Superior View Research Articles

Otsu Multi-Threshold Image Segmentation Based on Adaptive Double-Mutation Differential Evolution.

A quick and effective way of segmenting images is the Otsu threshold method. However, the complexity of time grows exponentially as the number of thresolds rises. The aim of this study is to address the issues with the standard threshold image segmentation method's low segmentation effect and high time complexity. The two mutations differential evolution based on adaptive control parameters is presented, and the twofold mutation approach and adaptive control parameter search mechanism are used. Superior double-mutation differential evolution views Otsu threshold picture segmentation as an optimization issue, uses the maximum interclass variance technique as the objective function, determines the ideal threshold, and then implements multi-threshold image segmentation. The experimental findings demonstrate the robustness of the enhanced double-mutation differential evolution with adaptive control parameters. Compared to other benchmark algorithms, our algorithm excels in both image segmentation accuracy and time complexity, offering superior performance.

Comparison of Laryngoscopic Glottic Views Obtained via Macintosh vs Miller Blade in Adults Undergoing General Anesthesia with Endotracheal Intubation

Objective: To compare the glottic views obtained through Miller and Macintosh blade laryngoscopy in adults undergoing general anesthesia with endotracheal intubation. Methodology: This quasi-experimental study was conducted at Holy Family Hospital, Rawalpindi, from June 2022 to September 2022. Sixty patients scheduled for elective surgery under general anesthesia with endotracheal intubation were enrolled. Patients were randomly assigned to two groups: Miller blade group (n=30) and Macintosh blade group (n=30). The anesthesiologist conducting the intubation recorded the Cormack Lehane grade obtained. Data analysis utilized SPSS version 27.0, employing independent-sample t-tests, Mann-Whitney U tests, chi-square, or Fisher's exact tests as appropriate. A p-value <0.05 was considered statistically significant. Results: In the Miller blade group, comprising 30 patients, the mean age was 44.60+13.310 years, and 53.3% were male. Cormack-Lehane grades were distributed as follows: 76.7% grade I, 20.0% grade II, and 3.3% grade III. In the Macintosh blade group, with 30 patients, the mean age was 40.93+12.798 years, and 46.7% were male. Cormack-Lehane grades were distributed as follows: 30.0% grade I, 50.0% grade II, 13.3% grade III, and 6.7% grade IV. Conclusion: The study concluded that Miller blade laryngoscopy provides superior glottic views compared to Macintosh blade laryngoscopy. However, the ease of intubation and the time taken for intubation were not investigated, suggesting areas for exploration in future studies.

Understanding a Lateral Truth: Paul Ricoeur’s Intercultural Hermeneutics

ABSTRACT Starting from Paul Ricoeur’s hermeneutic pluralism and its relevance from the point of view of the current intercultural debate, the article aims to elaborate a pluralistic model in which we recognize the need for a hermeneutic virtue, the phronesis as a prerequisite for understanding that each person can only see parts of truth ‘sideways’ and that it is not possible to compare one’s beliefs with those of others by looking at them from the outside, from a sort of superior view from above. Intercultural dialogue can only start from an awareness of the inadequacy and historical-cultural determinacy of different perspectives, avoiding the twin pitfalls of absolutizing singular points of view and falling into naïve relativism. In this way, the article aims to discuss Ricoeur’s conception of a situated and ‘lateral’ truth and, therefore, his original application of a phronetic-hermeneutic model in the dialogue between cultures.

Comparative evaluation of C-MAC and McGrath MAC videolaryngoscopes with Macintosh direct laryngoscope for endotracheal intubation in adult patients undergoing elective surgeries.

Videolaryngoscopes have an undisputed role in difficult airway management, but their role in routine intubation scenarios remains underappreciated. McGrath MAC is a lightweight laryngoscope with a disposable blade. It remains to be proven if it performs as efficiently as the reusable videolaryngoscopes like C-MAC and whether it has an advantage over standard Macintosh laryngoscope in predicted normal airways. We recruited 180 adult patients and randomly divided them into three groups for intubation with either Macintosh laryngoscope (Group-A), C-MAC (Group-B), and McGrath (Group-C). The primary objective was to compare the first attempt success rate. Secondary objectives included Cormack-Lehane (CL) grades, laryngoscopy time, intubation time, ease of intubation, need for optimization manoeuver, and the number of passes to place the endotracheal tube. The two videolaryngoscopes provided a superior first attempt success rate as compared to Macintosh laryngoscope (P = 0.027). The CL grade-I was 100% in group B, 41.7% in group-A and 90% in group-C (B vs C; P = 0.037). Laryngoscopy time was 9.9 ± 2.5 s, 12.6 ± 0.8 s, and 13.1 ± 0.8 s for groups A, B, and C, respectively (B vs C; P = 0.001). Intubation time was 24.4 ± 12 s, 28.3 ± 1.9 s, and 37.3 ± 5.8 s for groups A, B, and C, respectively (P < 0.0001). The number of tube passes was highest in group C. Videolaryngoscopes provided a superior glottic view and resulted in a superior first attempt success rate as compared to Macintosh laryngoscope. When comparing the two videolaryngoscopes, C-MAC resulted in better intubation characteristics (shorter intubation time, better glottic views, and higher first-attempt success rates) and should be preferred over McGrath for intubation in adult patients with normal airways.

THICKNESS MAPPING OF NEPALESE CALVARIA USING COMPUTERIZED TOMOGRAPHY

Background: The bony skeleton of the head is termed skull. Skull composed of cranial vault and base. Cranial vault is known as Calvaria. Cranial vault (Calvaria) is the superior view of skull (Norma Verticalis). Calvarium consists of frontal, parietal, temporal and occipital bones. Total thickness of calvarial bones includes outer table, diploe and inner table. Diploe is made up of spongy bone. Outer and inner table made up of compact bone. This study aims to measure the image assisted measurement of thickness of Calvaria and to observe the variation in thickness with age, gender and ethnicity. Methods: This was a descriptive cross-sectional study conducted at Department of Radiology, Chitwan Medical College Teaching Hospital Bharatpur-13, Chitwan. Patient of age 15 to 50 years with normal CT finding were included in the study. Using the axial view of brain CT, the thickness of Calvaria was measured and recorded in millimeter. Results: Hundred calvarial thickness was measured using computerized tomography scan. Thickness of frontal bone; parietal bone and occipital bone ranges from 0.37 mm to 0.97mm with mean value 0.6991±0.311mm;0.36mm to 0.99 with mean 0.6772±0.15058 mm and 0.30 to 0.95mm with mean 0.68±0.15236 respectively. No significant correlation between thickness of frontal, parietal and occipital bone is observed using Pearson coefficient. Conclusions: There is slight variation of calvarial thickness of frontal, parietal and occipital bone. The frontal, parietal and occipital bone thickness are not significantly correlated with each other.

Fracture line and comminution zone characteristics, and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humeral fractures: complex proximal humerus fracture map.

To identify fracture characteristics and zones of comminution as well as the relationship with anatomic landmarks and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humerus fractures. Computed tomography images of 201 OTA/AO 11C3 fractures were included. Fracture lines were superimposed to a 3D proximal humerus template, created from a healthy right humerus, after fracture fragment reduction on 3D reconstruction images. Rotator cuff tendon footprints were marked on the template. Lateral, anterior, posterior, medial, and superior views were captured for the interpretation of fracture line and comminution zone distribution as well as to define the relationship with anatomic landmarks and rotator cuff tendon footprints. A total of 106 females and 95 males (mean age = 57.5 ± 17.7 [range 18-101] years) with 103 C3.1-, 45 C3.2-, and 53 C3.3-type fractures were included. On the lateral, medial, and superior humeral surfaces, fracture lines and comminution zones were distributed differently in 3 groups. Tuberculum minus and medial calcar region were significantly less severely affected in C3.1 and C3.2 fractures than C3.3 fractures. The supraspinatus footprint was the most severely affected rotator cuff footprint area. Specifically defining the certain differences for repeatable fracture patterns and comminution zones in OTA/AO 11C3-type fractures and the relationship between the rotator cuff footprint and the joint capsule may contribute to the decision-making process of surgeons.

Comparative evaluation of a lower dose CBCT acquisition protocol for preoperative implant site assessment in dry human skulls.

Restoration of edentulous sites with dental implants is increasingly becoming a popular choice. Cross-sectional 3D imaging using CBCT provides a superior view of the implant site to help the clinician plan the procedure better. In spite of the advantages, radiation dose remains a concern. The evolution of lower dose protocols is ongoing but whether those acquisition protocols yield comparable diagnostic information is still not well established. The objective of this study was to evaluate the diagnostic efficacy of a low dose, 180˚ rotational CBCT acquisition protocol for evaluating a potential implant site in comparison with a conventional 360˚ rotational acquisition. Ten dentate and partially edentulous dry human skulls were chosen for this study. Each skull was imaged using a 360˚ and a 180˚ rotational acquisition on a J. Morita's Accuitomo CBCT scanner. 82 randomized implant sites, 40 in the maxilla and 42 in the mandible were analyzed. Evaluation of cortical and trabecular bone, proximity to crucial structures such as the inferior alveolar nerve canal and the maxillary sinus, and width of the potential placement site were measured. An oral surgeon and an oral radiologist rated the diagnostic efficacy of the scans by evaluating the above characteristics. Statistical evaluation of the data with linear regression showed significant agreement between both protocol measurements. Kappa analyses yielded a good inter-observer agreement. In this ex-vivo study, there was no significant difference in both the qualitative and quantitate evaluation between the conventional 36 0˚ acquisition protocol and the modified lower dose 180˚ rotational protocol.

Middle fossa triangles - A step-by-step dissection.

The anatomy and surgical approach to the cavernous sinus and the middle fossa can constitute a considerable challenge, specially for young surgeons. Although their surgical explorations have gone through a popular phase in the past, to this date, they remain an uncomfortable subject for many neurosurgeons. The aim of this paper is to systematically review its anatomy and multiple corridors through a step-by-step dissection of the middle fossa triangles, providing a roadmap for surgeons. A step-by-step dissection of the cavernous sinus was performed in two fresh-frozen cadavers aiming to describe the anatomy of ten different middle fossa triangles, demonstrating the feasibility of the use of their spaces while surgically approaching this area. The intradural opening of the roof of the cavernous sinus was obtained by dissection of clinoidal, carotid-oculomotor, supratrochlear, optic-carotideal, and oculomotor triangles, allowing an expanded superior view. On the counterpart, the extradural exploration of the lateral wall through the middle fossa floor peeling exposed the infratrochlear, anteromedial, and anterolateral triangles. The middle fossa floor itself was the door to approaching posterior fossa through anterior petrosectomy. The dissection of each individual triangle can be amplified exponentially with exploration of its adjacents, providing broader surgical corridors. The cavernous sinus still remains far from an "every man's land," but its systematic study based on direct approaches can ease the challenges of its surgical exploration, allowing surgeons to feel more comfortable with its navigation, with consequently benefit in the treatment of patients.

Differential morphometric analysis of the anterior fontanelle in an embryonic avian model of induced-thyrotoxicosis.

Craniosynostosis (CS) is the premature fusion of the cranial sutures during embryonic development, and this results in intracranial pressure and skull deformities. Thyrotoxicosis, specifically maternal hyperthyroidism, has been linked to the development of CS. Our lab is currently validating an avian model of thyroxine-induced CS to study the mechanism involved in thyroxine-enhanced cranial ossification. We hypothesized that thyroxine exposure will alter skull morphology. Two groups of fertilized chicken eggs were injected with saline or 25 ng T4 into the air cell on embryonic days (E) 11 and 15. A set of skulls from each group were collected on E17-19 (n = 17-21/day). They were fixed in formalin and processed using Alizarin Red whole-mount staining, imaged (superior view), and quantified to determine thyroxine-induced alteration in skull morphology. Geometric morphometric analysis using MorphoJ was performed to identify shape variation between treatment groups of the fibrous space between ossifying regions of the anterior fontanelle. These preliminary results demonstrated a significant variation in the shape of the fibrous gap between developing sutures on embryonic days 17, 18, and 19 (p&lt;0.05). Using the same methodology, an additional set of skulls on E19 were collected from each group and processed using both Alizarin red and Alcian blue whole-mount staining to better delineate the ossifying region of bone. Analysis is currently in progress. In conclusion, these findings support that our model is successful in promoting the fusing of the cranial bones with thyroxine exposure in our avian model through altered skull morphology visualized in the anterior fontanelle.

Correlation between Intraoperative Direct and Transesophageal Echocardiographic Assessment of Right Ventricular Outflow Tract Pressure Gradient in Patients Undergoing Tetralogy of Fallot Repair

Objectives: The objective of this study was to determine the correlation between intraoperative direct (needle) and transesophageal echocardiographic (TEE) assessment of right ventricular outflow tract (RVOT) pressure gradient in patients undergoing Tetralogy of Fallot (TOF) repair. Methodology: A total of 100 patients underwent for TOF repair were included. After completion of surgery and successful weaning from cardiopulmonary bypass, the TEE derived RVOT gradients were obtained from, the midesophageal ascending aortic short axis (AA Sax) view, upper esophageal aortic arch short axis (Arch Sax) view and trans-gastric RV outflow (TG RV outflow) view. Direct (needle) derived pressures from right ventricular (RV) and pulmonary artery (PA) were obtained by surgeon using a saline filled pressure transducer system. Correlation coefficient was computed between intraoperative direct and TEE assessment of RVOT gradient was evaluated. Results: In the sample of 100 patients, 41% were females and median age was 8 [5-11] years. The TEE derived RVOT gradients obtained in AA Sax, Arch Sax and TG RV outflow view were 26.46±6.98, 26.60±6.55, and 22.64±6.21 mmHg, respectively. Intraoperative RVOT pressure gradient was 19.05±8.9 mmHg. The correlation between intraoperative direct (needle) and TEE assessment of RVOT pressure gradient obtained in AA Sax, Arch Sax, and TG RV outflow view were 0.588 (p&lt;0.001), 0.283 (p&lt;0.001), and 0.383 (p&lt;0.001), respectively. Conclusion: Intraoperative TEE assessment of RVOT pressure gradient showed a moderate correlation with the direct (needle) assessment. The ascending aorta short axis view was found to be the superior esophageal view.

GLOTTIC VIEW COMPARISON BETWEEN MCGRATH MAC VIDEO AND MACINTOSH LARYNGOSCOPES

The purpose of the study was to compare the efcacy of the McGrath MAC videolaryngoscope and the Macintosh laryngoscope in tracheal intubation procedures. The study was conducted on 70 patients who were undergoing elective surgery and classied as ASA I or II. The patients were intubated by an anaesthesia trainee under the supervision of a senior anaesthetist. The primary outcome of the study was the improvement in the glottic view, which was assessed using the Cormack-Lehane (C-L) grading system. The results of the study indicated that the McGrath MAC videolaryngoscope provided a signicantly better glottic view compared to the Macintosh laryngoscope. 67.1% of the cases were found to have a C-L grade I view when assessed with the McGrath MAC, compared to 42.9% with the Macintosh. Furthermore, 17% of the cases showed an improvement in the glottic view to C-L grade I when assessed with the McGrath MAC. In addition to the improvement in glottic view, the study found that the McGrath MAC videolaryngoscope was easier to use and improved the self-condence of the anaesthesia trainee. This is of particular signicance in difcult airway situations where a quick and accurate intubation is of utmost importance. In conclusion, the study suggests that the McGrath MAC videolaryngoscope can be used as a safe and effective alternative airway device, providing a superior glottic view and ease of intubation in normal airway patients. The use of this device can also enhance the self-condence of anaesthetists in training, making tracheal intubation more secure and effortless in challenging circumstances.

A novel technique of handling the blade for videolaryngoscopy intubation in patients with a semi-rigid neck collar: a prospective randomized controlled trial.

Semi-rigid neck collars to protect the cervical spine can limit the extent of neck movement and mouth opening; this may further complicate orotracheal intubation. We aimed to compare intubation environments obtained with videolaryngoscopy using the technique of gliding a blade under the epiglottis and that obtained using the conventional Macintosh blade technique of blade tip placement on the vallecula. This prospective randomized study included patients aged ≥ 20 years with American Society of Anesthesiologists physical status I-III scheduled for cervical spine surgery between October 2020 and August 2021. Patients were divided into two groups according to the placement of the blade of the McGrathTM videolaryngoscope: the gliding and conventional groups. The percentage of glottic opening (POGO) score was the primary endpoint. We also recorded the time to obtain the optimal laryngoscopic view, intubation duration, and ease and satisfaction of the researcher performing intubation. Among 176 patients, the POGO scores were significantly higher in the gliding group than in the conventional group (88.9 ± 14.7 vs. 63.8 ± 27.4, P < 0.001). The time to achieve the optimal glottic view for intubation and duration of intubation were also shorter, and ease and satisfaction in performing intubation were better in the gliding group than in the conventional group. Our findings demonstrated a superior glottic view and more favorable intubation environments when the blade tip was placed under the epiglottis than using the conventional Macintosh technique in patients with immobilized cervical spine.

A COMPARATIVE STUDY OF McGRATH MAC VIDEO LARYNGOSCOPE AND MACINTOSH LARYNGOSCOPE FOR ORO-TRACHEAL INTUBATION IN NORMAL AIRWAY.

Background- Oro-tracheal intubation is practiced for oxygenation &amp; ventilation along with inhalational anesthetic delivery and in emergency conditions for securing airway. The objective of our study was to evaluate and compare the intubations by McGrath VL and Macintosh laryngoscope. A prospective, observational s Methodology- tudy in 80 patients undergoing elective surgical procedures with normal airway. All patients were premedicated and pre-oxygenated with 100% O2 for ve minutes and induced with inducing agent inj. Propofol 2mg/kg and neuromuscular blocking agent inj. Succinyl choline 1.5 mg/kg. Patients were divided into 2 groups for Macintosh Laryngoscope and McGrath VL. We have noted TTI, number of intubation attempts, C-L grade, POGO score, modication of positioning, the requirement of external laryngeal pressure manipulation and complications during and after intubations. Haemodynamic parameters were monitored and recorded. Time to intubate in McG VL Group (38.92 ± Observation &amp; Results- 11.07) was signicantly shortened than Mac L Group (57.95 ± 10.37)(). Percentage of glottic opening was better in McGrath Video Laryngoscope group (McG VL) than Macintosh laryngoscope group (Mac L). Incidence of complications were less in McG VL Group than Mac L group. The study Conclusionconcluded that McGrath MAC Video laryngoscope is better than Macintosh laryngoscope for oro-tracheal intubation in normal airway as it provides earlier time to intubate, signicantly superior glottic view, more rst attempt success rate without any complications and stable vitals.

Updated study of adult and subadult pectoral girdle bones from Sima de los Huesos site (Sierra de Atapuerca, Burgos, Spain). Anatomical and age estimation keys.

Here we present an updated inventory and study of pectoral girdle remains recovered from the Sima de los Huesos (SH) site. Here, we describe the key morphological traits of adults and, for the first time, subadult specimens. Because morphological traits can change with age, we also discuss some shortcomings related to age estimation in postcranial fossil specimens. Adult clavicles from the SH are long with a low robusticity index and marked curvatures in the superior view. Among these traits, only extreme clavicular length seems to characterize subadult individuals. Neandertals share all these traits. In the case of the scapula, the SH specimens share a relatively long and narrow glenoid fossa with Neandertals. This trait is also present in subadult individuals. Additionally, most specimens from SH, adults, and subadults showed a dorsal axillary sulcus on the scapular lateral border, a trait also present in most adult and subadult Neandertals. These traits in adult and subadult specimens supports substantial genetic control for many of them in both human species.

The medial wall and medial compartment of the cavernous sinus: an anatomic study using plastinated histological sections

The medial wall of the cavernous sinus (CS) has a significant role in evaluation and treatment of pituitary adenomas. This study was conducted to clarify the fine architecture of the medial wall and medial compartment of the CS at both macro- and micro-levels in twenty-one human cadaveric heads by using the epoxy sheet plastination technique. The sellar part medial wall is an intact dural layer that separates the CS from the pituitary gland. This dural wall adhered to the diaphragma sellae and the periosteum of the sella turcica to form fibrous triangles. Eight micro-protrusions of the pituitary gland were found at both sides of that wall. The thickness of the sellar part medial wall at its central portion was significantly thinner than that at the other surrounding portions. From the superior view, tortuous intracavernous carotid arteries can be divided into outward bending type and inward bending type. The inward bending intracavernous carotid was apt to bent towards the central part of the sellar part medial wall, where there were usually wide and short fibrous bands with more densely stained connective tissues between them. The micro-protrusion of the pituitary gland in the medial wall of the CS could provide an anatomical basis for the occult tumor invasion and the recurrence of residual tumor. Different bending facing states of tortuous intracavernous carotid arteries in the lateral direction may be a factor of the determination of the direction of growth of pituitary tumors.

3D Reconstruction of Phonatory Glottal Shape and Volume: Effects of Neuromuscular Activation.

Although phonatory glottal posture and airflow pulse shape affect voice quality, studies to date have been limited by visualization of vocal fold (VF) vibration from a superior view. We performed a 3D reconstruction of VF vibratory motion during phonation from a medial view and assessed the glottal volume waveform and resulting acoustics as a function of neuromuscular stimulation. In vivo canine hemilarynx phonation. Across 121 unique combinations of the superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN) stimulation, the hemilarynx was excited to the oscillation with airflow. VF medial surface reference points were tracked on high-speed video, mapped into 3D space, and surface shape was restored using cubic spline interpolation. Glottal surface shape, reconstruction-based parameters, and glottal volume waveform were calculated. Fundamental frequency (F0), cepstral peak prominence (CPP), and harmonic amplitude (H1-H2) were measured from high-quality audio samples. The glottis was convergent during opening and divergent during closing. Neuromuscular activation changed phonatory glottal shape and reduced glottal volume. Significant reduction in glottal volume and closing quotient were present with SLN stimulation. RLN stimulation significantly increased F0 and CPP and decreased H1-H2 (constricted glottis), while SLN effects were similar and synergistic with concurrent RLN stimulation. 3D reconstruction of in vivo medial surface vibration revealed effects of laryngeal nerve stimulation on glottal vibratory pattern and acoustic correlates of voice quality. SLN activation resulted in significantly quicker glottal closure per cycle, decreased glottal volume, and higher-pitched, less breathy, and less noisy voice. RLN had a similar effect on acoustic measures. NA, Basic Science Laryngoscope, 133:357-365, 2023.

Annals of Neurology: Volume 91, Number 6, June 2022

Results of the voxelwise general linear models indicating the voxels that differed significantly between AB– (n = 102) and AB+ (n = 51) groups, covarying for age and sex, color‐coded to delineate diffusion (FA = blue; MD = green; overlapping voxels shared by FA and MD = teal) and WMTI (AWF = blue; De,⊥= red; overlapping voxels shared by AWF and De,⊥= teal) metrics. Top and bottom rows from left to right: anterior, superior, and left lateral views. See paper in this issue by Benitez et al. (pp. 864–877).

Alternative positioning method for the superior-inferior axial shoulder projection - the Lewis modification.

The superior–inferior (SI) axial shoulder view is an important part of shoulder imaging. It provides a true orthogonal view to the anterior–posterior (AP) shoulder projection and is a supplementary view to the lateral scapula view. When positioned correctly, the glenohumeral joint is visualised with the superior and inferior aspects of the glenoid superimposed to demonstrate the true relationship between the glenoid and humerus. Positioning for the SI axial view is challenging. Often the glenoid is not superimposed on resulting images, and the glenohumeral relationship cannot be assessed accurately. Some positioning texts do not demonstrate the SI axial view, opting instead for the inferior–superior (IS) view. When the SI axial view is included, bony landmarks are not provided to assist medical imaging technologists (MITs) with accurate positioning. This paper outlines a proposed modification using bony landmarks that can assist MITs in positioning their patients for this important view and obtain diagnostic images that demonstrate the glenoid in true profile.

Dance as an agency of change in an age of totalitarianism

This article identifies two different paths where the amnesia described by Hannah- Arendt and the fragmentation identified by Willie James Jennings of our historical past has distorted how people today view dan-cing. I set out how the Christian entanglement with colonial powers has impacted on people’s abilities to relate to their bodies, lands and other creatures of the world. I describe how the colonial wound of Western society forms the basis of the loneliness and alienation that totalitarianism inculcates. After this, I examine how people who seek to find a solid tradition of dance within the Western traditions of Christianity often end up in a conundrum when they seek to legitimize the existence of the tradition in the wrong places. I show how seeking roots for Christian dance practices in Jewish customs is often entangled in supersessionist understandings. These arguments are constructed by means of both J. Kameron- Carter’s writings on race and theology and the black political theology outlined by Vincent W. Lloyd. The second-most-often chosen option for creating a dance tradition for Western forms of Christianity is to romanticize the non-Western ‘other’. Using Lindsey Drury’s work, I argue that dancers have perpetuated the interests that seek to possess the ‘other’ by bringing exotic dancers to the Western marketplace. Finally, I describe the third option – more commonly found amongst those critical of Christian tradition – to seek the roots of transformational dance practices in Hellenistic and more esoteric teachings flourishing in the early twentieth century. We run into the often forgotten or neglected stories of renowned dance teachers like Rudolf Laban and Isadora Duncan on this path. By combining esoteric bodily practices, Mother Earth ‘spirituality’ and superior views about race, they not only promoted but laid the foundation for how people were manipulated in the Third Reich. I end by sharing ethnographic stories of resistance towards how these past historical patterns have affected how dance is viewed today. Those exhibiting such resistance are not always consciously aware of the historical roots I have described. However, engagement in contemplative and healing dance practices seems to be forging new and better ways to create community and to live in a connected way with creation and our creatureliness (Hellsten 2021a). The central theme of these practices is to resist the illusion of perfection and control while helping people to listen to and discern the Holy Spirit leading them into a new way of living.

Low-dose three-dimensional CT angiography for the evaluation of posterolateral protrusion of the vertebral artery over the posterior arch of the atlas: a quantitative anatomical comparison study of the rotational and neutral positions

To investigate the changes in relevant anatomical parameters of posterolateral protrusion of the vertebral artery (VA) between head-neck rotational and neutral positions using low-dose three-dimensional computed tomography angiography (3D-CTA). Low-dose 3D-CTA images obtained for various craniocervical diseases in 36 non-dominant VA side patients with neutral, left and right head-neck rotational positions were evaluated. The relevant parameters from superior and inferior views, including external diameter (ED), internal diameter (ID), transverse diameter (TD), heights and diameters of posterolateral protrusion of the VA over the posterior arch of the atlas in the neutral and rotational positions, were recorded and compared. There was no significant differences in the rotational angle (left/right: 31.23±6.60/29.94±6.09°, p>0.05). There were no significant differences in heights and diameters of bilateral VA between rotational and neutral positions (all p>0.05). The contralateral ID, ED, and TD of the rotational positions were significantly shorter than those of the neutral position (all p<0.05), while there were no significant differences in the three ipsilateral diameters (all p>0.05). Posterolateral protrusion of the VA is not uncommon in the population, and surgeons should be aware of its presence, especially the increased possibility of injury to the VA caused by head-neck rotation, during the operation; thus, preoperative evaluation by low-dose 3D-CTA should be considered.