Border Distance Research Articles

Co-evolutive Resilience: The Hidden Identity of Phoenicia

Finiq is the biggest town in its municipality and has served as an administrative center for various years. Most of the dwellings are placed during the 1990-2000 decade, referring to the previous and the current maps. Because of massive emigration trends in the past, there are many abandoned and unfinished houses. The uninhabited villages that have been abandoned in recent decades make up a serious problem, which is all too common in many Balkan countries. As a result, various buildings are semi-finished and in a degraded state, both architectural and structural. Also, on top of the hill of Finiq, there is an archeological site of the old Phoenicia city. It serves as the main touristic attraction for the town, along with the bucolic scene of the countryside. By analyzing the territory of Finiq we figured out that there is a hidden identity of the urban structure. As the town lays morphologically on the strip, it fragmentises from the second and third row of buildings, showing a “missed typological block”. On the other hand, it shows the creation of spontaneous empty spaces, that suggest this hidden spirit of the town, created imaginatively by connecting them. The simple disposal of each building to the nearest one creates what Franco Purini calls the “border distance”, a distance that, like in Michelangelo’s fresco, creates a necessary situation for one to feel the magnetic force of attraction or repulsion between the two bodies. The space where this magnetic force is exerted is the key point from which to draw the hidden spirit of Finiq. It is precisely the shape of that space that will determine the rules for the evolution of the town's identity. We will analyze in this paper how this space "between" can “co-evolve” if the institutions and the people who live there find a common language to reinvent a new but existing architecture of the place. As spotted in the analysis, we can confirm that there is an identity in Finiq. A “hidden spirit” lies in empty and fragmented spaces. It’s a millennial town, therefore something stronger than the constructions exists there. The resilience of the context’s form, space, and time coexist in lost identity, which we can strongly expose by intervening surgically. the co-evolution of these public spaces must start from precise rules which, through the careful analysis of the architect and urban planner, must be able to direct the inevitable spontaneity of the place’s history, without having a drastic top- down effect.

Cone Beam CT Assessment of Mandibular Foramen and Mental Foramen Positions as Essential Anatomical Landmarks: A Retrospective Study in Vietnam.

The mandibular foramen (MnF) and the mental foramen (MF) are essential anatomical landmarks that should be considered before any surgical procedures in the mandible. This study aimed to investigate the characteristics of the MnF and MF in relation to adjacent anatomical structures, as well as age and gender differences, using cone beam computed tomography (CBCT) projections. The study was conducted from August 2023 to January 2024 at the Can Tho University of Medicine and Pharmacy Hospital, Vietnam. In this retrospective study, 50 CBCT images of Vietnamese patients were randomly taken for various clinical purposes. Furthermore, relevant data, such as gender and age groups, were selected to evaluate the correlations, along with specific inclusion criteria. Patients within the age range of 18-69 with a symmetrical mandible were included. The distance of the MnF-MN was 29.6±5.0 mm (right) and 30.1±4.6 mm (left) in males and 25.0±4.2 mm (right) and 26.3±5.0 mm (left) in females. The distance of the MnF-posterior border of the ramus (P) was 16.2±3.6 mm (right) and 15.0±2.3 mm (left) in males. For females, it was 17.1±2.9 mm (right) and 13.8±1.7 mm (left). The distance of the MF-body mandible (MB) was 15.4±2.4 mm (right) and 15.6±2.0 mm (left) in males and 14.0±2.1 mm (right) and 14.3±1.6 mm (left) in females. The distance of the MF-mandibular midline (MM) was 27.0±2.6 mm (right) and 27.0±2.9 mm (left) in males and 25.3±2.0 mm (right) and 25.1±2.2 mm (left) in females. These distances showed statistically significant differences depending on gender (P<0.05). It can be said that CBCT provides comprehensive information about the MnF and the MF for dentists in research and clinical practice.

USING SERIAL TRICHOTOMIZATION WITH MULTIPLE RADIOGRAPHIC PARAMETERS TO DIAGNOSE ATLANTOAXIAL INSTABILITY IN PREDISPOSED TOY-BREED DOGS

Objective radiographic measurements for determining atlantoaxial instability (AAI) in dogs have been reported. However, choosing a single optimal parameter among different studies is challenging. This study aimed to identify optimal parameters for AAI in small-breed dogs by simultaneously evaluating the flexed and nonflexed lateral radiographs. Moreover, the potential of using serial trichotomization with multiple parameters was investigated. Radiographs of 10 dogs diagnosed with AAI on magnetic resonance imaging (MRI) were compared with 26 control dogs to select parameters with the area under the curve ≥0.9 or ≤0.1. Parameters with outstanding discrimination included cranial border distance and C1–C2 angle on nonflexed radiographs and dens length on ventrodorsal radiographs. Using cutoff values reflecting 100% sensitivity and 100% specificity, the subject was determined into AAI diagnosed, ruled-out or indeterminate. The accuracy rate was 100% for each of the parameters. However, 31–47% of dogs were classified as indeterminate. Serial trichotomization in the order of dens length, cranial border distance, and C1–C2 angle significantly reduced the proportion of dogs in the uncertainty zone while maintaining accuracy. The established method was tested on 19 new subjects. A similar trend of high accuracy (100%) and small uncertainty zone (5%) was observed in the validation cohort. For certain breeds, serial trichotomization with dens length on the ventrodorsal radiograph and cranial border distance and C1–C2 angle on the nonflexed lateral radiograph showed good potential for determining AAI and identifying dogs in which advanced imaging is indicated for diagnosis.

Bone Flap Resorption After Cranioplasty: Risk Factors and Proposal of the Flap Integrity Score

BackgroundBone flap resorption is a known complication of post-decompressive autologous cranioplasty. Although several potential etiopathogenetic factors have been investigated, their role is still under discussion. To further complicate things, resorption is not an all-or-nothing event, patients frequently presenting with different degrees of flap remodeling. Focus of this paper was to describe the elaboration of a score quantifying bone resorption according to a set of clinical and radiological criteria, hopefully allowing prompt identification of patients needing re-surgery before the development of adverse events. MethodsIn a 10-years-time, 281 autologous cranioplasties were performed at our Institution following decompressive craniectomy. Pertinent clinical and radiological information was registered. A set of 3 clinical and 3 radiological parameters was established to score the degree of resorption, identified under the acronym FIS (Flap Integrity Score). Three groups of patients emerged, respectively showing no (208), partial (32) and advanced (41) resorption. ResultsAn overall 14.6% incidence of advanced bone resorption was found in our series. Younger age, bone multifragmentation, higher post-cranioplasty GOS scores, < 2 cm distance of medial craniectomy border from the midline, and cause leading to decompressive craniectomy were associated to a statistically significant higher risk of developing a relevant bone flap resorption. The first three variables confirmed as risk factors at multivariate analysis. FIS well discriminated the 3 different groups. ConclusionsAutologous bone repositioning is still a valuable, low-cost, cosmetically and functionally satisfactory procedure. Nonetheless, although resorption affects a minor percentage of patients, its early identification and treatment can improve long term results.

Prevalence of Incidental Maxillary Sinus Anomalies on CBCT Scans: A Radiographic Study.

CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant (p = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.

The Radiological Evaluation of the Anatomy of the Alveolar Antral Artery and the Lateral Wall Thickness Using Cone-Beam Computed Tomography: A Retrospective Study.

This study included CBCT scans from 238 patients. The detection diameter of AAA and distance of the lower border of AAA to the maxillary sinus floor at the first premolar, second premolar, first molar, and second molar locations were evaluated. The route of AAA was observed with novel classification. Furthermore, the distance from the maxillary sinus floor to the alveolar crest at four posterior tooth locations was measured respectively. Moreover, the lateral wall thickness at four locations was assessed. Data were subjected to statistical analysis. AAA was observed in 62.18% of all sinuses. The mean diameter was 0.99±0.21 mm, with significant differences within gender. Half of the route of AAA was intrasinus intraosseous type. The mean distance between the maxillary sinus floor and AAA was 8.00±2.68 mm, with a significant difference between dentate and edentulous status at the first molar location. Distance from the sinus floor to the alveolar ridge crest in edentulous status negatively correlated with the distance from the sinus floor to AAA at the first molar location. The mean thickness of the lateral wall was 2.03±0.91 mm, and the difference in thickness between males and females at the four locations was statistically significant. intrasinus-intraosseous type, is the most common route. Special care should be taken at the first molar location during a lateral window sinus floor elevation. CBCT is highly recommended to before lateral wall maxillary sinus floor elevation.

Retrospective evaluation of the morpometric and morphological anatomy of the occipital condyle, hypoglossal canal and foramen magnum in Turkish populaton with CBCT.

The aim of this study is to morphometrically and morphologically examine the occipital condyle, which is an important anatomical region in terms of surgery and forensic medicine, and its surrounding structures, to evaluate the change in mean values according to gender and age, and to evaluate the correlation of the measurements obtained. 180 (90 men, 90 women) CBCT images selected from the archive of Ankara University Faculty of Dentistry. Occipital Condyle length and width, Hypoglossal Canal-Basion distance, Hypoglossal Canal-Opistion distance, Hypoglossal Canal-Occipital Condyle anterior and posterior border distance, Occipital Condyle thickness, Hypoglossal Canal length, the widest diameter of Hypoglossal Canal, the narrowest diameter of the Hypoglossal Canal, the length of the Jugular Tubercle, the width of the Jugular Tubercle, the anterior intercondylar distance, the posterior intercondylar distance, and the Foramen Magnum index were measured. At the same time, the presence of septum or spicule in the hypoglossal canal and protrusion of the occipital condyle were evaluated. The relationship of age, gender, anterior and posterior intercondylar distance, and foramen magnum index measurements with all measurements were examined. In our study, all measurements were repeated 1month after the first measurements to evaluate the intra-observer agreement, and the agreement between the obtained measurements and the first measurements was evaluated by calculating the intraclass correlation coefficient and 95% confidence intervals. Men's measurements were found to be significantly higher than women's measurements. When the coefficients of concordance in all measurements were examined, it was observed that there was a perfect concordance. When the results of the study are evaluated, it is seen that the values ​​obtained are generally close to the studies related to CT. Considering this, an idea can be gained as to whether CBCT, which has a lower dose and less cost, can be used as an alternative to CT in studies to be conducted with more comprehensive and different methods in skull base surgical planning.

Mental foramen of mandible in South Kerala population - A digital radiographic study

To assess whether there is sexual dimorphism in the location of mental foramen from base of mandible in South Kerala population.A two-year retrospective study was conducted in 200 subjects [100 males and 100 females] using digital radiographs. The location of mental foramen mandible was assessed from digital orthopantomogram. The vertical distance was measured from the superior border of the mental foramen to the lower border of the mandible and the inferior border of the mental foramen to the lower border of the mandible. The obtained data statistically analyzed using SPSS software version 20. Descriptive statistics was analyzed. Independent t-test was done to determine the association between gender and different parameters. The level of significance set at p ≤ 0.05.The average value of the distance of lower border of mandible from the superior and inferior border of mental foramen is found to be significantly higher in males than females.The study revealed that there is sexual dimorphism in the location of mental foramen in South Kerala population.

In Vivo Retinal Pigment Epithelium Imaging using Transscleral Optical Imaging in Healthy Eyes

To image healthy retinal pigment epithelial (RPE) cells invivo using Transscleral OPtical Imaging (TOPI) and to analyze statistics of RPE cell features as a function of age, axial length (AL), and eccentricity. Single-center, exploratory, prospective, and descriptive clinical study. Forty-nine eyes (AL: 24.03 ± 0.93 mm; range: 21.9-26.7 mm) from 29 participants aged 21 to 70 years (37.1 ± 13.3 years; 19 men, 10 women). Retinal images, including fundus photography and spectral-domain OCT, AL, and refractive error measurements were collected at baseline. For each eye, 6 high-resolution RPE images were acquired using TOPI at different locations, one of them being imaged 5 times to evaluate the repeatability of the method. Follow-up ophthalmic examination was repeated 1 to 3 weeks after TOPI to assess safety. Retinal pigment epithelial images were analyzed with a custom automated software to extract cell parameters. Statistical analysis of the selected high-contrast images included calculation of coefficient of variation (CoV) for each feature at each repetition and Spearman and Mann-Whitney tests to investigate the relationship between cell features and eye and subject characteristics. Retinal pigment epithelial cell features: density, area, center-to-center spacing, number of neighbors, circularity, elongation, solidity, and border distance CoV. Macular RPE cell features were extracted from TOPI images at an eccentricity of 1.6° to 16.3° from the fovea. For each feature, the mean CoV was < 4%. Spearman test showed correlation within RPE cell features. In the perifovea, the region in which images were selected for all participants, longer AL significantly correlated with decreased RPE cell density (R Spearman, Rs=-0.746; P < 0.0001) and increased cell area (Rs= 0.668; P < 0.0001), without morphologic changes. Aging was also significantly correlated with decreased RPE density (Rs=-0.391; P= 0.036) and increased cell area (Rs= 0.454; P= 0.013). Lower circular, less symmetric, more elongated, and larger cells were observed in those > 50 years. The TOPI technology imaged RPE cells invivo with a repeatability of < 4% for the CoV and was used to analyze the influence of physiologic factors on RPE cell morphometry in the perifovea of healthy volunteers. Proprietary or commercial disclosure may be found after the references.

Greater Palatine Canal: Computed Tomography-Based Anatomic Analysis And Clinical Significance for the Sinus and Skull Base Surgeon.

Our aim is to describe the location and course of the greater palatine canal (GPC) by analyzing its relationship with anatomical landmarks that can be used during endoscopic sinus surgery. This information might help prevent injury to the neurovascular bundle. A retrospective evaluation of paranasal sinus CT scans of 100 consecutive random patients, 200 sides, was performed. Five measurements related to the course of the GPC were conducted, from cranial to caudal. The anatomical landmarks were the inferior bony border of the sphenopalatine foramen to the cranial entrance of the GPC, the distance from the most dorsal, and inferior bony insertion of the middle turbinate and the inferior turbinate bones to the anterior margin of the GPC. The angle between the horizontal palatine bone and the GPC, its length, and the prevalence of osteophytes in GPC was also assessed. The mean distance of the inferior border of the sphenopalatine foramen to the cranial entrance of the GPC was 9.39 ± 1.72mm. The mean distance of the dorsal insertion of the middle turbinate to the anterior margin of the GPC was 3.89 ± 0.93mm. The distance of the dorsal insertion of the inferior turbinate to the anterior margin of the GPC was 3.16 ± 0.81mm. The mean angle between the horizontal palatine bone and the GPC was 114.33 ± 10.92º and the mean length of the GPC was 30.23 ± 3.74mm. None of the measurements showed a significant difference between the two sides. The landmarks used are easy to locate and assess on CT scans. These findings may help to make dissection safer in pathologies related to the pterygopalatine fossa, lateral sphenoid sinus or adjacent skull base.

Border to border distance based lung parenchyma segmentation including juxta-pleural nodules

Border to border distance based lung parenchyma segmentation including juxta-pleural nodules

Single access upper blepharoplasty and lower lid lateral fat pad removal: A proven technique with low recurrence rate

The transconjunctival approach is commonly performed in lower lid blepharoplasty so as not to violate the orbicularis oculi muscle integrity and avoid additional scars. This technique does not, however, permit easy access to the lateral fat pad (LFP). As upper and lower blepharoplasty are frequently combined in our clinical practice, the removal of LFP via upper blepharoplasty is a surgical approach that we found most applicable with good outcomes. A prospective review of 47 consecutive bilateral combined upper and lower blepharoplasty cases using a single access technique was conducted; patient outcomes and the occurrence of any complications were recorded, in addition to preoperative and postoperative measurements between standardized anatomical landmarks. Forty-seven patients were included in our study. Postoperative measurements showed a decrease of both lateral cantus to inferior orbital border distance and horizontal width of LFP. Good esthetic outcomes and patient satisfaction with surgical results were achieved in the majority of patients. The single access upper blepharoplasty and lower lid LFP removal technique can improve esthetic outcomes in lower blepharoplasty. The advantages are many; a low risk of missing the lateral pad, ease of achieving a uniform contour of lower eyelid; short lower transconjunctival incision, minimizing complications associated with an intra-conjunctival scar. This technique, based on cadaveric anatomical studies, has been found to be safe and is of great utility to those patients requiring upper and lower lid blepharoplasties.

Spatial Relationship Perception is Not Affected by Short-term Cortical Reorganization

Aims: Long-term cortical reorganization after cortical damage can induce abnormal spatial relationship perception (spatial anisotropy) but there is also evidence of short-term, reversible cortical re-modulation even in the absence of cerebral damage: simulated hemianopic deprivation, in fact, is found to affect the positional judgment. This study investigates if the same occurs for spatial relationship perception.&#x0D; Study Design: Case series.&#x0D; Place and duration of Study: Service of Neuro-Ophthalmology, University of Turin, Italy, from January 2020 to July 2020.&#x0D; Methodology: Spatial relationship perception (SRP) of three subjects was measured in the presence of simulated homonymous hemianopia with a psychophysical procedure that estimates the discrimination threshold between elliptical and circular stimuli centered to the fixation point. The extent of the deprivation was graded as the distance of the proximal border of the nonresponsive area from the fixation point.&#x0D; Results: Overall, spatial relationship perception is not affected by the hemifield deprivation in terms of distance of the scotoma from the fixation point (P= 0.26), laterality (P= 0.07), and distance X laterality (P= 0.15). However, a significant effect of distance and laterality (P= 0.01 and P= 0.02, respectively) was found in the sole observer who showed an anisotropic perception in normal (no-simulated) condition.&#x0D; Conclusion: SRP appears to be robust toward the reversible spatial remapping induced by simulated hemianopia along the deprived area. However, the response of the visual system to artificial visual deprivation seems conditioned by pre-existing anisotropy.

Morphological parameters of the posterior pole in a high myopia population aged over 40 years: a 10-year follow-up study

Objective To study the long-term changes of the morphological parameters of the posterior pole in highly myopic patients over 40 years old in Chinese natural population. Methods A population-based follow-up study. The study included 71 patients (27 males, 44 females; 110 eyes) with high myopia who completed the Beijing Eye Study in 2001 and 2011 and had assessable color fundus photographs. The age of the patients in 2011 was 56.2±9.5 years old. According to the definition of pathological myopia by the meta-analysis of the Pathological Myopia Research Group, the fundus photos in 2001 were interpreted, and 110 eyes were divided into groups of simple high myopia (79 eyes) and pathological myopia (31 eyes). The morphological parameters during the 2 follow-up visits in 2001 and 2011 were measured in the color fundus photos, including optic disc tilt ratio, optic disc rotation degree, β zone area, disc-fovea distance, disc-outer β zone border distance, fovea-outer β zone border distance, and vertical distance between temporal arterial arcades, and compared in all the subjects, patients with simple high myopia and patients with pathological myopia. Correlations between the 10-year changes of these parameters and other parameters were analyzed using multiple linear regression analysis. Results In all subjects, the incidence of optic disc tilt and rotation was 41.1% (44/107) and 63.3% (68/107), respectively. The optic disc tilt ratio in 2001 and 2011 was 1.34±0.31 and 1.34±0.33, respectively. The optic disc rotation degree was 30.4±26.3° and 30.0±25.3 in 2001 and 2011, respectively. The differences in optic disc tilt ratio (Z=-0.317, P>0.05) and optic disc rotation degree (t=0.159, P>0.05) were not statistically significant. The β zone area [1.34 (0.45,3.73)mm2, Z=-7.295, P<0.05], disc-fovea distance [(5.18±0.54)mm, t=-3.523, P<0.05], and disc-outer β zone border distance [1.55 (0.24,2.16)mm, Z=-6.825, P<0.05] in 2011 were significantly increased compared to those in 2001 [1.05 (0.23,1.88)mm2, 5.08±0.43, 1.39 (0.77,1.93)mm]. There was no statistically significant difference in the vertical distance between temporal arterial arcades (Z=-1.858, P>0.05). The fovea-outer β zone border distance in the simple high myopia group in 2011 was significantly shorter than that in 2001 (Z=-3.221, P<0.05), while there was no significant change in this parameter in the pathological myopia group (t=0.655, P<0.05). In multivariate analysis, larger β zone area was significantly correlated with longer corneal curvature (r=0.462, P<0.05) and longer axial length (P<0.05). Longer disc-fovea distance was significantly correlated with lower best corrected visual acuity (r=0.348, P<0.05) and longer axial length (P<0.05). Similarly, longer disc-outer β zone border distance was related to lower best corrected visual acuity (r=0.538, P<0.05) and longer axial length (P<0.05). In addition, the progression of myopic maculopathy (Z=-3.425, P<0.05) and the progression from simple high myopia to pathological myopia (Z=-2.911, P<0.05) were both related to enlargement of the β zone. Conclusion For patients with high myopia aged over 40 years, the optic disc morphology is relatively stable, while the disc-fovea distance and β zone area will continue to increase with the progression of myopia. This may be due to the elongation of axial length. Enlargement of the β zone may be a predictor for the progression of myopic maculopathy. (Chin J Ophthalmol, 2021, 57:908-915).

Digital analysis of external fixation area of proximal humerus fractures in elderly patients

IntroductionThe purpose is based on anatomical basis, combined with three-dimensional measurement, to guide the clinical repositioning of proximal humeral fractures, select the appropriate pin entry point and angle, and simulate surgery.Methods11 fresh cadaveric specimens were collected, the distance of the marked points around the shoulder joint was measured anatomically, and the vertical distance between the inferior border of the acromion and the superior border of the axillary nerve, the vertical distance between the apex of the humeral head and the superior border of the axillary nerve, the vertical distance between the inferior border of the acromion and the superior border of the anterior rotator humeral artery, and the vertical distance between the apex of the humeral head and the superior border of the anterior rotator humeral artery were marked on the 3D model based on the anatomical data to find the relative safety zone for pin placement.ResultsContralateral data can be used to guide the repositioning and fixation of that side of the proximal humerus fracture, and uniform data cannot be used between male and female patients. For lateral pining, the distance of the inferior border of the acromion from the axillary nerve (5.90 ± 0.43) cm, range (5.3-6.9) cm, was selected for pining along the medial axis of the humeral head, close to the medial cervical cortex, and the pining angle was measured in the coronal plane (42.84 ± 2.45)°, range (37.02° ~ 46.31°), and in the sagittal plane (28.24 ± 2.25)°, range (19.22° ~ 28.51°). The pin was advanced laterally in front of the same level of the lateral approach point to form a cross-fixed support with the lateral pin, and the pin angle was measured in the coronal plane (36.14 ± 1.75)°, range (30.32° ~ 39.61°), and in the sagittal plane (28.64 ± 1.37)°, range (22.82° ~ 32.11°). Two pins were taken at the greater humeral tuberosity for fixation, with the proximal pin at an angle (159.26 ± 1.98) to the coronal surface of the humeral stem, range (155.79° ~ 165.08°), and the sagittal angle (161.76 ± 2.15)°, with the pin end between the superior surface of the humeral talus and the inferior surface of the humeral talus. The distal needle of the greater humeral tuberosity was parallel to the proximal approach trajectory, and the needle end was on the inferior surface of the humeral talus.ConclusionBased on the anatomical data, we can accurately identify the corresponding bony structures of the proximal humerus and mark the location of the pin on the 3D model for pin placement, which is simple and practical to meet the relevant individual parameters.

Anatomical Dimensions of the Anterior Column of the Acetabulum with Imaging Criteria in Patients with Surgical Acetabular Fractures

Introduction: This study was conducted to determine the imaging criteria (dimensions) of the anterior pelvis in patients referred to Taleghani Hospital in Tehran, Iran.Methods: The present study was performed as a retrospective cross-sectional study from 2018 to 2020 in the orthopedic clinic of Taleghani Hospital. The target population of this study included all hospitalized patients with a diagnosis of pelvic fracture (unstable acetabular fracture). For sampling, the census method was used, which according to the inclusion criteria, only 102 files were selected for inclusion in the study. In this study, a two-part checklist was used. Results: the angle of coronal cut and sagittal cut at variable levels, the dimensions of the anterior pelvis in three areas of stenosis at variable levels and BMI, the distance from the bladder to the posterior border at the variable levels of BMI, the posterior border at the anterior column to venous at variable levels of BMI, posterior border distance in the anterior column to the artery at variable levels of age and BMI, and lateral ileum to three narrowing zones at varying levels of gender, age, and BMI are significantly different. The results also showed that age had a significant negative correlation with posterior border distance in the anterior column with artery, vein, and BMI index had a significant positive correlation with pelvic anterior column dimensions and lateral ileum distance.Conclusion: To determine the imaging criteria of the anterior pelvic column, variables such as age, gender, and body mass index must be considered.Keywords: Anterior Pelvis, BMI, Imaging, Acetabular Fractures

How do trees survive a cyclone? The relative role of individual and site characteristics over mortality

AbstractCyclones are an increasing disturbance in the subtropical region of South America, but their impacts over the forests are still poorly documented. Here, we evaluate the effects of an extratropical cyclone over tree mortality in Araucaria Forest remnants in southern Brazil. We surveyed 116 sites (10 × 20 m each) and collected data on all tree individuals presenting DBH ≥ 4.8 cm before (2009) and after (2014) the occurrence of an extratropical cyclone. Using GLM models, we checked how the cyclone occurrence, different plant traits (DBH, trunk branching, wood density, successional group and evolutionary distinctiveness) and site characteristics (basal area, exposure, landscape protection, nearest border distance, cyclone border distance and the presence of native bamboo species) could impact tree mortality. The GLM model selection shows that the lowest AIC model considers all predictors separately and their interaction with the cyclone. The results showed that the cyclone occurrence and some site characteristics (bamboo presence, site exposure, landscape protection, nearest border distance and cyclone border distance) and plant traits (successional group and evolutionary distinctiveness) are related to tree mortality. The intense deforestation and fragmentation of the Araucaria Forest coupled with the increase in cyclone frequency expected for the region due to climate change may increase mortality rates of these forests, affecting their resilience and phylogenetic structure. Further biodiversity conservation efforts in the Araucaria Forest need to consider the characteristics of sites for enabling the protection of forest remnants in areas under different exposures to cyclone impacts.

3D Prostate Reconstruction and Cognitive Fusion to Improve Planning of Retzius Sparing Robotic Assisted Radical Prostatectomy (RS-RARP): Initial Report

50-years-old male with intermediate risk prostate cancer with PSA = 12, clinical stage p T2b and Gleason score = 7(3 + 4). Our propose was RS-RARP. Our figure comparing reconstruction performed at Docdo software and intraoperative endoscopic dissection shows to the perfect correlation between anatomic appearance of bladder neck and prostatic apex. The distance of midline and lateral border evaluate at 3D reconstruction facilitate surgeon to find the exact place between prostatic surface and neurovascular bundle to bilateral preservation.

The mitigating effect of low firearm background check requirements on firearm homicides in border states

:Background:Firearm-related violence is a significant public health issue in the US. Research has found an increase in guns used in crimes sourced from low gun law states into high gun law states. The purpose of this study is to evaluate the effect of distance from states without universal background checks (UBC), background checks at shows (BCS), or permit to purchase (PTP) laws on firearm homicide rates in states with them.Methods:States were identified based on their enactment of laws that are designed to prevent the private sale of firearms to criminals. Demographic data for each county were obtained for the years 2014 through 2017. The border distance from a county in a state with the evaluated gun laws to the nearest border state without the gun laws was obtained using Google Maps. Multiple regression analyses were performed to test the relationship between border distance and firearm homicide rates. Results:The regression model evaluating all formats found the border distance was negatively associated with firearm homicides (p=.009). The parameter estimate indicated as border distance increased, the firearm homicide rate decreased. When counties with UBC or PTP on all guns were evaluated separately from all formats model, the statistical significance was lost (p=.62). In counties where all handgun sales either require a background check or a PTP is required, the distance was also not statistically significant (p=.11). Conclusions:This study provides evidence that there may be a mitigating effect on the reduction of firearm homicides in states that require background checks or PTP on private sales when there is a state in close proximity that did not have these laws. Limited counties at certain distances may have contributed to the insignificant findings in other models.

The Effect of Patient Position on Psoas Morphology and in Lumbar Lordosis

Among the interbody fusions, lateral lumbar interbody fusion allows access to the lumbar spine through the major psoas muscle, which offers several advantages to the spine surgeon. However, some of its drawbacks cause surgeons to avoid using it as a daily practice. Therefore, to address some of these challenges, we propose the prone transpsoas technique, differing mainly from the traditional technique on patient position-moving from lateral to prone decubitus, theoretically enhancing the lordosis and impacting the psoas morphology. Twenty-four consecutive patients were invited to have magnetic resonance imaging examinations in 3 different positions (prone, dorsal, lateral). Two observers measured the following parameters: vertebral body size, psoas diameter, psoas anterior border distance, plexus distance, total lumbar lordosis, distal lumbar lordosis, and proximal lumbar lordosis. Values of P < 0.05 were deemed significant. The prone position yielded a significant increase in the lumbar lordosis, both in L1-S1 (57° vs. 46.5°) and proximal lordosis (40.4° vs. 36.9°) comparedwith the lateral position. Regarding the morphologic aspects, patients in the prone position presented lesser psoas muscles forward shift, but no difference was noted in the plexus position neither for L3-L4 nor L4-L5. The prone position resulted in a significantly increased lumbar lordosis, both distal and proximal, which may enable the spine surgeon to achieve significant sagittal restoration just by positioning. The prone position also produced a posterior retraction of the psoas muscle. However, it did not significantly affect the position of the plexus concerning the vertebral body.