Motion Abnormalities Research Articles

Age-dependent association between aneurysmal and isolated redundant inter-atrial septum with patent foramen ovale.

Interatrial septum (IAS) could be redundant by abnormal movement with or without aneurysmal bulging. We aimed to determine the prevalence of isolated redundant and aneurysmal IAS motion and their probable relationship with age and presence of patent foramen ovale (PFO) in a large-scale referral center. A total of 15,288 patients who underwent transthoracic echocardiography (TTE) at Tehran Heart Center were included From March 2019 to March 2021. Contrast echocardiography was conducted on patients with suspected PFO. Data were retrospectively analyzed from our previously established database. The prevalence of aneurysmal and redundant IAS and their relationship with age and PFO presence was evaluated. Aneurysmal and isolated redundant IAS were present in 4% and 12.4% of the participants, respectively. The aneurysmal group was older, more frequently female and had higher frequency of PFO. The frequency of PFO among patients with aneurysmal IAS was about 14.4% and 5.3% in isolated redundant IAS patients. In both groups, the prevalence of abnormal IAS motion increased across age groups from the youngest to the oldest, while the prevalence of PFO decreased. In conclusion, the frequency of PFO among patients with aneurysmal IAS was about 2.5 times more than that among patients with isolated redundant IAS and 24 times more than the normal population. The increasing trend observed across the aging group proposes a potential role for age in the pathophysiology of abnormal IAS. Furthermore, the decreasing prevalence of PFO among patients underlies its clinical significance as an important risk factor.

Initial experience with a 5G cellular network and robotic arm-based remote echocardiographic system in an all-comers setting

Abstract Background Echocardiography is the test-of-choice for the initial evaluation of many cardiac diseases and requires expertise that is often limited in rural area. Robotic arm-assisted remote echocardigram has been attampted for teleconsultation but was limited to heart failure patients(ref), primarily due to the network delay in telecommunication and the subsequent incoordination in robotic arm control. Purpose We aim to assess the feasibility and diagnostic accuracy of a 5G cellular network and robotic arm-based remote echocardiographic system in an all-comers setting. Methods 51 pts were enrolled from the outpatient cardiology clinic of our institute. All pts underwent standard comprehensive echocardiography on a 5G cellular network and robotic arm-based remote echocardiographic system (the robotic part was deployed at our hospital and the control part was located at another campus 20 kilometers away) (Figure 1)and a conventional echocardiographic platform (at our hospital) successively. The order in which patients were examined on the remote and conventional instruments was randomly determined. There was no interval between the two examinations, and examinations of the same patient were performed by experienced but different cardiologists, who were blinded to each other’s diagnosis. The doctor who used the remote system was also randomly allocated and had not been previously specifically trained. The exams were real-time and diagnoses were made right after the exams. Results Of the 51 pts, the image quality was sufficient for diagnosis in 50 patients (48% female, 40±18 years). 1 pt was excluded because some key views could not be obtained using the remote system (98% of exams successful). 17 pts had positive findings, including 10 with a primary diagnosis of valvulopathy (1 Barlow's syndrome, 1 bicuspid aortic valve and 8 less-than-moderate regurgitation), 2 cardiac surgery follow-ups (1 case of aortic valve replacement and septal myectomy, and 1 case of mitral valve replacement and tricuspid annuloplasty), and 2 hypertrophic cardiomyopathy (including 1 case of obstruction at papillary muscle level), 2 with abnormal left ventricular wall motion(including 1 case of apical mural thrombus) (Figure 2), and 1 with congenital heart disease (secumdum atrial septal defect). The main diagnosis was consistent in 98% of cases (papillary muscle level obstruction was missed in one case), using conventional echocardiographic findings as the standard. Time for image acquision using remote echocardiography was significantly longer than conventional one (24 minutes 36 seconds ± 4 minutes 52 seconds vs. 16 minutes 15 seconds ± 1 minute 54 seconds, p<0.0001, paired t-test). Conclusions Comprehensive echocardiographic exam with a 5G cellular network and robotic arm-based remote system is feasible with relatively good diagnostic accuracy.Figure 1Figure 2

A geometric model with stochastic error for abnormal motion detection of portal crane bucket grab

Abnormal swing angle detection of bucket grabs is crucial for efficient harbor operations. In this study, we develop a practically convenient swing angle detection method for crane operation, requiring only a single standard surveillance camera at the fly-jib head, without the need for sophisticated sensors or markers on the payload. Specifically, our algorithm takes the video images from the camera as input. Next, a fine-tuned ‘the fifth version of the You Only Look Once algorithm’ (YOLOv5) model is used to automatically detect the position of the bucket grab on the image plane. Subsequently, a novel geometric model is constructed, which takes the pixel position of the bucket grab, the steel rope length provided by the Programmable Logic Controller (PLC) system, and the optical lens information of the camera into consideration. The key parameters of this geometric model are statistically estimated by a novel iterative algorithm. Once the key parameters are estimated, the algorithm can automatically detect swing angles from video streams. Being analytically simple, the computation of our algorithm is fast, as it takes about 0.01 s to process one single image generated by the surveillance camera. Therefore, we are able to obtain an accurate and fast estimation of the swing angle of an operating crane in real-time applications. Simulation studies are conducted to validate the model and algorithm. Real video examples from Qingdao Seaport under various weather conditions are analyzed to demonstrate its practical performance.

Osteoarthritis After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Contributing Factors and Potential Treatments.

Anterior cruciate ligament (ACL) injuries result in abnormal knee motion and long-term joint degradation. ACL reconstruction (ACLR) is done with the aim of restoring normal knee kinematics and slowing the joint degradation process. It does appear that this inevitably happens and can be impacted by a multitude of factors. The aim of this review was to examine the factors that influence the progression of osteoarthritis (OA) after ACLR and examine possible treatments that can aid in slowing that progression. A systematic review was conducted by searching all levels of evidence for all studies in English that assessed risk factors for developing OA after ACL reconstruction, had a minimum follow-up of 10 years, and used radiographical outcomes to measure the presence of OA. Studies on trial treatments to reduce osteoarthritis after ACL reconstruction were also included. It was found that among the factors associated with an increased risk of post-ACLR OA are meniscal lesions, meniscectomy, increased age at the time of ACLR, increased time from injury to surgery, male sex, reduced range of motion, smaller thigh girth, graft complications, and failure. Additionally, in performing the ACLR, anteromedial femoral tunnel placement, higher graft tension, and following guidelines for performing anatomic ACLR have been shown to reduce the risk of OA as well. Patients should be adequately counselled on their risk pre-operatively for informed decision-making. Surgeons should also be aware of potential risk factors and how they can be mitigated.

Cardiovascular effects and clinical outcomes in acute opioid toxicity: A case-control study from Port Said and Damietta Governorates Egypt

Substance abuse, particularly opioid intoxication, presents a significant public health challenge, leading to severe cardiovascular complications. This case-control study assessed the cardiac profile and clinical outcomes of 51 patients with confirmed acute opioid toxicity, compared to 51 control participants, in general hospitals across Port Said and Damietta governorates, Egypt. The study revealed that opioid-intoxicated patients exhibited significant cardiovascular abnormalities, including hypotension (39.2 %) and electrocardiogram (ECG) changes (72.5 %), with sinus bradycardia (51 %) being the most common. Additionally, echocardiographic abnormalities were found in 40 % of cases, with abnormal regional wall motion and valvular defects observed in several patients. Elevated levels of cardiac enzymes, such as Troponin-I and CK-MB, were significantly correlated with increased ICU stay length and higher mortality rates. The most common morbidities included coma (64.7 %) and shock (39.2 %). The study underscores the critical need for early cardiac assessment in opioid-intoxicated patients to predict clinical outcomes and guide therapeutic interventions.

Relationship between the geopotential height anomalies induced by tropical cyclones and the meridional movement of the western Pacific subtropical high

The present study employs statistical analysis to investigate the relationship between the geopotential height anomalies induced by tropical cyclones (TCs) and the meridional movement of the western Pacific subtropical high (WPSH), as well as the mechanisms through which TCs can induce such geopotential height anomalies. Results show that TCs can cause the WPSH to move northward, and the meridional motion of the WPSH ridgeline is related with the geopotential height anomalies, which is better indicated by the relative geopotential height anomalies. In the process of TCs causing the WPSH to move northward, the TCs cause abnormal horizonal warm (cold) advection and abnormal ascending (descending) motion in the region south (north) of 40°N. Since the influence of the abnormal vertical motion is weaker, the abnormal temperature tendency eventually shows a more consistent phase distribution with the abnormal horizonal temperature advection, which is favorable for the temperature to abnormally increase near 40°N. Such an abnormal increase in temperature causes the geopotential height to abnormally increase under the static equilibrium constraint, which further changes the location of the centroid of the WPSH geopotential height, and hence the location of the WPSH ridgeline changes as well.

Olfactory Bulb Volume and Asymmetry as Predictors of Executive Dysfunction in Adolescents with Congenital Heart Disease.

Common sequelae for patients with congenital heart disease (CHD) are neurodevelopmental disabilities including executive function, attention, and socio-emotional deficits. Although these are common diagnoses for patients with CHD, limited research has investigated the mechanistic underpinnings of these findings. Our previous research examined the association between abnormal respiratory ciliary motion and brain abnormalities in infants with CHD. Results suggested that abnormal ciliary motion correlated to a spectrum of subtle dysplasia, notably within the olfactory bulb (OB)1. Our current study investigates whether OB anomalies predict neurodevelopmental outcomes for pediatric patients with CHD. We hypothesize that adolescents with CHD who exhibit aberrant morphological measurements in the OB are more likely to suffer from executive functional deficits. A prospective, observational study of 54 CHD and 75 healthy subjects, ages 6-25 years old, was completed under the supervision of a senior pediatric neuroradiologist. T2 3D Space and T2 Blade 2MM MRI images were manually segmented to extract volumetric bilateral regions of the OB and cerebrospinal fluid (CSF) using ITK-SNAP. Imaging metrics were correlated to OB asymmetry, CSF to OB ratio, total CSF volume, total OB volume, and independent left and right CSF and OB volumes. Linear regression was used to evaluate MRI morphologic measurements with co-variates: CHD status, sex, MRI age, and segmenter. Executive function was determined by the Behavioral Rating Inventory of Executive Function (BRIEF) Parent Report and Delis-Kaplan Executive Function System (D-KEFS) for subjects ages 6-16. Cognition and olfactory function were measured with the NIH Toolbox Cognitive Battery and Odor Identification Test, respectively. No statistically significant results were reported between cohorts for asymmetry of OB, CSF to OB ratio, total CSF volume, total OB volume, nor between independent left and right CSF and OB volumes. Increased OB volume was associated with worse outcomes on the BRIEF Parent Report (p≤0.03). Asymmetry of OB predicted poorer executive functioning as reported by parents on the BRIEF (p≤0.05). Overall, the CHD cohort demonstrated worse scores on the BRIEF Parent Report compared to controls. Across groups, no significant association was reported for olfaction function measured by the NIH Toolbox Odor Identification Test on a limited subset of participants. As survival rates for CHD improve, there is an increased risk of long-term neurodevelopmental impairments. Our findings identify adolescents who are at risk for executive dysfunction, particularly those showing increased OB volume and/or asymmetry of the OB. This is particularly concerning for the CHD population with atypical OB morphology, who also exhibit significantly poorer outcomes on the BRIEF Parent Report and face a higher overall risk. Increased OB volume and OB asymmetry are olfactory-based biomarkers that may help identify at-risk CHD patients earlier, enabling more timely intervention and support.

A comprehensive review of scapulothoracic abnormal motion (STAM): evaluation, classification, and treatment strategies.

The term "dyskinesia" has often been used interchangeably with "winging," leading to ambiguity in the literature. To address this, the broader term "scapulothoracic abnormal motion (STAM)" was introduced to describe any abnormal position or movement of the scapula on the chest, resulting in pain and dysfunction. Scapulothoracic abnormal motion has a wide range of causes, including musculoskeletal imbalances such as pectoralis minor hyperactivity, neurological impairments such as long thoracic nerve palsy, and genetic conditions like facioscapulohumeral muscular dystrophy (FSHD). This review aims to identify the different causes and classifications of STAM and to propose a detailed treatment algorithm specifically designed to manage these conditions effectively.

ABNet: AI-Empowered Abnormal Action Recognition Method for Laboratory Mouse Behavior.

The automatic recognition and quantitative analysis of abnormal behavior in mice play a crucial role in behavioral observation experiments in neuroscience, pharmacology, and toxicology. Due to the challenging definition of abnormal behavior and difficulty in collecting training samples, directly applying behavior recognition methods to identify abnormal behavior is often infeasible. This paper proposes ABNet, an AI-empowered abnormal action recognition approach for mice. ABNet utilizes an enhanced Spatio-Temporal Graph Convolutional Network (ST-GCN) as an encoder; ST-GCN combines graph convolution and temporal convolution to efficiently capture and analyze spatio-temporal dynamic features in graph-structured data, making it suitable for complex tasks such as action recognition and traffic prediction. ABNet trains the encoding network with normal behavior samples, then employs unsupervised clustering to identify abnormal behavior in mice. Compared to the original ST-GCN network, the method significantly enhances the capabilities of feature extraction and encoding. We conduct comprehensive experiments on the Kinetics-Skeleton dataset and the mouse behavior dataset to evaluate and validate the performance of ABNet in behavior recognition and abnormal motion detection. In the behavior recognition experiments conducted on the Kinetics-Skeleton dataset, ABNet achieves an accuracy of 32.7% for the top one and 55.2% for the top five. Moreover, in the abnormal behavior analysis experiments conducted on the mouse behavior dataset, ABNet achieves an average accuracy of 83.1%.

Anterior-Posterior Laxity in Midflexion After Posterior-Stabilized TKA Is Sensitive to MCL Tension in Passive Flexion: An in Vitro Biomechanical Study.

Knee instability in midflexion may contribute to patient dissatisfaction following total knee arthroplasty (TKA). Midflexion instability involves abnormal motions and tissue loading in multiple planes. Therefore, we quantified and compared the tensions carried by the medial and lateral collateral ligaments (MCL and LCL) following posterior-stabilized (PS) TKA through knee flexion, and then compared these tensions with those carried by the native knee. Finally, we examined the relationships between collateral ligament tensions and anterior tibial translation (ATT). Eight cadaveric knees (from 5 male and 3 female donors with a mean age of 62.6 years and standard deviation of 10.9 years) underwent PS TKA. Each specimen was mounted to a robotic manipulator and flexed to 90°. ATT was quantified by applying 30 N of anterior force to the tibia. Tensions carried by the collateral ligaments were determined via serial sectioning. Robotic testing was also conducted on a cohort of 15 healthy native cadaveric knees (from 9 male and 6 female donors with a mean age of 36 years and standard deviation of 11 years). Relationships between collateral ligament tensions during passive flexion and ATT were assessed via linear and nonlinear regressions. MCL tensions were greater following PS TKA than in the native knee at 15° and 30° of passive flexion, by a median of ≥27 N (p = 0.002), while the LCL tensions did not differ. Median tensions following PS TKA were greater in the MCL than in the LCL at 15°, 30°, and 90° of flexion, by ≥4 N (p ≤ 0.02). Median tensions in the MCL of the native knee were small (≤11 N) and did not exceed those in the LCL (p ≥ 0.25). A logarithmic relationship was identified between MCL tension and ATT following TKA. MCL tensions were greater following PS TKA with this typical nonconforming PS implant than in the native knee. Anterior laxity at 30° of flexion was highly sensitive to MCL tension during passive flexion following PS TKA but not in the native knee. Surgeons face competing objectives when performing PS TKA: they can either impart supraphysiological MCL tension to reduce anterior-posterior laxity or maintain native MCL tensions that lead to heightened anterior-posterior laxity, as shown in this study.

In vivo analysis of ankle joint kinematics and ligament deformation of chronic ankle instability patients during level walking.

Introduction: Chronic ankle instability (CAI) carries a high risk of progression to talar osteochondral lesions and post-traumatic osteoarthritis. It has been clinically hypothesized the progression is associated with abnormal joint motion and ligament elongation, but there is a lack of scientific evidence. Methods: A total of 12 patients with CAI were assessed during level walking with the use of dynamic biplane radiography (DBR) which can reproduce the in vivo positions of each bone. We evaluated the uninjured and CAI side of the tibiotalar and subtalar joint for three-dimensional kinematics differences. Elongation of the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL) were also calculated bilaterally. Results: For patients with CAI, the dorsiflexion of the tibiotalar joint had reduced (21.73° ± 3.90° to 17.21° ± 4.35°), displacement of the talus increased (2.54 ± 0.64mm to 3.12 ± 0.55mm), and the inversion of subtalar joint increased (8.09° ± 2.21° to 11.80° ± 3.41°). Mean ATFL elongation was inversely related to mean dorsiflexion angle (CAI: rho = -0.82, P < 0.001; Control: rho = -0.92, P < 0.001), mean ATFL elongation was related to mean anterior translation (CAI: rho = 0.82, P < 0.001; Control: rho = 0.92, P < 0.001), mean CFL elongation was related to mean dorsiflexion angle (CAI: rho = 0.84, P < 0.001; Control: rho = 0.70, P < 0.001), and mean CFL elongation was inversely related to mean anterior translation (CAI: rho = -0.83, P < 0.001; Control: rho = -0.71, P < 0.001). Furthermore, ATFL elongation was significantly (CAI: rho = -0.82, P < 0.001; Control: rho = -0.78, P < 0.001) inversely correlated with CFL elongation. Discussion: Patients with CAI have significant changes in joint kinematics relative to the contralateral side. Throughout the stance phase of walking, ATFL increases in length during plantarflexion and talar anterior translation whereas the elongation trend of CFL was the opposite. This understanding can inform the development of targeted therapeutic exercises aimed at balancing ligament tension during different phases of gait. The interrelationship between two ligaments is that when one ligament shortens, the other lengthens. The occurrence of CAI didn't change this trend. Surgeons might consider positioning the ankle in a neutral sagittal plane to ensure optimal outcomes during ATFL and CFL repair.

Unveiling the relationship: Sacroiliac Joint Dysfunction as an Overlooked Factor in Lumbar Back Pain

Introduction: The Sacroiliac joint (SIJ) is a crucial connection found between the sacrum and ilium. It plays a vital role in transferring forces during physical activity, such as running. Its biomechanical function is crucial for ensuring stability, as it is supported by ligaments and pelvic floor muscles that work together to ensure this for individuals. However, SIJ dysfunction can be linked to lower back pain, which is a condition that affects around 70-85% of Western society. Causes: SIJ dysfunction originates from various factors, such as abnormal motion or malalignment. These conditions can arise from multiple causes: arthritis, trauma, or nontypical gait patterns. Diagnosis: Physical examinations are included in the diagnosis of SIJ dysfunction. They are called FABER, compression, distraction, thigh thrust, and Gaenslen. Three provocative test results are oftentimes required for a diagnosis. Other methods of diagnosis are also used, like X-rays, MRIs, and joint injections. Misdiagnosis: Nevertheless, although multiple methods exist to diagnose SIJ dysfunction, it is very commonly misdiagnosed. This is because the condition mimics symptoms of other conditions, and its etiology is overlooked. Treatment: When diagnosed, SIJ dysfunction can be treated through a range of measures. Either conservative treatments can be done, like physical therapy and NSAIDs, or more invasive procedures, such as surgical interventions, can be used to treat SIJ dysfunction. Conclusion: SIJ dysfunction is a prevalent, misdiagnosed condition that affects many individuals. This review highlights the importance of raising awareness among the public and clinicians to ensure an accurate diagnosis and treatment is given to patients.

A Rare Case of an Adult with Spinal Cord Injury Without Neuroimaging Abnormality (SCIWONA)

BackgroundSpinal cord injury without radiographic abnormality (SCIWORA) is defined as having clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability. An abnormal finding, such as a fracture, subluxation, or abnormal intersegmental motion at the level of the spinal cord injury, excludes SCIWORA as the diagnosis. Prevalence of SCIWORA is highest among children younger than 8 years, and is a diagnosis seen primarily in children, owing to anatomic differences that put children at more risk of this condition. In more recent years, with the increasing use of magnetic resonance imaging in patients with suspected spinal cord injury, a new term, spinal cord injury without neuroimaging abnormality (SCIWONA) has been suggested as a more specific way to describe cases of SCIWORA that have negative neuroimaging. Case ReportHere we describe a case of a woman who presented with symptoms consistent with a spinal cord injury after a traumatic fall. Her presentation and imaging were consistent with SCIWONA. The patient subsequently had rapid and complete recovery of her neurologic function. Why Should an Emergency Physician Be Aware of This? Early recognition of SCIWONA and subsequent medical management is imperative for improved outcomes for these patients. Operative treatment is rare and typically only necessary in patients with consistent spinal cord instability.

Deep learning techniques for enhanced sea-ice types classification in the Beaufort Sea via SAR imagery

This study proposes a dual-branch encoder U-Net (DBU-Net) deep learning model to classify sea ice types based on synthetic aperture radar (SAR) images in the Beaufort Sea. The DBU-Net can segment multi-year ice (MYI), first-year ice (FYI), open water (OW), and leads on SAR images. We design a dual-branch encoder to fuse the polarization and the grey-level co-occurrence matrix (GLCM) information of SAR images to improve the model's classification capability. The model is subsequently fine-tuned using lead samples to identify leads. 24 Sentinel-1 SAR images acquired in the Beaufort Sea are utilized for model training and testing. The accuracy (Acc), mean intersection over union (mIoU), and kappa coefficient (Kappa) are employed as evaluation metrics. Experiments show that DBU-Net achieves 91.83%/0.841/0.849 in Acc/mIoU/Kappa in classifying MYI, FYI, and OW, significantly outperforming three traditional models based on support vector machine, random forest, or convolutional neural network. Compared with the original U-Net, the dual-branch encoder and the GLCMs improve 1.45%/4.4%/2.8% in Acc/mIoU/Kappa in MYI, FYI, and OW. Acc/mIoU/Kappa metrics of leads detection is 99.49%/0.801/0.754. Besides, 454 Sentinel-1 SAR images are fed into the optimal DBU-Net to generate 80 m sea ice products in the Beaufort Sea for winters 2018–2022. As the MYI draws wide attention and the FYI and MYI are complementary in the area during the Winter, we discuss the variation of MYI based on the generated sea ice products and explore the relationship between MYI's variation and the Beaufort High. We found that the MYI export in the 2018/19 winter was due to large summer sea ice remains and the abnormal sea ice motion caused by the southeast shifting Beaufort Atmospheric Pressure High (Beaufort High). The MYI import in the 2020/21 winter was due to a strong northward MYI import caused by the powerful Beaufort High.

Interpretation of SPECT wall motion with deep learning

ObjectivesWe sought to develop a novel deep learning (DL) workflow to interpret single-photon emission computed tomography (SPECT) wall motion. BackgroundWall motion assessment with SPECT is limited by image temporal and spatial resolution. Visual interpretation of wall motion can be subjective and prone to error. Artificial intelligence (AI) may improve accuracy of wall motion assessment. MethodsA total of 1038 patients undergoing rest electrocardiogram (ECG)-gated SPECT and echocardiography were included. Using echocardiography as truth, a DL-model (DL-model 1) was trained to predict the probability of abnormal wall motion. Of the 1038 patients, 317 were used to train a DL-model (DL-model 2) to assess regional wall motion. A 10-fold cross-validation was adopted. Diagnostic performance of DL was compared with human readers and quantitative parameters. ResultsThe area under the receiver operating characteristic curve (AUC) and accuracy (ACC) of DL model (AUC: .82 [95% CI: .79-.85]; ACC: .88) were higher than human (AUC: .77 [95% CI: .73-.81]; ACC: .82; P < .001) and quantitative parameter (AUC: .74 [95% CI: .66-.81]; ACC: .78; P < .05). The net reclassification index (NRI) was 7.7%. The AUC and accuracy of DL model for per-segment and per-vessel territory diagnosis were also higher than human reader. The DL model generated results within 30 seconds with operable guided user interface (GUI) and therefore could provide preliminary interpretation. ConclusionsDL can be used to improve interpretation of rest SPECT wall motion as compared with current human readers and quantitative parameter diagnosis.

The Relationship Between MRI Findings of Posterior Ligamentous Complex and Lumbar Instability in Degenerative Spondylolisthesis.

To determine the factors in posterior ligamentous complex indicating lumbar instability in patients diagnosed with degenerative spondylolisthesis on conventional magnetic resonance imaging (MRI). We retrospectively analyzed patients who underwent PLIF surgery for degenerative spondylolisthesis at our institution between 2018 and 2020 and who had complete eligible preoperative imaging data for review and study, including lumbar MRI and anteroposterior and flexion-extension radiographs. Fifty-three patients were confirmed to have lumbar instability (Unstable Group, 44%), while sixty-seven patients (Stable Group, 56%) did not have instability on radiographs. The patients in the stable group had more advanced status of the degeneration of intervertebral disc than in the unstable group (p<0.05). The degeneration of supraspinous ligament (SSL) was more severe in the unstable group (p<0.05). Compared with the patients with rotatory instability, advanced degeneration of interspinous ligament (ISL) and SSL was observed in patients with translatory instability (p<0.05). However, there was no significant difference with regard to the height of the spinous process and the interspinous distance in patients with or without instability. This MRI analysis showed that abnormal segmental motion is closely associated with the pathological characteristics of supraspinal ligament. Advanced degeneration of SSL in patients with degenerative spondylolisthesis should raise the suspicion for lumbar instability and additional evaluations. The status of ISL and ligamentum flavum (LF) may not be helpful for the diagnosis of lumbar instability. Functional radiographs combined with MRI may provide valuable information when diagnosing lumbar instability in patients with mechanical back pain.

Pulmonary Embolism in Patients Admitted With Takotsubo Cardiomyopathy: Prevalence and Associated In-Hospital Adverse Events.

Introduction Takotsubo cardiomyopathy (TCM) is a poorly understood condition typically characterized by abnormal left ventricular wall motion without causative coronary artery disease and typically presents in post-menopausal women after the experience of a physical or emotional stressor. The pathophysiology of TCM is complex and multifactorial, resulting in complications with varied severity; one of the most concerning complications is thromboembolism, specifically, pulmonary embolism (PE), which is understudied in its relation to TCM.The purpose of this study was to characterize and evaluate the real-world prevalence and outcomes of PE in TCM. Methods Data were derived from the National Inpatient Sample database from January 2016 to December 2019. The primary outcomes assessed were baseline and hospital admission characteristics and comorbidities for patients with TCM with and without PE. Outcomes for TCM patients with PEand predictors of mortality in TCM were also analyzed. Results PE developed in 788 of 40,120 patients with TCM (1.96%). After multivariate adjustment, PE was found to be independently associated with intracardiac thrombus (adjusted odds ratio (aOR) 2.067; 95% confidence interval (CI): 1.198-3.566; p = 0.009) and right heart catheterization (RHC) (aOR: 1.971; 95% CI: 1.160-3.350; p = 0.012). Mortality in patients with TCM was associated with, among other factors, age in years at admission (aOR: 1.104; 95% CI: 1.010-1.017; p = 0.001), African American race (aOR: 1.191; 95% CI: 1.020-1.391; p = 0.027), Asian or Pacific Islander race (aOR: 1.637; 95% CI: 1.283-2.090; p = 0.001), coagulopathy (aOR: 3.393; 95% CI: 2.889-2.986; p = 0.001), liver disease (aOR: 1.446; 95% CI: 1.147-1.824; p = 0.002), atrial fibrillation (aOR: 1.460; 95% CI: 1.320-1.615; p = 0.001), and pulmonary embolism (aOR: 2.217; 95% CI: 1.781-2.760; p = 0.001). Conclusion In a large cohort of patients admitted with TCM,we found the prevalence of PE to be 1.96%. PE, along with comorbidities such as coagulopathy and atrial fibrillation, was found to be a significant predictorof mortality in this patient cohort.

Health Monitoring Analysis of an Urban Rail Transit Switch Machine

This paper discusses the health evaluation of an urban rail transit switch machine. In this paper, the working current data of the S700K switch machine are processed, and four common abnormal operating current curves are obtained through the existing data. Then, the MLP is used as the feature extractor of the action current curve to analyze the input action current data, learn and capture deep features from raw current data as Q-networks, and build MLP-DQN models. The monitoring of the abnormal state operation current of the switch machine is optimized by learning and optimizing the model weight through repeated experience. The experimental results show that the training accuracy of this model is stable at about 96.67%. Finally, the Fréchet distance was used to analyze the abnormal motion current curve, combined with the occurrence frequency and repair complexity of the abnormal type curve, the calculated results were analyzed, and the health of the switch machine was evaluated, which proved the high efficiency and superiority of the MLP-DQN method in the fault diagnosis of the switch machine equipment. The good health evaluation function of the switch machine can effectively support the maintenance of the equipment, and it has an important reference value for the intelligent operation and maintenance of subway signal equipment. The research results mark the maintenance of key equipment of urban rail transit systems, represent a solid step towards intelligent and automated transformation, and provide strong technical support for the safe operation and intelligent management of future rail transit systems.

3-Dimensional pose estimation to detect posture transition in freestall-housed dairy cows

Freestall comfort is reflected in various indicators, including the ability for dairy cattle to display unhindered posture transition movements in the cubicles. To ensure farm animal welfare, it is instrumental for the farm management to be able to continuously monitor occurrences of abnormal motions. Advances in computer vision have enabled accurate kinematic measurements in several fields, such as human, equine, and bovine biomechanics. An important step upstream to measuring displacement during posture transitions is determining that the behavior is accurately detected. In this study, we propose a framework for detecting lying-to-standing posture transitions from 3-dimensional (3D) pose estimation data. A multiview computer vision system recorded posture transitions between December 2021 and April 2022 in a Swedish stall housing 183 individual cows. The output data consisted of the 3D coordinates of specific anatomical landmarks. The sensitivity of posture transition detection was 88.2%, and precision reached 99.5%. In analyzing those transition movements, breakpoints detected the timestamp of onset of the rising motion, which was compared with that annotated by observers. Agreement between observers, measured by intraclass correlation, was 0.85 between 3 human observers and 0.81 when adding the automated detection. The intra-observer mean absolute difference in annotated timestamps ranged from 0.4 s to 0.7 s. The mean absolute difference between each observer and the automated detection ranged from 1.0 s to 1.3 s. We found a significant difference in annotated timestamps between all observer pairs, but not between the observers and the automated detection, leading to the conclusion that the automated detection does not introduce a distinct bias. We conclude that the model is able to accurately detect the phenomenon of interest and that it is equitable to an observer.

Cardiac evaluation in pregnant patients with dyspnea and palpitations

BackgroundSymptoms of underlying cardiac disease in pregnancy can often be mistaken for common complaints due to normal physiologic changes in pregnancy. Echocardiographic evaluation of patients with symptoms of palpitations and dyspnea can detect structural changes and identify high-risk features. ObjectiveThe study's objective was to examine transthoracic echocardiograms (TTEs) of perinatal individuals completed for palpitations or dyspnea to determine the frequency of identifying structural changes. Study DesignWe performed a retrospective cohort study of all perinatal individuals with a TTE at a single academic center between October 1, 2017, and May 1, 2022. The indication for the echocardiogram, demographics, and clinical characteristics were recorded. TTEs with any abnormal findings noted in the TTE report were reviewed and categorized into findings of congenital heart disease, valvular disease, pericardial effusion, evidence of ischemia/wall motion abnormalities, abnormal diastolic/systolic function, and other. ResultsOf our sample of 539 TTEs completed on 478 different individuals who were pregnant or in the 12-week post-partum period, 96 (17.8%) had an indication of palpitations and 32 (5.9%) were listed dyspnea as the indication. Abnormal findings were seen in 21.9% of patients with palpitations and in 34.4% of those with dyspnea. In the patients with palpitations who had abnormal findings, 33.3% had congenital heart disease, 33.3% had mild valvular disease including mitral valve prolapse, 19.0% had a pericardial effusion, and 14.3% had evidence of ischemia/wall motion defects. Abnormal TTE findings in the dyspnea cohort included ischemia/wall motion defects (27.3%), mild valvular disease or mitral valve prolapse (36.4%), and abnormal systolic/diastolic function (36.4%). ConclusionMany of the TTEs completed for patients with dyspnea or palpitations identified no structural abnormalities, however, in about one in three to one in four patients underlying structural heart disease was identified. While some of these abnormalities were unlikely to change delivery plans like mild valvular disease or small effusions, others such as ischemia, congenital abnormalities, and abnormal systolic/diastolic function were likely to have implications for pregnancy and post-partum management.