Challenging trophic position assessments in complex ecosystems: Calculation method, choice of baseline, trophic enrichment factors, season and feeding guild do matter: A case study from Marquesas Islands coral reefs.

Assessments of ecosystem functioning are a fundamental ecological challenge and an essential foundation for ecosystem-based management. Species trophic position (TP) is essential to characterize food web architecture. However, despite the intuitive nature of the concept, empirically estimating TP is a challenging task due to the complexity of trophic interaction networks. Various methods are proposed to assess TPs, including using different sources of organic matter at the base of the food web (the 'baseline'). However, it is often not clear which methodological approach and which baseline choices are the most reliable. Using an ecosystem-wide assessment of a tropical reef (Marquesas Islands, with available data for 70 coral reef invertebrate and fish species), we tested whether different commonly used TP estimation methods yield similar results and, if not, whether it is possible to identify the most reliable method. We found significant differences in TP estimates of up to 1.7 TPs for the same species, depending on the method and the baseline used. When using bulk stable isotope data, the choice of the baseline significantly impacted TP values. Indeed, while nitrogen stable isotope (δ15N) values of macroalgae led to consistent TP estimates, those using phytoplankton generated unrealistically low TP estimates. The use of a conventional enrichment factor (i.e. 3.4‰) or a 'variable' enrichment factor (i.e. according to feeding guilds) also produced clear discrepancies between TP estimates. TPs obtained with δ15N values of source amino acids (compound-specific isotope analysis) were close to those assessed with macroalgae. An opposite seasonal pattern was found, with significantly lower TPs in winter than in summer for most species, with particularly pronounced differences for lower TP species. We use the observed differences to discuss possible drivers of the diverging TP estimates and the potential ecological implications.

Playing position and match location affect the number of high-intensity efforts more than the quality of the opposition in elite football players.

This study aimed to examine the impact of playing position (PP), match location (ML), and opposition standard (OS) on team and individual acceleration (ACC) and deceleration (DEC) efforts. Fifty professional football players were monitored across 24 English Premier Development League matches during the 2020/21 season. High-intensity ACC and DEC thresholds were set at > +3 m · s-2 and < -3 m · s-2, respectively. Players were divided into five PPs: centre backs (CB; n = 68), full-backs (FB; n = 24), centre midfielders (CM; n = 54), wide midfielders (WM; n = 15), centre forwards (CF; n = 27). Opposition standard was categorised as Top (1st-4th), Middle (5th-9th), and Bottom (9th-13th) based on final league ranking of the study season. Each match location was classified as Home or Away. One way analysis of variance (ANOVA) and a multivariate ANOVA analysed the independent effect of PP, ML and OS on ACC and DEC efforts, and the interaction of all contextual factors, respectively. Acceleration efforts were affected by PP and ML. FB performed 22% more ACC than WM. All players performed 6% more ACC actions during home matches compared to away fixtures. DEC efforts were only affected by PP, with FB and CM executing 26% and 32% greater DEC efforts than CB, respectively. When playing against top or middle teams at home, CB, CM, and CF tended to perform more high-intensity actions than when playing away. In contrast, when playing against top teams at home, FB and WM performed fewer high-intensity actions than when playing away. Playing position and ML affected ACC and DEC actions but not OS.

JointTracker: Real-time inertial kinematic chain tracking with joint position estimation.

In-field human motion capture (HMC) is drawing increasing attention due to the multitude of application areas. Plenty of research is currently invested in camera-based (markerless) HMC, with the advantage of no infrastructure being required on the body, and additional context information being available from the surroundings. However, the inherent drawbacks of camera-based approaches are the limited field of view and occlusions. In contrast, inertial HMC (IHMC) does not suffer from occlusions, thus being a promising approach for capturing human motion outside the laboratory. However, one major challenge of such methods is the necessity of spatial registration. Typically, during a predefined calibration sequence, the orientation and location of each inertial sensor are registered with respect to the underlying skeleton model. This work contributes to calibration-free IHMC, as it proposes a recursive estimator for the simultaneous online estimation of all sensor poses and joint positions of a kinematic chain model like the human skeleton. The full derivation from an optimization objective is provided. The approach can directly be applied to a synchronized data stream from a body-mounted inertial sensor network. Successful evaluations are demonstrated on noisy simulated data from a three-link chain, real lower-body walking data from 25 young, healthy persons, and walking data captured from a humanoid robot. The estimated and derived quantities, global and relative sensor orientations, joint positions, and segment lengths can be exploited for human motion analysis and anthropometric measurements, as well as in the context of hybrid markerless visual-inertial HMC.

Effects of three-dimensional femur and tibia postures on the parameters of standing long-leg radiographs for osteoarthritic knees in elderly female subjects.

BACKGROUND: Long-leg frontal radiographs of the lower extremities are used to assess knee osteoarthritis. Given the three-dimensional (3D) nature of alignment changes in osteoarthritis, postural alterations in the femur and tibia extend beyond the coronal plane (in-plane) to include the transverse and sagittal planes (out-of-plane). This study investigates the impact of these out-of-plane factors on in-plane knee alignment parameters observed in frontal radiographs. METHODS: A total of 97 osteoarthritic knees in women were examined. Using a 3D-to-two-dimensional (2D) image matching technique, we evaluated the 3D postures of the femur and tibia in the standing position as viewed from frontal radiographs in the world coordinate system. Statistical analyses were conducted to explore associations between these 3D postures and 2D alignment parameters obtained from frontal radiographs under identical conditions. FINDINGS: The femur exhibited a medial inclination of 2.7°, a posterior inclination of 3.9°, and an internal rotation of 4.2°, whereas the tibia showed a lateral inclination of 6.4°, an anterior inclination of 6.7°, and an internal rotation of 6.7°. Both coronal and rotational postures of femur and tibia influenced the hip-knee-ankle angle, mechanical axis percentage, and medial proximal tibial angle. However, only coronal factors of tibia impacted tibial joint line obliquity relative to the floor. INTERPRETATION: Attention should be paid to the potential impact of the out-of-plane postures of the femur and tibia on parameters assessed in plain frontal radiographs of the lower extremities.

SymTC: A symbiotic Transformer-CNN net for instance segmentation of lumbar spine MRI.

Intervertebral disc disease, a prevalent ailment, frequently leads to intermittent or persistent low back pain, and diagnosing and assessing of this disease rely on accurate measurement of vertebral bone and intervertebral disc geometries from lumbar MR images. Deep neural network (DNN) models may assist clinicians with more efficient image segmentation of individual instances (discs and vertebrae) of the lumbar spine in an automated way, which is termed as instance image segmentation. In this work, we proposed SymTC, an innovative lumbar spine MR image segmentation model that combines the strengths of Transformer and Convolutional Neural Network (CNN). Specifically, we designed a parallel dual-path architecture to merge CNN layers and Transformer layers, and we integrated a novel position embedding into the self-attention module of Transformer, enhancing the utilization of positional information for more accurate segmentation. To further improve model performance, we introduced a new data synthesis technique to create synthetic yet realistic MR image dataset, named SSMSpine, which is made publicly available. We evaluated our SymTC and the other 16 representative image segmentation models on our private in-house dataset and public SSMSpine dataset, using two metrics, Dice Similarity Coefficient and the 95th percentile Hausdorff Distance. The results indicate that SymTC surpasses the other 16 methods, achieving the highest dice score of 96.169 % for segmenting vertebral bones and intervertebral discs on the SSMSpine dataset. The SymTC code and SSMSpine dataset are publicly available at https://github.com/jiasongchen/SymTC.

The effect on back pain, anxiety, and comfort levels of an elevated supine position and back support applied to patients undergoing coronary angiography: A randomized controlled experimental study.

OBJECTIVES: To determine the effect of elevated supine position with back support on back pain, anxiety and comfort in patients undergoing coronary angiography. METHODS: This randomized-controlled, experimental study was conducted in the Coronary Intensive Care Unit between September 2021 and January 2022, with an intervention group of 51 patients and a control group of 53 patients. Data were collected using a patient information form, a visual analog scale, the anxiety state inventory and the immobilization comfort questionnaire. Following angiography, the intervention group received pillow support to the back and the bedhead was elevated to 30 degrees. Routine nursing care was applied to the control group. In both groups, the severity of back pain was measured at 0, 2, and 4 hours, and anxiety and comfort at 0 and 4 hours. RESULTS: The pain severity at 2 and 4 hours after the procedure was determined to be significantly lower in the intervention group than in the control group (p<0.001, p<0.001). At 4 hours, the anxiety levels were similar in both groups (p<0.05), and the comfort level was higher in the intervention group (p<0.001). The mean pain value was 6.003 points lower and the comfort level was 20.499 points higher in the intervention group than in the control group. CONCLUSION: The elevated supine position with back support was seen to reduce back pain, increase comfort, and did not change anxiety levels.Clinical Trials No: NCT05546216.

Finite element analysis of mechanical stress in a cementless tapered-wedge short stem in the varus position.

BACKGROUND: In recent years, the use of tapered-wedge short stems has increased due to their ability to preserve bones and tendons. Surgical techniques occasionally result in a varus position of the stem, which is particularly pronounced in short stems. Although the varus position is not clinically problematic, there are reports of an increased incidence of stress shielding and cortical hypertrophy. Thus, we evaluated and examined the acceptable range of varus angles using finite element analysis. METHODS: Patients diagnosed with osteoarthritis of the hip joint who had undergone arthroplasty were selected and classified into three types [champagne-flute (type A), intermediate (type B), and stovepipe (type C)]. Finite element analysis was performed using Mechanical Finder. The model was created using a Taperloc microplasty stem with the varus angle increased by 1° from 0° to 5° from the bone axis and classified into seven zones based on Gruen's zone classification under loading conditions in a one-leg standing position. The volume of interest was set, the mean equivalent stress for each zone was calculated. RESULTS: A significant decrease in stress was observed in zone 2, and increased stress was observed in zones 3 and 4, suggesting the emergence of a distal periosteal reaction, similar to the results of previous studies. In zone 2, there was a significant decrease in stress in all groups at a varus angle ≥ 3°. In zone 3, stress increased from ≥ 3° in type B and ≥ 4° in type C. In zone 4, there was a significant increase in stress at varus angles of ≥ 2° in types A and B and at ≥ 3° in type C. CONCLUSION: In zone 2, the varus angle at which stress shielding above Engh classification grade 3 may appear is expected to be ≥ 3°. Distal cortical hypertrophy may appear in zones 3 and 4; the narrower the medullary cavity shape, the smaller the allowable angle of internal recession, and the wider the medullary cavity shape, the wider the allowable range. Long-term follow-up is required in patients with varus angles > 3°.

Component rotational mismatch in the standing position is a potential risk factor for unfavourable functional outcomes after total knee arthroplasty.

Purpose: This study assessed rotational mismatch between components after total knee arthroplasty (TKA) in the supine and standing positions and aimed to investigate the effect of rotational mismatch in the standing position on postoperative patient-reported outcome measures (PROMs). Methods: Seventy-one patients (71 knees) who underwent TKA for medial knee osteoarthritis were used to investigate rotational mismatches between components. Rotational mismatches between components were examined on postoperative standing whole-leg and supine knee radiographs using a three-dimensional-to-two-dimensional model image registration technique, and the angles between the reference axes of the components were measured. Component alignment was evaluated using postoperative computed tomography images, and a questionnaire (2011 version of the Knee Society Score: [KSS 2011]) was mailed to investigate postoperative PROMs. Results: In the entire cohort, rotational mismatches in the supine and standing positions were similar (p = 0.9315). In 15% of patients, the mismatch was large (>5°) in the supine position but small (<5°) in the standing position (overestimated group). However, in 23% of patients, the mismatch was small (<5°) in the supine position and large (>5°) in the standing position (underestimated group). The underestimated group had severe preoperative varus deformity, resulting in external rotation of both femoral and tibial components. Rotational mismatch in the standing position (p = 0.0032) was a significant risk factor for unfavourable PROMs. Patients with a mismatch in the standing position had significantly lower scores than those without a mismatch (p = 0.0215), exceeding the minimal clinically important difference values. Conclusions: The underestimated group is clinically important because the surgical procedure and intraoperative assessment of component placement are performed in the supine position. In cases of severe preoperative varus deformity, care should be taken not to place the component in malrotation to avoid rotational mismatch in the standing position. Level of Evidence: Ⅳ, Case series.

Rapid generation of single-insertion transgenics by Tol2 transposition in zebrafish.

BACKGROUND: The Tol2 transposable element is the most widely used transgenesis tool in zebrafish. However, its high activity almost always leads to multiple unlinked integrations of the transgenic cassette in F1 fish. Each of these transgenes is susceptible to positional effects from the surrounding regulatory landscape, which can lead to altered expression and, consequently, activity. Scientists therefore must strike a balance between the need to maximize reproducibility by establishing single-insertion transgenic lines and the need to complete experiments within a reasonable timeframe. RESULTS: In this article, we introduce a simple competitive dilution strategy for rapid generation of single-insertion transgenics. By using cry:BFP reporter plasmid as a competitor, we achieved a nearly fourfold reduction in the number of the transgene of interest integrations while simultaneously increasing the proportion of single-insertion F1 generation transgenics to over 50%. We also observed variations in transgene of interest expression among independent single-insertion transgenics, highlighting that the commonly used ubiquitous ubb promoter is susceptible to position effects. CONCLUSIONS: Wide application of our competitive dilution strategy will save time, reduce animal usage, and improve reproducibility of zebrafish research.

Accuracy of oscillometric noninvasive blood pressure at the ankle in the lateral position during general anesthesia.

BACKGROUND: This study aimed to evaluate the accuracy of ankle blood pressure measurements in relation to invasive blood pressure in the lateral position. METHODS: This prospective observational study included adult patients scheduled for elective non-cardiac surgery under general anesthesia in the lateral position. Paired radial artery invasive and ankle noninvasive blood pressure readings were recorded in the lateral position using GE Carescape B650 monitor. The primary outcome was the ability of ankle mean arterial pressure (MAP) to detect hypotension (MAP < 70 mmHg) using area under the receiver operating characteristic curve (AUC) analysis. The secondary outcomes were the ability of ankle systolic blood pressure (SBP) to detect hypertension (SBP > 140 mmHg) as well as bias (invasive measurement - noninvasive measurement), and agreement between the two methods using the Bland-Altman analysis. RESULTS: We analyzed 415 paired readings from 30 patients. The AUC (95% confidence interval [CI]) of ankle MAP for detecting hypotension was 0.88 (0.83-0.93). An ankle MAP of ≤ 86 mmHg had negative and positive predictive values (95% CI) of 99 (97-100)% and 21 (15-29)%, respectively, for detecting hypotension. The AUC (95% CI) of ankle SBP to detect hypertension was 0.83 (0.79-0.86) with negative and positive predictive values (95% CI) of 95 (92-97)% and 36 (26-46)%, respectively, at a cutoff value of > 144 mmHg. The mean bias between the two methods was - 12 ± 17, 3 ± 12, and - 1 ± 11 mmHg for the SBP, diastolic blood pressure, and MAP, respectively. CONCLUSION: In patients under general anesthesia in the lateral position, ankle blood pressure measurements are not interchangeable with the corresponding invasive measurements. However, an ankle MAP > 86 mmHg can exclude hypotension with 99% accuracy, and an ankle SBP < 144 mmHg can exclude hypertension with 95% accuracy.

Omnidirectional image super-resolution via position attention network.

For convenient transmission, omnidirectional images (ODIs) usually follow the equirectangular projection (ERP) format and are low-resolution. To provide better immersive experience, omnidirectional image super resolution (ODISR) is essential. However, ERP ODIs suffer from serious geometric distortion and pixel stretching across latitudes, generating massive redundant information at high latitudes. This characteristic poses a huge challenge for the traditional SR methods, which can only obtain the suboptimal ODISR performance. To address this issue, we propose a novel position attention network (PAN) for ODISR in this paper. Specifically, a two-branch structure is introduced, in which the basic enhancement branch (BE) serves to achieve coarse deep feature enhancement for extracted shallow features. Meanwhile, the position attention enhancement branch (PAE) builds a positional attention mechanism to dynamically adjust the contribution of features at different latitudes in the ERP representation according to their positions and stretching degrees, which achieves the enhancement for the differentiated information, suppresses the redundant information, and modulate the deep features with spatial distortion. Subsequently, the features of two branches are fused effectively to achieve the further refinement and adapt the distortion characteristic of ODIs. After that, we exploit a long-term memory module (LM), promoting information interactions and fusions between the branches to enhance the perception of the distortion, aggregating the prior hierarchical features to keep the long-term memory and boosting the ODISR performance. Extensive results demonstrate the state-of-the-art performance and the high efficiency of our PAN in ODISR.

A proposed novel digital condylar position adjustment technique to help restore a normal disc-condyle relationship.

Objectives: To demonstrate a novel digital technique that enables real-time visualisation of occlusal transfer and adjustment of condyle position, to (1) improve the repeatability of occlusal transfer and the accuracy of condyle position adjustment and (2) be clinically effective in helping to restore the disc-condyle relationship. Materials and methods: Three participants were included in the study and underwent facebow transfers using two different methods. The digital method used patient-related three-dimensional imaging data matched with digital dental casts for occlusal transfer. The conventional method used anatomical facebows. The condylar position was adjusted based on occlusal transfer results. The results were evaluated and compared in three dimensions. In addition, clinical application data from 36 patients were analysed before and after condylar position adjustment. Statistical significance was set at p < 0.05. Results: Differences in the spatial positions of the three anatomical structures reproduced by both methods were statistically significant (p = 0.000). After adjusting the rotation of the condylar position, the positional deviation of the condylar point along the X- and Z-axes was significantly lower in the digital group (p < 0.05). After adjustment for translation (X and Z), the positional deviation showed no difference along the X- and Z-axes (p > 0.05) but a significant difference along the Y-axis (p < 0.001). Conclusion: A novel digital technique for occlusal transfer and condylar position adjustment was presented. This technique simplifies clinical practice, improves the accuracy of results, and can help restore a normal disc-condyle relationship.

Assessment of the Acceptable Range of Lips and Chin Position in Two Different Geographical Zones of Iran among Laypersons.

Statement of the Problem: The position of the chin and lips are important components in the lower third of the face and can be changed by orthodontic treatment. It seems that factors such as diversity in culture, ethnicity, and place of residence are among the factors affecting people's perception of beauty. Iran, as a vast country, contains different ethnicities and cultures, and of course, it is not exempt from this point of view. Purpose: Our purpose of conducting this study is to investigate the impact of the difference in living environment and culture on people's aesthetic perception. Orthodontists and oral surgeons can use these data to choose the best treatment plan for the patients according to their geographical zones. Material and Method: A descriptive cross-sectional study was conducted to evaluate the perception of lips and chin position. A series of 25 profile images were prepared in 5 sets. Each set contained 5 profile images. Northern and Southern lay people and orthodontists were asked to evaluate the profile series of each set in 1 session and score them from 1 to 5: 1, very unattractive; 2, unattractive; 3, neither attractive nor unattractive; 4, attractive; or 5, very attractive. Results: 652 participants in 3 groups, including 16 orthodontists (10 men and 6 women), 318 lay people of the North of Iran (172 men and 138 women), and 318 lay people of the South of Iran (175 men and 139 women) participated in this study. Regardless of the chin position, normal lip position and slight changes of that (in both protruded and retruded positions) were more favorable for all three groups. The images with moderately retruded lips were scored as the least attractive by all three groups and orthodontist gave the lowest score to these profiles. Southern people could better tolerate moderately retruded lips than other two groups. In the fifth series, orthodontists preferred slightly and moderately protruded lips in comparison to other two groups of laypeople. Conclusion: Regardless of the chin position, normal and slightly (-2mm to +2mm) protruded and retruded lips were more favorable in all three groups. Southern people could better tolerate moderately retruded lips than the two other groups.

Towards accurate abdominal tumor segmentation: A 2D model with Position-Aware and Key Slice Feature Sharing.

Abdominal tumor segmentation is a crucial yet challenging step during the screening and diagnosis of tumors. While 3D segmentation models provide powerful performance, they demand substantial computational resources. Additionally, in 3D data, tumors often represent a small portion, leading to imbalanced data and potentially overlooking crucial information. Conversely, 2D segmentation models have a lightweight structure, but disregard the inter-slice correlation, risking the loss of tumor in edge slices. To address these challenges, this paper proposes a novel Position-Aware and Key Slice Feature Sharing 2D tumor segmentation model (PAKS-Net). Leveraging the Swin-Transformer, we effectively model the global features within each slice, facilitating essential information extraction. Furthermore, we introduce a Position-Aware module to capture the spatial relationship between tumors and their corresponding organs, mitigating noise and interference from surrounding organ tissues. To enhance the edge slice segmentation accuracy, we employ key slices to assist in the segmentation of other slices to prioritize tumor regions. Through extensive experiments on three abdominal tumor segmentation CT datasets and a lung tumor segmentation CT dataset, PAKS-Net demonstrates superior performance, reaching 0.893, 0.769, 0.598 and 0.738 tumor DSC on the KiTS19, LiTS17, pancreas and LOTUS datasets, surpassing 3D segmentation models, while remaining computationally efficient with fewer parameters.

A method for calculating vector forces at human-mattress interface during sleeping positions utilizing image registration.

The vector forces at the human-mattress interface are not only crucial for understanding the distribution of vertical and shear forces exerted on the human body during sleep but also serves as a significant input for biomechanical models of sleeping positions, whose accuracy determines the credibility of predicting musculoskeletal system loads. In this study, we introduce a novel method for calculating the interface vector forces. By recording indentations after supine and lateral positions using a vacuum mattress and 3D scanner, we utilize image registration techniques to align body pressure distribution with the mattress deformation scanning images, thereby calculating the vector force values for each unit area (36.25 mm × 36.25 mm). This method was validated through five participants attendance from two perspectives, revealing that (1) the mean summation of the vertical force components is 98.67% ± 7.21% body weight, exhibiting good consistency, and mean ratio of horizontal component force to body weight is 2.18% ± 1.77%. (2) the predicted muscle activity using the vector forces as input to the sleep position model aligns with the measured muscle activity (%MVC), with correlation coefficient over 0.7. The proposed method contributes to the vector force distribution understanding and the analysis of musculoskeletal loads during sleep, providing valuable insights for mattress design and evaluation.

Assessing bolus peak position in CT perfusion: High variance persisting despite age-dependency in a large cohort.

PURPOSE: CT perfusion (CTP) is a valuable tool in suspected acute ischemic stroke. A substantial variability of the delay between contrast injection and bolus arrival in the brain is conceivable. We investigated the distribution of the peak positions of the concentration time curves measured in an artery (arterial input function, AIF) and - in cases with ischemia - also measured in the penumbra. METHODS: We report on 2624 perfusion scans (52 % female, mean age 72.2 ± 14.4 years) with stroke present in 1636 cases. From the attenuation time curves of the AIF and the penumbra, we calculated the respective bolus peak positions and investigated the distribution of the peak positions. Further, we analyzed the bolus peak positions for associations with age. RESULTS: The bolus peaked significantly later in older patients, both in the AIF and in the penumbra (all p < 0.001). In the whole cohort, we found a significant association of age with the bolus peak position of the AIF (ρ = 0.334; p < 0.001). In patients with stroke, age was also associated to the peak position of the AIF (ρ = 0.305; p < 0.001), and the penumbra (ρ = 0.246, p < 0.001). However, a substantial range of peak positions of the AIF and penumbra was noted across all age ranges. CONCLUSIONS: This study revealed a strong age-dependency of the contrast bolus arrival in both healthy and ischemic tissue. This variability makes non-uniform sampling schemes, which have been suggested to reduce radiation dose, problematic, as they might not always optimally capture the bolus in all cases.

Enhancing the Unicompartmental Knee Arthroplasty Safety via Finite Element Analysis of Coronary Plane Alignment: A Case Report.

Although Oxford unicompartmental knee arthroplasty is often used to successfully treat patients with knee osteoarthritis isolated at the medial compartment, we present a case of fracture just below the tibial keel caused by either a shift in medial loading position or an increased amount of tibial osteotomy. Finite element analysis was used to determine which factor was more important. First, a 3D-surface model of the patient's tibia and the implant shape were created using computed tomography-Digital Imaging and Communications in Medicine (CT-DICOM) data taken preoperatively. The finite element analysis found that following unicompartmental knee arthroplasty, the cortical stress (normal, 5.8 MPa) on the medial tibial metaphyseal cortex increased as the load point moved medially (3 and 12 mm medially: 7.0 and 10.7 MPa, respectively) but was mild with increased tibial bone resection (2 and 6 mm lower: 6.1 and 6.5 MPa, respectively). Implanting the femoral component more medially than the preoperative plan increases stresses in the medial cortex of the tibia and may cause fractures.

Congenital Fibrosis of Extraocular Muscles: A Retrospective Study of 76 Patients.

Background Congenital fibrosis of the extraocular muscles (CFEOM) is a non-progressive sporadic or familial disease characterized by abnormal innervation of the extraocular muscles. This study aims to evaluate the types of diseases, management steps, and surgical outcomes. Methodology A total of 76 patients diagnosed with CFEOM between 2000 and 2022 were evaluated retrospectively. Patients were divided into CFEOM 1, 2, or 3 based on clinical findings. Preoperative and postoperative ocular deviations, as well as abnormal head positions (AHPs), of the patients were evaluated. Excellent outcomes for the head position were defined as less than 5°, good as less than 10°, and poor as greater than 10°. Excellent alignment for strabismus was considered to be less than 10 prism diopters (PD), good as less than 20 PD, and poor as greater than 20 PD. Results The average age at the first surgery in our clinic was 11.6 (1-51) years. The mean follow-up was 28.6 ± 7.4 months (range = 4-56 months). Type 1 disease was detected in 48 (63.2%) patients, type 2 disease in eight (10.5%), and type 3 disease in 20 (26.3%) patients. Of the 49 patients with AHP, 20 achieved excellent outcomes, 17 had good outcomes, and the remaining had poor outcomes. Ocular alignment in the primary position following the latest surgery was excellent in 30 patients, good in 26 patients, and poor in 20 patients. Conclusions No single best surgical method can be universally applied to every patient diagnosed with CFEOM. Patients must be evaluated individually and carefully, and the appropriate surgical procedure must be chosen. In this way, satisfactory gaze alignment and improvement of the AHP can be achieved.

Research on the characteristics of electro-hydraulic position servo system of RBF neural network under fuzzy rules.

A radial basis function neural network PID controller under fuzzy rules (FUZZY-RBF-PID) was designed for the electro-hydraulic position servo system under the influence of uncertain factors such as load mutation, and load stiffness change. Firstly, the mathematical model of the system is established, and the frequency domain and time domain analysis of the system are carried out. Secondly, based on the analysis results, a radial basis function (RBF) neural network PID controller is designed, and fuzzy rules are innovatively used to adjust the learning rate of PID parameters in the RBF neural network learning algorithm in real time. Thirdly, the simulation results show that under the action of the FUZZY-RBF-PID controller, the unit step response of the system has high steady-state accuracy, fast response speed, and under the condition of large load stiffness, the system can recover to the steady-state value faster after being disturbed. At the same time, when the input signal is the sinusoidal signal of 10 HZ, the system under the action of the FUZZY-RBF-PID controller has no obvious phase lag phenomenon, and the tracking error is minimal. The proposed method can effectively improve the comprehensive performance of the electro-hydraulic position servo system under the influence of uncertain factors.

Impact of Glycemic Control on Shoulder Proprioception in Type 2 Diabetes Mellitus: Mediating the Connection - Insights from a Cross-Sectional Analysis.

Introduction: Shoulder proprioception is vital and this cross-sectional study investigated the association between glycemic control and shoulder joint proprioception in Type 2 Diabetes Mellitus (T2DM). Methods: A total of 120 participants, including 60 with T2DM and 60 healthy individuals, were assessed for shoulder joint position sense (JPS) using a digital inclinometer. The T2DM group exhibited significantly greater mean shoulder joint position errors in flexion (4.32° vs 2.15°), abduction, medial rotation, and lateral rotation compared to the healthy group (p < 0.001). Results: The study found significantly greater shoulder joint position errors in the T2DM group compared to the healthy group, highlighting notable proprioceptive deficits in individuals with T2DM. Additionally, a significant positive correlation was found between HbA1c levels and shoulder joint position errors in the T2DM group, suggesting a link between long-term glycemic control and proprioceptive accuracy. Discussion: The significant positive correlation between HbA1c levels and shoulder joint position errors suggests that poor glycemic control is associated with impaired proprioception in T2DM patients. This underscores the need for comprehensive management strategies to mitigate proprioceptive deficits and improve the quality of life in individuals with T2DM.