary care settings. Full article

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article

CareCoach seeks to enhance self-efficacy in family caregivers of people living with dementia and has been feasibility tested in a multicentre randomised controlled trial. The intervention offers two face-to-face sessions with a trained coach and access to an online platform with nine modules. This paper reports findings from an embedded qualitative process evaluation assessing implementation from the implementer’s (‘coach’s’) (n = 8) perspective using individual interviews and implementer group discussions. Qualitative data were transcribed verbatim, inductively coded and analysed using Normalisation Process Theory. Implementers demonstrated (1) ‘Coherence’ by seeking to understand how CareCoach compared to current practice, highlighting the importance of supporting coaches to differentiate and identify boundaries between their new ‘coach role’ and usual practice; (2) ‘Cognitive Participation’ by reviewing training and resources to understand their role own responsibilities and facilitate delivery of coaching sessions; group supervision and peer support were also emphasised; (3) ‘Collective Action’ through interactions with carers to deliver key behavioural aspects such as goal setting, problem solving, and providing feedback; and (4) ‘Reflexive Monitoring’ by appraising the intervention to gain useful insights that could facilitate refinement of CareCoach training and delivery. This study provides a theoretically informed understanding of the implementation of CareCoach for caregivers of people living with dementia and provides recommendations to enhance training for coaches, intervention delivery and carer engagement. Full article

Effective energy management in Low Earth Orbit satellites is critical, as inefficient energy management can significantly affect mission objectives. The dynamic and harsh space environment further complicates the development of effective energy management strategies. To address these challenges, we propose a Deep Reinforcement Learning approach using Deep-Q Network to develop an adaptive energy management framework for Low Earth Orbit satellites. Compared to traditional techniques, the proposed solution autonomously learns from environmental interaction, offering robustness to uncertainty and online adaptability. It adjusts to changing conditions without manual retraining, making it well-suited for handling modeling uncertainties and non-stationary dynamics typical of space operations. Training is conducted using a realistic satellite electric power system model with accurate component parameters and single-orbit power profiles derived from real space missions. Numerical simulations validate the controller performance across diverse scenarios, including multi-orbit settings, demonstrating superior adaptability and efficiency compared to conventional Maximum Power Point Tracking methods. Full article

Inspired by the human ability to learn continuously and adapt to changing environments, researchers have proposed Online Open-World Object Detection (OLOWOD). This emerging paradigm faces the challenges of detecting known categories, discovering unknown ones, continuously learning new categories, and mitigating catastrophic forgetting. To address these challenges, we propose Category Prototype-guided Streaming Multi-Level Perturbation, PSMP, a plug-and-play method for OLOWOD. PSMP, comprising semantic-level, enhanced data-level, and enhanced feature-level perturbations jointly guided by category prototypes, operates at different representational levels to collaboratively extract latent knowledge across tasks and improve adaptability. In addition, PSMP constructs the “contrastive tension” based on the relationships among category prototypes. This mechanism inherently leverages the symmetric structure formed by class prototypes in the latent space, where prototypes of semantically similar categories tend to align symmetrically or equidistantly. By guiding perturbations along these symmetric axes, the model can achieve more balanced generalization between known and unknown categories. PSMP requires no additional annotations, is lightweight in design, and can be seamlessly integrated into existing OWOD methods. Extensive experiments show that PSMP achieves an improvement of approximately 1.5% to 3% in mAP for known categories compared to conventional online training methods while significantly increasing the Unknown Recall (UR) by around 4.6%. Full article

Background: Brain health is a growing public health priority due to the high global burden of neurological and mental disorders. Promoting brain health across the lifespan supports individual and societal well-being, creativity, and productivity. Objective: To address the need for specialized education in this field, the University of Bern developed a Certificate of Advanced Studies (CAS) in Brain Health. This article outlines the program’s rationale, structure, and goals. Program Description: The one-year, 15 ECTS-credit program is primarily online and consists of four modules: (1) Introduction to Brain Health, (2) Brain Disorders, (3) Risk Factors, Protective Factors and Interventions, and (4) Brain Health Implementation. It offers a multidisciplinary, interprofessional, life-course approach, integrating theory with practice through case studies and interactive sessions. Designed for healthcare and allied professionals, the CAS equips participants with skills to promote brain health in clinical, research, and public health contexts. Given the shortage of trained professionals in Europe and globally, the program seeks to build a new generation of brain health advocates. It aims to inspire action and initiatives that support the prevention, early detection, and management of brain disorders. Conclusions: The CAS in Brain Health is an innovative educational response to a pressing global need. By fostering interdisciplinary expertise and practical skills, it enhances professional development and supports improved brain health outcomes at individual and population levels. Full article

Background: The purpose of this study was to evaluate Achilles tendon ruptures (ATR) in NHL players and the effects on return to play and player performance metrics. The incidence, mechanism of injury, management strategy, return to play (RTP), and post-injury were assessed from official online sports databases. Methods: A retrospective review of NHL players who sustained a partial or complete tear of the Achilles tendon from 2008 to 2024 was performed. Data were collected from NHL injury databases and media reports, and included player demographics, injury mechanism, treatment, and post-injury performance metrics. A Wilcoxon signed rank test was used to compare pre-injury and post-injury performance metrics, with significance set at p < 0.05. Results: Here, 15 NHL players with a mean age of 27.8 years were identified, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. Overall, 73.3% of ATRs were non-contact in nature, with 60.0% of ATRs occurring during off-season training. Fourteen players were managed with non-operative treatment, with no re-ruptures reported. The RTP rate was 93.3%, with players missing a mean number of 45.7 games. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury. Conclusions: This study found that Achilles tendon ruptures are an uncommon injury in NHL players, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. A high RTP rate of 93.3% was observed in this cohort. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury, highlighting the potential devastating sequelae of ATRs in elite NHL athletes. Full article

Background: This study examines current trends in Canada using data from the Canadian Joint Replacement Registry (CJRR) and includes a national survey to understand the varied uptake of cement for femoral stem fixation. Methods: The survey was available online and the website link was distributed to all orthopaedic surgeons through the Canadian Orthopaedic Association between September and December 2022. The CJRR obtained data from the Canadian Institute for Health Information (CIHI), and information pertaining to patients 55 years of age and older who underwent hemiarthroplasty for hip fracture in Canada between April 2017 and March 2022 was used. Results: Most respondents practiced in an academic community setting (52%). Only 53% of respondents reported using cement, and 71% indicated that cemented fixation was the best practice. The main reasons for using uncemented stems were less operative time (23%), cement disease concerns (11%), and surgeons’ comfort (10%). Similarly, CJRR data showed only 51% cemented fixation among 42,386 hemiarthroplasties performed between 2017 and 2022. The proportion of cemented implants varied by province, but overall, the increase in the use of cement from 2017 to 2022 was from 42.9% to 57.7%. Conclusions: This study demonstrates variability in the use of cement for femoral fixation despite solid evidence showing improved outcomes using cement. Some of the main reasons in favour of uncemented stems include operative time, surgical training, and concerns about cement disease. Establishing clear position statements and guidelines supporting cemented fixation may be prudent to build universal consensus on this practice. Full article

The rise in online learning, accelerated by the COVID-19 pandemic, has led to greater use of synchronous hybrid learning (SHL) in higher education. SHL allows simultaneous teaching of in-person and online learners through videoconferencing tools. Previous studies have identified various benefits (e.g., flexibility) and challenges (e.g., student engagement) to SHL. Whilst systematic reviews have emerged on this topic, few studies have considered the experiences of staff. The aim of this review was threefold: (i) to better understand how staff experiences and perceptions are assessed, (ii) to understand staff experiences in terms of the benefits and challenges of SHL and (iii) to identify recommendations for effective teaching and learning using SHL. In line with the PRISMA guidance, we conducted a systematic review across four databases, identifying 14 studies for inclusion. Studies were conducted in nine different countries and covered a range of academic disciplines. Most studies adopted qualitative methods, with small sample sizes. Measures used were typically novel and unvalidated. Four themes were identified relating to (i) technology, (ii) redesigning teaching and learning, (iii) student engagement and (iv) staff workload. In terms of recommendations, ensuring adequate staff training and ongoing classroom support were considered essential. Additionally, active and collaborative learning were considered important to address issues with interactivity. Whilst these findings largely aligned with previous work, this review also identified limited reporting in research in this area, and future studies are needed to address this. Full article

Tea cultivation faces significant threats from red spider mite (RSM: Oligonychus coffeae) infestations, which reduce yields and economic viability in major tea-producing regions. Current automated detection methods rely on supervised deep learning models requiring extensive labeled data, limiting scalability for smallholder farmers. This article proposes AIM-Net (AI-based Infestation Mapping Network) by evaluating SwAV (Swapping Assignments between Views), a self-supervised learning framework, for classifying RSM infestation severity (Mild, Moderate, Severe) using a geo-referenced, field-acquired dataset of RSM infested tea-leaves, Cam-RSM. The methodology combines SwAV pre-training on unlabeled data with fine-tuning on labeled subsets, employing multi-crop augmentation and online clustering to learn discriminative features without full supervision. Comparative analysis against a fully supervised ResNet-50 baseline utilized 5-fold cross-validation, assessing accuracy, F1-scores, and computational efficiency. Results demonstrate SwAV’s superiority, achieving 98.7% overall accuracy (vs. 92.1% for ResNet-50) and macro-average F1-scores of 98.3% across classes, with a 62% reduction in labeled data requirements. The model showed particular strength in Mild_RSM-class detection (F1-score: 98.5%) and computational efficiency, enabling deployment on edge devices. Statistical validation confirmed significant improvements (p < 0.001) over baseline approaches. These findings establish self-supervised learning as a transformative tool for precision pest management, offering resource-efficient solutions for early infestation detection while maintaining high accuracy. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Piano fingering estimation remains a complex problem due to the combinatorial nature of hand movements and no best solution for any situation. A recent model-free reinforcement learning framework for piano fingering modeled each monophonic piece as an environment and demonstrated that value-based methods outperform probability-based approaches. Building on their finding, this paper addresses the more complex polyphonic fingering problem by formulating it as an online model-free reinforcement learning task with a novel training strategy. Thus, we introduce a novel Elite Episode Replay (EER) method to improve learning efficiency by prioritizing high-quality episodes during training. This strategy accelerates early reward acquisition and improves convergence without sacrificing fingering quality. The proposed architecture produces multiple-action outputs for polyphonic settings and is trained using both elite-guided and uniform sampling. Experimental results show that the EER strategy reduces training time per step by 21% and speeds up convergence by 18% while preserving the difficulty level and result of the generated fingerings. An empirical study of elite memory size further highlights its impact on training performance in solving piano fingering estimation. Full article