Subsequent Maneuvers Research Articles

Cranial bone maneuver ameliorates Alzheimer's disease pathology via enhancing meningeal lymphatic drainage function.

Alzheimer's disease (AD) is a progressive neurodegenerative disease and the leading cause of dementia. Recent research highlights meningeal lymphatics as key regulators in neurological diseases, suggesting that enhancing their drainage function could be a potential therapeutic strategy for AD. Our proof-of-concept study demonstrated that cranial bone transport can improve meningeal lymphatic drainage function and promote ischemic stroke recovery. This study defined cranial bone maneuver (CBM) technique. After osteotomy, a small circular bone flap was made and attached to an external fixator for subsequent maneuver in a controlled fashion for a defined period using 5xFAD mice. CBM treatment improved memory functions, reduced amyloid deposits, and promoted meningeal lymphatic drainage function. CBM induced cascades of inflammatory and lymphangiogenic processes in skull and meninges. Meningeal lymphatics are indispensable elements for the therapeutic effects of CBM. CBM might be a promising innovative therapy for AD management, warranting further clinical investigation. Cranial bone maneuver (CBM) alleviated memory deficits and amyloid depositions. CBM promoted meningeal lymphangiogenesis and lymphatic drainage function. The beneficial effects of CBM lasted for a long time following the CBM procedures. CBM induced cascades of inflammatory and lymphangiogenic processes in the meninges. Meningeal lymphatic vessels are indispensable elements for CBM therapeutic effects.

A Qualitative Analysis to Determine the Critical Features of a Frontside Bottom Turn in Professional Surfing.

Surfing bottom turns underpin the quality of subsequent maneuvers, and surfing performance overall. Despite this, no study has investigated coaching cues to determine their association with performance. This study investigated the frontside bottom turn, to identify critical features associated with quality performance, and second to determine whether any of these features could predict whether a surfer would subsequently perform either a cutback or a top turn maneuver. Videos of every frontside bottom turn from all finals heats of the 2017 World Surf League, Corona Open Jeffrey's Bay event were analyzed. A total of 199 frontside bottom turns were identified and categorized as either a bottom turn leading to a cutback maneuver (n = 106), or a bottom turn leading to a top turn maneuver (n = 93). A checklist of 47 potential critical features was developed after consultation with coaching and competition judging experts, thereby enabling a systematic analysis of each turn to determine the expected and actual frequency of occurrence for each potential feature. Consequently, an extensive list of critical features of the frontside bottom turn was identified and associated with a high level of performance, being executed successfully by professional athletes during high-stakes competition. Several features, particularly during the exit phase of the bottom turn, also helped predict whether these athletes subsequently performed either a cutback or a top turn maneuver. The findings of this study provide surf coaches with cues that can be used as a guide to effectively coach two main frontside bottom turn variations.

Revisiting Rasheed Araeen's Structures: 8bS at Manufactured Art, 1970

Abstract In May 1970, Rasheed Araeen's work “8bS” appeared in Manufactured Art, a group exhibition dedicated to artistic engagements with industrial processes and advanced technology. Araeen's contribution, like many of his 1960–70s works, comprised lattice-like structures that engaged forms and techniques common to his professional training as a civil engineer. Like the Minimalist object, “8bS” deployed the grammar of productive techniques to structure artistic form, breaking with the compositional principles of formalist modernism and moving towards art beyond objecthood. Yet Araeen's contribution to Manufactured Art suggests that Araeen's structures also avoided the limitations of the Minimalist object's negative mimesis of technological infrastructure, while anticipating subsequent manoeuvres by artists such as Robert Morris. Revisiting Araeen's structures in Manufactured Art reinforces the singular importance of Araeen's structuralist modality, while provincializing US Minimalism as one of multiple trajectories working out of the stasis of modernist objecthood.

Vehicle Trajectory Prediction Using Hierarchical Graph Neural Network for Considering Interaction among Multimodal Maneuvers.

Predicting the trajectories of surrounding vehicles by considering their interactions is an essential ability for the functioning of autonomous vehicles. The subsequent movement of a vehicle is decided based on the multiple maneuvers of surrounding vehicles. Therefore, to predict the trajectories of surrounding vehicles, interactions among multiple maneuvers should be considered. Recent research has taken into account interactions that are difficult to express mathematically using data-driven deep learning methods. However, previous studies have only considered the interactions among observed trajectories due to subsequent maneuvers that are unobservable and numerous maneuver combinations. Thus, to consider the interaction among multiple maneuvers, this paper proposes a hierarchical graph neural network. The proposed hierarchical model approximately predicts the multiple maneuvers of vehicles and considers the interaction among the maneuvers by representing their relationships in a graph structure. The proposed method was evaluated using a publicly available dataset and a real driving dataset. Compared with previous methods, the results of the proposed method exhibited better prediction performance in highly interactive situations.

BPPV: Comparison of the SémontPLUS With the Sémont Maneuver: A Prospective Randomized Trial.

Objective: To compare the efficacy of the Sémont maneuver (SM) with the new “SémontPLUS maneuver” (SM+) in patients with posterior canal BPPV canalolithiasis (pcBPPVcan).Methods and Patients: In a prospective trinational (Germany, Italy, and Belgium) randomized trial, patients with pcBPPVcan were randomly assigned to SM or SM+; SM+ means overextension of the head by 60+° below earth horizontal line during the movement of the patient toward the affected side. The first maneuver was done by the physician, and the subsequent maneuvers by the patients 9 times/day on their own. Each morning the patient documented whether vertigo could be induced. The primary endpoints were: “How long (in days) does it take until no attacks can be induced?” and “What is the efficacy of a single SM/SM+?”Results: In the 194 patients analyzed (96 SM, 98 SM+), it took 2 days (median, range 1–21 days, mean 3.6 days) for recovery with SM and 1 day (median, range 1-8 days, mean 1.8 days) with SM+ (p = 0.001, Mann-Whitney U-test). There was no difference in the second primary endpoint (chi2-test, p = 0.39).Interpretation: This prospective trial shows that SM+ is more effective than SM when repeated therapeutic maneuvers are performed but not when a single maneuver is performed. It also supports the hypothesis of the biophysical model: overextension of the head during step 2 brings the clot of otoconia beyond the vertex of the canal, which increases the effectivity.Classification of Evidence: This study provides Class I evidence that SM+ is superior to SM for multiple treatment maneuvers of pcBPPVcan.

Localization of the Chang’e-5 Lander Using Radio-Tracking and Image-Based Methods

Chang’e-5, China’s first unmanned lunar sample-return mission, was successfully landed in Northern Oceanus Procellarum on 1 December 2020. Determining the lander location precisely and timely is critical for both engineering operations and subsequent scientific research. Localization of the lander was performed using radio-tracking and image-based methods. The lander location was determined to be (51.92°W, 43.06°N) by both methods. Other localization results were compared for cross-validation. The localization results greatly contributed to the planning of the ascender lifting off from the lander and subsequent maneuvers, and they will contribute to scientific analysis of the returned samples and in situ acquired data.

The biomechanical effect of warm-up stretching strategies on landing mechanics in female volleyball athletes

ABSTRACT Female volleyball athletes incorporate dynamic and static stretching into a warm-up, with evidence generally supporting dynamic stretching to improve performance. However, the effects of these stretching practices on injury risk during subsequent volleyball manoeuvres have yet to be fully elucidated in the warm-up literature. Three-dimensional kinematic data associated with non-contact, lower extremity injury were recorded on 12 female collegiate club volleyball athletes during unilateral landing tasks on the dominant and non-dominant limb. Participants performed landings as part of a volleyball-simulated manoeuvre prior to and post-dynamic (DWU) and combined dynamic-static (CDS) warm-ups. A significant reduction in non-dominant hip adduction angle was found at 15 min post CDS warm-up (p = 0.016; d = 0.38), however, no other warm-up differences were detected. The non-dominant limb demonstrated greater knee abduction (p = 0.006; d = 0.69) and internal rotation angle (p = 0.004; d = 0.88), suggesting that this limb demonstrates more risky landing patterns that are potentially due to altered trunk positioning upon landing. The results show that the majority of selected landing kinematics are unaffected by additional static stretching to a dynamic warm-up and that the non-dominant limb may be at a higher injury risk in female volleyball athletes.

Population analysis of predictors of difficult intubation with direct laryngoscopy in pediatric patients with and without thyroid disease.

There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3) evaluates the effect of DI on postoperative care and length-of-stay. A single-center retrospective cohort analysis of procedures in patients assigned with an ICD-9 code for thyroid disease between June 2012 and February 2016. A comparative group was created which comprised of patients without thyroid disease receiving orthopedic or urologic surgeries to determine differences in DI prevalence. Univariate analyses compared demographics and intubation details between groups, and logistic regression identified independent variables associated with DI. Patients with and without DI were compared based on procedure duration, PACU-LOS, and escalation-of-care. DI prevalence was greater in the thyroid group (4.9%, 51/1046) compared to the non-thyroid group (2.6%, 33/1289) (OR 1.95, 95% CI 1.25-3.05; p=0.003). DI was associated with younger age, higher American Society of Anesthesiologists (ASA) class, and smaller body habitus (p<0.001 for all comparisons). Congenital hypothyroidism (OR 2.49, 95% CI 1.44-4.32; p=0.002)) and acquired hypothyroidism (OR 2.20, 95% CI 1.42-3.41; p<0.001) were seen in a greater proportion of DI patients. After adjustment for demographic confounders, age and ASA class were independently associated with DI (p<0.05), while hypothyroidism did not reach statistical significance (p=0.077). Direct laryngoscopy (DL) was most frequently used as the successful subsequent maneuver in securing the airway in DI patients. A longer PACU length-of-stay was seen after procedures with DI (p<0.001). Elective pediatric surgical patients with thyroid-related diagnoses at our institution had a higher prevalence of DI than those without thyroid disease, but this finding could not be isolated to thyroid pathology. Repeat DL achieves successful intubation in the majority of DI patients. DI patients often require longer recovery times due to prolonged cardiopulmonary monitoring.

Staged Left Ventricular Recruitment and Biventricular Conversion for Patients With Borderline Left Heart

A borderline left heart may be present in patients with hypoplastic left heart syndrome or an unbalanced atrioventricular canal defect. Traditionally, such patients have been managed either by high-risk biventricular repair in infancy or during the neonatal period, or by definitive single-ventricle palliation. In this article, we present an approach for staged left ventricular recruitment that promotes gradual rehabilitation of left heart structures and allows delay in the commitment to either a single-ventricle pathway or a biventricular pathway. The rationale, techniques, and early results are described.

East–West GEO Satellite Station-Keeping with Degraded Thruster Response

The higher harmonic terms of Earth’s gravitational potential slowly modify the nominal longitude of geostationary Earth orbit (GEO) satellites, while the third-body presence (Moon and Sun) mainly affects their latitude. For this reason, GEO satellites periodically need to perform station-keeping maneuvers, namely, east–west and north–south maneuvers to compensate for longitudinal and latitudinal variations, respectively. During the operational lifetime of GEO satellites, the thrusters’ response when commanded to perform these maneuvers slowly departs from the original nominal impulsive behavior. This paper addresses the practical problem of how to perform reliable east–west station-keeping maneuvers when thruster response is degraded. The need for contingency intervention from ground-based satellite operators is reduced by breaking apart the scheduled automatic station-keeping maneuvers into smaller maneuvers. Orbital alignment and attitude are tracked on-board during and in between sub-maneuvers, and any off nominal variations are corrected for with subsequent maneuvers. These corrections are particularly important near the end of the lifetime of GEO satellites, where thruster response is farthest from nominal performance.

Treaty versus Contract: Comments on US Supreme Court's Opinion on BG Group Plc. Petitioner v. Republic of Argentina

In BG Group Petitioner v. Republic of Argentina, the Majority Opinion of US Supreme Court held that local litigation requirement stipulated in Article 8 (2) of pertinent BIT was a procedural condition precedent to arbitration, rather than the consent of arbitration, and therefore the interpretation and application thereof was primarily for the arbitrators. Reviewing courts must give considerable deference to tribunal instead of reviewing their decision de novo. However, the Dissenting Opinion rightly pointed out local litigation requirement was the part of the very consent of Contracting States to arbitrate and the compliance of investors to such requirement was the acceptance to Contracting State’s standing offer in BIT until which a completed arbitration agreement was constituted. Local litigation requirement was a condition on consent to arbitrate and therefore whether an investor has complied with that requirement was a question a court must decide de novo, rather than an issue for the arbitrator to decide subject only to the most deferential judicial review. The Majority Opinion is legally inaccurate and political unsustainable. The Majority Opinion may in the present dispute protect US investor’s interest in the Award but on cost of unnecessary systematic disturbance to the evolution of whole international investment law system as well the risk of future exposure of US to wrong arbitral decisions and enforcement scenarios. On the contrary, the Dissenting Opinion is conducive to avoid the unnecessary systematic disturbance and save the troublesome subsequent maneuvers of pertinent states, and contributes to the coherence and consistency of international investment law.

ZebraZoom: an automated program for high-throughput behavioral analysis and categorization

The zebrafish larva stands out as an emergent model organism for translational studies involving gene or drug screening thanks to its size, genetics, and permeability. At the larval stage, locomotion occurs in short episodes punctuated by periods of rest. Although phenotyping behavior is a key component of large-scale screens, it has not yet been automated in this model system. We developed ZebraZoom, a program to automatically track larvae and identify maneuvers for many animals performing discrete movements. Our program detects each episodic movement and extracts large-scale statistics on motor patterns to produce a quantification of the locomotor repertoire. We used ZebraZoom to identify motor defects induced by a glycinergic receptor antagonist. The analysis of the blind mutant atoh7 revealed small locomotor defects associated with the mutation. Using multiclass supervised machine learning, ZebraZoom categorized all episodes of movement for each larva into one of three possible maneuvers: slow forward swim, routine turn, and escape. ZebraZoom reached 91% accuracy for categorization of stereotypical maneuvers that four independent experimenters unanimously identified. For all maneuvers in the data set, ZebraZoom agreed with four experimenters in 73.2–82.5% of cases. We modeled the series of maneuvers performed by larvae as Markov chains and observed that larvae often repeated the same maneuvers within a group. When analyzing subsequent maneuvers performed by different larvae, we found that larva–larva interactions occurred as series of escapes. Overall, ZebraZoom reached the level of precision found in manual analysis but accomplished tasks in a high-throughput format necessary for large screens.

Correlação da técnica bottom turn com as notas atribuídas no surf de alto rendimento

The surf contests worldwide have presented a high and homogeneous level of performance by the athletes. Thus, the hypothesis that the bottom turn (BT), curve on the base of the wave which is essential to the construction of subsequent maneuvers, might influence the results in high performance competitions. The objective of this study was to quantify the time taken in the execution of the BT by the athletes and correlate it to the scores awarded. The research sample was composed of four contests of the Surfing World Tour. Four heats of each contest were assessed, in a total of sixteen heats studied. The analysis of each BT was performed by using the video split feature available in the Sony Vegas Pro 10.0 software. The statistic analysis was performed with the software SPSS 18.0. The Pearson correlation coefficient was calculated with a significance level of p&lt;0.01. According to the correlations, there was an association between the variables for 87.5% of the cases. Results show that the increase of the curve in the base of the wave (BT) can maximize the performance potential of the surfers, suggesting that BT is a fundamental technical aspect in the construction of subsequent maneuvers that suit the judging criteria of this category.

Correlação da técnica bottom turn com as notas atribuídas no surf de alto rendimento

The surf contests worldwide have presented a high and homogeneous level of performance by the athletes. Thus, the hypothesis that the bottom turn (BT), curve on the base of the wave which is essential to the construction of subsequent maneuvers, might influence the results in high performance competitions. The objective of this study was to quantify the time taken in the execution of the BT by the athletes and correlate it to the scores awarded. The research sample was composed of four contests of the Surfing World Tour. Four heats of each contest were assessed, in a total of sixteen heats studied. The analysis of each BT was performed by using the video split feature available in the Sony Vegas Pro 10.0 software. The statistic analysis was performed with the software SPSS 18.0. The Pearson correlation coefficient was calculated with a significance level of p<0.01. According to the correlations, there was an association between the variables for 87.5% of the cases. Results show that the increase of the curve in the base of the wave (BT) can maximize the performance potential of the surfers, suggesting that BT is a fundamental technical aspect in the construction of subsequent maneuvers that suit the judging criteria of this category.

Are There Standard Conflict Resolution Maneuvers in Air Traffic Control?

We analyzed samples of aircraft track data involving conflict alerts and subsequent resolution maneuvers from five U.S. air route traffic control centers. Vertical conflict resolution maneuvers were used in the majority of the cases examined. Within the vertical dimension, reductions of current vertical change (climb or descent) were collectively the most frequent resolution maneuver type, but descents were about three times as frequent as climbs. Three contingency analyses were performed to test for independence between conflict geometries and subsequent resolution maneuvers. The results show that conflict resolution maneuvers do not seem to be independent from conflict geometries. Additional analyses on conflict angles and vertical speed differences between aircraft as continuous variables revealed disproportionately fewer turns on crossing courses than on opposite or same courses. These results provide critical baseline information for understanding just how large departures from the current ingrained practices the advent of the NextGen air traffic management infrastructure may bring about, particularly in extremely safety-critical tasks such as airborne conflict resolutions. Pilots' conflict resolution maneuver preferences have received some attention, but corresponding research on air traffic controllers' practices is almost nonexistent. Moreover, our results emerged from objective data through objective analyses. To our knowledge, this is the first time analyses like these have been applied to data like these.

Modeling of the visual approach to landing using neural networks and fuzzy supervisory control

During the visual approach to landing of a fixed wing aircraft, a human pilot bases control and timing of subsequent maneuvers mainly on the out-the-window view, as there is not sufficient time to read all instruments. The skill of making smooth and soft landings is acquired mainly through experience. Research has been done to identify the most important features in the visual scene (cues) for two phases of the visual approach to landing: glide slope tracking and the flare maneuver. Using simulator and real flight data, neural networks have been trained for both phases to mimic the pilot's control based on the visual cues available. By using the γ operator in neuron transfer functions, a transparent model is obtained. Fuzzy supervisory control is proposed to couple the networks and thus provide insight in the pilot's decision making process with respect to timing the flare initiation.

Femoral neck fracture following intramedullary nailing with misplacement of an end cup: report of two cases.

Femoral neck fracture is an unusual complication of intramedullary fixation of a broken femur. We report on two cases of femoral neck fractures attributed to misplacement of an end cup and subsequent invasive maneuvers in an effort to remove it. Iatrogenic fractures of the femoral neck during or after intramedullary nailing are reported in the medical literature. Authors associate it with many possible technical mistakes performed during the procedure, yet no complications after missed end cup placement were noted. We suggest that the fractures described below were a consequence of injury to the vascular supply and bone stock of the initially intact femoral neck.

Rapid Reduction of Oxygenation Index by Employment of a Recruitment Technique in Patients with Severe ARDS

Richards G, White H, Hopley M. Rapid reduction of oxygenation index by employment of a recruitment technique in patients with severe ARDS. J Intensive Care Med 2001;16:193–199. Mechanical ventilation of patients with acute respiratory distress syndrome (ARDS) may contribute to pulmonary injury and systemic inflammation. The objective of this study was to examine the safety and efficacy of a recruitment maneuver that rapidly improves atelectasis and oxygenation, and in so doing may reduce the potential for ventilator-induced lung injury. Nineteen patients with severe ARDS (defined as PaO2:FiO2≤ 150) from diverse etiologies were turned prone and a positive pressure of 40 cmH2O was applied for a period of 90 seconds. This pressure was increased in 5 cmH2O increments in subsequent maneuvers to a maximum of 50 cmH2O if there was an inadequate initial response. Subsequently pressure-limited mechanical ventilation with a PEEP of 15 cmH2O was instituted to prevent derecruitment. Peak pressures were maintained at ≤35 cmH2O. Outcome measures were oxygenation index, PaO2:FiO2 ratio, and alveolar-arterial oxygen difference. The oxygenation index decreased from a median of 31 cmH2O/mmHg to 14 cmH2O/mmHg immediately after recruitment and to 11 cmH2O/mmHg (p < 0.0001) 24 hours later. The A-aDO2 improved from 454 mmHg to 128 mmHg (p < 0.0001) and the PaO2:FiO2 ratio from 75 to 218 (p < 0.0001) 24 hours later. Twenty-five percent of patients had PaO2:FiO2 ratios of more than 300 mmHg at 24 hours. Mean airway pressure increased by 3 cmH2O initially, from 23 cmH2O to 26 cmH2O as a consequence of the increase in PEEP, but this had decreased to 25 cmH2O after 24 hours. There were no significant complications. Rapid reductions in FiO2 can be achieved safely by the implementation of a relatively simple recruitment technique.

Rapid Reduction of Oxygenation Index by Employment of a Recruitment Technique in Patients with Severe ARDS

Mechanical ventilation of patients with acute respiratory distress syndrome (ARDS) may contribute to pulmonary injury and systemic inflammation. The objective of this study was to examine the safety and efficacy of a recruitment maneuver that rapidly improves atelectasis and oxygenation, and in so doing may reduce the potential for ventilator-induced lung injury. Nineteen patients with severe ARDS (defined as PaO2: FiO2 ≤ 150) from diverse etiologies were turned prone and a positive pressure of 40 cmH2O was applied for a period of 90 seconds. This pressure was increased in 5 cmH2O increments in subsequent maneuvers to a maximum of 50 cmH2O if there was an inadequate initial response. Subsequently pressure-limited mechanical ventilation with a PEEP of 15 cmH2O was instituted to prevent derecruitment. Peak pressures were maintained at ≤35 cmH2O. Outcome measures were oxygenation index, PaO2: FiO2 ratio, and alveolar-arterial oxygen difference. The oxygenation index decreased from a median of 31 cmH2O/mmHg to 14 cmH2O/mmHg immediately after recruitment and to 11 cmH2O/mmHg (p &lt; 0.0001) 24 hours later. The A-aDO2 improved from 454 mmHg to 128 mmHg (p &lt; 0.0001) and the PaO2:FiO2 ratio from 75 to 218 (p &lt; 0.0001) 24 hours later. Twenty-five percent of patients had PaO2:FiO2 ratios of more than 300 mmHg at 24 hours. Mean airway pressure increased by 3 cmH2O initially, from 23 cmH2O to 26 cmH2O as a consequence of the increase in PEEP, but this had decreased to 25 cmH2O after 24 hours. There were no significant complications. Rapid reductions in FiO2 can be achieved safely by the implementation of a relatively simple recruitment technique.

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