Practical Test Research Articles

Clinical Utility of Metagenomic Next-Generation Sequencing of Plasma Microbial Cell-Free DNA: a Single-Center Retrospective Study

Abstract Infectious diseases account for significant morbidity and mortality in healthcare, and metagenomic next-generation sequencing of plasma microbial cell-free DNA has emerged as a promising non-invasive diagnostic tool in this scenario. However, the available data on the real impact of this test in clinical practice is limited and conflicting. In this context, we performed a retrospective evaluation of the utilization of this test at our institution since February 17, 2019. A total of 76 tests were performed in this period in 68 different patients. The mean age of the patients was 9 years old, with 40 being male (58.82%) and 28 female (41.18%). The ordering specialties included infectious diseases (82.90%), hematology/oncology (9.21%), neurology (3.95%), pulmonology (2.63%), and dermatology (1.31%). The vast majority of the tests were ordered as inpatient (73 tests, 96.05%). 45 tests (59.21%) resulted as positive, of which 19 (42.22%) were polymicrobial. The tests were concordant with conventional microbiological studies 47 times (61.84%). Most tests (67 tests, 88.16%) had no significant clinical impact, 8 tests (10.53%) had a positive impact, and one test (1.31%) had an indeterminate impact. No tests were determined to have a negative clinical impact. Overall, our data is consistent with most studies which assessed the clinical utility of metagenomic next-generation sequencing of plasma microbial cell-free DNA in the literature, showing that testing did not have a significant impact on patient care for the majority of cases. There were some cases, however, in which testing showed a positive impact in escalating or de-escalating antibiotic therapy. In conclusion, despite being mostly a bystander, in selected cases and in the right clinical context, the test can be useful to guide antimicrobial treatment without causing significant harm. More studies are needed to further investigate the real utility of the test.

Estimating best nanomaterial for energy harvesting through reinforcement learning DQN coupled with fuzzy PROMETHEE under road-based conditions

Energy harvesters based on nanomaterials are getting more and more popular, but on their way to commercial availability, some crucial issues still need to be solved. The objective of the study is to select an appropriate nanomaterial. Using features of the Reinforcement Deep Q-Network (DQN) in conjunction with Fuzzy PROMETHEE, the proposed model, we present in this work a hybrid fuzzy approach to selecting appropriate materials for a vehicle-environmental-hazardous substance (EHS) combination that operates in roadways and under traffic conditions. The DQN is able to accumulate useful experience of operating in a dynamic traffic environment, accordingly selecting materials that deliver the highest energy output but at the same time bring consideration to factors such as durability, cost, and environmental impact. Fuzzy PROMETHEE allows the participation of human experts during the decision-making process, going beyond the quantitative data typically learned by DQN through the inclusion of qualitative preferences. Instead, this hybrid method unites the strength of individual approaches, as a result providing highly resistant and adjustable material selection to real EHS. The result of the study pointed out materials that can give high energy efficiency with reference to years of service, price, and environmental effects. The proposed model provides 95% accuracy with a computational efficiency of 300 s, and the application of hypothesis and practical testing on the chosen materials showed the high efficiency of the selected materials to harvest energy under fluctuating traffic conditions and proved the concept of a hybrid approach in True Vehicle Environmental High-risk Substance scenarios.

Design and development of an eHealth intervention to support self-management in people with musculoskeletal disorders: 'eHealth: it's TIME'.

This study aimed to co-design and develop a user-centred, theory-based eHealth-mediated self-management support follow-up prototype for adults with musculoskeletal disorders. A three-step system development cycle was employed. Step 1 involved creating intervention features and content, with two focus groups reviewing prioritised eHealth intervention elements based on earlier research. Step 2 involved heuristic testing using Nielsen's 10 heuristic principles. Step 3 incorporated qualitative think-aloud interviews and the System Usability Scale. Republic of Ireland. Step 1 included adults with musculoskeletal disorders (n = 12). Step 2 involved five reviewers. Step 3 included people with musculoskeletal disorders (n = 5) and musculoskeletal physiotherapists (n = 5). Participants in step 1 approved four main intervention components, which map to recognised theoretical frameworks, and suggested increased use of visual and interactive elements. Heuristic testing in step 2 identified design and navigation issues. In Step 3, usability testing, additional navigation, content and design recommendations were identified. The overall median system usability score (interquartile range) was 75 (0) out of 100 for adults with musculoskeletal disorders and 77.5 (2.5) out of 100 for musculoskeletal physiotherapists, indicating good usability. A theory-based, user-centred eHealth-mediated follow-up self-management support prototype has been developed for people with musculoskeletal disorders, with the next steps focusing on feasibility testing in clinical practice, with a more diverse population.

E-Module Innovation: A Product-Based Approach to Database Practicum

<span lang="EN-US">This research aims to develop a product-based e-module for database practice in the Software Engineering (RPL) program at SMK Negeri 1 Sintuk Toboh Gadang. The Research and Development (R&D) method using the 4D model (Define, Design, Develop, Disseminate) was employed, involving 23 students as subjects. The study resulted in a valid, practical, and effective e-module that aligns with curriculum demands and fosters students' creativity. Validation tests demonstrated high validity and reliability across content, presentation, and format aspects. Practicality tests yielded a Reproducibility Coefficient (Kr) of 0.98 and a Scalability Coefficient (Ks) of 0.95, confirming the e-module's usability. The effectiveness of the e-module was evidenced by significant improvements in student learning outcomes, with an N-Gain score of 0.73, indicating high effectiveness. The findings suggest that the product-based e-module is a valuable tool for enhancing practical learning in database subjects, promoting independent and creative learning among students</span>

A Versatile Shared-Aperture Antenna for Vehicle Communications

This communication introduces a versatile, multi-service, shared-aperture antenna system for multiple vehicle applications. The design comprises three antenna elements: a rotatable microstrip antenna for global positioning system (GPS) communication, a cross-dipole circularly polarized antenna for satellite communication in the S-band, and a pattern reconfigurable antenna for V2V (vehicle-to-vehicle) communication. These antennas collectively support GPS, satellite communication (Satcom), and V2V communication in a single, shared-aperture design. This shared-aperture antenna system offers cost savings and occupies less space compared to using separate antennas for each service. The microstrip antenna covers the 1575 MHz frequency band used for GPS communication. The cross-dipole circularly polarized antenna provides continuous wideband coverage for S-band satellite communication. The pattern reconfigurable antenna, tailored for the specific application scenario, covers the 5.9 GHz V2V working frequency band (5.855–5.925 GHz). Practical testing and simulation results confirm the effectiveness of this antenna system for the intended applications. In summary, the microstrip antenna has a bandwidth of 1.565–1.578 GHz and a realized gain of 7 dBi with radiation efficiency of 81%, the cross-dipole antenna has a bandwidth of 2.2–3.8 GHz (53.3%) and a realized gain of 8.3 dBi with radiation efficiency of 90%, and the pattern reconfigurable antenna has a 5.8–6 GHz bandwidth and a realized gain of 3.7 dBi with radiation efficiency of 85%, and the isolation between antennas with different frequencies is 25 dB, 20 dB, and 30 dB in three frequency bands.

A Development of English for Tourism Book Based on Tourism Places in Dompu to Improve Students’ Speaking Skills

The aim of this research is to develop a valid, practical, and effective book of English for Tourism based on tourism places in Dompu. This study is a R&D (Research and Development) approach using the 4D model (Define, Design, Develop, and Disseminate). The book that had been developed was implemented in the English learning process at the class XI of Tourism Vocational High School Dompu, Department of Travel and Tourism Business with a total of 27 students, in academic year 2024. The validity test results of the developed book obtained from media expert is 88% (very valid) and 92% (very valid) from material expert. Moreover, the practicality test result from students and teacher was at the level “practical” with average score 3,8 or 76%. Lastly, based on students’ speaking test result, the average total score obtained by 27 students is 77. On other word, 100% students or all 27 students obtained average scores more than or equal to 70. It means all students have successfully done the task with good scores. Based on that, the use of English for tourism book based on tourism places in Dompu is effective to improve students’ speaking skill. Another remarkable finding in this reseach is that both teacher and students strongly agree that the material in book is able to stimulate students to be active in the learning process.

The implementation of molecular tumor profiling in the practice of pediatric cancer pathology: The pathologists' experience.

The increased accessibility and utilization of molecular testing including next-generation sequencing (NGS) has impacted the practice of pediatric pathology, with diagnostic, prognostic, and therapeutic implications for our patients. This survey is the first to describe the utilization of molecular testing in the routine practice of pediatric pathology for the care of children with known or suspected solid tumors. The Society for Pediatric Pathology Practice Committee distributed a survey to our membership asking 25 questions about training, practice setting, molecular ordering practices, and barriers to testing. Seventy-five pathologists responded to the survey. The survey provides valuable insight into the current use of molecular testing for the care of children with known or suspected solid tumors. Most respondents reported that they are increasingly using a variety of molecular techniques, with increased use over time, and that NGS is useful. These results highlight a variety of barriers to molecular testing, including cost, insurance coverage, turnaround time, limitations of available assays (including limited coverage of pediatric-specific alterations), and difficulty in determining the most appropriate test to order. These data may be useful in supporting pediatric pathologists in their practice.

Sensitivity, Specificity, and Cost-Benefit Effect Between Primary Human Papillomavirus Testing, Primary Liquid-Based Cytology, and Co-Testing Algorithms for Cervical Lesions.

Cytology has long been a major screening method for cervical cancer prevention. Human papillomavirus (HPV) testing has recently been introduced for cervical cancer screening, and HPV tests become a major screening method in some countries. To seek the optimal strategy considering the cost-effectiveness for cervical cancer screening, we compared the performance of primary LBC, primary HPV test, and LBC plus HPV co-test in real practice. From March 2016 to June 2018, 3742 patients were included in this study. Liquid-based cytology (LBC), HPV test, and histopathological assessment were performed in 3727, 1063, and 508 cases, respectively. The sensitivity, specificity, and cost-benefit effects of primary HPV, primary LBC, and co-test algorithms were simulated for 317 cases with LBC, HPV, and histopathological results. On the LBC, 13.0% of the cases were diagnosed with atypical squamous cells of undetermined significance or higher grade lesions. In the HPV test, high-risk HPV was found in 43.5%, and 11.9% was positive for HPV type 16 or 18. Among the three simulated algorithms, the co-test demonstrated the best sensitivity (97.5%) and the lowest specificity (50.3%). The primary LBC demonstrated the best specificity (53.5%) and a slightly better sensitivity, compare with the primary HPV (95.1% vs. 93.8%). Using the primary LBC algorithm, 82.0% can be determined without additional HPV test, whereas 50.1% could be determined without additional LBC using the primary HPV algorithm. The primary LBC algorithm for uterine cervical cancer (UCC) screening is comparable to the primary HPV algorithm and has the best cost-benefit effect among the three algorithms.

Pharmacogenetics testing for poor response to antidepressants: a transnosographic case series.

Pharmacogenetics (PGx) holds promise for optimizing psychotropic medication use, with CYP2D6 and CYP2C19 identified as key genes in antidepressant treatment. However, few studies have explored the genetic variants of these genes in real-world settings for patients experiencing ineffectiveness or adverse drug reactions (ADRs) to antidepressants. This case series includes 40 patients who underwent PGx testing due to antidepressant ineffectiveness or ADRs between June 2020 and April 2022. We describe the patients' demographic, clinical, and genetic characteristics and assess the value of PGx testing based on feedback from their psychiatrists. The most common diagnoses were major depressive disorder (60.0%) and post-traumatic stress disorder (30.0%). Ineffectiveness was reported in 65.0% of patients, ADRs in 2.5%, and both in 32.5%. The antidepressants involved included SSRIs (45.0%), SNRIs (27.5%), atypical antidepressants (20.0%), and tricyclics (17.5%). Only 17.5% of patients had normal CYP2D6 and CYP2C19 metabolic activity. Actionable genetic variants were identified in 22.0% of CYP2D6/CYP2C19-antidepressant-response pairs. PGx recommendations were followed in 92.7% of cases, with significant improvement in ADRs reported in 71.4% of patients and efficacy improvement in 79.5%. Our findings suggest that PGx testing can guide prescribing decisions for patients with antidepressant ineffectiveness or ADRs. The relatively high prevalence of genetic variants affecting pharmacokinetics supports the broader adoption of PGx testing in psychiatric practice.

Unit Leadership and Climates for Evidence-Based Practice Implementation in Maternal-Infant Health Units: A Cross-Sectional Descriptive Study.

To describe unit leadership and climates for evidence-based practice implementation and test for differences in unit leader and staff nurses' perceptions within maternal-infant units. A cross-sectional descriptive study. A convenience sample of maternal-infant unit leaders and nurses (labour, postpartum, neonatal intensive care, paediatrics) from four Midwestern United States hospitals completed a survey including the Implementation Leadership Scale (ILS) and Implementation Climate Scale (ICS). Descriptive statistics described items, subscales and total scores. Independent t-tests with Bonferroni correction tested for differences in perceptions. A total of 470 nurses and 21 unit leaders responded, representing 17 units. Ratings of unit leadership and climates for implementation were modest at best [ICS: M = 2.17 (nurses), 2.41 (leaders); ILS: M = 2.4 (nurses), 2.98 (leaders)]. Unit leader ratings were statistically significant and higher than nurse ratings. This study is one of the first to describe unit leadership and climates for implementation in maternal-infant health. To improve outcomes and equity in maternal-infant health, attention on leadership behaviours and unit climates for evidence-based practice implementation is needed. Nurse leaders are encouraged to evaluate their leadership behaviours and the unit climates they facilitate, and work to improve areas of concern or where staff perceptions differ. Staff nurses should work with their leaders to identify resources and rewards/recognition which support and facilitate EBP implementation. This study addressed a gap in research examining the social dynamic factors of unit leadership and climate for evidence-based practice implementation in maternal-infant units. Leadership behaviours for implementation and unit climate were rated moderately by both staff and leaders. Unit leaders rated their implementation leadership and climates higher in almost all items. This study is relevant to unit leaders and nurses in maternal-infant units in the United States. This study adhered to STROBE guidelines. No patient or public contribution.

PENGEMBANGAN MEDIA PEMBELAJARAN KARTU PERTOLONGAN DAN TANTANGAN PADA MATA PELAJARAN PENDIDIKAN PANCASILA DI KELAS IV SDN 09 KOTO BARU

This study aims to develop a learning media in the form of help and challenge cards for the subject of Pancasila Education for fourth-grade students at SDN 09 Koto Baru. This media is designed using the 4-D model, which includes the stages of defining, designing, developing, and disseminating. The validity of the media was tested by three validators, including lecturers and education practitioners, with highly valid results in terms of graphics, content/material, and language. Practicality tests showed that this media is very practical, with a 100% positive response from teachers and students. The effectiveness of the media was tested through learning outcome tests, showing a completion rate of 89.47%, with 17 out of 19 students meeting the criteria. The results of this study indicate that the "PERTA" help and challenge card learning media is highly effective in increasing student motivation and learning outcomes in Pancasila Education.

Pengembangan Multimedia Interaktif Menggunakan Aplikasi Articulate Storyline pada Mata Pelajaran Informatika Kelas X SMA

Learning in the classroom, teachers have not optimized the use of media other than LKS, so students tend to be bored because they do not understand the material because the images are not clear in the LKS. This research aims to produce interactive multimedia that is valid and practical so that it can be used by teachers, especially in informatics subjects. This type of research is Research and Development (R&D) research, the development model used is the 4-D (Define, Design, Development, & Disseminate) development model. The subject of the study is class X students of SMA Pertiwi 1 Padang with a total of 20 students. In the research process, data collection by observation and using questionnaires. Data processing obtained from media validation, material validation and student practicality tests with assessment using a Likert scale questionnaire with a score range of 1 to 5. Validity Test, validation from material experts with an average score of 4.87 in the very valid category, validation results from media experts obtained an overall average of 4.85 in the very valid category. The results of the practicality test on students obtained an average score of 4.62 with the category of very practical. Based on these results, interactive multimedia using the Articulate Storyline application in the informatics subject class X of high school is very valid and practical to be used as a learning medium

Efektivitas Pemanfaatan Media Video Pembelajaran bagi Siswa Fase E Pada Mata Pelajara Informatika di SMAN 1 Matur

The learning process carried out by teachers does not utilize media that is in accordance with informatics materials, resulting in a lack of enthusiasm and interest for students. This study aims to determine the effectiveness of the use of learning video media for phase E students in the Informatics subject at SMAN 1 Matur. The type of research used is a quantitative approach with a quasi-experimental method. The research design used is a Nonequivalent Control Group with a design form that provides different treatment to each class. The sampling technique used in this study is purposive sampling. The data needed was obtained from the students' learning outcomes, written and practical tests. The data obtained were analyzed using a t-test which was previously carried out first a normality test and a homogeneity test

Integrating traditional and non-traditional model risk frameworks in credit scoring

Background: An improved understanding of the reasoning behind model decisions can enhance the use of machine learning (ML) models in credit scoring. Although ML models are widely regarded as highly accurate, the use of these models in settings that require explanation of model decisions has been limited because of the lack of transparency. Especially in the banking sector, model risk frameworks frequently require a significant level of model interpretability.Aim: The aim of the article is to evaluate traditional model risk frameworks to determine their appropriateness when validating ML models in credit scoring and enhance the use of ML models in regulated environments by introducing a ML interpretability technique in model validation frameworks.Setting: The research considers model risk frameworks and regulatory guidelines from various international institutions.Method: The research is qualitative in nature and shows how through integrating traditional and non-traditional model risk frameworks, the practitioner can leverage trusted techniques and extend traditional frameworks to address key principles such as transparency.Results: The article proposes a model risk framework that utilises Shapley values to improve the explainability of ML models in credit scoring. Practical validation tests are proposed to enable transparency of model input variables in the validation process of ML models.Conclusion: Our results show that one can formulate a comprehensive validation process by integrating traditional and non-traditional frameworks.Contribution: This study contributes to existing model risk literature by proposing a new model validation framework that utilises Shapley values to explain ML model predictions in credit scoring.

Pengembangan Multimedia Interaktif Berbasis TPACK pada Mata Pelajaran Informatika Kelas VII di SMP

The research aims to develop framework-based interactive multimedia on Techonogical Pedagogical Content Knowledge in informatics subjects at the junior high school level. The type of research used is the Research and Development (R&D) method with a development model (Analysis, Design, Development, Implementation, Evaluation). At the development stage, an analysis of needs in the field, storyboard design, media development using the articulate storyline application, and product trials were carried out to students. The instruments used in the study consist of observations, questionnaires, and learning outcome tests with the aim of determining the practicality and effectiveness of the products developed. The validation test data from the material aspect obtained a score of 4.00 with the criterion of "Strongly Agree". Meanwhile, in terms of media tested by two media validators, the average score from validator 1 was 3.85 with the "Valid" category and from media expert 2 was 4.74 with the "Very Valid" category. The results of the practicality test were obtained with a score of 4,210 in the category "Very Practical". The results of the effectiveness test obtained an average N-gain score of 71.24% which is included in the category of "Quite Effective". Based on the assessment that has been obtained, the TPACK-based interactive multimedia developed is very feasible and effective to be used in learning activities

Efficient Boolean-to-Arithmetic Mask Conversion in Hardware

Masking schemes are key in thwarting side-channel attacks due to their robust theoretical foundation. Transitioning from Boolean to arithmetic (B2A) masking is a necessary step in various cryptography schemes, including hash functions, ARX-based ciphers, and lattice-based cryptography. While there exists a significant body of research focusing on B2A software implementations, studies pertaining to hardware implementations are quite limited, with the majority dedicated solely to creating efficient Boolean masked adders. In this paper, we present first- and second-order secure hardware implementations to perform B2A mask conversion efficiently without using masked adder structures. We first introduce a first-order secure low-latency gadget that executes a B2A2k in a single cycle. Furthermore, we propose a second-order secure B2A2k gadget that has a latency of only 4 clock cycles. Both gadgets are independent of the input word size k. We then show how these new primitives lead to improved B2Aq hardware implementations that perform a B2A mask conversion of integers modulo an arbitrary number. Our results show that our new gadgets outperform comparable solutions by more than a magnitude in terms of resource requirements and are at least 3 times faster in terms of latency and throughput. All gadgets have been formally verified and proven secure in the glitch-robust PINI security model. We additionally confirm the security of our gadgets on an FPGA platform using practical TVLA tests.

Who is Doing Taxonomy, Whereabouts, and Who Is Funding Them? A Practical Test of What Knowledge Graphs Can Tell Us about Taxonomic Research

Who is Doing Taxonomy, Whereabouts, and Who Is Funding Them? A Practical Test of What Knowledge Graphs Can Tell Us about Taxonomic Research

Harnessing the potential of Type-II heterostructures: NiO/TiO2/ZnO fibers for enhanced photocatalytic and electrochemical performance in asymmetric supercapacitors

A novel two-step approach, electrospinning followed by wet chemical route, was used for the synthesis of NiO/TiO2/ZnO heterostructure fibers. Structural, morphological, and elemental analyses confirmed the single-phase formation with a unique, one-dimensional furry insect-like morphology, free of impurities. BET analysis revealed a significant increase in the specific surface area from 12.64 to 54.50 m2/g for NiO/TiO2/ZnO heterostructure fibers, indicating the existence of more active sites for catalytic and redox activities. Optical studies demonstrated a reduction in the band gap of NiO in the presence of TiO2 and ZnO, enhancing the photocatalytic properties. The Langmuir-Hinshelwood kinetic model was employed to measure the reaction rate constant, showing improved photocatalytic performance of NiO by enhancing the separation rate of photo-generated electrons and holes on its surface. Furthermore, the electrochemical performance of the prepared fibers-based asymmetric supercapacitors (ASCs) showed a low polarization, attributed to low charge transfer resistance. The NiO/TiO2/ZnO fibers-based ASCs exhibited higher specific capacitance (108 F/g), with a maximum specific energy density of 9.6 Wh/kg at a specific power density of 2000 W/kg indicating excellent performance suitable for finding potential uses in energy storage applications. Various practical and physical tests further certified the efficient performance of the prepared NiO/TiO2/ZnO heterostructure fibers-based asymmetric supercapacitors. The contribution of NiO and TiO2 to the inner surface were ∼52.02 and ∼47.08 %, respectively. In contrast, the NiO/TiO2/ZnO fibers showed a notable difference, with ZnO-NWs contributing ∼4.99 % to the overall surface. This increase in the inner surface contribution to around 95.01 % indicates that the growth of ZnO-NWs provides additional channels for electrochemical reactions during redox processes and enhances adhesion between the ZnO-NWs and NiO/TiO2 heterostructure, facilitating OH− ions transportation.

A-236 Rapid multiplexed PCR (polymerase chain reaction) tests for respiratory disease improve process and time to diagnosis versus laboratory-based molecular testing

Abstract Background The Infectious Disease Society of America recommends molecular testing for symptomatic patients suspected of having COVID-19. Molecular tests can be performed at the point of care or in a centralized laboratory, using different methodologies, and can be singleplex or multiplex. Limited data are available examining the use of these tests in clinical practice and impact of different test types on patient outcomes; however, common antiviral treatments for both COVID-19 and influenza are more effective when taken earlier and are not indicated for use more than 5 and 2 days after symptom onset, respectively. The aim of this study was to describe the diagnostic journey for non-inpatients who received molecular testing for respiratory pathogens in the laboratory versus those who received testing using a rapid, multiplexed real-time RT-PCR test that can be performed at the point of care. Methods De-identified administrative claims were analyzed from July 1, 2020 through September 30, 2022 for commercially insured and Medicare Advantage enrollees in the Optum Labs Data Warehouse. Patients with ≥1 medical claim for a non-inpatient visit with a procedure code for testing for SARS-CoV-2 were identified; patients who received antigen testing at index were excluded. Patients were followed for up to 90 days. Two patient groups were selected for the final study sample: 1) Patients with ≥1 claim with CPT code 0240U or 0241U with a point-of-care or laboratory place of service on the index date (proprietary laboratory analyses codes for Xpert® Xpress CoV-2/Flu/RSV, or “Xpert Xpress”); and 2) Patients with other laboratory-based molecular testing on the index date. Standardized difference of >0.10 or <-0.10 was considered a significant imbalance in proportions or means. Results In total, 51,602 patients received testing with Xpert Xpress while 317,192 received laboratory testing. Patients who were tested with Xpert Xpress were significantly older (mean 49.82 vs 42.19, SD 0.3), had a higher Charlson Comorbidity Index (mean 0.7 vs 0.35, SD 0.29), and were more likely to have a respiratory risk factor (6.09% vs 2.38%, SD 0.19). On average, patients who were tested with Xpert Xpress had significantly fewer tests for SARS-CoV-2 on the index date (mean 1.2 vs 1.58, SD -0.55), and fewer tests for SARS-CoV-2, influenza, or RSV on the index date and through the end of the 90-day fixed follow-up period (mean 1.64 vs 2.57, SD -0.45). They were also significantly more likely to be diagnosed with COVID-19 on the index date (23.31% vs 16.53%, SD 0.17). Among patients with a diagnosis for COVID-19, mean time to diagnosis was significantly shorter among patients tested with Xpert Xpress (4.85 vs 8.86 days, SD -0.27; median 0 vs 4 days). This finding was also consistent for influenza (4.05 vs 20.28 days, SD -0.74; median 0 vs 5 days). Conclusions Testing with Xpert Xpress at index resulted in fewer total tests and faster diagnosis compared to testing in the laboratory. Rapid, multiplex PCR testing provides a faster time to diagnosis and may support more appropriate and effective treatment.

The Effect of Contextual Interference on the Acquisition and Learning of Motor Skill with an Emphasis on Cognitive Flexibility

Background: The effect of contextual interference (CI) on motor skill learning may be influenced by various factors, such as cognitive abilities. Objectives: The purpose of the current research was to investigate the effect of CI on the acquisition and learning of soccer skills, with an emphasis on the role of cognitive flexibility (CF). Methods: Eighty students, aged 9 - 12 years, were randomly selected and administered the Wisconsin Card Sorting Test. From this group, 60 students who scored the highest and lowest points were selected as the final subjects. After completing the pre-test on Moore-Christine's pass, shoot, and dribble skills, the subjects were divided into four groups of 15 participants each (high CF with Random Practice (RP) and Blocked Practice (BP), low CF with RP and BP). The subjects then engaged in practice sessions according to their assigned protocols for three sessions, with each session consisting of three blocks of 12 trials across all three skills—passing, shooting, and dribbling. Following the practice, acquisition, immediate retention, delayed retention, and transfer tests were conducted. Results: The results showed that practice in all four groups had significant beneficial effects on the acquisition and learning of skills. Additionally, the high CF with RP group demonstrated better performance in all skills compared to the other groups. Conclusions: Therefore, it can be concluded that RP may be more beneficial for individuals with higher CF. Teachers and educators should consider this when teaching sports skills.