Search Results (618)

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: Optic nerve bending and chiasmal compression impair vision in patients with sellar lesions; however, their effect on optic nerve head (ONH) blood flow remains unclear. This study used laser speckle flowgraphy to examine the relationship between clinical features and ONH blood flow in patients with optic nerve bending and chiasmal compression. Methods: This retrospective study included 32 eyes (16 eyes with and 16 without optic nerve bending on the contralateral side) from 16 patients with sellar lesions. The best-corrected visual acuity (BCVA), simple visual field impairment score (SVFIS), optic nerve head mean blur rate (ONH-MBR), and six-segmented macular ganglion cell layer + inner plexiform layer (GCL + IPL) thickness were examined. Results: Preoperative BCVA and SVFIS in eyes with optic nerve bending were significantly worse than those in eyes without bending, and significantly correlated with the optic nerve-canal bending angle (ONCBA). After tumor resection, BCVA and SVFIS significantly improved in both groups. Preoperative ONH-MBR was significantly lower in bending eyes but increased significantly post-treatment in both groups. Preoperative ONH-MBR correlated with ONCBA, while postoperative ONH-MBR correlated with nasal GCL + IPL thickness. Conclusions: Optic nerve bending and chiasmal compression showed reduced blood flow to the ONH. These changes in blood flow may be associated with GCL + IPL thickness and optic nerve bending angle. Full article

Introduction: Downbeat nystagmus (DBN) is an ocular motor disorder characterized by persistent to-and-fro eye movements with a slow phase directed upwards and a corrective fast phase downwards. DBN in the context of myelin oligodendrocyte glycoprotein-associated disorder (MOGAD) represents a rare clinical presentation. Case Presentation: A 24-year-old male with MOGAD presented with DBN, status epilepticus, and longitudinally extensive transverse myelitis (LETM). Intervention: The clinical course, diagnostic findings, and management approach are described in detail within the full report. Outcomes: The patient at follow-up was able to ambulate independently, and his nystagmus had improved. He continued to demonstrate transient DBN on supine positioning and head-shaking test. Conclusions: This case report contributes to the understanding of DBN as a manifestation of MOGAD. The accompanying literature review examines the neuroanatomy, pathophysiology, and emerging therapeutic approaches for DBN, providing context for this unusual presentation. Full article

Background: Generative AI (GenAI) models like ChatGPT have gained significant attention in recent years for their potential applications in healthcare. This study evaluates the concordance of responses generated by ChatGPT (versions 3.5 and 4.0) with the key action statements from the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) clinical practice guidelines (CPGs) for Ménière’s disease translated into Chinese. Methods: Seventeen questions derived from the KAS were translated into Chinese and posed to ChatGPT versions 3.5 and 4.0. Responses were categorized as correct, partially correct, incorrect, or non-answers. Concordance with the guidelines was evaluated, and Fisher’s exact test assessed statistical differences, with significance set at p < 0.05. Comparative analysis between ChatGPT 3.5 and 4.0 was performed. Results: ChatGPT 3.5 demonstrated an 82.4% correctness rate (14 correct, 2 partially correct, 1 non-answer), while ChatGPT 4.0 achieved 94.1% (16 correct, 1 partially correct). Overall, 97.1% of responses were correct or partially correct. ChatGPT 4.0 offered enhanced citation accuracy and text clarity but occasionally included redundant details. No significant difference in correctness rates was observed between the models (p = 0.6012). Conclusions: Both ChatGPT models showed high concordance with the AAO-HNS CPG for MD, with ChatGPT 4.0 exhibiting superior text clarity and citation accuracy. These findings highlight ChatGPT’s potential as a reliable assistant for better healthcare communication and clinical operations. Future research should validate these results across broader medical topics and languages to ensure robust integration of GenAI in healthcare. Full article

Aiming at the complex construction environment and autonomous navigation challenges in underground coal mine roadways, this paper proposes a path navigation and deviation correction control method for tracked roadheaders in confined roadway spaces. First, a two-dimensional planar grid model of the working scenario was constructed, with dimensionality reduction in the roadway model achieved through a heading reference influence degree threshold of the tracked roadheaders. Based on the kinematics theory of tracked roadheaders, kinematic and dynamic models for deviation correction in fully mechanized excavation roadways were established. Subsequently, a path planning and tracking correction algorithm was developed, along with a heading deviation correction control algorithm based on fuzzy neural network PID. Online optimization of the particle swarm algorithm was realized through crossover-mutation operations, enabling optimal strategy solving for construction path planning and precise control of travel deviation correction. Finally, simulation experiments evaluating algorithm performance and comparative simulations of control algorithms validated the feasibility and superiority of the proposed method. This research provides strategic guidance and theoretical foundations for rapid precision deployment and intelligent deviation correction control of tracked engineering vehicles in confined underground coal mine spaces. Full article

The treatment of shoulder dysplasia resulting from brachial plexus birth injury (BPBI) remains a matter of debate within pediatric orthopedic and neurosurgical communities. Various approaches have been proposed to address the muscular imbalance and joint incongruity that develop in affected children, with special attention paid to the roles of humeral head reduction and tendon transfers. Background/Objectives: These procedures aim to correct the disproportionate strength between internal and external rotators of the shoulder. However, the specific contribution of skeletal procedures such as glenoid osteotomy to restoring shoulder mechanics remains controversial. Glenoid osteotomy, a technique that involves surgically reorienting the glenoid cavity, is hypothesized to promote better containment of the humeral head and allow more physiological joint development. On one hand, altering the glenoid axis could enhance joint congruency and facilitate remodeling during growth. On the other hand, there is limited evidence supporting its efficacy and safety. Methods: This review aims to assess the available literature to determine whether glenoid osteotomy represents a safe and effective procedure for patients with BPBI-associated shoulder dysplasia. A comprehensive literature search yielded 1380 titles. After excluding studies focused on adults and those failing to meet inclusion criteria, only three studies were selected for final analysis. Due to the limited data and variability in study design, no statistical meta-analysis could be performed. Results: Findings suggest that glenoid osteotomy, particularly when combined with tendon transfers, may lead to improvements in shoulder abduction and external rotation. However, outcomes are often difficult to interpret in isolation, and the specific benefits attributable to the osteotomy remain unclear. The lack of standardized imaging, follow-up, and scoring systems limits the strength of current conclusions. Conclusions: Further multicenter, prospective studies are needed to evaluate the long-term efficacy of glenoid osteotomy, its role in skeletal remodeling, and its contribution to overall shoulder stability and function. Such studies would help clarify the true potential of this surgical technique in the broader context of BPBI treatment. Full article

Background: In glaucoma screening programs, a large proportion of patients remain free of open-angle glaucoma (OAG) or have no need of intraocular eye pressure (IOP)-lowering therapy within 10 years of follow-up. Is it possible to identify a large proportion of patients already at the initial examination and, thus, to safely exclude them already at this point? Methods: A total of 6889 subjects received a complete ophthalmological examination, including objective optic nerve head and quantitative disc measurements at the initial examination, and after an average follow-up period of 11.1 years, complete data were available of 585 individuals. Two neural network models were trained and extensively tested. To allow the models to refuse to make a prediction in doubtful cases, a reject option was included. Results: A prediction for the first endpoint, ‘remaining OAG-free and no IOP-lowering therapy within 10 years’, was rejected in 57% of cases, and in the remaining cases (43%), 253/253 (=100%) received a correct prediction. The second prediction model for the second endpoint ‘remaining OAG-free within 10 years’ refused to make a prediction for 46.4% of all subjects. In the remaining cases (53.6%), 271/271 (=100%) were correctly predicted. Conclusions: Most importantly, no eye was predicted false-negatively or false-positively. Overall, 43% all eyes can safely be excluded from a glaucoma screening program for up to 10 years to be certain that the eye remains OAG-free and will not need IOP-lowering therapy. The corresponding model significantly reduces the screening performed by and work load of ophthalmologists. In the future, better predictors and models may increase the number of patients with a safe prediction, further economizing time and healthcare budgets in glaucoma screening. Full article

Reliable estimates of aquifer properties are needed for groundwater resources management and for engineering applications. Pumping tests conducted in fractured aquifers using an open borehole may not produce a proper characterization of the aquifer properties leading to the failure of engineering solutions. In this work, we apply a radial flow model to reproduce the time drawdown curves recorded at an observation borehole instrumented with multi-level piezometers drilled in the Permo-Triassic sandstone, which is a complex fractured hydraulic unit. The radial flow model and the optimization code PEST are used to estimate the aquifer hydraulic parameter values. The model is then used to investigate the implications of replacing the multi-level piezometers with an open borehole. The results show that the open borehole does not only significantly alter the groundwater head and flow patterns around the borehole, but the analysis of the time drawdown curve obtained would produce estimates of aquifer properties that bear no relationship with the actual hydraulic properties of the aquifer. For engineering control studies, the pumping test must be carefully designed to account for the presence of fractures, and these must be represented in the analysis tools to ensure the correct characterization of the hydraulic system. Full article

Humanoid robots have attracted considerable attention for their anthropomorphic structure, extended workspace, and versatile capabilities. This paper presents a novel humanoid upper-body robotic system comprising a pair of 8-degree-of-freedom (DOF) arms, a 3-DOF head, and a 3-DOF torso—yielding a 22-DOF architecture inspired by human biomechanics and implemented via standardized hollow joint modules. To overcome the critical reliance of zeroing neural network (ZNN)-based trajectory tracking on the Jacobian matrix derivative, we propose an integration-enhanced matrix derivative observer (IEMDO) that incorporates nonlinear feedback and integral correction. The observer is theoretically proven to ensure asymptotic convergence and enables accurate, real-time estimation of matrix derivatives, addressing a fundamental limitation in conventional ZNN solvers. Workspace analysis reveals that the proposed design achieves an 87.7% larger total workspace and a remarkable 3.683-fold expansion in common workspace compared to conventional dual-arm baselines. Furthermore, the observer demonstrates high estimation accuracy for high-dimensional matrices and strong robustness to noise. When integrated into the ZNN controller, the IEMDO achieves high-precision trajectory tracking in both simulation and real-world experiments. The proposed framework provides a practical and theoretically grounded approach for redundant humanoid arm control. Full article

Head and neck squamous cell carcinomas (HNSCCs) represent a heterogeneous group of tumors with a complex molecular profile. Despite therapeutic advances, patient prognosis remains poor, emphasizing the need for more effective treatment strategies. Traditional chemotherapy, with cisplatin and 5-fluorouracil (5-FU), remains the gold standard but is limited by toxicity and tumor resistance. Immunotherapy, particularly immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1) and its ligand (PD-L1), has improved overall survival, especially in patients with high PD-L1 expression. In parallel, targeted therapies such as poly (ADP-ribose) polymerase 1 (PARP1) inhibitors—which impair DNA repair and increase replication stress—have shown promising activity in HNSCC. Cyclin-dependent kinase (CDK) inhibitors are also under investigation due to their potential to correct dysregulated cell cycle control, a hallmark of HNSCC. This review aims to summarize current and emerging pharmacotherapies for HNSCC, focusing on chemotherapy, immunotherapy, and PARP and CDK inhibitors. It also discusses the evolving role of targeted therapies in improving clinical outcomes. Future research directions include combination therapies, nanotechnology-based delivery systems to enhance treatment specificity, and the development of diagnostic tools such as PARP1-targeted imaging to better guide personalized treatment approaches. Full article

Accurate in vitro models of intestinal permeability are essential for predicting oral drug absorption. Standard models like Caco-2 cells have well-known limitations, including lack of segment-specific physiology, but are widely used. Emerging models such as organoid-derived monolayers and microphysiological systems (MPS) offer enhanced physiological relevance but require comparative validation. We performed a head-to-head evaluation of Caco-2 cells, human jejunal (J2) and duodenal (D109) enteroid-derived cells, and EpiIntestinal^TM tissues cultured on either static Transwell and flow-based MPS platforms. We assessed tissue morphology, barrier function (TEER, dextran leakage), and permeability of three model small molecules (caffeine, propranolol, and indomethacin), integrating the data into a physiologically based gut absorption model (PECAT) to predict human oral bioavailability. J2 and D109 cells demonstrated more physiologically relevant morphology and higher TEER than Caco-2 cells, while the EpiIntestinal^TM model exhibited thicker and more uneven tissue structures with lower TEER and higher passive permeability. MPS cultures offered modest improvements in epithelial architecture but introduced greater variability, especially with enteroid-derived cells. Predictions of human fraction absorbed (F_abs) were most accurate when using static Caco-2 data with segment-specific corrections based on enteroid-derived values, highlighting the utility of combining traditional and advanced in vitro gut models to optimize predictive performance for F_abs. While MPS and enteroid-based systems provide physiological advantages, standard static models remain robust and predictive when used with in silico modeling. Our findings support the need for further refinement of enteroid-MPS integration and advocate for standardized benchmarking across gut model systems to improve translational relevance in drug development and regulatory reviews. Full article

Background/Objectives: Septoplasty is a commonly performed surgical procedure aimed at correcting nasal septal deviations, to improve nasal airflow and respiratory function. Traditional approaches to septal correction rely on either direct visualization or endoscopic guidance. Recently, a novel technology known as exoscopy has been introduced into surgical practice. Exoscopy is an “advanced magnification system” that provides an enlarged, three-dimensional view of the operating field. In this article, we present our experience with exoscope-assisted septoplasty, developed over the last two years, and compare it with our extensive experience using the endoscopic approach. Methods: Our case series includes 26 patients, predominantly males and young adults, who underwent exoscope-assisted septoplasty. We discuss the primary advantages of this technique and, most importantly, provide an analysis of its learning curve. The cohort of patients treated using the exoscopic approach was compared with a control group of 26 patients who underwent endoscope-guided septoplasty, randomly selected from our broader clinical database. Finally, we present a representative surgical case that details all phases of the exoscope-assisted procedure. Results: Our surgical experience has demonstrated that exoscopy is a safe and effective tool for performing septoplasty. Moreover, the learning curve associated with this technique exhibits a rapid and progressive improvement. Notably, exoscopy provides a substantial educational benefit for trainees and medical students, as it enables them to share the same visual perspective as the lead surgeon. Conclusions: Although further studies are required to validate this approach, we believe that exoscopy represents a promising advancement for a wide range of head and neck procedures, and certainly for septoplasty. Full article

Modern electronic devices such as smartphones, wearable devices, and robots typically integrate three-dimensional sensors to track the device’s movement in the 3D space. However, sensor measurements in three-dimensional vectors are highly sensitive to device orientation since a slight change in the device’s tilt or heading can change the vector values. To avoid complications, applications using these sensors often use only the magnitude of the vector, as in geomagnetic-based indoor positioning, or assume fixed device holding postures such as holding a smartphone in portrait mode only. However, using only the magnitude of the vector loses the directional information, while ad hoc posture assumptions work under controlled laboratory conditions but often fail in real-world scenarios. To resolve these problems, we propose a universal vector calibration algorithm that enables consistent three-dimensional vector measurements for the same physical activity, regardless of device orientation. The algorithm works in two stages. First, it transforms vector values in local coordinates to those in global coordinates by calibrating device tilting using pitch and roll angles computed from the initial vector values. Second, it additionally transforms vector values from the global coordinate to a reference coordinate when the target coordinate is different from the global coordinate by correcting yaw rotation to align with application-specific reference coordinate systems. We evaluated our algorithm on geomagnetic field-based indoor positioning and bidirectional step detection. For indoor positioning, our vector calibration achieved an 83.6% reduction in mismatches between sampled magnetic vectors and magnetic field map vectors and reduced the LSTM-based positioning error from 31.14 m to 0.66 m. For bidirectional step detection, the proposed algorithm with vector calibration improved step detection accuracy from 67.63% to 99.25% and forward/backward classification from 65.54% to 100% across various device orientations. Full article

This paper presents a multi-sensor fusion framework for the accurate indoor localization and trajectory tracking of a differential-drive mobile robot. The proposed system integrates Ultra-Wideband (UWB) trilateration, wheel odometry, and Attitude and Heading Reference System (AHRS) data using a Kalman filter. This fusion approach reduces the impact of noisy and inaccurate UWB measurements while correcting odometry drift. The system combines raw UWB distance measurements with wheel encoder readings and heading information from an AHRS to improve robustness and positioning accuracy. Experimental validation was conducted through repeated closed-loop trajectory trials. The results demonstrate that the proposed method significantly outperforms UWB-only localization, yielding reduced noise, enhanced consistency, and lower Dynamic Time Warping (DTW) distances across repetitions. The findings confirm the system’s effectiveness and suitability for real-time mobile robot navigation in indoor environments. Full article