Height Asymmetry Research Articles

Navicular Drop Height Asymmetry as an Intrinsic Risk Factor for Lower Limb Injury in Male Recreational Athletes

Morphological and functional asymmetry of the lower limbs is a well-recognized factor contributing to musculoskeletal injuries among athletes across different levels. However, limited research exists on evaluating foot mobility asymmetry as a potential predictor of such injuries. This study aimed to (1) assess the frequency of foot mobility asymmetries among amateur athletes, (2) investigate the predictive value of foot mobility asymmetry (measured via navicular height drop) for injury risk, and (3) explore the relationship between foot type and injury occurrence. A cross-sectional sampling method was employed to select 45 physically active male amateur athletes (runners and team sports practitioners) from a university. Injury history was retrospectively recorded, and a modified navicular drop test was conducted to classify foot arch height. The predictive power of navicular height drop asymmetry was analyzed using ROC curves, and the relationship between foot type (neutral and defective combinations—pronated or supinated) and injury occurrence was examined using chi-square tests for independence. Multiple logistic regression was applied to calculate injury risk odds ratios across different foot type subgroups. The results revealed a significant frequency (51.1%) of participants with at least one defective foot, including 31.1% with one neutral and one defective foot and 20% with both feet defective. Navicular height drop asymmetry emerged as a valuable predictor of injuries, with a 36% asymmetry identified as the cut-off for increased injury risk (AUC = 0.832, 95% CI: 0.691–0.973, p < 0.001). A significant relationship was found between foot type and injury occurrence. Only one out of 22 participants with neutral feet (4.55%) experienced an injury, compared to 9 out of 14 (64.29%) with one neutral and one defective foot and 5 out of 9 (55.56%) with both feet defective. These differences were statistically significant (χ2 = 16.24, p < 0.001, Cramer’s V = 0.60). The odds ratio for injury risk was 37.8 (p = 0.016) for those with asymmetry (one neutral and one defective foot) and 26.3 (p = 0.102) for those with both feet defective, compared to participants with both feet neutral. In clinical practice, these findings suggest that routine screenings for physically active individuals should incorporate foot mobility asymmetry assessment. However, it is essential to integrate this factor with other risk indicators. For individuals exhibiting high asymmetry, general foot defect correction programs may be beneficial, but injury prevention strategies should adopt a more comprehensive approach, focusing on overall fitness and tailored interventions for high-risk individuals.

Axial length association with corneoscleral sagittal height and scleral asymmetry.

To determine how corneoscleral geometry changes with axial length and to assess the usefulness of including the sagittal configuration of the anterior segment when predicting the axial length. An observational study was performed including 96 healthy subjects (96 eyes). Axial length was calculated from optical biometry (IOL Master 500). Corneal curvature and scleral sagittal height parameters at 13, 14 and 15 mm were obtained automatically using corneoscleral topography (eye surface profiler; ESP). In addition, corneal and scleral sagittal heights at numerous locations (21 radii: 0-10 mm from the corneal apex at 12 angles: 0-330°) were calculated using the raw height data extracted from the ESP. The relationships between axial length and the study parameters were analysed using Pearson correlation analysis. The equations for the prediction of axial length were obtained by fitting multiple linear regression models. The temporal-nasal scleral asymmetry at 13-, 14- and 15-mm chord lengths was significantly correlated with axial length (r2 ≤ 0.26; p < 0.001). Significant inverse correlations were found between the temporal scleral sagittal height and axial length (r2 ≤ 0.28; p ≤ 0.02). The nasal scleral sagittal height was not associated with axial length. Three significant multiple linear regression models were fitted based on spherical equivalent, corneal radius and scleral asymmetry at 13 (r2 = 0.79; p < 0.001), 14 (r2 = 0.80; p < 0.001) and 15 (r2 = 0.80; p < 0.001) mm chord lengths. Larger ocular globes show reduced temporal-nasal scleral asymmetry, mainly due to the lower sagittal height of the temporal sclera. Thus, the geometry of the temporal scleral may be a factor of interest during myopia progression.

Optical quality changes of the eye during peak SARS-CoV-2 pandemic in young adults

IntroductionTo determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection affects corneal morphology and optical quality. MethodsIn this cross-sectional study, ophthalmological indicators were examined during the peak of SARS-CoV-2 infection after adjusting for public health control measures. Participants were divided into control (remained uninfected), A (infected during follow-up), and B (infected prior to the first consultation) groups. Effects of varying SARS-CoV-2 infection levels were determined using reverse transcription polymerase chain reaction. Changes in corneal morphology, backscatter, and aberrations were measured. Corneal parameters, such as flat keratometry, steep keratometry, and surface variance, vertical asymmetry, height asymmetry, and height decentration indices were considered. ResultsOverall, 110 participants (208 eyes, 42.7% male; age 17–31 years) were enrolled. Eighteen (16.3%) were infection-free during the outbreak with unchanged corneal morphology, backscatter, and aberration. In group A, 34.73 ± 9.30 days after infection, the backscatter of the anterior corneal layer and central layer (both p=0.000) decreased. Total low-order aberration, defocus, horizontal coma, and spherical aberration of the cornea increased (p<0.05), while corneal morphology after infection did not change (p>0.05). In group B, a decrease in backscattering in the corneal middle layer and an increase in horizontal coma (p<0.05) were noted. ConclusionBackscattering of the anterior and intermediate layers of the cornea decreased and corneal aberrations increased after SARS-CoV-2 infection, which affected corneal optical quality. However, corneal morphology and thickness remained unchanged. Ophthalmological indicators and optical quality should be monitored during SARS-CoV-2 infection.

Does mandible ramus height asymmetry affect postoperative skeletal stability in orthognathic surgery patients?

BackgroundRelapses following orthognathic surgery have been reported to exceed 2% to 50%, depending on multiple factors. This study aimed to analyze the stability after orthognathic surgery in patients with mandibular ramus height asymmetry through 3D reconstruction using Cone-beam CT.MethodsThis retrospective cohort study investigated patients who underwent mandibular setback surgery using bilateral sagittal split ramus osteotomy. Three-dimensional CT scans were taken at three different time points. Evaluation of the postoperative stability involved measuring changes in the x, y, and z axes as well as roll and yaw rotations of the mandible at specific landmarks (B point, mental foramen) on 3D CT scans obtained immediately after surgery and 6–12 months postoperatively. They were categorized into four groups based on bilateral mandibular height asymmetry through Asymmetry index (AI). The one-way ANOVA was implemented to compare the intergroup differences and Tukey's post hoc test was employed. Additionally, the Pearson correlation coefficient was also calculated.ResultsA total of 24 patients were included in this study. The corresponding AI, representing the degree of asymmetry in both mandibles, were calculated as Group 1 was 1.25 ± 0.64%, Group 2 was 2.89 ± 0.47%, Group 3 was 5.03 ± 0.51%, and Group 4 was 9.40 ± 1.99%. The x-axis change in Group 4 was significantly larger at 1.71 mm compared to Group 1 at 0.64 mm. The mandibular roll, Group 4 showed a statistically significant increase at 1.33° compared to Group 1 at 0.35°. And there was a significant positive correlation observed between x-axis change and AI (p = 0.019), as well as between mandibular roll and AI (p = 0.025).ConclusionAfter orthognathic surgery, stability was influenced by numerous factors, with the findings of this study suggesting that the degree of ramus height asymmetry in the mandible can be considered one contributing factor.

Periocular Asymmetry Index in Caucasian Populations Using Three-dimensional Photogrammetry Assessment.

To quantitatively assess the periocular asymmetry and investigate its sex and age-related differences in a Caucasian population using three-dimensional (3D) stereophotogrammetry. Standardized 3D photos of the periocular region of 301 Caucasians were taken using the VECTRA M3 3D Imaging System. Standardized landmarks were positioned, and data measurements in the periocular region were obtained from these images using VAM software and assessed using intraclass correlation coefficients (ICC) for reliability. Absolute differences and asymmetry index between the right and the left periocular region were calculated with a focus on gender and age-related differences. Fissure height asymmetry was positively correlated with age (p < 0.01). Furthermore, reflex distance asymmetry was positively correlated with age in the elderly group (p < 0.05). Absolute differences of upper eyelid crease were 0.65 ± 0.79 mm for females and 0.90 ± 0.94 mm for males (p < 0.05). In the elderly group, the absolute differences of reflex distance were 0.664 ± 0.471 mm for males and 0.470 ± 0.408 mm for females (p < 0.05), while the absolute differences of fissure height were 0.619 ± 0.469 mm and 0.436 ± 0.372 mm, respectively (p < 0.05). All measurements had an inter-rater ICC and intra-rater ICC between 0.761 and 0.957. Periocular asymmetry is more prominent in older and male people. 3D photogrammetry is a reliable tool to detect periocular asymmetry and might provide an accurate and effective reference for periocular cosmetic, plastic, and reconstructive surgery in the clinical routine. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .

Improving ion rejection by optimizing the structure and charge distribution of the Janus membrane

Due to the asymmetry of charge distribution and geometric structure, the Janus membrane can simultaneously intercept counter-ions and co-ions. This work constructed four Janus membrane configurations using numerical simulation methods. Due to the different potential within the membrane and the selectivity level, there is a significant deviation in the interception performance. The results found that the change in the height of the Janus membrane affects the distribution of anion and cation concentration inside the nanochannel, and the asymmetry of the nanochannel height is more conducive to interception than a uniform nanochannel. The effect of the nanochannel length of the first section on the rejection rate is higher than that of the second section. Considering the design of the membrane, we recommend that the pore length of the first section be set to about 50 nm. Since the flow potential balances the electroviscous force, the optimization of the flow rate for ion transport is often opposite to the interception effect. The Janus membrane has asymmetric pore size and charge distribution characteristics and has excellent retention ability for divalent salts under low-pressure intensity and high-concentration conditions.

The Effect of Knee Height Asymmetry on Gait Biomechanics.

Though the primary goal for limb length discrepancy (LLD) management is to equalize the leg lengths, symmetry between corresponding long bones is usually not achieved, leading to knee height asymmetry (KHA). To date, there is minimal information on what effect KHA has on gait biomechanics and joint loading. Thus, the purpose of this study is to determine the impact of KHA on gait biomechanics. Seventeen subjects with KHA after limb equalizing surgery and 10 healthy controls were enrolled. Subjects participated in 3D gait analysis collected using self-selected speed. Lower extremity kinematics, kinetics, work generated/absorbed, and total work were calculated. Standing lower limb x-rays and scanograms were used to measure LLD and calculate the tibia-to-femur (TF) ratio for each limb. Two sample t tests were used to compare differences in standing LLD, TF ratio, and work between groups. Bivariate correlation using Pearson correlation coefficients was conducted between TF ratio and total mechanical work, as well as between knee height asymmetry indices and total work asymmetry (α=0.05). Among participants, there were no differences between LLD; however, there were differences between TF ratio and knee height asymmetry. We found a nonsignificant relationship between TF ratio and total mechanical work for individual lower extremities. Therefore, the length of individual bones (TF ratio) relative to each other within the individual lower extremity was not associated with the amount of work produced. However, when a difference exists between sides (asymmetry, ie, TF ratio asymmetry), there were associated differences in work (work asymmetry) produced between sides (r=0.54, P =0.003). In other words, greater knee height asymmetry between limbs resulted in more asymmetrical mechanical work during walking. These findings may have implications for the management of LLD. Asymmetrical total mechanical work could lead to atypical joint loading during gait. Surgeons may want to consider prioritizing achieving knee height symmetry as a postoperative goal when correcting limb length discrepancy. Level III, Case Control Study.

Retrospective Evaluation of Condyle and Ramus Asymmetry with Ortopantomography in Dentate and Total Edentulous Patients

Objectives: A symmetrical facial appearance affects people's social relationships. Mandibular asymmetry directly effects the facial appearance and may have many morphological and functional causes. Clinically healthy individuals may experience complete edentulousness in advancing ages, which may lead to asymmetry in the condyles and facial appearance. Our aim in this study is to evaluate whether fully-toothed and total edentulous conditions cause changes in the vertical height of the condyle and ramus and also asymmetry. Material and Methods: A total of 200 patients (104 female, 96 male) with 100 fully-toothed and 100 edentulous were included in the study. Right and left condylar ramus were measured and recorded according to the asymmetry measurement index of Habets et al., with using tracing paper under the reflector light on the patients' orthopantomographic images. Statistical analysis was done using SPSS:22 package program. T-tests, Mann-Whitney U and chi-square tests were used for comparisons. P &amp;lt;0.05 were considered significant. Results: In previous studies, the difference between the genders was found to be statistically insignificant, therefore we evaluated men and women together. In our research, the mean of the condyle and ramus height asymmetry index in edentulous patients was 4.76 mm and 2.12 mm respectively, and the mean of the condyle and ramus height asymmetry index in fully-toothed patients was 4.88 mm and 2.34 mm, respectively. According to the t-test, the mean of the condyle height and ramus height asymmetry index was found to be higher in fully-toothed patients but this difference was not statistically significant (p&amp;gt;0.05). Conclusion: Although condylar asymmetry was more common than ramus asymmetry in this study, this difference was not statistically significant when total edentulous and fully-toothed patients were compared. Keywords: Habets technique; condylar asymmetry; ramus asymmetry

Second harmonic generation in Harmonic-Gaussian asymmetric double quantum well: effect of magnetic and intense laser fields

We have theoretically analyzed the effects of externally applied fields (magnetic and intense laser) as well as various structural parameters such as well width, barrier width, barrier height, and structural asymmetry on the second harmonic generation (SHG) coefficients of GaAs/Al0.3Ga0.7As Harmonic-Gaussian asymmetric double quantum wells (QW). The time-independent Schrödinger equation was solved using the diagonalization method and effective mass approximation to obtain the energy eigenvalues and eigenfunctions of the structure. An expression derived within the compact density matrix approach has been used to evaluate the second harmonic generation (SHG) coefficient. Our numerical results indicate that increasing the magnitude of the magnetic (intense laser) field causes the peak positions of SHG to shift towards higher energy regions/blue (lower energy regions/red). On the other hand, as the structural parameters A1 and A2 ( k and z0 ) increase, the peak positions of the SHG coefficients exhibit a shift towards higher energy regions/blue (lower energy regions/red). We expect that the results of our study will contribute to the development of new optoelectronic devices based on the Harmonic-Gaussian asymmetric double quantum well structure.

Validity and reliability of the My Jump 2 app for detecting interlimb asymmetry in young female basketball players.

The aim of this study was to examine the validity and reliability of the My Jump 2 app for the assessment of interlimb jump asymmetry in young female basketball players. Nine athletes (age 15 ± 0.9 years; weight 62.9 ± 5.8 kg; height 173.6 ± 6.1 cm) performed single-leg drop jumps (DJs) and both-leg drop jumps on a force plate (Kistler Quattro jump) and were simultaneously recorded on two smartphones using the My Jump 2 app. Jump height from flight time and contact time data were statistically analyzed to evaluate the validity of two different camera settings, drop jump performance, and interlimb jump asymmetry in basketball players. The testing was repeated after 1 week for test retest reliability. High test-retest reliability [intraclass correlation coefficient (ICC) > 0.88] was observed in DJ height. High correlation between the force plate and the My Jump 2 app was observed in DJ height (r = 0.99) and DJ contact time (r = 0.98). For the interlimb jump height asymmetries, mean differences were 0.6 percentages for the My Jump 2 app and the force plate, respectively (p = 0.77). Inter-device reliability revealed almost perfect correlation for the DJ height (ICC = 0.99, r = 0.98). The My Jump 2 app is a valid and reliable tool to assess drop jump performance and interlimb asymmetry in young female basketball players.

Corneal Collagen Crosslinking for Ectasia After Refractive Surgery: A Systematic Review and Meta-Analysis.

Corneal ectasia leads to progressive irregular corneal curvature and reduced visual acuity. To assess the safety and effectiveness of corneal collagen cross-linking (CXL) for managing corneal ectasia resulting from refractive laser surgery (RSL). A systematic review and meta-analysis were realized according to PRISMA guidelines. We searched PubMed, EMBASE, Cochrane, and Web of Science databases for studies on CXL in patients with ectasia after RLS. The outcomes of interest included visual acuity, refractive outcomes, topographic parameters (Kmax, index surface variance (ISV), index of Vertical Asymmetry (IVA), keratoconus index (KI), central keratoconus index (CKI), index of height asymmetry (IHA), index of height decentration (IHD) and Rmin (minimum sagittal curvature)), central corneal thickness, endothelial cell count, and possible adverse events. Statistical analysis was performed using the R software (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria). 15 studies encompassing 421 patients (512 eyes) were included. The mean age was 32.03 ± 4.4 years. The pooled results showed a stable uncorrected visual acuity post-CXL, with a significant improvement in corrected distance visual acuity (SMD = 0.09; 95% CI: -0.07 to 0.26). The spherical equivalent decreased significantly (SMD = -0.09; 95% CI: -0.35, -0.02). The topographic parameter Kmax decreased significantly (SMD = 0.15; 95% CI:0.01 to 0.28); however, the other parameters, ISV, IVA, KI, CKI, IHA, IHD, and Rmin, did not change significantly. Central corneal thickness decreased significantly (SMD = 0.24; 95% CI:0.07 to 0.41), and the endothelial cell count remained stable The complications were rare. CXL is a safe and effective technique for managing corneal ectasia after RLS.

Jumping Asymmetries and Risk of Injuries in Preprofessional Ballet

Background: Preprofessional ballet dancers are exposed to the risk of injuries, primarily in the lower extremities, with most injuries occurring during jumping and landing activities. Interlimb asymmetry during jumping and landing activities has been associated with the injury risk in adolescent athletes, but this has not been examined in dancers. Purpose: To investigate associations between interlimb asymmetry during a double-leg countermovement jump (DL-CMJ) and single-leg jump (SLJ) and the injury risk in adolescent preprofessional ballet dancers. Study Design: Cohort study; Level of evidence, 2. Methods: Adolescent preprofessional ballet dancers (N = 255) performed 3 DL-CMJs and 3 SLJs on force plates during annual screening. Absolute and directional (separate values for left and right limb dominance) asymmetries in a set of kinetic variables during a DL-CMJ and in jump height during an SLJ were calculated. Each variable was characterized as having “high” or “normal” asymmetry according to the percentage of asymmetry (greater than or less than or equal to, respectively, the mean ± 0.5 SD) based on the present sample. Risk ratios (RRs) and 95% CIs were calculated based on the injury incidence in the subsequent academic year. Results: Of the 242 dancers that satisfied the inclusion criteria, 128 injuries were observed in the subsequent academic year. In the whole sample, 3 absolute, 7 left limb–dominant, and 1 right limb–dominant kinetic asymmetry in the eccentric, concentric, and landing phases of the DL-CMJ as well as left limb–dominant jump height asymmetry in the SLJ were associated with a significant (P < .001) increase in the injury risk (RR, 1.28-1.69 [95% CI, 1.02-2.37]). Separating by sex, asymmetries in the eccentric and landing phase of the DL-CMJ were not significant in boys, while in girls, RRs for asymmetries in the eccentric and landing phase of the DL-CMJ increased, and SLJ jump height asymmetry was not significant. Conclusion: Higher asymmetries in certain kinetic variables during the DL-CMJ and in jump height during the SLJ were associated with an elevated risk of injuries in elite preprofessional ballet dancers with some sex-specific differences. Associations were mainly identified for high left limb–dominant asymmetry in the takeoff phase, suggesting that the injury risk may be specific to a relative right limb deficit.

Corneal topographic indices of Scheimpflug camera in type 2 diabetic and non‐diabetic elderly population

Aims/Purpose: To determine the corneal topographic indices of Scheimpflug camera in type 2 diabetic and non‐diabetic in elderly population of Tehran, Iran.Methods: A total of 1105 subjects were selected using random cluster sampling from Tehran, Iran and categorized into two groups including diabetics and non‐diabetics. The diabetic group had HbA1c levels ≥6.4% with no other systemic problems. The non‐diabetic participants had normal eye findings and no systemic diseases. The keratometry values, Q‐value, index of surface variance (ISV), index of vertical asymmetry (IVA), central keratoconus index (CKI), keratoconus index (KI), index of height asymmetry (IHA), index of height decentration (IHD), anterior average radius of curvature (ARC), posterior average radius of curvature (PRC), and pachymetric progression index (PPI) values were measured using the Pentacam AXL.Results: A total participants included 429 diabetic (38.46% male) and 676 non‐diabetic (38.76% male). Only PPIavg and PPImax were higher in the diabetics versus non‐diabetics (p = 0.019 and p = 0.010, respectively). The HbA1c level was 5.47 ± 0.34, 6.70 ± 0.17, and 8.72 ± 1.16 in the first, second, and third group, respectively. There was a significant difference in PPImax between the three groups (p = 0.036). There were significant differences only in IVA, CKI, PPIAvg, and PPImax between different stages of DR (p = 0.045, p = 0.005, p = 0.002, and p = 0.004, respectively). The diabetic subjects were divided into two groups based on the presence of DR. There was a significant difference in ISV, IVA, PPIavg, and PPImax between diabetic subjects with and without DR (p = 0.016, p = 0.022, p &lt; 0.001, and p &lt; 0.001, respectively).Conclusions: The results of this study showed that DM and DR change several topographic indices and the HbA1c level may affect PPImax. Therefore, special attention should be paid to these patients for different treatment strategies.

Effects of Exercise-Induced Neuromuscular Fatigue on Jump Performance and Lower-Limb Asymmetries in Youth Female Team Sport Athletes.

The objective of the present study was to examine the effect of acute neuromuscular fatigue on unilateral jump performance and inter-limb asymmetries. Thirty elite youth female team sport athletes (age: U-14 to U-18) performed the Unilateral Countermovement Jump (UCJ) and the Unilateral Drop Jump (UDJ) (18-cm box) tests before and approximately 10 minutes after the 30-15 intermittent fitness test (30-15 IFT). A paired samples t-test showed significant reductions in UCJ jump height in the right leg after the 30-15 IFT (p = 0.018; d = 0.33), but not in the left leg (p = 0.459; d = 0.48). For the UDJ, significant reductions in jump height were shown in both the right (p < 0.001; d = 0.33) and left (p < 0.001; d = 0.33) legs. In addition, for the reactive strength index (UDJ), significant reductions were seen in the left leg after the 30-15 IFT (p < 0.001; d = 0.31), but not in the right leg (p = 0.948; d < 0.001). Only UCJ inter-limb jump height asymmetries increased significantly post 30-15 IFT (p = 0.033; d = 0.46). In conclusion, the current study indicates that the 30-15 IFT provides a sufficient dose of activity for inducing acute fatigue in elite youth female team sport athletes. Therefore, monitoring jump height in unilateral jump testing is recommended given the tests' sensitivity to detect significant differences in physical performance and inter-limb asymmetries under acutely fatigued conditions in healthy youth female athletes.

Coronal, Sagittal, and Horizontal Classification of the Chest Shape and Its Role in Selection of Proper Implants.

The number of female breast correction procedures has been steadily increasing. Despite extensive literature being available on these procedures, few authors have discussed the role of preoperative chest wall analysis in relation to postoperative outcomes. To date, no comprehensive classification of chest shape has been introduced in the literature. The aim of this study was to present a novel classification of chest shapes, based on three basic planes: coronal (C), sagittal (S), and horizontal (H), hence the proposed name "CSH classification." In this study, a retrospective analysis of 1000 randomly selected chest and breast images was conducted by three independent nonmedical evaluators, using standardized digital images captured with the Vectra 3D body scanner. All examined patients were qualified for breast augmentation surgery. Among 1000 randomly examined patients, 923 were classified in the coronal plane, 920 in the sagittal plane, and 627 in the horizontal plane. Other patients were excluded from the study due to insufficient quality of the images. A notable 43.2% of women have shoulder height asymmetries. A relationship between shoulder height asymmetry and chest width was confirmed by the chi-square Pearson test (P = 0.04), indicating that a higher shoulder is associated with a greater chest width on the same side. Furthermore, 84.7% of women displayed excessive upper chest projection, whereas 28.4% showed excessive lower chest projection. Additionally, 84.4% of women had chest projection asymmetries. The vast majority of the women had natural asymmetries of the breast or and chest wall. The CSH classification allows systematizing the chest shape assessment. The chest shape has a significant impact on breast implant selection and the choice of the breast surgery technique.

Anterior segment indices in mentally retarded children

To compare the anterior segment indices between mentally retarded and normal children. The current study was conducted as a cohort. In this study, 73 mentally retarded and 76 normal children were selected from normal school and special schools for mentally retarded children using random cluster sampling method. Mental retardation in children was confirmed by a psychologist. Optometry examinations including visual acuity and refraction were performed for all participants, and ultimately, corneal imaging measurements were taken by Pentacam. The mean age of mentally retarded and normal children was of 13.30 ± 1.83 and 13.05 ± 1.82 years, respectively (P = 0.180). A multiple generalized estimating equations model demonstrated that there is a significant association between central corneal thickness (CCT) (coef = 1.011, P < 0.001), corneal diameter (CD) (coef = 0.444, P = 0.046), anterior chamber depth (ACD) (coef = 0.23), P < 0.001) and index of vertical asymmetry (IVA) (coef = 0.12, P < 0.001) and mental retardation. Cerebral palsy children had higher keratoconus index (KI), central keratoconus index (CKI), index of height asymmetry(IHA), and index of height decentration (IHD) compared to those without cerebral palsy (P < 0.05). Children with moderate mental retardation had higher index of surface variance (ISV), IVA, IHA, and IHD than those with mild mental retardation (P < 0.05). The mean and standard deviation of CCT, CD, ACD and IVA index in mentally retarded children were 535.3 ± 46.68 micron, 11.87 ± 0.42 mm, 3.29 ± 0.24 mm and 0.25 ± 0.18 mm, respectively. These indices in the normal group were 525.53 ± 47.52 micron, 11.84 ± 0.38 mm, 3.15 ± 0.28 mm and 0.17 ± 0.05 mm, respectively. The findings of this study showed that some anterior segment indices were different in mentally retarded compared to normal children. Moreover, some keratoconus indicators were worse in cerebral palsy children and children with higher grade mental retardation. So, it is important to consider keratoconus screening in these children.

Effects of increasing the degree of building height asymmetry on ventilation and pollutant dispersion within street canyons

Rational urban design helps to build sustainable cities with high ventilation capacity and pollutant removal capacity, but the effect of building height on ventilation and pollutant dispersion inside asymmetric canyons has not been fully studied. In this paper, we studied the effect of increasing the degree of building height asymmetry (DBHA) on canyon ventilation and pollutant diffusion in shallow and deep asymmetric street canyons by considering six different building height ratios (BHR = 3/4, 1/2, 1/3, 4/3, 2/1 and 3/1). The results show that increasing the DBHA in asymmetric canyons can improve the ventilation and pollutant removal capacity. For step-up canyons, increasing the downwind building height is very useful to improve ventilation and pollutant removal. For shallow/deep step-up canyons with BHR = 1/3, the air exchange rate (ACH) increased to 211.2% and 380.1% of the flat canyons, respectively. The spatially-average pollutant concentration in the pedestrian zones (leeward Kavg* ang windward Kavg*) decreases significantly with the increase of DBHA, especially for the deep step-up canyon with BHR = 1/3, the leeward Kavg* and windward Kavg* decrease to 15.3% and 3%, respectively. Also, increasing the upwind building height can also improve the ventilation capacity in the step-down canyons. For the deep step-down canyon with BHR = 3/1, the leeward Kavg* and windward Kavg* decreased to 40.6% and 24.1% of the deep flat canyon, respectively. Notably, the ventilation capacity is very low for step-down canyons with BHR = 4/3, and for step-down canyons with BHR ≥ 2/1, the ventilation capacity and pollutant removal capacity increase significantly with the increase of DBHA. Therefore, in urban planning, step-down canyons with BHR = 4/3 should be avoided and designed to satisfy the condition of BHR ≥ 2/1. These findings will be a valuable reference for urban designers to build sustainable cities with high ventilation capacity.

50. Perceptual Smile Asymmetry is Impacted by Five Smile Parameters

PURPOSE: Facial expressions are integral to nonverbal communication. Dynamic smile reconstruction is a goal of care, and the aim of surgery is to create symmetry. This project evaluates how much asymmetry is tolerated in smile perception and quantifies that asymmetry. METHODS: Fifty-six facial photographs were categorized based on increasing smile asymmetry. Emotrics software was used to compute asymmetry in five mouth metrics. A Qualtrics survey consisting of 56 cropped photographs was disseminated using Amazon’s Mechanical Turk (MTurk). Three questions accompanied each photograph: 1) Is the person smiling? 2) What emotion is being expressed? 3) How symmetric is the facial expression? ANOVA, chi-squared, and multivariable linear modeling were performed. RESULTS: A total of 618 survey responses were analyzed. Smile recognition was 100%, 78%, and 33% in the symmetric, mild-moderately asymmetric, and asymmetric categories (p<0.001). Happy was identified in 89% of symmetric smiles, compared to 15% of asymmetric smiles (p<0.001). Disgust was conveyed in 26% of asymmetric smiles (p<0.001). If a smile was recognized, then 65% were happy; if not recognized, then disgust was chosen most frequently (p<0.001). Multivariable linear models using asymmetry in five mouth metrics predicted: smile recognition, happy emotion identification, and symmetry score (p<0.001). A 1% increase in asymmetry of lower lip height and commissure position decreased symmetry score by 32- and 18-points, respectively. CONCLUSIONS: Survey respondents are unable to recognize severely asymmetric smiles as smiles. Severely asymmetric smiles convey disgust rather than positivity. Mild differences in lower lip and commissure positions contribute to asymmetry perception, and models incorporating five smile parameters—nasolabial fold angle, interlabial distance, commissure height, commissure position, and lower lip height—were able to predict smile asymmetry.

Highlights of recent clinically relevant papers

Equine Veterinary EducationVolume 35, Issue 6 p. 282-283 RESEARCH HIGHLIGHTS Highlights of recent clinically relevant papers Sue Wright, Corresponding Author Sue Wright [email protected] orcid.org/0000-0002-5513-8571 EVE Editorial Office Email: [email protected]Search for more papers by this author Sue Wright, Corresponding Author Sue Wright [email protected] orcid.org/0000-0002-5513-8571 EVE Editorial Office Email: [email protected]Search for more papers by this author First published: 03 May 2023 https://doi.org/10.1111/eve.13797Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References Fouquet, G., Abbas, G., Johnson, J.P., Pompermayer, E., Harel, C., Aldous, E. et al. (2022) Ultrasound-guided injection technique of the equine cervical nerve roots. Frontiers of Veterinary Science. Available from: https://doi.org/10.3389/fvets.2022.992208 eCollection 2022. Kolding, S.A., Sørensen, J.N., Kramer, J., McCracken, M.J., Reed, S.K. & Keegan, K.G. (2023) Prevalence and clinical significance of increasing head height asymmetry as a measure of forelimb lameness in horses when trotting in a straight line after palmar digital nerve block. Equine Veterinary Journal. Available from: https://doi.org/10.1111/evj.13921 Melly, V., Ortved, K.F., Manzi, T.J., Richardson, D.W., Stefanovski, D. & Wulster, K.B. (2023) Identification of a previously unreported site of subchondral bone injury in the dorsodistolateral calcaneus in thoroughbred racehorses. Equine Veterinary Journal. Available from: https://doi.org/10.1111/evj.13928 Miglinci, L., Reicher, P., Nell, B., Koch, M., Jindra, C. & Brandt, S. (2023) Detection of equine papillomaviruses and gamma-herpesviruses in equine squamous cell carcinoma. Pathogens, 12(2), 179. Available from: https://doi.org/10.3390/pathogens12020179 Wanstrath, M.A., Bauck, A.G., Smith, A.D. & Freeman, D.E. (2022) Surgical enlargement of the epiploic foramen in horses. Veterinary Radiology & Ultrasound, 52, 308– 314. Available from: https://doi.org/10.1111/vsu.13927 Wolkowski, D.D., McCarthy, R.D., Schoonover, M.J., Taylor, J.D. & Eastman, T.G. (2022) Effects of intra-articular injection of an acellular equine liquid amniotic allograft in healthy equine joints. Veterinary Surgery, 52, 62– 68. Available from: https://doi.org/10.1111/vsu.13918 Volume35, Issue6June 2023Pages 282-283 ReferencesRelatedInformation

Alteration in corneal topography asymmetry indices following corneal refractive surgery

Purpose We aimed to follow up corneal refractive asymmetry index changes following refractive surgery for cornea after correction of low-grade myopia and to determine which technique causes marked affection of the indices. Patients and methods This prospective study conducted from October 2020 to December 2021 included two groups of patients, the photorefractive keratectomy (PRK) group and the laser in-situ keratomileusis (LASIK) group. Every patient in each group had to follow a schedule of visits after surgery for the next day, 1 week, 1 month, and after 3 months. Patients who failed to follow this schedule were excluded from the study. Results The PRK group contained 42 eyes with a mean uncorrected visual acuity that improved significantly, corneal power (K-reading) and pupil center thickness reduced significantly. Surface variance index, central keratoconus index, and height decentration index did not change significantly. Vertical asymmetry index and minimum radius of curvature (Rmin) increased significantly while height asymmetry index decreased significantly. Our LASIK group contained 40 eyes that underwent changes similar to those in the PRK group regarding uncorrected visual acuity, the K-reading, and the pupil center thickness. The surface variance index, vertical asymmetry index, and height asymmetry index, height decentration index and Rmin increased significantly while the central keratoconus index decreased significantly. The keratoconus index reduced significantly in both groups. Conclusion The PRK is a more conservative technique than the LASIK technique regarding the affection of corneal asymmetry indices.