Pelvic Height Research Articles

A Study on Imaging Risk Factors for Hip Osteoarthritis.

Due to low prevalence and few studies, the morphologic risk factors for hip osteoarthritis (HOA) in Chinese population remain unknown. The purpose of this study was to investigate the relationship between 10 radiographic parameters measured via anteroposterior pelvic X-ray radiography and HOA in Chinese population. Thirty-three patients who required total hip arthroplasty for unilateral HOA (2017-2022) and 132 healthy individuals were selected for this case-control study. We measured 10 radiological parameters via anteroposterior pelvic X-ray radiography, which were sharp angle, center edge angle, sourcil angle, neck shaft angle, α angle, pelvic height, pelvic width, femoral head diameter, femoral neck width, and ratio of the femoral head diameter to the femoral neck width. After measurements were obtained, logistic regression analysis was utilized to calculate the adjusted odds ratios (ORs) for confounding variables such as age, sex, and body mass index (BMI). Receiver operating characteristic (ROC) curves were utilized to determine the proportional risk contribution (PRC) of each radiographic factor. After adjustment for confounding factors, individuals with a larger sourcil angle (SA) (OR = 4.89, 95% CI 1.66-14.42, p = 0.004), larger α angle (OR = 4.14, 95% CI 1.53-11.23, p = 0.005), and wider femoral neck (OR = 5.27, 95% CI 1.50-18.51, p = 0.01) were found to have a greater risk of developing HOA. Among all radiographic parameters, the SA demonstrated the greatest risk contribution (PRC = 13.695%). Radiographic parameters correlate with the incidence of HOA. The SA is probably the most powerful of all the parameters related to HOA.

The adaptability of Garut sheep grazing on oil palm and rubber plantations in tropical conditions of Indonesia.

The productivity of sheep in humid tropical plantation areas relies on their ability to adapt. Oil palm plantations serve as potential grazing lands for livestock. This study aimed to identify Garut sheep adaptations in oil palm and rubber plantations of the Garut district, West Java, Indonesia. The total number of sheep used was 103 as the object of this study. Each individual of sheep was used for several different observations, including: Physiological assessment using 24 sheep of various ages, molecular analysis of heat stress using 31 sheep, worm egg count using 59 sheep, and for morphological assessment using 98 sheep. A general linear model was employed to analyze rectal temperature (RT), heart rate (HR), respiratory rate, number of eggs in each gram of sample feces, body weight (BW), body condition score, and morphometric measurements according to age and sex. Forage was compared between oil palm and rubber plantations during the vegetation analysis. RT, HR, and panting frequency were significantly (p < 0.05) affected by the age and sex of the sheep. The mutation was found in the coding region of the HSP70 gene, which is approximately 232 bp long. Fecal eggs were found in 99% of the fecal samples, consisting of 100% Strongyle eggs and 1.75% Moniezia eggs. BW, body condition score, shoulder height, body length, pelvic height, chest circumference, and number of eggs were significantly affected (p < 0.05) by the age and sex of the sheep. The average fresh matter of vegetation under the plantation was 248.69 ± 120.94 g/m2 and 718.15 ± 249.93 g/m2 for oil palm and rubber plantations, respectively. Garut sheep were adapted to oil palm and rubber plantations in the humid tropical region. Plantations are potential sources of sheep grazing and roughage. Further research is needed regarding the consumption of forages in oil palm and rubber plantations.

Morphometric Analysis of Hip Bones for Gender Identification in Unexpected Death Cases in Kabul, Afghanistan

Introduction: Unexpected deaths in Kabul Afghanistan often involve victims who cannot be identified due to facial disfigurement or missing identity documents. Gender identification is an important step in the forensic identification process, especially in cultural and religious contexts that have strict norms regarding gender. Pelvic bone morphometric analysis offers an accurate and non-invasive method for gender identification. This study aims to evaluate the effectiveness of hip bone morphometric analysis in identifying gender in cases of unexpected death in Kabul, Afghanistan. Methods: The samples consisted of 100 human pelvises, 50 of each gender, collected from skeletal remains at Kabul hospitals and burial grounds. Pelvic dimensions were measured using calibration techniques and statistical analysis was performed to identify significant morphometric differences between the gender. Results: Morphometric analysis showed significant differences in several pelvic dimensions between men and women. The most informative dimensions for gender identification are pelvic width, pelvic height, and superior diameter of the acetabulum. The prediction model developed using these dimensions achieved a gender identification accuracy of 94%. Conclusion: Pelvic bone morphometric analysis can be a valuable tool for forensic identification in cases of unexpected deaths in Kabul Afghanistan. This method offers high accuracy, is non-invasive and easy to apply, and can help in the process of identifying victims and resolving legal cases.

Characteristics of walking techniques with different pelvic height and pelvic rotation: effect on muscle activation and energy consumption.

Purpose: Previous studies have proven that modifications in the natural walking technique alter muscle activation and energy consumption. This research aimed to determine the differences in muscle activation, energy consumption, kinematic characteristics, perceived muscular exertion and perceived cardio-respiratory fatigue between natural and modified walking techniques with altered pelvic height and rotation. Methods: Nine physically active, non-injured males walked on a treadmill. Modified walking techniques assumed maintenance of constant pelvic height and application of maximal pelvic rotation. Walking speed was subtransit - 0.4 km/h less than the transit. Sampled variables were: average normalized maximal activation during contact and swing phase relativized to maximal voluntary activation, average submaximal oxygen consumption relativized to body mass and subtransit speed, average step length and frequency, rating of perceived muscular exertion and perceived cardio-respiratory fatigue. Muscle activation, energy consumption and kinematic characteristics were assessed throughout each walking session. Perceived muscular exertion and perceived cardio-respiratory fatigue were evaluated post-session. Electromyographic activity was assessed for rectus femoris, gluteus maximus, vastus medialis, biceps femoris, tibialis anterior and gastrocnemius lateralis. Results: The most significant changes in muscle activation were observed during the contact phase. A decrease in pelvic height increased muscle activation of rectus femoris, vastus medialis and gastrocnemius lateralis. An increase in pelvic rotation increased muscle activation of all monitored muscles except for gluteus maximus. Both modifications increased energy consumption, perceived muscular exertion and perceived cardio-respiratory fatigue, and altered kinematic characteristics. Conclusions: Modifications in pelvic height and rotation at the same walking speed alter muscle activation, energy consumption, kinematic characteristics, perceived exertion and fatigue.

Clinical applicability of external and internal body dimensions in predicting dystocia in late‐gestation Holstein‐Friesian heifers

AbstractThe objective of this study was to determine the clinical applicability of maternal intrapelvic area (PA) and selected morphometric parameters that can be measured before parturition in predicting dystocia in dairy heifers. The measurements were performed in 374 late‐gestation Holstein‐Friesian heifers. Inner pelvic height and width were measured using a pelvimeter, and PA was calculated. The heifers were monitored continuously around the time of calving, and calving difficulty was categorized as: unassisted calving (UC), slight assistance (SA), considerable difficulty (CD) and veterinary assistance (VA). Calving performance was analysed with the χ2 test, and the effect of body dimensions on the course of parturition was evaluated by one‐way analysis of variance. Dystocia (CD + VA) was predicted with the use of the classification tree method. Dystocia accounted for 29.14% of all deliveries. The percentages of stillbirths and retained placenta increased (p &lt; .01) with increasing calving difficulty. Average PA immediately before parturition was smaller (p &lt; .01) in group VA (223.2 cm2) than in group UC (253.3 cm2). According to the classification tree, dystocia may occur (74.07% odds) in heifers with PA &lt; 254.2 cm2 and a rump angle &lt;5.68° before parturition. Measurements of heifer's cannon circumference and sire's body size improve the accuracy of dystocia prediction.

Impact of unilateral mastectomy on body posture: A prospective longitudinal observational study

ObjectiveUnilateral mastectomy is known to induce postural alterations, yet the temporal development pattern of these changes remains elusive. This study aimed to explore the impact of unilateral mastectomy on body posture. MethodsA prospective, longitudinal, observational study with a one-group repeated-measures design was conducted. Patients undergoing unilateral mastectomy were recruited from a university-affiliated hospital in Western China and monitored for 12 months post-surgery. A trained nurse assessed seven postural baseline parameters on the day of suture removal and at 3, 6, and 12 months after unilateral mastectomy. Two parameters were in the sagittal plane (forward head posture and trunk rotation angle), and five were in the coronal plane (neck tilt, shoulder asymmetry, scapular asymmetry, scapular asymmetry relative to the spine, and pelvic tilt). ResultsThe final analysis included 159 patients. Baseline prevalence of most postural abnormalities ranged from 50.94% to 59.75%, with mean deviations between 2.74 and 4.51 mm. At 12 months post-mastectomy, prevalence and mean deviations increased by more than 30% and 3.50 mm, respectively, compared to baseline. Postural abnormalities increased gradually in the first 3 months, notably between the 3rd and 6th months, and slowed between the 6th and 12th months. On the mastectomy side, coronal plane abnormalities significantly increased within 12 months: earlobe to acromion distance (Wald χ2 = 45.283, P < 0.001), depressed shoulder height (Wald χ2 = 42.253, P < 0.001), depressed scapula height (Wald χ2 = 31.587, P < 0.001), scapula to spine distance (Wald χ2 = 45.283, P < 0.001), and elevated pelvic height (Wald χ2 = 48.924, P < 0.001). ConclusionsPostural changes are common post-unilateral mastectomy, with prevalence and deviation increasing gradually, particularly between 3 and 6 months post-mastectomy. Early rehabilitation initiation is recommended to mitigate postural changes. Trial registrationChiCTR2000040897

18F-sodium fluoride positron emission tomography provides pertinent additional information to computed tomography for assessment and management of tarsal pain in horses.

To assess the value of 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) for imaging the tarsus and proximal metatarsus and compare it with CT and lameness evaluation. 25 horses with lameness localized to the tarsal and proximal metatarsal regions that underwent 18F-NaF PET/CT between 2016 and 2021. 18F-NaF PET and CT images were retrospectively independently evaluated by 3 observers. Standardized uptake values (SUV) were used to characterize 18F-NaF uptake. Correlation between PET and CT findings with subjective and objective maximum (Max-D) and minimum pelvic height lameness data was estimated. The inter-observer Kappa-weighted value (κ) was higher for PET (κ = 0.66) than CT (κ = 0.6). CT and PET scores were fairly correlated (R = 0.49; P < 0.05). PET SUVratio (SUV of the main lesion/SUV talus) had the highest correlation with Max-D (R = 0.71; P < .05). PET and CT scores for the plantar region were significantly higher in Quarter Horses (P < .05) and showed consistently higher correlation with objective lameness data (CT plantar grade - Max-D [R = 0.6; P < .05], PET plantar grade - Max-D [R = 0.47; P = .04]) than other regions of the distal tarsal joints. Three Warmbloods presented marked uptake at the medial cochlea of the distal tibia. PET had a moderate correlation with CT for assessment of tarsal lesions. The degree of PET uptake can help differentiate active versus inactive lesions. Specific location of the uptake is important in determining clinical relevance.

Pelvic coronal inclination change in adolescent flexible flatfoot surgically treated with arthroereisis

Objective: To evaluate adolescent pelvic coronal inclination angle change after flatfoot treated with arthroereisis. Method: A case-series study. From June 2018 to September 2020, 25 children with flexible flat foot and pelvic obliquity were included in this retrospective study in Peking University Shenzhen Hospital. There were 17 males and 8 females with a mean age of (11.2±2.2) years (9-15 years). There were 5 cases of unilateral flatfoot and 20 cases of bilateral flatfoot. All of the patients were surgically treated with arthroereisis. Regular follow-up was done in 3 months, 1 and 2 years postoperatively. Weightbearing fluoroscopy of entire lower limb and foot were investigated to measure Meary's angle, calcaneal pitch angle, height difference at ankle and pelvic plane, pelvic inclination and sacrum-iliac distance (F value) on coronal plane. Results: The mean Mearys' angle at 3 month postoperatively was improved when compared with that before the operation (3.1°±1.5° vs 25.9°±4.3°, P<0.001), and it remained at the same level 2 years after the operation (compared with that at 1 year after the operation, P=0.748). The calcaneal pitch angle improved significantly at 3-month follow-up when compared with that before the operation (16.6°±2.4° vs 9.9°±1.5°, P<0.001), and there was no significant change between 1 year and 2 years after operation (P=0.542). The height difference at mortise plane were also reduced at the 3-month follow-up(P<0.001), and it remained at the same level at 1 year and 2 years after the operation (P=0.159). Pelvic height difference decreased dramatically from (12.4±1.7) mm (before operation) to (7.1±1.2) mm(3 month after the operation) (P<0.001), it decreased to (3.6±1.8) mm 1 year after the operation (compared with that at 3 months after the operation, P<0.001), and no further reduction was observed 2 years after the surgery (P=0.483). The pelvic inclination angle and sacrum-iliac distance were also improved at 3-month follow-up when compared with those before the operation (both P<0.001), and they declined further 1 year after the operation(both P<0.05), but the decreasing trend disappeared at the 2-year follow-up (both P>0.05). Conclusion: For adolescent flexible flat foot patients with pelvic obliquity, the coronal inclination and pelvic height discrepancy would partially recovered with correction of flatfoot deformity, but it could not be completely corrected in the mean follow-up period of 2 years after the operation.

Pelvic index: A new pelvic parameter for assessing sagittal spinal alignment

The incidence of correctional surgery for adult spinal deformity (ASD) has increased significantly over the past 2 decades. Pelvic incidence, an angular measurement, is the gold standard pelvic parameter and is used to classify spinal shapes into Roussouly types. Current literature states that restoration of the spine to its original Roussouly classification optimizes outcomes. We propose a new pelvic parameter, pelvic index, as a length measurement to complement pelvic incidence in more accurately characterizing Roussouly types. This study is a retrospective evaluation of sagittal spinal radiographs of 208 patients who were assessed by a single fellowship trained orthopedic spine surgeon between January and December 2020. Measurements included pelvic incidence, sacroacetabular distance, and L5 vertebral height. Pelvic index was calculated as the ratio of sacroacetabular distance to L5 height. Each spine was also classified into one of the Roussouly types: 1, 2, 3 anteverted pelvis (AP), 3, or 4. The 2 pelvic parameters were compared between groups to assess their ability to differentiate between Roussouly types. Of the 208 patients included, 103 (49.5%) were female and 105 (50.5%) were male. The mean pelvic incidence was 54.9 ± 12.3° and the mean pelvic index was 3.99 ± 0.38. The difference in mean pelvic index was statistically significant between types 1 and 2 (0.15; p=.046) and between types 1 and 3 AP (0.19; p=.029). It was not statistically significant between types 3 and 4 (0.05; p=.251). However, in terms of pelvic incidence, the mean difference was statistically significant only between types 3 and 4 (10.4; p<.001). Pelvic index is the ratio of the sacroacetabular distance to the height of the L5 vertebra. In conjunction with pelvic incidence, pelvic index can help to distinguish between Roussouly types 1 and 2 and between types 1 and 3 AP, the low-pelvic incidence types.

Analysis of the mechanism and clinical classification of thoracolumbar scoliosis using three-dimensional EOS and surface electromyography

To analyze a thoracolumbar scoliosis group, we analyzed data from the acquired database by groups: the sEMG group (n = 16) and 3D-EOS group (n = 55). The asymmetric hyper/hypoactivation ratio of muscle and LLD (>3 mm) were measured in the sEMG group. In the 3D-EOS group, we recorded the values of parameters including LLD, pelvis rotation, and kyphosis/lordosis. In the sEMG study, sEMG examinations were conducted individually in patients with idiopathic scoliosis to analyze hyper/hypoactivation of the paraspinal muscle. In the three-dimensional EOS study, the Cobb angle, femoral height difference, and thoracic kyphosis and lumbar lordosis angles were measured using 2D images and 3D reconstructed images.Sixteen patients with thoracolumbar scoliosis were classified into asymmetric hyperactivation (A-Hyper) and asymmetric hypoactivation (A-Hypo) groups. The Cobb angle of the A-Hyper subtype was significantly higher than that of the A-Hypo subtype (22.41 versus 15.2, p = 0.023). Coronal deviation (p = 0.028) and the pelvis rotation angle (p = 0.001) were significantly higher in the LLD (+) subtype than in the LLD (−) subtype. When we classified patients cross-sectionally along with A-Hyper/Hypo and LLD (±), A-Hyper elevated the Cobb angle, and LLD (+) was significantly correlated with coronal deviation and pelvis rotation. In the 3D-EOS evaluation, the pelvic height difference (p = 0.043) and coronal deviation (p = 0.001) were significantly higher in the LLD (+) subtype than in the LLD (−) subtype.In conclusions, paraspinal muscular asymmetry and LLD can be strong factors in inducing or progressing thoracolumbar scoliosis.

Effects of different pelvic osteotomy surgeries on acetabular center and pelvic morphology

ObjectiveTo compare the effects of Salter pelvic osteotomy, Pemberton pelvic osteotomy, and triple pelvic osteotomy on the center of acetabulum and pelvic morphology in children with hip joint disease.MethodsThe data of children treated with Salter pelvic osteotomy (2 males and 14 females with an average age of 2.49 years), Pemberton pelvic osteotomy (4 males and 11 females with an average age of 6.11 years), and triple pelvic osteotomy(4 males and 8 females with an average age of 9.59 years) between January 2011 and December 2020 were collected. After discharge, the outpatient review was followed up for at least 1 year. All patients underwent anterior–posterior pelvic X-ray scanning before surgery, three months after surgery in the first year and every six months after the first year. The following X-ray features were analyzed: bilateral pelvic height (PH), iliac crest inclination (ICI), a horizontal distance of the acetabulum center (HD), and vertical distance of the acetabulum center (VD).ResultsThe mean follow-up time was 16.9 ± 4.9 months in the Salter group, 20.7 ± 5.1 months in the Pemberton group, and 18.0 ± 5.4 months in the triple group (all P > 0.05). No significant differences between PH, HD, and VD of both sides on the preoperative AP pelvic x-ray were found. However, at the last follow-up, PH, HD,VD, and ICI increased in the Salter group (all P < 0.05), PH and VD increased in the Pemberton group (all P < 0.05), and VD decreased in the Triple group (P < 0.05).ConclusionSalter pelvic osteotomy may cause pelvic height to increase and the center of acetabulum to move outward and downward. In contrast, Pemberton pelvic osteotomy may cause pelvic height to increase and the center of acetabulum to move downward. Triple pelvic osteotomy only causes the center of acetabulum to move downward.

The choice of pelvic osteotomy technique in young children with hip dysplasia

BACKGROUND: The choice of pelvic osteotomy in young children with late diagnosis of hip dysplasia most often depends on the experience and preferences of the surgeon, and the diagnosis of the degree of violation of the ratios is based on the generally accepted classification of hip dysplasia without considering possible variants of the deformation of the acetabulum. We hypothesized that the choice of the pelvic osteotomy technique in the surgical treatment of children with hip dysplasia of varying severity should be based on the variant of acetabulum deformation and the corrective capabilities of pelvic osteotomy.&#x0D; AIM: This study aimed to compare and analyze the results of the surgical treatment of children with hip dysplasia of varying severity and to evaluate the effectiveness of the proposed differentiated approach to the choice of the pelvic osteotomy technique.&#x0D; MATERIALS AND METHODS: The study included 150 patients (150 hip joints) aged 24 years (3.1 0.45) with grade IIIV hip dysplasia, according to the supplemented classification of Tnnis. Depending on the verified variant of acetabulum deformity and taking into account the corrective capabilities of various osteotomies, we divided the patients into three groups. All patients underwent conventional clinical and X-ray examinations. During radiometry, the following indicators were evaluated: acetabular index (AI), Wiberg angle, neckshaft angle (NSA), anteversion angle of the proximal femur, degree of bone coverage, acetabulum depth (AD) and pelvic height, length of the acetabular arch (LAA), and presence or absence of a bone oriel (BO).&#x0D; RESULTS: In the comparative analysis of the radiographic anatomical condition of the hip joint in children with hip dysplasia of varying severity, the differentiated use of the modified Salter pelvic osteotomy without autograft and pericapsular acetabuloplasty according to Pemberton and Pembersal surgery led to adequate correction of various variants of congenital acetabular deformity with approximately normal anatomy of the acetabulum and not lead to significant deformation of the hemipelvis, such as elongation.&#x0D; CONCLUSIONS: The results of the surgical treatment of young children with hip dysplasia of varying severity according to the proposed differentiated approach to the choice of the pelvic osteotomy technique, which is based on the variant of acetabulum deformation, indicate the achievement of adequate correction of congenital deformity of the acetabular component of the joint with the restoration of its anatomical structure and avoidance of secondary deformation of the hemipelvis. The effectiveness of the proposed approach to the choice of pelvic osteotomy technique in the treatment of young children with hip dysplasia of varying severity is confirmed by the changes in AI, Wiberg angle, AD, and PH, whose values became close to the individual norm (p 0.05), and reduction of possible secondary deformities.

Single-Session Impact of High-Power Laser with Moses Technology for Lower Pole Stones in Retrograde Intrarenal Surgery: Retrospective Study

Background: This study aimed to evaluate the efficacy of a high-power holmium laser with Moses technology (MT) for the treatment of lower pole stones during retrograde intrarenal surgery (RIRS). Methods: Herein, 305 patients with lower pole stones who underwent RIRS using a high-power holmium laser with MT were retrospectively classified into the stone-free (SF) and non-SF groups. We measured the stone burden, stone volume, stone hardness, pre- or post-operative stent placement, infundibulopelvic angle (IPA), infundibular width (IW), infundibular length (IL), and calyceal pelvic height in terms of pelvicalyceal anatomy using retrograde pyelograms and evaluated the predictive factors of postoperative SF. Results: A total of 173 (56.7%) and 229 (75.1%) patients achieved a SF status on postoperative day one and at one month, respectively. Operation time in the SF group was shorter than that in the non-SF group (51.0 vs. 74.5 min). There were no significant differences in postoperative complications between the SF and non-SF groups. Significantly predictive risk factors in postoperative SF included total stone volume (odds ratio (OR), 1.056; 95% CI, 1.015-1.099; p = 0.007), IPA (OR, 0.970; 95% CI, 0.956-0.993; p = 0.009), and IW (OR, 0.295; 95% CI, 0.121-0.718; p = 0.007). The cut-off values of stone volume, IPA, and IW were 515.2 mm3, 46.8°, and 7.75 mm, respectively. Conclusions: A high-power holmium laser with MT in lower pole stones is a valuable option for positive outcomes and patient's safety. Larger stone volume, acute IPA, and narrow IW were negative predictors related to postoperative SF status.

Pelvicalyceal anatomy on the accessibility of reusable flexible ureteroscopy to lower pole calyx during retrograde intrarenal surgery.

This study aimed to evaluate the pelvicalyceal anatomy on accessibility of reusable flexible ureteroscopy (fURS) to the lower pole calyx during retrograde intrarenal surgery (RIRS). Here, 854 patients with ureteral or kidney stones with access to a renal collecting system using reusable fURS were classified into either the accessible group, in whom the deepest lower pole calyces could be touched; and the inaccessible group, in whom the deepest lower calyces could not be touched. We measured the infundibulopelvic angle (IPA), infundibular width (IW), infundibular length (IL), and calyceal pelvic height (CPH) using retrograde pyelograms and performed intergroup comparisons. The median IPA, IW, IL, and CPH in the accessible and inaccessible group were 60.5° and 45.6° (p < 0.001), 10.8 and 9.4 mm (p < 0.001), 33.2 and 36.4 mm (p < 0.001), and 25.9 and 30.9 mm (p < 0.001), respectively. IPA (OR 0.963, 95% CI 0.952-0.974, p < 0.001) and IW (OR 0.519, 95% CI 0.331-0.816, p=0.004) were significant risk factors of renal pelvicalyceal anatomy related to the accessibility of the lower pole calyces. The cut-off value for IPA and IW was 45.8°(p < 0.001) and 7.8 mm (p < 0.001), respectively. IPA < 45.8° and IW <7.8 mm were negative predictors to access the lower pole calyces when using reusable fURS during RIRS.

Novel scoring system combined with a virtual reality technique for the preoperative evaluation of the stone-free status after flexible ureteroscopy: the H.L.P.E.S. score

ObjectiveThe original S.O.L.V.E. scoring system was modified using virtual reality technology, and a new H.L.P.E.S scoring system was constructed to improve the accuracy of predicting the stone-free rate after flexible ureteroscopy.MethodsWe retrospectively analyzed clinical and virtual reality data of 150 patients with renal calculi who underwent flexible ureteroscopy at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China, from September 2019 to January 2022. Factors affecting the stone-free rate were evaluated in univariate and multiple logical regression analyses. Factors were divided by cut-off value under the receiver-operating characteristic curve and scored accordingly to a well-known international scoring system. Area under the curve predicted the stone-free rate. The accuracy and superiority of the stone-free rate after flexible ureterorenoscopy was compared between this scoring system and the S.O.L.V.E, R.I.R.S, T.O.HO, and RUSS scores.ResultsMultiple logistic regression showed that the stone surface area, renal pelvis volume, and length of the calyces funnel were correlated with stone-free rate (P < 0.01, P = 0.021, P = 0.019, respectively). The H.L.P.E.S. score included stone surface area (1–2 points), renal pelvis volume (1–2 points), length of calyces funnel (1–2 points), pelvic calyceal height (1–2 points), and essence of stone (1–2 points). The area under the receiver-operating characteristic curve of H.L.P.E.S. score was 0.927, which was higher than the S.O.L.V.E., R.I.R.S., T.O.HO, and RUSS scores.ConclusionH.L.P.E.S. scoring can effectively predict the stone-free rate after flexible ureteroscopy for renal calculi and is superior to other scoring systems.

Morphometric measurements and the relationship with body weight in the Sudanese Dorcas Gazelle and Bohor Reedbuck

The objectives were to describe the morphometric measurements and determine the best model for estimating the relationship between body weight and morphometric measurements of the two Sudanese antelopes, Dorcas Gazelle (Gazella dorcas) and Bohor Reedbuck (Redunca redunca). Twenty-four animals belonging to two Sudanese antelope species, six males and six females from each species were used. Data on body weight and body measurements were recorded from each species. Averages of body weight and morphometric traits of Bohor Reedbuck were larger than the corresponding values of Dorcas Gazelle, while the opposite was true in the case of horn thickness, which was larger in the later. Stepwise regression analysis indicated that, the best model for Dorcas Gazelle had the variables neck length, belly girth and chest height, while Bohor Reedbuck had body length, head length, neck length, tail length, chest girth and pelvic height. These variables explained 82% of the total variation in body weight of Dorcas Gazelle, and 92% of the variation of Bohor Reedbuck. These results are discussed in relation to morphometric measurements reported for antelopes elsewhere.

Conformity assessment of a computer vision-based posture analysis system for the screening of postural deformation

BackgroundThis study evaluates the conformity of using a computer vision-based posture analysis system as a screening assessment for postural deformity detection in the spine that is easily applicable to clinical practice.MethodsOne hundred forty participants were enrolled for screening of the postural deformation. Factors that determine the presence or absence of spinal deformation, such as shoulder height difference (SHD), pelvic height difference (PHD), and leg length mismatch (LLD), were used as parameters for the clinical decision support system (CDSS) using a commercial computer vision-based posture analysis system. For conformity analysis, the probability of postural deformation provided by CDSS, the Cobb angle, the PHD, and the SHD was compared and analyzed between the system and radiographic parameters. A principal component analysis (PCA) of the CDSS and correlation analysis were conducted.ResultsThe Cobb angles of the 140 participants ranged from 0° to 61°, with an average of 6.16° ± 8.50°. The postural deformation of CDSS showed 94% conformity correlated with radiographic assessment. The conformity assessment results were more accurate in the participants of postural deformation with normal (0–9°) and mild (10–25°) ranges of scoliosis. The referenced SHD and the SHD of the CDSS showed statistical significance (p < 0.001) on a paired t-test. SHD and PHD for PCA were the predominant factors (PC1 SHD for 79.97%, PC2 PHD for 19.86%).ConclusionThe CDSS showed 94% conformity for the screening of postural spinal deformity. The main factors determining diagnostic suitability were two main variables: SHD and PHD. In conclusion, a computer vision-based posture analysis system can be utilized as a safe, efficient, and convenient CDSS for early diagnosis of spinal posture deformation, including scoliosis.

Can genetic propensity for lambing difficulty be predicted by pelvic and body shape dimensions measured by X-ray computed tomography (CT) scanning of ram lambs?

The ability of sheep to lamb unaided is important for both financial and welfare reasons. Current recording of lambing ease is subjective and unreliable for breeding purposes. The aim of this study was to investigate genetic control of measurements that could be taken from routine x-ray computed tomography (CT) scanning of ram lambs, within UK breeding programmes, to predict lambing difficulty of their progeny, or their daughters’ progeny. Measurements of 6 CT-derived lambing ease predictor traits (hip width, shoulder width, pelvic area, pelvic height, pelvic width, pelvic angle) were taken from archived CT images from 437 Texel ram lambs from 58 flocks (average age ~20 weeks) scanned over 15 years, as part of the UK national terminal sire breeding programme. Heritabilities, after adjusting for live weight, ranged from 0.16 to 0.65, with the highest estimates for the pelvic traits. Lambing difficulty scores (17705 records over 16 years), recorded on a six-point scale of increasing severity, were available from lambs born within the same flocks. Lambing difficulty was lowly heritable when expressed either as a trait of the lamb (h2 = 0.05) or the ewe (h2 = 0.02) with large common litter effects, low maternal effects and low repeatability in the ewe. Genetic correlations gave some indication that wide hips and shoulders, at a fixed live weight, may be associated with increased lambing difficulty of the lamb (rg = 0.28 and 0.47) and that lower pelvic width and angle (more horizontal) may be associated with increased lambing difficulty of the ewe (rg = −0.22 and −0.39), although standard errors were high. Moderate genetic correlations between body width and pelvic measurements suggest scope to select for optimal combinations of these measurements. Further research in this area could lead to incorporation of robust breeding values for lambing ease into sheep breeding programmes to improve animal welfare.

John Charnley Award: Deep Learning Prediction of Hip Joint Center on Standard Pelvis Radiographs.

Accurate hip joint center (HJC) determination is critical for preoperative planning, intraoperative execution, clinical outcomes after total hip arthroplasty, and commonly used classification systems in primary and revision hip replacement. However, current methods of preoperative HJC estimation are prone to subjectivity and human error. The purpose of the study was to leverage deep learning (DL) to develop a rapid and objective HJC estimation tool on anteroposterior (AP) pelvis radiographs. Radiographs from 3,965 patients (7,930 hips) were included. A DL model workflow was created to detect bony landmarks and estimate HJC based on a pelvic height ratio method. The workflow was utilized to conduct a grid-search for optimal nonspecific, sex-specific, and patient-specific (using contralateral hip) pelvic height ratios on the training/validation cohort (6,344 hips). Algorithm performance was assessed on an independent testing cohort for HJC estimation comparison. The algorithm estimated HJC for the testing cohort at a rate of 0.65 seconds/hip based on features in AP radiographs alone. The model predicted HJC within 5 mm of error for 80% of hips using nonspecific ratios, which increased to 83% with sex-specific and 91% with patient-specific pelvic height ratio models. Mean error decreased utilizing the patient-specific model (3.09 ± 1.69 mm, P < .001). Using DL, we developed nonspecific, sex-specific, and patient-specific models capable of estimating native HJC on AP pelvis radiographs. This tool may provide clinical value when considering preoperative component position in patients planned to undergo THA and in reducing the subjective variability in HJC estimation. Diagnostic, level IV.

Effect of Needle and Extracorporeal Shockwave Stimulation of Acupuncture Points on Equine Chronic Multilimb Lameness Using a Single-Formula Approach

Abstract Objective The aim of this study was to compare effects with conventional (needle and electroacupuncture, NAP) and shockwave stimulation of acupuncture points (SAP) on chronic multilimb lameness in horses. Study Design Randomized crossover block design; ten mature Standardbred mares with multilimb lameness (&lt; 4/10) underwent 3-weekly point stimulations (NAP/SAP) selected on the basis of their uniform applicability. Groups were reversed following a washout period (9 weeks). Lameness at the trot was video recorded and quantified objectively using an inertial sensor-based system during a 4-week pre- and post-treatment period. Blinded expert review of recordings resulted in subjective qualitative (better, same, or worse) and quantitative outcome measures (0–10 lameness grade). Mixed effect repeated measures analyses were performed on objective quantitative gait parameters specific to fore (Vector sum [VSHead]) and hindlimb lameness (average differences in minimum [DIFFMINPelvis] and maximum pelvic height [DIFFMAXPelvis]) Qualitative data were assessed in non-parametric tests. Results SAP had no effect on forelimb but improved hindlimb lameness (DIFFMINPelvis; p &lt; 0.001). NAP was associated with deterioration of forelimb lameness (VSHead, p &lt; 0.001) and had no effect on hindlimb lameness. VSHead data differed between modalities when accounting for the time of observation (interaction effect; p = 0.002). For other quantitative gait parameters, a difference between modalities was not observed. SAP was associated with greater animal comfort post-treatment compared with pre-treatment assessments (p = 0.036). Typically, improvement occurred by one and deterioration by two lameness grades. Conclusion SAP and NAP were not associated with the same treatment outcome. SAP slightly improved but did not alleviate all lameness. Given the non-invasive nature of SAP, this method may have potential in the management of chronic multilimb lameness.