Lateral Deviation Research Articles

A Modern Artillery to put off the Electric Storm of the Brain–A case report of aborting seizure with brivaracetam 2-minute intravenous bolus in a patient with a compromised airway. (P8-7.004)

<h3>Objective:</h3> A case report of successful seizure treatment using bolus administration of intravenous brivaracetam over 2 minutes in a patient with compromised airway. <h3>Background:</h3> As time is brain, it is paramount to rapidly treat seizures and status epilepticus to avoid permanent neuronal injuries. Benzodiazepines are the recommended first-line antiepileptic medications, but with initial and repetitive dosing, airway compromise can occur even before seizure resolution. Alternative fast-acting antiepileptics that can minimize this effect could lead to better outcomes and decreased ICU stays. <h3>Design/Methods:</h3> N/A <h3>Results:</h3> Our patient is a 47-year-old male with a history of developmental delay and chronic ventriculomegaly was successfully extubated after external ventricular drain weaning. While his mentation improved, he had ongoing difficulties clearing secretions requiring a heated high-flow nasal cannula and repeated nebulizer treatments. The following day, the patient acutely had a seizure, manifesting as obtundation, whole body rigidity, and left lateral forced gaze deviation. Given ongoing respiration issues, lorazepam was held, and he was given a 2-minute bolus of intravenous brivaracetam 100mg instead. Post administration, patient’s mentation improved with the resolution of the gaze deviation. Continuous video electroencephalogram did not show any electrographic seizures. Patient was continued on brivaracetam 100 mg twice daily. <h3>Conclusions:</h3> Brivaracetam with high lipophilicity of 1.04 and T-max of less than 5 minutes can be given intravenously as a rapid 2-minute bolus. While there are no high-quality studies substantiating the efficacy of brivaracetam as a first-line medication, its pharmacokinetic/pharmacodynamic properties could make it a reasonable alternative to benzodiazepines as the first-line anti seizures medication, especially in pre-existing tenuous airways to avoid further compromise and reduce ICU and hospital length of stay. The benefits of its fast onset of action and efficacy may mitigate the major barriers of ready accessibility and cost. <b>Disclosure:</b> Dr. Tang has nothing to disclose. Prathyankara Premkumar has nothing to disclose.

Deviation of Dental Implants Placed by Guided Implant Surgery in Bone Structures with Different Densities.

Purpose: This study aimed to evaluate the deviations of implants with two different geometries placed with a bone-supported stereolithographic surgical template into the bone of Misch classification densities of D2, D3, and D4. Materials and Methods: Eight maxilla and eight mandible models were macrodesigned according to the jaw geometries. Bone densities of these models were created in parallel with the most frequently observed densities in the locations: D3 bone density in the anterior maxilla, D4 bone density in the posterior maxilla, D2 bone density in the anterior mandible, and D3 bone density in the posterior mandible. A bone-supported stereolithographic surgical template was prepared in accordance with the jaw models and planning and used to place 64 NobelParallel Conical Connection RP 4.3 × 13 mm and 64 NobelActive 4.3 × 13 mm implants on the models. Global deviation, lateral deviation, angular deviation, and depth deviation between planned and placed implants were calculated with Hypermesh. The Kruskal-Wallis test was used to analyze the differences between deviation data of the study groups, and the Mann-Whitney U test was used for pairwise comparisons of groups with significant differences. Significance was evaluated as P < .05. Results: The study groups showed statistical differences in terms of global, lateral, and depth deviation (P = .017, P = .044, and P = .012, respectively); no statistical difference was detected in terms of angular deviation (P > .05). When the data of all studies were evaluated, the deviation values for all maxillary and mandibular implants were examined regardless of bone and implant type; no statistical difference was found between the arches in terms of deviation type (P > .05). Conclusion: Regardless of the macrogeometry of the dental implants placed with the guide, no significant difference was observed between the deviation values of the different bone densities they were applied to.

Driving Behaviour in Depression Based on Subjective Evaluation and Data from a Driving Simulator

Road traffic collisions are a major issue for public health. Depression is characterized by mental, emotional and executive dysfunction, which may have an impact on driving behaviour. Patients with depression (N = 39) and healthy controls (N = 30) were asked to complete questionnaires and to drive on a driving simulator in different scenarios. Driving simulator data included speed, safety distance from the preceding vehicle and lateral position. Demographic and medical information, insomnia (Athens Insomnia Scale, AIS), sleepiness (Epworth Sleepiness Scale, ESS), fatigue (Fatigue Severity Scale, FSS), symptoms of sleep apnoea (StopBang Questionnaire) and driving (Driver Stress Inventory, DSI and Driver Behaviour Questionnaire, DBQ) were assessed. Gender and age influenced almost all variables. The group of patients with depression did not differ from controls regarding driving behaviour as assessed through questionnaires; on the driving simulator, patients kept a longer safety distance. Subjective fatigue was positively associated with aggression, dislike of driving, hazard monitoring and violations as assessed by questionnaires. ESS and AIS scores were positively associated with keeping a longer safety distance and with Lateral Position Standard Deviation (LPSD), denoting lower ability to keep a stable position. It seems that, although certain symptoms of depression (insomnia, fatigue and somnolence) may affect driving performance, patients drive more carefully eliminating, thus, their impact.

Morphologic Changes in Postaxial Polydactyly of the Foot: A Standardized Quantitative Analysis Using the Watanabe-Fujita Classification.

Postaxial polydactyly of the foot is one of the most common congenital abnormalities. A wide forefoot, short toe, and lateral joint deviation are associated with aesthetic and functional outcomes. This study used the Watanabe-Fujita classification to characterize the preoperative and postoperative skeletal morphology of postaxial polydactyly of the foot. This retrospective study included 42 patients (51 feet) with postaxial polydactyly treated at age 1 year. Radiographs taken at ages 0 and 3 to 4 years were used for morphologic analysis. The length of the reconstructed toe, the distance between the fourth and fifth metatarsals, and joint deviation angles were measured. The length measures were standardized using the length of the third metatarsal. Morphologic characteristics were compared based on the Watanabe-Fujita classification at ages 0 and 3 to 4 years. Long-term outcomes were also evaluated in patients followed up for longer than 6 years. The fifth-ray proximal phalangeal subtype had the shortest toe length both at ages 0 and 3 to 4 years. Proximal phalangeal joint lateral deviation improved postoperatively in 78% of patients with the fifth-ray middle phalangeal subtype, regardless of reconstruction type. There was no significant change in proximal phalangeal joint deviation between ages 3 to 4 years and 7 years or older. A residual metatarsal was associated with lateral metatarsophalangeal joint deviation and a wide intermetatarsal distance, and required revision surgery. Morphologic changes of postaxial polydactyly of the foot were successfully characterized using the Watanabe-Fujita classification. This classification could be useful for planning surgical strategies and anticipating morphologic outcomes. Therapeutic, IV.

Struktur Dan Desain Bangunan Tradisional Bali Di Banjar Cekeng, Desa Sulahan, Bali

The structure and design of traditional Balinese buildings are still great features, especially when it comes to keeping culture, society, and religion alive in old buildings. Research on building design structures still needs to be reported. This study aims to analyze the structure and design of traditional Balinese buildings in Banjar Cekeng, Sulahan Village, Bali. The mixed method study design was used to direct residents of Br Cekang to sekanem and Paon buildings. Data analysis is carried out descriptively. As a result, the traditional Balinese structure and design of the Sakanem and Paon (kitchen) in Banjar Cekeng meet SNI based on structural analysis. The findings show the strength of the structure for the beams and that the bale Sakanem and Paon horses have sufficient vertical rigidity to withhold the working boundary loads. Furthermore, at the lateral deviation of the Sakanem and Paon building structures, they have sufficient lateral rigidity to withstand the earthquake loads in the x and y directions. Maximum factored force analysis obtained the results of the structures of models 1 (Sakanem), consisting of column and beam structure components made of wooden material, and models 2 (Paon), with concrete column structure components, bamboo, and wooden beams. The nominal bending and sliding capacities of Sakanem and Paon beams are greater than the ultimate bending and sliding capacities. The combined capacity of bending and axial columns in Sakanem and Paon buildings is smaller than the bending and axial capacity of ultimate and practical columns in Paon buildings, not crossing the interaction boundary line.

Machine learning assisted two-dimensional beam-steering for integrated optical phased arrays

Optical phased arrays (OPAs) offer promising beam-steering solutions for ultra-small light detection and ranging applications and free-space optical communication systems. The paper presents a new machine learning assisted two-dimensional beam formation and steering technique, which calibrates phase errors via a convolutional neural network architecture to mitigate phase errors emanating from fabrication imperfections, thermal crosstalk and wavelength tuning effects. The technique is experimentally validated on an eight-channel OPA, and the results demonstrate strong control predictive capabilities with a very low mean squared error of 0.0026 and a high correlation coefficient of 0.97 after training. Reconstructed signals derived from a subset of predicted control inputs yielded a maximum lateral peak intensity deviation of a single pixel resolution (0.15°) from the ground truth, and no observable longitudinal displacement error, for a full-width at half-maximum beam-width of approximately 1.5°.

Design and Test of an Automatic Navigation Fruit-Picking Platform

With the development in agricultural mechanization and information technology, orchard agricultural machinery is also constantly pursuing the goal of intelligence and efficiency. Fruit picking is the most labor-intensive part of the orchard harvesting process. In order to resolve the problems of high labor intensity, low picking efficiency, and labor shortage when harvesting dwarf high-density orchards, an automatic navigation fruit-picking platform with voice control was developed in the present study. First, the platform utilized a voice-controlled high-level extendable working platform and a fruit-box-lifting device to adapt to varying orchard planting row spacing and enable convenient fruit box loading and unloading. Second, an automatic navigation system, which employed China’s Beidou navigation satellite system to acquire positional data and the Stanley algorithm for path-tracking control, was implemented. Third, the fruit-picking platform with automatic navigation system was fabricated and assembled, its outer wheel steering was measured to have a maximum angle of 30.3° and an average minimum turning radius of 4.5 m, meeting the turning radius requirements under orchard conditions. Finally, automatic navigation tests of the developed platform were performed in the orchard conditions. The results indicated that the platform could maintain a straight-line path with a maximum lateral deviation of 101.5 mm and a maximum absolute average deviation of 44.1 mm at 0.4 m/s. Under the U-shaped paths, the measured maximum lateral deviation was 148.6 mm and the maximum absolute average deviation was 57.2 mm. The navigation accuracy was sufficient to meet the requirements for the harvesting platform’s routine operation in the orchards.

Research on Path Tracking of Articulated Steering Tractor Based on Modified Model Predictive Control

With the development of agricultural mechanization and information technology, automatic navigation tractors are becoming a more common piece of farm equipment. The accuracy of automatic navigation tractor path tracking has become critical for maximizing efficiency and crop yield. Aiming at improving path tracking control accuracy and the real-time performance of the traditional model predictive control (MPC) algorithm, the study proposed an adaptive time-domain parameter with MPC in the path tracking control of the articulated steering tractor. Firstly, the kinematics model of the articulated steering tractor was established, as well as the multi-body dynamics model by RecurDyn. Secondly, the genetic algorithm was combined with MPC. The genetic algorithm was used to calculate the optimal time domain parameters under real-time vehicle speed, vehicle posture and road conditions, and the adaptive MPC was realized. Then, path tracking simulations were conducted by combining RecurDyn and Simulink under different path types. Compared with the traditional MPC algorithm under the three paths of U-shaped, figure-eight-shaped and complex curves, the maximum lateral deviations of the modified MPC algorithm were reduced by 59.0%, 24.9% and 13.2%, respectively. At the same time, the average lateral deviation was reduced by 72%, 43.5% and 20.3%, respectively. Finally, the real path tracking tests of the articulated steering tractor were performed. The test results indicated that under the three path tracking conditions of straight line, front wheel steering and articulated steering, the maximum lateral deviation of the modified MPC algorithm was reduced by 67.8%, 44.7% and 45.1% compared with the traditional MPC. The simulation analysis and real tractor tests verified the proposed MPC algorithm, considering the adaptive time-domain parameter has a smaller deviation and can quickly eliminate the deviation and maintain tracking stability.

Highly energetic rockfalls: back analysis of the 2015 event from the Mel de la Niva, Switzerland

Process-based rockfall simulation models attempt to better emulate rockfall dynamics to different degrees. As no model is perfect, their development is often accompanied and validated by the valuable collection of rockfall databases covering a range of site geometries, rock masses, velocities, and related energies that the models are designed for. Additionally, such rockfall data can serve as a base for assessing the model’s sensitivity to different parameters, evaluating their predictability and helping calibrate the model’s parameters from back calculation and analyses. As the involved rock volumes/masses increase, the complexity of conducting field-test experiments to build up rockfall databases increases to a point where such experiments become impracticable. To the author’s knowledge, none have reconstructed rockfall data in 3D from real events involving block fragments of approximately 500 metric tons. A back analysis of the 2015 Mel de la Niva rockfall event is performed in this paper, contributing to a novel documentation in terms of kinetic energy values, bounce heights, velocities, and 3D lateral deviations of these rare events involving block fragments of approximately 200 m3. Rockfall simulations are then performed on a “per-impact” basis to illustrate how the reconstructed data from the site can be used to validate results from simulation models.

Atlanto‐occipital subluxation in an adult Thoroughbred gelding

SummaryA 13‐year‐old gelding was referred to the University of Liverpool Equine Hospital for further investigation of ataxia and neck pain following a suspected traumatic incident in the field 5 days prior. The following case report documents the clinical presentation, ultrasonographic, radiographic and computed tomographic (CT) findings of a right lateral atlanto‐occipital (AO) subluxation. In brief, clinical presentation included abnormal head carriage, ataxia and cranial cervical swelling with associated neck pain. Radiography showed lateral deviation of the poll and subluxation of the right AO joint with significant widening of the left AO joint. CT was undertaken standing which confirmed lateral luxation of the right occipital condyle in relation to the right articular process of the AO joint such that the right articular process of the atlas was located medial to the right occipital condyle. The gelding was subjected to euthanasia and post‐mortem the subluxation was resolved with a closed traction procedure. This case initiates discussion of diagnosis, management and outcome for this uncommon injury. The use of CT in this case gives previously undocumented detail on the nature of the subluxation and assisted in the management and post‐mortem closed reduction procedure.

Neural network optimization algorithm based non-singular fast terminal sliding-mode control for an uncertain autonomous ground vehicle subjected to disturbances

As computer computing capabilities increase, optimization algorithms are becoming more useful for solving engineering problems. Up to now, several metaheuristic algorithms have been exploited in control engineering. However, this effort remains weak in addressing the autonomous ground vehicles (AGVs) trajectory tracking problem. This research presents a novel optimal approach merging the robust non-singular fast terminal sliding-mode control method (NFTSMC) and the neural network optimization algorithm (NNA) for automatic lane changing. First, a reference double lane-change path (DLC) is designed, and the robust non-singular fast terminal sliding-mode steering controller is developed, according to Lyapunov stability theory, to suppress the lateral deviation and ensure the yaw stability. Then, the control strategy is optimized by the NNA algorithm to adjust the steering controller optimally while avoiding local optimums. A comparison, under the same conditions, with the particle swarm optimization algorithm (PSO) revealed the superiority of the control law resulting from the NNA-based optimization. Furthermore, the proposed approach shows its excellent tracking performance versus the integrated backstepping sliding-mode controller (IBSMC) and the adaptive sliding-mode control (ASMC) under severe conditions typical of real-world lane changes.

An Improved Model Predictive Control-Based Trajectory Planning Method for Automated Driving Vehicles Under Uncertainty Environments

For automated driving vehicles, trajectory planning is responsible for obtaining feasible trajectories with velocity profiles according to driving environments. From the perspective of trajectory planning, multiple uncertainties of environments and tracking deviations are two significant factors affecting driving safety. The former disturbs the judgment of trajectory planning on the environments, and the latter reduces the tracking accuracy of planned trajectories. To solve these problems, an improved model predictive control (MPC) trajectory planning method is proposed in this paper. Firstly, a Kalman filter fusion method is carried out to predict obstacle trajectory and their uncertainty, which combines model-based and data-based prediction methods. Based on the prediction results, a tube-based MPC trajectory planning method is applied to plan a reference trajectory with a small tracking deviation. The tube-based MPC is composed of two parts. One is the MPC with tightened constraints that is used to plan a feasible trajectory according to a nominal vehicle system and driving environment. The other is a state feedback control that is proposed to adjust the above planned trajectory to reduce the tracking deviations. To our knowledge, this paper proposes Kalman filter fusion and tube-based MPC planning method for the first time to consider the uncertainties of trajectory prediction and tracking control meanwhile in the planning. The planning method is verified by simulations and experiments in multiple scenes. Results show that the method is suitable for both static and dynamic scenes. Compared with applying the basic prediction method, the lateral deviation of the proposed method from the ideal trajectory is decreased by 46.5%. Compared with the nominal MPC method, the lateral tracking deviations of the proposed method are decreased by 77.42%.

Esophageal Perforation in a 76-Year-Old Man After C5-C7 Anterior Discectomy and Anterior Plate Fusion

Anterior cervical discectomy and fusion (ACDF) is indicated for the treatment of various cervical pathologies, including myelopathy, cervical disc degeneration, and radiculopathy. Esophageal perforation is a rare postsurgical complication of ACDF, although it poses serious and potentially fatal outcomes. Esophageal perforation has been described as the most fatal complication of the gastrointestinal tract as delayed diagnosis can lead to sepsis and death. Diagnosis of this complication is often difficult because it can be masked by various symptoms such as recurrent aspiration pneumonia, fever, dysphagia, and neck pain. While this complication usually occurs within the first 24 h post-surgery, it can also develop later and persist chronically in rare cases. Awareness and early recognition of this complication may improve outcomes and reduce mortality and morbidity. A 76-year-old man underwent C5-C7 ACDF in October 2017. A thorough review of the patient's postoperative condition included computed tomography (CT) and esophagogram, which were negative for signs of acute complications. The postoperative recovery was uneventful until several months post-procedure when he began to develop vague dysphagia and weight loss of unknown etiology. A CT scan was obtained 6 months postoperatively and was negative for perforation. He then underwent a battery of inconclusive procedures and scans at multiple institutions. After several months of persistent dysphagia and weight loss without a diagnosis, the patient presented to our network for further workup and treatment recommendations. Upper endoscopy was performed and showed fistulization between the esophagus and the metal hardware in the cervical spine. Esophagram demonstrated no obstruction but decreased peristalsis of the lower esophagus and lateral rightward deviation of the left upper cervical esophagus with minimal mucosal irregularities. These findings were secondary to mass effect of the cervical plate. The patient was successfully treated with a surgical approach using esophagogastroduodenoscopy (EGD) guided repair in layers and a sternocleidomastoid muscle flap. This report demonstrates a rare case of delayed esophageal perforation after ACDF and successful treatment of the perforation by surgical repair using the dual technique.

Effect of different platoon configurations on strains and fatigue performance of flexible pavements

This paper presents part of the studies developed in the European project ENSEMBLE. (ENabling SafE Multi-Brand pLatooning for Europe). The first part of the paper describes the validation of a numerical model based on comparisons with experimental results obtained from a test section subjected to the pass of 3 human-driven trucks simulating a platoon configuration. The numerical model is then used to predict the maximum and accumulated strains produced by the passage of each truck on the same test section at two different temperatures when the following platoon parameters are varied: (1) inter-truck time gap, (2) truck speed and (3) lateral deviation (wandering). The results confirm that the proper control of these parameters can help to keep the same level of fatigue damage as with trucks in individual configurations. In this way, the environmental, social and economic benefits of platooning can be attained without compromising the existing pavement structures.

Robotics Coupled With Navigation for Pediatric Spine Surgery: Initial Intraoperative Experience With 162 Cases.

This study assesses intraoperative efficacy, accuracy, and complications of pedicle screw placement using robotic-assisted navigation (RAN) in pediatric spine surgery. A retrospective review of patients who underwent spine deformity surgery using RAN at a single pediatric institution from 2019 to 2021 was conducted. Patient demographics, perioperative metrics, screw execution and accuracy, technical difficulties, and other outcomes were summarized. In cases with postoperative computed tomography scans, screws were classified using the Gertzbein and Robbins classification scale. Fisher exact tests were used to assess the relationship between procedural changes and lateral screw malposition. One hundred sixty-two cases with an average patient age of 15.1 years (range, 4 to 31y) were reviewed. The most common diagnosis was adolescent idiopathic scoliosis (n=80) with an average major curve of 65 degrees. Of 1467 screws attempted, 1461 were executed successfully (99.6%). All failures were in Type D pedicles and were lateral deviations recognized with routine intraoperative fluoroscopy. In cases with postoperative computed tomography imaging, 100% of screws (n=197) were placed with complete containment (Grade A). Remaining screws were graded as accurate by mirroring fluoroscopy and planned computer software positions. In 4% of cases, loss of registration was detected by a safety check before drilling at the planned level. There were no neurological deficits or returns to the operating room. Two changes occurred as part of the learning curve associated with this technique. (1) Adoption of a high-speed navigated drill: Change 1 (last 74 cases). (2) Drilling all pilot holes robotically first, then placing screws within the robotically established tracts to avoid motion and subsequent registration disruption: Change 2 (last 39 cases). Change 1 was less likely to result in screw malposition as no screws skived lateral with the technique ( P =0.03). Change 2 trended toward statistical significance for avoidance of screw malposition and loss of registration, as no loss of registration occurred after adopting this technique. This study highlights the safety and screw accuracy associated with the use of RAN in pediatric patients. Level III.

Anesthetic management of a Kyphoscoliotic parturient with Mitral valve prolapse posted for emergency cesarean section

Kyphoscoliosis is a spinal deformity with forward and lateral deviation of the normal spine. It occurs in up to 4% of the population. This condition in pregnancy causes altered growth of gravid uterus and leads to unpredictable delivery. These deformities if extreme can cause obstructed labor which will require cesarean section and are usually associated with physiologic derangements in cardiopulmonary function causing difficulties in conducting both general and regional anaesthesia. One of the causes of kyphoscoliosis can be secondary to cardiothoracic surgery in the childhood. Subarachnoid block in kyphoscoliotic patients is always challenging to an anesthesiologist due to the deformity of spine and spread of anesthetic drug to unpredicted level. We present a known case of post cardiac surgery, mitral valve prolapse with kyphoscoliosis in the thoracolumbar region posted for emergency cesarean section managed under subarachnoid blockade.

Surgical treatment of pseudoankylosis of the temporomandibular joint in a dog

AbstractPseudoankylosis of the temporomandibular joint is infrequent in veterinary practice and mostly seen secondary to trauma. This case report describes the surgical treatment of a 1‐year old, male, entire lurcher that presented with progressive lateral deviation of the muzzle to the left and decreased vertical mandibular range of motion of 6‐month duration. There was no history of trauma, no pain on palpation and complete loss of temporomandibular joint movement, even under sedation. Computed tomography investigation showed a left‐sided temporomandibular pseudoankylosis with osseous fusion between the zygomatic arch and mandible. Surgical excision of the ankylosed bone was performed and achieved an initial 5 cm interincisal gap. The surgical site healed, with no complications reported. Re‐examination at 4 weeks revealed good vertical mandibular range of motion with interincisal gap of approximately 5 cm. At 9 months post‐operatively, the dog had maintained good vertical mandibular range of motion and was able to eat normally, pant and hold large toys.

Ocular Lateral Deviation as a Vestibular Sign to Improve Detection of Posterior Circulation Strokes: A Review of the Literature

BackgroundPosterior circulation stroke can present with dizziness/vertigo without other general neurological symptoms or signs, making it difficult to detect, and missed stroke can deteriorate. Therefore, a sign that can be easily identified during an examination would be helpful to improve the detection of this type of stroke. ObjectiveThe objective of this review is to highlight an ocular sign that is seen in posterior circulation strokes called ocular lateral deviation (OLD). OLD is mostly seen in dorsolateral medullary strokes, and it is also seen in pontine and cerebellar strokes. OLD is detected by asking a patient to look straight ahead and then briefly close their eyes. Upon re-opening their eyes, the examiner will see that the eyes have deviated to one side; the patient's eyes will then make corrective saccade(s) to return to looking straight ahead. Complete eye deviation is a central sign of posterior circulation stroke. DiscussionOLD is an under-recognized vestibular ocular sign of central vestibulopathies including posterior circulation stroke. The most common location is in the dorsolateral medulla, where one-third of such strokes have complete OLD. Eye deviation can also be appreciated on computed tomography or magnetic resonance imaging. OLD can be detected up to 6 months after a posterior circulation stroke. ConclusionsChecking for the sign of complete eye deviation in patients with dizziness/vertigo could be a simple, quick method for detecting posterior circulation stroke, and a means to improving the patients’ outcome.

An obstacle avoidance path planner for an autonomous tractor using the minimum snap algorithm

Autonomous tractors use a GNSS-based approach combined with other sensors to provide higher efficiency and minimize human intervention. The basis of field automated navigation is the agricultural route planning of the entire field. One of the main aspects of agricultural route planning is obstacle avoidance path planning, which can provide a safe continuous trajectory for autonomous tractors to pass obstacles. In this study, a collision-free path planning method was proposed using the minimum snap algorithm to enable the tractor to safely navigate from one point to another. To authenticate the proposed algorithm, a tripartite experimental scheme was designed, encompassing a ROS-based simulation, robot platform validation, and a field test. Simulation results demonstrate that the collision-free path generated by the proposed algorithms can effectively guide the tractor to follow the given path with a lateral error of 1.75 cm. For the robot platform validation test, the mean lateral deviations were 2.63 cm, 5.01 cm, and 6.80 cm at speeds of 0.5 m/s, 0.8 m/s, and 1.0 m/s, respectively. The feasibility of using the developed algorithms was followed by a field test with a 162-KW CVT autonomous tractor. The mean lateral deviations were 5.17 cm, 5.13 cm, and 6.10 cm at speeds of 0.6 m/s, 0.8 m/s, and 1.0 m/s, respectively. The test results showed that the model could provide a safe and stable collision-free path for agricultural machines operating in the field.

Evaluating Cardiac Lateralization by MRI to Simplify Estimation of Cardiopulmonary Impairment in Pectus Excavatum.

The severity of pectus excavatum is classified by the Haller Index (HI) and/or Correction Index (CI). These indices measure only the depth of the defect and, therefore, impede a precise estimation of the actual cardiopulmonary impairment. We aimed to evaluate the MRI-derived cardiac lateralization to improve the estimation of cardiopulmonary impairment in Pectus excavatum in connection with the Haller and Correction Indices. This retrospective cohort study included a total of 113 patients (mean age = 19.03 ± 7.8) with pectus excavatum, whose diagnosis was verified on cross-sectional MRI images using the HI and CI. For the development of an improved HI and CI index, the patients underwent cardiopulmonary exercise testing to assess the influence of the right ventricle's position on cardiopulmonary impairment. The indexed lateral position of the pulmonary valve was utilized as a surrogate parameter for right ventricle localization. In patients with PE, the heart's lateralization significantly correlated with the severity of pectus excavatum (p ≤ 0.001). When modifying HI and CI for the individual's pulmonary valve position, those indices are present with greater sensitivity and specificity regarding the maximum oxygen-pulse as a pathophysiological correlate of reduced cardiac function (χ2 10.986 and 15.862, respectively). The indexed lateral deviation of the pulmonary valve seems to be a valuable cofactor for HI and CI, allowing for an improved description of cardiopulmonary impairment in PE patients.