Change In Position Research Articles

Anatomical Location of the Bowel in Different Surgical Positions: Implications for Lateral Access in Prone Single-Position Surgery.

Radiographic analysis. Evaluate the anatomical relationships of the bowel to the lateral surgical corridor and the spine in various surgical positions. Retroperitoneal transpsoas lateral lumbar interbody fusion (LLIF) may be performed with patients in the prone position, allowing for lateral and posterior approaches to the spine without repositioning the patient. Few, if any, studies discuss changes of the bowel position during these procedures. Ten healthy volunteers underwent MRI in 3 positions: supine, prone with hips extended (prone-extension), and right lateral decubitus (left side up) with hips flexed (lateral decubitus-flexion). Anatomical relationships of the bowel to fixed spinal landmarks were assessed at L1-5, and the changes among participants' positions were compared. Anterior bowel movement was noted with prone-extension (range: 0.32-1.39cm) and lateral decubitus-flexion (range: 0.97-2.18cm) positioning compared with supine positioning. Significant anterior movement of the bowel was observed at L1-2 (P=0.03) and L2-3 (P=0.04) disc levels in participants in the prone position and at L2-3 (P=0.002) and L3-4 (P=0.01) in those in the lateral position when compared with those in the supine position. No differences in bowel movement were found for prone and lateral positioning. The percentages of participants with bowels located in the operative corridor were similar among the surgical positions (all P>0.07). 3D volumetric analysis showed that the magnitude of these changes was greatest for the upper left colon. The results showed that the bowel was positioned anteriorly at L1-5 disc levels when participants were in prone-extension and lateral decubitus-flexion positions compared with the supine position. Overall, the magnitude of bowel positional change was small and variable. These findings suggest that the bowel does not fall away from the surgical corridor when performing retroperitoneal access for single-position prone surgery compared with the lateral decubitus-flexion position.

Positioning accuracy and post-treatment changes in the mandibular arch after insertion of a CAD/CAM titanium retainer.

Fixed retention is the method of choice for permanent stabilization of the treatment outcome. In recent years, CAD/CAM techniques have been developed to produce retainers with high precision and tension-free fit. The aim of this retrospective study was to evaluate the suitability of a semi-industrial retainer manufacturing process (office-based construction, external laboratory manufacturing) in terms of positioning accuracy and post-treatment changes. The accuracy of 41 retainers that were digitally designed and produced from a titanium plate by water jet cutting was analyzed. The patient received the retainer through fixation with dental flosses, without using a transfer tray. We compared the position in the mouth after insertion with the virtual setup using 3D software for superimposition. Intraoral scans of 25 CAD/CAM retainers and 25 0.0175" hand-bent retainers were evaluated after one year of usage. We measured the width between the canines, the angle between the lateral incisors, and the angle of contact between the canines and the lateral incisors. The largest and significant positioning deviations occurred in the vertical position, whereas positional changes in the horizontal and sagittal were small. The CAD/CAM retainers and the hand-bent retainers showed similar and minimal post-treatment alterations, which were not statistically significant. Semi-industrial CAD/CAM titanium retainers offer good positioning accuracy in the mandible even without a transfer tray. Increased deviations between planned and actual position only occur in the vertical plane. In addition, these retainers offer good retention properties with minimal posttreatment changes, making them suitable for permanent retention.

Left neck and right biceps muscle vibrations have similar effects on perceived body orientation

Vibrating muscles to manipulate proprioceptive input creates the sensation of an apparent change in body position. This study investigates whether vibrating the right biceps muscle has similar effects as vibrating the left posterior neck muscles. Based on previous observations, we hypothesized that both types of muscle vibration would shift the perception of healthy subjects’ subjective straight-ahead (SSA) orientation in the horizontal plane to the left. Such a finding would be extremely interesting for future treatment of spatial neglect, a disorder following right-sided stroke brain lesions. Twenty healthy participants (11 females, 9 males, aged 20–52) were tested under five conditions: baseline (no vibration), vibration of left neck muscles, vibration of right biceps with the arm fixed to the wall, vibration of right biceps with the arm lying on a table, and vibration of right triceps with the arm fixed to the wall. Participants had to align a laser pointer (by verbal instructions) with their perceived SSA position in complete darkness. ANOVA revealed significant SSA shifts with neck and biceps vibrations but not with triceps vibration. The largest leftward SSA shift occurred with right biceps vibration while the arm was lying on the table (-6.1°), followed by left neck muscle vibration (-6.0°), and right biceps vibration with the arm fixed to the wall (-5.4°). Post-hoc power analyses showed high power (> 0.98) for the significant differences compared to the baseline condition. The finding that right biceps vibration affects SSA perception similarly to left neck muscle vibration offers potential for clinical applications in treating spatial neglect. Future research should explore the therapeutic efficacy of vibrating the right biceps in neurological patients with spatial neglect.

Potential for Misdiagnosis of Detrusor Underactivity Due to Urodynamic Voiding Position and Seating Characteristics.

Detrusor underactivity (DUA) is a lower urinary tract (LUT) diagnosis that is diagnosed with multichannel urodynamic studies (UDS). The effect of voiding position and DUA detection is unclear. We investigated whether moving individuals from the UDS chair to their typical voiding position would more accurately assess detrusor function in cases of absent or nonrepresentative voiding. We hypothesized that patients unable to achieve a representative void while on the UDS chair may be misdiagnosed with DUA, and that changing position may reveal intact detrusor function. We retrospectively studied patients who underwent UDS with a single provider over 2 years. Studies were included if a patient was moved to a new position after unsuccessful or unrepresentative void attempts on the UDS chair. Two neurourologists reanalyzed the studies and recorded: time spent attempting to void on UDS chair and after moving position, whether a bladder contraction occurred on UDS chair, pdet Q max and Q max when voiding occurred, presence of a bladder contraction in new position, and pdet Q max and Q max in new position, and Valsalva effort. 503 patients underwent UDS; 94/503 patients were moved to a new position and 81/94 studies were interpretable. 71% of patients without a bladder contraction on the UDS chair demonstrated contraction in new position. UDS voiding position and surface can impact whether patients produce a bladder contraction and representative void during urodynamic testing. Positional change to more natural voiding positions and surfaces improves detection of intact detrusor function.

Assessment of Reference Values for Shoulder Ultrasonography and Effects of Position Change on Shoulder Hemodynamics

ABSTRACTPurposeThis study aimed to examine the reference values for shoulder ultrasonography and the effects of positional changes on anterior humeral circumflex artery (AHCA) hemodynamics.MethodsIn this study, shoulder ultrasound was examined in 92 healthy participants (women: 48; men: 44; age 37.8 ± 13.6 years). The thickness of the rotator cuff and the cross‐sectional area of the long head of the biceps tendon (LHB) were determined using ultrasonography. After gray‐scale evaluations, the pulse Doppler mode was used to measure the peak systolic velocity (PSV) of the AHCA in four shoulder positions: neutral, internal rotation, external rotation, and backward extension.ResultsThe mean thickness of the supraspinatus tendon and cross‐sectional area of the LHB were significantly different between sexes and ages (p < 0.05). Compared to the neutral position, the PSV of the AHCA significantly decreased during internal rotation (p < 0.001).ConclusionThe findings of our study may be useful in daily shoulder practice.

Transfer of Share Ownership and Change of Position of Director of a Limited Liability Company Due to Misuse of GLA Online Accounts

The misuse of General Legal Administration (GLA) Online accounts, a system developed to streamline public services for notaries, has caused significant issues, including unauthorized transfers of share ownership and changes in director positions within Limited Liability Companies. This research aims to analyze the legal mechanisms surrounding these corporate actions, investigate the challenges posed by account misuse, and propose effective legal remedies for affected parties. Employing a doctrinal research method, the research relies on literature analysis, interviews with experts, and a case research of the Cibinong District Court Decision Number 9/Pdt.G/2024/PN.Cbi. Primary legal materials include laws and court decisions, while secondary materials encompass books, journals, and credible online sources. The findings reveal that both the transfer of shares and the replacement of directors, as a result of account misuse, violate the Company Law and corporate governance principles. To mitigate these issues, the Directorate General of GLA suggests procedural remedies, including police reports, Regional Supervisory Council investigations, and State Administrative Court filings. This research highlights the need for enhanced digital security measures, such as face recognition, and emphasizes stricter notary accountability. Future research can explore the broader implications of digital platform governance in corporate law, aiming to improve legal frameworks and prevent similar misuse.

A remote monitoring approach for coastal engineering projects

High costs and project-based (short-term) financing mean that coastal engineering projects are often undertaken in the absence of appropriate post-construction monitoring programmes. Consequently, the performance of shoreline-stabilizing structures or beach nourishments cannot be properly quantified. Given the high value of beaches and the increase in erosion problems and coastal engineering responses, managers require as much accurate data as possible to support efficient decision-making. This work presents a methodological approach to characterise coastline position changes as a result of engineering actions. We describe a new, low-cost method based on satellite remote sensing to monitor shoreline evolution at high temporal and spatial resolution pre-, during and post-implementation. Initially, satellite-derived waterlines are identified and extracted from publicly available satellite imagery of the Landsat 5, 7, 8, and 9, and Sentinel-2 constellations using the automatic shoreline extraction tool SHOREX. The waterline positions are then compiled, differences over time are quantified, and a matrix is constructed that allows easy depiction and interpretation of spatial and temporal patterns of erosion/accretion. This allows the access and the comprehension of the morphological data by the non-expert. Two examples of application on the Valencian coast of Spain at different spatial scales demonstrate how beach response to coastal engineering actions can be characterised at different levels of detail (from local to regional) and over different periods of time. These applications evidence the utility of the approach as it allows analysis of pre- and post-intervention coastal change and offers a means to overcome the widespread lack of monitoring and hence to improve coastal engineering practice.

Therapy Potential of Oblique Lumbar Interbody Fusion 360 for Severe Lumbar Spinal Stenosis.

The advent of O-arm navigation optimized the oblique lumbar interbody fusion (OLIF) procedure, allowing the operator to simultaneously perform OLIF and percutaneous posterior pedicle screw implantation without patient position change, thus improving the fluency and accuracy of the OLIF procedure (called as OLIF360). Nevertheless, a consensus regarding its suitability for patients with severe spinal stenosis remains elusive. This study aims to investigate the clinical efficacy of OLIF360 and its imaging changes in severe lumbar spinal stenosis cases. This retrospective study analyzed clinical data from 63 patients with severe lumbar spinal stenosis. Fourteen patients were treated with OLIF360, and another 37 patients were treated with posterior lumbar interbody fusion (PLIF). Lumbar spinal stenosis was assessed using the modified Schizas classification. Clinical efficacy scale scores and postoperative imaging parameter changes were compared between the two groups. Shapiro-Wilk, t-tests or Mann-Whitney U tests, repeated measures ANOVA, and Bonferroni post hoc tests were applied for statistical analysis. Both groups showed significant improved pain (p < 0.05). At 1-month and 3-month postoperative follow-ups, OLIF360 group scores superior in Visual Analog Scale than PLIF group (p < 0.05). Greater disc height and lumbar lordosis were displayed in OLIF360 group than PLIF group (p < 0.05). No significant difference in screw placement accuracy between groups was observed. Moreover, significant increases in spinal canal area postoperatively (71.04 ± 6.27 mm2 preop to 109.65 ± 12.34 mm2 postop, p < 0.05) and bilateral foraminal areas were found in the OLIF360 group. OLIF360 can have promising short-term efficacy for severe lumbar stenosis treatment with shorter recovery time than PLIF.

Glucagon-Like Peptide-1 Receptor Agonists in Patients With Durable Left Ventricular Assist Devices.

GLP-1 RAs improve cardiometabolic outcomes in obese, diabetic, and heart failure patients. Data on the safety and efficacy of GLP-1 RA in advanced heart failure with durable LVAD is limited. To assess the safety and efficacy of GLP-1 RA in durable LVAD patients. We conducted a single-center retrospective analysis of patients on durable LVAD support treated with GLP-1 RA. Outcomes included cardiometabolic efficacy and LVAD and GLP-1 RA related adverse events up to 1 year post GLP-1 RA initiation. Forty LVAD patients were treated with GLP-1 RA therapy between 2018 and 2023. At 1 year follow-up, the patient's weight was significantly reduced (116 (98-134) vs. 110 (91-129) kg, p-value < 0.001), HBA1C was improved (6.4 (5.8-8.1) vs. 5.7 (5.3-6.1), p-value 0.003), and NT-proBNP levels were significantly reduced (810 (594-1413) vs. 732 (354-1155) pg/mL, p-value 0.04). GLP-1 RA therapy was not associated with cannula position change (cannula coronal angle of 29.7° (15.0-42.0) vs. 23.1° (12.8-42.3), p-value 0.683), and LVADs complication rate was relatively low (12.5% of the patients had hemocompatibility adverse events, 15% had driveline infection, 12% had HF hospitalization, and 2.5% (1 patient) died due to HeartMate2 malfunction). There was no interruption of drug administration due to adverse events. Durable LVAD patients treated with GLP-1 RA had improved cardiometabolic profiles and low major adverse events. GLP-1 RA therapy holds promise as a potential adjunctive treatment strategy in LVAD recipients, offering improved cardiometabolic profile, hemodynamics, and potential future transplant candidacy.

Three-dimensional quantitative temporomandibular joint changes in skeletal class I malocclusion treated with extraction and non-extraction protocols: a comparative study of fixed orthodontic appliances and clear aligners

ObjectiveThis study aimed to evaluate the positional and morphological changes in the temporomandibular joint (TMJ) in adult patients with skeletal Class I malocclusion treated with fixed orthodontic appliances (FAs) and clear aligners (CAs), both with and without premolar extractions.MethodsThis retrospective study involved 120 adult patients divided into non-extraction and extraction groups, each further subdivided equally into those treated with FAs and CAs. Cone beam computed tomography (CBCT) was used to assess the TMJ measurements before (T0) and after treatment (T1). Statistical analyses were conducted to compare the mean changes in intra- and inter-groups. A significance level of p ≤ 0.05 was considered.ResultsIn the non-extraction group, specifically in FAs, significant increases were observed in TMJ parameters; anteroposterior condylar position (APCP) and mediolateral condylar inclination (MCI). Conversely, significant decreases were noted in vertical condylar position (VCP) and vertical condylar inclination (VCI). In the extraction group, significant increases were noted in APCP and anterior joint space (AJS), while posterior joint space (PJS) and anteroposterior condylar joint position (APCJP) decreased. For inter-group comparisons, the extraction group showed significant increases in APCP in FAs compared to CAs, and a significant decrease in APCJP in FAs compared to CAs.ConclusionFAs significantly impact condylar positions and joint spaces, especially in extraction cases. Monitoring TMJ parameters during orthodontic treatment is crucial to ensure positive outcomes and prevent TMJ disorders (TMDs). These findings may guide the selection of orthodontic appliances based on individual malocclusion characteristics.

Action toward sound sources enhances auditory spatial confidence: on the metacognitive consequences of reaching to sounds

Each perceptual process is accompanied with an evaluation regarding the reliability of what we are perceiving. The close connection between confidence in perceptual judgments and planning of actions has been documented in studies investigating visual perception. Here, we extend this investigation to auditory perception by focusing on spatial hearing, in which the interpretation of auditory cues can often present uncertainties. We asked if confidence in perceived sound position changes when we interact with the sound source by planning a sound-directed motor action (reaching) vs. a verbal response (naming). We tested 30 participants in a sound localization task in which they were both asked to localize sound sources by reaching them or by naming the labels above them in a within-participants experimental design. Participants performed the task with binaural hearing and with one ear plugged to increase errors and reduce confidence. Results showed that sound localization performance did not differ between reaching and naming, and yet participants felt more confident and required less time to complete the trial when reaching to the sources compared to naming them, regardless of the listening condition. Moreover, we found that during monaural listening the coherence between performance and confidence was reduced in each trial, irrespective of response type, suggesting increased difficulties in metacognitive monitoring. These findings suggest that, even in the case of spatial hearing, motor action planning plays a role in the formulation of confidence judgments, alongside sensory inputs and decision-making processes and stress the importance of including metacognitive measurements into spatial hearing research.

Predicting nanofluid behavior in inflamed stenotic arteries: a neural network and finite element-Based analysis

This study examines heat transfer and nanofluid-enhanced blood flow behaviour in stenotic arteries under inflammatory conditions, addressing critical challenges in cardiovascular health. The blood, treated as a Newtonian fluid, is augmented with gold nanoparticles to improve thermal conductivity and support drug delivery applications. A hybrid methodology combining finite element method (FEM) for numerical modelling and artificial neural networks (ANN) for stability prediction provides a robust analytical framework. Parametric analysis reveals that increasing stenosis severity (60% to 80%) results in a 45% enhancement in heat transfer, demonstrating the efficacy of nanoparticle integration. The results show that the size of the vortices decreases due to the position changing of the upper stenoses, whereas it rises with increasing stenosis peak. Higher nanoparticle volume fraction ( ϕ ) amplifies momentum diffusion, resulting in larger vortices, while improved thermal conductivity enhances heat transfer. Inflammation significantly affects flow patterns and heat transport with important implications in treating cardiovascular disorders and biological applications. The regression analysis confirms a close match between predicted and target data, showcasing the robustness of the FEM-ANN hybrid approach for modelling biofluid systems.

Rotating radial injection pattern for highly sensitive electrical impedance tomography of human lung anomalies.

Electrical Impedance Tomography (EIT) is a non-invasive technique used for lung imaging. A significant challenge in EIT is reconstructing images of deeper thoracic regions due to the low sensitivity of boundary voltages to internal conductivity variations. The current injection pattern is decisive as it influences the current path, boundary voltages, and their sensitivity to tissue changes. &#xD;Approach. This study introduces a novel current injection pattern with radially placed electrodes excited in a rotating radial pattern. The effectiveness of the proposed pattern was investigated using a 3D computational model that mimics the human thorax, replicating its geometry and tissue electrical properties. To examine the detection of lung anomalies, models representing both healthy and unhealthy states, including cancer-like anomalies in three different positions, were developed.&#xD;The new pattern was compared to common patterns-Adjacent, Skip 1, and Opposite-using Finite Element Analysis (FEA). The comparison focused on the current density within lung nodules and the sensitivity to changes in anomaly positions. &#xD;Main Results. Results showed that the new pattern achieved the maximum current density within anomalies compared to surrounding tissues, with peak values near the closest electrode pairs to the anomalies. Specifically, current density magnitudes reached 72.73 10^{-9} A.m, 145.24 10^{-9} A.m, and 26.43 10^{-9} A.m for the three different positions, respectively. Furthermore, the novel pattern's sensitivity to anomaly position changes surpassed the common patterns. These results demonstrate the efficiency of the proposed injection pattern in detecting lung anomalies compared to the common injection patterns.

Rotating radial injection pattern for highly sensitive electrical impedance tomography of human lung anomalies.

Electrical Impedance Tomography (EIT) is a non-invasive technique used for lung imaging. A significant challenge in EIT is reconstructing images of deeper thoracic regions due to the low sensitivity of boundary voltages to internal conductivity variations. The current injection pattern is decisive as it influences the current path, boundary voltages, and their sensitivity to tissue changes. &#xD;Approach. This study introduces a novel current injection pattern with radially placed electrodes excited in a rotating radial pattern. The effectiveness of the proposed pattern was investigated using a 3D computational model that mimics the human thorax, replicating its geometry and tissue electrical properties. To examine the detection of lung anomalies, models representing both healthy and unhealthy states, including cancer-like anomalies in three different positions, were developed.&#xD;The new pattern was compared to common patterns-Adjacent, Skip 1, and Opposite-using Finite Element Analysis (FEA). The comparison focused on the current density within lung nodules and the sensitivity to changes in anomaly positions. &#xD;Main Results. Results showed that the new pattern achieved the maximum current density within anomalies compared to surrounding tissues, with peak values near the closest electrode pairs to the anomalies. Specifically, current density magnitudes reached 72.73 10^{-9} A.m, 145.24 10^{-9} A.m, and 26.43 10^{-9} A.m for the three different positions, respectively. Furthermore, the novel pattern's sensitivity to anomaly position changes surpassed the common patterns. These results demonstrate the efficiency of the proposed injection pattern in detecting lung anomalies compared to the common injection patterns.

Health-related quality of life after Dega pelvic osteotomy and varus derotation osteotomy due to spastic hip disease in children with cerebral palsy.

Our study aimed to present health-related quality of life (HRQL) after combined bone reconstruction in nonambulatory patients with cerebral palsy (CP) after at least a 2-year follow-up and to assess its impact on HRQL using the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire (CPCHILD) as the primary outcome measure. In this prospective study, we analyzed 31 nonambulatory patients with spastic or mixed CP (GMFCS levels IV-V) who underwent hip reconstructive surgery between 2015 and 2021. The surgical procedures included one-sided varus derotation osteotomy of the femur with Dega transiliac osteotomy and, on the opposite side, varus derotation osteotomy (VDRO) of the femur with shortening and, as needed, Dega pelvic osteotomy. The study demonstrated significant improvement in the hip joint motion range, as assessed by the Thomas test, in hip abduction and rotational movements of the hip, as well as reduction of spasticity. The procedures also resulted in significant radiographic improvement of the femoral head coverage. The assessment of symptoms and problems associated with the hip revealed a positive influence of the surgery on pain, contractures, toileting/perineal hygiene, dressing, seating, transferring, and position changes. The mean improvement at a follow-up visit was significant in all domains of the CPCHILD, except for communication and social interaction. Hip reconstruction with VDRO and Dega pelvic osteotomy can enhance the HRQL of children with CP. These surgical interventions can help to achieve the correct hip position and to reduce pain, which positively affects the patient QL, although proactive treatment results in less invasive procedures. IV case series.

Stroke phase differences in the linear relationship between swimming velocity and vertical body position during front crawl

ABSTRACT We aimed to investigate whether a linear relationship exists between swimming velocity and vertical body position for each stroke phase in front crawl, and to determine whether there are differences in the velocity effect among the stroke phases. Eleven male swimmers performed a 15 m front crawl at various swimming velocities. The whole-body centre of mass (CoM) was estimated from individual digital human models using inverse kinematics. The horizontal CoM velocity and vertical CoM position from the water surface were calculated for one stroke cycle and divided into five stroke phases: entry, pull, push, release, and recovery. Linear mixed-effects model analysis revealed a positive trend between the mean swimming velocity and the mean vertical CoM position for each stroke phase (p < 0.001 for all phases). The interaction term between stroke phase and swimming velocity was significant (p < 0.001), and the slopes of the propulsive phases (pull and push) were larger than those of the non-propulsive phases (entry, release, and recovery) (p < 0.001). These findings provide practical implications that vertical body position can be evaluated independently of the stroke phase while considering velocity effects, and that focusing on propulsive phases allows easier detection of vertical body position changes.

Reduction of ischemic time using the pull-through technique for scapular free flap.

Current scapular free flap (SFF) harvest in mandibular reconstruction often requires repositioning, hindering simultaneous harvest and resection and potentially increasing ischemic time. This study evaluated the efficacy of the pull-through technique (PTT) for SFF harvest, aiming to reduce ischemic time during mandibular segmental resection. A retrospective analysis was conducted on 24 patients who underwent mandibular reconstruction using SFF at two maxillofacial surgery departments between January 2015 and May 2022. In total, 13 patients received PTT, while the remaining 11 underwent non-PTT. Demographic and clinical data were collected, including age, sex, diagnosis, resected mandibular segments, operative time, and ischemic time. Statistical analysis was performed to compare these variables between the PTT and non-PTT groups. The study found no significant differences between the groups in terms of age, sex, diagnosis, number of resected segments, or total operative time. However, ischemic time was significantly shorter in the PTT group than in the non-PTT group. PTT also allowed for minimal position changes during surgery compared with non-PTT. Our study investigated the impact of the PTT on SFF reconstruction during mandibular segmental resection. We found that utilizing PTT-SFF significantly reduced ischemic time compared with the traditional method. This technique offers a potential advantage by facilitating stable blood flow visualization and potentially improving flap viability. Not applicable.

Importance of Post-Reduction CT Scans in Posterior and Transverse Posterior Wall Acetabular Fracture-Dislocations.

To report the frequency of patients with pre- and post-reduction computed tomography (CT) scans associated with acetabular fracture-dislocations and the change of associated intra-articular fragments occurring with joint reduction. Design: Retrospective case series. Regional Level 1 trauma center. Patients who sustained an OTA/AO 62A1 and 62B1 posterior wall or transverse posterior wall acetabular fracture-dislocations with pre- and post-reduction CT imaging from February 2020 until July 2023. Intra-articular fragments were identified and change in position (fossa to cranial, intra-articular to extra-articular, etc.) noted from pre- to post-reduction scans. Operative reports and post-operative CT scans were reviewed to determine the frequency of fragment retrieval. 119 out of 394 (30.2%) patients meeting fracture pattern inclusion received a CT scan prior to hip reduction. Of the 394 patients, 100 (25.9%) had pre- and post-reduction CT scans and were studied (average age of 35.5 years (range 16 - 87 years), 59 male). 45 of 100 patients (45%) had pre-reduction CT imaging demonstrating the presence of intra-articular fragment(s). 30 of 45 patients with a pre-reduction intra-articular fragment (66.7%) had an intra-articular fragment location change during the reduction. Of the 55 patients who did not have an intra-articular fragment on pre-reduction imaging, 28 of 55 (50.9%) had at least 1 intra-articular fragment on the post-reduction CT. Complete fragment retrieval was performed in 71.4% of patients. The study demonstrated 30.2% of patients with posterior wall and transverse posterior wall acetabular fracture-dislocations received a CT scan prior to hip reduction. It was common to find intra-articular fragments on the post-reduction CT in patients who did not have them on the pre-reduction CT. Obtaining and scrutinizing the post-reduction CT scan provided accurate knowledge of the location of all osseous fragments associated with the fracture-dislocations which facilitated thorough preoperative planning, intraoperative implementation, and hopeful long-term patient outcomes. Prognostic Level IV.

Crowd counting in domain generalization based on multi-scale attention and hierarchy level enhancement

In order to solve the problem of weak single domain generalization ability in existing crowd counting methods, this study proposes a new crowd counting framework called Multi-scale Attention and Hierarchy level Enhancement (MAHE). Firstly, the model can focus on both the detailed features and the macro information of structural position changes through the fusion of channel attention and spatial attention. Secondly, the addition of multi-head attention feature module facilitates the model’s capacity to effectively capture complex dependency relationships between sequence elements. In addition, the three-stage encoding and decoding processing mode enables the model to effectively represent crowd density information. Finally, the fusion of multi-scale features derived from different receptive fields is further enhanced through multi-scale hierarchy level feature fusion, thereby enabling the model to learn high-level semantic information and low-level multi-scale visual field feature information. This method enhances the model’s capacity to capture key feature information, even in highly differentiated datasets, thereby improving the model’s generalization ability on a single domain. The model has demonstrated strong generalization capabilities through extensive experiments on different datasets. This study not only improves the accuracy of crowd counting, but also introduces a new research approach for single domain generalization of crowd counting.

INVESTIGATION OF GEOMETRIC PARAMETERS ON FLAP AND SLAT AERODYNAMICS IN A THREE-ELEMENT AIRFOIL

Three-element airfoils are commonly employed in airplanes to provide additional lift, reduce runway length requirements, and improve cargo capacity. Due to the small distances between its components and flow interactions, the three-element airfoil has complex flow dynamics. The aerodynamic characteristics of an airfoil system comprising of three elements are greatly influenced by the geometric positioning of the flap and slat. The present study uses the computational techniques to examine how the geometric characteristics affect the aerodynamics of specific pieces, particularly the flap and slat. In this work, computational techniques are used to examine how geometric characteristics, particularly those affecting the flap and slat, affect the aerodynamics of individual components of the multielement airfoil. The chosen design space is generated through the sampling based on the Sobol sequence. The flow physics around each element due to the change in position of individual elements of the three-element airfoil is investigated in detail. Furthermore, it was shown that the leading-edge components greatly influence the flow behavior of the trailing edge components, while the opposite is not significant. Finally, the study reveals that the most significant effect on the aerodynamics characteristics of the three-element airfoil is governed by the gap in the flap.