OBJECTIVE: This study aims to develop an automated approach for estimating the vertical rotation of the thorax, which can be used to assess the technical adequacy of chest X-ray radiographs (CXRs).
METHODS: Total 800 chest radiographs were used to train and establish segmentation networks for outlining the lungs and spine regions in chest X-ray images. By measuring the widths of the left and right lungs between the central line of segmented spine and the lateral sides of the segmented lungs, the quantification of thoracic vertical rotation was achieved. Additionally, a life-size, full body anthropomorphic phantom was employed to collect chest radiographic images under various specified rotation angles for assessing the accuracy of the proposed approach.
RESULTS: The deep learning networks effectively segmented the anatomical structures of the lungs and spine. The proposed approach demonstrated a mean estimation error of less than 2° for thoracic rotation, surpassing existing techniques and indicating its superiority.
CONCLUSIONS: The proposed approach offers a robust assessment of thoracic rotation and presents new possibilities for automated image quality control in chest X-ray examinations.
CONCLUSIONS: This study presents a novel deep learning-based approach for the automated estimation of vertical thoracic rotation in chest X-ray radiographs. The proposed method enables a quantitative assessment of the technical adequacy of CXR examinations and opens up new possibilities for automated screening and quality control of radiographs.

BACKGROUND: Research in functional asymmetry of Major Depressive Disorder (MDD) under different tasks is crucial for clinical diagnose.
METHODS: Fifty individuals with MDD and twenty healthy controls (HCS) were recruited for hemodynamic data collection under four fNIRS tasks (Emotional picture, Verbal fluency, Fingering and Negative emotional picture description task). Integral values and functional connectivity strength were employed to probe neural activation and functional connectivity in frontal and temporal lobes in MDD. Following, asymmetry characteristic of the frontal cortex between MDD and HCS under four tasks were carefully analyzed and compared.
RESULTS: Individuals with MDD demonstrated heightened connectivity between the frontal and right temporal lobes and reduced connectivity between the frontal and left temporal lobes compared to HCS in all tasks. Additionally, MDD exhibited attenuated activation in the left frontal lobes and exaggerated activation in the right frontal lobes, diverging from HCS. Furthermore, the disparities in left-right asymmetry characteristic of frontal cortex activation between MDD and HCS were more pronounced during the combined task.
CONCLUSIONS: Further research is required to grasp the neurophysiological mechanisms governing left-right asymmetry across various tasks and the influence of task-induced brain fatigue on cerebral cortex hemodynamics in MDD.
CONCLUSIONS: The left-right asymmetry feature provides valuable neurophysiological insights for diagnosing MDD clinically. Variations in activation patterns and functional connectivity features between MDD and HCS are closely tied to the task chosen. Thus, in clinical practice, carefully selecting appropriate fNIRS tasks and relevant features can significantly improve the diagnostic accuracy of MDD.

BACKGROUND: A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.
OBJECTIVE: To explore open-label tolerability and associations between trial outcomes and asymmetry data.
METHODS: We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry.
RESULTS: 14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS.
CONCLUSIONS: Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.

The first night in an unfamiliar environment is marked by reduced sleep quality and changes in sleep architecture. This so-called First-Night Effect (FNE) is well established for two consecutive nights and lays the foundation for including an adaptation night in sleep research to counteract FNEs. However, adaptation nights rarely happen immediately before experimental nights, which raises the question of how sleep adapts over non-consecutive nights. Furthermore, it is yet unclear, how environmental familiarity and hemispheric asymmetry of slow-wave sleep (SWS) contribute to the explanation of FNEs. To address this gap, 45 healthy participants spent two weekly separated nights in the sleep laboratory. In a separate study, we investigated the influence of environmental familiarity on 30 participants who spent two non-consecutive nights in the sleep laboratory and two nights at home. Sleep was recorded by polysomnography. Results of both studies show that FNEs also occur in non-consecutive nights, particularly affecting wake after sleep onset, sleep onset latency, and total sleep time. Sleep disturbances in the first night happen in both familiar and unfamiliar environments. The degree of asymmetric SWS was not correlated with the FNE but rather tended to vary over the course of several nights. Our findings suggest that non-consecutive adaptation nights are effective in controlling for FNEs, justifying the current practice in basic sleep research. Further research should focus on trait- and fluctuating state-like components explaining interhemispheric asymmetries.

Clinical walk tests may not predict the development of frailty in healthy older adults. With advancements in wearable technology, it may be possible to predict the development of frailty using loading asymmetry parameters during clinical walk tests. This prospective cohort study aimed to test the hypothesis that increased limb loading asymmetry predicts frailty risk in community-living older adults. Sixty-three independently ambulant community-living adults aged ≥ 65 years were recruited, and forty-seven subjects completed the ten-month follow-up after baseline. Loading asymmetry index of net and regional (forefoot, midfoot, and rearfoot) plantar forces were collected using force sensing insoles during a 10 m walk test with their maximum speed. Development of frailty was defined if the participant progressed from baseline at least one grading group of frailty at the follow-up period using the Kihon Checklist. Fourteen subjects developed frailty during the follow-up period. Increased risk of frailty was associated with each 1% increase in loading asymmetry of net impulse (Odds ratio 1.153, 95%CI 1.001 to 1.329). Net impulse asymmetry significantly correlated with asymmetry of peak force in midfoot force. These results indicate the feasibility of measuring plantar forces of gait during clinical walking tests and underscore the potential of using load asymmetry as a tool to augment frailty risk assessment in community-dwelling older adults.

UNASSIGNED: Quadriceps and hamstring strength deficits are related to the increased risk of reinjury after anterior cruciate ligament reconstruction (ACLR).
UNASSIGNED: Knee angle-specific quadriceps and hamstring strength differences would be observed in patients with ACLR 6 and 12 months after surgery.
UNASSIGNED: Case-series.
UNASSIGNED: Level 4.
UNASSIGNED: A total of 23 postprimary unilateral ACLR patients followed-up at 6 and 12 months postoperatively and 25 controls were included. Isokinetic knee extension and flexion strength were evaluated at 60 deg/s from 20° to 90°. Statistical parametric mapping were performed to explore the angle-specific strength and the limb symmetry index (LSI).
UNASSIGNED: At 6 months postoperatively, the reconstructed leg demonstrated lower knee extension and flexion strength than the contralateral (20°-77°, 24°-90°) (P < 0.01) and control legs (22°-90°, 40°-82°) (P < 0.01). From 6 months to 12 months, knee extension (60°-90°) and flexion (20°-79°) strength improved in the reconstructed leg (P < 0.05), while LSI remained unchanged (P > 0.02). At 12 months, knee extension strength differences persisted in the reconstructed leg compared with the contralateral (20°-81°) and controls (25°-63°) (P < 0.01). ACLR patients had lower LSI of knee extension strength at 6 (20°-59°) and 12 (24°-57°) months postoperatively than the controls (P < 0.02).
UNASSIGNED: The reconstructed leg exhibited differences in knee extension strength compared with the contralateral and control legs. Although bilateral knee extension strength increased from 6 to 12 months postoperatively, LSI did not show improvement during this period.
UNASSIGNED: Quadriceps restoration was observed only in knee flexion angles greater than 60° compared with controls. Future studies should investigate whether knee extension strength, especially in lower flexion angles, can be enhanced through rehabilitation programs. Furthermore, assessing the impact of this improvement on long-term outcomes and reinjury risk in ACLR patients is warranted.

The asymmetry between the left and right sides seems to be a general principle of organization of the nervous systems in Bilateria, providing the foundations for a plethora of leftward and rightward biases in behaviour as documented in species ranging from Caenorhabditis elegans nematodes to humans. Several theories have been put forward to account for the existence and maintenance in the evolution of the asymmetric organization of the brain at both individual and population levels. However, what is missing in theorizing about the evolution of brain asymmetry is an overarching general hypothesis that may subsume all different aspects of current models. Here, we tried to provide an overarching general framework based on the energy and free-energy minimization principle, which proved so valuable in other areas of neuroscience. We found that at the individual level the antisymmetric singlet configuration realizes the lowest energy state of the system, whereas at the group level, the spontaneous emergence of directional asymmetry arises as a consequence of the minimization of the free energy of the system, which guarantees its stability and equilibrium. We thus argue that the various phenomenological aspects of brain asymmetry that have been captured in biology-e.g. sparing of neural tissue, control of unitary motor responses and, at the population level, evolutionarily stable strategies described by mathematical games theory-may be thought of as the manifestation of a more general principle of energy minimization generating, among others, asymmetry of the brains.

OBJECTIVE: The aim of the present study was to objectively assess the degree of residual facial asymmetry after primary treatment of non-syndromic unilateral cleft lip and palate (UCLP) in children and to correlate it with subjective ratings of facial appearance.
METHODS: Stereophotometry was used to record the faces of 89 children with UCLP for comparison of cleft and non-cleft sides up to 5 years after primary cleft closure. Root mean square values were calculated to measure the difference between the shape of cleft and non-cleft sides of the face and were compared to controls without a cleft lip. The Asher-McDade Aesthetic Index (AMAI) was used for subjective rating of the nasolabial area through 12 laypersons.
RESULTS: Children with a cleft lip (CL) showed no significant difference in RMS values compared to controls. Significant differences occurred when the evaluation was limited to the nasolabial area, however only in patients with cleft lip alveolus (CLA) and cleft lip palate (CLAP)(p < 0.001). In contrast, subjective ratings showed significantly higher values for all three cleft severity groups (CL, CLA, CLAP) compared to controls (p < 0.001). There was a non-linear correlation between the RMS (root mean square) values and the AMAI score.
CONCLUSIONS: Even non-significant discrete objective deviations from facial symmetry in children after primary closure of UCLP are vigilantly registered in subjective ratings and implemented in the judgement of facial appearance.
CONCLUSIONS: 3D stereophotometry is a usefull tool in monitoring asymmetry in patients with a cleft.

Only a small number of studies have assessed structural differences between the two hemispheres during childhood and adolescence. However, the existing findings lack consistency or are restricted to a particular brain region, a specific brain feature, or a relatively narrow age range. Here, we investigated associations between brain asymmetry and age as well as sex in one of the largest pediatric samples to date (n = 4265), aged 1-18 years, scanned at 69 sites participating in the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) consortium. Our study revealed that significant brain asymmetries already exist in childhood, but their magnitude and direction depend on the brain region examined and the morphometric measurement used (cortical volume or thickness, regional surface area, or subcortical volume). With respect to effects of age, some asymmetries became weaker over time while others became stronger; sometimes they even reversed direction. With respect to sex differences, the total number of regions exhibiting significant asymmetries was larger in females than in males, while the total number of measurements indicating significant asymmetries was larger in males (as we obtained more than one measurement per cortical region). The magnitude of the significant asymmetries was also greater in males. However, effect sizes for both age effects and sex differences were small. Taken together, these findings suggest that cerebral asymmetries are an inherent organizational pattern of the brain that manifests early in life. Overall, brain asymmetry appears to be relatively stable throughout childhood and adolescence, with some differential effects in males and females.

OBJECTIVE: Due to the indistinguishable clinical features of corticobasal syndrome (CBS), the antemortem differentiation between corticobasal degeneration (CBD) and its mimics remains challenging. However, the utility of conventional magnetic resonance imaging (MRI) for the diagnosis of CBD has not been sufficiently evaluated. This study aimed to investigate the diagnostic performance of conventional MRI findings in differentiating pathologically confirmed CBD from its mimics.
METHODS: Semiquantitative visual rating scales were employed to assess the degree and distribution of atrophy and asymmetry on conventional T1-weighted and T2-weighted images. Additionally, subcortical white matter hyperintensity (SWMH) on fluid-attenuated inversion recovery images were visually evaluated.
RESULTS: In addition to 19 patients with CBD, 16 with CBD mimics (progressive supranuclear palsy (PSP): 9, Alzheimer\'s disease (AD): 4, dementia with Lewy bodies (DLB): 1, frontotemporal lobar degeneration with TAR DNA-binding protein of 43 kDa(FTLD-TDP): 1, and globular glial tauopathy (GGT): 1) were investigated. Compared with the CBD group, the PSP-CBS subgroup showed severe midbrain atrophy without SWMH. The non-PSP-CBS subgroup, comprising patients with AD, DLB, FTLD-TDP, and GGT, showed severe temporal atrophy with widespread asymmetry, especially in the temporal lobes. In addition to over half of the patients with CBD, two with FTLD-TDP and GGT showed SWMH, respectively.
CONCLUSIONS: This study elucidates the distinct structural changes between the CBD and its mimics based on visual rating scales. The evaluation of atrophic distribution and SWMH may serve as imaging biomarkers of conventional MRI for detecting background pathologies.