Anomalous Position Research Articles

First-principles calculation of orbital Hall effect by Wannier interpolation: Role of orbital dependence of the anomalous position

First-principles calculation of orbital Hall effect by Wannier interpolation: Role of orbital dependence of the anomalous position

Infantile nystagmus syndrome: An observational, retrospective, multicenter study.

This multicenter study assessed clinical and psychological aspects of infantile nystagmus syndrome (INS) focusing on its management and nonsurgical treatment. This study aimed to assess clinical features, management, relationship life, and psychological impact in a group of patients with nystagmus onset in pediatric age. This observational study included patients diagnosed with INS referred to two Italian centers from January 1, 2017, to December 31, 2020. Ophthalmologic and orthoptic features and impact of visual function on quality of life, according to nystagmus-specific nystagmus quality of life questionnaire, were analyzed within the overall sample and in any of INS subgroups. Forty-three patients were included; 65.1% of them had idiopathic INS (IINS), and 34.9% had INS associated with ocular diseases (INSOD). The median age was 15.4 years (interquartile range [IQR], 10.4 to 17.3 years), significantly different between groups (median, 15.8 years among those with IINS vs. 12.3 years among those with INSOD; p<0.001). In the INSOD subgroup, strabismus was significantly more prevalent (93.3 vs. 57.1%; p=0.017). Binocular distance best-corrected visual acuity in primary position was significantly higher in the IINS subsample (p<0.001). Such behavior was further confirmed at anomalous head position evaluation (p<0.001). At near best-corrected visual acuity assessment, differences between groups were more remarkable in primary position (p<0.001) than in anomalous head position. Contrast sensitivity showed significantly higher values in the IINS subgroup (p<0.001). The nystagmus quality of life questionnaire disclosed a significantly lower score in IINS as compared with INSOD (median total score, 90.5 [IQR, 84 to 97] vs. 94 [IQR, 83.0 to 96.5]; p<0.001). The IINS group showed significantly better ophthalmologic and orthoptic outcomes than the INSOD group. The psychological and quality-of-life impact was instead significantly greater in the IINS group. To the best of our knowledge, this is the first multicenter study investigating the clinical features of IIN and comparing the two main subgroups, IINS and INSOD.

ANOMALY OF ORIGIN AND COURSE OF THE CIRCUMFLEX ARTERY: AN ECHOCARDIOGRAPHIC DIAGNOSIS

ANOMALY OF ORIGIN AND COURSE OF THE CIRCUMFLEX ARTERY: AN ECHOCARDIOGRAPHIC DIAGNOSIS

The Wagging Plasma Tail of Comet C/2020 S3 (Erasmus)

Long-period comet C/2020 S3 (Erasmus) reached perihelion at 0.398 au on UT 2020 December 12.67, making it a bright, near-Sun object. Images taken between 2020 mid-November and December using the HI-1 camera and COR2 coronagraph on board STEREO-A, as well as the LASCO/C3 coronagraph on board SoHO, show significant variations in the plasma tail position angles. To analyze these variations, a simple technique was developed to calculate the aberration angles. These angles are defined as the angle between the Sun–comet line and the tail axis, measured in the orbital plane. The aberration angles were found to range from 1.°2 to 46.°8, with an average (median) value of approximately 20.°3 (16.°3). By considering the aberration angles, the solar wind radial velocities during the observations were inferred to range from 73.9 to 573.5 km s−1, with a mean (median) value of approximately 205.5 km s−1 (182.3 km s−1). Throughout the observations, two periods were identified where the tails showed forward tilting, which cannot be explained by aberration alone. In one case, this anomalous position angle was sustained for at least 11 days and is possibly due to corotating interaction regions. In the other case, the tail exhibited dramatic excursions from 180° to 150° back to 210° over a limited period of around 34 hr. This behavior is tentatively explained as a consequence of the interaction with a halo coronal mass ejection that was launched from NOAA Active Region 12786 and arrived at comet C/2020 S3 during the time when the tail displayed its wagging behavior.

Machine Learning Effectively Diagnoses Mandibular Deformity Using Three-Dimensional Landmarks

Jaw deformity diagnosis requires objective tests. Current methods, like cephalometry, have limitations. However, recent studies have shown that machine learning can diagnose jaw deformities in two dimensions. Therefore, we hypothesized that a multilayer perceptron (MLP) could accurately diagnose jaw deformities in three dimensions (3D). Examine the hypothesis by focusing on anomalous mandibular position. We aimed to: (1) create a machine learning model to diagnose mandibular retrognathism and prognathism; and (2) compare its performance with traditional cephalometric methods. An in-silico experiment on deidentified retrospective data. The study was conducted at the Houston Methodist Research Institute and Rensselaer Polytechnic Institute. Included were patient records with jaw deformities and preoperative 3D facial models. Patients with significant jaw asymmetry were excluded. The tests used to diagnose mandibular anteroposterior position are: (1) SNB angle; (2) facial angle; (3) mandibular unit length (MdUL); and (4) MLP model. The resultant diagnoses: normal, prognathic, or retrognathic. None. A senior surgeon labeled the patients' mandibles as prognathic, normal, or retrognathic, creating a gold standard. Scientists at Rensselaer Polytechnic Institute developed an MLP model to diagnose mandibular prognathism and retrognathism using the 3D coordinates of 50 landmarks. The performance of the MLP model was compared with three traditional cephalometric measurements: (1) SNB, (2) facial angle, and (3) MdUL. The primary metric used to assess the performance was diagnostic accuracy. McNemar's exact test tested the difference between traditional cephalometric measurement and MLP. Cohen's Kappa measured inter-rater agreement between each method and the gold standard. The sample included 101 patients. The diagnostic accuracy of SNB, facial angle, MdUL, and MLP were 74.3, 74.3, 75.3, and 85.2%, respectively. McNemar's test shows that our MLP performs significantly better than the SNB (P=.027), facial angle (P=.019), and MdUL (P=.031). The agreement between the traditional cephalometric measurements and the surgeon's diagnosis was fair. In contrast, the agreement between the MLP and the surgeon was moderate. The performance of the MLP is significantly better than that of the traditional cephalometric measurements.

Клинический случай применения ботулинического токсина типа А без гемагглютининового комплекса у пациента с редким типом нистагма (spasmus nutans)

This article demonstrates a clinical case of botulinum toxin type A without a hemagglutinin complex application in a patient with a rare type of nystagmus. Patient L. 1 year 9 months old with manifestations of spasmus nutans(oscillatory eye movements, head nodding, and anomalous head position), who underwent chemodenervation of oculomotor muscles using botulinum toxin type A without hemagglutinin complex. The use of chemodenervation in patients with nystagmus is one of the methods of effective treatment of this pathology. Key words: nystagmus, chemodenervation, botulinum toxin type A, spasmus nutans

Ripeness obscured: inductive lessons from Türkiye’s (transactional) mediation in the Russia–Ukraine war

PurposeConventional wisdom tells us that mediation without ripeness is a fool’s errand (Zartman and Touval, 1985). What, then, is Türkiye’s motivation for mediating the war in Ukraine in lieu of ripeness – and what can its behavior as a mediator tell us about that motivation? In pursuit of this question, this paper inductively analyzes Turkish mediation in the Ukraine war to unpack the relationship between a contextual (ripeness) and actor-level (motivation) variable. Of particular interest is the decision-making and behavior of third parties (like Türkiye in Ukraine) who elect to mediate highly complex conflicts in which ripeness is indiscernible. The purpose of this research is not to propose or test a causal relationship between obscured ripeness and mediation, but rather to examine mediation behavior in situations where ripeness is obscured.Design/methodology/approachThe impact of weaponized information on ripeness and third-party mediation is evaluated through an original, systematic and inductive case study analysis of Turkish mediation in the Russia–Ukraine war. As an intense theater of operations for information warfare for well over a decade, the war in Ukraine serves as an especially apt choice for an analysis of “obscured ripeness.” Likewise, Türkiye’s anomalous position as the only substantive source of mediation in the conflict lends significance to an empirical examination of its motivation and behavior as a mediator.FindingsThis research reveals that the pervasive use of weaponized information in the Russia–Ukraine war has distorted and disordered the information environment, thereby obscuring the ability of third parties to determine if the conflict is or could be ripe for mediation. However, the condition of obscured ripeness that prevails in the conflict has not proven a deterrent for mediation by Türkiye, which, as the only mediator in the conflict, has used a transactional approach to mediation motivated by self-regarding interests and animated by a manipulative mediation strategy. In sum, this inductive analysis of Turkish mediation in Ukraine reveals that the use of weaponized information in a conflict indirectly selects on transactional mediation (and mediators). The significance of this finding is magnified by the widespread use of weaponized information in contemporary conflicts as well as the declining frequency of third-party mediation.Originality/valueThere have been few, if any, systematic assessments in Turkish mediation of the Russia–Ukraine war, and none specifically concerned with the effects of weaponized information. Additionally, the paper proposes a typology of mediator motivation that is used to structure that assessment, while also introducing a new concept (“obscured ripeness”) and linking that concept both to the existing literature on ripeness and to the use of weaponized information in contemporary armed conflicts. As such, this manuscript represents an important contribution both to the empirical and theoretical landscape with respect to the study of mediation and international conflict management.

A case study of the association between adolescent idiopathic scoliosis, weight training and shoulder dislocation

This study shows a rare association between the anomalous position of the shoulder girdle, due to scoliosis, with altered shoulder kinematics, injury of joint capsule ligaments and rotator cuff tendons, and shoulder dislocation due to a traumatic event. The subject has developed adolescent idiopathic scoliosis, with convex curvatures to the right side in the lower region of the thorax (with the Cobb angle of 13 degrees) and to the left side of the upper region of the thorax (with the Cobb angle of 24-degrees), both of them with the axial rotation of vertebra and with visible gibbosities. The upper axial rotation has a 6.5-degree, which causes an unbalance between the two shoulder girdles. In normal situations, the shoulder joint is turned 30 degrees anterior to the coronal plane, but in his case, the right shoulder girdle is pulled 28 degrees anterior by the groove, and the left one is pushed 34.5 degrees anterior by the gibbosity. The major effect of shoulder girdle unbalance appears to be the maximum extension of the upper limbs when the hands can’t be aligned to the coronal plane and this is an important risk factor for the injuries of the left shoulder joint, while some weight training exercises are performed.

Radiographic assessment of unerupted permanent maxillary canines and their relationship to the phases of dentition in mixed dentition Spanish children: a retrospective cross-sectional study.

Evaluate if there is a significant association between the position and inclination of the unerupted maxillary canine measured on a panoramic radiograph, and their relationship to gender, age of the patient and stage of dentition. 138 panoramic radiographs were examined for this retrospective cross-sectional investigation. Only patients living in Madrid, Spain with mixed dentition were included. These measurements were performed on radiographs, considering the inclination and position of the maxillary canines with regards to the midline, and height with respect to the occlusal plane. Spearman's correlation coefficient was used to analyze the relation among the canine angle and height. p < 0.05 was considered to be significant. The prevalence of patients with an altered canine angle was 10%, while 43.5% had an apparently abnormal position (overlapping at least half of the adjacent lateral incisor root). No statistically significant association was found between these two variables. In 5% of the patients, the maxillary canine was with an anomalous angle and position. Significant differences were obtained when comparing canine height between children with ectopic canines and normal canines (p = 0.032). No significant association was found between the position and inclination of the unerupted maxillary canine in our sample. Ectopic maxillary canines had a higher incidence in girls, although we did not find statistically significant differences between genders. We observed a higher prevalence of abnormal position and inclination of the permanent maxillary canine in early mixed dentition. Maxillary canines were significantly elevated, further from the occlusal plane, in children with ectopic canines.

Anomalous position of Paleozoic faults of Western Donbas

Statement of the general problem. The oil and gas-bearing province of Eastern Ukraine is located in the Dnipro-Donetsk Basin (DDB). It covers the Paleozoic structural floor and is buried under younger sediments. The Paleozoic structural floor of the territory is represented as a long rift graben. The maximum thickness of the sedimentary cover in the graben is 15–17 km. According to geophysical data, the thickness of the earth's crust is 31–32 km under the axial part of the DDB and increases towards the sides. But according to the maximum thickness and facies characteristics of the Paleozoic deposits, the thickness of the Earth's crust below them could not exceed 20 km. The modern thickness is 1.5 times higher. Therefore, such a geological-geophysical model of the structure of the DDB is contradictory. Analysis of recent research and publications. The removal of the contradiction is possible due to the detection of a series of Hercynian thrusts with total amplitude of thrusts of the order of 50 km. Such thrusts began to be established on the northern and southern flanks of the DDB. Hercynian thrusts have a southwestern vergence. In the north, the Voronezh crystalline massif is pushed onto the DDB along the Noviy thrust with an amplitude of 9–10 km. In the south, the South Donbas melange zone is established, which pushes the folded Donbas onto the Ukrainian shield. On its continuation to the northwest is the southern side of the DDB - the so-called Southern monocline. The well-studied Pavlograd-Petropavlovsk coal mining district of Western Donbass with operating coal mines is located within its borders. An unsolved part of the overall problem. Numerous faults with relatively small amplitudes are established within the Paleozoic Southern Monocline. Together, they form a system of horsts and grabens with a north-western extension. But the bottom parts of the grabens are 1–3 km higher than the tops of the horsts. Such a geological situation is anomalous. This indicates the post-fault dislocation of the horst-graben system as a whole. The purpose of the article is identification of the causes of the anomalous structural position of the graben-horst system in the modern geological structure of the Southern Monocline and in the general model of the geological structure of Eastern Ukraine. Research materials and methods. Were involved more than 390 geological sections, constructed based on the data of more than 10,000 wells. Of them, 265 wells revealed the folds that are being analyzed. In addition, were used data of catagenetic transformations of the sedimentary section. Presentation of the main research material. The South Donbas mélange zone falls to the northeast and continues under the Southern Monocline. It is located in the upper block of this regional thrust structure and is in an allochthonous setting. According to geological data, the true amplitude of the thrust of Western Donbas on the Ukrainian shield is 15–20 km, and the vertical component of this amplitude exceeds 3 km. Such spatial parameters explain the abnormality of the structural position of the horsts and grabens of Western Donbass - their southwestern flanks were significantly raised relative to the northeastern flanks during thrusting. Scientific novelty. Therefore, in the modern geological structure, the Dnipro-Donetsk "basin" is not a rift, but a post-rift Hercynian folded region. It is formed by high-amplitude thrusts on the northern and southern flanks. The Hercynian fold region is buried under Mesozoic and Cenozoic sediments and is further complicated by Laramian and Attic fold-thrust dislocations of lesser intensity. Conclusions. The thrust model brings the geophysical parameters into the correspondence with the geological data and is confirmed by the actual material.

P256 AN UNUSUAL CASE OF PACEMAKER MALFUNCTION WITH NON COMMON ELCTROCARDIOGRAPHIC PRESENTATION AND UNEXPECTED ECHOCARDIOGRAPHIC FINDING

Abstract This clinical case shows the diagnostic challenge and the management of a 79 y–o male with recent hospitalization for infero–lateral STEMI undergoing primary PCI of Right Coronary Artery with 2 DES and following DDDR MRI PM (pacemaker) implantation due to the development of persistent 2:1 Atrio–Ventricular Block. One month later, admission at Emergency Department for syncope. Normal parameters were found at laboratory analyses. The electro–stimulator activity evaluation showed a PM malfunction with ventricular capture failure. Thus, the increase of PM output up to electric ventricular capture (8 Volt/120 msec) was performed, but the following Electrocardiogram showed a PM–induced rhythm with RBBB–morphology. Then, the bedside Echocardiogram showed an apparent presence of a linear hyper–echogenic image into left ventricle with no inter–ventricular septal defect neither inter–ventricular shunt, inter–atrial septal hypermobility with no evident inter–atrial shunt at rest; while a chest Radiography identified the atrial and ventricular leads with no accurate individuation of their position. The patient was admitted in Intensive Cardiac Care Unit with confirmation of intermittent failure to ventricular capture and RBBB–morphology during PM–induced rhythm at telemetry monitoring. Due to Electrocardiographic and Echocardiographic findings, a strong suspect of abnormal position of the ventricular lead into left ventricle through a possible PFO has been raised. A chest Computed Tomography was performed confirming the anomalous position of the ventricular lead: it reached the left atrium through an inter–atrial defect/patent foramen ovale (PFO), then crossing the mitral valve up to left ventricle. The PM–lead repositioning was scheduled two days after. After positioning of temporary stimulator lead in right ventricle, the ventricular lead has been withdrawn from left–side chambers and positioned into septal–apical right ventricle; furthermore, the position of right atrial lead has been optimized (because of frequent spontaneous passage to the left atrium through the PFO, during manual maneuvers) thus obtaining good stability of the device. During the following days, the telemetry monitoring showed a PM–induced rhythm, without capture nor sensing failure. The chest Radiography confirmed the correct position of leads and the pre–discharge Echocardiography showed a LVEF 57% with no valvular pathology and with atrial and ventricular leads into right–side chambers.

P390 CARDIAC INVOLVEMENT IN A VERY RARE CASE OF CUTIS LAXA

Abstract The "Cutis Laxa" is a rare pathology of the connective tissue characterized by redundant skin and diffuse manifestations are identified by other organs (mainly heart and lungs). The low elasticity of the tissue is believed to be attributable to an anomalous elastin formation. Cutis Laxa is usually a genetic disease, but acquired forms have also been described. The case we describe is that of a 34 –year –old young woman with a diagnosis of Cutis Laxa acquired from the age of 15, complicated by a serious impairment at the pulmonary level in the form of marked emphysema and severe asthmatic framework. It came to our observation following the PEA type cardiovascular arrest episode during tracheostomy procedure, promptly resolved by resuscitation maneuvers according to the Als protocol. The echocardiogram was performed by the only belowocostal window by which a 4 –chamber apical projection was viewed, highlighting an anomalous position of the cardiac Hague (lower and media). The left ventricle appeared to be normal endocavity dimensions and parietal thicknesses with preserved indexes of systo–diastolic functionality in the presence of SIV discline; The right ventricle was instead slightly dilated, hypertrophic, with reduced Chinese of the free wall (nappese 18 mm), the tricuspid regurgitation was moderate with indirect signs of increased lung pressures. The echocardiographic appearance was therefore compatible with a chronic pulmonary heart frame, secondary to progressive pulmonary enfisema, and described in literature as the most fearful complication of Cuis Laxa syndrome, associated with an inauspicious prognosis and premature death.

Hearing-related problems in children with cleft palate: A single-center cross-sectional study in the sub-Himalayan population

Purpose: Cleft palate is known to cause recurrent otitis media with hearing loss. Various studies have stated the incidence of middle ear disease in patients with cleft palate is around 90%. The anomalous position of the Eustachian tubes in patients with cleft palate leads to otitis media with effusion. If left uncorrected this leads to complications such as cholesteatoma, retraction pockets, and atelectasis leading to permanent hearing loss. In this study, we evaluated the children presenting to our institute with cleft palate for hearing-related issues. Materials and Methods: The study was conducted in our institute from January 2017 to September 2020. It was a cross-sectional study, where 45 children with cleft palate were compared with 36 children with cleft lip who were considered the control group. Hearing of all children was assessed using tympanometry, otoscopy, and brainstem evoked response audiometry (BERA). Results: About 93.3% of children in the cleft palate group had an abnormal tympanic membrane on otoscopy, whereas in the control group only 11.1% of children had an abnormal tympanic membrane on otoscopy. About 97.8% of children in the cleft palate group had a hearing threshold greater than 25 decibels, whereas only 13.9% of children in the control group had a hearing threshold of above 25 decibels. More children in the cleft palate group had an abnormal tympanogram (42.2% had a type B tympanogram and 46.7% had a type C tympanogram) compared to the control group (5.6% had a type B tympanogram and 2.8% had a type C tympanogram). Conclusion: Our study adds to the evidence that there is a high incidence of hearing impairment in children with cleft palate. Hence, we advocate that early identification by screening measures such as otoscopy, tympanometry, auditory brainstem response, and pure tone audiometry during the first visit itself in these children so that early treatment can be initiated.

262 AN UNUSUAL CAUSE OF PACEMAKER MALFUNCTION WITH NON-COMMON ELECTROCARDIOGRAPHIC PRESENTATION AND UNEXPECTED ECHOCARDIOGRAPHIC FINDING

Abstract This clinical case shows the diagnostic challenge and the management of a 79 y-o male with arterial hypertension, tabagism, obesity and a recent hospitalization for infero-lateral STEMI undergoing primary PCI of Right Coronary Artery with 2 DES and following DDDR MRI PM (pacemaker) implantation (through left cephalic vein) due to the development of persistent 2:1 AV block (atrio-ventricular block). One month later, admission at Emergency Department for syncope. The admission therapy included Aspirin plus Clopidogrel, Ramipril, Atorvastatin. Normal parameters were found at laboratory analyses. The electro-stimulator activity evaluation showed a PM malfunction with ventricular capture failure. Thus, the increase of PM output up to electric ventricular capture (8 Volt/120 msec) was performed, but the following Electrocardiogram (ECG) showed a PM-induced rhythm with RBBB-morphology. Then, the bedside Echocardiogram showed an apparent presence of a linear hyper-echogenic image (lead?) into left ventricle with no inter-ventricular septal defect neither inter-ventricular shunt, inter-atrial septal hypermobility with no evident inter-atrial shunt at rest; while a chest Radiography identified the atrial and ventricular leads with no accurate individuation of their position. The patient was admitted in Intensive Cardiac Care Unit with confirmation of intermittent failure to ventricular capture and RBBB-morphology during PM-induced rhythm at telemetry monitoring. Due to Electrocardiographic and (above all) Echocardiographic findings, a strong suspect of abnormal position of the ventricular lead into left ventricle through a possible PFO has been raised. A chest Computed Tomography was performed confirming the anomalous position of the ventricular lead: the atrial lead was in the right atrium whereas the ventricular lead reached the left atrium through an inter-atrial defect/patent foramen ovale (PFO), then crossing the mitral valve up to left ventricle. The PM-lead repositioning was scheduled two days after. With intra-operative fluoroscopy, a further verify of leads position was observed (the ventricular one into left ventricle through PFO and mitral valve, the atrial one mildly displaced upwards) and the leads repositioning was performed. After positioning of temporary stimulator lead in right ventricle, the ventricular lead has been withdrawn from left-side chambers and positioned into septal-apical right ventricle; furthermore, the position of right atrial lead has been optimized (because of frequent spontaneous passage to the left atrium through the PFO, during manual maneuvers). Finally, the optimal stability of the device was obtained, as well as the optimal atrial and ventricular capture during stimulation test. During the observation in Cardiology Unit in following days, the telemetry monitoring and ECG showed a PM-induced rhythm, without capture nor sensing failure. The chest Radiography confirmed the correct position of atrial and ventricular leads. Finally, the pre-discharge transthoracic Echocardiography showed a LVEF 57% with no valvular pathology nor pericardial effusion, and with atrial and ventricular leads into right-side chambers.

Surgical Treatments to Improve Visual Acuity in Infantile Nystagmus Syndrome: A Report by the American Academy of Ophthalmology

To review the literature on the efficacy of surgical procedures to improve visual acuity (VA) in patients with infantile nystagmus syndrome (INS). Literature searches were last conducted in January 2022 in the PubMed database for English-language studies with no date restrictions. The combined searches yielded 354 abstracts, of which 46 were reviewed in full text. Twenty-three of these were considered appropriate for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist. One included study was a randomized trial; the remaining 22 were case series. The 23 studies included children and adults with INS and a variable proportion with anomalous head position (AHP), strabismus, and sensory diagnoses. The surgical interventions evaluated included large recessions, tenotomy and reattachment (TAR), myectomy with or without pulley fixation, and anterior extirpation of the 4 horizontal rectus muscles, as well as various procedures to correct an AHP in which VA was reported as a secondary outcome. The data were mixed, with improvements in binocular best-corrected visual acuity (BCVA) ranging from no improvement to 0.3 logarithm of the minimum angle of resolution (logMAR), or 3 lines. (Most studies were in the range of 0.05-0.2 logMAR.) Statistically significant improvement in VA was noted in 12 of 16 studies (75%) that performed statistical analyses, with no clear advantage of any single procedure. Complications and reoperations were lowest in patients who underwent TAR and highest in those who underwent myectomy or anterior extirpation. The best available evidence suggests that eye muscle surgery in patients with INS results in a modest improvement in VA. Proprietary or commercial disclosure may be found after the references.

Аномальное положение головы: новая парадигма

Purpose. To determine the most common ocular causes and types of anomalous head position and give details of their functional features. Material and methods. The research included 105 patients with an anomalous head position. Depending on the oculomotor pathology, patients were divided into 6 groups. 1st group – 10 patients with Brown syndrome, 2nd group – 20 patients with Duane syndrome of types 1 and 2, 3rd group – 30 patients with nystagmus, 4th group – 30 patients with n. abducensparalysis, 5th group – 15 patients with n. trochlearisparalysis, and control 6th group – 20 patients with one of the above pathology, but without anomalous head posture (AHP). Results. Out of 105 patients with AHP, 83.8% had both fusion and stereopsis. There was no statistical difference in the rate of fusion or stereopsis among the different AHP types (p=0.580). The control group showed accurately low scores of stereopsis and fusion loss (5.3%) (p=0.001). The overall incidence of amblyopia in all groups of patients with AHP (with Brown, Duyane syndrome, with nystagmus by 3.7 times, with paralysis and paresis of n. abducensand n. trochlearis) is statistically significantly lower (p&lt;0.001) than in the control group. Conclusion. The most common ocular causes of anomalous head position are nystagmus and paralysis of the abducens nerve, as well as Duane syndrome and paralysis of the trochlear nerve. Head rotation is most commonly associated with congenital nystagmus, Duane syndrome, and n. abducens paralysis and paresis. Head tilt or various combinations of head tilt with a raised chin is most characteristic of n. trochlearis paralysis and paresis and Brown syndrome. AHP formation is a «protective» mechanism in terms of developing amblyopia and loss of binocular single vision. Key words: abnormal head position, binocular vision, stereopsis, amblyopia.

Hot metamorphic complex in the Foreland Zone of the Variscan chain: insights from the Monte Filau orthogneiss (SW Sardinia), Italy

The Mt. Filau Orthogneiss belongs to the low-pressure (LP) - high-temperature (HT) Sulcis Metamorphic Complex located in the foreland zone of the Variscan belt (southern Sardinia). It consists of a core of orthogneiss and high metamorphic grade host rock tectonically juxtaposed below weakly- to non-metamorphic tectonic units, by the Tuerredda ductile shear zone. Our new petrographic and microstructural data on the fine–grained leucocratic facies of the Mt. Filau Orthogneiss are consistent with metamorphic peak under conditions of incipient partial melting in the sillimanite stability field at 680–700°C and 0.32–0.46 GPa. The retrograde P–T path occurred in the andalusite stability field, according to the growth of andalusite after sillimanite in leucocratic facies. The P-T conditions of metamorphic peak and incipient melting are both consistent with development, in the foreland zone, of a thermal anomaly accompanied by the upward rise of deep hot crust in the footwall of the Tueredda ductile shear zone. This transtensive shear zone acted as preferential channel for upward advection of deep hot melts during tectonically-driven isothermal decompression of middle crust. Therefore, we interpret the Sulcis Metamorphic Complex as the result of a tectonically controlled thermal perturbation, and underline the role of this late Variscan crustal scale tectonic structure in the development of hot metamorphic complex in an anomalous position within the foreland zone of the Variscan collisional belt.

Shelf Water Export at the Brazil-Malvinas Confluence Evidenced From Combined in situ and Satellite Observations

The Brazil-Malvinas Confluence (BMC) is the region where opposing and intense western boundary currents meet along the Southwestern Atlantic slope at about 38°S, generating one of the most energetic mesoscale regions of the global ocean. Based on shipborne observations acquired within the Uruguayan Economic Exclusive Zone (EEZ), combined with satellite data and an eddy tracking algorithm, we analyze the cross-shelf exchanges during May 2016, when the BMC was in an anomalous northern position. Two types of shelf water export were observed triggered by mesoscale dynamics: one was the export of shallow Rio de la Plata Plume waters driven off-shelf by the retroflection of the Brazil Current. This export formed a 70 km wide, 20 m deep filament that propagated offshore at 0.3 m s–1, with a transport of 0.42 Sv. It lasted about 10 days before being mixed with ambient Confluence waters by strong winds. An additional type of off-shelf transport consisted of a subsurface layer of Subantarctic Shelf Waters (SASW) about 60 m thick that subducted at the BMC reaching 130 m deep and transporting 0.91 ± 0.91 Sv. We show that geostrophic currents derived from satellite altimetry over the slope can be useful to track this subsurface off-shelf export as they are significantly correlated with absolute velocity measurements at this depth. Argo temperature and salinity profiles show evidence of these two types of shelf water export occurring between the BMC front and the separation of the Brazil Current from the shelf-break, suggesting this is a relatively frequent phenomenon, in agreement with previous observations.

English

Wandering spleen is a rare clinical entity characterized by anomalous position of the spleen in the abdomen due to impaired splenic ligamentous attachments that produce an elongation of the vascular pedicle, favouring a possible volvulus of partial or complete vascular axis. Wandering spleen was first described in autopsies by Johannes Van Horne in 1667. Wandering spleen mainly presents as an asymptomatic mass or seldomly presents as recurrent abdominal pain or acute abdomen. The absence of splenic parenchyma in the left upper quadrant and ectopic location of the spleen can be shown by USG, CT and MRI The procedure of choice in the treatment of wandering spleen is splenopexy. Here we present a case of torsion in a wandering spleen in a 32 years old female. Wandering spleen is a rare clinical entity characterized by anomalous position of the spleen in the abdomen due to impaired splenic ligamentous attachments that produce an elongation of the vascular pedicle, favouring a possible volvulus of partial or complete vascular axis.1 Its aetiology is not clear. Congenital factors exist such as an alteration in the development of the dorsal mesogastrium2 and acquired factors such as hormonal changes during pregnancy,3 abdominal wall weakness, splenomegaly. Clinical presentation is variable, from asymptomatic to chronic abdominal pain or acute abdomen. The most common complication is acute torsion of the splenic pedicle causing acute abdominal pain.

Two-stage orthodontic treatment outcomes of children with dentoalveolar class II malocclusion

Background. During the rehabilitation of children with distal occlusion, it is not always possible to achieve the desired outcomes. In this context, the factors influencing the outcomes of treatment for class II malocclusions in children at different stages of occlusion development.&#x0D; Aim. To study two-stage orthodontic treatment outcomes in children with dentoalveolar class II malocclusion by the clinical case.&#x0D; Material and methods. We analyzed the physical examination results of the patient within the treatment from 6 to 17 years. Facial proportion symmetry, aesthetic, type of face, plaster dental models were determined by using the photographs. Orthopantomography was used to analyze the condition of temporary and permanent teeth, jaw bone tissue and to assess functional disorders. Orthodontic treatment in a mixed dentition period was carried out using removable devices, including those improved by the authors. In the permanent dentition, orthodontic brackets with power elements were used.&#x0D; Results. Untimely contacting the doctor, an insufficient level of motivation to implement recommendations for improving posture and dental care contributed to an increase in treatment duration. Keeping excessive cervical spine flexion and head tilted back, the bad habit of placing (pressure) the hand on the chin, and the rejection of a myo-gymnastic exercise (physical therapy) interfered with the synchronous (normal) development of the jaws. Premature loss of a temporary molar on one side led to dentoalveolar asymmetry and disruption of occlusal contacts. Additional orthodontic appliances were used to correct these deformities. Over-retained deciduous teeth led to the delayed eruption of permanent teeth and, presumably, to the curvature of their roots. Violation of the tooths root shape and asymmetry in permanent teeth crown size prevented the full correction of their position using highly effective modern non-removable orthodontic equipment. The anomalous position of the rudiment of the third molar, the refusal for timely tooth extraction further led to the increasing complexity of the surgical technique.&#x0D; Conclusion. The timing and effectiveness of orthodontic treatment of a patient with dentoalveolar class II malocclusion were influenced by a poor body posture, extraction of a primary molar, the delayed eruption and crown size asymmetry of permanent teeth, the presence of bad habits and minimal cooperation of the patient with the orthodontist.