Cutoff Time Research Articles

An approach to estimate optimal cut-off time under deficit irrigation

An approach to estimate optimal cut-off time under deficit irrigation

Sclerotic lines around the radial tuberosity of the proximal radius in patients with atypical femoral fractures associated with long-term bisphosphonate use: a preliminary report

Purpose: Sclerotic lines have been detected at specific locations on the forearm and metaphysis of the lower extremities (femur and tibia) in some patients with atypical femoral fractures (AFFs) associated with long-term bisphosphonate (BP) use. Herein, we present our preliminary data relating to the factors associated with the occurrence of sclerotic lines in patients diagnosed with AFFs. Methods: We inspected the clinical charts of patients who were prescribed BPs at our institution between 2010 and 2020. Fifty-six patients were finally investigated, including patients with sclerotic line lesions at the radial tuberosity (21 patients), and those without any pathognomonic lesions on either radius on a simple radiograph (35 patients). Results: No significant between-group differences in basic demographic characteristics, bone mineral density, or the total period of BP administration were observed (p>0.05). Multivariate analyses of the variables that exhibited significant between-group differences in the univariate analyses demonstrated that the time since the last BP administration at the time of AFF diagnosis (odds ratio [OR], 0.441) and the concurrent presence of similar lines on the femur (OR, 36.00) were significantly associated with the presence of sclerotic lines on the proximal radius. The cutoff time after the last BP administration at the time of AFF diagnosis was 16.5 months, which may serve as a predictor for the development of a sclerotic line around the radial tuberosity.Conclusion: Sclerotic lines on the proximal radius were detected more frequently in patients who had been recently treated with a BP or had similar lines on the lower extremities.

The Impact of Symptom Duration on Postoperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.

The optimal timing at which patients should undergo Anterior Cervical Discectomy and Fusion (ACDF) surgery to achieve the best outcomes has not been determined. Given that patients may experience delays in care and that insurance companies often require a minimum of six weeks of conservative treatment before surgery, it is essential to determine the impact of symptom duration on outcomes following ACDF. To evaluate the impact of symptom duration on outcomes following ACDF surgery. Systematic review and meta-analysis. Medline, Embase and Cochrane Library were searched from inception through July 2nd, 2024 in accordance with the PRISMA guidelines. Data on Neck Disability Index (NDI), Visual Analogue Scale (VAS) for neck and arm pain, and Short Form-12 (SF-12) physical and mental component scores were extracted. Subgroup analyses were performed to compare the outcomes at 6-months, 12-months and 24-months cutoff time points. Mean differences with 95%CI were used for continuous data. Nine studies comprising 1,511 patients (48.64% female) with a mean age of 50.56±9.88 years were included in this study. All patients achieved improvements in NDI, VAS, and SF-12 following ACDF. The amount of improvement decreased as symptom duration increased with patients experiencing greater than 24 months of symptoms experiencing statistically significantly less improvement in NDI (8.70 vs. 18.93, p=0.03), VAS Neck (1.95 vs. 3.33, p=0.003), and VAS Arm (1.74 vs. 3.72, p<0.001) in comparison to patients with less than 24 months of symptoms. There were no statistically significant differences in outcomes at the 6 and 12 months cut off points between cohorts. Longer symptom duration is associated with worse outcomes compared to shorter symptom duration with statistically significant differences observed at the 24-month cutoff for NDI, VAS Arm, and VAS Neck scores. Patients with greater than 24 months of symptoms also failed to achieve clinically significant improvement in neck pain postoperatively. Given the lasting impact of disability and pain on patients, more studies should assess the impact of symptom duration on postoperative outcomes and at even shorter cut-off points.

One-Leg Standing Test with Eyes Open as a Screening Tool for Prefrailty in Community-Dwelling Older Japanese Women.

Background/Objectives: One-leg standing test with eyes open (OLST), a well-known balance assessment, is simple to implement and requires no special measuring equipment or space. Prefrailty has greater reversibility than frailty, and early detection of prefrailty is essential for frailty prevention in older adults, especially women. However, the association between the OLST and prefrailty remains unclear. Therefore, this study aimed to verify the relationship between the OLST and prefrailty and to validate the effectiveness of the OLST as a screening tool for prefrailty in older Japanese women. Methods: This study included 208 community-dwelling older women (mean age: 74.4 ± 5.1 years; range: 65-89) who underwent frailty assessments and OLST. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. The association between prefrailty and OLST was assessed by binary logistic regression analysis, and receiver operating characteristic analyses were performed to examine the effectiveness of OLST as a screening tool for prefrailty. Results: OLST time was significantly associated with prefrailty, and those with higher OLST times were less likely to have prefrailty (ORs: 0.98; 95% CI: 0.97-0.99; p < 0.001). The area under the curve of the OLST for prefrailty was 0.713 (p < 0.001), and the optimal OLST cut-off time for discriminating prefrailty was 24 s (sensitivity: 0.56, specificity: 0.77). Conclusions: OLST could be used as a screening tool for prefrailty in older Japanese women. These findings may contribute to the early detection and prevention of frailty.

The effect of pre-COVID and post-COVID vaccination on long COVID: A systematic review and meta-analysis

Long COVID affects millions of people and results in a substantial decrease in quality of life. Previous primary studies and reviews attempted to study the effect of vaccination against long COVID, but these studies varied in the cut-off time of long COVID. We adhered to the WHO's definition of long COVID and conducted a systematic review and meta-analysis on the effect of pre-COVID and post-COVID vaccination on long COVID. We obtained data from 13 databases up to 18 February 2024, including peer reviewed and preprint studies. Our inclusion criteria were: (1) long COVID definition as 3 months or beyond, (2) comparing long COVID symptoms between vaccinated and unvaccinated groups, (3) subjects received vaccinations either before or after infected with COVID, (4) the number of doses received by participants was specified. We extracted study characteristics and data and computed the summary odds ratio (OR) with the DerSimonian and Laird random effects model. We then performed subgroup analyses based on the main vaccine brand and long COVID assessment method. ROBINS-I framework was used for assessment of risk of bias and the GRADE approach was used for evaluating the certainty of evidence. We included data from 25 observational studies (n=14,128,260) with no randomised controlled trials. One-dose pre-COVID vaccination did not have an effect on long COVID (number of studies = 10, summary OR = 1.01, 95% CI = 0.88-1.15, p-value = 0.896). Two-dose pre-COVID vaccination was associated with a 24% reduced odds of long COVID (number of studies = 15, summary OR = 0.76, 95% CI = 0.65-0.89, p-value = 0.001) and 4 symptoms (fatigue, headache, loss of smell, muscle pain) out of 10 symptoms analysed. The OR of three-dose pre-COVID vaccination against overall long COVID was statistically insignificant but was far away from 1 (number of studies = 3, summary OR = 0.31, 95% CI = 0.05-1.84, p-value = 0.198). One-dose post-COVID vaccination was associated with a 15% reduced odds of long COVID (number of studies = 5, summary OR = 0.85, 95% CI = 0.73-0.98, p-value = 0.024). The OR of two-dose post-COVID vaccination against long COVID was statistically insignificant but was far away from 1 (number of studies = 3, summary OR = 0.63, 95% CI = 0.38-1.03, p-value = 0.066). Our study suggests that 2-dose pre-COVID vaccination and 1-dose post-COVID vaccination are associated with a lower risk of long COVID. Since long COVID reduces quality of life substantially, vaccination could be a possible measure to maintain quality of life by partially protecting against long COVID.

Reviewing “Nil Per Os” Guidance for Clear Fluids in Children Before Anesthesia: Survey of the Pediatric Anesthesia Leadership Council

BACKGROUND: Several international pediatric anesthesia societies have endorsed a change in the traditional nil per os (NPO) cutoff of clear fluids (CF) from 2 hours to 1 hour. These recommendations were compiled from large-scale outcomes, gastric ultrasound, and quality improvement studies. The American Society of Anesthesiologists (ASA) recently published their updated guidelines. Despite the lack of prospective randomized studies with conclusive outcomes, several major children’s health systems in North America have already implemented or are modifying their institutional guidelines for CF. The objectives of this survey were to evaluate the current practices, changing trends, perceived benefits, and barriers in reducing the NPO times for CF in children presenting for anesthesia. METHODS: After approval from the Penn State University Institutional Review Board, an electronic survey of the Pediatric Anesthesia Leadership Council (PALC, consortium of Pediatric Anesthesiology Chairs and Division Chiefs across the United States) members was conducted by the Society for Pediatric Anesthesia Quality and Safety Committee (SPA-QS) NPO Clears Task Force between June 2023 and October 2023. Inclusion criteria were PALC membership and single response from each institution. RESULTS: A total of 88 member institutions were represented by the PALC group. The final response rate was 75 of 88 (85.2%) from across 33 states. Eighty-eight percent of the respondents belonged to a tertiary pediatric center, and 94.7% belonged to an academic setting. At the time of the survey, 8 out of 75 (10.6%) responding institutions followed 1-hour CF cutoff, 7 (9.3%) were in the process of changing to 1-hour and 60 (80%) followed a 2-hour cutoff. 55(73%) respondents actively encouraged CF up to the time they had to be NPO. 46.7% of the respondents reported significant issues (hypoglycemia, dehydration, difficulty in establishing intravenous access, patient and parental dissatisfaction) with prolonged fasting in children. The survey responses included multiple comments in favor of changing guidelines to 1 hour for CF in healthy young children. The overarching concern for implementation of 1-hour cutoff for CF was the potential medicolegal ramification of a policy change in the absence of an official statement from national professional societies. CONCLUSIONS: The survey demonstrates growing trends toward implementing the reduced NPO time for CF to 1 hour nationally. Based on the current ASA guidelines, the SPA-QS committee recommends close attention to NPO times and strongly encourages CF consumption up to the recommended cutoff time. It appears reasonable to follow a 1-hour cutoff for CF as deemed appropriate by the attending anesthesiologist or the institution.

Association of the distance travelled, and the call to hospital arrival time with early neonatal mortality in neonates born to mothers using emergency medical services at term gestation: a retrospective observational study

BackgroundMost neonatal deaths in India occur due to a lack of timely and proper care just before and during delivery. Timely availability of an ambulance for institutional delivery has led...

Optimization of border irrigation variables based on a correction factor for irrigation quota

The optimization of surface irrigation variables, i.e., the selection of the optimal combination of the inflow rate per unit width (q) and cutoff time (tco), is essential for obtaining high performance. The main objective of this study was to optimize irrigation variables by considering different irrigation requirements and the total loss model, which includes the irrigation water loss and crop yield loss. A correction factor for the irrigation quota (Cf) was introduced to achieve this objective. Cf considers different irrigation requirements, as it represents the ratio of the actual irrigation quota for certain irrigation to the designed irrigation quota (Dreq). Uniform design theory was used to determine random combinations of q and Cf from a selected range. The q value ranged from 3 to 9 L.m-1. s-1. Because the actual irrigation quota does not greatly deviate from the design irrigation quota, Cf should reach approximately 1.00. The selected Cf ranged from 0.80 to 1.38. To obtain higher crop yields, lower economic losses, and more reasonable design variables for surface irrigation, a total loss model for uneven border irrigation was established, which was defined as the objective function to optimize border irrigation design—the total loss model was combined with uniform design theory and the WinSRFR model to analyze different scenarios. The results showed that Cf has a clear meaning and exerts a favorable application effect on the irrigation performance evaluation indicators and can be used to design border irrigation systems. Based on the total loss model for uneven border irrigation, the optimal irrigation variables q and Cf for design irrigation quotas of 60, 80, and 100 mm are q=6.22 L.m-1. s-1 and Cf=1.17; q=4.60 L.m-1. s-1 and Cf=1.14; and q=3.80 L.m-1. s-1 and Cf=1.10, respectively. Compared with the conventional design results, q in the optimal design results based on the loss model decreased, Cf increased, and the total loss significantly decreased. Optimization of irrigation variables based on the border irrigation loss model could ensure favorable irrigation performance evaluation indicators, improve the water use efficiency, provide higher crop yields, and minimize the total economic losses caused by uneven irrigation.

Intraoperative Position System guided with Augmented Reality Improves the Learning Curve of Endovascular Navigation in Endovascular Naïve Operators

ObjectiveThis study aimed to compare the completion of gate cannulation task performed by participants of varying experience using fluoroscopy, the Intra-Operative Positioning System (IOPS) – an FDA-cleared endovascular navigation system that has been developed to reduce dependence on fluoroscopy – or an investigational augmented reality electromagnetic navigation technology based on IOPS. MethodsThe task consisted in the cannulation of the gate of a GORE Excluder AAA endoprosthesis bifurcated aortic stent graft (W.L. GORE & Associates, Flagstaff, AZ USA) deployed into a 3D printed abdominal aortic aneurysm (AAA) model connected to a 7000 MDX flow pump (Sarns Inc/3M, Ann Arbor, MI USA) reproducing physiological conditions. The procedure was performed in a hybrid operating room (GE Allia IGS 7). Each participant performed the cannulation task with fluoroscopy, standard IOPS guidance with flat screen display (IOPS-FS), and the investigational IOPS with augmented reality headset (IOPS-AR), in a randomly assigned order. All participants used the same sensorized guidewire and steerable 6Fr catheter during their three cannulation tasks. A total of 26 participants were classified in three groups of experience: Group 1 (endovascular naïve; n = 13), Group 2 (surgeon in training; n = 12) and Group 3 (one expert surgeon). Primary endpoints included cannulation time and technical success, which was defined as the advancement of the catheter over the guidewire within the main body of the aortic stent graft within a maximum 15 minutes cutoff time for each trial. ResultsIn group 1, the mean cannulation time was shorter using IOPS-AR versus fluoroscopy (4.3 ±4.4 min vs 7.1±4.9 min; P=.04), but not statistically different when comparing IOPS-FS and fluoroscopy (6.3±4.5 min vs 7.1±4.9 min; P=.63). In group 1, technical success was 77% with fluoroscopy and 92% with both IOPS-FS and IOPS-AR (P=.59). In group 2, although there was no significant difference between cannulation time amongst the three different endovascular approaches, there was a trend towards shorter cannulation times with IOPS-FS or IOPS-AR as compared to fluoroscopy (mean time of 2.5±0.9, 4.4±4.0 and 5.2±4.5 min, respectively). In group 2, technical success was 92% with fluoroscopy and 100% with both IOPS-FS and IOPS-AR (P>.99). The expert vascular surgeon repeated the cannulation task four times for each endovascular approach, with 100% technical success and no difference in mean cannulation time between the imaging modalities (P=.89). ConclusionsAugmented reality allows for reducing the gate cannulation time as compared to fluoroscopy in participants with no previous exposure to any endovascular procedure. This suggests that augmented reality can be beneficial for individuals early in their career and can mitigate the learning curve. As individuals become experts, their ability to adapt to different endovascular modalities increases, eliminating the learning curve altogether.

Stochastic properties of musical time series

Musical sequences are correlated dynamical processes that may differ depending on musical styles. We aim to quantify the correlations through power spectral analysis of pitch sequences in a large corpus of musical compositions as well as improvised performances. Using a multitaper method we extend the power spectral estimates down to the smallest possible frequencies optimizing the tradeoff between bias and variance. The power spectral densities reveal a characteristic behavior; they typically follow inverse power laws (1/f β-noise), yet only down to a cutoff frequency, where they end in a plateau. Correspondingly the pitch autocorrelation function exhibits slow power law decays only up to a cutoff time, beyond which the correlations vanish. We determine cutoff times between 4 and 100 quarter note units for the compositions and improvisations of the corpus, serving as a measure for the degree of persistence and predictability in music. The histogram of exponents β for the power law regimes has a pronounced peak near β = 1 for classical compositions, but is much broader for jazz improvisations.

Association of 5-times sit-to-stand test with muscle weakness and prognosis in older patients with cardiovascular disease

Abstract Background/Introduction In the elderly with cardiovascular disease (CVD), maintaining muscle strength and physical function is essential for preventing adverse outcomes like falls and hospitalizations. The decline in lower limb strength signals increased morbidity and mortality risks. The 5-times sit-to-stand test (5STS) is a practical method for assessing lower limb strength, yet its predictive value for muscle weakness and prognosis in older CVD patients is underexplored. Purpose This study aims to elucidate the 5STS's role in identifying muscle weakness and its impact on the prognosis of older patients with CVD, offering insights for targeted interventions. Methods We included 3585 patients aged ≥ 65 years with CVD (mean age, 75.8 ± 6.6 years, 64.5% male) who underwent assessment of the 5STS before discharge. Maximal quadriceps isometric strength (QIS) was evaluated as a marker of lower limb strength and expressed relative to body weight (% body weight: BW). The primary outcome was all-cause mortality. We used the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for each sex to calculate the cut-off values of the 5STS for low QIS (male &amp;lt; 45%BW, female &amp;lt; 35%BW), which have been reported to be associated with prognosis. In addition, we performed Kaplan-Meier curves and Cox regression analyses in five groups defined by 5STS time quartile and 5STS inability to assess the prognostic significance of 5STS. Cox regression analysis was performed as a multivariate model including the following variables; age, sex, body mass index, acute coronary syndrome, heart failure, hypertension, diabetes, dyslipidemia, current smoker, prior myocardial infarction, prior heart failure, prior chronic obstructive pulmonary disease, prior dementia, albumin, hemoglobin, estimated glomerular filtration rate, C-reactive protein. Result Over a median follow-up of 2.23 years (interquartile range 0.87-4.52 years), 657 (18.3%) patients died. Kaplan-Meier analysis indicated that both slow 5STS performance and inability to execute the 5STS were significantly linked with poorer prognosis (log-rank p &amp;lt; 0.001, Figure 1). After comprehensive adjustment, the slowest quartile and inability to perform the 5STS were associated with significantly higher mortality rates compared to the fastest quartile (HR 1.34; 95% CI: 1.05-1.72; p = 0.021; HR: 2.28; 95% CI: 1.60-3.24; p &amp;lt; 0.001, Figure 2). The ROC AUC for 5STS in identifying low QIS was 0.75 (95% CI: 0.73-0.77) for males and 0.75 (95% CI: 0.72-0.77) for females, with cut-off times established at 9.71s for males and 9.48s for females. Conclusion The 5STS, assessable in diverse settings without specialized equipment and reflecting key clinical outcomes, could serve as a standard tool for evaluating lower limb function.

Time to positivity of blood cultures in paediatric patients.

Continuous monitoring of blood culture (BC) systems allows rapid detection of microbial growth. We aimed to determine differences in time to positivity (TTP) in BACTEC BC between organisms and whether a 36-h period was sufficient to detect all relevant pathogenic bacteria for children admitted to a tertiary care paediatric hospital. This was a retrospective audit of positive aerobic (AE) and anaerobic (AN) BC from paediatric inpatients with available TTP from 1 August 2016 to 2 January 2019. First positive BC per bacteraemia episode was analysed. Overall, 649 BC were positive, of which 480 first positive BC were analysed: 246 AE (51.3%) only, 216 paired (45%) (108 AE and 108 AN) and 18 AN (3.8%) only. There were 372 episodes of bacteraemia in 340 patients. Median age was 19 months (interquartile range (IQR): 1.25-60). Median TTP for AE and AN cultures was 13.20 (IQR: 9.84-18.48) and 13.92 h (IQR: 10.32-17.04), respectively. Organisms were GNR 49.7%, GPC 29.6%, contaminants 14.5%, mixed 3.0%, other 2.4% and yeast 0.8%. Streptococcus agalactiae had the fastest median TTP in AE and AN cultures, followed by Escherichia coli (AE 8.88 vs. 10.20 h). For paired AE and AN cultures, TTP was faster for AE versus AN cultures (13.36 vs. 14.52 h, P = 0.001). A 36-h cut-off time captured 97.7% AE BC and 99.1% AN BC with pathogens, and 86.5% AE BC and 91.7% AN BC with contaminants, respectively. GNR were the commonest pathogens in paediatric BC and faster growth was detected in AE versus AN cultures. By 36 h, >97.7% of BC were positive for pathogens versus 86.5% for contaminants.

Inappropriate therapies in modern implantable cardioverter-defibrillators: A propensity score–matched comparison between single- and dual-chamber discriminators in single-chamber devices THe sINGle lead Study (THINGS Study)

BackgroundIn patients with implantable cardioverter-defibrillators (ICDs), inappropriate therapies (ITs) are often caused by supraventricular tachyarrhythmias (SVTs). ObjectiveWe aimed to estimate the incidence of IT in modern single-lead ICDs. MethodsThe THINGS study enrolled patients with single-lead ICDs with 2 SVT discrimination modalities: dual chamber (DC) with an atrial floating dipole or single chamber (SC) with morphology criterion. All devices were programmed with 2-zone therapy: ventricular tachycardia (VT) zone from 170 beats/min with ≥15 seconds (≥36 beats) detection time and SVT discriminators; and ventricular fibrillation (VF) zone from 214 beats/min with ≥7 seconds (≥24 beats) detection time. The primary end point was the first occurrence of IT, adjudicated by an independent board. ResultsA total of 526 patients (median age, 66 years; 83% male), 183 (34.8%) with DC and 343 (65.2%) with SC discrimination, were observed for a median of 2.2 years. The incidence rate of IT was 4.2% (95% confidence interval [CI], 2.7%–6.4%) at 1 year and 7.1% (95% CI, 5.0%–9.9%) at 2 years. Younger age (adjusted hazard ratio, 0.97; 95% CI, 0.95–0.99; P = .013) and history of atrial fibrillation (adjusted hazard ratio, 2.67; 95% CI, 1.30–5.46; P = .007) were significantly associated with increased IT risk. In a propensity score–matched comparison, DC discrimination showed a trend toward reduced IT rates compared with SC discrimination in the VT zone (1-year incidence, 1.8% vs 3.5%; P = .105). ConclusionHigh-rate VF cutoff and prolonged detection time programming resulted in a low IT rate in single-lead ICD patients with modern SVT discriminators. A trend favoring the DC system was observed in the VT zone.

A shared robot control system combining augmented reality and motor imagery brain–computer interfaces with eye tracking

Objective: Brain-computer interface (BCI) control systems monitor neural activity to detect the user's intentions, enabling device control through mental imagery. Despite their potential, decoding neural activity in real-world conditions poses significant challenges, making BCIs currently impractical compared to traditional interaction methods. This study introduces a novel motor imagery (MI) BCI control strategy for operating a physically assistive robotic arm, addressing the difficulties of MI decoding from electroencephalogram (EEG) signals, which are inherently non-stationary and vary across individuals.&#xD;Approach: A proof-of-concept BCI control system was developed using commercially available hardware, integrating MI with eye tracking in an augmented reality (AR) user interface to facilitate a shared control approach. This system proposes actions based on the user's gaze, enabling selection through imagined movements. A user study was conducted to evaluate the system's usability, focusing on its effectiveness and efficiency.&#xD;Main results:Participants performed tasks that simulated everyday activities with the robotic arm, demonstrating the shared control system's feasibility and practicality in real-world scenarios. Despite low online decoding performance (mean accuracy: 0.52 9, F1: 0.29, Cohen's Kappa: 0.12), participants achieved a mean success rate of 0.83 in the final phase of the user study when given 15 minutes to complete the evaluation tasks. The success rate dropped below 0.5 when a 5-minute cutoff time was selected.&#xD;Significance: These results indicate that integrating AR and eye tracking can significantly enhance the usability of BCI systems, despite the complexities of MI-EEG decoding. While efficiency is still low, the effectiveness of our approach was verified. This suggests that BCI systems have the potential to become a viable interaction modality for everyday applications&#xD;in the future.

Reliability and validity of the L test in people with multiple sclerosis

ObjectivesFunctional mobility is an essential factor affecting the activities of daily living in people with multiple sclerosis (PwMS). The L test is a comprehensive assessment tool for functional mobility that incorporates sit-to-stand, transfers and bidirectional turning. The purpose of this study was to determine the psychometric properties of the L test in PwMS. DesignCross-sectional study. ParticipantsThirty-four PwMS [Expanded Disability Status Scale (EDSS) score 0 to 5] and 34 healthy controls were included in this study. Main outcome measuresThe L test was administered along with the timed up and go (TUG) test, 10-m walk test (10-MWT), 6-minute walk test (6-MWT), timed 360 degree turn test, and EDSS by the same rater. Fall history was recorded to categorize PwMS with and without a history of falls. The L test was repeated after 1 week to determine test–retest reliability. ResultsThe L test showed excellent test–retest reliability (intraclass correlation coefficient 0.995). The minimum detectable change for the L test time was 1.4 seconds. The L test demonstrated significant positive correlations with the TUG test, timed 360 degree turn test and EDSS score, and significant negative correlations with the 10-MWT and 6-MWT (P < 0.001). Significant differences in the L test times were found between PwMS and healthy controls, and between PwMS with a history of falls and those without a history of falls (P < 0.05). The cut-off time of 14.7 seconds on the L test was found to best discriminate between PwMS and healthy people, while 16.4 seconds was found to best discriminate between PwMS with a history of falls and those without a history of falls. ConclusionThe L test is a reliable and valid tool for the assessment of functional mobility in PwMS. Clinical Trial Registration numberNCT05641714. Contribution of the Paper•The L test has excellent test–retest reliability and validity in PwMS.•The L test can provide insight into functional mobility, with high scores (long completion times) warranting further specific assessment of underlying components (turning, walking, etc.) that may contribute to the longer completion times.•The L test demonstrates a more comprehensive mobility assessment using an L-shaped pathway.

Transfer learning scenarios on deep learning for ultrasoundbased image segmentation

&lt;p&gt;Deep learning coupled with transfer learning, which involves reusing a pretrained model's network structure and parameter values, offers a rapid and accurate solution for image segmentation. Differing approaches exist in updating transferred parameters during training. In some studies, parameters remain frozen or untrainable (referred to as TL-S1), while in others, they act as trainable initial values updated from the first iteration (TL-S2). We introduce a new state-of-the-art transfer learning scenario (TL-S3), where parameters initially remain unchanged and update only after a specified cutoff time. Our research focuses on comparing the performance of these scenarios, a dimension yet unexplored in the literature. We simulate on three architectures (Dense-UNet-121, Dense-UNet-169, and Dense-UNet-201) using an ultrasound-based dataset with the left ventricular wall as the region of interest. The results reveal that the TL-S3 consistently outperforms the previous state-of-the-art scenarios, i.e., TL-S1 and TL-S2, achieving correct classification ratios (CCR) above 0.99 during training with noticeable performance spikes post-cutoff. Notably, two out of three top-performing models in the validation data also originate from TL-S3. Finally, the best model is the Dense-UNet-121 with TL-S3 and a 20% cutoff. It achieves the highest CCR for training 0.9950, validation 0.9699, and testing data 0.9695, confirming its excellence.&lt;/p&gt;

A spatiotemporal shape model fitting method for within-season crop phenology detection

Crop phenological information must be reliably acquired earlier in the growing season to benefit agricultural management. Although the popular shape model fitting (SMF) method and its various improved versions (e.g., SMF by the Separate phenological stage, SMF-S) have been successfully applied to after-season crop phenology detection, these existing methods cannot be applied to within-season crop phenology detection. This discrepancy arises due to the fact that, in the within-season scenario, phenological stages can beyond the defined cut-off time. Consequently, enhancing the alignment of the vegetation index (VI) curve segments prior to the cut-off time does not necessarily guarantee accurate within-season phenological detection. To resolve this issue, a new method named spatiotemporal shape model fitting (STSMF) was developed. STSMF does not seek to optimize the local curve matching between the target pixel and the shape model; instead, it determines similar local VI trajectories in the neighboring pixels of previous years. The within-season phenology of the target pixel was thus estimated from the corresponding phenological stage of the determined local VI trajectories. When compared with ground phenology observations, STSMF outperformed the existing SMF and SMF-S which were modified for the within-season scenario (SMFws and SMFSws) with the smallest mean absolute differences (MAE) between observed phenological stages and their corresponding model estimates. The MAE values averaged over all phenological stages for STSMF, SMFSws, and SMFws were 9.8, 12.4, and 27.1 days at winter wheat stations; 8.4, 14.9, and 55.3 days at corn stations; and 7.9, 12.4, and 64.6 days at soybean stations, respectively. Intercomparisons between after-season and within-season regional phenology maps also demonstrated the superior performance of STSMF (e.g., correlation coefficients for STSMF and SMFSws are 0.89 and 0.80 at the maturity stage of winter wheat). Furthermore, the performance of STSMF was less affected by the detection time and the determination of shape models. In conclusion, the straightforward, effective, and stable nature of STSMF makes it suitable for within-season detection of agronomic phenological stages.

Multi-stage deep sorting strategy for retired batteries based on the clustering of static and dynamic features

Echelon utilization is the optimal solution for handling retired lithium-ion batteries. How to ensure the economy and safety of retired batteries for echelon utilization, consistency sorting technology is crucial and valuable. However, batteries are influenced by multiple factors and the mapping of internal and external parameters is complex. Finding external features with discrimination and interpretability, and using effective sorting methods for consistency sorting is still challenged. To address the above problem, a multistage deep sorting strategy for retired batteries based on the clustering of static and dynamic features is proposed in this paper. Firstly, the density-based spatial clustering of applications with noise is used to remove abnormal batteries in the initial sorting stage, which ensures the safety of battery echelon utilization and the efficiency of energy utilization. Secondly, low-correlation static features are selected by Pearson correlation coefficient analysis, and the WK-means clustering algorithm was employed for the secondary sorting of retired batteries. Finally, the sliding window method is used to extract the time-square dynamic features from the dynamic stress test data, and the clustering algorithm is employed to subdivide the retired batteries again with precision. The experimental results indicate that the proposed method in this paper can effectively achieve consistency assessment and sorting of retired batteries. After sorting, the capacity, resistance, and open-circuit voltage of the battery are compactly distributed, resulting in a reduction of their corresponding standard deviations by 36.76 %, 62.97 %, and 71.62 %, respectively. Furthermore, the cut-off time and voltage drop of dynamic profile are reduced by 8.87 % and 65.36 %, respectively.

Experimental investigation of the effect of phase change material on backup time and equivalent energy consumption of domestic refrigerator

Load shedding is a significant problem in rural areas. During a power outage, the cabin temperature of a refrigerator increases owing to the heat gain. In practice, a door should be opened to load and unload refrigerator products, particularly when the power failure period is longer. The use of a phase-change material (PCM) in the refrigerator cabin restricts the increase in temperature and provides a backup time that reduces energy consumption. Door-opening tests are essential during a power cut-off time to investigate the reduction in backup time owing to door openings. This article presents an experimental investigation on the influence of PCM masses of potassium chloride (KCl), sodium chloride (NaCl), and sodium fluoride (NaF) dissolved in water on the backup time and equivalent energy consumption of a domestic refrigerator for closed and open doors according to the standards IS 1476 and IEC 62552:2015. The backup time of closed-door tests was significantly increased by the PCM for all masses, i.e., between 15 and 200 min in absolute terms and between 14% and 182% in relative terms. The backup time for the closed-door tests was 1.8–1.03 times longer than that for the door-opening tests. The backup time of door-opening tests decreased significantly owing to heat entering the cabin for all masses, i.e., between 50 and 10 min in absolute terms and between 45.45% and 3.23% in relative terms. The equivalent energy consumption of a refrigerator decreased with an increase in PCM mass. In closed-door tests, it varied from 0.55 to 0.41 kWh.6-1 h for the 0–1.75 kg mass of all tested PCMs. In the door-opening tests, the equivalent energy consumption increased owing to door opening. The equivalent energy consumption for the door-opening tests was 1.12–1.02 times larger than that for the closed-door tests.

Improving Irrigation Performance of Raised Bed Furrow Using WinSRFR Model

Agricultural productivity is intricately tied to efficient water management strategies, with raised bed furrow systems being a prevalent method for irrigation. However, the optimization of these systems remains a critical area of exploration. The border irrigation method is commonly employed in developing countries for irrigation and leads to significant water loss, reduced irrigation efficiency, and increased irrigation durations. In contrast, raised bed furrow irrigation represents an improved surface irrigation technique that optimizes water usage in irrigated systems. This study seeks to assess the irrigation performance of raised bed furrows, encompassing deep percolation loss, distribution uniformity, adequacy, and application efficiency. The evaluation will be conducted for both existing conditions and an optimized scenario achieved through the application of the WinSRFR model. Field data facilitated the numerical simulation and the model was calibrated to reflect the existing irrigation system dynamics accurately. The performance of the model was assessed by utilizing the statistical indicator of root mean square error (RMSE) and revealed good agreement between advance and recession time. Results revealed that existing raised bed furrow irrigation exhibited up to 40% deep percolation loss, 80% distribution uniformity, and 60% application efficiency. Increasing furrow length had adverse effects; decreased application efficiency and distribution uniformity; and increased deep percolation losses. In contrast, reducing the furrow length and cutoff time by up to 33% and 40%, respectively, and increasing the width and inflow rate by up to 55% and 100%, respectively, enhanced the application efficiency and distribution uniformity, and minimized deep percolation loss. Overall, improved raised bed furrow irrigation provides a more efficient option and is encouraged to adopt for irrigation.