Anteroposterior Direction Research Articles

The cardiothoracic ratio on postmortem CT as a screening tool for cardiomegaly in the Thai population.

IntroductionIn forensic radiology, the cardiothoracic ratio (CTR) calculated from postmortem computed tomography (PMCT) images can be used to detect cardiomegaly. In this study, a new measurement method is studied that involves measurement in the anteroposterior (AP) and transverse directions, with a reference level based on the Thai population. ObjectiveTo screen for cardiomegaly using the CTR calculated from PMCT images. Research methodA sample size of 116 deceased Thai individuals who underwent PMCT before autopsy was obtained. Individuals were divided into two groups: normal heart weight and overweight heart. Hearts heavier than the mean plus one standard deviation were categorized into the overweight group. The CTR was calculated in both the AP and transverse directions at six reference levels. Receiver operating characteristic curves (ROC) were calculated to determine the CTR cutoff point for the diagnosis of cardiomegaly. ResultsThe CTR cutoff values for diagnosing cardiomegaly were as follows: 1) CTR >0.5 in the transverse direction at the mid-vertebra of T7 (sensitivity, 75.6%; specificity, 70.6%; area under the ROC curve 0.81), 2) CTR >0.49 in the transverse direction at the mid-vertebra of T8 (sensitivity 71%, specificity 81.4%, area under the ROC curve 0.80). The selection of the cutoff values depended on the location of the heart. The area under the ROC curve in the AP direction was in the range 0.5-0.7, which is inferior compared to the transverse direction (0.7-0.9). ConclusionCalculating the CTR with a reference level on PMCT images can assist in the diagnosis of cardiomegaly.

Postural control before and after transitional locomotor tasks in children on the autism spectrum: A case-control study

BackgroundInstrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. MethodsSixteen autistic children aged 6–10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers.The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 – quiet standing before step initiation, phase 2 – transit, and phase 3 - quiet standing until measurement completion. FindingsThe two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. InterpretationAutistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children.The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021).

A prospective study on the effect of tumor shrinkage on exit fluence gamma pass rate in high precision radiotherapy and influence of phantom setup error in patient-specific quality assurance.

Objective parameters for decision on adaptive radiotherapy depend on patient, tumor and treatment related factors. Present study reports geometric uncertainties occurring during high precision radiotherapy, beam fluence analysis and serial exit dose measurement as a patient-specific tool for adaptive radiotherapy. Serial exit dose fluence of 24 patients (at baseline and mid-treatment) undergoing IMRT/VMAT treatment were measured. Baseline and midtreatment exit dose evaluation was done using gafchromic films in predefined region of interest. Difference of volume of GTV at baseline (from simulation CT scan) and midtreatment CBCT scan was calculated (ΔGTV). Population based systematic errors (mm) were 4.15, 2.26, 0.88 and random errors (mm) were 2.56, 3.69, and 2.03 in mediolateral (ML), craniocaudal (CC) and anteroposterior (AP) directions respectively. Gamma pass rate reduced with incremental shift. For a 5 mm shift, maximum deviation was found in anteroposterior axis (22.16 ± 7.50) and lowest in mediolateral axis (12.85 ± 4.95). On serial measurement of exit dose fluence, tumor shrinkage significantly influenced gamma pass rate. The mean gamma pass rate was significantly different between groups with 50% shrinkage of tumor volume (86.36 vs 96.24, P = 0.008, on multivariate analysis P = 0.026). Rapid fall of gamma pass rate was observed for set up error of ≥3 mm. Serial measurement of exit dose fluence by radiochromic film is a feasible method of exit dose comparison in IMRT/VMAT, where EPID dosimetry is not available with linear accelerator configuration. Our study suggests that there is a significant difference between gamma pass rates of baseline and mid treatment exit dose fluence with greater than 50% tumor shrinkage.

Quiet standing and anteroposterior limits of stability in adolescents and young adults with bilateral spastic cerebral palsy

Stance stability in individuals with bilateral spastic cerebral palsy (BSCP) in various standing postures including the quiet standing (QS) and limits of stability (LoS) has been widely studied. However, the relationships between the QS and LoS remain unclear. This study aimed to determine the relationships between the positions and postural sway in the QS and anteroposterior LoS in individuals with BSCP. It included 27 adolescents and young adults with BSCP (BSCP group) and 27 adolescents and young adults without disability (control group). The position of center of pressure in the anteroposterior direction (CoPy position) and the path length of center of pressure (CoP path length) during the QS and the anterior and posterior LoS (A-LoS and P-LoS, respectively) were measured using a force platform. The CoPy positions in the A-LoS and P-LoS in the BSCP group were limited compared with those in the control group. In the BSCP group, the more anterior the CoPy position in the QS, the more anterior (i.e., limited) it was in the P-LoS. Although the CoP path length in the QS was larger in the BSCP group, those in the A-LoS and P-LoS were larger in the control group. The BSCP group also showed that the more anterior the CoPy position or the longer the CoP path length in the QS, the more decreased the anteroposterior LoS range was. Therefore, assessing various standing postures, including QS and anteroposterior LoS, is important to manage balance impairments in individuals with BSCP.

Immediate effect of kinesiology taping on muscle strength, static balance and proprioception after eccentric muscle fatigue on ankle: a randomized cross-over trial

BackgroundKinesiology Taping(KT) is commonly used as a physical therapy to prevent exercise-induced fatigue. This study aims to evaluate the immediate effects of KT on muscle strength, static balance, and proprioception after eccentric muscle fatigue on ankle.MethodsTwenty healthy male university students were recruited. The experimental protocol was structured into four sessions, each separated by a one-week washout period to prevent carryover effects. Participants were randomly allocated to one of four intervention conditions in each session, ensuring no participant received the same intervention twice. These conditions were: no taping(NT),sham taping(ST),athletic taping(AT),and kinesiology taping(KT).Taping was applied immediately following an eccentric muscle fatigue protocol targeting the ankle, and assessments were conducted in the order of proprioception, muscle strength and static balance. Isometric muscle strength and proprioception were evaluated using the Biodex isokinetic system. Static balance was measured using the TecnoBody balance platform.ResultsKT had a significantly higher plantarflexion/dorsiflexion peak torque, dorsiflexion average peak torque, and plantarflexion/dorsiflexion average power at 60°/s compared with NT and ST in terms of isometric muscle strength (p < 0.05).Furthermore, the plantarflexion peak torque of KT was significantly greater than AT at 60°/s[p = 0.005,95% confidence interval(CI) = 3.39 to 18.20] and 180°/s[p = 0.006,95%CI(2.62,21.98)]. In terms of proprioception, KT showed a lower absolute error in 25° plantarflexion and 10° dorsiflexion compared to NT, ST and AT. For static balance with eyes-open and eyes-closed conditions, AT and KT had a lower total sway area than NT and ST (p < 0.05). Additionally, a significant difference in total sway length with eyes-open condition was observed between AT and KT[p < 0.001,95%CI(-431.81,-168.25)];total sway area and the center of pressure(COP) velocity in the mediolateral(ML) and anteroposterior(AP) directions with eyes-closed condition were significantly lower in AT compared to KT.ConclusionThis study suggests that KT is more effective than other taping conditions in improving muscle strength and proprioception after eccentric muscle fatigue on ankle. However, AT is more helpful in increasing static postural control ability after ankle muscle fatigue than KT.Trial registrationThis study was registered with www.chictr.org.cn (registration number: ChiCTR2300068278) on 13/2/2023.

Comparative analysis of postural stability and risk of falling and developing disability among overweight and obese women over 40 years

BackgroundIncreased body mass index (BMI) adversely affects the mechanics of the musculoskeletal system. It is known that obese people have poorer postural stability and mobility-related outcomes compared to normal weight people, but there is limited research comparing overweight and class 1 obese people, two consecutive and prevalent BMI categories. AimsTo compare postural stability, functional mobility, and risk of falling and developing disability between overweight and obese women, and to investigate the relationship of BMI and body weight with the outcomes. MethodsThirty women with class 1 obesity and 30 overweight women were included. Standing postural stability with eyes-open and eyes-closed and stability limits were assessed using the Prokin system. The Timed Up and Go Test (TUG) was used to assess functional mobility and risk of falling (≥11 s) and developing disability (≥9 s). ResultsThe average center of pressure displacements on the y-axis (COPY) obtained during quiet standing with both eyes-open and eyes-closed were higher in obese women than overweight women (p < 0.05) and the effect sizes were moderate for the results. The COPY values in the eyes-open and eyes-closed conditions were correlated with BMI (r = 0.295 and r = 0.285, p < 0.05). Furthermore, the COPX value in the eyes-open condition and the TUG score were correlated with body weight (r = 0.274 and r = 0.257, p < 0.05). ConclusionsObese women had poorer static standing stability in the anteroposterior direction than overweight women, while functional mobility and risk of falling and developing disability did not differ. Furthermore, BMI and body weight were related to poorer static standing stability.

Finite element method-based study for spinal vibration characteristics of the scoliosis and kyphosis lumbar spine to whole-body vibration under a compressive follower preload

Purpose To analyze the dynamic response of the lumbosacral vertebrae structure of a scoliosis spine and a kyphosis spine under whole-body vibration. Methods Typical Lenke4 (kyphosis) and Lenke3 (scoliosis) spinal columns were used as research objects. A finite element model of the lumbosacral vertebrae segment was established and validated based on CT scanning images. Modal, harmonic response, and transient dynamic analyses were performed on the lumbar-sacral scoliosis model using the finite element software abaqus. Results The first four resonance frequencies of kyphosis spine extracted from modal analysis were 0.86, 1.45, 8.51, and 55.71 Hz. The first four resonance frequencies of scoliosis spine extracted from modal analysis were 0.76, 1.45, 10.51, and 63.82 Hz. The scoliosis spine had the maximum resonance amplitude in the transverse direction, while the kyphosis spine had the maximum resonance amplitude in the anteroposterior direction. The dynamic response in transient analysis exhibited periodic response over time at all levels. Conclusion The scoliosis and kyphosis deformity of the spine significantly complicates the vibration response in the scoliosis and kyphosis areas at the top of the spine. Scoliosis and kyphosis patients are more likely to experience vibrational spinal diseases than healthy people. Besides, applying vertical cyclic loads on a malformed spine may cause further rotation of scoliosis and kyphosis deformities.

Zip-up Loop Myopexy in Heavy Eye Syndrome.

To describe and report the results of a zip-up modification for loop myopexy for facilitating a muscle union procedure in heavy eye syndrome. A retrospective chart review was conducted on patients with heavy eye syndrome in whom the modified surgical technique was performed. Superior and lateral rectus muscle bellies were approximated using a suture 4 to 5 mm from the muscle insertion. Muscles were then zipped together by 5-0 polyester sutures placed in an anteroposterior direction using a hand-over-hand technique. Details of the surgical technique were reported. Ductions, versions, and angles of strabismus were evaluated before and after surgery. Complications were reported. A total of 8 patients were identified (mean age: 60.8 ± 7 years). Mean axial length was 33.2 ± 1.2 mm. Mean preoperative horizontal and vertical angles of deviation were 78 ± 20 prism diopters (PD) (range: 50 to 120 PD) and 34 ± 4 PD (range: 30 to 40 PD), respectively. Preoperative limitation of abduction and elevation was -4 to -5 in all patients. An average of seven to eight sutures were used. No intraoperative complications were reported. In 7 patients, both vertical and horizontal angles of deviation were reduced to within 8 PD from orthophoria and limitation of ductions was reduced to null or -1 after surgery. Undercorrection occurred in 1 patient with bilateral heavy eye syndrome who had unilateral surgery. No recurrences developed over a median of 6 months of follow-up. A zip-up modification for loop myopexy can facilitate the surgical procedure to achieve a satisfactory outcome in heavy eye syndrome. [J Pediatr Ophthalmol Strabismus. 2024;61(4):279-286.].

Effect of short foot exercise on lower-limb motor control function during single-leg standing in university students with flatfoot: A randomized controlled trial

IntroductionIntrinsic foot muscles (IFMs) play an important role in lower-limb motor control, including biomechanics and neuromuscular control function. Short foot exercise (SFE) and toe curl exercise (TC) are methods used to train the IFMs, but their effect on lower-limb motor control has not been reported in previous studies. This study evaluated the effects of SFE and TC on lower-limb motor control function during single-leg standing (SLS). Trial designRandomized control trial. MethodThirty-six participants with flatfoot were randomly assigned to the SFE or TC group and performed exercise for 8 weeks. The assessment items were navicular drop test, toe grip strength (TGS), plantar sensation, and SLS. In the SLS assessment, we measured the mean center of pressure (COP) amplitude in the anteroposterior (AP) and mediolateral (ML) directions, onset time of gluteus maximus (G. max) and gluteus medius (G. med), angle of forefoot/hindfoot protonation and hip adduction, and lateral pelvic shift. Mixed-model repeated-measures analysis of variance and Bonferroni corrections were performed in statistical analysis. ResultsThe SFE group showed significant differences between pre- and post-intervention for TGS (p < 0.001), COP ML (p = 0.039), and onset times of G. max (p = 0.015), and G. med (p < 0.001). The TC group showed no significant differences in all assessment items. ConclusionOur finding suggests that SFE contributes to lower neuromuscular control function in people with flatfoot. Trial registrationUMIN000049963.

Symmetric unipedal balance in quiet stance and dynamic tasks in older individuals

Previous evidence of increased difference of muscular strength between the dominant and non-dominant legs in older adults suggests the possibility of dissimilar balance control between the legs (between-leg asymmetry) associated with aging. In the current investigation, we evaluated between-leg asymmetries in older adults when performing quiet and dynamic balance tasks. Fifty-two physically active and healthy older adults within the age range of 60 to 80 years were recruited. Participants performed balance tasks in unipedal stance, including quiet standing and cyclic sway (rhythmic oscillation) of the non-supporting leg in the anteroposterior or mediolateral directions, producing foot displacements with amplitudes of 20 cm paced in 1 Hz through a metronome. Body balance was evaluated through trunk accelerometry, by using the sensors embedded into a smartphone fixed at the height of the 10th-12th thoracic spines. Analysis revealed lack of significant differences in balance control between the legs either when comparing the right versus left or the preferred versus non-preferred legs, regardless of whether they were performing quiet stance or dynamic tasks. Further examination of the data showed high between-leg correlation coefficients (rs range: 0.71–0.84) across all tasks. Then, our results indicated symmetric and associated between-leg balance control in the examined older adults.

Regional variation of the cortical and trabecular bone material properties in the rabbit skull.

The material properties of some bones are known to vary with anatomical location, orientation and position within the bone (e.g., cortical and trabecular bone). Details of the heterogeneity and anisotropy of bone is an important consideration for biomechanical studies that apply techniques such as finite element analysis, as the outcomes will be influenced by the choice of material properties used. Datasets detailing the regional variation of material properties in the bones of the skull are sparse, leaving many finite element analyses of skulls no choice but to employ homogeneous, isotropic material properties, often using data from a different species to the one under investigation. Due to the growing significance of investigating the cranial biomechanics of the rabbit in basic science and clinical research, this study used nanoindentation to measure the elastic modulus of cortical and trabecular bone throughout the skull. The elastic moduli of cortical bone measured in the mediolateral and ventrodorsal direction were found to decrease posteriorly through the skull, while it was evenly distributed when measured in the anteroposterior direction. Furthermore, statistical tests showed that the variation of elastic moduli between separate regions (anterior, middle and posterior) of the skull were significantly different in cortical bone, but was not in trabecular bone. Elastic moduli measured in different orthotropic planes were also significantly different, with the moduli measured in the mediolateral direction consistently lower than that measured in either the anteroposterior or ventrodorsal direction. These findings demonstrate the significance of regional and directional variation in cortical bone elastic modulus, and therefore material properties in finite element models of the skull, particularly those of the rabbit, should consider the heterogeneous and orthotropic properties of skull bone when possible.

Older adults and individuals with Parkinson's disease control posture along suborthogonal directions that deviate from the traditional anteroposterior and mediolateral directions.

A rich and complex temporal structure of variability in postural sway characterizes healthy and adaptable postural control. However, neurodegenerative disorders such as Parkinson's disease, which often manifest as tremors, rigidity, and bradykinesia, disrupt this healthy variability. This study examined postural sway in young and older adults, including individuals with Parkinson's disease, under different upright standing conditions to investigate the potential connection between the temporal structure of variability in postural sway and Parkinsonism. A novel and innovative method called oriented fractal scaling component analysis was employed. This method involves decomposing the two-dimensional center of pressure (CoP) planar trajectories to pinpoint the directions associated with minimal and maximal temporal correlations in postural sway. As a result, it facilitates a comprehensive assessment of the directional characteristics within the temporal structure of sway variability. The results demonstrated that healthy young adults control posture along two orthogonal directions closely aligned with the traditional anatomical anteroposterior (AP) and mediolateral (ML) axes. In contrast, older adults and individuals with Parkinson's disease controlled posture along suborthogonal directions that significantly deviate from the AP and ML axes. These findings suggest that the altered temporal structure of sway variability is evident in individuals with Parkinson's disease and underlies postural deficits, surpassing what can be explained solely by the natural aging process.

MV CBCT based assessment of setup uncertainties and planning target volume margin in head and neck cancer.

Set-up errors are an undesirable part of the radiation treatment process. The goal of online imaging is to increase treatment accuracy by reducing the set-up errors. This study aimed to determine the daily variation of patient set-up uncertainties and planning target volume (PTV) margins for head and neck cancer patients using pre-treatment verification by mega voltage cone-beam computed tomography (MV-CBCT). This retrospective study was internal record base of head and neck (H&N) cancer patients treated with definitive radiotherapy, adjuvant radiotherapy, and hypo-fractionated radiotherapy at our institution since the implementation of HalcyonTM 2.0 machine (Varian, US). Errors collected from each patient setup were recorded and evaluated for each direction [medio-lateral (ML), supero-inferior (SI), antero-posterior (AP)] discretely. For each patient, the systematic error (∑) and random error (σ) were collected. Clinical target volume (CTV) to planning target volume (PTV) margin was calculated using International Commission on Radiation Units and Measurements (ICRU) 62 ( ), Stroom's (PTV margin = 2∑ + 0.7σ), and Van Herk's (PTV margin = 2.5∑ + 0.7σ) formula. A total of 7900 pre-treatment CBCT scans of 301 patients were analyzed and a total of 23,000 error measurements in the ML, SI, and AP directions were recorded. For all of our H&N cancer patients, the CTV to PTV margin, calculated from the van Herk formula for the head and neck patients was 0.49 mm in the anteroposterior axis. An isometric PTV margin of 5 mm may be considered safe if daily imaging is not being done. In case daily online pretreatment imaging is being utilized, further reduction of PTV margin is possible.

Use of posturography in patients with ankylosing spondylitis: A systematic review.

Ankylosing spondylitis (AS) is characterised as a chronic inflammatory disease of the axial skeleton. The force platform is an option for performing the postural assessment of these individuals. To review and evaluate the behaviour of the centre of pressure (CoP) variables during the postural control examination in patients with AS compared to a control group. A systematic review, registered in PROSPERO, that followed the PRISMA Statement. A search was carried out in the following databases: Medline, Web of Science, Embase, Scopus, and Scielo, from 1945 to 2023. Studies were selected that aimed to understand the use of the force platform for the assessment of postural control. The risk of bias assessment was performed using the AXIS tool. Five studies were included, with a total of 247 participants. The assessment of risk of bias presented high scores in the AXIS tool. Patients with a diagnosis of AS presented increased thoracic kyphosis in most of the studies, as well as large displacements in the anteroposterior (AP) and mediolateral (ML) directions, and altered total mean velocity (TMV) and frequency, indicating worse postural stability. Regarding the functional status, the most used questionnaires were the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Disease Activity Index (BASDAI). Patients with ankylosing spondylitis present postural instability, verified by means of higher values of centre of posture variables. Individuals with ankylosing spondylitis presented postural instability and balance deficit. Therefore, exercises for balance training and postural control are essential in the clinical management of these patients.

The tortuous course of the anterior ethmoidal artery in the orbit: A cadaveric study

AimThe study aimed to define the coursing pattern of the anterior ethmoidal artery (AEA) in the orbit to minimize complications during endoscopic interventions. Materials and methodsA total of ten formalin-fixed cadaveric halves were included in the study. Orbital regions were shown with a superior approach. The superior rectus and superior oblique muscles, as well as the connective tissue and vessels were removed to observe the path of the anterior ethmoidal artery. Measurements such as the width of the artery, the anterior-posterior length of the U formation, the length of the intraorbital part of the ophthalmic artery, and the distance of the AEA from its opthalmic origin to the anterior ethmoidal foramen were made. ResultsTen of the AEAs originated from the ophthalmic artery. The AEA branches originated from the ophthalmic artery approximately 18.4 mm after the orbital artery entered the orbital, and the mean width of the AEAs was 0.82 mm. In seven of the total anterior ethmoidal arteries, they coursed in the intraethmoidal cavities below the cranial base. The mean distance from the origin of AEAs to the medial wall of the orbit was 4.9 mm. After leaving the ophthalmic artery, seven of the AEAs were coursing forward and turned back ('U' turn formation), which have proximately 1.5 mm in anteroposterior direction. ConclusionThe anterior ethmoidal artery is 0.8 mm wide, originates from the distal part of the ophthalmic artery, entering the orbit after a 1.5 mm U-turn.

Propulsive forces and muscle activation during gait: comparisons between premenopausal and postmenopausal midlife women.

The aim of this study was to investigate whether there is a reduction in propulsive force during gait in postmenopausal women compared with premenopausal women. Forty-four women (21 premenopausal and 23 postmenopausal women) aged 40 to 55 years were selected. The ability to reach peak propulsive forces was assessed during the step execution test. The test was performed at the usual speed on 2 nonconsecutive days, with two attempts per day, using a force platform. Four temporal parameters were defined and calculated: initiation phase, preparation phase, swing phase, and total time. Peak force (anteroposterior and vertical) and time to reach peak force were obtained in both preparation and swing phases. The rate of force development was defined as peak force divided by time to reach peak force. The postmenopausal women group presented a longer time in the preparation phase (540.6 ± 77 ms vs 482.5 ± 93 ms, P = 0.024) and consequently a longer total time in the step execution test (1,191 ± 106.4 ms vs 1,129 ± 114.3 ms, P = 0.045). There were differences between the groups for the rate of force development in the anteroposterior (postmenopausal women, 142.5 ± 38.1 N/s vs premenopausal women, 174.7 ± 70.5 N/s; P = 0.022) and vertical directions in the preparation phase (postmenopausal women, 102.7 ± 62.3 N/s vs premenopausal women, 145.3 ± 71 N/s; P = 0.012). No significant differences ( P > 0.05) were found in force, time to peak force, and rate of force development during the swing phase. In addition, there were no observed differences in surface electromyography of the medial and lateral gastrocnemius muscles during the preparation phase and swing phase of the step execution test between the two groups. Postmenopausal women exhibited lower ability to generate propulsive force rapidly (rates of force development) in both the anteroposterior and vertical directions during the preparation phase of gait compared with premenopausal women. This indicates that postmenopausal women experience a reduction in propulsive force during gait.

The Effects of a Simulated Duathlon on Trunk Motion: A Sensor Based Approach

Duathlon consists of two durations of running separated by cycling in a format similar to triathlon. The addition of cycling and the associated loadings on the neuromuscular system can modify spatiotemporal variables in running including trunk motion, which can impact running economy. Changes to trunk motion can be inferred by measuring accelerations of the centre of mass (CoM). However, there is scarce research into trunk dynamics in duathlon. Therefore, the aim of this study was to use an inertial sensor (an accelerometer) to compare acceleration magnitudes of the trunk in the vertical, mediolateral, and anteroposterior directions during a simulated field-based duathlon. Specifically, running performance and magnitudes of trunk acceleration were compared pre and post a cycling load. Ten well-trained duathletes (seven males, three females (mean ± SD; age: 31.1 ± 3.4 years; body mass: 70.9 ± 6.9 kg; body height: 177 ± 5.82 cm; 9.45 ± 1.7 weekly training hours per week; 9.15 ± 5.2 years training experience)) completed a 5 km run performed at a self-selected pace (described as moderate intensity) prior to 20 km of continuous cycling at four varied cadence conditions. This was immediately followed by a 2.5 km run. Mean completion times for the final 2.5 km in running pre-cycling (4.03:05 ± 0.018) compared to the 2.5 km in running post-cycling (4.08:16 ± 0.024) were significantly different. Regarding trunk acceleration, the largest difference was seen in the vertical direction (y axis) as greater magnitudes of acceleration occurred during the initial 1 km of running post-cycling combined with overall significant alterations in acceleration between running pre- and post-cycling (p = 0.0093). The influence of prior cycling on trunk acceleration activity in running likely indicates that greater vertical and mediolateral trunk motion contributes to decremental running performance. In future, further advanced simulation and analysis could be performed in ecologically valid contexts whereby multiple accelerometers might be used to model a more complete set of dynamics.

Influence of celiac disease on balance control and bone mineral density in adult women

AbstractBackground and PurposeCeliac Disease (CD) is a chronic form of autoimmune enteropathy caused by gluten and related prolamin consumption. CD presents as a neurological, rheumatological, and musculoskeletal disorder, with ataxia and peripheral neuropathy being the most common. These symptoms could affect balance control and consequently the daily activities and decreased bone mass of these individuals. Although balance disorders are increasingly common, and the diagnosis of celiac diseases is growing worldwide, there is no consensus on the influence of a gluten‐free diet (GFD) on balance control and bone mineral density (BMD). This study aimed to analyze the influence of celiac disease on balance control and BMD in adult women.MethodsA total of 52 adult women aged 18–56 years participated in the study and were divided into two groups: with (26 patients) and without celiac disease (26 patients). The outcome variables were obtained by anthropometry and sociodemographic data. The Celiac Dietary Adherence Test questionnaire was used to assess adherence to the GFD, Neurocom ™ Smart Equitest® to determine balance control, and GE® Lunar Prodigy Advance DXA Bone densitometer for evaluation of BMD. The displacement of the center of pressure in the anteroposterior and mediolateral directions was evaluated under six conditions of the sensory organization test through a routine test performed in MATLAB.ResultsAdult women with CD who adhered to a GFD had vestibular system deficits and normal BMD.DiscussionAdult women with CD presented less balance control when they required greater activation of the vestibular system, suggesting that adherence to a GFD leads to normal bone mass.

Analysis of respiratory-induced motion trajectories of individual liver segments in patients with hepatocellular carcinoma.

To analyze the respiratory-induced motion trajectories of each liver segment for hepatocellular carcinoma (HCC) to derive a more accurate internal margin and optimize treatment protocol selection. Ten-phase-gated four-dimensional computed tomography (4DCT) scans of 14 patients with HCC were analyzed. For each patient, eight representative regions of interest (ROI) were delineated on each liver segment in all 10 phases. The coordinates of the center of gravity of each ROI were obtained for each phase, and then the respiratory motion in the left-right (LR), anteroposterior (AP), and craniocaudal (CC) directions was analyzed. Two sets of motion in each direction were also compared in terms of only two extreme phases and all 10 phases. Motion of less than 5mm was detected in 12 (86%) and 10 patients (71%) in the LR and AP directions, respectively, while none in the CC direction. Motion was largest in the CC direction with a maximal value of 19.5mm, with significant differences between liver segment 7 (S7) and other segments: S1 (p<0.036), S2 (p<0.041), S3 (p<0.016), S4 (p<0.041), and S5 (p<0.027). Of the 112 segments, hysteresis>1mm was observed in 4 (4%), 2 (2%), and 15 (13%) in the LR, AP, and CC directions, respectively, with a maximal value of 5.0mm in the CC direction. A significant amount of respiratory motion was detected in the CC direction, especially in S7, and S8. Despite the small effect of hysteresis, it can be observed specifically in the right lobe. Therefore, caution is required when using 4DCT to determine IM using only end-inspiration and end-expiration. Understanding the respiratory motion in individual liver segments can be helpful when selecting an appropriate treatment protocol.

Analysis of the origin and invasion of prostate cancer from autopsy and radical prostatectomy specimens.

Without a pseudocapsule, prostate cancer is invasive in volume growth and has some regularity in spatial distribution. Our study aims to explore the specific origin location, invasive characteristics, and morphology of prostate cancer. Ninety-eight clinical specimens with tumor volume equal to or less than one-third of the organ volume and 111 autopsy specimens were retrospectively analyzed. The origin location and invasion of prostate cancer in four horizontal quadrants and 11 vertical slides were demonstrated. In addition, the median maximum anteroposterior, left-right, horizontal, and vertical diameters of lesions were compared, and the spatial morphology of lesions was described. There were 335 lesions in the autopsy and clinical specimens. There was no significant difference in the distribution of lesions confined to the horizontal quarter quadrant (P=0.064). The number of lesions with a single positive slide above the apex 0.5-1.4 cm was 75 (49.7%). No significant difference was found when compared with the maximum vertical and horizontal diameters (P=0.421). However, the maximum left-right and horizontal diameters were longer than the maximum anteroposterior diameter (P=0.046 and P<0.001). The number of lesions with a tumor area that decreased from the center to both sides was 85 (46.2%) and decreased from the center to one side was 81 (44.0%). Approximately 50% of the lesions originated from the apex above 0.5-1.4 cm. The invasive tendency of prostate cancer was consistent in the horizontal and vertical dimensions but less so in the anteroposterior direction. About ninety percent of lesions with tumor area decreased from the center to both sides or one side.