High-power laser facilities necessitate predicting incremental damage to final optics to identify evolving damage trends. In this study, we propose a surface damage detection method utilizing image segmentation employing ResNet-18, and a damage area estimation network employing U-Net++. Paired sets of online and offline images of optics obtained from a large laser facility is used to train the network. The trends of varying damage could be identified by incorporating additional experimental parameters. A key advantage of the proposed method is that the network can be trained end-to-end on small samples, eliminating the need for manual labeling or feature extraction. The software developed based on these models can facilitate the daily inspection and maintenance of optics in large laser facilities.

Minimally invasive surgery for adult spinal deformities (MIS deformity surgery) utilizes MIS lumbar interbody fusion and percutaneous pedicle screw fixation (PPSF) without posterior corrective osteotomy. While MIS reduces issues associated with open deformity surgery, it has limitations in correcting sagittal imbalance. This review discusses the limitations and solutions of lateral lumbar interbody fusion (LLIF) and introduces our experience in addressing marked sagittal deformities. We reviewed the literature and incorporated our clinical experience to evaluate the efficacy of recent MIS techniques, particularly focusing on oblique lumbar interbody fusion (OLIF) at L1-5 and L5-S1. The use of higher profile and greater angle cages and the application of PPSF with curved rods and percutaneous rod compression were discussed. Advances in MIS techniques, such as OLIF, have enabled significant improvements in increasing disc height and angle. Combining these new techniques and concepts, we successfully corrected marked sagittal deformities using MIS deformity surgery. Early onset of proximal junctional kyphosis was identified as a notable complication. Although recent advancements in MIS deformity surgery have shown promise in correcting sagittal deformities, further clinical experience and data are necessary to enhance outcomes and mitigate complications such as proximal junctional kyphosis.

Background and Objective: There is a paucity of literature comparing unilateral instrumented transforaminal lumbar interbody fusion (UITLIF) with bilateral instrumented TLIF (BITLIF) regarding radiological alignment, including the coronal balance, even though UITLIF might have asymmetric characteristics in the coronal plane. This retrospective study aimed to compare the clinical and long-term radiological outcomes of 1-level UITLIF and BITLIF in lumbar degenerative diseases (LDD). Materials and Methods: Patients who underwent 1-level UITLIF with two rectangular polyetheretherketone (PEEK) cages or BITLIF with ≥ 5 years of follow-up at a single hospital were included. We compared the clinical and radiological outcomes between the UITLIF and BITLIF. Results: In total, 63 and 111 patients who underwent UITLIF and BITLIF, respectively, were enrolled. The median follow-up was 85.55 months (range: 60–130). The UITLIF group had a significantly shorter operation time (185.0 [170.0–210.0] vs. 225.0 [200.0–265.0], p < 0.001) and lower estimated blood loss (300.0 [250.0–500.0] vs. 550.0 [400.0–800.0], p < 0.001) than BITLIF group. Regarding the clinical outcomes, there were no significant differences in the intermittent claudication score (p = 0.495) and Kirkaldy–Willis criteria (p = 0.707) at 1 year postoperatively. The interval changes of the local coronal Cobb angle at the index level, L1-S1 lordotic angle, and coronal off-balance from the immediate postoperative radiograph to the last follow-up were not significantly different (p = 0.687, p = 0.701, and p = 0.367, respectively). Conclusion: UITLIF with two rectangular PEEK cages is a viable option for providing comparable clinical outcomes and radiological longevity to BITLIF in 1-level LDD. In addition, UITLIF has advantages over BITLIF in terms of operative time and blood loss.

Background/Objectives:The first attempts of posterior lumbar interbody fusion can be traced back to the 1940s, where their performance was marked by animosity due to high rates of failure. Nowadays, the use of interbody fusion involves a much more complicated consideration of factors such as global alignment, disc height, fusion rates, and operative risk, all combined at once.Our study aims to examine all these effects using Flarehawk 9 as a means of interbody fusion.Materials and methods: A total of 58 patients underwent open posterior lumbar surgery using Flarehawk 9 between September 2021 and February 2023 with a mean follow up of 1 year.The mean age was 59.8 years old ( range between 33 and 79 years old), 36 of them are males while 22 of them are females. The diagnostic groups included spinal canal stenosis (n=40), failed back surgery syndrome-revision surgery (n=5),spondylolisthesis with slip percentage 25% (n=4),recurrent herniated disc (n=7) and adjacent segment disease (n=2). Results: The majority of patients demonstrated remarkable improvement based on ODI scores.The rate of union varied based on the fused levels and whether the patients had previous surgery or not.The amount of lordosis postoperatively is increased by 2±0.4 degrees.Conclusions: Even though anterior approaches become more and more popular and advanced nowadays, posterior fusion with interbody cage still remains a safe and effective method to treat various spine surgical pathologies with optimal results.

Transforaminal lumbar interbody fusion (TLIF) is a commonly used technique for treating lumbar degenerative diseases. In this study, we developed a fully computer-supported pipeline to predict both the cage height and the degree of lumbar lordosis subtraction from the pelvic incidence (PI-LL) after TLIF surgery, utilizing preoperative X-ray images. The automated pipeline comprised two primary stages. First, a deep learning model was employed to extract essential features from X-ray images. Subsequently, five machine learning algorithms were trained to identify the optimal models to predict interbody cage height and postoperative PI-LL. LASSO regression and support vector regression demonstrated superior performance in predicting interbody cage height and postoperative PI-LL, respectively. For cage height prediction, the root mean square error (RMSE) was calculated as 1.01, and the model achieved the highest accuracy at a height of 12 mm, with exact prediction achieved in 54.43% (43/79) of cases. In most of the remaining cases, the prediction error of the model was within 1 mm. Additionally, the model demonstrated satisfactory performance in predicting PI-LL, with an RMSE of 5.19 and an accuracy of 0.81 for PI-LL stratification. In conclusion, our results indicate that machine learning models can reliably predict interbody cage height and postoperative PI-LL.

Patients with neuromuscular diseases usually have progressive neuromuscular scoliosis (NMS), requiring invasive surgery. Some patients present with severe scoliosis at the time of consultation and are difficult to treat. Posterior spinal fusion (PSF) surgery combined with anterior release and pre or intraoperative traction would be effective for severe spinal deformity, but invasive. This study aimed to evaluate the outcomes of PSF only surgery for patients with severe NMS with Cobb angle >100 °. Thirty NMS patients (13 boys and 17 girls; mean age 13.8 years) who underwent PSF only surgery for scoliosis with Cobb angle >100 ° were included. We reviewed the lower instrumented vertebra (LIV), duration of surgery, blood loss, perioperative complications, preoperative clinical findings, and radiographic findings including Cobb angle and pelvic obliquity (PO) in the sitting position pre and postoperatively. The correction rate and correction loss of the Cobb angle and PO were also calculated. The mean duration of surgery was 338 min, intraoperative blood loss was 1,440 mL, preoperative %VC was 34.1%, FEV1.0 (%) was 91.5%, and EF was 66.1%. There were eight cases of perioperative complications. The Cobb angle and PO correction rates were 48.5% and 42.0%, respectively. We divided the patients into two groups: the L5 group, in which the LIV was L5, and the pelvis group, in which the LIV was the pelvis. The duration of surgery and PO correction rate in the pelvis group was significantly higher than that of the L5 group. Patients with severe NMS demonstrated severe preoperative restrictive ventilatory impairments. PSF only surgery for severe NMS showed satisfactory outcomes, although highly invasive. Instrumentation and fusion to the pelvis for severe scoliosis in patients with NMS showed good PO correction and low correction loss of Cobb angle and PO, but a longer duration of surgery.

Background and Objectives: Although adult spinal deformity (ASD) surgery brought about the improvement of quality of life in patients, it accompanied with a high invasiveness of surgery and several complications. Specifically, mechanical complications of rod fracture, instrumentation failures, and pseudarthrosis are still unsolved issues. To better improve these problems, the oblique lateral interbody fusion at L5/S1 (OLIF51) was introduced since 2015 in my institution. The objective of this study was to compare the clinical and radiographic outcomes of anterior-posterior combined surgery for ASD between the use of OLIF51 versus transforaminal interbody fusion (TLIF) at L5/S1. Materials and Methods :A total of 117 ASD patients received anterior-posterior correction surgeries either use of OLIF51 (35 patients) or L5/S1 TLIF (82 patients). In both groups, L1-5 OLIF and minimally invasive posterior procedures of hybrid or circumferential MIS were employed. The sagittal and coronal spinal alignment and spino-pelvic parameters are recorded preoperatively and at follow-up. The quality of life parameters and visual analogue scale were evaluated as well as surgical complications at follow-up. Results: The average follow-up period was thirty months (13-84). The average fused segments were eight (4-12). The operation time and estimated blood loss were significantly smaller in OLIF51 that those in TLIF. The PI-LL mismatch, LLL, L5/S1 segmental lordosis, and L5 coronal tilt were significantly better in OLIF51 than TLIF. The complication rate was statistically equivalent between two groups. Conclusion: The introduction of OLIF51 for adult spine deformity surgery led to the decrease of operation time and estimated blood loss as well as the improvement of sagittal and coronal correction when compared to TLIF.

Transforaminal lumbar interbody fusion (TLIF) is a commonly used technique for treating lumbar degenerative diseases. Here, we developed a fully computer-supported pipeline to predict the cage height and the degree of lumbar lordosis subtraction from the pelvic incidence (PI-LL) after TLIF surgery through preoperative X-ray images. The automated pipeline included two primary stages. First, a deep learning model was used to extract essential features from X-ray images. Second, five machine learning algorithms were trained to identify the optimal models to predict the interbody cage height and postoperative PI-LL. Lasso regression and support vector regression exhibited superior performance for predicting the interbody cage height and postoperative PI-LL, respectively. For cage height prediction, the root mean square error (RMSE) was calculated as 1.01, and the model achieved the highest accuracy at a height of 12 mm, with exact prediction achieved in 54.43% (43/79) of cases. In most of the remaining cases, the prediction error of the model was within 1 mm. In addition, the model demonstrated adequate performance for predicting PI-LL, with an RMSE of 5.19 and an accuracy of 0.81 for PI-LL stratification. In conclusion, the interbody cage height and postoperative PI-LL can be reliably predicted using artificial intelligence and ML models.

The mechanisms underlying the establishment of asymmetric structures during development remain elusive. The wing of Drosophila is asymmetric along the Anterior-Posterior (AP) axis, despite that its growth signals that drive its growth are presumably symmetric. Here, we investigated the contribution of cell recruitment, a process that drives wing fate differentiation in Drosophila, to the asymmetric shape and pattern of the adult wing. Genetic impairment of cell recruitment results in a significant reduction in adult wing asymmetry, primarily affecting the region between longitudinal vein 5 and the wing margin (L5-M). Morphometric analysis reveals that the lack of cell recruitment results in a more symmetric wing with respect to the AP, suggesting a contribution of cell recruitment to the establishment of asymmetry in the adult wing. A close examination of the expression of the wing selector gene vestigial (vg) in wing disc does not support this hypothesis. However, the circularity of the Vg pattern significantly increase in recruitment-impaired wing disc, suggesting that while the decrease of the L5-M region in the adult wing may not be attributed to cell recruitment, it could contribute to the overall asymmetry of the adult wing. We conclude that cell recruitment, a widespread mechanism that participates in growth and patterning of several developing systems, could drive, at least partially, the asymmetric shape of the Drosophila wing.

A portable laser photoacoustic sensor based on a Field-Programmable Gate Array (FPGA) is reported for methane detection. A tunable DFB diode laser in the 1654 nm wavelength range is used as an excitation source. The photoacoustic signal processing was implemented by a FPGA device. A small resonant photoacoustic cell is designed. The minimum detection limit (1σ) of 10 ppm for methane (CH₄) is demonstrated.

Ménière's disease (MD) has an unclear cause. The microvascular dysregulation of the inner ear has been increasingly pointed as a potential contributor. This study investigates the prevalence of cardiovascular risk factors (CVRFs) in MD patients compared to those with posterior circulation cerebral infarction (POCI). CVRFs like hypertension, diabetes, dyslipidemia, obesity, coronary heart disease, and smoking were assessed in both MD and POCI patients. Brain MRI identified POCI etiology as "small vessel occlusion" (SVO) or "other etiology" (OE). The study included 64 MD and 84 POCI patients. Compared to MD, POCI OE showed a higher prevalence of CVRFs across various age groups, including hypertension, diabetes, dyslipidemia, and smoking. Notably, the odds of having POCI OE were significantly higher for individuals with hypertension and smoking. On the other hand, POCI SVO showed similar prevalence of CVRFs compared to MD. This study reveals no significant difference in CVRF prevalence between MD and smaller vessel POCI. However, a clear distinction emerges when comparing MD to POCI with involvement of larger blood vessels. Further research is needed to confirm these findings and explore potential shared risk factors between POCI (SVO) and MD.

Background: Good reduction of the articular surface and restoration of the congruent joint space are crucial for promoting positive outcomes in ankle fracture treatment. A good understanding of the mechanism of ankle fractures is indispensable to achieve these goals. Unfortunately, until now, the mechanism has still not been fully elucidated, particularly regarding the posterior malleolar fractures (PMFs). This study aims to provide insight into the mechanism of PMFs, thereby grasping the key to proceeding with PMFs reduction and fixation. Methods: An FE model of a normal ankle in tiptoe posture with 9 collateral ligaments was constructed from CT images. On the model, lateral malleolar fractures were made below, through, and above the syndesmosis; the medial malleolus was broken at its base; and ligaments were suppressed to simulate ligament rupture. A force of 1000 Newtons was applied on the talus head along talus axis. The posterior malleolar fragment (PMF) displacement, whether the talus impacts the posterior malleolus, and the initial mechanism displacing the PMF, were recorded. Results: A total of 15 tests were conducted. The tests, 'all collateral ligaments rupture', 'LMFB', 'LMFC+AITFL rupture', 'ATFL+CFL+PTFL rupture', 'ATTL+PTTL+TCL rupture', 'MMF', and 'MMF+AITFL rupture', presented significant PMF displacement. In tests 'MMF' and 'ATTL+PTTL+TCL rupture', the talus hit the medial edge of the PMF; but in tests 'ATFL+CFL+PTFL rupture' and 'all collateral ligaments rupture', the talus impacted the center part of the PMF. Except tests 'all collateral ligaments rupture' and 'ATFL+CFL+PTFL rupture', where PMF displacement was initially caused by talus impact, the other tests demonstrated PMF displaced following PITFL drag. Conclusions: This research discovered that rotation is the initial and major mechanism causing PMF displacement. The subsequent impact of the talus on the posterior malleolus may be the reason for large/blocky PMF. The talus impacting the posterior malleolus is always combined with talus rotation. Without the medial ankle structure being broken, big/blocky PMF may not occur. These findings suggest that, in clinical practice, reconstructing both the medial and lateral ankle structures is critical for achieving ankle stability, and this procedure even takes precedence over posterior malleolar fracture fixation itself.

Aiming at the problems of inaccurate segmentation of long object and information loss of small object in real-time semantic segmentation algorithm, this paper proposes a lightweight multi-branch real-time semantic segmentation network based on BiseNetV2. The new auxiliary branch makes full use of spatial details and context information to cover the long object in the field of view. Meanwhile, in order to ensure the inference speed of the model, the asymmetric convolution is used in each stage of the auxiliary branch to design a structure with low computational complexity. In the multi-branch fusion stage, the alignment and fusion module is designed to provide guidance information for deep and shallow feature mapping, so as to make up for the problem of feature misalignment in the fusion of information at different scales, and thus reduce the loss of small target information. In order to further improve the model’s awareness of key information, a global context module is designed to capture the most important features in the input data. The proposed network uses NVIDIA GeForce RTX 3080 Laptop GPU experiment, on the road street view data set Cityscapes and CamVid average occurring simultaneously ratio reached 77.1% and 78.4% respectively, with running speed of 127 frames/s respectively and 112 frames/s. The experimental results show that the proposed algorithm can achieve real-time segmentation and improve the accuracy significantly, showing good semantic segmentation performance

Background/Objectives: Patient positioning during surgery can influence intra- and postoperative complications. Therefore, we assessed the impact of the sitting and park-bench positions on anesthetic parameters and complications in neurosurgical patients. Methods & Patients: For this retrospective study, 314 adults who underwent neurosurgical procedures for posterior fossa pathologies were divided into two groups: sitting (n=231) and park bench (n=83). The following data were collected, monitored, recorded and compared: age, sex, tumor type, surgical approach, cardiovascular and respiratory complications, and postoperative surgical complications. The association of hypotension with position was further investigated through multivariate logistic regression models by adjusting for CO2 decrease, desaturation and documented gas embolism. Results: The average age was significantly lower in the sitting group (55 years, interquartile range (IQR)=43-63; female proportion=59.74%) than in the park-bench group (62 years, IQR=45-74; female proportion=57.83%) (p<0.001). Cerebellopontine angle tumors were detected in 37.23% of the patients who underwent operation in the sitting position and in 7.26% who underwent operation on in the park-bench position (p<0.001). Patients in the sitting position had significantly greater anesthetic complication (91.77% vs. 71.08%, p<0.001), hypotension (61.9% vs. 16.87%),and >2-mmHg CO2 decrease (35.06% vs. 15.66%, p<0.001) incidences. Hypoxemia and death occurred more frequently in the park-bench group (8.43% vs. 1.73% and 6.03% vs. 1.3%, respectively). Conclusions: Compared with the park-bench position, the sitting position was associated with a greater specific anesthetic complication incidence and lower postoperative mortality rate, indicating a need for careful risk‒benefit assessment when selecting each individual patient’s surgical position.

The proliferation of Unmanned Aerial Vehicle (UAV) networks is increasing, driven by their capacity to deliver automated services tailored to the varied demands of numerous smart city applications. Trust, security, and privacy remain paramount in the public domain. Traditional centralized network designs fall short of ensuring device authentication, data integrity, and privacy within UAV networks’ highly dynamic and adaptable environments. Decentralized reputation systems emerge as a promising solution to enhance the reliability and trustworthiness of data and communications within these networks while safeguarding UAV security. This paper presents an exhaustive survey of trust and reputation systems, exploring existing frameworks and proposed innovations alongside their inherent challenges. It highlights the crucial role of reputation systems in strengthening trust, security, and privacy throughout these networks and discusses various strategies to mitigate existing vulnerabilities. As a useful resource for researchers and practitioners seeking to advance the state of the art in UAV network security, we hope this survey will spark further community discussion and stimulate innovative ideas in this burgeoning field.

With an increase in proportion of elderly patients, the global burden of spinal disease is on the rise. Likewise, there has been an increasing trend in the number of spine surgeries being performed worldwide. As we know, rehabilitation following spine surgery is critical for optimal recovery. However, current literature lacks consensus regarding the appropriate post operative rehabilitation protocol. The goals of rehabilitation after lumbar spine surgery are to improve physical and psychosocial function and may include multiple modalities such as physical therapy, cognitive behavioral therapy, specialized instruments, and instruction to be followed during activities of daily living. In recent years, not only are a greater number of spine surgeries being performed, various different techniques of lumbar spine surgery and spinal fusion have emerged. Physical therapy programs need to be curated after assessing the functional status of the patient by using various patient reported outcome measures and taking into consideration the technique of spinal fusion used and the muscle groups involved in these surgeries. By doing so it is possible to assess the level of functional impairment and then specifically target strengthening of those muscle groups affected by surgery whilst also improving impaired balance and allowing return to activities of daily living. We reviewed available literature pertaining to the history of spinal rehabilitation, the popular patient reported outcome measures used and different rehabilitation methods with the purpose of summarizing the current guidelines for postoperative rehabilitation after spine surgery and to introduce the rehabilitation after lumbar surgeries that we provide at our hospital.

Introduction:Lumbar radiculopathy, frequently triggered by disc herniation, affects around one in 50 young adults (30-55 ages), leading to significant impacts on quality of life. When conservative treatments fail to alleviate symptoms, surgical intervention such as discectomy is often pursued. Technological advancements have led to various minimally invasive techniques, promising improved outcomes. Our aim was to compare clinical outcomes of different techniques.Methods:We conducted a systematic search in PubMed using "lumbar disc hernia" and the meta-analysis filter. Inclusion criteria comprised meta-analyses focusing on lumbar disc herniation treatments, published in English. A rigorous selection process adhering to PRISMA guidelines ensured high-quality evidence extraction.Results:From 28,171 initial records, 31 meta-analyses involving 87,852 patients were included. Heterogeneity across the literature presented challenges, notably in study populations, surgical techniques, and research designs. Among the techniques evaluated, full-endoscopic lumbar discectomy (FELD) emerged as superior in various perioperative parameters, including Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI), operation time, and complications. Conversely, automated percutaneous discectomy (AUTD) consistently exhibited poorer outcomes, suggesting limited effectiveness compared to other techniques. Conclusion:Despite advancements, the heterogeneity observed in the literature underscores the need for standardized approaches in minimally invasive spinal surgery research. FELD stands out as a preferred technique, offering favorable outcomes across multiple parameters. Conversely, techniques like AUTD raise concerns regarding efficacy. Future research should aim for uniformity in methodologies to facilitate accurate comparisons and guide clinical decision-making.

To ensure consumers can purchase high-quality rice, accurate identification of rice varieties is particularly important. Methods: This article conducts research based on machine learning algorithms from the perspectives of image, spectrum, and spectrogram fusion. Six types of hyperspectral image data of rice were preprocessed using convolutional smoothing (SG) and multiple scatter correction (MSC). Texture information of the images was extracted using gray-level co-occurrence matrix. Spectra, texture, and spectrogram data were fused into a new matrix. Spectral, texture, and spectrogram fusion data were used as inputs for the model, and support vector machines (SVM), logistic regression (LR), and K-nearest neighbors (KNN) classification models were constructed and compared. Results: From the classification results, the spectrogram fusion classification performance was better than classification models using only spectra or texture. Conclusion: The research results showed that the accuracy of SVM and LR classification models exceeded 90%, and the LR model performed the best, effectively classifying rice varieties.

This study extends the CGAN-based MODIS cloud vertical-profile (64×64-scene, about 70km width×15km height) retrieval technique developed by Leinonen et al. (2019) [1] to construct seamless 3D cloud fields for the MODIS granules [2]. Firstly, the accuracy and spatial continuity of the Leinonen et al. [1] retrievals are statistically evaluated. Then, according to the characteristics of the retrieval error, a spatially overlapping-scene ensemble generation method and a bi-directional Ensemble Binning Probability Fusion (CGAN-BEBPF) technique are developed, which improves the CGAN retrieval accuracy and support to construct seamless 3D clouds. The CGAN-BEBPF technique involves three steps: cloud masking, intensity scaling, and optimal value selection. It ensures adequate coverage of the low reflectivity areas while preserving the high reflectivity cloud cores. The technique is applied to retrieve the 3D cloud fields of Typhoon Chaba and a multi-cell convective system. The cloud structures of the CGAN-BEBPF results are highly consistent with the ground-based radar observations. It can retrieve weak clouds at the top levels of convective storms and hurricanes that were missed by ground-based radars and fill the gaps of the ground-based radar lower-level PPI scan. Overall, CGAN-BEBPF can be automated to retrieve the rich informative 3D structures of typhoons and severe convective systems over the oceans along the MODIS swath, which certainly presents great value for improving maritime and near-shore typhoons and convection prediction and other cloud-sensitive applications.

This paper proposes a new approach for multi-focus images fusion based on Region Mosaicing on Contrast Pyramids (REMCP). A density-based region growing method is developed to construct a focused region mask for multi-focus images. The segmented focused region mask is decomposed into a mask pyramid, which is then used for supervised region mosaicking on a contrast pyramid. In this way, the focus measurement and the continuity of focused regions are incorporated and the pixel level pyramid fusion is improved at the region level. Objective and subjective experiments show that the proposed REMCP is more robust to noise than compared algorithms and can fully preserves the focus information of the multi-focus images meanwhile reducing distortions of the fused images.

Achievement of solid fusion of the lumbosacral junction (L5-S1 level) is an important factor in adult spinal deformity (ASD) surgery. The purpose of this study is to explore the effectiveness and feasibility of injectable rhBMP-2 (a combination of Eschericia coli-derived rhBMP-2 and hydrogel type β-TCP carrier; NOVOSIS Inject) as a bone substitute for the fusion of lumbosacral junction. 20 patients (average age 69.1 years) diagnosed with ASD with sagittal imbalance who underwent surgical treatment including anterior lumbar interbody fusion (ALIF) in the L5-S1 level were evaluated. Injectable rhBMP-2 was applied in L5-S1 ALIF and followed-up for 1-year. Solid fusion rates and changes of clinical outcomes (Oswestry Disability Index [ODI], Visual Analog Scale [VAS] of back and leg) were measured and analyzed at 6 and 12 months after surgery. All postoperative adverse events were evaluated about the association with injectable rhBMP-2. Fusion rates were 68.4% and 100% at 6 and 12 months after surgery. Compared to baseline, ODI were improved to 45.8% and 63.7%, VAS(back) were improved to 69.2% and 72.8%, and VAS(leg) were improved to 49.2% and 64.8% at 6 and 12 months after surgery (p&lt;0.001, respectively). There were no adverse events associated with injectable rhBMP-2. Thus, injectable rhBMP-2 may be a suitable choice of a bone graft substitute when achieving solid interbody fusion in the lumbosacral junction.

Ambulatory heart rate (HR) monitors that acquire electrocardiogram (ECG) or/and photoplethysmographm (PPG) signals from the torso, wrists, or ears are notably less accurate in tasks associated with high levels of movement compared to clinical measurements. However, reliable estimation of HR can be obtained through data fusion from different sensors. These methods are especially suitable for multimodal hearable devices, where heart rate can be tracked from different modalities, including electrical ECG, optical PPG, and sounds (heart tones). Combined information from different modalities can compensate for single source limitations. In this paper, we evaluate the possible application of data fusion methods in hearables. We assess data fusion for heart rate estimation from simultaneous in-ear ECG and in-ear PPG, recorded on eight subjects while performing 5-minute sitting and walking tasks. Our findings show that data fusion methods provide a similar level of mean absolute error as the best single-source heart rate estimation but with much lower intra-subject variability, especially during walking activities. We conclude that data fusion methods provide more robust HR estimation than a single cardiovascular signal. These methods can enhance the performance of wearable devices, especially multimodal hearables, in heart rate tracking during physical activity.

To address the problems of insufficient semantic fusion between text and questions and the lack of consideration of global semantic information encountered in machine reading comprehension models, we proposed a machine reading comprehension model called BERT_hybrid based on BERT and hybrid attention mechanism. In this model, BERT is utilized to separately map the text and questions into the feature space. Through the integration of Bi-LSTM, attention mechanism, and self-attention mechanism, the proposed model achieves comprehensive semantic fusion between text and questions. The probabilities distribution of answers is computed using Softmax. Experimental results on the public dataset DuReader demonstrate that the proposed model achieves improvements in BLEU-4 and ROUGE-L scores compared to existing models. Furthermore, to validate the effectiveness of the proposed model design, we analyze the factors influencing the model’s performance.

In pattern recognition domain, deep architectures are widely used nowadays and they have achieved fine grades. However, these deep architectures need special demands, especially big datasets and GPU. Aiming to gain better grades without deep networks, we propose a simplified algorithm framework using fusion features extracted from the salient areas of faces. Furthermore, the proposed algorithm has achieved a better result than some deep architectures. For extracting more effective features, this paper firstly defines the salient areas on the faces. This paper normalizes the salient areas of the same location in the faces to the same size, therefore it can gain more similar features from different subjects. LBP and HOG features are extracted from the salient areas, fusion features’ dimensions are reduced by Principal Component Analysis( PCA) and we apply softmax to classify the six basic expressions at once. This paper proposes a salient areas definitude method which uses peak expressions frames to compare with their neutral faces. This paper also proposes and applies the idea of normalizing the salient areas to align the specific areas which express the different expressions. This makes the salient areas found from different subjects have the same size. Besides, gamma correction method is firstly applied on LBP features in our algorithm framework which improves our recognition rates significantly. By applying this algorithm framework, our research has gained state-of-the-art performances on CK+ database and JAFFE database.

Posterior capsule opacification (PCO) is the most common complication of cataract surgery. It causes a gradual deterioration of visual acuity, which would otherwise remain improved after a successful procedure. Despite recent advances in ophthalmology, this complication has not been eradicated and the incidence of PCO can be as high as 10%. This article reviews the literature concerning the pathomechanism of PCO and examines the biochemical pathways involved in its formation and methods to prevent this complication. We also review the reported tests performed in cell cultures under laboratory conditions, in experimental animal models, and in ex vivo human lens capsules. Finally, we describe research involving human eyes in the clinical setting and pharmacological methods that may reduce the frequency of PCO. Due to the multifactorial eti-ology of PCO, in vitro studies make it possible to assess the factors contributing to its complica-tions and search for new therapeutic targets. Not all pathways involved in cell proliferation, mi-gration, and contraction of the lens capsule are reproducible in laboratory conditions; moreover, PCO in humans and laboratory animals may be additionally stimulated by various degrees of postoperative reactions depending on the course of surgery. Therefore, further studies are necessary.

We propose a novel adaptive importance sampling scheme for Bayesian inversion problems where the inference of the variables of interest and the power of the data noise is split. More specifically, we consider a Bayesian analysis for the variables of interest (i.e., the parameters of the model to invert), whereas we employ a maximum likelihood approach for the estimation of the noise power. The whole technique is implemented by means of an iterative procedure, alternating sampling and optimization steps. Moreover, the noise power is also used as a tempered parameter for the posterior distribution of the the variables of interest. Therefore, a sequence of tempered posterior densities is generated, where the tempered parameter is automatically selected according to the actual estimation of the noise power. A complete Bayesian study over the model parameters and the scale parameter can be also performed. Numerical experiments show the benefits of the proposed approach.

Background: New controversies have raised on brain death (BD) diagnosis when lesions are localized in the posterior fossa. Objective: To discuss the particularities of diagnosis BD in patients with posterior fossa lesions. Material and Methods. The author made a systematic review of literature on this topic. Results and Conclusions: A supratentorial brain lesion usually produces a rostrocaudal transtentorial brain herniation, resulting in forebrain and brainstem loss of function. In secondary brain lesions [i.e., cerebral hypoxia], the brainstem is also affected like the forebrain. Nevertheless, some cases complaining posterior fossa lesions [i.e., basilar artery thrombotic infarcts, or hemorrhages of the brainstem and/or cerebellum] may retain intracranial blood flow and EEG activity. In this article I discuss that if a posterior fossa lesion does not produce an enormous increment of intracranial pressure, a complete intracranial circulatory arrest does not occur, explaining the preservation of EEG activity, evoked potentials, and autonomic function. I also address Jahi McMath, who was declared braindead, but ancillary tests, performed 9 months after initial brain insult, showed conservation of intracranial structures, EEG activity, and autonomic reactivity to “Mother Talks” stimulus, rejecting the diagnosis of BD. Jahi McMath’s MRI study demonstrated a huge lesion in the pons. Some authors have argued that in patients with primary brainstem lesions it might be possible to find a in some cases partial recover of consciousness, even fulfilling clinical BD criteria. This was the case in Jahi McMath.

In this paper, we proposed the fusion of two projection based face recognition algorithms: local binary Patterns in DCT domain and singular value decomposition (SVD) characterized by its simplicity and efficiently. Standard databases ORL are used to test the experimental results which prove that proposed system achieves more accurate face recognition as compared to individual method.

In order to improve contrast and restore color for underwater image captured by camera sensors without suffering from insufficient details and color cast, a fusion algorithm for image enhancement in different color spaces based on contrast limited adaptive histogram equalization (CLAHE) is proposed in this article. The original color image is first converted from RGB color space to two different special color spaces: YIQ and HSI. The color space conversion from RGB to YIQ is a linear transformation, while the RGB to HSI conversion is nonlinear. Then, the algorithm separately operates CLAHE in YIQ and HSI color spaces to obtain two different enhancement images. The luminance component (Y) in the YIQ color space and the intensity component (I) in the HSI color space are enhanced with CLAHE algorithm. The CLAHE has two key parameters: Block Size and Clip Limit, which mainly control the quality of CLAHE enhancement image. After that, the YIQ and HSI enhancement images are respectively converted backward to RGB color. When the three components of red, green, and blue are not coherent in the YIQ-RGB or HSI-RGB images, the three components will have to be harmonized with the CLAHE algorithm in RGB space. Finally, with 4 direction Sobel edge detector in the bounded general logarithm ratio operation, a self-adaptive weight selection nonlinear image enhancement is carried out to fuse YIQ-RGB and HSI-RGB images together to achieve the final fused image. The enhancement fusion algorithm has two key factors: average of Sobel edge detector and fusion coefficient, and these two factors determine the effects of enhancement fusion algorithm. A series of evaluate metrics such as mean, contrast, entropy, colorfulness metric (CM), mean square error (MSE) and peak signal to noise ratio (PSNR) are used to assess the proposed enhancement algorithm. The experiments results showed that the proposed algorithm provides more detail enhancement and higher values of colorfulness restoration as compared to other existing image enhancement algorithms. The proposed algorithm can suppress effectively noise interference, improve the image quality for underwater image availably.

Objectives: To assess the short-term impact of a single global stretching session on plantar pressures and lumbar range of motion (RoM) over one week in sedentary university students. Design: A randomised controlled trial with two parallel groups. Participants: Sixty-four university students were randomly assigned to a stretching group or control group. The stretching group received a single session of global stretching and the control group remained seated for the same length of time as the stretching session. Main outcome measures: Lumbar RoM and plantar pressures were assessed before, immediately after, 48 hours after, and 7 days after intervention. Results: Group-by-time interaction was significant for lumbar lateral flexion (p = 0.044), right maximal pressure (p = 0.003), left maximal pressure (p = 0.008), right mean pressure (p = 0.025), left mean pressure (p = 0.002), and maximal pressure minus mean pressure in right foot (p = 0.007). The model with plantar pressures showed a significant difference for group-by-time interaction (p = 0.010).Conclusion: Global stretching seems to counteract the ill-effects of prolonged sitting up to seven days with respect to plantar pressure in standing without improving lumbar ROM

Gastric cancer is the fifth most common and fourth deadliest cancer worldwide, with a bleak 5-year survival rate of about 20%. Despite significant research into its pathobiology, prognostic predictability remains insufficient due to pathologists’ heavy workloads and the potential for diagnostic errors. Consequently, there is a pressing need for automated and precise histopathological diagnostic tools. This study leverages Machine Learning and Deep Learning techniques to classify histopathological images into healthy and cancerous categories. By utilizing both handcrafted and deep features and shallow learning classifiers on the GasHisSDB dataset, we conduct a comparative analysis to identify the most effective combinations of features and classifiers for differentiating normal from abnormal histopathological images without employing fine-tuning strategies. Our methodology achieves an accuracy of 95% with the SVM classifier, underscoring the effectiveness of feature fusion strategies. Additionally, cross-magnification experiments produced promising results with accuracies close to 80% and 90% when testing the models on unseen testing images with different resolutions.

Ocean exploration is crucial for utilizing its extensive resources. Images captured by underwater robots suffer from issues such as color distortion and reduced contrast. To address the issue, we propose an innovative enhancement algorithm that integrates Transformer and Convolutional Neural Network (CNN) in a parallel fusion manner. Firstly, a novel transformer model is intro-duced to capture local features, employing peak-signal-to-noise ratio (PSNR) attention and linear operations. Subsequently, to extract global features, both temporal and frequency domain features are incorporated to construct convolutional neural network. Finally, the Fourier’s high and low-frequency information of the original image are utilized to fuse different features. To demon-strate the algorithm's effectiveness, underwater images with various levels of color distortion are selected for both qualitative and quantitative analyses. The experimental results demonstrate that our approach surpasses other mainstream methods, achieving superior PSNR and structural sim-ilarity index measure (SSIM) metrics and leading to a detection performance improvement of over ten percent.

Background: Rod fracture (RF) is the most common cause of revision in adult spinal deformity (ASD) surgery, and various treatment strategies for preventing RF are reported in literature. This retrospective study involving 139 ASD patients (aged ≥65 years and a minimum 2-year follow-up) who underwent long-segment fixation from T10 to sacrum with pedicle subtraction osteotomy (PSO), analyzed long-term results, including radiographical parameters and the incidence of recurrent RF (re-RF), to determine the most effective revision method for preventing RF. Methods: Patients were classified into three groups according to the revision method performed for RF; simple rod replacement (SR group, n=17), lateral lumbar interbody fusion around PSO site (LLIF group, n=8), and accessory rod integration (AR group, n=22). Baseline characteristics, radiographical and clinical parameters were analyzed. Results: RF occurred in 47 patients (34%) at an average of 28 months following primary deformity correction. Re-RF occurred in six patients (13%) at an average of 37 months. Re-RF occurred most commonly in SR group (p=.048). Every re-RF in SR group occurred at the PSO site, none occurred in LLIF group, and one in AR group occurred near L4–5. After both primary deformity correction and revision surgery, spinopelvic parameters had shown favorable results and clinical outcomes had improved in all three groups, without significant intergroup differences. Conclusions: Accessory rod integration or additional LLIF around the PSO site seems to provide greater strength and stability to the previously fused segments than simple rod replacement, which demonstrates the need for additional support in revision surgery for RF after PSO.

Ship detection from synthetic aperture radar (SAR) imagery is crucial for various fields in real-world applications. Numerous deep learning-based detectors have been investigated for SAR ship detection, which require a substantial amount of labeled data for training. However, SAR data annotation is time-consuming and demands specialized expertise, resulting in that deep learning-based SAR ship detectors struggle due to a lack of annotations. With limited labeled data, semi-supervised learning is a popular approach for boosting detection performance by excavating valuable information from unlabeled data. In this paper, a semi-supervised SAR ship detection network is proposed, termed as Multi-Teacher Dempster-Shafer Evidence Fusion Net-work (MTDSEFN). The MTDSEFN is an enhanced framework based on the basic teacher-student skeleton frame, comprising two branches: the Teacher Group (TG) and the Agency Teacher (AT). The TG utilizes multiple teachers to generate pseudo-labels for different augmentation versions of unlabeled samples, which are then refined to obtain high-quality pseudo-labels by using Dempster-Shafer (D-S) fusion. The AT not only serves to deliver weights of its own teacher to the TG at the end of each epoch, but also updates its own weights after each iteration, enabling the model to effectively learn rich information from unlabeled data. The combination of TG and AT guarantees both reliable pseudo-label generation and learning comprehensive diversity information from numerous unlabeled samples. Extensive experiments were performed on two public SAR ship datasets, and the results demonstrated the effectiveness and superiority of the proposed approach.

Hyperspectral images (HSI) contain abundant spectral information. Efficient extraction and utilization of this information for image classification remain prominent research topics. Previously, hyperspectral classification techniques primarily relied on statistical attributes and mathematical models of spectral data. Deep learning classification techniques have recently been extensively utilized for hyperspectral data classification, yielding promising outcomes. This study proposes a deep learning approach that uses polarization feature maps for classification. Initially, the polar coordinate transformation method is employed to convert the spectral information of all pixels in the image into spectral feature maps. Subsequently, the proposed Deep Context Feature Fusion Network (DCFF-NET) is utilized to classify these feature maps. The model is validated using three open-source hyperspectral datasets: Indian Pines, Pavia University, and Salinas. The experimental results indicated that DCFF-NET achieves excellent classification performance. Experimental results on three public HSI datasets demonstrate that the proposed method accurately recognizes different objects with an overall accuracy (OA) of 86.68%, 94.73%, and 95.14% based on the pixel method, and 98.15%, 99.86%, and 99.98% based on the pixel-patch method.

The incidence of radiculopathy due to lumbar spinal stenosis has been on the increase in the aging population. However, patients aged 80 years hesitate to undergo conventional open surgery under general anesthesia because of the risk of postoperative morbidity and adverse events. Therefore, less invasive surgical alternatives are required for the elderly or medically handicapped patients. Transforaminal endoscopic lumbar lateral recess decompression (TELLRD) may be helpful for those patients. This study aimed to demonstrate the efficacy of TELLRD for treating radiculopathy in octogenarian patients. A total of 21 consecutive octogenarian patients with lumbar foraminal stenosis underwent TELLRD between January 2017 and January 2021. The inclusion criterion was unilateral radiculopathy, which stemmed from lumbar lateral recess stenosis. The pain source was verified using imaging studies and selective nerve blocks. Full-scale lateral canal decompression was performed using a percutaneous transforaminal endoscopic approach under local anesthesia. We found the pain scores and functional status improved significantly during the 24-month follow-up period. The clinical improvement rate was 95.24% (20 of 21 patients) with no systemic complication. In conclusion, endoscopic lateral recess decompression via the transforaminal approach is practical for octogenarian patients while reducing the medical risks of aggressive open surgery.

The aim of the study was to assess the relationship between the shape of the anterior-posterior curvature of the spine and body composition in school-children. The study included 257 children, aged 11-12. Correct spinal curvature was established in 106 (41.08%) subjects. Other types included: decreased kyphosis and correct lordosis - 40 participants (15.50%), correct kyphosis and decreased lordosis - 24 individuals (9.30%), increased kyphosis and correct lordosis - 17 subjects (6.59%), correct kyphosis and increased lordosis - 22 children (8.53%), decreased kyphosis and decreased lordosis - 32 people (12.40%), decreased kyphosis and increased lordosis - 4 of the examined subjects (1.55%), increased kyphosis and lordosis - 13 people (5.04%). In addition, 134 (51.94%) demonstrated scoliotic posture and 8 (3.10%) scoliosis. There were significant relationships between the shape of the anterior-posterior curvatures and body composition in school-children. Those with a strong body build (predominance of mesomorphs) were generally characterised by the correct formation of these curvatures. In contrast, lean people (with the predominance of ectomorphic factors) were more likely to experience abnormalities. No correlations with body composition were observed in the group with scoliotic posture or scoliosis.

With the growing demand for positioning services, angle-of-arrival (AoA) estimation or direction-finding (DF) has been widely investigated for applications in fifth-generation (5G) technologies. Many existing AoA estimation algorithms only require the measurement of the direction of the incident wave at the transmitter to obtain correct results. However, for most of the cellular systems such as Bluetooth indoor positioning system due to multipath and non-line-of-sight (NLOS) propagation, the indoor positioning accuracy is severely affected. In this paper a comprehensive algorithm is investigated that combines radio measurements from Bluetooth AoA local navigation systems with indoor position estimates obtained using particle filtering, which allows us to explore new optimised methods to reduce estimation errors in indoor positioning. First, particle filtering is used to predict the rough position of a moving target. Then, an algorithm with robust beam weighting is used to estimate the AoA of the multipath components. Based on this, a system of pseudo-linear equations for target positioning based on the probabilistic framework of PF and AoA measurement is derived. Theoretical analysis and simulation results show that the algorithm can improve the positioning accuracy by about 25.7% on average.

Atlas Posterior Arch Deficiency (APAD) is a rare anatomical variation of the atlas vertebra that can be detected using cone-beam computed tomography (CBCT). This study aims to evaluate the prevalence, classification, and clinical implications of APAD in an Italian cohort.

In aerospace, robotics, network engineering and mechanical engineering, there exist complex and urgent challenges that can be abstracted into mathematical optimization problems. Therefore, exploring solutions to these optimization problems is a crucial task. Metaheuristic algorithms have been applied across various fields.The Snake Optimization Algorithm (SO) is an innovative metaheuristic method recognized for its efficient solving capabilities.However, this algorithm encounters challenges such as diminished search efficiency in the later stages and a propensity to become ensnared in local optima. To mitigate these issues, this paper introduces an enhanced Snake Optimization Algorithm (ISO). ISO integrates the RIME Algorithm(RIME)and introduces two effective enhancement strategies to improve its capability to evade local optima.To assess the effectiveness of ISO,the population distribution state was first measured using three algorithms, including Star Discrepancy, and the exploration and exploitation performance was analyzed using the CEC2017 test functions. Subsequently, utilized 23 benchmark functions for testing.The evaluation outcomes indicate that ISO exhibits outstanding performance in terms of convergence velocity and robustness.Additionally, it was applied to engineering fields including UAV path planning,Robot path planning, Wireless sensor network node deployment and Pressure vessel design.In comparison to the SO algorithm, the ISO algorithm demonstrates superior stability, converges earlier, and improves its ability to solve for optimal .These findings highlight the significant potential of the ISO algorithm in diverse test functions and a wide range of interdisciplinary problems.

Laser-targeted weeding methods further enhance the sustainable development of green agriculture, with one key technology being the improvement of weed localization accuracy. Here, we propose an improved YOLOv8 instance segmentation based on bidirectional feature fusion and deformable convolution (BFFDC-YOLOv8-seg) to address the challenges of insufficient weed localization accuracy in complex environments with resource-limited laser weeding devices. Initially, by training on extensive datasets of plant images, the most appropriate model scale and training weights are determined, facilitating the development of a lightweight network. Subsequently, the introduction of the Bidirectional Feature Pyramid Network (BiFPN) during feature fusion effectively prevents the omission of weeds. Lastly, the use of Dynamic Snake Convolution (DSConv) to replace some convolutional kernels enhances flexibility, benefiting the segmentation of weeds with elongated stems and irregular edges. Experimental results indicate that the BFFDC-YOLOv8-seg model achieves a 4.9% increase in precision, an 8.1% increase in recall rate, and a 2.8% increase in mAP50 value to 98.8% on a vegetable weed dataset compared to the original model. It also shows improved mAP50 over other typical segmentation models such as Mask R-CNN, YOLOv5-seg, and YOLOv7-seg by 10.8%, 13.4%, and 1.8%, respectively. Furthermore, the model achieves a detection speed of 24.8 FPS on the Jetson Orin nano standalone device, with a model size of 6.8MB that balances between size and accuracy. The model meets the requirements for real-time precise weed segmentation, suitable for complex vegetable field environments and resource-limited laser weeding devices.

In response to the issues of sensor noise and accumulated motion errors that lead to low positioning accuracy and insufficient robustness during large maneuvers or continuous flight of small unmanned aerial vehicles (UAVs) in complex environments, this paper proposes a multi-source and multimodal data fusion method. Initially, it employs a multimodal data fusion of various sensors including GPS (Global Positioning System), IMU (Inertial Measurement Unit), and visual sensors to complement the strengths and weaknesses of each hardware component, thereby eliminating motion errors to enhance accuracy. To mitigate the impact of sudden changes in sensor data, the method introduces a digital twin UAV data source. By utilizing the Extended Kalman Filter algorithm, it fuses data from both the real UAV and its digital twin, and the filtered positional information is fed back into the control system of the real UAV. This enables real-time correction of UAV positional deviations caused by sensor noise and environmental disturbances. The multi-source multimodal fusion Kalman filter method proposed in this paper significantly improves the positioning accuracy of UAVs in complex scenarios and the overall stability of the system. This method holds significant value in maintaining high-precision positioning in variable environments and has important practical implications for enhancing UAV navigation and application efficiency.

This study explores novel techniques to improve the detection accuracy of skarn iron deposits using advanced image processing methodologies. Leveraging the capabilities of Aster image, Band Ratio (BR) images, and Principal Component Analysis (PCA), alongside the power of 3D Convolutional Neural Networks (3D-CNN), the research aims to enhance the precision and efficiency of ore detection in complex geological environments. The proposed method employs a specific 3D-CNN architecture, accepting input as a 7×7×C image patch, where C represents the combined number of selected Aster image bands, Principal Component (PC) bands, and computed BR images. To evaluate the accuracy of the proposed method, five distinct image bands combinations, including the proposed bands combination, were tested and evaluated based on the overall accuracy (OA), average accuracy (AA), and kappa coefficient. The results demonstrated that while the incorporation of BR images alongside Aster bands initially seemed promising, it introduced significant confusion in certain classifications, leading to unexpected mis-classification rates. Surprisingly, utilizing solely Aster bands as input parameters yielded higher accuracy rates (OA= 93.13%, AA = 91.96%, Kappa = 90.91%) compared to scenarios involving the integration with band ratios (OA = 87.02%, AA = 79.15, and Kappa = 82.60%) or the integration of BR images to PC bands (OA= 87.78%, AA = 82.39%, Kappa = 83.81%). However, the amalgamation of Aster bands with selected PC bands showed slight improvements in accuracy (OA= 94.65%, AA = 92.93%, Kappa = 93.45%), although challenges in accurately classifying certain features persisted. Ultimately, the proposed combination of Aster bands, PC bands, and BR images (proposed bands combination) presented the most visually appealing and statistically accurate results (OA = 96.95%, AA= 94.87%, and Kappa = 95.93%), effectively addressing misclassifications observed in the other combinations. These findings underscore the synergistic contributions of each of the Aster bands, PC bands, and BR images, with Aster bands proving pivotal for optimal skarn classification, PC bands enhancing intrusions classification accuracy, and BR images strengthening wall rock classification accuracy. In conclusion, the proposed combination of input image bands emerges as a robust and comprehensive methodology, demonstrating unparalleled accuracy in the remote sensing detection of skarn iron minerals.

The design of torsional springs for Series Elastic Actuators (SEAs) is challenging, especially when it comes to balancing good stiffness characteristics and efficient torque robustness. This study focuses on the design of a lightweight, low-cost, and compact torsional spring for use in rotary series elastic actuator (ES-RSEA) of lumbar support exoskeleton. The exoskeleton is used as an assistive device to prevent lower back injuries. The torsion spring was designed following design for manufacturability (DFM) principles, focusing on minimal space and weight. The design process consisted of determining the potential topology and optimizing the selected topology parameters through finite element method (FEM) to reduce equivalent stress. The prototype was made using a waterjet cutting process with low-cost material (AISI-4140-alloy) and tested using a custom-made test rig. The results showed that the torsion spring had a linear torque-displacement relationship with 99% linearity, and the deviation between FEM simulation and experimental measurements was less than 2%. The torsion spring has a maximum torque capacity of 45.7 Nm and a stiffness of 440 Nm/rad. The proposed torsion spring is a promising option for lumbar support exoskeletons and similar applications requiring high stiffness, low weight-to-torque ratio, and cost-effectiveness.

Background. The purpose of the study was to evaluate the intensity and frequency of low back pain (LBP) in people with multiple sclerosis (PwMS) and the patient's knowledge of physiotherapeutic methods of combating. Methods. In this study, patients with confirmed multiple sclerosis were selected. The study was carried out using an original survey questionnaire and a numerical pain intensity scale (Visual Analogue Scale). PwMS were divided into 3 age groups: 18-30 years, 31-50 years, and over 50 years. Results. Ninety PwMS (68 women and 22 men) aged 18 to 60 years were included in the study. The mean duration of the disease was 9.5±4.9 years, and the mean EDSS was 3.5±1.6. Most of the patients had a relapse-remitting form. 68.9% of PwMS felt lower back pain (n = 62). The relationship tested was statistically significant (p=0.0000012), and the strength of the relationship was high (rc=0.695). The average level of low back pain among PwMS was 4.7 out of 10 on the VAS scale. The prevalence of LBP was higher in female patients (p<0.001), with a secondary progressive form (p<0.001) and with a longer duration of the disease (p=0.023). The most widely used methods of LBP therapy were kinesitherapy and manual therapy. Conclusions. LBP is common in multiple sclerosis. A female sex, a secondary progressive form of MS, and a longer duration of the disease increased the risk of LBP. It is important to implement properly planned physiotherapy activities and educate patients on how to combat LBP.

In this paper we study a special kind of finite mixture model. The sample drawn from the model consisits of three parts. The first two parts are drawn from specified distributions f1 and f2, while the third one is drawn from the mixture. A problem of interest is whether the two distributions f1 and f2 are the same. To test this hypothesis, we first define the regular location and scale family of distributions and assume that f1 and f2 are regular denisty functions. Then the hypothesis transforms to the equalities of the location and scale parameters, respectively. To utilize the information in the sample, we use Bayes’ theorem to obtain the posterior distribution and give the sampling method. Then we propose the posterior p-value to test the hypothesis. The simulation studies show that our posterior p-value largely improves the power in both normal and logistic cases while nicely controls the Type-I error. A real halibut dataset is used to illustrate the validity of our method.

A multicenter, prospective cohort study conducted in 5 physiotherapy clinics in the UAE from January 2021 to March 2023 to assess coronal lumbar spine radiographic parameters as a predictor of conservative therapy outcomes in patients suffering from low back and leg pain due to lumbar disc herniation (HNP). Ninety patients (mean age 44 yrs., 54% male) with lumbar HNP underwent conservative therapy. All participants received lumbar spine MRI and radiography to assess spine alignment. Interventions included specific exercises, diathermy, traction, education, a home-based exercise pro-gram, and medications. Detailed demographic data was collected. Follow-up was 6-months after discharge. A successful outcome was based on a minimum of the following four outcomes: (1) reduction of pain by 17.5 points (0–100 NRS); (2) fatigue reduction by 7.5 points; (3) distress reduction by 5 points; and (4) interference reduction by 9.5 points. At 6-month follow-up it was found that patient age, education, and radio-graphic determined lumbosacral angle measures significantly affected the odds of a successful outcome. Increasing age 1-year significantly decreased the odds of success of improving pain, fatigue (OR = 0.85, p = 0.016) and interference scores (OR = 0.89, p = 0.042) by 15%, 15%, and 11% respectively. Lower education significantly increased the odds of success for improving pain, fatigue, and interference by 26.18, 26.18, and 7.5 (p = 0.006, = 0.006, and = 0.029 respectively). Increasing (worsening) the radiographic lumbosacral angle by each 1° significantly reduced the odds of success for improving pain, fatigue, distress, and interference by 3.52, 3.52, 27.99, and 2.55, respectively (p < 0.001, < 0.001, = 0.003, = 0.001). Our findings indicate that younger age, less education, and better coronal radiological lumbar spine alignment all had a substantial impact on the likelihood of success of 6-month outcomes in patients suffering from chronic lower back pain and radiculopathy due to HNP.

The joint extraction of entities and relations is a critical task in information extraction, and its performance directly affects the performance of downstream tasks. However, existing joint extraction models based on deep learning exhibit weak processing capabilities for the phenomenon of multiple pronunciations of one character and multiple characters of one pronunciation when processing Chinese texts, resulting in performance loss. To address these issues, this paper introduces part-of-speech (POS) and pinyin features to aid the model in learning semantic features that are more contextually appropriate. A Chinese Joint Entity and Relation Extraction Model based on Progressive Contrastive Learning and Heterogeneous Feature Fusion is proposed (CJE-PCHF). During model training, an interactive fusion network based on progressive contrastive learning is employed to learn the dependencies between pinyin, POS, and semantic features. This guides the model in heterogeneous feature fusion, capturing higher-order semantic associations between heterogeneous features. On the commonly used DuIE evaluation dataset for joint extraction, this model achieved a significant improvement, with the F1 score increasing by 5.4% compared to the benchmark model CasRel.

Titanium-based metal-matrix composites manufactured by additive manufacturing offer tremendous lightweighting opportunities. However, processing high reinforcement content remains challenging. This study reports an improved manufacturing process for Ti-TiC enabling high reinforcement content and significant fracture strain concurrently: mechanical blending, followed by laser powder bed fusion and a single heat treatment. As-built microstructure shows both un-melted TiC particles and sub-stoichiometric TiC dendrites resulting from a partial dissolution of TiC particles. The heat treatment is shown to fully convert TiC dendrites into equiaxed TiC grains. Reduction of the C/Ti ratio in TiC during the process results in an increase in the reinforcement content, from a nominal 12 vol% to an effective 21.5 vol%. Ti-TiC tensile samples reached fracture strains of up to 1.7%, Young’s moduli of up to 149 GPa and ultimate tensile strengths of up to 827 MPa. Lower TiC initial powder size distributions displayed the best mechanical performance.

The last-mile logistics in cities have become an indispensable part of the urban logistics system. This study aims to explore the effective selection of last-mile logistics nodes to enhance the efficiency of logistics distribution, strengthen the corporate distribution image, and further reduce corporate operating costs and alleviate urban traffic congestion. This paper proposes a clustering-based approach to identify urban logistics nodes from the perspective of geographic information fusion. This method comprehensively considers several key indicators, including the coverage, balance, and urban traffic conditions of logistics distribution. Additionally, we employed a greedy algorithm to identify secondary nodes around primary nodes, thus constructing an effective nodal network. To verify the practicality of this model, we conducted an empirical simulation study using the logistics demand and traffic conditions in the Xianlin District of Nanjing. This research not only identified the locations of primary and secondary logistics nodes but also provided a new perspective for constructing the urban last-mile logistics system, enriching the academic research related to logistics node construction. The results of this study are of significant theoretical and practical importance for optimizing urban logistics networks, enhancing logistics efficiency, and promoting the improvement of urban traffic conditions.

Object detection algorithms for open water aerial images present challenges such as small object size, unsatisfactory detection accuracy, numerous network parameters, and enormous computational demands. Current detection algorithms struggle to meet the accuracy and speed requirements while being deployable on small mobile devices. This paper proposes DFLM-YOLO, a lightweight small-object detection network based on the YOLOv8 algorithm with multiscale feature fusion. Firstly, to solve the class imbalance problem of the SeaDroneSee dataset, we propose a data augmentation algorithm called Small Object Multiplication (SOM). SOM enhance dataset balance by increasing the number of objects in specific categories, thereby improving model accuracy and generalization capabilities. Secondly, we optimize the backbone network structure by implementing Depthwise Separable Convolution (DSConv) and the newly designed FC-C2f, which reduces the model's parameters and inference time. Finally, we design the Lightweight Multiscale Feature Fusion Network (LMFN) to address the challenges of multiscale variations by gradually fusing the four feature layers extracted from the backbone network in three stages. In addition, LMFN incorporates the Dilated Re-param Block structure to increase the effective receptive field and improve the model's classification ability and detection accuracy. Experimental results on the SeaDroneSea dataset indicate that DFLM-YOLO improves mAP by 12.4% compared to the original YOLOv8s, while reducing parameters by 67.2%. This achievement provides a new solution for UAVs to conduct object detection missions in open water efficiently.

Aim: To investigate the application of anterior and posterior corneal higher order aberrations (HOAs) in detecting keratoconus (KC) and suspect keratoconus (SKC). Method: This is a retrospective, case-control study which evaluated non-ectatic (normal) eyes, SKC eyes, and KC eyes. The Sirius Scheimpfug (CSO, Italy) analyzer was used to measure HOAs of the anterior and posterior corneal surfaces. Sensitivity, specificity and area under receiver operating characteristic curve (AUC) were calculated. Results: Two-hundred and twenty eyes were included in the analysis (normal n = 108, SKC n= 42, KC n= 70). Receiver operating characteristic (ROC) curve analysis revealed a high predictive ability for anterior corneal HOAs parameters: Root mean square (RMS) total corneal HOAs, RMS trefoil and RMS coma to detect keratoconus (AUC > 0.9 for all). RMS Coma (3, ±1) derived from the anterior corneal surface was the parameter with the highest ability to discriminate between suspect keratoconus and normal eyes (AUC = 0.922; cutoff > 0.2). All posterior corneal HOAs parameters were insufficient in discriminating between SKC and normal eyes (AUC < 0.8 for all). In contrast, their ability to detect KC was excellent with AUC of > 0.9 for all except RMS spherical aberrations (AUC = 0.846). Conclusion: Anterior and posterior corneal higher order aberrations can differentiate between keratoconus and normal eyes, with a high level of certainty. In suspect keratoconus disease however, only anterior corneal HOAs, and in particular coma-like aberrations, are of value. Corneal aberrometry may be of value in screening for keratoconus in populations with a high prevalence of the disease.

Polarimetric Synthetic Aperture Radar (PolSAR) images encompass valuable information that can facilitate extensive land cover interpretation and generate diverse output products. Extracting meaningful features from PolSAR data poses challenges distinct from those encountered in optical imagery. Deep Learning (DL) methods offer effective solutions for overcoming these challenges in PolSAR feature extraction. Convolutional Neural Networks (CNNs) play a crucial role in capturing PolSAR image characteristics by leveraging kernel capabilities to consider local information and the complex-valued nature of PolSAR data. In this study, a novel three-branch fusion of complex-valued CNN named Shallow to Deep Feature Fusion Network (SDF2Net) is proposed for PolSAR image classification. To validate the performance of the proposed method, classification results are compared against multiple state-of-the-art approaches using the Airborne Synthetic Aperture Radar (AIRSAR) datasets of Flevoland, San Francisco, and ESAR Oberpfaffenhofen dataset. The results indicate that the proposed approach demonstrates improvements in OA, with 1.3% and 0.8% enhancement for the AIRSAR datasets and 0.5% improvement for the ESAR dataset. The analyses conducted on the Flevoland data underscore the effectiveness of the SDF2Net model, revealing a promising OA of 96.01% even with only 1% sampling ratio.

Ionic liquids have been recognised as interesting solvents applicable in the efficient lignocellulosic biomass valorisation, especially in the biomass fractionation into individual polymeric components or direct hydrolysis some of biomass fractions. Considering the chemical character of ionic liquids, two different approaches, paved the way for a fractionation of biomass. The first strategy integrated a pre-treatment, hydrolysis and conversion of biomass through the employment of hydrogen-bond acidic 1-ethyl-3-methyimidazolim hydrogen sulfate ionic liquid. The second one relied on the use of a three-step fractionation process with hydrogen-bond basic 1-ethyl-3-methylimidazolium acetate to produce high purity cellulose, hemicellulose and lignin fractions. The proposed approaches were scrutinised for wheat straw and eucalyptus residues. Those different biomasses allowed understanding that enzymatic hydrolysis yields are dependent on the crystallinity of pre-treated biomass. The use of acetate based ionic liquid allowed to change crystalline cellulose I to cellulose II and consequently enhanced glucan to glucose yield to 93.14.1 mol% and 82.91.2 mol% for wheat straw and eucalyptus, respectively. Whereas for hydrogen sulfate ionic liquid, the same enzymatic hydrolysis yields were 61.6  0.2 mol% for wheat straw and only 7.90.3 mol% for eucalyptus residues. These results demonstrate the importance of either ionic liquid character or biomass type on the efficient biomass processing.

This study describes a novel method for grading pathological sections of gliomas. Our own integrated hyperspectral imaging system was employed to characterize 270 bands of cancerous tissue samples from microarray slides of gliomas. These samples were then classified according to the guidelines developed by the World Health Organization, which define the subtypes and grades of diffuse gliomas. We explored a hyperspectral feature extraction model called SMLME-Resnet using microscopic hyperspectral images of brain gliomas of different malignancy grades. The model combines the channel attention mechanism and multi-scale image features to automatically learn the pathological organization of gliomas and obtain hierarchical feature representations, effectively removing the interference of redundant information. It also completes multi-modal, multi-scale spatial and spectral feature extraction to improve the automatic classification of glioma subtypes. The proposed classification method demonstrated high average classification accuracy (>97.3\%) and Kappa coefficient (0.954), indicating its effectiveness in improving the automatic classification of hyperspectral gliomas. The method is readily applicable in a wide range of clinical settings, offering valuable assistance in alleviating the workload of clinical pathologists. Furthermore, the study contributes to the development of more personalized and refined treatment plans, as well as subsequent follow-up and adjustment of treatment, by providing physicians with insights into the underlying pathological organization of gliomas.

Background: Idiopathic normal pressure hydrocephalus is a syndrome with neuroradiological findings and clinical pattern characteristic but not specific for the pathology. Since the prevalence is growing due to the rapidly aging society, standardized and validated protocol for diagnosis is needed, also because this condition may mimic other disorders among elderly such as Parkinson's and Alzheimer's disease. Material and methods: We analysed data from 44 patients with suspect diagnosis of idiopathic normal pressure hydrocephalus with age > 60 years, clinical triad and neuroradiological pattern examined in our ward from November 2018 to November 2022. Neu-ropsychological assessment includes Mini Mental State Examination and Mental Deterioration Battery. Motor scores were collected from gait and balance tests. The evaluation was performed before and after an extended lumbar drainage last 48h. Patients who has scores improvement after the extended lumbar drainage, undergo ventriculoperitoneal shunt with a programmable valve. Results: All patients undergo neuropsychological assessment and motor tests, only 2 patients were unable to perform motor tests because bedridden. 16 patients showed no benefit from the tests, in 2 cases even a worsening of cognitive performance. 28 patients showed an improvement in their performances, but in most cases the improvement involved only the neuropsychological as-sessment. All patients underwent ventriculoperitoneal shunt have had a typical answers pattern in Mental Deterioration Battery test. We performed 9 ventriculoperitoneal shunt and 1 ventricu-lo-atrial shunt. Conclusions: Qualitative neurocognitive tests come out to be more sensitive compared to quantitative neurocognitive tests in identifying patients with suspected idiopathic normal pressure hydrocephalus benefiting from extended lumbar drainage test and then un-derwent surgical treatment. This could be considered a valid screening in elderly patients with suspected idiopathic normal pressure hydrocephalus in order to minimize the number of invasive procedures. More studies are necessary to validate this tool.

Posterior dislocations of the sterno-clavicular joint (SCJ) are rare events, most commonly due to motor vehicle accidents or sports injuries and they often occur in young and active patients. This injury can represent a real emergency because of the vital structures located posterior to the medial clavicle such as anonymous artery, anonymous vein, trachea, subclavian artery and vein, esophagus and thoracic duct. The diagnosis could be insidious given the not peculiar clinical presentation and it is often necessary to perform a computed tomography to identify it. In case of failure of reduction maneuvers, the surgical treatment becomes a mandatory choice, but unfortunately literature reports a restricted cohort of cases and proposes different stabilization techniques without showing a significant comparison of results. Moreover, due to the rarity and high risk of complications, other than the lack of knowledge about the injury and its repair techniques, the management of these injuries are mutually discharged from orthopedic surgeon to the thoracic surgeon and vice-versa. A deep study of the joint anatomical characteristics and its biomechanics allow the surgeon to face surgery more safely, choosing the most appropriate technique. Given the importance of the SCJ for the movement of the shoulder girdle, authors believe that the surgeon’s goal should be to restore the complete range of movement of the joint in case of dislocation. For this reason, stabilization with semitendinosus tendon graft has to be considered one of the best solutions at our disposal to date.

BACKGROUND: Functional constipation can lead to painful defecations, fecal incontinence, and abdominal pain, significantly affecting a child's quality of life. Treatment options include non-pharmacological and pharmacological approaches, but some cases are intractable and require alternative interventions like neuromodulation. A subtype of neuromodulation, called Transcutaneous Posterior Tibial Nerve Stimulation (TPTNS), comprises electrical stimulation at the ankle level, by means of electrodes fixed to the skin. TPTNS is a minimally invasive, easy-to-apply technique that can potentially improve constipation symptoms in the pediatric population by stimulating the sacral nerves. AIM: To evaluate the clinical results and applicability of TPTNS as an adjuvant treatment for children and adolescents with functional constipation. METHODS: Between April 2019 and October 2021, 38 patients diagnosed with functional constipation according to the Rome IV Criteria were invited to participate in the study. The study followed a single-center, uncontrolled, prospective cohort design. Patients received TPTNS for 4 or 8 weeks, with assessments conducted immediately after the periods of TPTNS and 4 weeks after the end of the intervention period. The data normality distribution was determined by the Shapiro-Wilk test. Wilcoxon test and Student's t-test for paired samples were used to compare quantitative variables, and the McNemar test was used to compare categorical variables. RESULTS: Of the 38 enrolled patients, 28 children and adolescents with intractable function constipation completed the study, receiving TPTNS for 4 weeks. Sixteen patients (57.1%) extended the intervention period for 4 extra weeks, receiving 8 weeks of intervention. TPTNS led to significant improvements in stool consistency, frequency of defecation, and bowel function scores, with a reduction in abdominal pain. Quality of life across physical and psychosocial domains showed substantial enhancements. The quality of life-related to bowel habits also improved significantly, particularly in lifestyle, behavior, and embarrassment domains. The positive effects of this intervention are seen relatively early, detected after 4 weeks of intervention, and even 4 weeks after the end of the intervention. TPTNS was well-tolerated, with an adherence rate of approximately 78%, and no adverse effects were reported. CONCLUSION: TPTNS is an adjuvant treatment for intractable functional constipation, improving bowel function and quality of life. The effects of TPTNS were observed relatively early and sustained even after treatment cessation.

Identifying skeletal remains has been and will remain a challenge for forensic doctors and forensic anthropologists, especially in disasters with multiple victims or skeletal remains in an advanced stage of decomposition. This study proposes a machine learning method to determine gender starting from morphometric analysis of L1-L5 lumbar vertebrae in a modern Romanian population. The purpose of the present study was to observe whether by using the ML method there is a good predictability of gender in forensic identification based on parameters obtained from the metric analysis of the lumbar spine specific to the Romanian population. This paper offers two models of ML, RF and XGB, each with its own characteristics, and presenting different performance, random forest having the best. For both, we used two metrics (accuracy and roc_auc), the latter being the most used to highlight model performance. The L1-L5 lumbar vertebrae exhibit sexual dimorphism and can be used in gender estimation. Machine learning is more accurate in determining gender than discriminatory function analysis.

The study put forward a data fusion approach for urban remote sensing that combines SAR (Synthetic Aperture Radar) and optical satellite data. By integrating datasets from different sensors and spatial-temporal scales, the technique aims to extract more accurate information. The fusion approach utilizes two methods: feature-based fusion, where relevant features are extracted and fused, and simple layer stacking (SLS), where the original datasets are directly stacked as multiple layers. This study extracted features using SAR textures (using Sentinel-1) and modified indices (using Landsat-8), and then classified these features using an XGBoost algorithm implemented in Python and Google Earth Engine. Researchers examined five cities, each representing a distinct climatic zone and urban dynamic: Cape Town, Guangzhou, Los Angeles, Mumbai, and Osaka. An accuracy assessment was conducted using random validation points, achieving an overall accuracy of 89.5% using the proposed MSFI method. A comparison was also performed with three well-known global products. The proposed approach, outperformed all three global products achived 89% accuracy while ESA (84%), ESRI (81%) and Dynamic World (82%). Additionally, Land surface temperature analysis was accomplished to investigate the relationship between extracted UIS and Land Surface Temperature (LST) across selected cities to show the practical use of proposed MSFI method. Los Angeles, a warm temperate city, showed the highest LST among all five cities. The datasets, along with the GEE and Python codes, are available at https://github.com/mnasarahmad/sls.

This study outlines a 3-step production process for Ti-TiC Metal Matrix Composite (MMC) employing powder Mechanical Blending, Laser Powder Bed Fusion (LPBF), and a heat treatment. A TiC fraction of more than 20 vol% was formed in-situ through the reaction of titanium with carbon during the LPBF process. The manufactured MMC pieces showed a record stiffness and fracture strain combination. The LPBF energy density impacted strongly porosity type. The as-built microstructure displayed an homogeneous distribution of sub-stoichiometric TiC dendrites which were fully converted into equiaxed TiC grains during the heat treatment. The TiC C/Ti ratio was found to be close to 0.5, resulting in an effective reinforcement content nearly twice the one expected for stoichiometric TiC, leading to stronger reinforcement. The mechanical analysis revealed a Young’s modulus of up to 149 GPa and an ultimate tensile strength of up to 770 MPa, indicating a 27% and 34% improvement, respectively, compared to commercially pure Titanium produced by LPBF and heat treated in the same conditions. A fracture strain of up to 2.8% was achieved. The combination of in-situ formation of defect-free TiC reinforcement and subsequent heat treatment enables to reach an exceptional ductility, considering the 20 vol% reinforcement content.

A teratoma is a neoplasm composed of cell populations or tissues that remind, in their appearance, normal elements derived from at least two embryonic layers. Fetal mature teratomas are normally benign, cystic, and typically occur along the midline, while they are rare in the posterior mediastinum. Teratomas are frequently solitary, however they may sometimes be associated with other congenital anomalies and/or with chromosomal abnormalities. Clinically, they are often asymptomatic but can occasionally cause compression symptoms. Prenatal diagnoses are uncommon and made with ultrasonography; differential diagnosis with other congenital conditions is mandatory. We report the case of a 21 weeks of gestational age-old fetus with a Mature Triphyllic Fetal Cystic Teratoma, grade 0, located in the right posterior mediastinum.

Incobotulinumtoxin A and Yoga-like Isometric Exercise in Adolescent Idiopathic Lumbar Scoliosis – a randomized pilot study Abstract: Background: Approximately 90% of scoliosis is adolescent idiopathic (AIS). From its first appearance at 10-14 until age 18 it is most vulnerable to deterioration; young people are most susceptible to the condition worsening. An effective non-surgical means of remediation would be welcome. Design: Randomized control two-arm study, assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant healthy 12 – 18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), given the side plank (Vasisthasana) done thrice daily with placebo injection (control sub-group 2) or given the thrice-daily side-plank with botulinum injection (Intervention group 3). Injection: 33 IU of incobotulinum toxin type A (Xeomin) injected into concave-side lumbar paraspinals and quadratus lumborum at L2-3 and the psoas muscle at L3-4, or injected similarly with placebo. Randomization by Random.com. Objective: Assess whether muscular asymmetry treated with botulinum toxin injection and the side-plank are safe and effective in AIS.Results: Outcome: Twelve intervention and 12 placebo patients (Groups 1 + 2), 12 -18 years old completed the three-month study period. Mean daily side-plank time = 165 seconds. Mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p<0.0001); mean curvature at 3 weeks was 29.5 degrees. (SD 14.23) (p<0.0001); mean curvature at 3 months was 26.0 degrees (SD 12.81) Onset vs 3-month value: p<0.0001. Two patients in Group 3 complained of shoulder pain, and 2 of wrist pain that resolved when the side-plank was done on the elbow. Conclusion: Muscle asymmetry appears relevant to AIS treatment. Incobotulinum injections combined with the side-plank done with the convex side downward may be safe and helpful in adolescent idiopathic lumbar scoliosis.

Incobotulinumtoxin A and Yoga-like Isometric Exercise in Adolescent Idiopathic Lumbar Scoliosis – a randomized pilot study Abstract: Background: Approximately 90% of scoliosis is adolescent idiopathic (AIS). From its first appearance at 10-14 until age 18 it is most vulnerable to deterioration; young people are most susceptible to the condition worsening. An effective non-surgical means of remediation would be welcome. Design: Randomized control two-arm study, assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant healthy 12 – 18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), given the side plank (Vasisthasana) done thrice daily with placebo injection (control sub-group 2) or given the thrice-daily side-plank with botulinum injection (Intervention group 3). Injection: 33 IU of incobotulinum toxin type A (Xeomin) injected into concave-side lumbar paraspinals and quadratus lumborum at L2-3 and the psoas muscle at L3-4, or injected similarly with placebo. Randomization by Random.com. Objective: Assess whether muscular asymmetry treated with botulinum toxin injection and the side-plank are safe and effective in AIS. Results: Outcome: Twelve intervention and 12 placebo patients (Groups 1 + 2), 12 -18 years old completed the three-month study period. Mean daily side-plank time = 165 seconds. Mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p<0.0001); mean curvature at 3 weeks was 29.5 degrees. (SD 14.23) (p<0.0001); mean curvature at 3 months was 26.0 degrees (SD 12.81) Onset vs 3-month value: p<0.0001. Two patients in Group 3 complained of shoulder pain, and 2 of wrist pain that resolved when the side-plank was done on the elbow. Conclusion: Muscle asymmetry appears relevant to AIS treatment. Incobotulinum injections combined with the side-plank done with the convex side downward may be safe and helpful in adolescent idiopathic lumbar scoliosis.

(Background) the aim was to determine related factors to recurrent vitreous hemorrhage (RVH) in a sample of proliferative diabetic retinopathy (PDR) patients. (Methods) A retrospective, review-based study. We studied 183 eyes from 121 type 2 diabetes patients with PDR. We recorded diabetes duration, history of hypertension, retinal photocoagulation status, the posterior vitreous status, the mean HbA1c, mean hemoglobin, the renal function, and the systemic complications related to diabetes. We also recorded the use of ranibizumab prior to vitrectomy and the following surgical variables: the application of segmentation and diathermy on fibrovascular proliferative tissue, the use of silicone oil, and the occurrence of surgical complications, to study which independent variables were significantly related to the presence of RVH. (Results) Duration of diabetes (P= 0.028), hemoglobin (P=0.02), status of the posterior vitreous (P=0.03), retinal photocoagulation (P=0.002) and use of segmentation surgery technique (P=0.003) have significant link to the presence of RVH. In addition, patients with diabetic polyneuropathy, myocardial infarction and ischemia in lower limbs had more vitreous hemorrhage events (p&lt;0.001). (Conclusions) Patients with PDR and with longer diabetes duration, anemia, attached posterior vitreous, deficient retinal photocoagulation, and previously cardiovascular events, were more prone to RVH.

Extracting entities from large volumes of chicken epidemic texts is crucial for knowledge sharing, integration, and application. However, Named Entity Recognition (NER) encounters significant challenges in this domain, particularly due to the prevalence of nested entities and domain-specific named entities, coupled with a scarcity of labeled data. To address these challenges, we compiled a corpus from 50 books on chicken diseases, covering 28 different disease types. Utilizing this corpus, we developed a nested NER model, MFGFF-BiLSTM-EGP. This model integrates the Multiple Fine-Grained Feature Fusion (MFGFF) module with a BiLSTM neural network and employs an Efficient Global Pointer (EGP) for predicts the entity location encoding. In MFGFF module we designed three encoders, character encoder, word encoder and sentence encoder, this design effectively captures fine-grained features and improves the recognition accuracy of nested entities. Experimental results show that the model performs robustly, with F1 scores of 91.98%, 73.32%, and 82.54% on the CDNER, CMeEE V2, and CLUENER datasets, respectively, outperforming other commonly used NER models. Specifically, on the CDNER dataset, the model achieved an F1 score of 79.68% for nested entity recognition. This research not only advances the development of knowledge graph and intelligent question-answering system for chicken diseases but also provides a viable solution for extracting disease information that can be applied to other livestock species.

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific postoperative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have been not clarified yet. Methods: This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and postoperative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the occurrence rate of postoperative interscapular pain. Results: The mean age was 57.6±10.8 years, and the M:F ratio was 2.1. The preoperative mean VAS-arm was 7.15±0.81 among the 20 patients reporting brachialgia, and the mean VAS-neck was 4.36±1.43 among those 9 patients reporting cervicalgia. At 1 month interscapular pain was still reported by 8 out of the 17 patients who experienced it postoperatively, and it was recovered in all patients after 2 months. The regression analysis showed how the interscapular pain was not directly associated to age(p=0,74), gender(p=0,46), smoking status(p=0,44), diabetes(0,42), preoperative brachialgia(p=0,21) or cervicalgia(p=0,48), symptoms duration(p=0,13), baseline VAS-arm(p=0,11), VAS-neck(p=0,93), or mJOA(p=0,63) scores, or disc height modification(p=0,90). However, the postoperative increase of the mean zygapophyseal joint rims distance was identified as an independent factor in determining interscapular pain (p=0,02). Conclusions: Our study revealed that the onset of interscapular pain following ACDF may be determined by over-distraction of the zygapophyseal joints rim. Then, proper sizing of prosthetic implants could reduce this painful complication.

Aging is associated with muscle atrophy and fatty infiltration of skeletal muscle. The multifidus muscle stabilizes the lumbar spine and undergoes adipose accumulation with age, leading to functional decline in the elderly. Therefore, quantitative assessment of the multifidus muscle can be beneficial for the elderly when formulating treatment strategies and reducing future complications. Fifty-seven patients (mean age, 73.89 ± 6.09; 23 male patients) who underwent lumbar Magnetic resonance imaging (MRI) were prospectively recruited. The cross-sectional area (CSA) of the multifidus from the L2-S1 level and the CSA of the L4-5 level psoas muscle were measured. The functional CSA (fCSA) of the multifidus muscle was measured by excluding the fat infiltration area from the multifidus CSA. The CSA to fCSA ratio was obtained by multiplying 100 by the value obtained by dividing CSA by the fCSA. Pfrrmann classification was used to evaluate the degree of disc degeneration. The functional disability measurements were the Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), grip strength, and functional reach test (FRT). Pearson's correlation analysis was used to examine the relationship between the functional disability measurements and the multifidus muscle. The CSA to fCSA ratio value was relatively constant at each spine level and showed a significant correlation with the SPPB, grip strength, FRT, and psoas index (p&lt;0.05). However, degree of disc and multifidus muscle degeneration were not statistically significant. So, age-related changes play a significant role in developing back muscle fatty infiltration than disc dgeneration. Moreover, Grip strength showed a stronger relationship with the quality of the multifidus muscle than other functional disability measurements.

Low back pain is a common problem in the active population, and the second reason for visiting a physician. In patients with lumbar disc protrusion, the nucleus pulposus bulges against the disc and the latter protrudes into the spinal column, but the annulus fibrosus remains intact. The purpose of this study was to prove that starting an early complex rehabilitation treatment results into pain and disability reduction, and increased muscle strength and mobility in patients with lumbar disc protrusions. We performed a prospective cohort study, enrolling 60 patients (25 men and 35 women) aged between 26 to 76 years, diagnosed with lumbar disc protrusion. Patients in the experimental group registered significant improvements in all studied variables (pain, mobility, muscle strength, disability) after 6 months of treatment. The results of our study suggest that, in the lumbar disc disease, a combined rehabilitation program may be more effective in terms of pain and disability reduction, if it starts early after diagnosis. The current study proves the importance of combining electrotherapy with hydrotherapy and physical therapy. Patients who received this treatment combination showed an extremely significant improvement in pain relief, and reduction of functional disability after 6 months of treatment.

Tuberculosis (TB) is an infectious disease declared a global emergency by the World Health Organization and continues as one of the world’s top ten causes of death. TB diagnosis is more critical in developing countries where demanded infrastructure for detection, and treatment complicates the efforts against the disease. These aspects related to limited resources are significant, especially in areas away from the main cities, with few mechanisms to make a timely diagnosis that contributes to successfully addressing the possible patients. Artificial intelligence has begun to be essential in providing additional strategies in the diagnosis processes for health professionals’ support. This paper uses natural language processing (NLP) and machine learning (ML) techniques to create models that can supply TB diagnosis when the needed infrastructure is unavailable. Two different sources were explored: text extracted from electronic medical records (EMR) and patient clinical data (CD). Four proposals using five different machine learning models were implemented. The first two models employed ML and each data source independently. Then, two additional approaches developed a data fusion from both sources. This strategy’s employment was analyzed with physicians according to their pertinence in the process and understanding of the EMR. Finally, the results of the data fusion were compared to each source, obtaining better performance at using only the CD, where an area under the ROC curve of 69.9±2.3% was obtained. However, the advantage of analyzing physician’s reports is the availability of this information contrasted to clinical-specific data, which can be more useful in places far from the main cities without enough basic structure for its obtaining.

Dissimilar welds between ferritic and austenitic steels represent a good solution for exploiting the best performance of stainless steels at high and low temperatures and in aggressive environments, while minimizing costs. Therefore, they are widely used in nuclear and petrochemical plants, however, due to the different properties of the steels involved, the welding process can be challenging. Fusion welding can be specifically addressed to connect low-carbon, or low-alloy steels, with high-alloy steels, which have similar melting point. Welding of thick plates can be performed with electric arc in multiple passes or in a single pass by means of a laser beam equipment. Since microstructure and consequently mechanical properties of the weld are closely related to composition, the choice of the filler metal and processing parameters, which in turn affects the dilution rate, plays a fundamental role. Numerous technical solutions were proposed for welding dissimilar steels and much research was developed on the weldment metallurgy; therefore, this article is aimed at a review of the most recent scientific literature on the issues relating to the fusion welding of ferritic / austenitic steels. Two specific sections are dedicated respectively to electric arc and laser beam welding; finally, metallurgical issues, related to dilution and thermal field are debated in the discussion section.

Nuclear fusion is essential for the sexual reproduction of various organisms, including plants, animals, and fungi. During the life cycle of flowering plants, nuclear fusion occurs three times: once during female gametogenesis and twice during double fertilization, when two sperm cells fertilize the egg and the central cell. Haploid nuclei migrate in an actin filament-dependent manner to become in close contact, then two nuclei fuse. The nuclear fusion process in plant reproduction is achieved by the sequential nuclear membrane fusion events. Recent molecular genetic analyses using Arabidopsis thaliana showed the conservation of nuclear membrane fusion machinery between plants and the budding yeast Saccharomyces cerevisiae. These include the heat shock protein 70 in the endoplasmic reticulum and conserved nuclear membrane proteins. Analyses of A. thaliana mutants of these components show that completion of the sperm nuclear fusion at fertilization is essential for proper embryo and endosperm development.

Background/Objectives: Transforaminal endoscopic lumbar discectomy (TELD) under local anesthesia is a promising minimally invasive surgical option for intractable lumbar disc herniation (LDH). However, our understanding of access pain prediction during foraminal pathological procedures is limited. To our knowledge, no predictive rules for access pain during TELD have been established for foraminal or extraforaminal LDH. This study, with its potential to predict access pain during TELD and to discuss strategies for pain prevention and management, could significantly impact the field of endoscopic spine surgery. Methods: This observational study included 73 consecutive patients who underwent TELD for foraminal or extraforaminal LDH between January 2017 and December 2022. Preoperative clinical and radiographic factors affecting significant access pain and the impact of access pain on clinical outcomes were evaluated. Results: The rate of significant access pain was 13.70% (10 of 73 patients). Extraforaminal LDH tended to cause more severe pain than foraminal LDH during TELD under local anesthesia (p &lt; 0.05). Although the degree of access pain was not related to global outcomes, increased pain was strongly associated with a prolonged operative time and length of hospital stay (p &lt; 0.05). Conclusions: TELD can be an effective surgical option for foraminal or extraforaminal LDH under local anesthesia. More access pain may develop during TELD for extraforaminal LDH. The extraforaminal component of LDH can narrow the safety working zone. Significant access pain may prolong the duration of surgery and hospitalization. Thus, a specialized technique is required for the clinical success of TELD.

The introduction of exoskeletons in the industry has focused on improving worker safety. Exoskeletons have the objective of decreasing the risk of injury or fatigue when performing physically demanding tasks. The exoskeleton’s effects on the muscles is one of the most common focus in the assessments. The present study aims to analyse the muscle interactions generated by using a passive lumbar exoskeleton during load-handling tasks in laboratory conditions with and without an exoskeleton. Electromyographic data of the muscles involved in the task were recorded from twelve participants performing load-handling tasks. Correlation Coefficient, Coherence Coefficient, Mutual Information, and Multivariate Sample Entropy were calculated to determine if there were significant differences in muscle interactions between the two test conditions. Results showed statistically significant differences for all pairs of muscles and indicated that the use of the exoskeleton implied more constant values throughout the exercise. The Directed Conditional Granger Causality was obtained to study the directionality of the interactions, with significant differences in two muscle pairs Gluteus-Quadriceps and Gluteus-Lumbar in the gravity-positive direction in both cases. In conclusion, EMG parameters chosen appear to be appropriate measurements for studying the exoskeleton effects over muscle couplings.

Manual material handling tasks in industry cause work-related musculoskeletal disorders. Exoskeletons are being introduced to reduce the risk of musculoskeletal injuries. This study investigated the effect of using a passive lumbar exoskeleton in terms of moderate ergonomic risk. Eight participants were monitored by electromyogram (EMG) and motion capture (MoCap) while performing tasks with and without the lumbar exoskeleton. The results showed a significant reduction in the root mean square (VRMS) for all muscles tracked: erector spinae (8%), semitendinosus (14%), gluteus (5%), and quadriceps (10.2%). The classic fatigue parameters showed a significant reduction in the case of the semitendinosus: 1.7% zero-crossing rate, 0.9% mean frequency, and 1.12% median frequency. In addition, the logarithm of the normalized Dimitrov’s index showed reductions of 11.5, 8, and 14% in erector spinae, semitendinosus, and gluteus, respectively. The calculation of range of motion in the relevant joints demonstrated significant differences, but in almost all cases, the differences were smaller than 10. The findings of the study indicate that the passive exoskeleton reduces muscle activity and introduces a minor change of strategies for motion. Thus, EMG and MoCap appear to be appropriate measurements for designing an exoskeleton assessment procedure.

Background: Low back pain (LBP) is a major cause of disability globally, and the diagnosis of LBP is challenging for clinicians. Objective: This study aimed to assess the accuracy level of arti-ficial intelligence as a Clinical Decision Support System (CDSS) called Therapa compared to MRI in predicting lumbar disc herniated patients. Methods: One hundred low back pain patients aged ≥18 years old were included in the study. The study was conducted in 3 stages, at first, a case se-ries was conducted by matching MRI and Therapha diagnosis for 10 patients. Subsequently, Delphi methodology was employed to establish a clinical consensus. Lastly, to determine the ac-curacy of the newly developed software, a cross-sectional study was undertaken, involving 100 patients. Results: The software showed a significant diagnostic accuracy with the area under the curve in the ROC analysis determined as 0.84 with a sensitivity of 88% and a specificity of 80%. Conclusion: The study’s findings revealed that CDSS using Therapha has a reasonable level of ef-ficacy, and this can be utilized clinically to acquire faster and more accurate screening of patients with lumbar disc herniation.

Chromium (Cr) metal has garnered significant attention in alloy systems owing to its exceptional properties, such as high melting point, low density, and superior oxidation and corrosion resistance. However, its processing capabilities are hindered by the high Ductile-Brittle Transition Temperature (DBTT). Recently, powder bed fusion-laser beam for metals (PBF-LB/M) has emerged as a promising technique, offering the fabrication of net shapes and precise control over crystallographic texture. Nevertheless, research investigating the mechanism underlying crystallographic texture development in pure Cr via PBF-LB/M still needs to be conducted. This study explores the impact of scan speed on relative density and crystallographic texture. At the optimal scan speed, an increase in grain size attributed to epitaxial growth was observed, resulting in the formation of cubic texture. Consequently, a reduction in High Angle Grain Boundaries (HAGB) was achieved, suppressing defects such as cracks and enhancing relative density up to 98.1%. Furthermore, with increasing densification, Vickers hardness also exhibited a corresponding increase. These findings underscore the efficacy of PBF-LB/M for processing metals with high DBTT properties.

The rapid urbanization in China has significantly contributed to the vast expansion of urban built-up areas. Precisely extracting and monitoring these areas is crucial for understanding and optimizing the developmental process and spatial attributes of smart, compact cities. However, most existing studies tend to focus narrowly on a single city or global scale with a single dimension, often ignoring mesoscale analysis across multiple urban agglomerations. In contrast, our study employs GIS and image processing techniques to integrate multi-source data for the identification of built-up areas. We specifically compare and analyze two representative urban agglomerations in China: the Yangtze River Delta (YRD) in the east and the Chengdu-Chongqing (CC) region in the west. We use different methods to extract built-up areas from socio-economic factors, natural surfaces, and traffic network dimensions. Additionally, we utilize a high-precision built-up area dataset of China as a reference for verification and comparison. Our findings reveal several significant insights: (1) The multi-source data fusion approach effectively enhances the extraction of built-up areas within urban agglomerations, achieving higher accuracy than previously employed methods. (2) Our research methodology performs particularly well in the CC urban agglomeration. The average precision rate in CC is 96.03%, while the average precision rate in YRD is lower at 80.33%. This study provides an objective and accurate assessment of distribution characteristics and internal spatial structure of built-up areas within urban agglomerations. This method offers a new perspective for identifying and monitoring built-up areas in Chinese urban agglomerations.

Reparative osteogenesis in the damaged vertebrae is a complex cascade of morphological and biochemical processes that result in the consolidation of the vertebral body. This research was aimed at studying the features of reparative osteogenesis in damaged thoracic and lumbar vertebral bodies at different time points after injury. We analyzed the morphological findings of the vertebral tissues harvested during surgical interventions in 43 patients with recent, subacute and long-standing injuries to thoracic and lumbar spine, and found that cell differentiation in osteogenesis is closely related to angiogenesis and the metabolic cascade. In areas with sufficient oxygenation, good partial pressure of oxygen, and active growth of microvasculature the normal cycle of development and differentiation of osteoblasts and osteocytes occurs, and hypoxia and acidosis lead to pathological osteogenesis. The reclination maneuver with dorsal tools on Day 10-12 of the injury may be ineffective due to the formation of adhesions between fragments, and reclination of the body of the damaged vertebra two weeks or more after the injury is apparently doomed to failure. Timely ventral fusion performed for objective indications is the key to successful rehabilitation of patients, on the one hand, and reduction of the surgical trauma volume in the future, on the other.

The nuclear fusion reaction can be catalyzed in a suitable fusion fuel by muons(heavy electron)."For the fractal relation, ranging from DNA knots to solar neutrino flux signals" ever derived f scale-invariant properties distinguished between classical invariant theory & quantum invariant theory subfactors. Accompanying isomorphicity & Connes Fusion Tensor Product retrieved to muon-catalyzed fusions where surroundings of room temperature fusion driven by the balance in mt-Dna fusion &fission.

Purpose: To compare the standard implantation technique of a new ab externo microshunt (PRESERFLO) to a posterior technique with a small incision. The standard anterior approach (A) requires a relatively large, 6-8 mm perilimbal peritomy. In contrast, the posterior approach (P) involves only a 2-3 mm snip incision 2 mm posterior to the limbus. Methods: Charts of 126 PRESERFLO patients (54 A and 72 P) were retrospectively analyzed. Follow-up was 270 days. We compared the surgical time, intraocular pressure (IOP), number of medications, and complications. Results: The preoperative IOP in A was 21.8±8.5 mmHg and 23.9±8.1 mmHg in P (p=0.08). The surgical time for A was 26±0.8 minutes and 10±0.4 minutes for B (p<0.001). Following a low-pressure phase during the first week, A and P had an IOP value of 10.8±5.9 mmHg and 10.6±4.5 mmHg at 30 days, respectively (p=0.62). IOPs remained at this level throughout the study (all intra-group p> 0.08). There were no inter-group differences in IOP at any visit (all p-values > 0.3). Patients in A and P took 3.2 ± 1.3 and 3.3 ± 1.0 pressure-lowering medications at baseline, respectively (p=0.4). These values declined to 0.2 ± 0.6 in A and 0.3 ± 0.7 in P at 270 days. Both groups had a similar number of revisions (13 (10.3%) versus 10 (7.9%, p=0.14)) and complications (26 (20.8%) versus 31 (24.6%, all p>0.25). Conclusion: The posterior PRESERFLO insertion technique was 2.6 times faster than the standard anterior technique and yielded similar results with a large reduction in IOP and medications and a safety profile favorable over traditional filtering surgery.

Patients' functional adaptation to pain can affect global sagittal alignment. This study evaluated the short-term spinal sagittal alignment change after Transforaminal Epidural Steroid Injection (TFESI) in lumbar spinal stenosis patients. Patients with lumbar spinal stenosis who underwent TFESI were retrospectively examined. Clinical outcomes were Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Before and two weeks after the intervention, whole spine lateral standing view radiographs were taken. Radiographic parameters, e.g., Sagittal Vertical Axis (SVA), C2C7 Cobb, Thoracic Kyphosis (TK), Lumbar Lordosis (LL), Pelvic Incidence (PI), Pelvic Tilt (PT), Sacral Slope (SS), and Lumbopelvic Mismatch (PI-LL), were measured. Ninety-nine patients (mean age 64.3 ± 9.2 years) were included in this study. Both VAS and ODI outcomes were statistically improved after two weeks of intervention. Radiographic parameters showed that SVA, PT, and PI-LL mismatch were significantly decreased, while C2C7 Cobb, TK, SS, and LL were significantly increased after the intervention. SVA was improved by 29.81% (52.76 ± 52.22 mm to 37.03 ± 41.07 mm, P &lt; 0.001). PT was also decreased significantly from 28.71° ± 10.22° to 23.84° ± 9.96° (P &lt; 0.001). Transforaminal Epidural Steroid Injection (TFESI) significantly improves VAS, ODI, and global sagittal parameters in lumbar spinal stenosis patients.

Lumbar support exoskeletons with active and passive actuators are currently the cutting-edge technology for preventing back injuries in workers while lifting heavy objects. However, many challenges still exist in both types of exoskeletons, including rigid actuators, risks of human-robot interaction, high battery consumption, bulky design, and limited assistance. In this paper, the design of a compact, lightweight energy storage device combined with rotary series elastic (ES-RSEA) is proposed for use in a lumbar support exoskeleton to increase the level of assistance and exploit the human bioenergy during the two stages of the lifting task. ES takes the responsibility to store and release passive mechanical energy while RSEA provides excellent compliance and prevents injury from the human body's undesired movement. The experimental tests on the spiral spring showed excellent linear characteristics (above 99%) with an actual spring stiffness of 9.96 Nm/rad. The results demonstrate that ES-RSEA can provide maximum torque assistance in the ascent phase with 66.6 Nm while generating nearly 21 Nm of spring torque during descent without turning on the DC motor. Ultimately, the proposed design can maximize the energy storage of human energy, exploit the biomechanics of lifting tasks, and reduce the burden on human effort to perform lifting tasks.

The analysis of social media content plays a crucial role in uncovering intricate user behaviors and trends across diverse digital platforms. Social media is inherently multimodal, incorporating texts, images, audios, and videos, each offering unique insights into user engagement and preferences. Traditional classification methods often focus narrowly on the most prominent modality, typically neglecting the synergistic potential of integrating multiple data types. To address this gap, we introduce the Unified Multimodal Classifier (UMC), a suite of streamlined models that adeptly harness and integrate these varied modalities. UMC leverages a novel architecture that combines a pooling layer with auxiliary learning tasks, facilitating the formation of a robust and shared feature space. This integration allows UMC to not only accommodate but also capitalize on the inherent diversity of social media data. The models are designed to be inherently flexible, adjusting to the availability of data modalities and maintaining high classification accuracy under varied conditions. In emotion classification scenarios, UMC has shown exceptional performance, significantly outperforming traditional methods by effectively synthesizing information across modalities. Its robustness is highlighted in its ability to deliver consistent results, even in the absence of one or more modalities. The simplicity and efficiency of UMC make it a potent tool for social media analytics, enabling it to achieve higher accuracies and maintain effectiveness even with limited data inputs. This adaptive capability ensures that UMC can be deployed in real-world applications where data incompleteness is common, thus broadening the scope of its applicability in various analytical contexts.

The increasing prevalence of spinal disorders and the subsequent rise in spinal fusion surgeries stress the necessity for optimizing spinal fusion cages, crucial for stabilizing the spine and supporting osseointegration. Despite the widespread attempts at material modifications and surface enhancements to improve these devices, failure rates and complications remain significant. This research explores an imaginitive approach to enhancing spinal fusion cages through the application of geometric tiling designs, a method scarcely employed . The study systematically investigates the potential of triangular, diamond, and hexagonal tiling patterns to improve the structural integrity and capability for osseointegration of spinal fusion cages. Through a finite element analysis simulation, each design's ability to withstand multi-directional loads and effectively distribute stress was tested under simulated conditions that mimic the complexities of spinal motion. Preliminary findings in fields of engineering indicate that geometric tiling can significantly enhance the load-bearing capabilities and stress distribution of spinal fusion cages, potentially reducing the likelihood of implant subsidence and failure. The triangular and hexagonal designs, in particular, demonstrate superior performance in maintaining structural stability under axial and anterior compressive forces compared to traditional cage designs. This research opens a new pathway for the development of more durable and efficient spinal fusion cages. By leveraging the structural advantages of geometric tiling, future spinal implants could achieve better clinical outcomes, leading to improved patient recovery and reduced rates of complications.

The aim of this study was to evaluate implants survival rate, marginal bone loss, surgical and prosthetic complications of implants placed through sinus floor elevation and tilted implants en-gaged in basal bone in order to bypass maxillary sinus. 60 patients were enrolled for this study. According with residual bone height of posterior maxilla the sample was divided in three groups of 20 patients: Group A (lateral sinus floor elevation), Group B (transrectal sinus floor elevation) and Group C (tilted implants employed to bypass sinus floor). Follow-up visits were performed one week after surgery, at 3, 6 months and then once a year for next 4 years. The outcomes were implants survival rate, marginal bone loss and surgical and prosthetic complications. Although the Group A, B and C have demonstrated an implants survival rate of 83.3%, 86,7% and 98,3% respectively, the statistically analysis showed that there was no statistically significant difference between groups. Statistically significant differences between the groups were also not found con-cerning marginal bone loss, as recorded by intra-oral X-ray measurements during follow-up. About complications it wasn’t possible to perform a statistical analysis. To as to reduce potential surgical risks implants placement in basal bone should be preferred.

Background: Two types of medicinal systems are available in Korea: Western and oriental. These exist as separate services that independently provide medical care to patients. We determined the utility and benefits of compressive and integrated medical services (CIMS) comprising 12 sessions of acupuncture and healing programs over 6 weeks. Methods: In this two-group parallel single-center randomized controlled assessor-blinded trial, 24 participants were assigned to either the experimental (conventional medical treatment plus CIMS, n = 12) or control (conventional medical treatment, n = 13) group. Spinal nerve root block was performed on the compressed spinal nerve root (identified using magnetic resonance imaging) when no improvement was observed after the initial treatment. The experimental group received 12 cycles of acupuncture and manual therapy for 6 weeks; the control group received conventional medical treatment alone. Results: The average age of participants in the experimental and control groups was 70.73 ± 5.95 and 67.33 ± 8.89 years, respectively. There were no significant differences between the groups in terms of age, body mass index, Leeds Assessment of Neuropathic Symptoms and Signs, sex, and current medical history. We found high compliance for both programs (acupuncture and healing). On exclusion of between-group effects, the visual analog scale (VAS) score improved significantly over time (p = 0.045). Further, comparison of the groups after excluding the effects of visits revealed significantly lower VAS scores in the experimental group than in the control group (p = 0.000). Conclusions: Patients with degenerative lumbar spinal stenosis who mainly complain of radiating pain in the lower leg may benefit from CIMS after spinal nerve root block for ≤3 months after treatment. Our study findings suggest that this treatment improves spinal function and Oswestry Disability Index score. However, CIMS did not improve QoL.

Unwanted proteins and metabolic waste in cerebral spinal fluid are cleared from the brain by meningeal and nasal lymphatics, and perineural sheath of cranial nerves; however, the distribution and clearance of CSF along the subarachnoid space of the entire spinal cord is not fully understood. It was hypothesized that the anatomical resolution of Cryo-Fluorescence Tomography (CFT) could provide the visual evidence of clearance across the spinal cord at each level of the vertebral column. To that end, isoflurane anesthetized mice were infused into the lateral cerebroventricle with 5.0 µl of quantum dots [QdotR 605 ITKTM amino (PEG)] over two mins. Mice were allowed to recover (ca 2-3 min) and remained awake and ambulatory for 5, 15, 30, 60 and 120 minutes after which they were euthanized, and the entire intact body frozen at -800. The entire mouse was sectioned and imaged to produce an isotropic voxel resolution of 35 µm. Both white light and fluorescent images were captured after each slice to produce high resolution three-dimensional volumes for each mouse. CFT highlighted the circulation of tracer throughout the ventricular system and central canal of the spinal cord and the entire subarachnoid space of the CNS. Signal could be visualized in the nasal cavity, deep cervical lymph nodes, thoracic lymph nodes and more superficial submandibular lymph nodes as early as 15 min post infusion. Fluorescent signal could be visualized along the dorsal root ganglia and down the proximal extension of the spinal nerves of the thoracic and lumbar segments at 30 min. There was significant accumulation of tracer in the lumbar and sacral lymph nodes between 15- 60 min. The dense fluorescent signal in the thoracic vertebrae noted at 5- and 15-mins post infusion was significantly reduced by 30 min. Indeed, all signal in the spinal cord was ostensibly absent by 120 min except for trace amounts in the coccyx. The brain still had some residual signal at 120 min. These data show that Qdots with a hydrodynamic diameter of 16-20 nm rapidly clear from the brain of awake mice. These data also clearly demonstrate the rapid distribution and efflux of trace along a major length of the vertebral column and the potential contribution of the spinal cord in the clearance of brain waste.

Evidence regarding the effect of the onlay preparation design for different CAD/CAM restorative materials considering the preservation of cusps is lacking. Molars were 3D modeled in four preparation designs for onlay restoration: traditional design with functional cusp coverage (TFC), non-retentive design with functional cusp coverage (NFC), traditional design with non-functional cusp coverage (TNFC), non-retentive design with non-functional cusp coverage (NNFC). Restorations were simulated with two CAD/CAM restorative materials: LD – lithium disilicate (IPS e.max CAD) and RC - resin composite (GrandioBloc). A 100 N axial load was applied to the occlusal surface simulating the centric contact point. Von Mises (VM) and maximum principal (Pmax) stresses were evaluated for restorations, cement layer and dental substrate. The non-retentive preparation design reduced the stress concentration in the tooth structure in comparison to the conventional retentive design. For LD onlays, the stress distribution on the restoration intaglio surface showed that the preparation design as well as the prepared cusp, influenced the stress magnitude. The non-retentive preparation design provided better load distribution in both restorative materials and more advantageous for tooth structure. The resin composite restoration on non-functional cusp is recommended when functional cusp is preserved, in order to associate conservative dentistry and low stress magnitude.

Object. Utilization of pedicle screws (PS) for spine stabilization is common in spinal surgery. With reliance on visual inspection of anatomical landmarks prior to screw placement, the free-hand technique requires a high level of surgeon skill and precision. Three-dimensional (3D) computer-assisted virtual neuronavigation improves the precision of PS placement and minimize steps. Methods. Twenty-three patients with degenerative, traumatic, or neoplastic pathologies received treatment via a novel three-step PS technique that utilizes a navigated power driver in combination with virtual screw technology. 1) Following visualization of neuroanatomy using intraoperative CT, a navigated 3-mm match stick drill bit was inserted at anatomical entry point with screen projection showing virtual screw. 2) Navigated Stryker Cordless Driver with appropriate tap was used to access vertebral body through pedicle with screen projection again showing virtual screw. 3) Navigated Stryker Cordless Driver with actual screw was used with screen projection showing the same virtual screw. One hundred and forty-four consecutive screws were inserted using this three-step, navigated driver, virtual screw technique. Results. Only 1 screw needed intraoperative revision after insertion using the three-step, navigated driver, virtual PS technique. This amounts to a 0.69% revision rate. One hundred percent of patients had intraoperative CT reconstructed images to confirm hardware placement. Conclusions. Pedicle screw placement utilizing the Stryker-Ziehm neuronavigation virtual screw technology with a three step, navigated power drill technique is safe and effective.

Sensor fusion algorithms and models have been widely used in recent times. Although research evidence has informed the use of sensor fusion models in diverse applications, there is room for improvement, especially in home-based health monitoring applications which require less supervision and technical knowledge of users. The present work compares data mining-based fusion software packages such as RapidMiner Studio, Anaconda, Weka, and Orange, and proposes a data fusion framework suitable for in-home applications. 574 privacy-friendly (binary) images and 1,722 datasets gleaned from thermal and Radar sensing solutions respectively, were fused using the software packages on instances of homogeneous and heterogeneous data aggregation. Experimental results indicated that the proposed fusion framework achieved an average Classification Accuracy of 84.7% and 95.7% on homogeneous and heterogeneous datasets respectively, with the help of data mining and machine learning models such as Naïve Bayes, Decision Tree, Neural Network, Random Forest, Stochastic Gradient Descent, Support Vector Machine, K-Nearest Neighbours and CN2 induction. Further evaluation of the sensor data fusion framework based on cross validation of features indicated average values of 94.4% for Classification Accuracy, 95.7% Precision and 96.4% for Recall.

In the context of Shared Autonomous Vehicles, the need to monitor the environment inside the car will be crucial. This article focuses on the application of deep learning algorithms to detect objects, namely lost/forgotten items to inform the passengers, and aggressive items to monitoring if violent actions may arise between passengers. For object detection algorithms was used public datasets (COCO and TAO) to train state-of-the-art algorithms, such as YOLOv5. For violent action detection was used the MoLa InCar dataset to train on state-of-the-art algorithms such as I3D, R(2+1)D, SlowFast, TSN and TSM. At the end an embedded automotive solution was used to demonstrate both methods running in real-time.

The market for autonomous vehicles (AV) is expected to experience significant growth over the coming decades and to revolutionize the future of transportation and mobility. The AV is a vehicle that is capable of perceiving its environment and perform driving tasks safely and efficiently with little or no human intervention and is anticipated to eventually replace conventional vehicles. Self-driving vehicles employ various sensors to sense and perceive their surroundings and, also rely on advances in 5G communication technology to achieve this objective. Sensors are fundamental to the perception of surroundings and the development of sensor technologies associated with AVs has advanced at a significant pace in recent years. Despite remarkable advancements, sensors can still fail to operate as required, due to for example, hardware defects, noise and environment conditions. Hence, it is not desirable to rely on a single sensor for any autonomous driving task. The practical approaches shown in recent research is to incorporate multiple, complementary sensors to overcome the shortcomings of individual sensors operating independently. This article reviews the technical performance and capabilities of sensors applicable to autonomous vehicles, mainly focusing on vision cameras, LiDAR and Radar sensors. The review also considers the compatibility of sensors with various software systems enabling the multi-sensor fusion approach for obstacle detection. This review article concludes by highlighting some of the challenges and possible future research directions.

Face verification for unrestricted faces in the wild is a challenging task. This paper proposes a method based on two deep convolutional neural networks(CNN) for face verification. In this work, we explore to use identification signal to supervise one CNN and the combination of semi-verification and identification to train the other one. In order to estimate semi-verification loss at a low computation cost, a circle, which is composed of all faces, is used for selecting face pairs from pairwise samples. In the process of face normalization, we propose to use different landmarks of faces to solve the problems caused by poses. And the final face representation is formed by the concatenating feature of each deep CNN after PCA reduction. What's more, each feature is a combination of multi-scale representations through making use of auxiliary classifiers. For the final verification, we only adopt the face representation of one region and one resolution of a face jointing Joint Bayesian classifier. Experiments show that our method can extract effective face representation with a small training dataset and our algorithm achieves 99.71% verification accuracy on LFW dataset.

A common spinal condition, spondylolisthesis is the presence of a relative back or forth displacement between the upper and lower vertebra due to one vertebra being oriented away from the smooth curvature of a normal spine. Aging-related illnesses such as degenerative spondylolisthesis are especially burdensome on social welfare and health-care systems in an aging society, especially radiologists and clinical physicians. Therefore, we proposed a computer aided diagnosis algorithm, named LumbarNet, for vertebral slippage detection on clinical X-ray images. Collaborating with i) a P-grade, ii) a piecewise slope detection scheme, and iii) a dynamic shift detection routine, LumbarNet was thus specialized for analyzing complex structural patterns in lumbar spine X-ray images and outcompeted other U-Net based methods. Extensive experiments on lumbar spine X-ray images in standard clinical practices showed that LumbarNet achieved a mean intersection over union value of 0.88 in vertebral region detection and an accuracy of 88.83% in vertebral slippage detection.

A partial or complete pulpotomy is a type of vital pulp therapy (VPT) that aims to remove the in-flamed, infected pulp, leaving behind healthy, vital pulp that is capable of healing. VPT has gained renewed popularity as a treatment option in permanent mature posterior teeth with irre-versible/moderate-severe pulpitis, its high success rates matching that of root canal treatment (RCT). There is currently no consensus regarding diagnostic and prognostic predictors of success of pulpotomies for managing such cases. Therefore, we conducted a scoping review to identify and analyze how these factors affect the outcome of treatment. A literature search using the PRISMA guidelines was undertaken using PubMed and Scopus on July 7, 2023. A total of 22 studies met the inclusion criteria and were qualitatively analyzed by two reviewers. The follow-ing diagnostic and prognostic factors were recognized and discussed; presenting signs and symptoms, periapical diagnosis, bleeding time, indicators of inflammation (bleeding time, con-centration of inflammatory biomarkers), patient age and medical status, the depth, activity and location of caries, and restorative factors. Based on the studies assessed, there is limited evidence to support their prognostic value. Further research is necessary to identify solid predictors of outcome.

Omicron SARS-CoV-2 variants have dominated the strains of COVID-19 circulating worldwide for the last two years. Although the mortality rate of the COVID-19 Omicron variants is only approximately half that of previous variants, vaccines effective against Omicron are needed. Demonstrating that a SARS-CoV-2 vaccine can protect against Omicron in an in vivo infection model, particularly in that of Syrian hamsters, is important for the preclinical characterization of SARS-CoV-2 vaccines. Here, we report on the evaluation of W-PreS-O for its ability to protect Syrian hamsters against infection by Omicron. W-PreS-O is a chimeric vaccine based on a single fusion protein (W-PreS-O), combining RBDs from Wuhan hu-1 wild-type and Omicron adsorbed to aluminum hydroxide. The Syrian hamsters were immunized three times at three-week intervals with W-PreS-O or with aluminum hydroxide (placebo), and then they were infected with Omicron BA.1. Non-infected and non-vaccinated animals served as controls. Neutralizing antibody (nAB) titers, weight, lung symptoms (i.e., edema and pneumonia index), and viral loads, as measured using RT-PCR in the upper and lower respiratory tracts, were determined. In addition, infectious virus titers from the lungs were measured using a plaque-forming assay. W-PreS-O-vaccinated hamsters developed robust nABs against Omicron, showed almost no development of pneumonia, and had significantly reduced infectious virus titers in the lungs. Importantly, the viral loads in the nasal cavities of W-PreS-O-vaccinated hamsters were close to or above the PCR cycle threshold considered to be non-infectious. Our data provide compelling evidence demonstrating that the W-PreS-O vaccine has protective effect against Omicron in a Syrian hamster in vivo infection model. W-PreS-O is therefore a highly promising candidate vaccine for Omicron infections, and it should be further evaluated in clinical studies.

Objective To explore the endoscopic anatomical structures of lumbar surgery. Methods A total of 290 patients who underwent lumbar endoscopic surgery due to lumbar intervertebral disc (IVD) herniation from September 2020 to September 2022 were retrospectively reviewed in our hospital,179 patients had complete surgical video recordings, including 108 males and 71 females, aged from 19 to 65 years, with an average age of 41±16 years. The endoscopic structures through the intervertebral foramen and interlaminar space were independently identified by 3 doctors with more than 3 years of related surgery experience. When there were differences of opinions, the three doctors would discuss and come to a consensus. The probability, location, and neighboring structures of each specific structures were statistically analyzed. Results The anatomical structures observed through the lumbar foramen under endoscopy include muscles and ligaments attached to the superior articular process (SAP), main blood vessels inside the intervertebral foramen, blood vessels on the surface of IVD, and blood vessels on the surface of the dural sac and nerve root. The major anatomical structures observed through interlaminar space are multifidus, the conjugated ligament of ligament flavum and capsule ligament (capsule part of flavum ligaments), edges of the lamina, specific vessel bundle to facet with exit nerve root. Conclusion The anatomical structures under spinal endoscopy have certain characteristics, which are grossly different from those under open surgery. Familiarity with these anatomical structures has important clinical significance.

Nowadays, the uses of laser and optics in the medical areas are extremely vivid, especially low-level laser therapy. The light with the wavelength of 633 nm to 1200 nm could penetrate and propagate deep in biological tissue. To develop the low-level laser therapy device, optimizing light delivery is critical to accurately stimulate the biological effects inside the biological tissue. Nevertheless, each form of the tissues at each zone on the body had various refractive optic, absorption, scattering, and anisotropy coefficients. This paper describes the simulation results of low-level laser propagation from skin surface at the lower spine, the knee, the femur and the prostate gland with four wavelengths (633 nm, 780 nm, 850 nm, and 940 nm) by the Monte Carlo method. These simulation results are the base for developing the low-level laser therapy device, that could be used in clinical for treating the fracture, knee osteoarthritis, spinal degeneration, and benign prostatic hypertrophy.

In the dynamic landscape of E-commerce, the proliferation of user-generated queries regarding products highlights the critical need for advanced automatic question answering (AQA) systems. These systems are instrumental in harnessing the vast array of information available online to deliver immediate and informative responses to potential buyers. Recognizing the complexity of such queries, which often require synthesis of reviews, product specifications, and responses to similar questions, we introduce a sophisticated model, the Comprehensive E-commerce Answer Generation System (CEAGS). This model adeptly navigates the challenges posed by irrelevant data and sentiment ambiguity in user-generated content. Our approach leverages a dual-phase process of relevance determination and sentiment clarity, setting the stage for a transformative response generation mechanism. Empirical analyses reveal the superiority of CEAGS, with our relevance assessment framework outstripping existing models by a notable margin in precision metrics, and our answer generation module achieving unprecedented gains in content preservation and coherence. Notably, CEAGS marks a pioneering contribution to the E-commerce domain by integrating disparate information sources to formulate responses that are not only accurate but also contextually rich and user-centric.