Vertical Axis Research Articles

Inter-individual variability in elliptical and diagonal error distributions potentially relevant to optimal motor planning in football instep kicking

The distribution of motor errors can influence optimal motor planning (where to aim). In football instep kicking, it was shown that ball landing locations exhibit the right-up-left-down elliptical distribution in right-footed kickers and vice versa. However, this was reported as a result of mixed multiple kickers; the individual-level error distribution has been unclear. Here we show substantial inter-individual variability in error shape and error direction in the 30 kicks aimed at a target (1.7 m high, 11.0 m in front) by 27 male football players. All players exhibit right-up-left-down distributions with ellipticity (minor/major radius ratio of the 95% confidence ellipse) ranging from 0.25 to 0.77 and major axis angle ranging from 13 to 67° from the horizontal axis. The mean absolute error and the area of the 95% confidence ellipse are not significantly correlated with major axis angle (ρ ≤ 0.312) and ellipticity (|r| ≤ 0.343). By simulating shots aimed at the top-right and top-left edges of a goal with these observed ranges and normalised ellipse area, we reveal a wide range of probability of shots on goal (top-right: 2.7-fold difference, top-left: 1.5-fold difference) due to inter-individual variability in error shape and direction independent of error size. Further simulation shows that, depending on the shape-direction combination, the aiming points with the same 80% probability of shots on goal change by up to 0.3 m vertically, even for the same minimal error size. We highlight the importance for football players to consider not only accuracy/precision, but also error shape and direction to optimise motor planning.

Variable designs of vertical axis wind turbines—a review

Variable designs of vertical axis wind turbines—a review

A novel approach to improve double-tube thermal energy storage: Impacts of inner tube twisting and its location

Thermal energy storage (TES) systems are a crucial component of solar energy harvesting cycles. Our objective in this study is to enhance the efficiency of a double-tube TES that utilizes lauric acid, a phase change material (PCM), and heated water as a heat transfer fluid (HTF). For the first time, this study examined the effects of utilizing a twisted inner tube inside a double-tube TES containing HTF. The finite volume method based on the enthalpy porosity model was used to investigate the effects of three different cross-sectional aspect ratios (AR = 0.5, 0.75, and 1) of the inner tube, at three different normalized locations along the vertical axis (Y = 0, −0.2, and − 0.4). The results were evaluated based on liquid fraction, temperature, velocity, total melting time, and average Nusselt number. The obtained results revealed that the AR effect of the inner tube varies depending on its location along the Y-axis. It is established that placing the tube at lower Y values in cases where a helical tube is present will yield significantly better results than higher Y values. Finally, the best case with the lowest total melting time occurred when the inner tube was located at Y = -0.4 and AR = 0.5. This case resulted in a total melting time decrease of up to 63 % compared to the reference case (AR = 1 at Y = 0).

Optimization of Joint Space Trajectories for Assistive Lower Limb Exoskeleton Robots: Real-Time and Flexible Gait Patterns

This research focuses on designing a real-time, flexible gait planner for lower limb exoskeleton robots to assist patients with lower limb disabilities. Given the dynamic nature of gait parameters, which vary according to ground conditions and user intent, the challenge lies in developing a gait planner capable of adapting to these changes in real-time. To avoid planning complications in the cartesian space and to comply with the speed constraints of joint motors, this paper proposes planning in joint space. Furthermore, the approach also considers the maximum speed capabilities of the joint motors, aiming to generate an executable gait pattern and simultaneously enhance the robot’s walking speed by determining the minimum time required for implementation. The introduced gait planner optimizes joint trajectories for minimal angular acceleration. To provide flexibility, generalized boundary conditions suitable for different scenarios are defined. The effectiveness of the proposed planner is validated through comprehensive performance analysis, simulations, and successful implementation trials on the Exoped® robot in various scenarios.

Significance of 3D rectangular closed domain filled with charged particles and nanoparticles engaging finite element methodology

Abstract This article aims to use passive flow control to analyze the transportation of heat, mass, and charged particles toward a 3D plate. The current problem offers a novel exploration of the flexible domain of non-Newtonian materials, which are well known for their wide range of applications in the engineering and industrial domains. The current study explores the complex dynamics of heat and mass transfer in a fluid that flows over an elongating sheet. The motion of the nanofluid on the surface is caused by the stretching of the 3D plate. The suspension of mixtures of tetra-hybrid nanoparticles can enhance thermal performance and cooling mechanism. Moreover, the 3D model includes modeling of multiple important parameters, such as heat source, thermal radiation, and Hall and Ion slip effects, in Cartesian coordinates for a three-dimensional stretched plate. This comprehensive analysis of various effects offers a new perspective to the field. Partial differential equations represent the emergent phenomena in the problem formulation process. It was estimated that an enhancement of charged particles and motion regarding nanoparticles is enhanced versus an enhancement of charged particles. With the greater power law index, suction, and Weissenberg number, the acceleration of nanoparticles is enhanced.

Use of the kickstand rod improves coronal alignment and maintains correction compared to control at 2year follow-up.

To assess and compare coronal alignment correction at 2year follow-up in adult spinal deformity (ASD) patients treated with and without the kickstand rod (KSR) construct. ASD patients who underwent posterior spinal fusion at a single-center with a preoperative coronal vertical axis (CVA) ≥ 3cm and a minimum of 2year clinical and radiographic follow-up were identified. Patients were divided into two groups: those treated with a KSR and those who were not. Patients were propensity score-matched (PSM) controlling for preoperative CVA and instrumented levels to limit potential biases that my influence the magnitude of coronal correction. One hundred sixteen patients were identified (KSR = 42, Control = 74). There were no statistically significant differences in patient characteristics (p > 0.05). At baseline, the control group presented with a greater LS curve (29.0 ± 19.6 vs. 21.5 ± 10.8, p = 0.0191) while the KSR group presented with a greater CVA (6.3 ± 3.6 vs. 4.5 ± 1.8, p = 0.0036). After 40 PSM pairs were generated, there were no statistically significant differences in baseline patient and radiographic characteristics. Within the matched cohorts, the KSR group demonstrated greater CVA correction at 1year (4.7 ± 2.4cm vs. 2.9 ± 2.2cm, p = 0.0012) and 2year follow-up (4.7 ± 2.6cm vs. 3.1 ± 2.6cm, p = 0.0020) resulting in less coronal malalignment one (1.5 ± 1.3cm vs. 2.4 ± 1.6cm, p = 0.0056) and 2year follow-up (1.6 ± 1.0 vs. 2.5 ± 1.5cm, p = 0.0110). No statistically significant differences in PROMs, asymptomatic mechanical complications, reoperations for non-mechanical complications were observed at 2year follow-up. However, the KSR group experienced a lesser rate of mechanical complications requiring reoperations (7.1% vs. 24.3%. OR = 0.15 [0.03-0.72], p = 0.0174). Patients treated with a KSR had a greater amount of coronal realignment at the 2year follow-up time period and reported less mechanical complications requiring reoperation. However, 2year patient-reported outcomes were similar between the two groups.

Data-driven quantum chemical property prediction leveraging 3D conformations with Uni-Mol+

Quantum chemical (QC) property prediction is crucial for computational materials and drug design, but relies on expensive electronic structure calculations like density functional theory (DFT). Recent deep learning methods accelerate this process using 1D SMILES or 2D graphs as inputs but struggle to achieve high accuracy as most QC properties depend on refined 3D molecular equilibrium conformations. We introduce Uni-Mol+, a deep learning approach that leverages 3D conformations for accurate QC property prediction. Uni-Mol+ first generates a raw 3D conformation using RDKit then iteratively refines it towards DFT equilibrium conformation using neural networks, which is finally used to predict the QC properties. To effectively learn this conformation update process, we introduce a two-track Transformer model backbone and a novel training approach. Our benchmarking results demonstrate that the proposed Uni-Mol+ significantly improves the accuracy of QC property prediction in various datasets.

The impact of standard Wiener process on the optical solutions of the stochastic nonlinear Kodama equation using two different methods

The stochastic nonlinear Kodama (SNLK) equation forced in the Stratonovich sense by multiplicative noise is considered here. New elliptic, hyperbolic, trigonometric, and rational stochastic solutions are acquired using ( G′/ G)-expansion method and mapping method. Because the SNLK equation is extensively used in is extensively used in nonlinear optics, fluid dynamics, and plasma physics, the obtained solutions may be used to study a broad range of relevant physical phenomena. In order to interpret the effects of multiplicative noise, the dynamic performances of the various obtained solutions are displayed utilizing 3D and 2D graphs. We infer that multiplicative noise impacts and stabilizes the solutions of SNLK equation.

Three-Dimensional Morphometric Analysis of the Volar Cortical Shape of the Lunate Facet of the Distal Radius.

In cases of distal radius fractures, the fixation of the volar lunate facet fragment is crucial for preventing volar subluxation of the carpal bones. This study aims to clarify the sex differences in the volar morphology of the lunate facet of the distal radius and its relationship with the transverse diameter of the distal radius. Sixty-four CT scans of healthy wrists (30 males and 34 females) were evaluated. Three-dimensional (3D) images of the distal radius were reconstructed from the CT data. We defined reference point 1 as the starting point of the inclination toward the distal volar edge, reference point 2 as the volar edge of the joint on the bone axis, and reference point 3 as the volar edge of the distal radius lunate facet. From the 3D coordinates of reference points 1 to 3, the bone axis distance, volar-dorsal distance, radial-ulnar distance, 3D straight-line distance, and inclination angle were measured. The transverse diameter of the radius was measured, and its correlations with the parameters were evaluated. It was found that in males, compared to females, the transverse diameter of the radius is larger and the protrusion of the volar lunate facet is greater. This suggests that the inclination of the volar surface is steeper in males and that the volar locking plate may not fit properly with the volar cortical bone of the lunate facet, necessitating additional fixation.

Novel multi-degree-of-freedom force–displacement mixed control framework for low loading rate substructure hybrid testing

In substructure hybrid tests, imposing realistic multi-degree-of-freedom (MDOF) displacement and force boundary conditions on a specimen involves controlling several actuators to emulate the MDOF boundary conditions of the experimental substructure. This setup presents significant challenges for decoupling control in MDOF systems. Due to the typically high stiffness of the specimen in the axial direction, force control is preferred over displacement control, which has limited accuracy in this direction. Typically, force control in the axial direction is combined with simultaneous displacement control in the softer direction, forming an MDOF force-displacement mixed control scheme. This scheme transforms force control into displacement control in the inner loop in the axial direction to ensure safe loading. The scheme involves addressing two major challenges: the nonlinear force–displacement transformation and the nonlinear coordinate transformation from the local actuator space (LAS) to the global Cartesian coordinate (GCC) system. To address these challenges, the Modified Newton–Raphson iteration integrated with proportional integral plus feed-forward (MNR-PIFF) and incremental kinematic transformation integrated with proportional integral plus feed-forward (IKT-PIFF) methods are proposed. Based on these methods, a novel MDOF force–displacement mixed control (NMFDC) framework is developed for substructure hybrid testing. A 6-DOF cyclic test simulation using the NMFDC framework was conducted to demonstrate its superiority. Furthermore, a 6-DOF cyclic test and substructure hybrid test at low loading rates were performed to validate the NMFDC framework because of the loading equipment limit. Experimental results and numerical simulations indicate that the NMFDC framework achieves swifter response with lower error levels. For applications in fast and real-time hybrid testing, dynamic loading equipment need to be used, the PIFF controller in the NMFDC framework should be replaced by adaptive time delay compensation in future developments.

A novel phase measuring deflectometry based on polar coordinate

Phase measuring deflectometry (PMD) is a method measure the surface of a mirror. However, when measuring convex mirrors, Cartesian coordinate fringes experience extreme compression. To address this issue, this paper proposes a novel PMD based on polar coordinate. This new method defines two linearly independent phase modulation directions, using the orthogonal basis of polar coordinate. It establishes polar coordinate fringes with rotational symmetry and radial pre-modulation, effectively reducing the impact of extreme compression at the edges. To correct the phase errors in polar coordinate fringes, a phase error compensation algorithm based on greyscale gradient is introduced. The algorithm calculates the influence factor of the eight connected domains around the error points to be compensated, utilising the phase grey gradient. The wavefront gradient data obtained through polar coordinate fringes are radial and tangential. Hence, a surface reconstruction method is proposed based on the Zernike partial derivative polynomial based on polar coordinate. In this method, the tangential partial derivatives and radial partial derivatives of the first 36 terms of Zernike in polar coordinate to construct Gram matrix equations. As a result, linearly independent Zernike recovery coefficients are obtained from coupled aliasing gradient data. Compared to the Cartesian coordinate system, the proposed method significantly reduces the fitting coefficient errors. Experimental measurements of convex mirrors with radii of curvature of 200 mm and 100 mm were conducted. The results demonstrate that compared to traditional PMD, this technique not only effectively suppresses extreme compression and increases the measurement area but also improves measurement accuracy by six times.

Brushy C-Decorated BiTe-Based Thermoelectric Film for Efficient Photodetection and Photoimaging.

Current strategies for simultaneously achieving high thermoelectric performance and high light absorption efficiency still suffer from complex steps and high costs. Herein, two kinds of amorphous thermoelectric films of n-type Bi2Te3 and p-type Bi0.5Sb1.5Te3 with high Seebeck coefficients were prepared by pulsed laser deposition (PLD) technology. In addition, C-decorated films with excellent light absorption efficiency at the junction of the thermoelectric legs were prepared by simple drop coating and reactive ion etching (RIE) method. The TE/C-RIE composite device exhibits excellent photodetection performance under the conditions of simulated natural light, monochromatic light, and high-frequency chopping. The maximum responsivity and specific detectivity of the device can reach 153.58 mV W-1 and 6.97 × 106 cm Hz1/2 W-1 (under simulated natural light), respectively. This represents an improvement rate of 85.91% compared to that of the pure TE device. Benefiting from the excellent photodetection efficiency of the device and integration advantage of PLD technology, the composite structure can be expanded into integrated photoimaging devices. The accurate identification of patterned light sources with letters (T, J, and U) and digitals (0-9) was successfully realized by associating the response electrical signals of each electrode with the position coordinates. This work provides valuable guidance for the design and fabrication of wide-spectrum photodetectors and complex optical imaging devices.

Fundamental Invariant Neural Network (FI-NN) Potential Energy Surface for the OH + CH3OH Reaction with Analytical Forces.

The hydrogen abstraction reaction of OH + CH3OH plays a great role in combustion and atmospheric and interstellar chemistry and has been extensively studied theoretically and experimentally. Theoretically, the numerical gradients with respect to the Cartesian coordinates of atoms in molecular simulations on our recent potential energy surface (PES) for the title reaction trained using the permutationally invariant polynomial neural network (PIP-NN) approach hinder the extensive calculation because of the unaffordable computation cost. To address this issue, we in this work report a new full-dimensional accurate analytical PES for the title reaction using the fundamental invariant neural network (FI-NN) approach based on 140,192 points of the quality UCCSD(T)-F12a/AVTZ. Besides, the spin-orbit (SO) corrections of OH in the entrance channel were determined at the level of complete active space self-consistent field with the AVTZ basis set. As a compromise between computational cost and efficiency, the Δ-machine learning approach was employed to construct the SO-corrected PES. Based on this new FI-NN PES with analytical forces, thermal rate coefficients and various dynamic properties, including the integral cross sections, the differential cross sections, and the product energy partitioning, were determined by running a total of 5.5 million trajectories. The use of analytical gradients of the FI-NN PES accelerated simulations and about 99% of computation cost was saved, compared to that for the PIP-NN PES with numerical gradients. Such a significant acceleration is achieved mainly by replacing PIPs with FIs.

Robotic versus Mini-Laparoscopic Colposacropexy to Treat Pelvic Organ Prolapse: A Retrospective Observational Cohort Study and a Medicolegal Perspective.

Background: POP (pelvic organ prolapse) involves the descent of one or more pelvic organs downwards with or without protrusion from the vaginal opening, caused by the relaxation and weakening of ligaments, connective tissue, and pelvic muscles. Such an outcome negatively impacts the quality of life. The gold standard procedure for repairing apical compartment prolapse is colposacropexy (CS) to secure the anterior and posterior walls of the vagina to the anterior longitudinal sacral ligament, located anteriorly to the sacral promontory, using a mesh. Several surgical approaches are feasible. Laparotomic or minimally invasive methods, including laparoscopic or robotic ones, can restore the horizontal axis of the vagina and typically involve concomitant hysterectomy. Methods: This study is based on 80 patients who underwent CS at Palermo's Ospedali Riuniti Villa Sofia-Cervello from 2019 to 2023. Women aged 35-85 at the time of surgery were divided into two groups: 40 patients underwent mini-laparoscopic surgery, and 40 patients underwent robotic surgery. The following parameters were accounted for: demographic data (initials of name and surname, age), preoperative clinical diagnosis, date of surgery, surgical procedure performed, estimated intraoperative blood loss, duration of surgical intervention, length of hospital stay, postoperative pain assessed at 24 h using the VAS scale, and any complications occurring in the postoperative period. Mini-laparoscopic CS (Minilap) and robotic CS (Rob) were then compared in terms of outcomes. Results: In the Minilap group, 11 patients out of 40 had a preoperative diagnosis of vaginal vault prolapse. The average age in this group was 61.6. Five of these patients had isolated cystocele, while the rest presented vaginal stump prolapse linked to cystocele, rectocele, or both. The remaining 29 patients in the Minilap group had a preoperative diagnosis of uterovaginal prolapse, also associated with cystocele, rectocele, or both, or isolated in nine cases. In the Rob group (average age: 60.1), 13 patients were diagnosed with vaginal prolapse (isolated or associated with cystocele), while the remaining 27 had a diagnosis of uterovaginal prolapse. In the Minilap group, the average procedure duration was 123.3 min, shorter than the Rob group (160.1 min). Conclusions: The data collected throughout this prospective study point to the mini-laparoscopic approach as being preferable over the robotic one in terms of surgical procedure length, intraoperative blood loss, postoperative pain, and aesthetic outcome. Hospital stay duration and post operative complication rates were similar for both groups. The innovative and ever-progressing nature of such procedures calls for novel standards prioritizing patient care as well as medicolegal viability.

Stereo-Photogrammetry for Impression of Full-Arch Fixed Dental Prosthesis—An Update of the Reviews

Photogrammetry (PG) appeared as an alternative for multiple implant impressions. Stereo-photogrammetry is a more sophisticated alternative to PG, which estimates the 3D coordinates of the points of an object, making the process quicker and more precise. A search in PubMed MEDLINE, PMC, and Google Scholar was conducted to find systematic reviews published in the last 10 years. The PICdental® camera (IDITEC NORTH WEST, SL; Torrelodones, Spain) is a stereocamera that records implant positions in the mouth by means of photogrammetry with the objective of registering and obtaining a viable, reliable, and direct digital impression of the positions of the multiple implants. The use of photogrammetry via PiCdental® camera as an alternative to digital impression for multiple implants is an easy and trustworthy technique that permits an adequate fit without prosthetic complications.

Correlations of spinopelvic parameters with quality of life of patients with adult degenerative scoliosis after posterior correction.

This study aimed to investigate the correlations of spinopelvic parameters with the quality of life of patients with adult degenerative scoliosis (ADS) after posterior correction, and their relationships with efficacy Patients and methods: Ninety patients (40 females, 50 males; mean age: 62.4±3.3 years; range, 47 to 73 years) with adult spinal deformity treated from March 2016 to May 2020 were retrospectively enrolled. The Scoliosis Research Society (SRS)-22 questionnaire was filled in by the patients, and the Oswestry disability index (ODI) and Visual Analog Scale (VAS) for back and lower limb pain were assessed. All the patients underwent posterior correction. Spearman's analysis was conducted for the correlations of the spinopelvic sagittal parameters with quality of life. The risk factors for efficacy were identified using the multivariate logistic regression model to construct a nomogram model for efficacy and risk prediction. After the operation, significant reductions were detected in the sagittal vertical axis (SVA), pelvic tilt (PT), T1 pelvic angle (TPA), pelvic incidence minus lumbar lordosis (PI-LL), and the ODI score (p<0.05). The SVA and LL were significantly negatively correlated with all subitems on the SRS-22 questionnaire but positively correlated with VAS scores for back pain (p<0.05). Thoracic kyphosis was significantly positively correlated with self-image and mental status on the SRS-22 questionnaire (p<0.05), while TPA was negatively correlated with pain and self-image (p<0.05). The PI-LL was significantly negatively correlated with pain (p<0.05). The SVA, LL, PT, and PI-LL were independent predictors of improvement in ODI after operation for ADS. The postoperative changes in spinopelvic parameters affected the clinical outcomes in patients with ADS.

Sarcopenia and the management of spinal disease in the elderly.

Sarcopenia, generally defined by the loss of skeletal mass and function, may disproportionately affect elderly individuals and heavily influence spinal disease. Muscle atrophy is associated with myriad clinical problems, including thoracic kyphosis, increased sagittal vertical axis (SVA), spinal implant failures, and postoperative complications. As such, the aim of this narrative review is to synthesize pertinent literature detailing the intersection between sarcopenia and the impact of sarcopenia on the management of spine disease. Specifically, we focus on the domains of etiology, diagnosis and assessment, impact on the cervical and lumbar spine, spinal augmentation procedures, neoplastic disease, whiplash injury, and recovery/prevention. A narrative review was conducted by searching the PubMed and Google Scholar databases from inception to July 12, 2024, for any cohort studies, systematic reviews, or randomized controlled trials. Case studies and conference abstracts were excluded. Diagnosis of sarcopenia relies on the assessment of muscle strength and quantity/quality. Strength may be assessed using clinical tools such as gait speed, timed up and go (TUG) test, or hand grip strength, whereas muscle quantity/quality may be assessed via computed tomography (CT scan), magnetic resonance imaging (MRI), and dual-energy X-ray absorptiometry (DXA scan). Sarcopenia has a generally negative impact on the clinical course of those undergoing cervical and lumbar surgery, and may be predictive of mortality in those with neoplastic spinal disease. In addition, severe acceleration-deceleration (whiplash) injuries may result in cervical extensor muscle atrophy. Intervention and recovery measures include nutrition or exercise therapy, although the evidence for nutritional intervention is lacking. Sarcopenia is a widely prevalent pathology in the advanced-age population, in which the diagnostic criteria, impact on spinal pathology, and recovery/prevention measures remain understudied. However, further understanding of this therapeutically challenging pathology is paramount, as surgical outcome may be heavily influenced by sarcopenia status.

Comparative study of dynamic characteristics between a FHAWT and a helical type FVAWT

Floating offshore wind turbines (FOWTs) are a growing area of interest, with significant ongoing research work and commercial development. There are two types of FOWT, namely floating horizontal axis wind turbine (FHAWT) and floating vertical axis wind turbine (FVAWT). It has been a long-standing debate on which type of FOWT has better technical and economic performance. However, the research work on comparative study of these two types of FOWT is very rare. In this study, we aim to systematically evaluate the performance of FHAWT and FVAWT, with particular focus on comparing their dynamic characteristics by using coupled numerical models. Tank testing for these two types of FOWT was conducted at the wave basin, and a series of code-to-experiment comparisons were carried out to validate the numerical models. Afterwards, dynamic characteristics, including the control strategy, aerodynamic power, floater motions, tower base bending moments, and blade deformations, are compared between the FHAWT and helical type FVAWT. Results show that the FHAWT presents better performance on the aerodynamic performance and tower base bending moments, while the helical type FVAWT has the advantage of minimal blade deformations.

Optimalisasi Penentuan Posisi Access Point Untuk Meminimalisir Area Blankspot Pada Pantai Panrangluhu

This research aims to determine the optimal position of Access Point to reduce blankspot area in Panrangluhu Beach. The research methodology involves several main steps: (1) Research planning is done by collecting important data such as beach plan, Access Point height, location coordinates, distance between points, and RSSI (Received Signal Strength Indicator) value; (2) Access Point and receiver position coordinates are determined in an outdoor environment; (3) RSSI value data received by the receiver is collected using WiFi Signal Meter software. To ensure even network coverage, network quality testing was conducted in the eight cardinal directions at each hotspot point. The results showed that four hotspot points were needed to achieve optimal network coverage throughout the beach area. With this strategic placement, it is expected that there are no areas that are not covered by the network, so that visitors to Panrangluhu Beach can enjoy stable and evenly distributed internet access throughout the beach.

Extensive macular atrophy with pseudodrusen-like appearance: comprehensive review of the literature.

This review focuses on extensive macular atrophy with pseudodrusen-like appearance (EMAP), a recently described maculopathy presenting with pseudodrusen-like lesions and chorioretinal atrophy more pronounced in the vertical axis. Narrative review of the literature published until May 2024. The early onset age of EMAP (50-55 years) and its distinctive natural history, which includes night blindness followed by severe vision loss, differentiate it from atrophic age-related macular degeneration (AMD). A clear pathogenesis has not been determined, but risk factors include female gender and complement system abnormalities (altered levels of C3 and CH50). Moreover, lifelong exposure to pesticides has been suggested as risk factor for direct neuronal degeneration involving rods and cones. In the early phase of the disease, reticular pseudodrusen-like lesions appear in the superior perifovea and tend to coalescence horizontally into a flat, continuous, reflective material localized between the retinal pigmented epithelium and Bruch's membrane. Over time, EMAP causes profound RPE and outer retinal atrophy in the macular area, with a recent classification reporting a 3-stages evolution pattern. Blue autofluorescence showed rapidly evolving atrophy with either hyperautofluorescent or isoautofluorescent borders. Significant similarities between the diffuse-trickling phenotype of geographic atrophy and EMAP have been reported. Macular neovascularization is a possible complication. EMAP is specific form of early-onset atrophic macular degeneration with rapid evolution and no treatment. Further studies are needed to assess the best management.