An evaluation of head position and craniofacial reference line variation

Natural head position (NHP) is the usual, balanced position of the head which is adopted for viewing the horizon or an object at eye level. Determination of NHP is useful when reconstructing facial form in art, forensics, orthodontic diagnosis and treatment planning for surgical management of craniofacial dysmorphic conditions. When NHP is uncertain, correction such as orientation to Frankfurt horizontal (FH) has been advocated. However, FH angulation varies between individuals and is subject to landmark identification error. Previous studies have measured FH and other craniofacial planes in relation to the true horizontal (HOR) with subjects in NHP and have found similar variation to that found with FH. This study measured craniofacial planes in 40 Aboriginal Australians (20 male, 20 female, aged 17 years or greater) from lateral cephalographs and compared its results with classical previous studies. Four planes, the neutral horizontal axis (NHA), FH, Krogman-Walker line (KW line), and palatal plane (P plane) demonstrated near parallelism and averaged between −1° and −2° from HOR. The combined use of NHA, FH, KW line, and P plane enables more effective corrected head position (CHP).     

Influence of head position on thermal stress in newborns: simulation using a thermal mannequin.

The influence of head position on thermal stress was assessed by using a heavily clothed thermal mannequin in three different body positions [supine, face straight up (FSU); supine, face to the side (FTS); prone, FTS] and with or without the head covered by a bonnet. The mannequin was exposed to air temperatures of 29, 32, 34, and 36 degrees C. When the head is uncovered, body or head position has no impact on heat loss. When the head is covered, dry heat loss from the mannequin as a whole (and that from the head in particular) is lower (-0.35 to -0.40 W) in the FTS position than in the FSU position as a result of decreased heat loss from the surface area of the face in contact with the mattress. In the FTS position and with the head covered, there was no difference in heat loss between the prone and supine positions. The results suggest that in heavily clothed newborns whose head is covered by a bonnet, thermal stress depends on the head position.     

Influence of head position on carotid hemodynamics in young adults

Studies in adults have shown marked changes in geometry and relative positions of the carotid arteries when rotating the head. The aim of this study was to quantify the change in geometry and analyze its effect on carotid hemodynamics as a result of head rotation. The right carotid arteries of nine young adult subjects were investigated in supine position with straight and left turned head positions, respectively. The three-dimensional (3D) carotid geometry was reconstructed by using 3D ultrasound (3D US), and the carotid hemodynamics were calculated by combining 3D US with computational fluid dynamics. It was observed that cross-sectional areas and shapes did not change markedly with head rotation, but carotid vessel center lines altered with planarification of the common carotid artery as a main feature (P < 0.05). Measured common carotid flow rates changed significantly at the individual level when the head was turned, but on the average, the change in mean common carotid flow rate was relatively small (0.37 +/- 1.11 ml/s). The effect of the altered center lines and flow rates on the atherogenic nature of the carotid bifurcation was evaluated by using calculated hemodynamic wall parameters, such as wall shear stress (WSS) and oscillatory shear index (OSI). It was found that WSS and OSI patterns changed significantly with head rotation, but the variations were very subject dependent and could not have been predicted without assessing the altered geometry and flow of the carotid bifurcation for individual cases. This study suggests that there is a need for standardization of the choice of head position in the 3D US scan protocol, and that carotid stents and emboli diverters should be studied in different head positions.     

Analysis of the effect of swimmer's head position on swimming performance using computational fluid dynamics

The aim of this numerical work is to analyze the effect of the position of the swimmer's head on the hydrodynamic performances in swimming. In this initial study, the problem was modeled as 2D and in steady hydrodynamic state. The geometry is generated by the CAD software CATIA and the numerical simulation is carried out by the use of the CFD Fluent code. The standard k-epsilon turbulence model is used with a specific wall law. Three positions of the head were studied, for a range of Reynolds numbers about 10(6). The obtained numerical results revealed that the position of the head had a noticeable effect on the hydrodynamic performances, strongly modifying the wake around the swimmer. The analysis of these results made it possible to propose an optimal position of the head of a swimmer in underwater swimming.     

Effects of head position on errors in 3-D pointing to remembered locations

The accuracy of pointing movements performed under different head positions to remembered target locations in 3-D space was studied in healthy persons. The subjects fixated a visual target, then closed their eyes and after 1.0 sec performed the targeted movement with their right arm. The target (a point light source) was presented in random order by a programmable robot arm at one of five space locations. The accuracy of pointing movements was examined in a spherical coordinate system centered in respect with the shoulder of the responding arm. The pointing movements were most accurate under natural eye-head coordination. With the head fixed in the straight-ahead position, both the 3-D absolute error and its standard deviation increased significantly. At the same time, individual components of spatial error (directional and radial) did not change significantly. With the head turned to the rightmost or leftmost position, the pointing accuracy was disturbed within larger limits than under head-fixed condition. The main contributors to the 3-D absolute error were the changes in the azimuth error. The latter depended on the direction of the head-turn: the rightmost turn either increased leftward or decreased rightward shift, and conversely, the left turn increased rightward shift or decreased leftward shift of the target-directed movements.It is suggested that the increased inaccuracy of pointing under head-fixed condition reflected the impairment of the eye-head coordination underlying gaze orientation, and increased inaccuracy under the head-turned condition may be explained by changes in the internal representation of the head and target position in space.Neirofiziologiya/Neurophysiology, Vol. 26, No. 2, pp. 122–131, March–April, 1994.     

Predictions of the elastic modulus of trabecular bone in the femoral head and the intertrochanter: a solitary wave-based approach

Biomechanics and Modeling in Mechanobiology - This paper deals with the numerical prediction of the elastic modulus of trabecular bone in the femoral head (FH) and the intertrochanteric (IT) region...     

The influence of head position on the flight behaviour of the fly. Calliphora erythrocephala

The heads of flies were passively turned during fixed flight (open loop conditions). The turning stimuli had ramp-shaped onsets. The resulting torque produced by the thorax was plotted as a function of the degree of head-turn.Directional, passive turns of the head evoke active turning tendencies (yawing forces) of the same sign from the thorax. The strength of these tendencies is dependent on the size of the given angle through which the head was turned. The cushion of sensory hairs on the neck (prosternal organ) is very important in the elicitation of the turning tendencies. The results which have been obtained indicate that the position of the fly's head has a substantial influence on the magnitude of the turning tendencies elicited by visual stimuli.     

Perception of gravity-vertical as a function of head and trunk position

Summary The apparent or subjective vertical (AV) was measured as a function of time and lateral tilt-positions of head and trunk. The AV depended mainly on head position. At head-positions from 0–90° the influence of the trunk-position was small; at the inverted head-positions (135, 180°), however, it was much more pronounced. Intra- and inter-subject variability increased with increasing head-tilt; at the inverted head-positions they appeared to be also dependent on the position of the trunk. It is concluded, that with increasing lateral tilt the statolith-organs become less effective in determining the AV, and that consequently the influence of the somato-receptors becomes greater.

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Zusammenfassung Die scheinbare Vertikale (AV) wurde in Abhängigkeit von der Zeit und von verschiedenen Seitwärtslagen von Kopf und Rumpf untersucht. Sie war im Wesentlichen abhängig von der Lage des Kopfes. Der Einfluß der relativen Rumpf-zu-Kopfstellung war bei Kopflagen 0–90° klein, bei den inversen Kopflagen (135, 180°) jedoch sehr ausgeprägt. Intra- und interindiv.-Streuungen nahmen mit zunehmender Kopfneigung zu; in den inversen Lagen waren sie auch von der relativen Rumpflage abhängig. Wie die Ergebnisse schließen lassen, wird mit zunehmender Seitwärtsneigung der Einfluß der Statolithenorgane auf die AV schwächer und dementsprechend die Wirksamkeit der Somatoreceptoren des Rumpfes stärker.

     

Muscle efficiency in total shoulder prosthesis implantation: dependence on position of the humeral head and rotator cuff function]

Modern shoulder prostheses permit an anatomic reconstruction of the joint, although the biomechanical advantages are not proven. The goal of this study was to investigate the relationship between position of the humeral head and function of the shoulder prosthesis (muscle efficiency). Shoulder elevation-motion and rotator cuff defects were simulated in vitro in a robot-assisted shoulder simulator. The EPOCA Custom Offset shoulder prosthesis (Argomedical AG, Cham, CH) was implanted in seven normal shoulders (77 +/- 20 kg, 55 +/- 14 years). Active elevation was simulated by hydraulic cylinders, and scapulothoratic motion by a specially programmed industrial robot. Muscle efficiency (elevation-angle/muscle-force of the deltoid muscle) was measured in anatomic (ANA), medialised (MED) and lateralised (LAT) positions of the humeral head, with or without rotator cuff muscle deficiency. Medialisation increased efficiency by 0.03 +/- 0.04 deg/N (p = 0.022), lateralisation decreased it by 0.04 +/- 0.06 deg/N (p = 0.009). Supraspinatus muscle deficiency increased the deltoid force required to elevate the arm, and thus decreased efficiency (ANA p = 0.091, MED p = 0.018, LAT p = 0.028). The data confirm that the position of the humeral head affects the mechanics of total shoulder arthroplasty. Medialisation increases efficiency of the deltoid muscle and may prove useful in compensating isolated supraspinatus muscle deficiency. Lateralisation, in contrast, leads to an unfavorable situation.     

Accuracy of dose calculation on iterative CBCT for head and neck radiotherapy

PurposeTo evaluate the feasibility of the use of iterative cone-beam computed tomography (CBCT) for dose calculation in the head and neck region.MethodsThis study includes phantom and clinical studies. All acquired CBCT images were reconstructed with Feldkamp–Davis–Kress algorithm-based CBCT (FDK-CBCT) and iterative CBCT (iCBCT) algorithm. The Hounsfield unit (HU) consistency between the head and body phantoms was determined in both reconstruction techniques. Volumetric modulated arc therapy (VMAT) plans were generated for 16 head and neck patients on a planning CT scan, and the doses were recalculated on FDK-CBCT and iCBCT with Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB). As a comparison of the accuracy of dose calculations, the absolute dosimetric difference and 1%/1 mm gamma passing rate analysis were analyzed.ResultsThe difference in the mean HU values between the head and body phantoms was larger for FDK-CBCT (max value: 449.1 HU) than iCBCT (260.0 HU). The median dosimetric difference from the planning CT were <1.0% for both FDK-CBCT and iCBCT but smaller differences were found with iCBCT (planning target volume D_50%: 0.38% (0.15–0.59%) for FDK-CBCT, 0.28% (0.13–0.49%) for iCBCT, AAA; 0.14% (0.04–0.19%) for FDK-CBCT, 0.07% (0.02–0.20%) for iCBCT). The mean gamma passing rate was significantly better in iCBCT than FDK-CBCT (AAA: 98.7% for FDK-CBCT, 99.4% for iCBCT; AXB: 96.8% for FDK_CBCT, 97.5% for iCBCT).ConclusionThe iCBCT-based dose calculation in VMAT for head and neck cancer was accurate compared to FDK-CBCT.     

Ontogenetic shifts of heart position in snakes

Heart position relative to total body length (TL) varies among snakes, with anterior hearts in arboreal species and more centrally located hearts in aquatic or ground‐dwelling species. Anterior hearts decrease the cardiac work associated with cranial blood flow and minimize drops in cranial pressure and flow during head‐up climbing. Here, we investigate whether heart position shifts intraspecifically during ontogenetic increases in TL. Insular Florida cottonmouth snakes, Agkistrodon conanti , are entirely ground‐dwelling and have a mean heart position that is 33.32% TL from the head. In contrast, arboreal rat snakes, Pantherophis obsoleta , of similar lengths have a mean heart position that is 17.35% TL from the head. In both species, relative heart position shifts craniad during ontogeny, with negative slopes = −.035 and −.021% TL/cm TL in Agkistrodon and Pantherophis , respectively. Using a large morphometric data set available for Agkistrodon (N = 192 individuals, 23–140 cm TL), we demonstrate there is an anterior ontogenetic shift of the heart position within the trunk (= 4.56% trunk length from base of head to cloacal vent), independent of head and tail allometry which are both negative. However, in longer snakes > 100 cm, the heart position reverses and shifts caudally in longer Agkistrodon but continues toward the head in longer individuals of Pantherophis . Examination of data sets for two independent lineages of fully marine snakes (Acrochordus granulatus and Hydrophis platurus ), which do not naturally experience postural gravity stress, demonstrate both ontogenetic patterns for heart position that are seen in the terrestrial snakes. The anterior migration of the heart is greater in the terrestrial species, even if TL is standardized to that of the longer P. obsoleta , and compensates for about 5 mmHg gravitational pressure head if they are fully upright.     

Human body mass estimation: a comparison of "morphometric" and "mechanical" methods

In the past, body mass was reconstructed from hominin skeletal remains using both "mechanical" methods which rely on the support of body mass by weight-bearing skeletal elements, and "morphometric" methods which reconstruct body mass through direct assessment of body size and shape. A previous comparison of two such techniques, using femoral head breadth (mechanical) and stature and bi-iliac breadth (morphometric), indicated a good general correspondence between them (Ruff et al. [1997] Nature 387:173-176). However, the two techniques were never systematically compared across a large group of modern humans of diverse body form. This study incorporates skeletal measures taken from 1,173 Holocene adult individuals, representing diverse geographic origins, body sizes, and body shapes. Femoral head breadth, bi-iliac breadth (after pelvic rearticulation), and long bone lengths were measured on each individual. Statures were estimated from long bone lengths using appropriate reference samples. Body masses were calculated using three available femoral head breadth (FH) formulae and the stature/bi-iliac breadth (STBIB) formula, and compared. All methods yielded similar results. Correlations between FH estimates and STBIB estimates are 0.74-0.81. Slight differences in results between the three FH estimates can be attributed to sampling differences in the original reference samples, and in particular, the body-size ranges included in those samples. There is no evidence for systematic differences in results due to differences in body proportions. Since the STBIB method was validated on other samples, and the FH methods produced similar estimates, this argues that either may be applied to skeletal remains with some confidence.     

Three-dimensional head angular velocity detection from otolith afferent signals

Afferent signals from the otolith organs can produce compensatory eye position and velocity signals which has been described as linear vestibulo-ocular reflex (LVOR). The afferent otolith signals carry information about head orientation and changes of head orientation relative to gravity. A head orientation (tilt) related position signal can be obtained from population vector coding of tonic otolith afferent signals during static or dynamic head tilts, which in turn could produce compensatory eye position signals in the LVOR. On the other hand, eye angular velocity signals may be extracted, as proposed in this study, from the population response of tilt-velocity sensitive otolith afferents. Such afferents are shown to encode instantaneous head orientation relative to gravity at onset of a head movement and, as the movement continues, the projection of head angular velocity onto the earth-horizontal plane, indicating the instantaneous direction of movement relative to gravity. Angular velocity components along the earth-vertical direction which are not directly encoded by otolith afferents can be detected by central signal processing. Central reconstruction of 3D head angular velocity allows to obtain information about absolute head orientation in space even in the absence of semicircular canal related information. Such information is important for generating compensatory eye movements as well as for dynamic control of posture.     

Structure and kinematics of the prosternal organs and their influence on head position in the blowfly Calliphora erythrocephala Meig.

Summary The blowfly Calliphora has a mobile head and various, presumably proprioceptive, sense organs in the neck region. The prosternal organs are a pair of mechanosensory hair fields, each comprising ca. 110 sensilla. We studied their structure (Figs. 2–4), kinematics (Figs. 5, 6) and, after surgery, their influence on head posture (Figs. 7–11) in order to reveal their specific function.The hair sensilla are structurally polarized, all in roughly the same direction, and are stimulated by dorsoventral bending of the hairs (Figs. 3, 4). This occurs indirectly by flap-movements of two contact sclerites (Figs. 3, 6); they move in the same direction during pitch turns of the head, in opposite directions during roll turns, and barely at all during yaw turns of the head (Fig. 5).Bending and arresting all hairs of one field elicits a head roll bias to the non-operated side (Fig. 7) during tethered flight in visually featureless surroundings. In contrast, shaving all hairs of one field elicits a head roll to the operated side (Figs. 8–10). The surgically induced bias of head posture is not compensated within three days (Fig. 10). Our results show that the prosternal organs of Calliphora sense pitch and roll turns of the fly's head, and control at least its roll position.Abbreviations HP° TP° angular positions of the sagittal planes of the fly's head and thorax, respectively, relative to an external reference - HR° = HP — TP head roll angle of the fly's head relative to its thorax, HR>0° for clockwise head roll, looking in flight direction - N number of flies - n number of measurements - PO prosternal organ - SD standard deviation - SEM standard error of the mean     

Family planning and social position of women

This presentation began with at least three biases: (i) Acceptance of a secular approach to the problem of artificially controlling human reproduction; (ii) acceptance of an absolute egalitarian position in matter of choices and applications of family planning methods; and (iii) acceptance of the view that a small family gives women more opportunities to flourish as humans. The conclusion of the presentation is: though in implementing family planning programmes much deviation from the egalitarian principle could be found, in reality the implementation itself does bring about some opportunities for women to enhance their position in society. Undoubtedly the malpractices in family planning programmes cause death and miseries to women. But, until better methods are invented for both male and female sexes to replace the harmful ones and the male members of the society feel equal responsibility in matters of controlling reproduction, women have now no other choice but to accept the lesser evil.     

Strategies for simultaneous control of the equilibrium and of the head position during the raising movement of a leg

The coordination between equilibrium control and the ability to maintain the position of given segments (head, trunk) was studied in standing subjects, instructed to raise one leg laterally at an angle of 45 degrees in response to a light. Two sources of light placed at eye level indicated the side on which the movement was to be performed. Two populations were compared: naive subjects and dancers. Two control strategies were identified. An "inclination" strategy was used by the naive subjects. This consisted of an external rotation of the body around the antero-posterior ankle joint axis; a counter-rotation of the head with respect to the trunk was observed, which ensured some stabilization in the horizontal plane of the interorbital line. A "translation" strategy was used by the dancers. Here the external rotation of the leg around the ankle joint was associated with a feed-forward counter-rotation of the trunk around the coxofemoral joint so that the horizontality of the interorbital line and the verticality of the trunk axis were maintained. This new coordination results from a long-term training and indicates that a new motor program has been elaborated.     

Epidemiology of head injury.

To find the incidence of the various types of head injury that occur in the community separate yearly rates (per 10(5) population in Scotland) for deaths, admissions to hospital, and attendance at accident and emergency departments were estimated and compared (when possible) with rates in England and Wales and the United States. Hospital admissions provide the best data for comparing incidences in different geographical areas and rates of attendance at accident and emergency departments the most reliable guide to incidences in the community. Admission rates, however, vary with local facilities and policies, and these also determine the proportion of patients referred to regional neurosurgical units. Such epidemiological data must be sought both for planning health care for head injury and for monitoring the effectiveness of services.     

Magnitude of head impact exposures in individual collegiate football players

The purpose of this study was to quantify the severity of head impacts sustained by individual collegiate football players and to investigate differences between impacts sustained during practice and game sessions, as well as by player position and impact location. Head impacts (N = 184,358) were analyzed for 254 collegiate players at three collegiate institutions. In practice, the 50th and 95th percentile values for individual players were 20.0 g and 49.5 g for peak linear acceleration, 1187 rad/s2 and 3147 rad/s2 for peak rotational acceleration, and 13.4 and 29.9 for HITsp, respectively. Only the 95th percentile HITsp increased significantly in games compared with practices (8.4%, p = .0002). Player position and impact location were the largest factors associated with differences in head impacts. Running backs consistently sustained the greatest impact magnitudes. Peak linear accelerations were greatest for impacts to the top of the helmet, whereas rotational accelerations were greatest for impacts to the front and back. The findings of this study provide essential data for future investigations that aim to establish the correlations between head impact exposure, acute brain injury, and long-term cognitive deficits.     

Effects of body position on intracranial and cerebral perfusion pressures in isoflurane-anesthetized horses.

Inhalant anesthetics may interfere with normal cerebrovascular autoregulation. It was, therefore, hypothesized that intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in isoflurane-anesthetized horses would be especially sensitive to body and head position because of the potential for large hydrostatic gradients between the brain and heart in this species. Anesthesia was induced and maintained in six clinically healthy, unmedicated geldings with 1.57% isoflurane in O(2); mechanical ventilation was used to maintain normocapnia. ICP was measured by using a subarachnoid strain-gauge transducer. Blood gases and carotid arterial, right atrial, and airway pressures were also measured. Five body positions were studied in semirandomized order: dorsal recumbency (DR) with head down (HD), DR with head level (HL), lateral recumbency (LR), sternal recumbency (SR) with HL, and SR with head up (HU). Data were analyzed by using paired t-tests. ICP and CPP values, respectively, are as follows (means +/- SD): 36 +/- 4 and 55 +/- 18 mmHg (DR-HD); 34 +/- 6 and 51 +/- 32 mmHg (DR-HL); 24 +/- 5 and 48 +/- 4 mmHg (LR); 19 +/- 11 and 87 +/- 12 mmHg (SR-HL); and -14 +/- 7 and 71 +/- 10 mmHg (SR-HU). Significant differences were found among all positions, except for SR-HL vs. LR. Significant increases in CPP were observed only in sternal positions. In conclusion, ICP in isoflurane-anesthetized horses changes inversely with the brain-to-heart hydrostatic gradient. DR may also cause increases in ICP, irrespective of head position.