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Polysomnography (PSG) is the gold standard for clinical sleep monitoring, but its cost, discomfort, and limited suitability for continuous use present challenges. The flexible electrode sleep patch (FESP) emerges as an economically viable and patient-friendly solution, offering lightweight, simple operation, and self-applicable. Nevertheless, its utilization in young individuals remains uncertain. The objective of this study was to compare sleep data obtained by FESP and PSG in healthy young individuals and analyze agreement for sleep parameters and structure classification. Overnight monitoring with FESP and PSG recordings in 48 participants (mean age: 23 yr) was done. Correlation analysis, Bland-Altman plots, and Cohen's kappa coefficient assessed consistency. Sensitivity, specificity, and predictive values compared classification against PSG. FESP showed strong correlation and consistency with PSG for sleep monitoring. Bland-Altman plots indicated small errors and high consistency. Kappa values (0.70-0.84) suggested substantial agreement for sleep stage classification. Pearson correlation coefficient values for sleep stages (0.75-0.88) and sleep parameters (0.80-0.96) confirm that FESP has a strong application. Intraclass correlation coefficient yielded values between 0.65 and 0.97. In addition, FESP demonstrated an impressive accuracy range of 84.12-93.47% for sleep stage classification. The FESP also features a wearable self-test program with an error rate of no more than 8% for both deep sleep and wake. In young adults, FESP demonstrated reliable monitoring capabilities comparable to PSG. With its low cost and user-friendly design, FESP is a potential alternative for portable sleep assessment in clinical and research applications. Further studies involving larger populations are needed to validate its diagnostic potential.NEW & NOTEWORTHY By comparison with PSG, this study confirmed the reliability of an efficient, objective, low-cost, and noninvasive portable automatic sleep-monitoring device FESP, which provides effective information for long-term family sleep disorder diagnosis and sleep quality monitoring.
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Actigrafia , Espiperona/análogos & derivados , Dispositivos Eletrônicos Vestíveis , Humanos , Adulto Jovem , Adulto , Polissonografia , Reprodutibilidade dos Testes , Sono , EletrodosRESUMO
BACKGROUND: The Longshi Scale is a pictorial assessment tool for evaluating activities of daily living (ADL) in patients with stroke. The paper-based version presents challenges; thus, the WeChat version was created to enhance accessibility. Herein, we aimed to validate the inter-rater and test-retest reliabilities of the WeChat version of the Longshi Scale and explore its potential clinical applications. METHODS: We recruited 115 patients with stroke in the study. The ADL results of each patient were assessed using both the WeChat and paper-based version of the Longshi Scale; each evaluation was conducted by 28 health professionals and 115 caregivers separately. To explore the test-retest reliability of the WeChat version, 22 patients were randomly selected and re-evaluated by health professionals using the WeChat version. All evaluation criteria were recorded, and all evaluators were surveyed to indicate their preference between the two versions. RESULTS: Consistency between WeChat and the paper-based Longshi Scale was high for ADL scores by health professionals (ICC2,1 = 0.803-0.988) and caregivers (ICC2,1 = 0.845-0.983), as well as for degrees of disability (κw = 0.870 by professionals; κw = 0.800 by caregivers). Bland-Altman analysis showed no significant discrepancies. The WeChat version exhibited good test-retest reliability (κw = 0.880). The WeChat version showed similar inter-rater reliability in terms of the ADL score evaluated using the paper-based version (ICC2,1 = 0.781-0.941). The time to complete assessments did not differ significantly, although the WeChat version had a shorter information entry time (P < 0.001, 95% confidence interval: -43.463 to -15.488). Health professionals favored the WeChat version (53.6%), whereas caregivers had no significant preference. CONCLUSIONS: The WeChat version of the Longshi Scale is reliable and serves as a suitable alternative for health professionals and caregivers to assess ADL levels in patients with stroke. The WeChat version of the Longshi Scale is considered user-friendly by health professionals, although it is not preferred by caregivers. TRIAL REGISTRATION: This study was approved by the Ethics Committee of the Second People's Hospital of Shenzhen (approval number: 20210812003-FS01) and registered on the Clinical Trial Register Center website: clinicaltrials.gov on January 31, 2022 (registration no.: NCT05214638).
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Atividades Cotidianas , Acidente Vascular Cerebral , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação da Deficiência , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: The impairment of activities of daily living (ADL) has brought a heavy burden to the life of patients after stroke. Timely and accurate assessment of patients' activities of daily living is very necessary, which determines the whole process of diagnosis, rehabilitation and prognosis of patients. However, the patients with limited mobility or transportation are difficulted to gain high quality assessment services. This study aimed to explore the reliability of remote Longshi Assessment Scale of Activities of Daily Life (Longshi Scale) with smartphone video calls by comparing the consistency of remote assessment and bedside assessment, as well as the test-retest reliability of the remote assessment. The evaluation duration of these two methods was recorded and the level of satisfaction of patients was investigated. METHODS: In this prospective study, a total of 129 stroke survivors were recruited and accepted a bedside face-to-face assessment and a remote assessment by video calls. The Longshi Scale was used for both bedside and remote assessment and conducted with the inquiry between patients and evaluators. A satisfaction questionnaire was also launched. RESULTS: The result of disability level evaluated from the bedside and remote assessments was highly consistent. The intraclass correlation coefficient with weighted kappa (wK) value was 0.86 (95% confidence interval, 0.80â¼0.92). And test-retest of the remote assessment indicated an excellent agreement beyond chance, and its correlation coefficient with wK value was 0.96 (95% confidence interval, 0.92â¼1.00). It took 74.44±55.3 s to complete the bedside assessment and 90.86±63.30 s to complete the remote assessment of Longshi Scale. There was no statistical significance in the assessment duration between these two methods (P = 0.056). Satisfaction surveys showed more than 85% of participants were satisfied or very satisfied with remote Longshi scale assessment. CONCLUSIONS: The remote assessment of Longshi Scale with smartphone video calls is reliable and has high acceptance. This method can be readily implemented to evaluate the ADL of stroke patients to improve the capacity of rehabilitation and health services in remote areas.
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Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Telemedicina , Humanos , Smartphone , Atividades Cotidianas , Reprodutibilidade dos Testes , Estudos Prospectivos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapiaRESUMO
BACKGROUND: Many stroke survivors have multiple chronic diseases and complications coupled with various other factors which may affect their functional status. We aimed to investigate the factors associated with poor functional status in hospitalized patients with stroke in Shenzhen, China. METHODS: In this cross-sectional study, four urban hospitals were selected using convenient sampling, and all stroke patients in these four hospitals were included using cluster sampling. The functional status of stroke survivors was evaluated using Longshi Scale. Explanatory variables (factors affecting functional status comprising age, sex, body mass index, smoking, alcohol consumption, complications, and chronic conditions) were collected. Ordinal logistic regression was used to examine which factors were associated with poor functional status. RESULTS: Stroke survivors with poor functional status accounted for 72.14% and were categorised as the bedridden group based on Longshi scale, 21.67% of patients with moderate functional limitation were categorised as the domestic group, and 6.19% of the patients with mild functional restriction were categorised as the community group. The highest dependence scores were noted for feeding (73.39%), bowel and bladder management (69.74%) and entertainment (69.53%) among the bedridden group, and housework (74.29%) among the domestic group. In the adjusted model, the odds of poor functional status were higher among stroke patients with older age (odds ratio [OR] = 2.39, 95% CI: 1.55-3.80), female sex (OR = 1.73, 95% CI: 1.08-2.77), duration of stroke more than 12 months (OR = 1.94, 95% CI: 1.28-2.95), with pulmonary infection (OR = 10.91, 95% CI: 5.81-20.50), and with deep venous thrombosis (OR = 3.00, 95% CI: 1.28-7.04). CONCLUSIONS: Older adults (age ≥ 60 years) and women were more likely to exhibit poor functional status post-stroke. Pulmonary infection and deep venous thrombosis were related to an increased risk of being dependent on activities of daily living. Therefore, clinical and rehabilitation interventions aimed at preventing or treating these common complications should be addressed to deal with subsequent dysfunction post-stroke. Since all data were obtained in metropolitan areas where the economy is well developed, future studies should be conducted in rural areas and economically less developed cities.
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Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Trombose Venosa , Atividades Cotidianas , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Estado Funcional , Hospitais , Humanos , Pessoa de Meia-Idade , Acidente Vascular Cerebral/epidemiologia , SobreviventesRESUMO
BACKGROUND: Ability in the activities of daily life is often impaired in the older adults with a neurological disease. The Barthel Index is an instrument used worldwide to assess such ability. The Longshi Scale is a picture-based alternative, but its effectiveness has not been evaluated with older adult subjects. This study was to determine whether the Longshi Scale can effectively quantify the ability of older adults in the activities of daily living by comparing its ratings with those using the Barthel Index. METHODS: A multi-center cross-sectional study was conducted among patients over 65 years. A total of 2438 patients were divided into three groups, including bedridden, domestic, or community group based on their ability to go out of bed, move outdoors, and return indoors. Their ability in the activities of daily living among three groups was evaluated using both the Longshi Scale and the Barthel Index, and the results were compared. RESULTS: There was a significant difference in the average Barthel Index scores of three groups classified using the Longshi Scale. The average Longshi Scale scores also showed significant differences between the four groups classified using the Barthel Index. Spearman correlation coefficients showed strong correlation(>0.83) between the Longshi Scale and Barthel Index scores. CONCLUSIONS: The Longshi Scale can efficiently distinguish the ability in the activities of daily living of people with a neurological disease. Its rating correlate well with those using the Barthel Index.
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Atividades Cotidianas , Pessoas com Deficiência , Idoso , China/epidemiologia , Estudos Transversais , HumanosRESUMO
BACKGROUND: Robot-assisted gait training has been confirmed to have beneficial effect on the rehabilitation of stroke patients. An exoskeleton robot, named BEAR-H1, is designed to help stroke patients with walking disabilities. METHODS: 17 subjects in experimental group and 15 subjects in control group completed the study. The experimental group received 30 minutes of BEAR-H1 assisted gait training(BAGT), and the control group received 30 minutes of conventional training, 5 times/week for 4weeks. All subjects were evaluated with 6-minute walk test (6MWT), Fugl-Meyer Assessment for lower extremity (FMA-LE), Functional Ambulatory Classification (FAC), Modified Ashworth Scale (MAS), and gait analysis at baseline and after 4 weeks intervention. RESULTS: The improvements of 6MWT, FMA-LE, gait speed, cadence, step length and cycle duration in BAGT group were more noticeable than in the control group. However, there was no difference in the assessment of MAS between two groups. CONCLUSIONS: Our results showed that BAGT is an effective intervention to improve the motor and walking ability during 4 weeks training for subacute stroke patients.
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Exoesqueleto Energizado , Marcha , Extremidade Inferior/inervação , Atividade Motora , Robótica/instrumentação , Reabilitação do Acidente Vascular Cerebral/instrumentação , Acidente Vascular Cerebral/terapia , Adulto , China , Feminino , Estado Funcional , Análise da Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Estudos Prospectivos , Recuperação de Função Fisiológica , Método Simples-Cego , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Teste de CaminhadaRESUMO
BACKGROUND: Modified Rankin Scale and Barthel Index are the most common scales for assessing stroke outcomes in clinical practice and trials. Concordance between the Barthel Index scores and the modified Rankin Scale grades is important to define favorable outcome in clinical practice and stroke trials consistently. The purpose of this study was to examine the relationship between the scores of Barthel Index and 3-item Barthel Index Short Form with the modified Rankin Scale grades of acute stroke patients. METHODS: Barthel Index, Barthel Index Short Form scores and modified Rankin Scale grades of 516 stroke patients were obtained from a follow-up study of the Longshi Scale in China. A study showed that the assignment of modified Rankin Scale grades to stroke patients was prone to misclassification. Therefore, the recorded modified Rankin Scale grades were compared with the Barthel Index scores of each patient to produce the adjusted modified Rankin Scale grades. Receiver operating characteristics curve analyses were performed to determine the optimal cutoff scores, respective sensitivities and specificities of Barthel Index and Barthel Index Short Form with the corresponding adjusted modified Rankin Scale grades ≤1, ≤2 and ≤3. FINDINGS: About 44% of the recorded modified Rankin Scale grades of patients required adjustment. The optimal cutoff scores were ≥100 (sensitivity 100%; specificity 95.3%), ≥100 (sensitivity 98.1%; specificity 100%) and ≥75 (sensitivity 93.8%; specificity, 91.9%) for the Barthel Index and ≥40 (sensitivity 100%; specificity 78.9%), ≥40 (sensitivity 98.1%; specificity 82.8%), and ≥35 (sensitivity 99.3%; specificity, 91.6%) for the Barthel Index Short Form corresponding to the adjusted modified Rankin Scale grade ≤1, ≤2, and ≤3 respectively. The areas under the receiver operating characteristic curves were nearly all above 0.9. CONCLUSIONS: The optimal cutoff scores of Barthel Index and Barthel Index Short Form corresponding to the modified Rankin Scale grades ≤1, ≤2 and ≤3 were recommended to be ≥100 and ≥40, ≥100 and ≥40, and ≥75 and ≥35 respectively for determining the favorable and unfavorable outcome of stroke patients within three months of onset in clinical practice and trials.
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Atividades Cotidianas , Avaliação da Deficiência , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Idoso , Idoso de 80 Anos ou mais , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of this study was to validate a novel pictorial-based Longshi Scale for evaluating a patient's disability by healthcare professionals and non-professionals. DESIGN: Prospective study. SETTING: Rehabilitation departments from a grade A, class 3 public hospital, a grade B, class 2 public hospital, and a private hospital and seven community rehabilitation centers. SUBJECTS: A total of 618 patients and 251 patients with functional disabilities were recruited in a two-phase study, respectively. MAIN MEASURES: Outcome measure: pictorial scale of activities of daily living (ADLs, Longshi Scale). Reference measure: Barthel Index. The Spearman correlation coefficient was used to analyze the validity of Longshi Scale against Barthel Index. RESULTS: In phase 1 study, from March 2016 to August 2016, the results demonstrated that the Longshi Scale was both reliable and valid (intraclass correlation coefficient based on two-way random effect (ICC2,1) = 0.877-0.974 for intra-rater reliability; ICC2,1 = 0.928-0.979; κ = 0.679-1.000 for inter-rater reliability; intraclass correlation coefficient based on one-way random effect (ICC1,1) = 0.921-0.984 for test-retest reliability and Spearman correlation coefficient = 0.836-0.899). In the second phase, in March 2018, results further demonstrated that the Longshi Scale had good inter-rater and intra-rater reliability among healthcare professionals and non-professionals including therapists, interns, and personal care aids (ICC1,1 = 0.822-0.882 on Day 1; ICC1,1 = 0.842-0.899 on Day 7 for inter-rater reliability). In addition, the Longshi Scale decreased assessment time significantly, compared with the Barthel Index assessment (P < 0.01). CONCLUSION: The Longshi Scale could potentially provide an efficient way for healthcare professionals and non-professionals who may have minimal training to assess the ADLs of functionally disabled patients.
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Avaliação da Deficiência , China , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Psicometria , Reprodutibilidade dos TestesRESUMO
Glucose concentration is a crucial parameter for assessing human health. Over recent years, non-enzymatic electrochemical glucose sensors have drawn considerable attention due to their substantial progress. This review explores the common mechanism behind the transition metal-based electrocatalytic oxidation of glucose molecules through classical electrocatalytic frameworks like the Pletcher model and the Hydrous Oxide-Adatom Mediator model (IHOAM), as well as the redox reactions at the transition metal centers. It further compiles the electrochemical characterization techniques, associated formulas, and their ensuing conclusions pertinent to transition metal-based non-enzymatic electrochemical glucose sensors. Subsequently, the review covers the latest advancements in the field of transition metal-based active materials and support materials used in non-enzymatic electrochemical glucose sensors in the last decade (2014-2023). Additionally, it presents a comprehensive classification of representative studies according to the active metal catalysts components involved.
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OBJECTIVES: Patients with stroke often remain bedridden despite rehabilitation. Serum N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels increase after stroke. Our study aimed to investigate the difference in NT-pro-BNP levels between bedridden and non-bedridden patients with stroke and to explore the factors influencing NT-pro-BNP levels in bedridden patients. DESIGN: A single-centre, cross-sectional study. SETTING: This study was conducted in a hospital, Shenzhen, China. PARTICIPANTS: Between January 2019 and December 2022, 465 participants were included in this study. OUTCOME MEASURES: The collected data included basic information, laboratory data and echocardiographic parameters. Binary logistic regression analysis and receiver operating characteristic curves were used to identify factors associated with high NT-pro-BNP levels. RESULTS: Bedridden patients with stroke had higher levels of NT-pro-BNP, D-dimer, high-sensitivity C reactive protein (hs-CRP) and lower levels of creatinine, high-density lipoprotein cholesterol, albumin and haemoglobin, as well as lower left ventricular ejection fraction, fractional shortening and the ratio between the peak velocities of early and late diastolic filling than non-bedridden patients. In bedridden patients, age ≥75 years, high levels of hs-CRP and creatinine, and low levels of albumin were associated with high NT-pro-BNP levels. In non-bedridden patients, age ≥75 years and high creatinine levels were associated with high NT-pro-BNP levels. In bedridden patients with stroke, the area under the curve (AUC) of hs-CRP was 0.700 (p<0.001, 95% CI 0.638 to 0.762) with a cut-off value of 5.12 mg/L. The AUC of albumin was 0.671 (p<0.001, 95% CI 0.606 to 0.736) with a cut-off value of 37.15 g/L. CONCLUSIONS: NT-pro-BNP levels were higher in bedridden patients with stroke than in non-bedridden patients. Decreased albumin and elevated hs-CRP levels were associated with high levels of NT-pro-BNP in bedridden patients. Further studies are needed to explore the risk stratification and potential treatments for elevated NT-pro-BNP in bedridden patients with stroke.
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Peptídeo Natriurético Encefálico , Acidente Vascular Cerebral , Humanos , Idoso , Proteína C-Reativa/metabolismo , Estudos Transversais , Volume Sistólico , Pessoas Acamadas , Creatinina , Função Ventricular Esquerda , Fragmentos de Peptídeos , BiomarcadoresRESUMO
BACKGROUND: Patients with prolonged disorders of consciousness (pDOC) pose significant challenges to healthcare workers due to their severe motor impairments and limited interaction with the environment. Non-invasive brain stimulation such as high-definition transcranial direct current stimulation (HD-tDCS) and music stimulation show promise in awakening this population. OBJECTIVE: In this study, we present a protocol aiming at investigating the efficacy of combined HD-tDCS and music stimulation in awakening patients with pDOC through a single-blind, randomized controlled trial. METHODS: Ninety patients with pDOC will be randomly divided into three groups: active HD-tDCS with music stimulation, active HD-tDCS, and sham HD-tDCS. All participants will receive 20 treatment sessions over a period of 10 days and the Coma Recovery Scale-Revised, Glasgow Outcome Scale and electroencephalogram will be used as assessment measures to evaluate their level of consciousness throughout the study. Adverse events and complications will be recorded during treatment. Within-group pre-post comparisons and between-group efficacy comparisons will be conducted to identify the most effective intervention approach. Statistical analysis will be performed using SPSS software with a significance level set at Pâ<â0.05. CONCLUSION: The pursuit of awakening therapy for patients with pDOC remains a clinical research challenge. This study protocol is designed with the aim of introducing an innovative non-pharmacological approach which combined HD-tDCS and music stimulation to facilitate the reinstatement of consciousness in patients with pDOC.
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Transtornos da Consciência , Musicoterapia , Estimulação Transcraniana por Corrente Contínua , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Terapia Combinada , Transtornos da Consciência/reabilitação , Transtornos da Consciência/terapia , Musicoterapia/métodos , Método Simples-Cego , Estimulação Transcraniana por Corrente Contínua/métodos , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Functional near-infrared spectroscopy (fNIRS) seems opportune for neurofeedback in robot-assisted rehabilitation training due to its noninvasive, less physical restriction, and no electromagnetic disturbance. Previous research has proved the cross-session reliability of fNIRS responses to non-motor tasks (e.g., visual stimuli) and fine-motor tasks (e.g., finger tapping). However, it is still unknown whether fNIRS responses remain reliable 1) in gross-motor tasks, 2) within a training session, and 3) for different training parameters. Hence, this study aimed to investigate the within-session reliability of fNIRS responses to gross-motor tasks for different training parameters. Ten healthy participants were recruited to conduct right elbow extension-flexion in three robot-assisted modes. The Passive mode was fully motor-actuated, while Active1 and Active2 modes involved active engagement with different resistance levels. FNIRS data of three identical runs were used to assess the within-session reliability in terms of the map- ( R2 ) and cluster-wise ( Roverlap ) spatial reproducibility and the intraclass correlation (ICC) of temporal features. The results revealed good spatial reliability ( R2 up to 0.69, Roverlap up to 0.68) at the subject level. Besides, the within-session temporal reliabilities of Slope, Max/Min, and Mean were between good and excellent ( ICC < 0.86). We also found that the within-session reliability was positively correlated with the intensity of the training mode, except for the temporal reliability of HbO in Active2 mode. Overall, our results demonstrated good within-session reliability of fNIRS responses, suggesting fNIRS as reliable neurofeedback for constructing closed-loop robot-assisted rehabilitation systems.
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Robótica , Humanos , Reprodutibilidade dos Testes , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Extremidade SuperiorRESUMO
Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson's correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach's coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P < 0.05). The CAT-LS results obtained using the decision-tree scoring model were consistent with the scores for each BI item. A strong correlation was observed between CAT-LS and BI (Pearson's r: 0.6-0.894, P < 0.001). The CAT-LS demonstrated good internal consistency (Cronbach's α, 0.803-0.894) and interrater reliability (ICC, 0.928-0.979). CAT-LS is time-efficient and requires < 1 min to administer. The CAT-LS is a reliable and valid tool for assessing ADL function in stroke survivors and can provide rapid and accurate assessments that reduce the burden on healthcare professionals. Further validation of this tool in other populations and settings is necessary.Study registration number: No.: ChiCTR2000034067; http://www.chictr.org.cn/showproj.aspx?proj=54770 .
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Atividades Cotidianas , Acidente Vascular Cerebral , Humanos , Estudos Transversais , Reprodutibilidade dos Testes , SobreviventesRESUMO
Bimetallic CoPt alloy nanoparticles (NPs) immobilized on CeO2 nanorods (CoPt/CeO2) were synthesized by a facile wet-chemistry reduction method, which showed the highest catalytic efficiency reported to date for the complete dehydrogenation of hydrazine borane with a high TOF value of up to 5454 h-1 at 323 K.
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BACKGROUND: Robotic solutions for ankle joint physical therapy have extensively been researched. The optimal frequency and intensity of training for patients when using the ankle robot is not known which can affect rehabilitation outcome. OBJECTIVE: To explore the optimal ankle robot training protocol on foot drop in stroke subjects. METHODS: Subjects were randomly divided into four groups, with 9 in each group. The subjects received different intensities (low or high intensity) with frequencies (1 session/day or 2 sessions/day) of robot combination training. Each session lasted 20 minutes and all subjects were trained 5 days a week for 3 weeks. RESULTS: After 3 weeks of treatment, all groups showed an improvement in passive and active ankle dorsiflexion range of motion (PROM and AROM) and Fugl-Meyer Assessment for lower extremity (FMA-LE) compared to pre-treatment. When training at the same level of intensity, patients who received 2 sessions/day of training had better improvement in ankle dorsiflexion PROM than those who received 1 session/day. In terms of the improvement in dorsiflexion AROM and FMA-LE, patients who received 2 sessions/day with high intensity training improved better than other protocols. CONCLUSION: High frequency and high intensity robot training can be more effective in improving ankle dysfunction.
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Neuropatias Fibulares , Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Tornozelo , Articulação do Tornozelo , Robótica/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Resultado do Tratamento , ParesiaRESUMO
Bounded rationality, asymmetric information and spillover effects are widespread in the economic market, and had been studied extensively in oligopoly games, however, few literature discussed the incomplete information between bounded rational oligopolists in an enterprise cluster. Considering the positive externalities brought by the spillover effect between cluster enterprises, a duopoly Cournot-Bertrand game with bounded rationality and asymmetric information is proposed in this paper. In our model, firm 1 with an information advantage knows all the price information of firm 2 with an information advantage, while firm 2 only partially knows the output information of firm 1, and they adopt boundedly rational expectation and naïve expectation respectively. Interestingly, our theoretical analysis reveals that: (1) When the output adjustment speed of enterprises with information advantage is large or the substitutability between monopoly products is high, moderate effective information is beneficial to the stability of product market, while too low or too high effective information may lead to market disorder. (2) The relationship between cluster spillover and Nash equilibrium stability depends on product substitutability. When the substitutability is small, smaller cluster spillovers are more conducive to the stability of product output or price; when the substitutability is large, the larger the cluster spillover is, the more stable the product market is. Our research has an important theoretical and practical significance to the production-price competition in oligopoly markets.
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The increasing number of regions have begun to construct age-friendly medical institutions to further promote the "successful aging" of the elderly in mainland China. This study deeply analyzes the development status of age-friendly medical institutions abroad and describes the policies, research, evaluation, and certification of different countries. This study focuses on the current construction status of age-friendly medical institutions in mainland China. With the issuing of several national policies, mainland China has established a top-down system for the construction of age-friendly medical institutions, which has been gradually implemented in the actions of medical institutions. On the whole, the goal and evaluation standard are clear and the action is rapid. However, it also faces many challenges and problems. This study puts forward various suggestions for the construction of age-friendly medical institutions, such as increasing manpower and financial investment and carrying out evidence-based research. In particular, we should pay attention to promoting a bottom-up construction system, understand the actual needs of the elderly, pay attention to the personal experience of the elderly, and fully mobilize the active and full participation of the whole society.
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BACKGROUND: Generalized regression neural network (GRNN) and logistic regression (LR) are extensively used in the medical field; however, the better model for predicting stroke outcome has not been established. The primary goal of this study was to compare the accuracies of GRNN and LR models to identify the most optimal model for the prediction of acute stroke outcome, as well as explore useful biomarkers for predicting the prognosis of acute stroke patients. METHOD: In a single-center study, 216 (80% for the training set and 20% for the test set) acute stroke patients admitted to the Shenzhen Second People's Hospital between December 2019 to June 2021 were retrospectively recruited. The functional outcomes of the patients were measured using Barthel Index (BI) on discharge. A training set was used to optimize the GRNN and LR models. The test set was utilized to validate and compare the performances of GRNN and LR in predicting acute stroke outcome based on the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, and the Kappa value. RESULT: The LR analysis showed that age, the National Institute Health Stroke Scale score, BI index, hemoglobin, and albumin were independently associated with stroke outcome. After validating in test set using these variables, we found that the GRNN model showed a better performance based on AUROC (0.931 vs 0.702), sensitivity (0.933 vs 0.700), specificity (0.889 vs 0.722), accuracy (0.896 vs 0.729), and the Kappa value (0.775 vs 0.416) than the LR model. CONCLUSION: Overall, the GRNN model demonstrated superior performance to the LR model in predicting the prognosis of acute stroke patients. In addition to its advantage in not affected by implicit interactions and complex relationship in the data. Thus, we suggested that GRNN could be served as the optimal statistical model for acute stroke outcome prediction. Simultaneously, prospective validation based on more variables of the GRNN model for the prediction is required in future studies.
Assuntos
Redes Neurais de Computação , Acidente Vascular Cerebral , Humanos , Modelos Logísticos , Prognóstico , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnósticoRESUMO
Objective: To evaluate the safety, walking efficiency, physiological cost, don and doff time cost, and user satisfaction of Ai-robot. Design: Prospective, multi-center, and cross-over trial. Subjects: Paraplegic subjects (n = 40) with T6-L2 level spinal cord injury. Methods: Subjects who could walk independently using Aiwalker, Ailegs, and hip knee ankle foot orthosis (HKAFO) for 6 min within 30 days of training underwent 10 sets of tests. In each set, they completed three 6-min walk test (6MWT) sessions using the three aids in random order. Results: Skin lesions, pressure sores, and fractures, were the main adverse events, likely due to a lack of experience in using exoskeleton systems. The average 6MWT distances of the Aiwalker, Ailegs, and HKAFO groups were 134.20 ± 18.74, 79.71 ± 18.06, and 48.31 ± 19.87 m, respectively. The average heart rate increases in the Aiwalker (4.21 ± 8.20%) and Ailegs (41.81 ± 23.47%) groups were both significantly lower than that in the HKAFO group (62.33 ± 28.32%) (both p < 0.001). The average donning/doffing time costs for Ailegs and Aiwalker were significantly shorter than that of HKAFO (both p < 0.001). Satisfaction was higher in the Ailegs and Aiwalker groups (both p < 0.001). Conclusion: Subjects with paraplegia below T6 level were able to ambulate safely and efficiently with Ai-robot. The use of Ai-robot should be learned under the guidance of experienced medical personnel.
RESUMO
BACKGROUND AND OBJECTIVE: Various rehabilitation exoskeletons have been designed to help people regain normal gait from stroke effects. However, the evaluation and further optimization of these exoskeletons are not convenient and usually need complicated experimental works. The present study aims to establish a simulation-based method with a proprioceptive musculoskeletal model to conveniently evaluate the efficiency of a self-developed exoskeleton for further optimization. METHODS: Three volunteers who suffer from dyskinesia due to stroke were recruited for gait experiments with and without the self-develop exoskeleton. The corresponding simulations were implemented based on the proprioceptive model, the exoskeleton model, and the input kinematic data obtained from the experiments. The joint angles, muscle activations, and metabolic costs as well as the proprioceptor feedback stimulation were extracted for comparative analysis. RESULT: Several positive effects of the exoskeleton were noted based on the simulation results when using it to aid the patients' rehabilitation during the gait training. The CORA scores of the patients' joint angle to the normal data increased by 11.6~37.8% with the assistance of the exoskeleton. The wave frequency of proprioceptive feedback stimulation that can be directly correlated to the neural rehabilitation obviously inclined during a gait cycle. The muscle activations were also rearranged to better support the patient's walk when using the exoskeleton, while the metabolic costs were reduced for all the patients. CONCLUSION: In summary, the present simulation-based method can be practical for pre-evaluation and optimization of various exoskeleton design in the future.