413 research outputs found

    Mobilise-D insights to estimate real-world walking speed in multiple conditions with a wearable device

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    This study aimed to validate a wearable device’s walking speed estimation pipeline, considering complexity, speed, and walking bout duration. The goal was to provide recommendations on the use of wearable devices for real-world mobility analysis. Participants with Parkinson’s Disease, Multiple Sclerosis, Proximal Femoral Fracture, Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and healthy older adults (n = 97) were monitored in the laboratory and the real-world (2.5 h), using a lower back wearable device. Two walking speed estimation pipelines were validated across 4408/1298 (2.5 h/laboratory) detected walking bouts, compared to 4620/1365 bouts detected by a multi-sensor reference system. In the laboratory, the mean absolute error (MAE) and mean relative error (MRE) for walking speed estimation ranged from 0.06 to 0.12 m/s and − 2.1 to 14.4%, with ICCs (Intraclass correlation coefficients) between good (0.79) and excellent (0.91). Real-world MAE ranged from 0.09 to 0.13, MARE from 1.3 to 22.7%, with ICCs indicating moderate (0.57) to good (0.88) agreement. Lower errors were observed for cohorts without major gait impairments, less complex tasks, and longer walking bouts. The analytical pipelines demonstrated moderate to good accuracy in estimating walking speed. Accuracy depended on confounding factors, emphasizing the need for robust technical validation before clinical application. Trial registration: ISRCTN – 12246987

    Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete:Practice Guidelines Based on International Delphi Consensus

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    Background:There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation.Purpose:To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel.Study Design:Consensus statement.Methods:A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members.Results:Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria.Conclusion:Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity

    Sports injury prevention programmes from the sports physical therapist's perspective:An international expert Delphi approach

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    Objective To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports. Design Delphi. Setting LimeSurvey platform. Participants Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries. Main outcome measures Factors related to sports IPP planning, organization and implementation. Results We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement). Conclusion Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist

    A novel tomographic characterisation approach for sag and dross defects in metal additively manufactured channels

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    Channels and bores in metal components produced by laser powder bed fusion (LPBF) are internal features that are typically affected by defects such as dross and sag formation, dimensional errors and global deformations in different proportions. Such deviations from the ideal geometry may strongly limit the functionality of the channels, but are difficult to prevent, due to complex multi-physical production aspects. Different destructive and non-destructive approaches are available to investigate the geometry of the internal features and possibly correlate their results to the LPBF process parameters; however, such approaches do not offer a systematic method to derive key characteristics of the main contributors for channel deviations. Hence, this work proposes a novel tomographic non-destructive analysis of LPBF channels and bores, focusing on the derivation of sag and dross key parameters. The methodology works on polar-transformed profiles obtained from image stacks which are extracted perpendicularly to the channel axis from the X-ray computed tomography (CT) reconstructed volume. The method allows for the clear determination of surface characteristics and includes the quantitative evaluation of descriptors through an algorithm specifically developed for the purpose. In particular, general form deviations are addressed by fitting sinusoidals on the unwrapped mean surface profile, to tackle deviations induced by thermal residual stresses. Proposed descriptors of sag and dross are the onset angle of protrusions, separation criteria between sag and dross effects, and the peak analysis of the mean profile after approximation with a least squares spline. The developed algorithm is tested in the case study of a LPBF AlSi7Mg0.6 benchmark part comprising hollow cylinders and inter-connecting frusta with different diameters. The resulting evaluation of the benchmark part also corroborates how the proposed methodology can help to obtain more precise information regarding the correlation of LPBF fabrication conditions and obtained channels geometrical deviations. Furthermore, the results show possible routes to enable an a-priori compensation of the nominal channel design for first-time right LPBF manufacturing

    Increased in vitro Anti‐HIV Activity of Caffeinium‐Functionalized Polyoxometalates

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    Polyoxometalates (POMs), molecular metal oxide anions, are inorganic clusters with promising antiviral activity. Herein we report increased anti‐HIV‐1 activity of a POM when electrostatically combined with organic counter‐cations. To this end, Keggin‐type cerium tungstate POMs have been combined with organic methyl‐caffeinium (Caf) cations, and their cytotoxicity, antiviral activity and mode of action have been studied. The novel compound, Caf(4)K[ÎČ(2)‐CeSiW(11)O(39)]×H(2)O, exhibits sub‐nanomolar antiviral activity and inhibits HIV‐1 infectivity by acting on an early step of the viral infection cycle. This work demonstrates that combination of POM anions and organic bioactive cations can be a powerful new strategy to increase antiviral activity of these inorganic compounds

    PLoS One

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    Introduction The long-term prognosis of HIV-2-infected patients receiving antiretroviral therapy (ART) is still challenging, due to the intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and the suboptimal response to some protease inhibitors (PI). The objective was to describe the 5-years outcomes among HIV-2 patients harboring drug-resistant viruses. Methods A clinic-based cohort of HIV-2-patients experiencing virologic failure, with at least one drug resistance mutation was followed from January 2012 to August 2017 in Cîte d’Ivoire. Follow-up data included death, lost to follow-up (LTFU), immuno-virological responses. The Kaplan-Meier curve was used to estimate survival rates. Results A total of 31 HIV-2 patients with virologic failure and with at least one drug resistance mutation were included. Two-third of them were men, 28(90.3%) were on PI-based ART-regimen at enrolment and the median age was 50 years (IQR = 46–54). The median baseline CD4 count and viral load were 456 cells/mm3 and 3.7 log10 c/mL respectively, and the participants have been followed-up in median 57 months (IQR = 24–60). During this period, 21 (67.7%) patients switched at least one antiretroviral drug, including two (6.5%) and three (9.7%) who switched to a PI-based and an integrase inhibitor-based regimen respectively. A total of 10(32.3%) patients died and 4(12.9%) were LTFU. The 36 and 60-months survival rates were 68.5% and 64.9%, respectively. Among the 17 patients remaining in care, six(35.3%) had an undetectable viral load (2. Conclusions The 36-months survival rate among ART-experienced HIV-2 patients with drug-resistant viruses is below 70%,lower than in HIV-1. There is urgent need to improve access to second-line ART for patients living with HIV-2 in West Afric

    Improving the manufacturability of metal AM parts

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    Numerous challenges of additive manufacturing (AM) are tackled in the European Horizon 2020 project PAM^2 by studying and linking every step of the AM process cycle. For example, PAM^2 researchers from the design, processing and application side have collaborated in this work to optimise the manufacturability of metal AM parts using an improved Topology Optimisation (TO) approach, including a thermal constraint. Additionally, the project is focusing on modelling, post-processing, in- and post-process quality control and industrial assessment of AM parts, with the aim of moving beyond the state-of-the-art of precision metal AM

    A mold insert case study on topology optimized design for additive manufacturing

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    The Additive Manufacturing (AM) of injection molding inserts has gained popularity during recent years primarily due to the reduced design-to-production time and form freedom offered by AM. In this paper, Topology Optimization (TO) is performed on a metallic mold insert which is to be produced by the Laser Powder Bed Fusion (LPBF) technique. First, a commercially available TO software is used, to minimize the mass of the component while ensuring adequate mechanical response under a prescribed loading condition. The commercial TO tool adopts geometry-based AM constraints and achieves a mass reduction of ~50 %. Furthermore, an in-house TO method has been developed which integrates a simplified AM process model within the standard TO algorithm for addressing the issue of local overheating during manufacturing. The two topology optimized designs are briefly compared, and the advantages of implementing manufacturing constraints into the TO algorithm are discussed.IntroductionStructural Optimization and Mechanic