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Through phase-amplitude analysis, this study investigated how low-frequency postural fluctuations interact with high-frequency scalp electroencephalography (EEG) amplitudes, shedding light on age-related mechanic differences in balance control during uneven surface navigation. Twenty young (24.1 ± 1.9 years) and twenty older adults (66.2 ± 2.7 years) stood on a training stabilometer with visual guidance, while their scalp EEG and stabilometer plate movements were monitored. In addition to analyzing the dynamics of the postural fluctuation phase, phase-amplitude coupling (PAC) for postural fluctuations below 2 Hz and within EEG sub-bands (theta: 4-7 Hz, alpha: 8-12 Hz, beta: 13-35 Hz) was calculated. The results indicated that older adults exhibited significantly larger postural fluctuation amplitudes(p <0.001) and lower mean frequencies of the postural fluctuation phase (p=0.005) than young adults. The PAC between postural fluctuation and theta EEG (FCz and bilateral temporal-parietal-occipital area), as well as that between postural fluctuation and alpha EEG oscillation, was lower in older adults than in young adults (p <0.05). In contrast, the PAC between the phase of postural fluctuation and beta EEG oscillation, particularly in C3 (p= 0.006), was higher in older adults than in young adults. In summary, the postural fluctuation phase and phase-amplitude coupling between postural fluctuation and EEG are sensitive indicators of the age-related decline in postural adjustments, reflecting less flexible motor state transitions and adaptive changes in error monitoring and visuospatial attention.
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Virtual error amplification (VEA) in visual feedback enhances attentive control over postural stability, although the neural mechanisms are still debated. This study investigated the distinct cortical control of unsteady stance in older adults using VEA through cross-frequency modulation of postural fluctuations and scalp EEG. Thirty-seven community-dwelling older adults (68.1 ± 3.6 years) maintained an upright stance on a stabilometer while receiving either VEA or real error feedback. Along with postural fluctuation dynamics, phase-amplitude coupling (PAC) and amplitude-amplitude coupling (AAC) were analyzed for postural fluctuations under 2 Hz and EEG sub-bands (theta, alpha, and beta). The results revealed a higher mean frequency of the postural fluctuation phase (p = .005) and a greater root mean square of the postural fluctuation amplitude (p = .003) with VEA compared to the control condition. VEA also reduced PAC between the postural fluctuation phase and beta-band EEG in the left frontal (p = .009), sensorimotor (p = .002), and occipital (p = .018) areas. Conversely, VEA increased the AAC of posture fluctuation amplitude and beta-band EEG in FP2 (p = .027). Neither theta nor alpha band PAC or AAC were affected by VEA. VEA optimizes postural strategies in older adults during stabilometer stance by enhancing visuospatial attentive control of postural responses and facilitating the transition of motor states against postural perturbations through a disinhibitory process. Incorporating VEA into virtual reality technology is advocated as a valuable strategy for optimizing therapeutic interventions in postural therapy, particularly to mitigate the risk of falls among older adults.
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BACKGROUND: Osteoporosis (OP) can be caused by an overactive osteoclastic function. Anti-osteoporosis considerable therapeutic effects in tissue repair and regeneration because bone resorption is a unique osteoclast function. In this study, we mainly explored the underlying mechanisms of osteoclasts' effects on osteoporosis. METHODS: RAW264.7 cells were used and induced toward osteoclast and iron accumulation by M-CSF and RANKL administration. We investigated Hepcidin and divalent metal transporter 1 (DMT1) on iron accumulation and osteoclast formation in an ovariectomy (OVX)-induced osteoporosis. Osteoporosis was induced in mice by OVX, and treated with Hepcidin (10, 20, 40, 80 mg/kg, respectively) and overexpression of DMT1 by tail vein injection. Hepcidin, SPI1, and DMT1 were detected by immunohistochemical staining, western blot and RT-PCR. The bioinformatics assays, luciferase assays, and Chromatin Immunoprecipitation (ChIP) verified that Hepcidin was a direct SPI1 transcriptional target. Iron accumulation was detected by laser scanning confocal microscopy, Perl's iron staining and iron content assay. The formation of osteoclasts was assessed using tartrate-resistant acid phosphatase (TRAP) staining. RESULTS: We found that RAW264.7 cells differentiated into osteoclasts when exposed to M-CSF and RANKL, which increased the protein levels of osteoclastogenesis-related genes, including c-Fos, MMP9, and Acp5. We also observed higher concentration of iron accumulation when M-CSF and RANKL were administered. However, Hepcidin inhibited the osteoclast differentiation cells and decreased intracellular iron concentration primary osteoclasts derived from RAW264.7. Spi-1 proto-oncogene (SPI1) transcriptionally repressed the expression of Hepcidin, increased DMT1, facilitated the differentiation and iron accumulation of mouse osteoclasts. Overexpression of SPI1 significantly declined luciferase activity of HAMP promoter and increased the enrichment of HAMP promoter. Furthermore, our results showed that Hepcidin inhibited osteoclast differentiation and iron accumulation in mouse osteoclasts and OVX mice. CONCLUSION: Therefore, the study revealed that SPI1 could inhibit Hepcidin expression contribute to iron accumulation and osteoclast formation via DMT1 signaling activation in mouse with OVX.
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Osteoclastos , Osteoporose , Feminino , Animais , Camundongos , Fator Estimulador de Colônias de Macrófagos , Hepcidinas , LuciferasesRESUMO
In this study, we demonstrate the feasibility of rapid volumetric additive manufacturing in the solid state. This additive manufacturing technology is particularly useful in outer space missions (microgravity) and/or for harsh environment (e.g., on ships and vehicles during maneuvering, or on airplanes during flight). A special thermal gel is applied here to demonstrate the concept, that is, ultraviolet crosslinking in the solid state. The produced hydrogels are characterized and the water-content-dependent heating/cooling/water-responsive shape memory effect is revealed. Here, the shape memory feature is required to eliminate the deformation induced in the process of removing the uncrosslinked part from the crosslinked part in the last step of this additive manufacturing process.
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Plasma-catalytic bireforming of methane was studied and actively optimized using a La0.7Ce0.3NiO3 perovskite catalyst via experimentation in tandem with response surface modeling. Plasma power, inlet flow rate, temperature, CO2/CH4 ratio, and steam concentration were tuned to maximize a variety of process- and sustainability-based metrics. Analysis of the optimal conditions (with respect to different metrics) with and without the catalyst reveals that dry reforming is driven largely via noncatalytic reactions, while steam reforming and water gas shift reactions require the catalyst. The experimental outcome demonstrated that under optimum reaction conditions using the La0.7Ce0.3NiO3 catalyst it is possible to minimize global warming potential (GWP), in terms of inferred CO2 footprint normalized to hydrogen throughput, resulting in maximizing hydrogen yield through steam reforming (and water gas shift reactions) at an SEI of ≈12 eV/molecule. Furthermore, the highest CH4 conversion reached was 87% while the catalyst showed good activity stability in DBD plasma experiments.The actively learned iterative optimization procedure developed in this work allows for a direct juxtaposition of thermal (heat needed to make steam and heat the plasma reactor) and electrical (power requirement for plasma generation) carbon footprints in a highly nonlinear multivariate process. Furthermore, the corresponding GWP was calculated using a conventional electricity mix, wind electricity, and solar electricity, allowing a direct sustainability assessment in catalyst-assisted plasma conversion of carbonaceous feedstock to H2 and CO.
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This review article serves to highlight radiological services as a major cost driver for the healthcare sector, and the potential improvements in productivity and cost savings that can be generated by incorporating artificial intelligence (AI) into the radiology workflow, referencing Singapore healthcare as an example. More specifically, we will discuss the opportunities for AI in lowering healthcare costs and supporting transformational shifts in our care model in the following domains: predictive analytics for optimising throughput and appropriate referrals, computer vision for image enhancement (to increase scanner efficiency and decrease radiation exposure) and pattern recognition (to aid human interpretation and worklist prioritisation), natural language processing and large language models for optimising reports and text data-mining. In the context of preventive health, we will discuss how AI can support population level screening for major disease burdens through opportunistic screening and democratise expertise to increase access to radiological services in primary and community care.
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Many applications in science and engineering involve data defined at specific geospatial locations, which are often modeled as random fields. The modeling of a proper correlation function is essential for the probabilistic calibration of the random fields, but traditional methods were developed with the assumption to have observations with evenly spaced data. Available methods dealing with irregularly spaced data generally require either interpolation or computationally expensive solutions. Instead, we propose a simple approach based on least square regression to estimate the autocorrelation function. We first tested our methodology on an artificially produced dataset to assess the performance of our method. The accuracy of the method and its robustness to the level of noise in the data indicate that it is suitable for use in realistic problems. In addition, the methodology was used on a major application, the modeling of animal species connected with zoonotic diseases. Understanding the population dynamics of reservoirs of zoonotic diseases, such as bats, is a crucial first step to predict and prevent potential spillover of deadly viruses like Ebola. Due to the limited data on bats across Africa, their density and migrations can only be studied with probabilistic numerical models based on samples of the ecological bare carrying capacity (K0). For this purpose, the bare carrying capacity was modeled as a random field and its statistics calibrated with the available data. The bare carrying capacity of bats was found to be denser in central Africa. This is because climatic and environmental conditions are more suitable for the survival of bats. The proposed methodology for random field calibration was shown to be a promising approach, which can cope with large gaps in data and with complex applications involving large geographical areas and high resolution.
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BACKGROUND: This case report presents a patient with pyogenic spondylitis (PS) associated with lactation-related osteoporosis during pregnancy. The 34-year-old female patient experienced low back pain for one month, beginning one month postpartum, with no history of trauma or fever. Dual-energy X-ray absorptiometry of the lumbar spine revealed a Z-score of -2.45, leading to a diagnosis of pregnancy and lactation-associated osteoporosis (PLO). The patient was advised to cease breastfeeding and take oral calcium and active vitamin D. Despite these interventions, her symptoms worsened, and she had difficulty walking one week later, prompting her to revisit our hospital. CASE SUMMARY: Lumbar magnetic resonance imaging (MRI) scans showed abnormal signals in the L4 and L5 vertebral bodies and intervertebral space, while an enhancement scan displayed abnormal enhanced high signals around the L4/5 intervertebral disc, suggesting a lumbar infection. A needle biopsy was performed for bacterial culture and pathological examination, culminating in a final diagnosis of pregnancy and lactation-related osteoporosis with PS. Following treatment with anti-osteoporotic medications and antibiotics, the patient's pain gradually subsided, and she returned to normal life within five months. PLO is a rare condition that has garnered increasing attention in recent years. Spinal infections during lactation in pregnancy are also relatively uncommon. CONCLUSION: Both conditions primarily manifest as low back pain but require distinct treatments. In clinical practice, when diagnosing patients with pregnancy and lactation-associated osteoporosis, the possibility of spinal infection should be considered. A lumbar MRI should be conducted as needed to prevent delays in diagnosis and treatment.
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Neonatal hypoxic-ischemic encephalopathy (HIE) is a common disease that affects brain function in neonates. At present, mild hypothermia and hyperbaric oxygen therapy are the main methods for the treatment of neonatal HIE; however, they are independent of each other and cannot be combined for synchronous treatment, without monitoring of brain function-related physiological information. In addition, parameter setting of hyperbaric oxygen chamber and mild hypothermia mattress relies on the experience of the medical practitioner, and the parameters remain unchanged throughout the medical process. This article proposes a new device for the treatment of neonatal HIE, which has the modules of hyperbaric oxygen chamber and mild hypothermic mattress, so that neonates can receive the treatment of hyperbaric oxygen chamber and/or mild hypothermic mattress based on their conditions. Meanwhile, it can realize the real-time monitoring of various physiological information, including amplitude-integrated electroencephalogram, electrocardiogram, and near-infrared spectrum, which can monitor brain function, heart rate, rhythm, myocardial blood supply, hemoglobin concentration in brain tissue, and blood oxygen saturation. In combination with an intelligent control algorithm, the device can intelligently regulate parameters according to the physiological information of neonates and give recommendations for subsequent treatment.
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Oxigenoterapia Hiperbárica , Hipotermia Induzida , Hipotermia , Hipóxia-Isquemia Encefálica , Recém-Nascido , Humanos , Hipotermia Induzida/métodos , Hipotermia/terapia , Encéfalo , Eletroencefalografia , Hipóxia-Isquemia Encefálica/terapiaRESUMO
This study investigated behavioral and cortical mechanisms for short-term postural training with error amplification (EA) feedback in the elderly. Thirty-six elderly subjects (65.7 ± 2.2 years) were grouped (control and EA, n = 18) for training in stabilometer balance under visual guidance. During the training session (8 training rounds of 60 s in Day 2), the EA group received visual feedback that magnified errors to twice the real size, whereas the control group received visual feedback that displayed real errors. Scalp EEG and kinematic data of the stabilometer plate and ankle joint were recorded in the pre-test (Day 1) and post-test (Day 3). The EA group (-46.5 ± 4.7%) exhibited greater post-training error reduction than that of the control group (-27.1 ± 4.0%)(p = 0.020), together with a greater decline in kinematic coupling between the stabilometer plate and ankle joint (EA: -26.6 ± 4.8%, control: 2.3 ± 8.6%, p = 0.023). In contrast to the control group, the EA group manifested greater reductions in mean phase-lag index (PLI) connectivity in the theta (4-7 Hz)(p = 0.011) and alpha (8-12 Hz) (p = 0.027) bands. Only the EA group showed post-training declines in the mean PLI in the theta and alpha bands. Minimal spanning tree analysis revealed that EA-based training led to increases in the diameter (p = 0.002) and average eccentricity (p = 0.004) of the theta band for enhanced performance monitoring and reduction in the leaf fraction (p = 0.030) of the alpha band for postural response with enhanced automaticity. In conclusion, short-term EA training optimizes balance skill, favoring multi-segment coordination for the elderly, which is linked to more sophisticated error monitoring with less attentive control over the stabilometer stance.
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Body-temperature programmable elastic shape memory hybrids (SMHs) have great potential for the comfortable fitting of wearable devices. Traditionally, shore hardness is commonly used in the characterization of elastic materials. In this paper, the evolution of shore hardness in body-temperature programmable elastic SMHs upon cyclic loading, and during the shape memory cycle, is systematically investigated. Upon cyclic loading, similar to the Mullins effect, significant softening appears, when the applied strain is over a certain value. On the other hand, after programming, in general, the measured hardness increases with increase in programming strain. However, for certain surfaces, the hardness decreases slightly and then increases rapidly. The underlying mechanism for this phenomenon is explained by the formation of micro-gaps between the inclusion and the matrix after programming. After heating, to melt the inclusions, all samples (both cyclically loaded and programmed) largely recover their original hardness.
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BACKGROUND: Fibrosis-4 score (FIB4) was a non-invasive surrogate to estimate the amount of liver scarring in chronic hepatitis. Considering the presence of increased central venous pressure and congestive hepatopathy in patients with decompensated heart failure, we therefore investigated the prognostic values of FIB4 in acute heart failure (AHF) patients. METHOD: Patients hospitalised primarily for HF were drawn from an intramural registry. FIB4 was calculated according to age, aspartate aminotransferase, alanine aminotransferase and platelet count. All-cause mortality up to 5 years after discharge was obtained by linking to the national death registry. RESULTS: Among a total of 1854 participants, 940 patients died during a mean follow-up of 28.3 ± 21.8 months. FIB4 score was related to mortality and the composite of cardiovascular death or HF rehospitalisation, independent of age, sex, left ventricular ejection fraction, left atrial dimension, sodium and haemoglobin levels, estimated glomerular filtration rate, comorbidities, and medications [hazard ratio and 95% confidence interval of mortality: 1.009 (1.002-1.015), and the composite of cardiovascular death or HF hospitalisation: 1.020 (1.010-1.031)]. The prognostic value of FIB4 was predominantly in the subjects with heart failure and preserved or mildly reduced ejection fraction (HFpEF and HFmrEF), or coronary artery disease (CAD) than the counterparts [interaction p-value <0.001, and 0.004, respectively]. CONCLUSIONS: FIB4 was an independent predictor of survival in AHF patients, irrespective of the phenotypes of HF. The higher predictive value of mortality of FIB4 was observed in the subjects with HFpEF, HFmrEF or CAD.
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Insuficiência Cardíaca , Humanos , Volume Sistólico , Função Ventricular Esquerda , Prognóstico , Sistema de Registros , Fenótipo , FibroseRESUMO
With the increase in extremely low birth weight (ELBW) infants, their outcome attracted worldwide attention. However, in China, the related studies are rare. The hospitalized records of ELBW infants discharged from twenty-six neonatal intensive care units in Guangdong Province of China during 2008-2017 were analyzed. A total of 2575 ELBW infants were enrolled and the overall survival rate was 55.11%. From 2008 to 2017, the number of ELBW infants increased rapidly from 91 to 466, and the survival rate improved steadily from 41.76% to 62.02%. Increased survival is closely related to birth weight (BW), regional economic development, and specialized hospital. The incidence of complications was neonatal respiratory distress syndrome (85.2%), oxygen dependency at 28 days (63.7%), retinopathy of prematurity (39.3%), intraventricular hemorrhage (29.4%), necrotizing enterocolitis (12.0%), and periventricular leukomalacia (8.0%). Among the 1156 nonsurvivors, 90.0% of infants died during the neonatal period (≤ 28 days). A total of 768 ELBW infants died after treatment withdrawal, for reasons of economic and/or poor outcome. The number of ELBW infants is increasing in Guangdong Province of China, and the overall survival rate is improving steadily.
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Enterocolite Necrosante , Doenças do Prematuro , Estudos de Coortes , Enterocolite Necrosante/epidemiologia , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Recém-Nascido , Doenças do Prematuro/epidemiologiaRESUMO
In this paper, a UV cross-linkable vitrimer-like polymer, ureidopyrimidinone functionalized telechelic polybutadiene, is reported. It is synthesized in two steps. First, 2(6-isocyanatohexylaminocarbonylamino)-6-methyl-4[1H]-pyrimidinone (UPy-NCO) reacts with hydroxy-functionalized polybutadiene (HTPB) to obtain UPy-HTPB-UPy, and then the resulted UPy-HTPB-UPy is cross-linked under 365 nm UV light (photo-initiator: bimethoxy-2-phenylacetophenone, DMPA). Further investigation reveals that the density of cross-linking and mechanical properties of the resulting polymers can be tailored via varying the amount of photo-initiator and UV exposure time. Before UV cross-linking, UPy-HTPB-UPy is found to be vitrimer-like due to the quadruple hydrogen-bonding interactions. The UPy groups at the end of the chain also enable for rapid solidification upon the evaporation of the solvent. The unsaturated double bonds in the HTPB chains enable UPy-HTPB-UPy to be UV cross-linkable in the solid state at room temperature. After cross-linking, the polymers have good shape memory effect (SME). Here, we demonstrate that this type of polymer can have many potential applications in additive manufacturing. In the cases of fused deposition modelling (FDM) and direct ink writing (DIW), not only the strength of the interlayer bonding but also the strength of the polymer itself can be enhanced via UV exposure (from thermoplastic to thermoset) either during printing or after printing. The SME after cross-linking further helps to achieve rapid volumetric additive manufacturing anytime and anywhere.
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BACKGROUND: The dynamic balance of osteoblast and osteoclast is critical for bone homeostasis and overactive osteoclastic function may lead to osteoporosis. Activating transcription factor 1 (ATF1) is involved in osteoclastogenesis. However, the detailed mechanisms remain to be explored. METHODS: RAW264.7 cells were used and induced toward osteoclast by RANKL administration. We performed flow cytometry, CCK-8 assay and tartrate-resistant acid phosphatase (TRAP) staining to examine cell apoptosis, proliferation and differentiation of RAW264.7 cells, respectively. Mice were subjected to ovariectomy to induce osteoporosis. Micro CT, HE staining and TRAP staining were performed to evaluate bone loss in the OVX mouse model. Bioinformatics methods, luciferase assays and Chromatin Immunoprecipitation (ChIP) were used to predict and validate the interaction among ATF1, miR-214-5p, and ITGA7. RESULTS: ATF1 and miR-214-5p were up-regulated while ITGA7 was inhibited in RANKL-induced osteoclasts. MiR-214-5p was transcriptionally activated by ATF1. ATF1 knockdown suppressed osteoclast formation by miR-214-5p inhibition. ITGA7 was the direct target of miR-214-5p. Knockdown of miR-214-5p abolished osteoclastogenesis, which was reversed by ITGA7 knockdown. In OVX model, miR-214-5p knockdown suppressed osteoclast differentiation and prevented bone loss. CONCLUSION: ATF1/miR-214-5p/ITGA7 axis regulated osteoclast formation both in vivo and in vitro, thereby affecting OVX-induced bone resorption in mice. Knockdown of ATF1 might be a promising strategy to manage osteoporosis.
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Fator 1 Ativador da Transcrição , Antígenos CD , Cadeias alfa de Integrinas , MicroRNAs , Osteoporose , Fator 1 Ativador da Transcrição/genética , Animais , Antígenos CD/genética , Diferenciação Celular , Feminino , Cadeias alfa de Integrinas/genética , Integrinas , Camundongos , MicroRNAs/genética , Osteogênese/genética , Osteoporose/genética , Células RAW 264.7RESUMO
Dog-bone shaped poly(methyl methacrylate) (PMMA) samples were pre-stretched at different temperatures (within the glass transition range and slightly above) to different strains. Subsequently, these pre-stretched samples were aged at 40 °C for up to three months, and finally, all samples were uniaxially stretched to fracture. The Young's modulus, ultimate stress and toughness of the samples were obtained and plotted as a function of the temperature, and strain in pre-stretching in the contour format. The influence of aging was revealed when the contours of different aging times were compared. One of the most interesting findings was that the toughness of this PMMA can be tailored via controlling the temperature and strain in pre-stretching. The toughness of the pre-stretched samples ranged from 1.317 MJ/m3 to 23.281 MJ/m3 (without aging) and from 1.476 MJ/m3 to 27.532 MJ/m3 (after three months of aging). Based on the results of a series of additional experiments, a mechanism was proposed to reveal the fundaments behind the influence of the temperature and strain in pre-stretching and aging.
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OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS: There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
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Displasia Broncopulmonar , Síndrome do Desconforto Respiratório do Recém-Nascido , Displasia Broncopulmonar/epidemiologia , Feminino , Idade Gestacional , Humanos , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
(1) Background: Chest radiographs are the mainstay of initial radiological investigation in this COVID-19 pandemic. A reliable and readily deployable artificial intelligence (AI) algorithm that detects pneumonia in COVID-19 suspects can be useful for screening or triage in a hospital setting. This study has a few objectives: first, to develop a model that accurately detects pneumonia in COVID-19 suspects; second, to assess its performance in a real-world clinical setting; and third, by integrating the model with the daily clinical workflow, to measure its impact on report turn-around time. (2) Methods: The model was developed from the NIH Chest-14 open-source dataset and fine-tuned using an internal dataset comprising more than 4000 CXRs acquired in our institution. Input from two senior radiologists provided the reference standard. The model was integrated into daily clinical workflow, prioritising abnormal CXRs for expedited reporting. Area under the receiver operating characteristic curve (AUC), F1 score, sensitivity, and specificity were calculated to characterise diagnostic performance. The average time taken by radiologists in reporting the CXRs was compared against the mean baseline time taken prior to implementation of the AI model. (3) Results: 9431 unique CXRs were included in the datasets, of which 1232 were ground truth-labelled positive for pneumonia. On the "live" dataset, the model achieved an AUC of 0.95 (95% confidence interval (CI): 0.92, 0.96) corresponding to a specificity of 97% (95% CI: 0.97, 0.98) and sensitivity of 79% (95% CI: 0.72, 0.84). No statistically significant degradation of diagnostic performance was encountered during clinical deployment, and report turn-around time was reduced by 22%. (4) Conclusion: In real-world clinical deployment, our model expedites reporting of pneumonia in COVID-19 suspects while preserving diagnostic performance without significant model drift.
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Porous shape memory hybrids are fabricated with different matrix (silicone) hardness and different inclusion (polycaprolactone, PCL) ratios. They are characterized to obtain their mechanical response to cyclic loads (with/without pre-straining/programming) and their shape memory performances after body-temperature programming are investigated. These materials are lightweight due to their porous structures. Wetted hydrogels used in the fabrication process for creating pores are reusable and hence this process is eco-friendly. These porous shape memory hybrids exhibit the good shape memory effect of around 90% with higher inclusion (PCL) ratios, which is better than the solid versions reported in the literature. Hence, it is concluded that these materials have great potential to be used in, for instance, insoles and soles for comfort fitting, as demonstrated.
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Shrinkage is observed in many electrospun membranes. The stretched conformation of the macromolecular chains has been proposed as the possible cause. However, so far, our understanding of the fundamentals is still qualitative and cannot provide much help in the shrinkage control. In this paper, based on the crimped fibers after stimulus-induced shrinkage, a clear evidence of buckling, the gradient pre-strain field in the cross-section of the electrospun fibers, which is the result of a gradient solidification field and a tensile force in the fibers during electrospinning, is identified as the underlying mechanism for the stimulus-induced shrinkage. Subsequently, two buckling conditions are derived. Subsequently, a series of experiments are carried out to reveal the influence of four typical processing parameters (namely, the applied voltage, solution concentration, distance between electrodes, and rotation speed of collector), which are highly relevant to the formation of the gradient pre-strain field. It is concluded that there are some different ways to achieve the required shrinkage ratios in two in-plane directions (i.e., the rotational and transverse directions of the roller collector). Some of the combinations of these parameters are more effective at achieving high uniformity than others. Hence, it is possible to optimize the processing parameters to produce high-quality membranes with well-controlled shrinkage in both in-plane directions.