Lateral Deviation Research Articles

Antisaturation fixed-time backstepping fuzzy integral sliding mode control for automatic landing of fixed-wing unmanned aerial vehicles

This paper proposes a robust adaptive fixed-time control for automatic landing systems (ALS) of small-scale fixed-wing UAVs exposed to wind disturbances, parametric uncertainties, and input saturation. The control structure consists of three subsystems, i.e., the guidance system, the attitude control system, and the thrust control system. Considering the landing geometry, the guidance system computes the desired Euler angles to stabilize the dynamics of altitude deviation, lateral deviation, and lateral speed. An auxiliary system is designed to compensate for the effect of input saturation in the attitude control system. The fixed-time method, the backstepping control (BSC), the fuzzy logic control (FLC), and the integral sliding mode control (ISMC) techniques are adopted to synthesize the control law. All three functional parts of the proposed ALS are equipped with a fixed-time fuzzy sliding mode disturbance observer (FSMDO). FLC computes the gains of signum functions adaptively to attenuate the chattering. Fixed-time convergence of the system errors to an arbitrary residual set is proved by comprehensive stability analysis. Finally, the comparative simulation results verify the better dynamic response and stronger robustness under the proposed ALS.

Research on the Optimization of Ship Trajectory Clustering Based on the OD–Hausdorff Distance

With the growth of global trade, port shipping is becoming more and more important. In this paper, an analysis of a ship’s inbound and outbound track characteristics is conducted using the OD–Hausdorff distance. The accuracy and efficiency of trajectory data analysis have been enhanced through clustering analysis. Trajectories are arranged in a time sequence, and representative port segments are selected. An improved OD–Hausdorff distance method is employed to capture the dynamic characteristics of a ship’s movements, such as speed and heading. Additionally, the DBSCAN algorithm is utilized for clustering, allowing for the processing of multidimensional AIS data. Data cleaning and preprocessing have ensured the reliability of the AIS data, and the Douglas–Peucker algorithm is used for trajectory simplification. Significant improvements in the accuracy and efficiency of trajectory clustering have been observed. Therefore, the main channel of the Guan River and the right side of Yanwei Port are usually followed by ships greater than 60 m in length, with a lateral Relative Mean Deviation (RMD) of 7.06%. Vessels shorter than 60 m have been shown to have greater path variability, with a lateral RMD of 7.94%. Additionally, a crossing pattern at Xiangshui Port is exhibited by ships shorter than 60 m due to the extension of berths and their positions at turns. Enhanced clustering accuracy has provided more precise trajectory patterns, which aids in better channel management.

Review and Therapeutic Approach to Malalignment of the Great Toenails: A Common Condition That Is Uncommonly Diagnosed.

Malalignment of the great toenails is a common nail disorder that is uncommonly recognized in general practice. Review available literature on lateral malalignment of the great toenails to increase awareness of this underdiagnosed condition and provide management recommendations. A PubMed search was conducted using the terms "congenital malalignment toenail" and "malalignment great toenail". All articles were reviewed, and all relevant articles were included in this analysis. Thirty-four distinct articles encompassing 117 patients with similar clinical findings: lateral deviation of the great toenails with yellow brown dyschromia, thickening, and scalloping. Description of malalignment and terminology can vary, which may have led to exclusion of some relevant articles. Lateral malalignment is a common nail condition that is underappreciated and often misdiagnosed in general dermatologic and medical practice. This review aims to increase awareness to facilitate better care of these patients.

Anatomical differences of the vertebrobasilar artery between normal subjects and patients with cerebral infarction.

Previous studies have reported various anatomical differences in the cerebral artery between healthy subjects and patients with posterior circulation cerebral infarction. In particular, basilar artery angulation has been associated with posterior circulation cerebral infarction. We compared anatomical variations and the degree of anterior and lateral vertebrobasilar artery angulation and deviation to compare the incidence of cerebral infarction of healthy subjects and patients with posterior circulation cerebral infarction. We compared basilar artery anatomy using brain magnetic resonance angiography in 97 patients who underwent brain magnetic resonance angiography during health checkups at our hospital and in 92 patients diagnosed with posterior circulation cerebral infarction between 2012 and 2022. Anatomical variations, including fetal-type posterior cerebral artery, hypoplastic P1 segment, vertebrobasilar dolichoectasia, and dominant vertebral artery, as well as the degree of anterior and lateral deviation and angulation, were evaluated. Correlations between these variations and the occurrence of cerebral infarction were analyzed. The prevalence of hypoplastic P1 was significantly differences in patients with posterior circulation cerebral infarction (odds ratio: 5.655). Furthermore, patients with posterior circulation cerebral infarction exhibited more acute anterior and lateral angulation, as well as lateral deviation. Hypoplastic P1 and more acute anterior or lateral angulation of the vertebrobasilar artery are associated with increased frequency of cerebral infarction.

Identifying Risk Factors for Open Reduction in Pediatric Supracondylar Humerus Fractures.

Supracondylar humerus fractures (SCHFs) are the most common injuires of the elbow in children, often categorized by the Gartland classification. While type 1 and 2 fractures commonly managed conservatively, type 3 and 4 fractures typically require surgical treatment. Although closed reduction and percutaneous pinning have shown success, open reduction may be required in cases where adequate reduction cannot be achieved. This study aims to identify radiological and clinical risk factors associated with transitioning from closed reduction to open reduction in Gartland type 3 and 4 SCHF in children. We retrospectively analysed 159 patients operated on between 2014 and 2022 for Gartland type 3 and 4 SCHF. Parameters including age, gender, injury severity, time to surgery, neurovascular damage, medial spike angle, fracture-skin distance, medial-lateral deviation, rotation, fracture level, and Baumann angle were evaluated. A total of 159 SCHF in children aged 3 to 12 years, classified as Gartland type 3 (106 patients, 66.6%) and type 4 (53 patients 33.4%), underwent surgical intervention. Notably, 46 patients (28.9%) initially managed with closed reduction exhibited failure, prompting the necessity for conversion to open reduction. Injury severity, lateral deviation, advanced age, low medial spike angle, and low fracture tip-to-skin distance were found to be factors that could potentially increase the need for open reduction (P<0.05). Logistic regression analysis showed that the low medial spike angle, flexion type injury, and low fracture type increased the likelihood of open surgery (P<0.05). Sex, side, duration to surgery, and Baumann angle showed no significant associations. SCHF commonly necessitate surgical intervention in children. Although the risk factors for failed closed reduction and the need for open surgery have been discussed in the literature, there is no consensus. Preoperative planning, particularly for patients with specific factors like lateral deviation, advanced age, low medial spike angle, low fracture-to-skin distance and high injury severity, should consider potential open surgery requirements. Level III.

Research on Positioning and Navigation System of Greenhouse Mobile Robot Based on Multi-Sensor Fusion.

The labor shortage and rising costs in the greenhouse industry have driven the development of automation, with the core of autonomous operations being positioning and navigation technology. However, precise positioning in complex greenhouse environments and narrow aisles poses challenges to localization technologies. This study proposes a multi-sensor fusion positioning and navigation robot based on ultra-wideband (UWB), an inertial measurement unit (IMU), odometry (ODOM), and a laser rangefinder (RF). The system introduces a confidence optimization algorithm based on weakening non-line-of-sight (NLOS) for UWB positioning, obtaining calibrated UWB positioning results, which are then used as a baseline to correct the positioning errors generated by the IMU and ODOM. The extended Kalman filter (EKF) algorithm is employed to fuse multi-sensor data. To validate the feasibility of the system, experiments were conducted in a Chinese solar greenhouse. The results show that the proposed NLOS confidence optimization algorithm significantly improves UWB positioning accuracy by 60.05%. At a speed of 0.1 m/s, the root mean square error (RMSE) for lateral deviation is 0.038 m and for course deviation is 4.030°. This study provides a new approach for greenhouse positioning and navigation technology, achieving precise positioning and navigation in complex commercial greenhouse environments and narrow aisles, thereby laying a foundation for the intelligent development of greenhouses.

Gradual stabilization and narrowing of bone tunnels following primary anterior cruciate ligament reconstruction.

The purpose of this study is to dynamically assess variations in tunnel diameters following anterior cruciate ligament reconstruction (ACLR) and investigate correlations with patient-reported outcomes (PROs) and graft maturity based on signal-to-noise quotient (SNQ). Tunnel diameter and tunnel position were measured using three-dimensional models derived from computed tomography (CT) data. Postoperative graft maturity and integration were evaluated using magnetic resonance imaging (MRI). Clinical outcomes were assessed through PROs, which included the International Knee Documentation Committee Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Scores and Lysholm scores. The correlation between tunnel enlargement extent, PROs and SNQ values, as well as correlations between confounding factors, tunnel diameter differences and SNQ were analyzed. A total of 73 participants underwent primary ACLR and scheduled follow-ups. At the segment of the articular aperture, the femoral tunnel was enlarged by 32.3% to 10.4 ± 1.6 mm (p < 0.05), and the tibial tunnel was widened by 17.2% to 9.6 ± 1.2 mm (p < 0.05) at the 6-month follow-up. At 1 year postoperatively, diameters at the articular aperture were not further increased on the femoral (n.s.) and tibial (n.s.) sides. In early postoperative follow-up, the femoral tunnel was anteriorly and distally shifted, coupled with posterior and lateral deviation involving the tibial side, exhibiting minimal migration at 1-year follow-up. The degree of tunnel widening was not correlated with PROs and SNQ values. Age, gender, body mass index (BMI), time from surgery to follow-up, concomitant injuries and autograft type were not correlated with tunnel diameter differences and SNQ. The femoral and tibial bone tunnels exhibited eccentrical widening and gradually stabilized at 1 year following ACLR. Furthermore, the enlarged bone tunnels were not correlated with unsatisfied PROs and inferior graft maturity. Level IV.

Fast automatic docking control for electric tractors

In this study, we investigate the automatic docking of an electric tractor with a semi-trailer in narrow and long-distance scenarios. We propose an automatic docking method based on a multi-sensor fusion high-precision positioning algorithm and a multi-strategy docking control algorithm. To solve the heading-angle error of the involved camera due to mechanical errors, a compensation value in the form of angle deviation is introduced. To alleviate the increase in the camera detection error with longitudinal distance, a piecewise coordinate compensation function is proposed. Repositioning is performed using light detection and ranging (Lidar) to improve the pose-perception accuracy to the millimeter level. To avoid the interference of point clouds on the relocation accuracy of Lidar, a search-and-location method that combines both small and large neighborhoods is proposed. To achieve the desired docking success rate, a multi-strategy-adjustment control algorithm is used to enable comprehensive adjustment, including approximate control of the maximum angle based on lateral deviation and fine proportional-integral-differential (PID) control based on lateral deviation and longitudinal distance, security check cycle and premature warning mechanism, and risk avoidance control. Finally, the reliability and stability of the design scheme are verified by conducting multiple experiments involving actual vehicles.

Unveiling gap acceptance behaviour during lane change with EDIV data: A deep dive into driving behaviour on expressway using a three level mixed effect linear regression approach

Lane change has a potential significance in road safety. Gap acceptance phenomena serves as a primary and critical phase in lane change maneuver. This study aims to investigate the gap acceptance behaviour of drivers during lane changes on expressways, with a focus on understanding how various factors influence drivers' decisions to change lanes. An extensive dataset collected through various sensors tailored for expressway driving, known as the ‘Expressway Drive: Instrumented Vehicle (EDIV) Dataset’ is utilized. Driving data from 59 drivers covering a distance of around 4000 km was used in the current study. Total 2578 lane changing events are identified through computing lateral deviations measured through 3D LiDAR sensor. Substantial differences are observed within the groups in primary analysis which suggest that lane-change direction significantly affect gap acceptance. To effectively manage both intra- and inter-cluster variances, this study employs two separate three levels mixed-effects linear models. These models account for the interdependence of gap acceptance characteristics within individual drivers and for different directions of lane changes by incorporating random effects. Furthermore, these models examine relationships between lead/ lag gap acceptance and the various influencing factors as fixed effects. It was found that factors such as speed of the subject vehicle, gap position, relative speeds, and surrounding vehicle types had influence on gap acceptance during lane changes on expressways. The insights gained from this study could inform the development of advanced driver assistance systems (ADAS) as well as development of autonomous vehicles, contributing to improved road safety and traffic flow management in high-speed environments.

OVERVIEW OF ANEMIA AFTER SCOLIOSIS SURGERY IN THE INTENSIVE CARE UNIT (ICU) SOEHARSO ORTHOPEDIC HOSPITALINDONESIA

Anemia is a condition where the hemoglobin concentration is lower than normal. This condition reflects the lack of the normal number of erythrocytes in the body's circulation and consequently the amount of oxygen delivered to the body's tissues is also reduced. Miller &amp; Thompson (2019) scoliosis comes from the Greek word "scoliosis" which means crooked. Scoliosis is a complex three-dimensional deformity of the spine characterized by a lateral deviation of at least 10 degrees with spinal rotation and is usually associated with a reduction in the normal kyphotic curvature of the spine / hypokyphosis. The cause of bleeding in spinal surgery usually occurs more in cases of rigid scoliosis, pedicle subtraction osteotomy and vertebral column resection often referred to as triple column osteotomy and is considered a procedure with a high risk of complications with massive blood loss, reaching more than 10 liters (Jun. 2019). Based on its classification, this type of research is retrospective descriptive research. studies that discuss one or more variables separately, one-by-one, but do not examine the relationship between these variables, using the observation method with the subject being observed by looking at past conditions (Harlan &amp;Sutjiati, 2022). Using total sampling technique in sampling, the population is the medical records of patients admitted to the ICU, postoperative diagnosis of scoliosis with anemia, the sample size is 58 patient medical records. The variables observed were: indications for ICU admission and postoperative scoliosis, the inclusion criteria were medical record data for postoperative scoliosis patients with anemia admitted to the ICU for the period January 1 - December 31, 2022 and patients with the first scoliosis surgery. Based on this study, the following results were obtained: Most respondents were female (81%), the average age of respondents was 17 years. The most common type of scoliosis is adolescence idiopathic scoliosis (89.7%). The most Lenke classification is Lenke 3 (44.8%), the most types of surgery are stabilization, fusion, discectomy, laminectomy and osteotomy (56.9%). The duration of surgery was mostly 180-240 minutes (46.6%) with an average duration of surgery of 257 minutes, the average amount of bleeding was 884.5 ml, the average preoperative Hb was 13.3g/dL, the average postoperative Hb was 8.8 g/dL. The average postoperative Hemoglobin decrease was 5.3 g/dL, patients who were given blood transfusions (87.9%) with an average of 2.9 bags per patient, the most common type of transfused blood was PRC (90.2%).

FREQUENCY AND RELATED FACTORS OF HALLUX VALGUS AMONG FEMALE SCHOOL TEACHERS

Background/Aim of Study: HV is a progressive, chronic deformity affecting the first metatarsophalangeal joint causing big toe lateral deviation and 1st metatarsal being medially deviated hence our objective is to calculate the frequency, factors associated with Hallux valgus and their rehabilitation. Methodology: Non-probability A convenient sampling technique among 273 females aged 20-60 years from Jhelum District was done. Self-administrated questionnaires were filled out, and pain was measured using VAS. The goniometer and Manchester scale were used to evaluate HV deformity. Results: The overall frequency of Hallux valgus was found to be 75.46%. 43.96% elder and 31.5% younger females. Mean age of participants was 42.95 ± 9.96. HV angle showed 24.9% were normal, 57.9% mild, 16.5% moderate, and 0.7% had severe deformity. The association of HV with BMI and shoe shape was statistically significant. No association was found between age, work experience, and heel height. Conclusions: HV abnormality was high in elders when compared with youngers. The severity for HV grading showed mild deformity with bilateral HV more frequent among female. Foot wear i–e shoe shape and BMI plays a substantial role in the development of HV.

Robust Trajectory Planning of Gliding-Guided Projectiles with Weak Maneuverability

Due to constraints in launch platforms and cost, the maneuverability of gliding-guided projectiles is limited, necessitating a rational design of their trajectory schemes. To reduce the sensitivity of trajectory schemes to uncertainties while ensuring compatibility between flight schemes and guidance control systems and fully exploiting the control capability of the projectile, a closed-loop robust trajectory planning method is proposed. Models of major uncertain factors and state deviation at the control start point are established. Based on the NIPCE method, the stochastic dynamic model is transformed into a high-dimensional deterministic model with PCE coefficients as state variables, and the uncertainty propagation law is obtained. A PID algorithm is employed to design a tracking guidance law based on position error feedback, and open-loop and closed-loop robust trajectory planning models are established accordingly. The optimal control problem is solved by transforming it into a nonlinear programming problem using the direct shooting method. Our simulation results indicate that the NIPCE method can significantly improve the computational efficiency of uncertainty propagation while ensuring accuracy; compared with parallel MCS, the computation time is reduced by 96.8%. Open-loop robust planning can effectively mitigate the sensitivity of gliding trajectories to uncertainties (the standard deviations of terminal altitude and lateral deviations are reduced by 23.6% and 35.3%, respectively, compared to deterministic planning) but cannot completely eliminate terminal dispersion. Closed-loop robust planning effectively improves control effort consumption on the basis of open-loop planning.

A comparative analysis of age-related alterations in foot biomechanics and visual input in pre-adolescent and adolescent children with normal body mass index

Background: Foot biomechanics undergo age related changes and visual input may be important for postural stability and stance dynamics. This study aimed to investigate how age-related alterations in foot biomechanics and visual input interact to influence postural stability and stance dynamics in children aged 6 to 19 years. Materials and methods: Prospective observational study was conducted after getting permission from Institutional Ethics Committee. Informed consent was obtained before collecting data. OHM3000 used for collecting data. Data was collected for bipedal stance test, stabilometry test with eyes open and eyes closed, and dynamic stance test during walking with predefined protocol. Result: Statistically significant difference in maximum pressure, average pressure, foot area and foot length are exhibited in both feet with higher values in adolescents as compared to pre-adolescents. Maximum lateral deviation was significantly less in adolescent with eyes open toward right feet as compare to preadolescents and the difference was lost with eyes closed. Maximum pressure, average pressure, foot contact area and forefoot maximum pressure in both feet were statistical significance. Conclusion: Increased maximum pressure, average pressure, foot area and foot length indicating physical growth and higher load-bearing capacities in adolescents. Weight distribution over the forefoot and hindfoot remained consistent across age groups even if significant changes shown in foot size and pressure. Visual input significantly improved postural stability in both groups. Adolescents show better postural stability probably due to foot maturation. During walking, adolescents showed increased maximum and average pressures, especially in forefoot. Keywords: foot; clinical anatomy; biomechanics; adolescents; children; postural stability; gait; visual input

Autonomous navigation method based on RGB‐D camera for a crop phenotyping robot

AbstractPhenotyping robots have the potential to obtain crop phenotypic traits on a large scale with high throughput. Autonomous navigation technology for phenotyping robots can significantly improve the efficiency of phenotypic traits collection. This study developed an autonomous navigation method utilizing an RGB‐D camera, specifically designed for phenotyping robots in field environments. The PP‐LiteSeg semantic segmentation model was employed due to its real‐time and accurate segmentation capabilities, enabling the distinction of crop areas in images captured by the RGB‐D camera. Navigation feature points were extracted from these segmented areas, with their three‐dimensional coordinates determined from pixel and depth information, facilitating the computation of angle deviation (α) and lateral deviation (d). Fuzzy controllers were designed with α and d as inputs for real‐time deviation correction during the walking of phenotyping robot. Additionally, the method includes end‐of‐row recognition and row spacing calculation, based on both visible and depth data, enabling automatic turning and row transition. The experimental results showed that the adopted PP‐LiteSeg semantic segmentation model had a testing accuracy of 95.379% and a mean intersection over union of 90.615%. The robot's navigation demonstrated an average walking deviation of 1.33 cm, with a maximum of 3.82 cm. Additionally, the average error in row spacing measurement was 2.71 cm, while the success rate of row transition at the end of the row was 100%. These findings indicate that the proposed method provides effective support for the autonomous operation of phenotyping robots.

A Comparative of Knee Joint Instability and Muscle Activity Due to Medial or Lateral Deviation of Knee while Lunge Exercise

A Comparative of Knee Joint Instability and Muscle Activity Due to Medial or Lateral Deviation of Knee while Lunge Exercise

A Comparative of Knee Joint Instability and Muscle Activity Due to Medial or Lateral Deviation of Knee while Lunge Exercise

A Comparative of Knee Joint Instability and Muscle Activity Due to Medial or Lateral Deviation of Knee while Lunge Exercise

Autonomous navigation using machine vision and self-designed fiducial marker in a commercial chicken farming house

Indoor navigation within commercial animal farming houses is crucial for the increasing operations carried out by mobile robots. However, existing methods often suffer from issues such as sensitivity to ambient light, insufficient accuracy for precise animal operations, or complexity in implementation. In this study, we proposed a novel navigation method for mobile chassis in a commercial stacked cage farming house, utilizing an active light source, self-designed fiducial marker, and machine vision. Our navigation system incorporated imaging modules equipped with 850 nm infrared light to minimize animal stress and mitigate the effects of low illumination. The self-designed fiducial marker, DRITag, enabled precise maker identification with a recognition rate of 100 % and achieved high positioning accuracy, with an absolute mean error of 0.34 cm within a range of 1.2 m. To determine the chassis’ yaw angle, we employed the U-net deep learning network, which achieved satisfactory root mean square errors of 0.22° and 0.10° on the ground and upper floors, respectively. Global localization of the chassis across different farm areas was achieved through a combination of DRITag and odometry information. Our proposed method provided a flexible and user-friendly approach to navigation path planning, employing a waypoint task text file that enabled easy modification of the path through simple text file editing. Field tests conducted in a two-story commercial stacked cage chicken farming house demonstrated the high accuracy of our navigation method, with standard deviations of longitudinal deviations below 1.85 cm and 1.82 cm, and standard deviations of lateral deviations below 1.50 cm and 1.12 cm at a speed of below 0.3 m/s on the ground floor and at a speed of 0.2 m/s on the upper floor, respectively. Overall, our study presented an independent-of-ambient-light, highly accurate, and easily implementable navigation method for mobile chassis in commercial chicken farming houses, with significant potential for future research in mobile robotics within animal farming environments.

The effect on the performance of a dynamic navigation system of superimposing a standard tessellation language (STL) file obtained with an intraoral scan on a cone beam computer tomograph (CBCT). An experimental in vitro study

ObjectivesTo compare the accuracy and operative time of implant placement using a dynamic computer assisted implant surgery (dCAIS) system based on a cone beam computer tomography (CBCT) image, with and without superimposing a standard tessellation language (STL) file of an intraoral scan of the patient. MethodsTen identical resin models simulating an upper maxilla with posterior edentulism were assigned to two groups. In the CBCT+STL group, a CBCT file and an intraoral STL file were superimposed and used for registration; in the CBCT group, registration was performed using CBCT images. Six implants were placed in each model using the Navident® dynamic navigation system. Anatomy registration was performed by tracing fiducial points on the CBCT or STL image, depending on the group. Preoperative and postoperative CBCT images were overlaid to assess implant placement accuracy. ResultsSixty implants were analyzed (30 implants in each group). 3D platform deviation was significantly lower (mean difference (MD): 0.17 mm; 95 % confidence interval (CI): 0.01 to 0.23; P = 0.039) in the CBCT+STL group (mean: 0.71 mm; standard deviation (SD): 0.29) than in the CBCT group (mean: 0.88 mm; SD: 0.39). The remaining accuracy outcome variables (angular deviation MD: -0.01; platform lateral deviation MD: 0.08 mm; apex global MD: 0.01 mm; apex depth MD: 0.33 mm) and surgery time (MD: 3.383 min.) were similar in both groups (p > 0.05). ConclusionsThe introduction of an intraoral scan (STL) seems to reduce deviations slightly in dental implant placement with dCAIS systems. However, the clinical repercussion of this improvement is questionable. Clinical significanceSuperimposing an intraoral scan on the CBCT image does not seem to increase the accuracy of dCAIS systems but can be useful when radiographic artifacts are present.

Measurement of joint angles for the objective assessment of limb conformation in dairy calves

Poor limb conformation in cattle is believed to be closely associated with claw and limb disorders. Limb conformation is part of genetic evaluation and is assessed visually. In this descriptive study, the assessment of conformation in calves was evaluated objectively using joint angle measurements. A total of 100, 30- to 90-d-old, heifer calves of the Brown Swiss (n = 50) and Holstein (n = 50) breeds were photographed from both sides and the front and rear. Carpal, tarsal, autopodium and fetlock joint angles of the fore- or hind limbs were measured on the images using anatomic reference points and the ImageJ/Fiji® program. Each angle was measured 3 times, and the mean was used for analysis. Values from both sides were pooled. Deviations from defined standard angles were classified as slight or moderate. The positions of the front and hind feet were measured and scored. On average, the calves had moderate "knock-kneed" carpal conformation, and the autopodium of the front limb had a slight lateral deviation. In the rear view, the calves had slight, but close to moderate, "cow-hocked" tarsal conformation, and the autopodium of the hind limbs was parallel, but close to slightly deviated. Holstein calves were moderately, and Brown Swiss calves were slightly "cow-hocked". A moderate lateral deviation occurred in the metacarpal-digit angle in the front view and a slight lateral deviation occurred in the metatarsal-digit angle in the rear view. The front feet position score was >17° in 69% of the calves, and the hind feet position score was <17° in 90% of the calves. In the side views, the calves were slightly "over at the carpus" and slightly "straight-hocked" and had average fetlock conformation. In the mean values, most measured joint angles did not correspond to the straight or parallel classifications in our calves; moderate "knock-kneed" and slight "cow-hocked", and "toed-out" classifications were most common. The limb angles measured were based on anatomical features and therefore are unlikely to change substantially with increasing age. These aspects should be considered when assessing linear traits and investigating the relationship between limb conformation and claw diseases.

Congenital hallux valgus occurs in Fibrodysplasia Ossificans Progressiva and BMPR1B-associated dysplasia: an important distinction

BackgroundFibrodysplasia Ossificans Progressiva (FOP; OMIM #135100) is an ultrarare genetic disorder characterised by congenital bilateral hallux valgus (CBHV), intermittent soft tissue swellings and progressive heterotopic ossification. We report a three-month-old girl with great toe abnormalities similar to FOP, in whom comprehensive clinical workup and genetic investigations illustrates an alternative diagnosis.Case presentationA three-month-old girl presented with CBHV. The antenatal period was unremarkable, she was born by spontaneous vaginal delivery with an uneventful subsequent course, except for maternal concern of her bent toes which received reassurance from several health professionals. Her mother’s persisting concerns were explored via the internet and social media leading her to request referral to an expert bone centre for consideration of FOP. On examination, she was thriving, there was no dysmorphism, subcutaneous lumps, skeletal or extra-skeletal deformity except for shortened great toes with lateral deviation of the proximal and distal phalanges. FOP was a feasible diagnosis, for which CBHV is highlighted as an early sign. A cautionary potential diagnosis of FOP was counselled, including advice to defer intramuscular immunisations until genetic results available. Genetic investigation was undertaken through rapid whole genomic sequencing (WGS), with analysis of data from a skeletal dysplasia gene panel, which demonstrated no ACVR1variants. The only finding was a heterozygous variant of unknown significance in BMPR1B (c1460T>A, p.(Val487Asp)), which encodes a bone morphogenic receptor involved in brachydactyly syndromes A1, A2 and D and acromesomelic dysplasia 3 (only the latter being an autosomal recessive condition).ConclusionThis report highlights that CBHV serves as a vital diagnostic indicator of FOP and affected infants should be considered and investigated for FOP, including precautionary management whilst awaiting genetic studies. The second educational aspect is that CBHV may not represent a generalised skeletal disorder, or one much less significant than FOP. Receptor-ligand BMP and Activins mediated interactions are instrumental in the intricate embryology of the great toe. Recognition of non-FOP conditions caused by alterations in different genes are likely to increase with new genomic technology and large gene panels, enhancing understanding of bone signaling pathways.