In an event related potential (ERP) experiment using written language materials only, we investigated a potential modulation of the N400 by the modality switch effect. The modality switch effect occurs when a first sentence, describing a fact grounded in one modality, is followed by a second sentence describing a second fact grounded in a different modality. For example, "A cellar is dark" (visual), was preceded by either another visual property "Ham is pink" or by a tactile property "A mitten is soft." We also investigated whether the modality switch effect occurs for false sentences ("A cellar is light"). We found that, for true sentences, the ERP at the critical word "dark" elicited a significantly greater frontal, early N400-like effect (270-370 ms) when there was a modality mismatch than when there was a modality-match. This pattern was not found for the critical word "light" in false sentences. Results similar to the frontal negativity were obtained in a late time window (500-700 ms). The obtained ERP effect is similar to one previously obtained for pictures. We conclude that in this paradigm we obtained fast access to conceptual properties for modality-matched pairs, which leads to embodiment effects similar to those previously obtained with pictorial stimuli.
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Background: Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.Methods: In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.Results: Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.Conclusion: Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.
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Chest physical therapy (CPT) is a widely used intervention for patients with airway diseases. The main goal is to facilitate secretion transport and thereby decrease secretion retention in the airways. Historically, conventional CPT has consisted of a combination of forced expirations (directed cough or huff), postural drainage, percussion, and/or shaking. CPT improves mucus transport, but it is not entirely clear which groups of patients benefit from which CPT modalities. In general, the patients who benefit most from CPT are those with airways disease and objective signs of secretion retention (eg, persistent rhonchi or decreased breath sounds) or subjective signs of difficulty expectorating sputum, and with progression of disease that might be due to secretion retention (eg, recurrent exacerbations, infections, or a fast decline in pulmonary function). The most effective and important part of conventional CPT is directed cough. The other components of conventional CPT add little if any benefit and should not be used routinely. Alternative airway clearance modalities (eg, high-frequency chest wall compression, vibratory positive expiratory pressure, and exercise) are not proven to be more effective than conventional CPT and usually add little benefit to conventional CPT. Only if cough and huff are insufficiently effective should other CPT modalities be considered. The choice between the CPT alternatives mainly depends on patient preference and the individual patient's response to treatment.
MULTIFILE
Fontys University of Applied Science’s Institute of Engineering, and the Dutch Institute for Fundamental Energy Research (DIFFER) are proposing to set up a professorship to develop novel sensors for fusion reactors. Sensors are a critical component to control and optimise the unstable plasma of Tokamak reactors. However, sensor systems are particularly challenging in fusion-plasma facing components, such as the divertor. The extreme conditions make it impossible to directly incorporate sensors. Furthermore, in advanced reactor concepts, such as DEMO, access to the plasma via ports will be extremely limited. Therefore, indirect or non-contact sensing modalities must be employed. The research group Distributed Sensor Systems (DSS) will develop microwave sensor systems for characterising the plasma in a tokamak’s divertor. DSS will take advantage of recent rapid developments in high frequency integrated circuits, found, for instance, in automotive radar systems, to develop digital reflectometers. Access through the divertor wall will be achieved via surface waveguide structures. The waveguide will be printed using 3D tungsten printing that has improved precision, and reduced roughness. These components will be tested for durability at DIFFER facilities. The performance of the microwave reflectometer, including waveguides, will be tested by using it to analyse the geometry and dynamics of the Magnum PSI plasma beam. The development of sensor-based systems is an important aspect in the integrated research and education program in Electrical Engineering, where DSS is based. The sensing requirements from DIFFER offers an interesting and highly relevant research theme to DSS and exciting projects for engineering students. Hence, this collaboration will strengthen both institutes and the educational offerings at the institute of engineering. Furthermore millimeter wave (mmWave) sensors have a wide range of potential applications, from plasma characterisation (as in this proposal) though to waste separation. Our research will be a step towards realising these broader application areas.
The demand for mobile agents in industrial environments to perform various tasks is growing tremendously in recent years. However, changing environments, security considerations and robustness against failure are major persistent challenges autonomous agents have to face when operating alongside other mobile agents. Currently, such problems remain largely unsolved. Collaborative multi-platform Cyber- Physical-Systems (CPSs) in which different agents flexibly contribute with their relative equipment and capabilities forming a symbiotic network solving multiple objectives simultaneously are highly desirable. Our proposed SMART-AGENTS platform will enable flexibility and modularity providing multi-objective solutions, demonstrated in two industrial domains: logistics (cycle-counting in warehouses) and agriculture (pest and disease identification in greenhouses). Aerial vehicles are limited in their computational power due to weight limitations but offer large mobility to provide access to otherwise unreachable places and an “eagle eye” to inform about terrain, obstacles by taking pictures and videos. Specialized autonomous agents carrying optical sensors will enable disease classification and product recognition improving green- and warehouse productivity. Newly developed micro-electromechanical systems (MEMS) sensor arrays will create 3D flow-based images of surroundings even in dark and hazy conditions contributing to the multi-sensor system, including cameras, wireless signatures and magnetic field information shared among the symbiotic fleet. Integration of mobile systems, such as smart phones, which are not explicitly controlled, will provide valuable information about human as well as equipment movement in the environment by generating data from relative positioning sensors, such as wireless and magnetic signatures. Newly developed algorithms will enable robust autonomous navigation and control of the fleet in dynamic environments incorporating the multi-sensor data generated by the variety of mobile actors. The proposed SMART-AGENTS platform will use real-time 5G communication and edge computing providing new organizational structures to cope with scalability and integration of multiple devices/agents. It will enable a symbiosis of the complementary CPSs using a combination of equipment yielding efficiency and versatility of operation.
