Poor Reliability Research Articles

Reliability of the Unilateral Hearing Loss in Youth Instrument for Children With Single-Sided Deafness.

While general practice parameter recommendations for children with unilateral hearing loss or single-sided deafness (SSD) have been published, clinically utilized subjective instruments specifically designed to assess this population are scarce. Treatment options are evaluated using audiometric data, speech perception data, and quality of life instruments. The Unilateral Hearing Loss in Youth (uniHELO) is a subjective assessment instrument that aims to evaluate the listening challenges in this population, but it has not yet been studied in a clinical setting. This study examined the reliability of the uniHELO among children with SSD. This was a prospective within-subject study. Nine patients with SSD, aged 8-14 years, were enrolled. Participants had not used a personal hearing device for at least 6 months prior to enrollment. The uniHELO instrument was administered at two clinic visits separated by 3-4 weeks. For comparison, the Pediatric and Parent Speech, Spatial, and Qualities of Hearing Scale (SSQ) instruments were administered during the same visits. uniHELO scores were not significantly different between the first and second visits. The correlations of scale scores over time were: .96 for the uniHELO, which suggests excellent test-retest reliability; .84 for the Parent SSQ, which also suggests excellent test-retest reliability; and .27 for the Pediatric SSQ, which suggests poor test-retest reliability compared to the Parent SSQ and uniHELO. Within-subject scale uniHELO scores between clinic visits showed excellent test-retest reliability across items. The test-retest reliability scores for the uniHELO were also stronger than those for the Parent and Pediatric SSQ. These data support the use of the uniHELO to evaluate listening challenges in children with SSD.

Secondary fastener (tape) placement on a blood pressure cuff causes interindividual Doppler blood pressure measurement variability in healthy large-breed dogs.

The objective of this study was to compare Doppler blood pressure (DBP) measurements between blood pressure cuffs (BPCs) with and without a secondary fastener (tape) in healthy nonanesthetized large-breed dogs. 28 healthy dogs. Superficial palmar venous arch DBP measurements with and without tape on the BPC were performed in lateral recumbency with Doppler ultrasound. Each method was performed 6 consecutive times, with the final 5 values averaged. Bland-Altman plots were made and limits of agreement calculated. The limits of agreement were -40.8 (95% CI, -55.6 to -26.0) to 45.6 (95% CI, 30.8 to 60.4), indicating that the DBP measured with tape would be expected to be between 40.8 mm Hg below and 45.6 mm Hg above that measured without tape 95% of the time. The mean bias estimate was 2.4 mm Hg (SD, 22.0; 95% CI, -6.1 to 11.0; P = .724), indicating that DBP measurements with tape averaged 2.4 mm Hg higher than without tape. Doppler blood pressure measurements obtained with secondary fasteners on the BPCs differed by > 10 mm Hg compared to the BPCs' standard hook-and-loop fasteners 54% (30 of 56) of the time. Blood pressure cuffs with dysfunctional hook-and-loop fasteners should be replaced due to poor clinical reliability of DBP measurements. However, it is unclear whether Doppler sphygmomanometry is more accurate with the use of traditional Velcro BPC fasteners or with tape BPC fasteners.

Effect of factory reliability on bagasse usage and surplus

Poor factory reliability increases season length, reduces sugar production and reduces the supply of bagasse available for cogeneration and the production of by-products. The financial justification for capital expenditure, maintenance and control system upgrades usually account for the extended season length and lost sugar production associated with stoppages. However, the extra bagasse use due to stoppages is often harder to quantify, and, therefore, the resulting financial consequences are often not considered. This work attempts to quantify the effects of stoppages on bagasse use in factories so that the true costs of factory stoppages can be more accurately determined. Factory data have been used to predict the effects of long and short factory stops on bagasse consumption and surpluses. Calculations were carried out for a factory data set with a relatively small number of short stops and a factory data set with a large number of short stops. For both data sets, far more bagasse was lost due to short stops than long stops, and the quantity of bagasse consumed due to short stops represents a significant loss of revenue. Stops disrupt and increase the bagasse consumption of the boiler station in ways that are difficult to model, so it is likely that the calculations in this work underestimate the bagasse consumption and, therefore, revenue lost due to stops.

Phosphorylation Enables Nano‐Graphene for Tunable Artificial Synapses

AbstractFlexible and robust memristors with controllable resistance‐switching characteristics are important to neuromorphic computing. However, the nanomaterials‐based, solution‐processed resistance switching layer usually has poor reliability and tunability due to uneven morphology and invariable surface properties. Herein, phosphorylated graphene nanoflakes (phos‐GPs) are synthesized for high‐performance solution‐processed flexible memristors. In situ conductive atomic force microscopy reveals that the tightly stacked uniform nanoflakes and modified phosphorate groups jointly reduce the formation barrier of the conductive filaments. Furthermore, phosphorylation gives rise to surface silver ion coordination leading to enhanced radial growth of the conductive filaments. The memristor shows volatile characteristics in the Ag/phos‐GPs/ITO architecture and exhibits non‐volatile properties in the Ag/Ag+‐(phos‐GPs)/ITO structure. Both types of memristors display consistent I‐‐V curves during long‐term cycling and under repetitive mechanical bending, in addition to excellent synaptic plasticity. Moreover, ultrasmall nonlinearity is observed from non‐volatile long‐term synaptic potentiation and depression. By utilizing the tunable artificial synapses, the processes of memory‐forgetting and re‐recognition are simulated, and the image recognition tasks are accomplished by the artificial neural networks.

Otolaryngologists Demonstrate Low Agreement on Pediatric Airway Inflammation Assessment.

Microlaryngoscopy and bronchoscopy (MLB) are essential tools for evaluating airway inflammation, but the reliability of endoscopic assessments for this purpose remains unclear. The aim of this study was to assess surgeons' interrater reliability during endoscopic assessment of airway inflammation. The endoscopic factors used to determine overall airway inflammation were also assessed. We conducted a cross-sectional study involving 24 pediatric patients who underwent MLB and arytenoid biopsy. Surgeons rated airway inflammation based on endoscopic images, and interrater reliability was assessed using Fleiss' Kappa. Fleiss's Kappa demonstrated poor interrater reliability among all surgeons (0.111) and experienced surgeons (0.117). Surgeons varied in prioritizing visual features for assessing inflammation. Current subjective assessments of airway inflammation during MLB exhibit poor interrater reliability, necessitating further research for improved diagnostic accuracy and informed treatment decisions in pediatric airway interventions. Level 3 Laryngoscope, 2024.

High Thermal Conductive Crystalline Organohalide for Endurable Resistive Switching Non-Volatile Memory.

The organic-based memristive devices are widely studied as a next-generation electronics for eco-friendly wearable applications, thanks to materials` flexibility and biocompatibility. However, poor operational reliability and stability of the devices remain a critical challenge. Here, the study demonstrates a crystalline organohalide, Dabconium ammonium triiodide (DABCO-NH4-I3, DABCO is 1,4-diazabicyclo[2.2.2] octonium)-based memristive device with exceptionally high reliability and endurance. Owing to the low dielectric constant and anisotropic hexagonal crystal structure consisting of hydrogen bonds with a high bandgap, the DABCO-NH4-I3-based conductive bridging random access memory device demonstrates millivolt-scale operating voltages with a remarkably high on/off ratio of ≈109, capable of multi-level storage. The relatively higher thermal conductivity of the crystalline organohalide (1.06Wm-1K-1), compared to most of organic materials (0.1-0.5Wm-1K-1), is found to be beneficial to suppress intense heat accumulation generated by Joule heating effect during device operation. With the facilitated dissipation of the generated heat, the simple planar heterojunction structured device shows remarkably endurable resistive switching over 103 cycles of program-erase at both room temperature and 85 °C with high switching reliability. This study introduced a new class of materials that can overcome the limitations of existing organic materials for high-performance next-generation organic electronic devices.

Automatic cervical cancer classification using adaptive vision transformer encoder with CNN for medical application

Accurate and early cervical cancer screening can reduce the mortality rate of cervical cancer patients. The Pap test, often known as a Pap smear, is one of the frequently used methods for the early diagnosis of cervical cancer. However, manual analysis can be time-consuming. Previous approaches have faced challenges such as low accuracy, increased computing complexity, larger feature dimensionality, poor reliability, and increased time consumption due to subpar hyper-parameter optimization. This paper proposes an automatic cervical cancer classification system using a deep learning algorithm to address these issues. The proposed system consists of three stages: pre-processing, segmentation, and classification. Initially, images are collected and pre-processed through normalization, smoothing, and resizing. The pre-processed images are then passed to the segmentation stage, where an Adaptive Deep Residual Aggregation Network is utilized (ADRAN). After segmentation, the images are classified into seven categories: Carcinoma_in_situ, Light_dysplastic, Moderate_dysplastic, Normal_columnar, Normal_Intermediate, Normal_superficial, and Severe_dysplastic using an Adaptive Vision Transformer Encoder (AVTE) with CNN. To improve the efficiency of the transformer learning network, the hyperparameters of AVTE with CNN are optimized using an Adaptive Cat Swarm Optimization algorithm (ACSO). The efficiency of the presented technique is evaluated based on various metrics, and experimentation is conducted using the Herlev dataset.

Test-retest reliability of behavioral and computational measures of advice taking under volatility.

The development of computational models for studying mental disorders is on the rise. However, their psychometric properties remain understudied, posing a risk of undermining their use in empirical research and clinical translation. Here we investigated test-retest reliability (with a 2-week interval) of a computational assay probing advice-taking under volatility with a Hierarchical Gaussian Filter (HGF) model. In a sample of 39 healthy participants, we found the computational measures to have largely poor reliability (intra-class correlation coefficient or ICC < 0.5), on par with the behavioral measures of task performance. Further analysis revealed that reliability was substantially impacted by intrinsic measurement noise (indicated by parameter recovery analysis) and to a smaller extent by practice effects. However, a large portion of within-subject variance remained unexplained and may be attributable to state-like fluctuations. Despite the poor test-retest reliability, we found the assay to have face validity at the group level. Overall, our work highlights that the different sources of variance affecting test-retest reliability need to be studied in greater detail. A better understanding of these sources would facilitate the design of more psychometrically sound assays, which would improve the quality of future research and increase the probability of clinical translation.

A hydraulic motor fault diagnosis method based on weighted multi-channel information fusion

Abstract In response to the limitations of the existing single-sensor hydraulic motor fault diagnosis model, which includes significant fluctuations in fault identification accuracy, low data utilization, poor reliability, and insufficient generalization ability under variable working conditions, a novel hydraulic motor fault diagnosis method based on weighted fusion of multi-channel data and migration learning is proposed. Firstly, in order to fully extract the fault information in the multi-channel data set of the hydraulic motor, a multi-channel fusion method based on information entropy weighting is proposed. The information entropy method is employed to calculate the fusion weight of each channel of data, and the sampled data of each channel is weighted and fused. Subsequently, the fusion data from the source domain is employed to pre-train the deep transfer model, with the model parameters obtained from this pre-training serving as the initialization parameters for the target domain model. Further, the parameters of the target domain model’s feature extractor are fixed, and the parameters of its classifier are fine-tuned using the target domain’s fusion data. The distance between the source and target domains is reduced by incorporating an attention mechanism and constructing a loss function. The migration from the source domain to the target domain is achieved, which enables the classifier to adapt to the novel target sample recognition task. Ultimately, the experimental results of hydraulic motor migration diagnosis under variable operating conditions demonstrate that the proposed method is efficacious for hydraulic motor fault diagnosis. In comparison to conventional models such as CNN, LSTM and ResNet, the proposed method exhibits superior migration diagnosis accuracy and strong generalization and robustness under variable operating conditions.

Integration of CeO2-Based Memristor with Vertically Aligned Nanocomposite Thin Film: Enabling Selective Conductive Filament Formation for High-Performance Electronic Synapses.

The CeO2-based memristor has attracted significant attention due to its intrinsic resistive switching (RS) properties, large on/off ratio, and great plasticity, making it a promising candidate for artificial synapses. However, significant challenges such as high power consumption and poor device reliability hinder its broad application in neuromorphic microchips. To tackle these issues, in this work, we design a novel bilayer (BL) memristor by integrating a CeO2-based memristor with a Co-CeO2 vertically aligned nanocomposite (VAN) layer and compare it with the single layer (SL) memristor. Preliminary electrical testing reveals that the BL memristor offers a reduced set/reset voltage (∼67% lower), a higher on/off ratio (∼5 × 102), enhanced device reliability, and improved device-to-device variation compared to the SL memristor. Insight from COMSOL simulation, coupled with microstructural analysis, provides a comprehensive elucidation on how the VAN layer facilitates the selective conductive filament (CF) formation. Subsequently, the plasticity of the BL memristor is evaluated through long-term potentiation/depression (LTP/LTD), paired-pulse facilitation (PPF), and spike-time-dependent plasticity (STDP). The spiking neural network (SNN) built upon the BL memristor achieves remarkable accuracy (∼94%) after only 12 iterations, underscoring its potential for high-performance neural networks.

Reliability of Sensorimotor Control Tests in Individuals with Adolescent Idiopathic Scoliosis

Background: The presence of sensorimotor control deficits in adolescent idiopathic scoliosis compared to typically developed adolescents is supported by the literature but lacks reliability studies for assessment in this population. This study aimed to assess the reliability of eight sensorimotor control tests, in terms of static and dynamic balance, joint position sense (JPS) tests of the extremities and the spine, and a functional upper extremity proprioceptive test in adolescent idiopathic scoliosis subjects. Methods: Sixty adolescent idiopathic scoliosis subjects were divided into four groups. Each group underwent two tests by the same examiner, repeated at 15 min intervals. Reliability was measured using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable difference (SDD). Results: The results showed high reliability for the upper extremity functional proprioception test, for the dynamic and static balance test, and for the spinal lateral flexion joint position sense test in both directions. On the other hand, the shoulder external rotation, knee extension, elbow flexion, and spinal flexion joint position sense tests demonstrated poor reliability in adolescent idiopathic scoliosis subjects. Conclusions: Therapists are recommended to use the functional upper extremity proprioception test, the Fukuda test, the static balance test using a force footplate, and the spinal lateral flexion joint position sense test for assessing treatment progress in this population.

Grading Sonographic Severity of Adenomyosis: A Pilot Study Assessing Feasibility and Interobserver Reliability.

The reported prevalence of adenomyosis ranges widely due to different study populations, diagnostic tests and criteria. Categorizing the severity of disease may prove important. This study aims to develop a semi-quantifiable sonographic method to grade the severity of adenomyosis and assess the feasibility and interobserver reliability of this method. Cross-sectional pilot study performed at a gynecology outpatient clinic, included 35 premenopausal women with adenomyosis, not taking hormonal medication. Diagnosis required ≥1 direct sonographic feature of adenomyosis. Two-dimensional (2D) grayscale video clips and 3-dimensional (3D) volumes of the uterus of the first 5 patients were evaluated using 6 offline methods to assess feasibility. Feasible methods were analyzed for interobserver (n = 3) reliability (Fleiss kappa or intraclass correlation) and compared with current ultrasound methods (Cohen's weighted kappa and Spearman's rank correlation). Current methods include real-time estimation (mild/moderate/severe) and counting the individual sonographic features. "eXtended Imaging virtual organ computer-aided analysis (XI VOCAL) counting" (counting affected slices of 20 parallel slices in the 3D volume), "Multiplanar and 3D rendering (MPR) estimation" (grading volume by eyeballing in multiplanar render mode), and "2D-clip estimation" (grading volume in 2D-clips) emerged as feasible methods. "XI VOCAL counting" and "2D-clip estimation" demonstrated good interobserver reliability, whereas "MPR estimation" had poor reliability. Comparison with real-time estimation showed moderate reliability with all methods. "XI VOCAL counting" and "MPR estimation" correlated positively with the number of sonographic features. "XI VOCAL counting" demonstrated to be feasible with good interobserver reliability to assess the severity of adenomyosis in an objective, systematic, and semi-quantifiable fashion and should be validated with large-scale studies for future use. Future studies should also explore the association between sonographic severity and symptoms of adenomyosis.

Comparison of the Clinical Evaluation of Digital Tooth Shade Determination Using an Intraoral Scanner with Proven Subjective and Objective Methods.

Background/Objectives: Despite the increasing use of chromatic intraoral scanners, color determination is often performed visually, offering poor reliability and validity. In this study, we aimed to compare the reliability and validity of the tooth shade determination tool of an intraoral scanner (Trios3 Color) with that of two dental spectrophotometers (VITA Easyshade Advance 4.0 and SpectroShade Micro) and with visual determination using the VITA 3D-Master shade guide. Methods: In vivo tooth shade determination was performed on 33 participants using positioning splints for the right central incisor. Repeated measurements assessed the reliability in determining the percentage agreement with VITA 3D-Master shades. VITA Easyshade measurements were used as reference values for validity. The metric value Delta E (ΔE) in the International Commission on Illumination L*a*b* color space was compared to the reference, with ΔE greater than 1 indicating visible differences and a maximum value of ΔE 6.8 being clinically acceptable. Results: The reliabilities of VITA Easyshade, the intraoral scanner, and SpectroShade Micro were 75.8%, 87.9%, and 89.9%, respectively. The visual method had an agreement rate of 20.6%. Validity values, compared with the reference value, were ΔE 3.8 (clinically acceptable), 8.3, and 7.4 (the latter two both being clinically unacceptable) for the intraoral scanner, area-measuring device, and visual method, respectively. Conclusions: The intraoral scanner is a reliable and valid tool for tooth shade determination and is superior to the visual method in both aspects.

Parental Knowledge, Awareness, and Attitude Regarding Children With Epilepsy: A Cross-Sectional Study in Arar, Saudi Arabia.

Epilepsy is a chronic neurological condition marked by recurrent seizures, which differ widely in type and frequency. Globally, many families lack accurate information about epilepsy and may be misinformed by unreliable sources, often resulting in negative attitudes toward their children who have epilepsy. The aim of this study is to assess parental knowledge and attitude regarding epilepsy and identify the predictors affecting the knowledge and attitude in Arar city, Saudi Arabia. A cross-sectional study was conducted in Arar, Saudi Arabia, among 66 parents. A self-administered online questionnaire was disseminated between January and April 2024, and responses were collected anonymously. Surveys were distributed at the Maternity and Children Hospital in Arar, Saudi Arabia. The Cronbach's alpha for the knowledge domain was 0.55, indicating moderate reliability, and for the attitude domain it was 0.42, indicating poor reliability. Principal component analysis revealed that the knowledge domain loaded on two components explaining 59.44% of the variance in responses and the attitude domain loaded on three components explaining 61.16% of the variance in responses.Of the total respondents, 11 (16.7%) had good knowledge, 13 (19.7%) had fair knowledge, and 42 (63.6%) had poor knowledge. Of the total respondents, 38 (57.5%) had a good attitude, 17 (25.8%) had a fair attitude, and 11 (16.7%) had a poor attitude. The multiple linear regression analysis for the knowledge score revealed that a child's treatment duration of 6-10 years significantly increased the knowledge score by 1.75 (95%CI: 0.28 - 3.23, p=0.021). The attitude score revealed that a secondary or higher educational level significantly improved it by 1.95 (95%CI: 0.03 - 3.86, p=0.046), while an intermediate educational level non-significantly improved the attitude score by 1.40 (95%CI: -0.99 - 3.78, p=0.245). Employment status significantly decreased the attitude score by -0.79 (95%CI: -1.34 - -0.24, p=0.006). Additionally, a treatment duration of 6-10 years significantly improved the attitude score by 1.21 (95%CI: 0.12 - 2.29, p=0.030). Our study highlights a notable disparity between poor knowledge and positive attitudes among the parents surveyed. This underscores the imperative for targeted health education initiatives and awareness campaigns aimed at equipping parents with a comprehensive understanding of their children's condition.

Brazilian Portuguese version of questionnaires assessing evidence-based practice competencies in healthcare students: Translation, cross-cultural adaptation, and measurement properties

BackgroundWhile several instruments assess evidence-based practice (EBP) competencies, few are available for the Brazilian population, particularly healthcare students. ObjectiveTo perform a cross-cultural translation of the Student Evidence-Based Practice Questionnaire (S-EBPQ) and Evidence-Based Practice Evaluation Competence Questionnaire (EBP-COQ) into Brazilian Portuguese; to adapt and validate the Brazilian Portuguese versions for use with healthcare students from diverse courses; and to assess the measurement properties of the translated and adapted versions. MethodsFour hundred forty-two healthcare students were included, and three versions were tested: S-EBPQ-BR, EBP-COQ-BR for nursing students, and EBP-COQ-BR for healthcare students. We assessed internal consistency, reliability, construct validity, responsiveness, and ceiling/floor effects. For reliability, participants completed the questionnaires twice, one week apart. For responsiveness, they completed them after participating in an educational program. ResultsNo issues were identified with understanding or applicability. For overall scores, the translated questionnaires demonstrated strong internal consistency (Cronbach's alpha=0.87-0.92), good to moderate reliability (ICC3,1=0.63-0.88), construct validity with moderate to very strong correlations to the Evidence-Based Practice Questionnaire (r=0.43-0.89), no ceiling or floor effects, and adequate responsiveness with significant pre- and post-educational program score differences. For subscales, the majority of them demonstrated satisfactory measurement properties, except for S-EBPQ-BR attitude (low internal consistency, poor reliability, and ceiling effect), EBP-COQ attitude (inadequate construct validity), and EBP-COQ skills (inadequate construct validity). ConclusionThe Brazilian Portuguese versions of S-EBPQ and EBP-COQ exhibit strong measurement properties, including high internal consistency, adequate reliability, valid construct validity, and responsiveness. However, some subscales present suboptimal internal consistency, reliability, and construct validity.

Research on the application of a hybrid intelligent algorithm in reducing the negative response of shield tunneling construction

Traditional shield project control relies on manual monitoring and management, which suffers from poor reliability, lag, and other defects. In this paper, a hybrid algorithm based on Bayesian optimization (BO), light gradient enhancer (LGBM), and nondominated sorting genetic algorithm-III (NSGA-III) is proposed to realize intelligent control of shield construction safety. The BO-LGBM-NSGA-III is a multiobjective optimization algorithm that takes cutterhead wear and shield energy consumption as objective functions and the nonlinear mapping function of surface settlement and construction parameters as fitness functions. Based on the Pareto distribution of the optimized backing structure construction parameters, reasonable limits of the control parameters of the shield tunneling machine are obtained. The conclusions are as follows. (1) The R2 of the test set for surface subsidence prediction is 0.916, and the RMSE is 2.655. (2) The proposed method can achieve multiobjective optimization, and the surface settlement, cutter head wear, and shield energy consumption are optimized by 49.92%, 24.38%, and 41.88%, respectively. (3) By using this method, both prediction and optimization can be realized, and the optimal control scheme can be obtained. The negative impact of shield tunneling construction has been significantly reduced.

Test-retest reliability of exercise blood pressure and the workload-indexed systolic blood pressure slope in healthy males and females.

The reliability of blood pressure (BP) measured during submaximal and maximal exercise, and confounding effects of biological sex, remain to be fully established but have implications for using exercise BP as a cardiovascular risk factor. We hypothesize that exercise BP test-retest reliability will not differ between sexes but will be higher during submaximal compared to maximal exercise. Eighty-four participants (22 ± 5 yr; 36 females) completed two maximal treadmill tests (modified Bruce protocol) separated by ≥2 days. Exercise BP was measured every 90 s using automated auscultation (Tango M2 monitor). Breath-by-breath oxygen uptake was analyzed. Test-retest reliability was assessed using two-way, mixed-effects, consistency, single-rater intraclass correlation coefficient (ICC) analysis on the total group and separated by sex at submaximal and maximal exercise. Systolic BP during submaximal (ICC = 0.65 [0.49-0.76], P < 0.01) and maximal (ICC = 0.66 [0.52-0.77], P < 0.01) exercise both displayed substantial reliability between visits. In contrast, the SBP/MET slope showed poor submaximal (ICC = 0.12 [-0.09-0.33], P = 0.13) but substantial maximal (ICC = 0.63 [0.48-0.75], P < 0.01) exercise reliability. Females showed substantial reliability in submaximal systolic BP (ICC = 0.73 [0.53-0.85], P < 0.01) and peak systolic BP (ICC = 0.74 [0.54-0.87], P < 0.01) and SBP/MET slope (ICC = 0.78 [0.60-0.88], P < 0.01); the submaximal SBP/MET slope had fair reliability (ICC = 0.28 [-0.06-0.56], P = 0.05). Males showed moderate reliability in submaximal systolic BP (ICC = 0.53 [0.26-0.72], P < 0.01) and peak systolic BP (ICC = 0.41 [0.15-0.62], P < 0.01) and SBP/MET slope (ICC = 0.48 [0.22-0.67], P < 0.01); the submaximal SBP/MET slope had poor reliability (ICC = 0.06 [-0.18-0.31], P = 0.32). Systolic BP showed similar reliability during submaximal and maximal exercise, with females demonstrating higher reliability in exercise systolic BP compared to males.NEW & NOTEWORTHY Limited work has assessed the reliability of exercise blood pressure (BP) in young healthy males and females. Our results demonstrate that systolic BP test-retest reliability did not differ between submaximal and maximal exercise. Sex-specific analysis found that females had higher reliability in exercise systolic BP than males. Despite the acceptable average reliability, exercise BP measured using automated auscultation possesses wide confidence intervals, which impact sample size requirements in future trials.

Microwave-based passive wireless electronic transformer development

Abstract With the continuous development of intelligent substations and the past demand for intelligent transformation of power grids, electronic transformers have been widely utilized. Given that the active type of electronic transformer was susceptible to electromagnetic interference, particularly on the high-voltage power supply side, disturbances were challenging to evade, leading to its poor reliability. Based on microwave wireless transmission technology, this study theoretically proposed a dynamic wireless energy supply link for electronic transformers and designed a passive wireless electronic transformer utilizing microwave technology. Simultaneously, it developed the corresponding software and hardware systems, constructed an experimental test platform, conducted tests in high-voltage environments, and verified its performance by comparing it with active wired methods. The results demonstrated that the microwave-based passive wireless electronic transformer developed in this paper had good reliability and could be widely applied in practice.

Patients posture affects clinical outcomes and range of motion after reverse total shoulder arthroplasty: A clinical study

BackgroundMovement limitations following implantation of reverse total shoulder arthroplasty (RTSA) have been observed in some patients postoperatively, with implant design and positioning recognized as important influential factors. Recent analyses have identified patient’s posture, measured as scapula internal rotation on computed tomography (CT), as an additional factor influencing the functional outcome after RTSA. However, no clinical study has correlated the preoperatively photo documented posture to functional outcome. It was the aim of this study to correlate preoperatively photo documented posture to scapula orientation using CT and analyze the influence on functional outcome following RTSA implantation. MethodsA prospectively enrolled RTSA database was retrospectively reviewed to include a total of 360 patients with a minimum follow-up of 2 years. Patient´s posture was analyzed using standardized preoperative photo and video documentation. The posture was defined following the classification system of Moroder et al as Type A (upright posture, retracted scapulae), type B (intermediate), type C (kyphotic posture with protracted scapulae). Additionally, CT data were used to measure scapula position (internal rotation). Correlation analyses between them were conducted. Postoperative range of motion (ROM) and clinical outcomes (absolute and relative Constant Score (CSa, CSr)) were compared between the different posture types. ResultsAccording to the photo documented posture types, the patients were divided into posture types A (n=59), B (n=253) and C (n=48). Average CSa differed significantly among the groups (69±16 vs 69±14 vs 64±16, p < 0.05) favoring patients with posture types A and B over type C. In terms of ROM, flexion, abduction and internal rotation significantly differed among the groups. Types A and B exhibited better flexion and abduction (flexion 124±26º and 123±23º vs. 113±25º, abduction 140±34º and 137±30º vs 128±34º). Patients with posture type A demonstrated superior internal rotation (CS points: 5.9±2.9 vs 5.0±2.7 vs 4.4±2.8, p < 0.05). External rotation was better for type A compared to type C (A: 33±17° vs B: 30±16° vs C: 28±18°). Correlation analysis of posture classification using photo documentation and CT scan showed poor reliability (r=0.35). ConclusionPatients with clinical posture types A and B exhibited improved ROM values compared to type C postures. Clinical outcome scores were also notably superior in types A and B. However, the measurement of scapula internal rotation on supine CT does not reliably correlate with photo documentation of patient’s posture. Preoperatively, patient’s posture should be considered in RTSA planning because of the potential influence on ROM and clinical outcomes.

A generalized objective CT-based method for quantifying articular fracture severity

A CT-based method for objectively assessing fracture severity was previously developed and validated to address poor reliability in existing subjective fracture classification systems. The method involved quantifying the energy involved in creating a fracture. However, clinical utility of the method was hindered by reliance upon an intact contralateral CT and lengthy analysis time (8–10 h). Significant methodological improvements detailed here enable the assessment of fracture severity in any joints and bones, while obviating the need for an intact contralateral CT scan. Analysis time was reduced to <2 h per case. Fracture energies computed using the new methods showed strong agreement (R2 = 0.95, p < 0.001) with prior results in analyzing twenty tibial pilon fractures. New metrics, articular fracture edge length and subchondral energy, were developed to better describe joint injuries by incorporating knowledge of preferential chondrocyte death along fracture edges. Based on two-year radiographic grading for these pilon fractures, fracture energy, articular fracture edge length, and subchondral energy were all significantly different (p < 0.01) between cases that did or did not develop post-traumatic osteoarthritis. These developments enable measurement of fracture severity in larger populations and in more clinically relevant timeframes with articular fractures involving a variety of joints and bones. This generalized assessment method offers opportunity to change the way severity is considered in fracture treatment algorithms. Studies involving larger cohorts are anticipated to yield insights into the impact of fracture severity on PTOA risk and serve as a foundation for evaluating new treatment strategies.