Distal Research Articles

New Roughness Index of Passenger Car Rotational Vibration

Current road roughness indexes are limited to reflecting the unwanted rotational vibration of vehicles. This study focused on the relationship between the international roughness index (IRI) and rotational vibration around the longitudinal axis (pitch) and horizontal axis (roll) of the vehicle body. Sinusoidal wave input of different wavelengths and phase shifts between the left and right wheel tracks were used as excitation of a full-car model. Marked pitch and roll vehicle vibration were observed at shorter wavelengths (<1 m) and lower speeds (<50 km/h) of harmonic excitation. The IRI was limited to predicting the pitch and roll vibration of the full-car model at lower wavelengths, below 1 m. A simple alternative solution based on the IRI model was proposed as a robust, sensitive tool to detect unwanted rotational vibration of a vehicle. The proposal was based on the IRI approach using an alternative IRI model speed of 30 km/h, instead of the standard 80 km/h. The IRI for 30 km/h was several times more sensitive to pitch and roll vibration in the wavelength band up to 1.5 m than the IRI for 80 km/h. The new approach is recommended as an additional roughness index for monitoring roads with an allowable speed of up to 60 km/h.

Assessment of thermochromic phantoms for characterizing microwave ablation devices.

Thermochromic gel phantoms provide a controlled medium for visual assessment of thermal ablation device performance. However, there are limited studies reporting on the comparative assessment of ablation profiles assessed in thermochromic gel phantoms against those in ex vivo tissue. The objective of this study was to compare microwave ablation zones in a thermochromic tissue-mimicking gel phantom and ex vivo bovine liver and to report on measurements of the temperature-dependent dielectric and thermal properties of the phantom. Thermochromic polyacrylamide phantoms were fabricated following a previously reported protocol. Phantom samples were heated to temperatures in the range of 20°C-90°C in a temperature-controlled water bath, and colorimetric analysis of images of the phantom taken after heating was used to develop a calibration between color changes and the temperature to which the phantom was heated. Using a custom, 2.45GHz water-cooled microwave ablation antenna, ablations were performed in fresh ex vivo liver and phantoms using 65W applied for 5min or 10min (n=3 samples in each medium for each power/time combination). Broadband (500MHz-6GHz) temperature-dependent dielectric and thermal properties of the phantom were measured over the temperature range of 22°C-100°C. Colorimetric analysis showed that the sharp change in gel phantom color commences at a temperature of 57°C. Short and long axes of the ablation zone in the phantom (as assessed by the 57°C isotherm) for 65W, 5min ablations were aligned with the extents of the ablation zone observed in ex vivo bovine liver. However, for the 65W, 10min setting, ablations in the phantom were on average 23.7% smaller in the short axis and 7.4 % smaller in the long axis than those observed in ex vivo liver. Measurements of the temperature-dependent relative permittivity, thermal conductivity, and volumetric heat capacity of the phantom largely followed similar trends to published values for ex vivo liver tissue. Thermochromic tissue-mimicking phantoms provides a controlled, and reproducible medium for comparative assessment of microwave ablation devices and energy delivery settings. However, ablation zone size and shapes in the thermochromic phantom do not accurately represent ablation sizes and shapes observed in ex vivoliver tissue for high energy delivery treatments (65W, 10min). One cause for this limitation is the difference in temperature-dependent thermal and dielectric properties of the thermochromic phantom compared to ex vivobovine liver tissue, as reported in the present study.

Can we identify abnormal pelvic tilt using pre-THA anteroposterior pelvic radiographs?

Patients with increased pelvic tilt (PT) are at risk for instability following total hip arthroplasty (THA). Identification of increased PT using anteroposterior (AP) pelvic radiographs could avoid additional spinopelvic radiographs. This study aimed to (1) describe which AP pelvic parameters most accurately estimate sagittal PT, and (2) determine thresholds for these parameters that can identify patients with increased PT. This was a retrospective, consecutive, cohort study in a tertiary referral hospital on 225 patients (age: 66 ± 12 years-old; 52% female) listed for THA. Patients underwent pre-operative standing AP pelvic radiographs to measure distance- and angular- based parameters from several anatomical landmarks. Sagittal PT was measured on a standing lateral spinopelvic radiograph and considered high when ≥ 20°. No AP pelvic parameters correlated strongly with sagittal PT. Ratio between horizontal and vertical diameter of the pelvic foramen (C/D ratio) (rho - 0.341; p < 0.001); and vertical distance between trans-SIJ and trans-ASIS line (SITA) (rho 0.307; p < 0.001) correlated moderately with sagittal PT. Sacro-femoral-pubic (SFP) angle < 60° had highest sensitivity (85%), but lowest specificity (52%) to differentiate between patients with and without increased PT. If SITA > 62mm, C/D ratio < 0.5 and SFP < 60°, specificity increased (88%), but sensitivity was low (49%). In the absence of computerized models, AP pelvic parameters cannot accurately predict sagittal PT. However, an SFP < 60° should alert a hip surgeon that a patient may have an increased PT, and would benefit from additional lateral spinopelvic imaging prior to THA. Level II, diagnostic study.

Parameter tuning for active disturbance rejection control of fixed-wing UAV based on improved bald eagle search algorithm

PurposeThis paper aims to develop a method for tuning the parameters of the active disturbance rejection controller (ADRC) for fixed-wing unmanned aerial vehicles (UAVs). The bald eagle search (BES) algorithm has been improved, and a cost function has been designed to enhance the optimization efficiency of ADRC parameters.Design/methodology/approachA six-degree-of-freedom nonlinear model for a fixed-wing UAV has been developed, and its attitude controller has been formulated using the active disturbance rejection control method. The parameters of the disturbance rejection controller have been fine-tuned using the collaborative mutual promotion bald eagle search (CMP-BES) algorithm. The pitch and roll controllers for the UAV have been individually optimized to obtain the most effective controller parameters.FindingsInspired by the salp swarm algorithm (SSA), the interaction among individual eagles has been incorporated into the CMP-BES algorithm, thereby enhancing the algorithm's exploration capability. The efficient and accurate optimization ability of the proposed algorithm has been demonstrated through comparative experiments with genetic algorithm, particle swarm optimization, Harris hawks optimization HHO, BES and modified bald eagle search algorithms. The algorithm's capability to solve complex optimization problems has been further proven by testing on the CEC2017 test function suite. A transitional function for fitness calculation has been introduced to accelerate the ability of the algorithm to find the optimal parameters for the ADRC controller. The tuned ADRC controller has been compared with the classical proportional-integral-derivative (PID) controller, with gust disturbances introduced to the UAV body axis. The results have shown that the tuned ADRC controller has faster response times and stronger disturbance rejection capabilities than the PID controller.Practical implicationsThe proposed CMP-BES algorithm, combined with a fitness function composed of transition functions, can be used to optimize the ADRC controller parameters for fixed-wing UAVs more quickly and effectively. The tuned ADRC controller has exhibited excellent robustness and disturbance rejection capabilities.Originality/valueThe CMP-BES algorithm and transitional function have been proposed for the parameter optimization of the active disturbance rejection controller for fixed-wing UAVs.

Prediction of fetal brain gestational age using multihead attention with Xception

Accurate gestational age (GA) prediction is crucial for monitoring fetal development and ensuring optimal prenatal care. Traditional methods often face challenges in terms of precision and prediction efficiency. In this context, leveraging modern deep learning (DL) techniques is a promising solution. This paper introduces a novel DL approach for GA prediction using fetal brain images obtained via magnetic resonance imaging (MRI), which combines the strength of the Xception pretrained model with a multihead attention (MHA) mechanism. The proposed model was trained on a diverse dataset comprising 52,900 fetal brain images from 741 patients. The images encompass a GA ranging from 19 to 39 weeks. These pretrained models served as feature extraction components during the training process. The extracted features were subsequently used as the inputs of different configurable MHAs, which produced GA predictions in days. The proposed model achieved promising results with 8 attention heads, 32 dimensionality of the key space and 32 dimensionality of the value space, with an R-squared (R2) value of 96.5 %, a mean absolute error (MAE) of 3.80 days, and a Pearson correlation coefficient (PCC) of 98.50 % for the test set. Additionally, the 5-fold cross-validation results reinforce the model's reliability, with an average R2 of 95.94 %, an MAE of 3.61 days, and a PCC of 98.02 %. The proposed model excels in different anatomical views, notably the axial and sagittal views. A comparative analysis of multiple planes and a single plane highlights the effectiveness of the proposed model against other state-of-the-art (SOTA) models reported in the literature. The proposed model could help clinicians accurately predict GA.

MUM, a maternal unknown message, inhibits early establishment of the medio-lateral axis in the embryo of the kelp Saccharina latissima.

Brown algae are multicellular photosynthetic organisms that have evolved independently of plants and other algae. Here, we have studied the determinism of body axis formation in the kelp Saccharina latissima. After microdissection of the embryo, we show that the stalk, an empty cell that retains the embryo on the maternal tissue, represses longitudinal cell divisions in the early embryo, thereby reinforcing the establishment of the initial apico-basal axis. In addition, it promotes cell growth and controls cell shape and arrangement in the flat oblong embryo composed of cells aligned in rows and columns. Although the stalk persists for several weeks until the embryo reaches at least 500 cells, proper embryogenesis requires connection to maternal tissue only during the first 4 days after fertilisation, i.e. before the embryo reaches the 8-cell stage. Transplantation experiments indicate that the maternal signal is not diffused in seawater, but requires contact between the embryo and the maternal tissue. This first global quantitative study of brown algal embryogenesis highlights the role of MUM, an unknown maternal message, in the control of growth axes and tissue patterning in kelp embryos.

Assessing the current role of AP and Bernageau view radiographs in measurement of glenoid bone loss in patients with recurrent shoulder dislocation: correlation with computed tomography, magnetic resonance imaging, and arthroscopy.

Evaluation of glenoid bone loss following recurrent anterior shoulder dislocations is normally performed using cross sectional imaging. To assess how anteroposterior (AP) and Bernageau view radiographs compare to computed tomography (CT), magnetic resonance imaging (MRI) and arthroscopy for evaluating glenoid bone loss in patients with recurrent anterior shoulder dislocation. A prospective observational study was performed on 32 patients over two years at a tertiary orthopedic center. The loss of sclerotic glenoid rim (LSGL) on AP radiograph and the percentage relative glenoid bone loss on the Bernageau radiograph were assessed. The percentage glenoid bone loss and anterior straight line (ASL) were calculated using a best fit en face circle method using CT and MRI. Percentage glenoid bone loss was also calculated during arthroscopy in multiples of 5%. In our study, 90.6% (29) patients were males, while only 9.4% (3) were females. This can be attributed to the involvement of the males in outdoor activities and sports. Also, the maximum number of patients were found to belong to 21-30years of age, with the mean age being 28.66years. Of the 32 patients, loss of sclerotic glenoid line (LSGL) on AP radiographs correlated with glenoid bone loss on cross-sectional imaging in 27 patients. Three patients had equivocal LSGL and 2 patients with glenoid bone loss on CT did not demonstrate LSGL. The difference between the two modalities was not statistically significant (p value = 0.002). The glenoid bone loss on Bernageau view correlated with glenoid bone loss on cross sectional imaging in all but one patient. The bone loss as evaluated by radiograph Bernageau view was found to have strong correlation (correlation coefficient r = 0.948, p value < 0.0001). AP and Bernageau radiographic views for anterior shoulder dislocations demonstrate good correlation with glenoid bone loss on cross-sectional imaging. They may also be used as an adjunct to predict overall bone loss on CT and at arthroscopy.

Comparative transcriptome analysis reveals the developmental program in Yesso scallop Patinopecten yessoensis

Yesso scallop Patinopecten yessoensis is an economically and ecologically important cold-water bivalve molluscs. Elucidating the molecular mechanism regulating its early larval development holds great significance in aquaculture. This study performed comparative transcriptomic analysis across nine developmental stages from fertilized eggs to spats. A variety of differentially expressed genes (DEGs) were identified to be potentially involved in larval development, including cell proliferation (cyclins, CDKs, BMPs, TGF-β), immunity (TLR7, CTLs, cathepsins, SOD, GSTs), larval settlement and metamorphosis (MHC, MELC, paramyosin, DβH, GABA receptor), shell formation (iMSP5, MSP1, CHS1, CHI3, CAM, CAML5) as well as energy metabolism (glycolysis, TCA cycle and oxidative phosphorylation components). Additionally, weighted gene co-expression network analysis (WGCNA) identified the key indianred4 module, which may play vital roles in body axis formation, neurogenesis and myogenesis in scallop larvae. An integrative framework was established delineating molecular drivers of embryogenesis, larval growth, immune defense, metamorphosis, shell production and bioenergetics throughout larval development in scallops. These findings will help understand the molecular strategies governing larval developmental process, yielding great insights to inform ecological conservation and aquaculture practices.

Significant systematic bias of alpha angles measured on MRI compared to various radiographic views in patients with femoroacetabular impingement syndrome.

The aim of this study was to assess the inter-rater reproducibility and inter-method comparability of hip alpha angle measurements on magnetic resonance imaging (MRI)/magnetic resonance arthrography (MRA) and plain radiographs in patients with femoroacetabular impingement syndrome (FAIS). A cross-sectional study of patients who were diagnosed with symptomatic FAIS underwent preoperative MRI/MRA with axial oblique and/or radial plane imagingand had preoperative radiographs with anterior-posterior (AP), 45° Dunnand 90° Dunn views. Alpha angle measurements were performed independently by two musculoskeletal radiologists. Inter-rater reproducibility and inter-method comparability between MRI/MRA images and radiographic views were assessed using the intraclass correlation coefficient (ICC) with 95% confidence interval (CI). Ninety-seven patients were included of whom 93 (95.8%) received axial oblique plane images and 54 (55.6%) had radial plane MRI/MRA images. Inter-rater reproducibility was excellent (ICC > 0.9) for all planes on MRI/MRA and radiographs. MRI/MRA axial oblique images had poor (ICC 0.39, 95% CI [0.09, 0.59]), moderate (ICC 0.57, 95% CI [0.18, 0.75])and moderate (ICC 0.64, 95% CI [0.20, 0.81]) comparability with AP, 45° Dunnand 90° Dunn, respectively. MRI/MRA radial plane images had equivocal (0 included in all CIs) comparability with AP (ICC 0.66), 45° Dunn (ICC 0.35)and 90° Dunn (ICC 0.14) radiographs. On average, alpha angle measurements were significantly higher with radial images and lower with axial oblique images, when compared to all radiographic views (p < 0.05), except axial oblique versus 45° Dunn views, where angles measured on axial oblique were significantly larger. Alpha angle measurements taken on axial oblique MRI/MRA images show moderate comparability to radiographic 45° Dunnand 90° Dunn views despite negative bias to measurements taken on radiographic AP and 45° Dunn view. Larger alpha angles were appreciated on MRI/MRA radial and axial oblique views compared to radiographic views supporting the inclusion of MRI/MRA alpha angle measurements to properly identify deformity. Level II.

Enhancing total knee arthroplasty outcomes: the role of individualized femoral sagittal alignment in robotic-assisted surgery - A randomized controlled trial

BackgroundOptimal sagittal alignment of the femoral prosthesis is critical to the success of total knee arthroplasty (TKA). While robotic-assisted TKA can improve alignment accuracy, the efficacy of default femoral alignment versus individualized alignment remains under scrutiny. This study aimed to compare the differences in prosthetic alignment, anatomical restoration, and clinical outcomes between individualized femoral sagittal alignment and default sagittal alignment in robotic-assisted TKA.MethodsIn a prospective randomised controlled trial, 113 patients (120 knees) underwent robotic-assisted TKA were divided into two groups: 61 with individualized femoral flexion (individualized alignment group) and 59 with default 3–5° flexion (default alignment group). The individualized alignment was based on the distal femoral sagittal anteverted angle (DFSAA), defined as the angle between the mechanical and distal anatomical axes of the femur. The radiographic and clinical outcomes were compared.ResultsDespite similar postoperative femoral flexion angles between groups (P = 0.748), the individualized alignment group exhibited significantly lower incidences of femoral prosthesis extension and higher rates of optimal 0–3° prosthesis flexion (9.8% vs. 27.1%, P = 0.014,78.7% vs. 55.9%, p = 0.008, respectively). The individualized alignment group also demonstrated more favourable changes in sagittal anatomy, with higher maintenance of postoperative anterior femoral offset within 1 mm (54.1% vs. 33.9%, P = 0.026) and posterior condylar offset within 1 mm and 2 mm (44.3% vs. 25.4%, p = 0.031,73.8% vs. 50.8%, p = 0.010, respectively). Although slight improvement in the Hospital for Special Surgery Knee Score (HSS) at three months was observed (P = 0.045), it did not reach a minimal clinically important difference.ConclusionIndividualized tailoring of femoral sagittal alignment in robotic-assisted total knee arthroplasty (TKA) enhances prosthetic alignment and anatomical restoration, suggesting potential improvements in postoperative outcomes.

Modified Cranial Closing Wedge Osteotomy (AMA-Based CCWO) to Treat Cranial Cruciate Ligament Deficient Stifle in 204 Dogs Over 50 Kg: Magnitude of the Craniocaudal Angulation of the Proximal Tibia and Rate of Surgical Site Infection.

The aim of this retrospective study was to report the magnitude of the craniocaudal angulation of the proximal tibia (CCAPT) quantified by the angle between the anatomical axis (AA) and the mechanical axis (MA), called the AMA angle, and the tibial plateau angle (TPA) in dogs >50 kg that were treated by cranial closing wedge osteotomy based on the AMA angle (AMA-based CCWO). Furthermore, the percentage of dogs in which the AA and MA could be aligned postoperatively and the rate of surgical site infection (SSI) were reported. Medical records (between January 2016 and September 2023) were reviewed for 204 dogs that had AMA-based CCWO stabilized with a double locking plate (DLP) fixation with or without joint exploration plus a Robert Jones bandage (RJB) and were given postoperative antibiotics. The median (range) preoperative AMA angle and TPA were 3.1° (0-5.1°) and 30° (22-49.6°), respectively, and the postoperative AMA angle and TPA were 0° (-2.4 to 1.6°) and 9.2° (4-15°), respectively. The AA and MA were aligned in 82% of dogs. Grade 4 healing occurred in all osteotomies by 8 weeks postoperatively. Except for one dog, no SSIs were recorded. Concerning the magnitude of CCAPT in dogs >50 kg and the low SSI rate, AMA-based CCWO stabilized with a DLP fixation plus an RJB and postoperative antibiotics should be considered for treating cranial cruciate ligament-deficient stifles in this subset of dogs.

Functional diversity along the anteroposterior axis of the ventromedial hypothalamus.

Innate behaviors ensure animal survival and reproductive success. Defending their territory, escaping from predators or mating with a sexual partner, are fundamental behaviors determining the ecological fitness of individuals. Remarkably, all these behaviors share a common neural substrate, as they are under the control of the ventromedial hypothalamus (VMH). Decades of research have contributed to understanding the exquisite diversity of functional ensembles underlying the wide array of functions that the VMH carries out. These functional ensembles are usually distributed throughout the dorsoventral and mediolateral axes of this nucleus. However, increasing evidence is bringing to attention the functional diversity of the VMH across its anteroposterior axis. In this review, we will overview our current understanding of how different ensembles within the VMH control a wide array of animal behaviors, emphasizing the newly discovered roles for its anterior subdivision in the context of conspecific self-defense.

Changes in mandibular width and frontal-lower facial profile after orthognathic surgery using sagittal split ramus osteotomy with removal of internal bone interference in patients with class III skeletal malocclusion

BackgroundThe purpose of this study is to analyze changes in mandibular width and frontal view ramus inclination using cone beam CT in patients with skeletal class III malocclusion who underwent BSSRO, with the removal of bone interference between segments. MethodsFor all 20 subjects, cone-beam CT imaging was performed prior to surgery (T1), immediately post-surgery (T2), and 6 months after surgery (T3). Reorientation was performed using R2GATE software (MegaGen, Seoul, Korea). The gonion and antegonial notch were used as reference points in the sagittal view, and the most lateral point of the condyle head was used as the reference point in the frontal view. All measurements were recorded in the frontal view.ResultsInter-gonial width decreased by 2.64 mm at T3-T2 (P < .001) and by 2.58 mm at T3-T1 (P < .05). Inter-antegonial width decreased by 1.75 mm at T3-T2 (P < .05) and by 3.5 mm at T3-T1 (P < .001). In the frontal view, the right ramus inclination based on the gonion increased by 2.07° at T3-T1 (P < .05). The left ramus inclination based on gonion increased by 2.45° at T2-T1 (P < .05) and by 3.94° at T3-T1 (P < .001). The right ramus inclination based on antegonial notch increased by 2.35° at T2-T1 (P < .05) and by 3.04° at T3-T1 (P < .01). The left ramus inclination based on antegonial notch increased by 2.73° at T2-T1 (P < .001) and by 3.18° at T3-T1 (P < .001).ConclusionsDuring bilateral sagittal split osteotomy, removing bone interference between the proximal and distal segments results in a reduction of postoperative mandibular width and an increase in frontal view ramus inclination.

New data on the morphology of Ascarophis parupenei (Nematoda: Cystidicolidae), an intestinal parasite of the marine fish Parupeneus indicus in the Indian Ocean, revealed by SEM.

Scanning electron microscopy studies of three paratype specimens (two males and one female) of Ascarophis parupenei Moravec, Orecchia & Paggi, 1988, an intestinal parasite of the marine fish Parupeneus indicus (Shaw) in the Indian Ocean, made it possible to redescribe in detail the cephalic structures of this nematode as well as the morphology of the male caudal end. The presence of non-bilobed sublabia, phasmids in both males and females, bifurcated deirids, well-developed precloacal cuticular ridges (area rugosa) and a ventral median caudal protuberance in the male are reported in this species for the first time. The general morphology and measurements of A. parupenei somewhat resemble those of Rasheedia novaecaledoniensis Moravec & Justine, 2018 described from the same host species (P. indicus) from off New Caledonia, but both species clearly differ from each other by the shape and structure of pseudolabia and the anterior portion of the digestive tract, belonging thus to different nematode families (Cystidicolidae and Physalopteridae, respectively).

Reliable technique for acromion density assessment on CT.

Acromial stress fracture (ASF) is an uncommon but acknowledged complication of reverse total shoulder arthroplasty (RTSA). There is no standardised method to directly measure the bone mineral density of the acromion to allow a detailed analysis of the potential mechanism of ASF. The aim is to establish a reliable and reproducible technique for measurement of acromial density on computer tomography (CT). A retrospective review on CT scans obtained for three groups of patients: those planned for RTSA (n = 26); age and gender-matched non-operative (n = 26); and young non-operative patients (n = 28) were performed. Standardised axial images of 1 mm thickness at 1 mm increments were created following horizontal straightening on the coronal and sagittal views. To assess inter-rater reliability, two senior CT radiographers performed density measurements using standard region of interest (ROI) tool on the CTs with the ROI placed on the mid (ROI 1) and posterior (ROI 2) acromion. ROIs were selected as the most common locations for acromion fracture post RTSA. Measurements were repeated at least 6 weeks apart. Intra-class coefficients (ICC) were used to determine intra- and inter-rater reliability. ICCs demonstrated good to high intra-rater and inter-rater reliability for both ROI 1 and ROI 2 across all three groups. The lower margin of 95% confidence intervals was more than 0 for all intra-class coefficients. This study demonstrates a reliable method of measuring acromion density on CT. This method can be used to assess bone mineral density in the clinical setting and in future studies investigating ASF following RTSA.

Physiological complexity of body sway during dual-task gait in faller older adults

Background: The impact of simultaneous cognitive demand on gait’s physiological complexity in community-dwelling older adults with and without self-reported falls is yet unknown. Objective: To analyze whether the physiological complexity of body sway during dual-task and single gait is worse in once-only fallers than in non-faller older adults. Methods: A total of 58 community-dwelling older adults aged 60 to 80 participated in this study, of whom 21 had self-reported a single fall in the previous 12 months (fallers) and 37 matched participants with no fall self-reported (non-fallers). An inertial sensor (Physilog® 5, Gait Up, Switzerland) was used to acquire the time series of the body center of mass (CoM) sway in the anteroposterior (AP), mediolateral (ML) and vertical (V) directions during single gait (ST) and the gait under dual task (DT). The composite refined multiscale fuzzy entropy method was used to calculate the physiological complexity index (CI) in a MATLAB environment. SPSS (IBM; v.25.0) was used to analyze the effects of group (Fallers vs. Non-fallers), condition (ST vs. DT), and interaction (group vs. condition), using generalized linear mixed models, with an alpha of 5%. Results: No interaction or group effect was observed for the CI. However, when comparing DT with ST, a main effect of the condition was observed for the AP direction (F = 62.394; p &lt; .001) with a reduction of 0.53 (95% CI: -0.66 to -0.39), ML (F = 4.724; p = .034) with an increase of 0.22 (95% CI: 0.17 to 0.42), and V (F = 6.457; p = .014) with a decrease of 0.17. Conclusion: Just one fall in the previous 12 months does not deleteriously influence the body’s physiological complexity during gait under concurrent cognitive demand (dual task). On the other hand, DT significantly affects the gait physiological complexity in community-dwelling older adults.

A new method called MiKneeSoTA to minimize knee soft-tissue artifacts in kinematic analysis

The use of marker-based optical motion capture to estimate joint kinematics during gait is currently limited by errors associated with soft-tissue-induced motion artefacts (STIMA) and ambiguity in landmark palpation. This study therefore presents a novel protocol aiming to Minimize Knee Soft-Tissue Artefacts (MiKneeSoTA) and their effect on kinematic estimates. Relying on an augmented marker set and a new inverse kinematics approach, our method leverages frame-by-frame optimization to adjust best-fit cylinders that have been automatically generated based on the relative position of lower limb markers during an initial static trial. Tibiofemoral rotations and translations are then calculated along the anatomical joint axes based on the relative 3D motion of these cylinders. When compared against the conventional Helen-Hayes approach, in vivo assessment of fifteen healthy subjects revealed the MiKneeSoTA approach led to kinematic profiles with significantly lower standard deviations in joint rotations across trials, and even visibly reduced the presence of high frequency fluctuations presumably associated with e.g. soft-tissue vibration. In addition to agreeing with previously published bone pin and fluoroscopy datasets, our results illustrate MiKneeSoTA’s ability to abate the effect of STIMA induced by lateral knee ligaments. Our findings indicate that MiKneeSoTA is in fact a promising approach to mitigate knee joint STIMA and thus enable the previously unattainable accurate estimation of translational knee joint motion with an optoelectronic system.

Assessing the Reliability of Postoperative Cross-Table Radiographs Compared to CT Scans for Measuring Acetabular Anteversion Angle Following Total Hip Arthroplasty.

This study aimed to evaluate acetabular anteversion following total hip arthroplasty (THA) using cross-table lateral radiographs and CT scans and to determine the reliability of cross-table lateral radiographs compared to computed tomography (CT) scans for measuring acetabular anteversion. We conducted a cross-sectional study of patients undergoing THA at Justice K.S. Hegde Charitable Hospital, Deralakatte, Mangalore, from January 2020 to June 2021. Radiographs are typically taken in both anteroposterior (AP) and lateral views after THA. However, for this study, a cross-table lateral view was used instead of the usual lateral radiograph to measure the angle of anteversion. The anteversion was calculated using the method described by Woo and Morrey. Additionally, CT scans were performed on all patients as part of the study protocol. The anteversion measured in these scans was compared to that in the cross-table radiographs to assess the latter's reliability for routine use. The risk of radiation exposure from CT scans was minimized by adhering to the ALARA (As Low as Reasonably Achievable) principle, with only axial sections of the acetabular cup being scanned. The results show that the radiographic acetabular anteversion and CT scan measurements have a mean difference of 0.3036. There is a positive correlation between these measurements. The p-value is not statistically significant (p=0.698). Therefore, the measurements are correlated with each other with a linear relationship (r=0.919). For anteversion measurements using the X-ray method, the mean was 27.16 degrees with a standard deviation of ±9.49. The median was 27.26 degrees, ranging from 10.27 to 42.58 degrees. In comparison, the CT method yielded a mean anteversion of 27.40 degrees with a standard deviation of ±8.50 degrees. The median was 27.64 degrees, ranging from 12.35 to 43.11 degrees. Cross-table lateral radiographs are a reliable and comparable method to CT scans for measuring acetabular anteversion following total hip arthroplasty.

Segmental vertebral three-dimensional motion in patients with L4 isthmic spondylolisthesis under weight-bearing conditions

ObjectiveTo investigate in vivo 6-degree-of-freedom (DOF) vertebral motion in patients with isthmic spondylolisthesis (IS) during various functional weight-bearing activities.MethodsFifteen asymptomatic volunteers (mean age 54.8 years) and fourteen patients with IS at L4-5 (mean age 53.4 years) were recruited. The positions of the vertebrae (L4-L5) in the supine, standing, flexion–extension, left–right twisting and left–right bending positions were determined using previously described CT-based models and dual fluoroscopic imaging techniques. Local coordinate systems were established at the center of the anterior vertebra of L4 isthmic spondylolisthesis (AIS), the posterior lamina of L4 isthmic spondylolisthesis (PIS) and the center of the L5 vertebra to obtain the 6DOF range of motion (ROM) at L4-L5 and the range of motion (ROM) between the AIS and the PIS.ResultsThe translation along the anteroposterior axis at L4-L5 during flexion–extension, left–right bending and left–right twisting was significantly greater than that of the healthy participants. However, the translation along the mediolateral axis at L4-L5 presented paradoxical motion under different positions: the ROM increased in the supine-standing and flexion–extension positions but decreased in the left–right bending and left–right twisting positions. The separation along the anteroposterior axis during flexion was significantly greater than that during standing, on average, reaching more than 1 mm. The separation along the mediolateral axis during standing, flexion and extension was significantly greater than that in the supine position.ConclusionsThis study revealed the occurrence of displacement between the AIS and PIS, primarily in the form of separation during flexion. Symptomatic patients with isthmic spondylolisthesis exhibit intervertebral instability, which might be underestimated by flexion–extension radiographs.

Anterior or Posterior Tibial Tendon Transfer to the Peroneus Tertius for Equinovarus Deformity.

Equinovarus deformity correction was performed by soft tissue release and bone deformity correction, and tendon transfer to maintain deformity correction. Because of the high complication rate of tendon fixation methods, partial or total anterior tibial tendon or posterior tibial tendon transfer to the peroneus tertius tendon was reported. The purpose of this study was (i) to review the results of this tendon transfer technique after release and correction of talipes equinovarus, and (ii) to analyze the complication of this technique. Between February 2017 and May 2022, 176 patients (210 feet) with equinus and/or varus foot and ankle deformities underwent anterior or posterior tibial tendon transfer to the peroneus tertius in our institute. Preoperative and postoperative foot and ankle range of motion (passive and active) were checked. The postoperative radiographic assessment included antero-posterior (AP), lateral, and hindfoot alignment radiographs. Preoperative and postoperative lateral tibio-talar, talo-calcaneal, talo-first metatarsal, tibial-sole angles, hindfoot alignment, and anterior subluxation of the talus were checked. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, and visual analog scale (VAS) were used to assess pain. Paired Student's t-test was used to compare the clinical scores and radiographic angles before the operation and at the last follow-up. The mean age of the patients was 23.27 ± 13.44 years (range, 3-69 years). The mean follow-up time was 25.56 ± 16.37 months (range, 12-68 months). There were significant differences between the preoperative and postoperative measurements of the lateral tibio-talar angle, lateral talo-calcaneal angle, lateral talo-first metatarsal angle, lateral tibial-sole angle, and hindfoot alignment (p < 0.001). There was significant difference between the preoperative and postoperative AOFAS and VAS scores (p < 0.001). The early complications included infection in one patient, skin necrosis in two patients, and plantar numbness in three patients. The late complications included pin infection in three patients, tibio-talar joint compression in four patients, forefoot pain in two patients, toe flexion in two patients, and plantar numbness in one patient. There were three cases of complications (1.43%) related to the transferred tendons. Tibialis anterior or posterior tendon transfer to the peroneus tertius is a safe and effective method for equinovarus deformity correction. It yielded excellent outcomes that produced high patient satisfaction and few complications.