Search Results (64)

Background: Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) caused by repeated exposure to inhaled antigens in susceptible subjects. High-resolution computed tomography (HRCT) of the lungs is the leading diagnostic method for ILDs, but in some cases HRCT findings are not sufficient to distinguish HP and other ILDs, particularly, fibrotic HP (fHP) and usual interstitial pneumonia (UIP). Objective: The aim of this study was to develop HRCT criteria to diagnose fHP in patients with a UIP-like pattern. Methods: In this retrospective study, we analyzed HRCT scans of patients with fHP and a UIP-like pattern who underwent lung biopsy, and patients with idiopathic pulmonary fibrosis (IPF) and a UIP pattern in HRCT. Results: We included 51 patients with confirmed fHP and 24 patients with IPF/UIP in the analysis. IPF/UIP patients were older, were prevalently males, and did not have any systemic autoimmune diseases or risk factors for other ILDs. fHP patients were younger, with an equal number of males and females, and were more likely to be exposed to environmental antigens. HRCT abnormalities in the fHP group predominated in the lower lung areas or were diffuse in axial scans, whereas IPF/UIP patients mostly demonstrated a diffuse craniocaudal distribution and subpleural axial predominance. Centrilobular nodules and mosaic attenuation were present significantly more often in the fHP group; honeycombing, traction bronchiectasis, and emphysema prevailed in IPF/UIP patients. In the logistic regression analysis, patients with fHP and IPF/UIP differed in the presence of centrilobular nodules, honeycombing, and in both craniocaudal and axial distributions of HRCT abnormalities. In the ROC analysis, the combination of centrilobular nodules, honeycombing, and diffuse axial and craniocaudal distributions can predict the diagnosis of fHP (AUC, 0.953 ± 0.022; 95%CI, 0.910–0.995; p < 0.001). Mosaic attenuation and reticulation did not change the probability of fHP. Conclusions: The most significant HRCT features of fHP compared to the UIP pattern were centrilobular nodules, honeycombing, and a diffuse axial and craniocaudal distribution of abnormal findings. Reticulation, mosaic attenuation, and GGO do not increase the probability of fHP. Full article

The effectiveness of breathing interventions on postural alignment, pain reduction, and functional improvement in patients with forward head posture (FHP) and chronic neck pain remains uncertain. Previously conducted randomized controlled trials (RCTs) that involved breathing interventions were identified through searches of the PubMed, Cochrane Library, Web of Science, and Scopus databases. Studies were included if they applied diaphragmatic breathing, breathing muscle training, or feedback breathing exercises for at least 2 weeks to chronic neck pain (duration ≥ 3 months) and/or forward head posture. The craniovertebral angle (CVA), the visual analog scale (VAS), and the neck disability index (NDI) were the primary outcome measures. The results showed that breathing interventions had a moderate effect size in terms of improving the CVA. Limited effects were observed for pain reduction, and improvements in neck disability approached statistical significance. However, despite these positive findings, the overall evidence was rated as ‘very low certainty’ in the GRADE assessment, primarily due to high heterogeneity among studies, limited sample sizes, and the potential for unit-of-analysis errors in diagnosis-based subgroup analyses. Consequently, their overall effectiveness in chronic neck pain was limited. Future research is needed to explore a multidisciplinary approach to neck pain using standardized protocols and larger samples. Full article

The operational performance of Flexible Hinge Piezoelectric Stages (FHPSs), essential components in precision engineering, is fundamentally constrained by the inherent hysteresis of the piezoelectric actuator (PEA). A significant deficiency in prevailing characterization methods is their failure to consider the dynamic nature of the mechanical preload exerted by the flexible hinge. This position-dependent preload induces substantial deviations in the PEA’s response characteristics, thereby compromising the predictive accuracy of conventional design frameworks. To address this limitation, this paper proposes a Force-Dependent Prandtl–Ishlinskii (FPI) model that explicitly formulates the PEA’s hysteretic behavior as a function of variable preload conditions. The FPI model is subsequently integrated into a comprehensive FPI-FFEM characterization framework. Within this framework, a Force-analyzed Finite Element Method (FFEM) is utilized to compute the dynamic preload throughout the actuator’s operational stroke. This information, notably neglected in conventional FEM analysis, is essential to the fidelity of the proposed FPI model. Experimental validation demonstrates the superior fidelity of the FPI model in comparison to the traditional PI model for tracking preload-induced nonlinearities. Furthermore, the complete FPI-FFEM framework exhibits substantially enhanced prediction accuracy relative to both conventional PI-FEM and advanced LDPI-FEM methodologies, as demonstrated by a significant reduction in the Mean Absolute Error (MAE). Full article

Background/Objectives: The aim of this study was to examine the effectiveness of an exercise program based on principles of motor learning with cognitive elements (such as attention) in the correction of Forward Head Posture (FHP). Methods: A total of 55 university students from the University of Thessaly, aged between 18 and 25 years, participated in this study. Volunteers found to have a craniovertebral angle <50° were randomly divided into two groups: the intervention group IG (n = 27) and the control group CG (n = 28). The IG followed a treatment protocol consisting of three 30–45-min sessions per week for four weeks, a total of twelve sessions, while the control group received the same content instructions and group sessions upon completion. Results: After the four-week intervention period, significant improvements were observed in both static and dynamic craniovertebral angle measurements (p < 0.05) when comparing the IG to the CG. Additionally, there was a notable increase in the endurance of the deep neck flexors (p < 0.05), even though the intervention for the IG did not include specific strength exercises. Furthermore, participants with FHP were able to transfer (B–C) motor skills (p < 0.01) acquired during static position tasks to a similar but dynamically untrained task. They also retained (B–D) improvements in posture and strength during the two-week detraining period (p < 0.01), indicating sustained motor learning effects. Conclusions: The exercise intervention was successful at decreasing FHP in subjects, sustaining the results for a two-week period. This study supports the effectiveness of postural training by a program based on motor learning principles. New rehabilitation strategies based on motor control and motor learning could be introduced into physiotherapy practice to increase effectiveness. Full article

Background/Objectives: Accurate postural assessment is essential for managing musculoskeletal disorders; however, routine screening is often limited by radiation exposure, cost, and accessibility constraints of radiography. Recent advances in artificial intelligence (AI) have enabled automated, marker-free analysis using two-dimensional photographs. This study evaluated the validity and reliability of MORA Vu, an AI-based posture estimation software, against radiographic parameters. Methods: A prospective pilot study was conducted with 72 participants, divided equally into the cervical and lower-limb alignment groups. Forward head posture (FHP) and digital hip–knee–ankle (DHKA) angles were measured using MORA Vu and compared with corresponding radiographic parameters. Three healthcare professionals independently conducted the AI-based assessments. Correlations were analyzed, and interrater reliability was assessed using the intraclass correlation coefficient (ICC). Results: FHP showed the strongest correlation with the craniovertebral angle (r = −0.712) and C2–7 sagittal vertical axis (r = 0.704). The DHKA angle strongly correlated with the radiographic hip–knee–ankle angle (r = 0.754). Interrater reliability demonstrated high agreement (ICC: 0.84 FHP, 0.90 DHKA). Conclusions: MORA Vu demonstrated strong validity and high reliability, supporting its potential as a noninvasive screening tool for postural assessment. Given its accessibility and radiation-free nature, it may serve as a viable alternative for routine postural evaluation. Full article

The problem of using accounting semi-identity-based (ASI) models in Econometrics can be severe in certain circumstances, and estimations from OLS regressions in such models may not accurately reflect causal relationships. This dataset was generated through Monte Carlo simulations, which allowed for the precise control of a causal relationship. The problem of an ASI cannot be directly demonstrated in real samples, as researchers lack insight into the specific factors driving each company’s investment policy. Consequently, it is impossible to distinguish whether regression results in such datasets stem from actual causality or are merely a byproduct of arithmetic distortions introduced by the ASI. The strategy of addressing this issue through simulations allows researchers to determine the true value of any estimator with certainty. The selected model for testing the influence of the ASI problem is the investment-cash flow sensitivity model (Fazzari, Hubbard and Petersen (FHP hereinafter) (1988)), which seeks to establish a relationship between a company’s investments and its cash flows and which is an ASI as well. The dataset included randomly generated independent variables (cash flows and Tobin’s Q) to analyze how they influence the dependent variable (cash flows). The Monte Carlo methodology in Stata enabled repeated sampling to assess how ASIs affect regression models, highlighting their impact on variable relationships and the unreliability of estimated coefficients. The purpose of this paper is twofold: its first goal is to provide a deeper explanation of the syntax in the related article, offering more insights into the ASI problem. The openly available dataset supports replication and further research on ASIs’ effects in economic models and can be adapted for other ASI-based analyses, as the information comprised in the reusability examples prove. Second, our aim is to encourage research supported by Monte Carlo simulations, as they enable the modeling of a comprehensive ecosystem of economic relationships between variables. This allows researchers to address a variety of issues, such as partial correlations, heteroskedasticity, multicollinearity, autocorrelation, endogeneity, and more, while testing their impact on the true value of coefficients. Full article

Background and Objectives: Forward head posture (FHP) is associated with reduced stability limits, impaired balance performance, and compromised cervical proprioception. This study investigated the effects of capital flexion exercise (CFE) on the craniovertebral angle (CVA), trunk control, balance, and gait in chronic stroke patients with forward head posture. Materials and Methods: Twenty-six subjects were randomly assigned to the CFE group or the control group (n = 13 each). The CFE group underwent a familiarization process and performed CFE for 9 min per session, 3 times a week for 6 weeks, as well as the existing neurodevelopmental treatment (NDT). The control group received only the existing NDT. Results: The CVA, the Korean version of the Postural Assessment Scale for Stroke (K-PASS), the Berg Balance Scale (BBS), and the Timed Up and Go test (TUG) improved after the intervention in the CFE group (p < 0.05). In the control group, CVA and TUG improved after the intervention (p < 0.05). The CVA (d = 1.34, p = 0.002), K-PASS (d = 1.36, p = 0.000), and BBS (d = 1.68, p = 0.000) values of the CFE group showed statistically significant improvement compared to the control group. Although TUG improved in the CFE group, the between-group difference was not statistically significant (d = −0.28, p = 0.467). Conclusions: This study suggests that capital flexion exercises effectively improve craniovertebral angle, trunk control, and balance in chronic stroke patients with forward head posture. Full article

Background/Objectives: The present study aimed to investigate the relationship between forward head posture (FHP) and the mechanical properties of muscles as well as the influence of FHP on them. Methods: To define participants with FHP, craniovertebral angle (CVA) was measured. All participants were divided into two groups in accordance with their CVA: the experimental group (FHP) consisting of participants with a CVA below 50°, and the control group (CON) consisting of participants with a CVA above 50°. The tone, stiffness, and elasticity of the upper trapezius muscle (UT), the middle trapezius muscle (MT), the lower trapezius muscle (LT), the sternocleidomastoid muscle (SCM), the splenius capitis muscle (SC), the pectoralis major muscle (PM), and the serratus anterior muscle (SA) were measured using MyotonPro (Myoton AS, Tallinn, Estonia). Results: Both tone and stiffness in the UT were statistically significant (p < 0.05). In addition, stiffness in the LT was statistically significant (p < 0.05). No significant differences were found in tone, stiffness, and elasticity of the MT, SCM, SC, PM, and SA muscles (p > 0.05). A significant correlation was found between FHP and both tone and stiffness in the UT (r = −0.731, p = 0.000; r = −0.749, p = 0.000, respectively). No significant correlation was found between FHP and tone, stiffness, and elasticity of the MT, LT, SCM, SC, PM, and SA muscles. Conclusions: Since the UT was the muscle in which changes in mechanical properties were first induced by FHP, an approach targeting UT is necessary as a priority when treating patients with FHP. Full article

Leptospirosis, a global zoonotic disease caused by Leptospira spp., presents high morbidity and mortality risks, especially in tropical regions like Thailand. Military personnel deployed in endemic areas, such as during the Cobra Gold Joint exercise, face heightened exposure. This study assessed Leptospira’s prevalence in rodents and environmental reservoirs at military training sites from 2017 to 2022. A surveillance program was conducted at Engineering Civil Assistance Program (ENCAP) training sites using real-time PCR, dark-field microscopy, and 16S rRNA gene sequencing to detect Leptospira in rodents and environmental samples. Results showed a 1.3% infection rate in rodents (15 of 1161), while Leptospira was detected in 10.2% of water samples (42 of 413) and 23.1% of soil samples (30 of 130). Diverse Leptospira interrogans strains circulated among rodents, and three groups of naturally circulating Leptospira strains were detected in environmental reservoirs. These findings underscore Leptospira’s survival and transmission potential within exercise sites, informing Force Health Protection (FHP) decisions. By integrating pre-exercise data on primary hosts and environmental reservoirs with historical local outbreak records and research on risk factors, this study identifies key areas for public health intervention and potential mitigation strategies. Full article

Serrated polyposis syndrome (SPS) is characterized by the development of multiple colorectal serrated polyps and increased predisposition to colorectal cancer (CRC). However, the molecular basis of SPS, especially in cases presenting family history of SPS and/or polyps and/or CRC in first-degree relatives (SPS-FHP/CRC), is still poorly understood. In a previous study, we proposed the existence of two molecular entities amongst SPS-FHP/CRC families, proximal/whole-colon and distal SPS-FHP/CRC, according to the preferential location of lesions and somatic events involved in tumor initiation. In the present study, we aimed to investigate these distinct subgroups of SPS patients in a larger cohort at the germline level and to identify the genetic defects underlying an inherited susceptibility for these two entities. Next-generation sequencing was performed using multigene analysis with a custom-designed panel in a Miseq platform in 60 SPS patients (with and without/unknown FHP/CRC). We found germline pathogenic variants in 6/60 patients (ATM, FANCM, MITF, RAD50, RAD51C, and RNF43). We also found variants of unknown significance (VUS), with prediction of probable damaging effect in 23/60 patients (ATM, BLM, BRCA1, FAN1, ERCC2, ERCC3, FANCA, FANCD2, FANCL, MSH2, MSH6, NTHL1, PALB2, PDGFRA, PMS2, PTCH1, RAD51C, RAD51D, RECQL4, TSC2, WRN, and XRCC5 genes). Most variants were detected in gene coding for proteins of the Fanconi Anemia (FA) pathway involved in the DNA Interstrand-Cross Link repair (ICLR). Notably, variants in ICLR genes were significantly more frequent in the proximal/whole-colon than in the distal subgroup [15/44 (34%) vs 1/16 (6%), p = 0.025], as opposed to the non-ICLR genes that were slightly more frequent in the distal group [8/44 (18%) vs. 5/16 (31%), p > 0.05]. Germline defects in the DNA-ICLR genes may contribute to increased serrated colorectal polyps/carcinoma risk in SPS patients, particularly in proximal/whole-colon SPS. The inclusion of DNA-ICLR genes in the genetic diagnosis of SPS patients, mainly in those with proximal/whole-colon lesions, should be considered and validated by other studies. In addition, patients with germline defects in the DNA-ICLR genes may be more sensitive to treatment with platinum-based therapeutics, which can have implications in the clinical management of these patients. Full article

Forward head posture (FHP) has become a prevailing health issue in modern society as people spend more time on computers and smartphones. FHP is a posture where the head is forward and the anterior and posterior curvatures of the lower cervical and upper thoracic spines are both, respectively, exaggerated. FHP is often associated with neck pain, bad static balance, and hunched shoulders or back. To prevent this, consciously maintaining good posture is important. Therefore, in this study, we propose a system that gives users real-time, accurate information about their neck posture, and it also encourages them to maintain a good posture. This inexpensive system utilizes a single inertial measurement unit sensor and a Raspberry Pi system to detect the changes in state that can progress to an FHP. It retrieves data from the sensor attached to the user’s cervical spine to indicate their real-time posture. In a real-world office environment experiment with ten male participants, the system accurately detected the transition to the FHP state for more than 10 s, with a delay of less than 0.5 s, and it also provided personalized feedback to encourage them to maintain good posture. All ten participants recognized that their average craniovertebral angle had to be increased after receiving visual alerts regarding their poor postures in real time. The results indicate that the system has potential for widespread applications. Full article

Introduction: Hypersensitivity pneumonitis (HP) is an interstitial inflammatory lung disease that develops as a result of exposition to various, mostly organic antigens. In some patients, fibrotic HP is diagnosed. Factors predisposing to the development of fibrotic lung disease in HP patients are not well documented in the literature. The genetic susceptibility of the patient, type of inciting antigen, and type of exposure, as well as various demographic and clinical variables, may influence the fibrotic process. Aim: The aim of the present study was to investigate whether the type of inciting antigen increases the risk of fibrotic lung disease in HP patients. Methods: Clinical data of consecutive patients with HP diagnosed between 2019 and 2023 were retrospectively reviewed. The exposition to the inciting antigens was investigated by the standardized questionnaire. Recent HP classification into fibrotic (fHP) and non-fibrotic (non-fHP) types was applied. Results: Sixty-six patients diagnosed with HP were analyzed. All patients filled out the exposure questionnaire, and 62 (94%) reported at least one possible exposure. The most prevalent exposures reported were avian, water systems, feather duvets, and hay/straw. Exposure to avian antigens as well as to coal/biomass heating were significantly more prevalent among patients with fHP compared to those with non-fHP (70% vs. 40%, p = 0.03 and 27% vs. 5%, p = 0.04, respectively). Nevertheless, in the multivariate analysis, older age at diagnosis was the only factor influencing the development of fHP (OR 1.064, 95% CI 1.004 to 1.138, p = 0.04). Reported avian antigen exposure correlated well with positive precipitins to avian antigens, whereas no correlation was found between hay/straw exposure and positive antibodies to termophilic actinomycetes. Conclusions: Exposure to birds and coal heating was the most frequently present factor in subjects with fHP, but only older age at diagnosis remained a significant fHP predictor in the multifactor analysis. Full article

Background: Recent studies have found forward head posture (FHP) is associated with altered physiology. There is a lack of research into whether FHP is associated with altered gait parameters when cognitively challenged. Our hypothesis is that individuals with FHP and those without will demonstrate different responses when undergoing dual-task assessment. Methods: Forty-five asymptomatic participants with FHP, defined as a craniovertebral angle (CVA) < 50°, were matched to forty-five participants with normal head posture (NHP) with a CVA > 55°. Participants walked along a 10 m platform under a control condition (no cognitive load) while an optical motion-capture system assessed gait kinematics. Secondly, participants were assessed under a dual-task cognitive load condition to identify the impact on gait kinematics. Results: Under the single-task condition, there were no significant differences for any gait parameter. In the dual-task condition, 12/13 gait parameters were significantly altered for the FHP vs. NHP group (p < 0.01). A calculation of the dual-task cost (DTC) percentage showed significant increases in all gait parameters in participants with FHP (p < 0.02). Correlations between the CVA and gait parameters were not significant for the single-task condition, but all gait parameters were correlated to CVA for the dual-task condition (p < 0.01). The correlation between CVA and DTC for all gait variables was significant (p < 0.04). Conclusions: This study demonstrates that FHP significantly increases the cognitive cost during walking, highlighting the importance of proper postural alignment for maintaining cognitive function under a dual-task condition. Full article

(1) Background and objectives: Running-related injuries (RRIs) are commonly attributed to improper running posture and overuse. This study aims to analyze the running motions of individuals with and without RRIs using a sensor-free method, which offers a user-friendly and straightforward approach. (2) Materials and Methods: A total of 155 runners were divided into two groups: the normal runner group (runners who had never been injured, n = 50) and the RRI group (runners who had experience at least one injury while running, n = 105). The forward head posture (FHP), trunk lean, hip rotation, horizontal movement of the center of gravity (COG), vertical movement of the COG, pelvic rotation, hip hike, and type of strike were measured for posture analysis. (3) Results: We found that the left–right balance of the pelvis and the spinal posture during running were associated with RRIs. The difference in hip hike and FHP emerged as key predictors of running-related musculoskeletal injury occurrence from our logistic regression analysis. (4) Conclusions: Identifying pathological movements in runners through running motion analysis without the use of sensors can be instrumental in the prevention and treatment of RRIs. Full article

Currently, the market for wearable devices is expanding, with a growing trend towards the use of these devices for continuous-monitoring applications. Among these, real-time posture monitoring and assessment stands out as a crucial application given the rising prevalence of conditions like forward head posture (FHP). This paper proposes a wearable device that combines the acquisition of electromyographic signals from the cervical region with inertial data from inertial measurement units (IMUs) to assess the occurrence of FHP. To improve electronics integration and wearability, e-textiles are explored for the development of surface electrodes and conductive tracks that connect the different electronic modules. Tensile strength and abrasion tests of 22 samples consisting of textile electrodes and conductive tracks produced with three fiber types (two from Shieldex and one from Imbut) were conducted. Imbut’s Elitex fiber outperformed Shieldex’s fibers in both tests. The developed surface electromyography (sEMG) acquisition hardware and textile electrodes were also tested and benchmarked against an electromyography (EMG) gold standard in dynamic and isometric conditions, with results showing slightly better root mean square error (RMSE) values (for 4 × 2 textile electrodes (10.02%) in comparison to commercial Ag/AgCl electrodes (11.11%). The posture monitoring module was also validated in terms of joint angle estimation and presented an overall error of 4.77° for a controlled angular velocity of 40°/s as benchmarked against a UR10 robotic arm. Full article