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Despite numerous attempts to correct forward head posture (FHP), definitive evidence-based screening and diagnostic methods remain elusive. This study proposes a preliminary diagnostic methodology for FHP, utilizing a noninvasive body angle measurement system as a screening test for FHP and incorporating radiological parameters for sagittal alignment. We enrolled 145 adolescents for FHP screening. The forward neck tilt angle (FNTA), defined as the angle between the vertical line and the line connecting the participant's acromion and tragus, was measured using the POM-Checker (a noninvasive depth sensor-based body angle measurement system). A whole-spine standing lateral radiograph was obtained, and eight sagittal alignment parameters were measured. Statistical analyses of the association between the FNTA and eight sagittal alignment parameters were conducted. We used 70% of the participant data to establish a preliminary diagnostic model for FHP based on FNTA and each sagittal alignment parameter. The accuracy of the model was evaluated using the remaining 30% of the participant data. All radiological parameters of sagittal alignment showed weak statistical significance with respect to FNTA (best case: r = 0.16, p = 0.0500; cranial tilt). The proposed preliminary diagnostic model for FHP demonstrated 95.35% agreement. Notably, the model using FNTA without radiological parameters accurately identified (100%) participants who required radiographic scanning for FHP diagnosis. Owing to the weak statistical significance of the association between radiological parameters and external body angle, both factors must be considered for accurate FHP diagnosis. When a clear and severe angle variation is observed in an external body angle check, medical professionals should perform radiographic scanning for an accurate FHP diagnosis. In conclusion, FNTA assessment of FNTA through the proposed preliminary diagnostic model is a significant screening factor for selecting participants who must undergo radiographic scanning so that a diagnosis of FHP can be obtained. [ABSTRACT FROM AUTHOR]

Utilizing "You only look once" (YOLO) v4 AI offers valuable support in fracture detection and diagnostic decision-making. The purpose of this study was to help doctors to detect and diagnose fractures more accurately and intuitively, with fewer errors. The data accepted into the backbone are diversified through CSPDarkNet-53. Feature maps are extracted using Spatial Pyramid Pooling and a Path Aggregation Network in the neck part. The head part aggregates and generates the final output. All bounding boxes by the YOLO v4 are mapped onto the 3D reconstructed bone images after being resized to match the same region as shown in the 2D CT images. The YOLO v4-based AI model was evaluated through precision–recall (PR) curves and the intersection over union (IoU). Our proposed system facilitated an intuitive display of the fractured area through a distinctive red mask overlaid on the 3D reconstructed bone images. The high average precision values (>0.60) were reported as 0.71 and 0.81 from the PR curves of the tibia and elbow, respectively. The IoU values were calculated as 0.6327 (tibia) and 0.6638 (elbow). When utilized by orthopedic surgeons in real clinical scenarios, this AI-powered 3D diagnosis support system could enable a quick and accurate trauma diagnosis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the restoration of original anatomy after fixation of sawbone fractures using case-specific 3D printing plates based on virtual reduction (VR). Three-dimensional models of 28 tibia sawbones with cortical marking holes were obtained. The sawbones were fractured at various locations of the shaft and 3D models were obtained. The fractured models were reduced virtually and customized non-locking metal plates that fit the reduced model were produced via 3D printing. The fractured sawbones were actually fixed to the customized plate with nonlocking screws and 3D models were generated. With the proximal fragments of the 3D models overlapped, the changes in length, 3D angulation, and rotation of the distal fragment were evaluated. Compared to the intact model (IN), the virtual reduction model (VR) and the actual fixation model (AF) showed no significant differences in length. Compared to the IN, the VR and the AF had mean 3D angulations of 0.39° and 0.64°, respectively. Compared to the IN model, the VR and the AF showed mean rotations of 0.89° and 1.51°, respectively. A customized plate based on VR facilitates the restoration of near-original anatomy in fractures of tibial sawbone shaft. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to demonstrate the usefulness of 3D image-based virtual reduction by validating the evaluation criteria according to guidelines suggested by the AO Surgery Reference. Methods: For this experiment, 19 intact radial ORTHObones (ORTHObones radius, 3B Scientific, Germany, Hamburg) without any fractures were prepared. All ORTHObones with six cortical marking holes (three points on the distal part and three points on the proximal part) were scanned using a CT scanner twice (before/after intentional fracture of the ORTHObone). After the virtual reduction of all 19 ORTHObones, accuracy evaluations using the four criteria (length variation, apposition variation, alignment variation, Rotation Variation) suggested in the AO Surgery Reference were performed. Results: The mean (M) length variation was 0.42 mm, with 0.01 mm standard deviation (SD). The M apposition variation was 0.48 mm, with 0.40 mm SD. The M AP angulation variation (for alignment variation) was 3.24°, with 2.95° SD. The M lateral angulation variation (for alignment variation) was 0.09°, with 0.13° SD. The M angle of axial rotation was 1.27° with SD: 1.19°. Conclusions: The method of accuracy evaluation used in this study can be helpful in establishing a reliable plan. [ABSTRACT FROM AUTHOR]

Feasibility of proton boron fusion (PBF) reaction to radiotherapy has previously been studied using Monte Carlo simulation. Alpha particles are emitted from the fusion reaction between the proton and 11B close to the end of the Bragg peak. The generated alpha particles can theoretically induce critical damage to tumor cells due to their high linear energy transfer. Nevertheless, there has been a lack of experimental verification to detect the alpha particles and to apply in proton therapy due to the difficulty to observe the generated alpha particles with a very short range in medium. An experimental observation of the generation of alpha particles is indeed necessary for PBF to be applied to proton therapy. We have performed an experimental study using a medical proton accelerator and fine-grained nuclear emulsion films to detect tracks of alpha particles produced. These films, attached to the rear side of the natural boron containing plate located close to the end of the Bragg peak, were individually irradiated by 2 × 108 cm−2 density proton beams at an energy of 79.7 MeV. Some clear tracks of alpha particles, produced by the PBF reaction and clearly separated with those from n + 10B reaction, were observed with the use of a 3D microscope after the films were developed. Each track was analyzed, and alpha particle tracks were verified. A detailed experimental method will be presented using microscopy analysis. In conclusion, the experimental results showed that the observation of alpha particles resulted from PBF and the application feasibility of the PBF reaction to the proton therapy. [ABSTRACT FROM AUTHOR]

The use of boron (11B) is recently being investigated to be applied in proton therapy as a proton boron fusion dose enhancement agent. Alpha particles are emitted from the p + 11B → 3α fusion (PBF) reaction analogous to the 10B(n,7Li)α capture (BNC) reaction. If a natural boron content (80% 11B and 20% 10B) is used in proton therapy, the contaminated neutrons, induced by the proton beam traversing a water medium, will react with 10B and the primary protons will react with 11B. Each reaction will emit alpha particles according to its reaction cross section. The dose due to these alpha particles, together with the primary proton beam, can induce tumor cell kill. The purpose of this study is to computationally investigate these synergy effects using the Monte Carlo simulation with the target region located in the water medium. A 79.9 MeV proton beam (proton density: 1.9 × 108 cm−2) with 4 monitor unit was used to irradiate the target consisting of water, 10B, 11B, and natural B. The variation of the dose, the location of the reaction, and the energy distribution of the alpha particles were calculated according to the target material. As a result, we confirmed contributions of both BNC and PBF reactions to emitting alpha particles from proton beam irradiation with natural boron. This synergy effect induced an additional 7.29% enhanced dose by 331 984 alpha particles. This enhanced dose can sufficiently reduce the number of treatment fractions in proton therapy. [ABSTRACT FROM AUTHOR]

Utilizing "You only look once" (YOLO) v4 AI offers valuable support in fracture detection and diagnostic decision-making. The purpose of this study was to help doctors to detect and diagnose fractures more accurately and intuitively, with fewer errors. The data accepted into the backbone are diversified through CSPDarkNet-53. Feature maps are extracted using Spatial Pyramid Pooling and a Path Aggregation Network in the neck part. The head part aggregates and generates the final output. All bounding boxes by the YOLO v4 are mapped onto the 3D reconstructed bone images after being resized to match the same region as shown in the 2D CT images. The YOLO v4-based AI model was evaluated through precision-recall (PR) curves and the intersection over union (IoU). Our proposed system facilitated an intuitive display of the fractured area through a distinctive red mask overlaid on the 3D reconstructed bone images. The high average precision values (>0.60) were reported as 0.71 and 0.81 from the PR curves of the tibia and elbow, respectively. The IoU values were calculated as 0.6327 (tibia) and 0.6638 (elbow). When utilized by orthopedic surgeons in real clinical scenarios, this AI-powered 3D diagnosis support system could enable a quick and accurate trauma diagnosis.

The purpose of this study is to evaluate the prompt gamma ray imaging technique according to the clinical boron concentration range during proton boron fusion therapy (PBFT). To acquire a prompt gamma ray image from 32 projections, we simulated four head single photon emission computed tomography and a proton beam nozzle using a Monte Carlo simulation. We used modified ordered subset expectation maximization reconstruction algorithm with a graphic processing unit for fast image acquisition. Boron concentration was set as 20 to 100 μg at intervals of 20 μg. For quantitative analysis of the prompt gamma ray image, we acquired an image profile drawn through two boron uptake regions (BURs) and calculated the contrast value, signal-to-noise ratio (SNR), and difference between the physical target volume and volume of the prompt gamma ray image. The relative counts of prompt gamma rays were noticeably increased with increasing boron concentration. Although the intensities on the image profiles showed a similar tendency according to the boron concentration, the SNR and contrast value were improved with increasing boron concentration. This study suggests that a tumor monitoring technique using prompt gamma ray detection can be clinically applicable even if the boron concentration is relatively low., Competing Interests: CONFLICTS OF INTEREST None.

An applied bias voltage between the atomic force microscope tip and the substrate is one of the important factors related to the growth of oxide patterns. A pulse modulator was used to apply a pulsed bias voltage that synchronizes with the resonance frequency of the cantilever between the tip and the substrate in tapping mode. The height of the protruded oxide structure was increased for short duration times of the pulsed bias due to the reduction of built-up space charge in oxide. The aspect ratio of patterns using pulsed bias voltage was about two times higher than that using continuous bias voltage. This study revealed that the pulsed bias has an advantage for obtaining a higher aspect ratio pattern than the continuous bias by reducing the effect of space charge in oxide.