Quantitative Prediction of the Location of Carotid Bifurcation and Neurovascular Structures in the Carotid Region: A Cross-Sectional Cadaveric Study

Introduction. The carotid region is encountered in vascular and neurological surgery and carries a potential for vascular and cranial nerve trauma. The carotid bifurcation is an especially important landmark and difficult to predict based on currently established landmarks. This study is a detailed analysis of the carotid region and proposes a novel methodology to predict the height of the bifurcation. Materials and Methods. Superficial and deep dissections were performed on the anterior triangle of the neck to expose the carotid region in twenty-one formalin-fixed donor cadavers. Musculoskeletal and neurovascular structures were assessed in relation to the carotid bifurcation and the medial border of the clavicle (MBC). Results. The carotid bifurcation occurred, on average, 11.4 mm higher on the left ( p < 0.001 ; 95% CI: 9.28, 13.54). The superior thyroid artery ( p < 0.001 ), facial vein ( p < 0.001 ), and cranial nerve XII ( p < 0.001 ) were all more distal on the left side when measured from the MBC while the angle of the mandible and stylohyoid muscle remained symmetric. Left- and right-sided vascular structures were symmetric when measured from the carotid bifurcation. Conclusions. Neurovascular structures within the carotid region are likely to be anatomically superior on the left side while vessels are likely to remain symmetric in relation to the carotid bifurcation. When measured from the MBC, the bifurcation height can be predicted by multiplying the distance between the MBC and mastoid process by 0.65 (right side) or 0.74 (left side). This novel methodological estimation may be easily learned and directly implemented in clinical practice.

Introduction of longstanding complicated sulcus intraocular lens into the intact capsular bag

AIM: To propose a surgical technique that successfully reopened the empty and intact capsular bag after long periods of closure, with repositioning of the intraocular lens (IOL) from the ciliary sulcus into its preferred habitat inside the capsular bag. METHODS: This is a case series, prospective, and interventional study. The technique was first performed on an aphakic high myope with a closed posterior capsule for 18y. Afterwards, five patients with recurrently displaced sulcus IOLs for a range of 1mo to 7y were performed for the same technique. During surgery, identifying a “telltale white line” was an important landmark for detecting the site of major adhesions between the edge of the capsulorhexis and the posterior capsule. These adhesions were freed using combined manual and viscoelastic dissection, followed by an easier freeing of adhesions along the whole capsular bag. The IOL was safely implanted, exchanged, or introduced from the sulcus into the fibrotic and closed capsular bag. Patients were followed up for a period ranging from 6 to 17mo postoperatively. RESULTS: All the patients experienced a remarkable improvement in their subjective refraction. Slit lamp examination showed a postoperative centralized IOL in the bag. The follow up visits confirmed visual and IOL stability. CONCLUSION: This newly-introduced surgical technique facilitates the reopening of the empty yet intact capsular bag that has been closed by fibrotic proliferations, with secured implantation of the IOL inside the capsular bag. Patients with inadvertent implantation of IOLs into the ciliary sulcus, yet having an intact capsular bag, can benefit from this technique.

Addison, Samuel Johnson, and the Test of Time

This chapter explores the contours of Addison’s afterlife in the eighteenth century by looking carefully at Samuel Johnson’s varied criticism of his works over a lifetime of writing about him. In his final statement in his famous Life of Addison, Johnson declares Addison’s reputation secure from the ups and downs it underwent in the eighteenth century by determining that Addison’s works, like those of Shakespeare, had stood the test of time. In Johnson’s long journey to this conclusion, his work on the Dictionary is perhaps the most important landmark. By citing Addison so frequently and in illustration of so many common words, Johnson demonstrated that Addison’s prose had knit itself into the fabric of English and would therefore endure. Although the enthusiastic cult of Addison that saw him as a perfect Christian had faded by mid-century, Johnson saw his works enduring because they had, almost invisibly, become part of British social discourse, both linguistically and ethically, and thereby ‘given Addison a claim to be numbered among the benefactors of mankind’.

A study on changes in phonetics in completely edentulous patients before and after rehabilitation with conventional and customized complete dentures

<p><strong>Background</strong>: A realistic approach to the phonetic aspect in complete denture construction is most often subdued by various factors. The palatal rugae, an important landmark in speech orderliness, are frequently affected due to lack of proper texture on a complete denture. Establishing a correlation between customized palatal surfaces of complete dentures and speech improvement will help to ameliorate post insertion appointments of articulation deficiencies.</p><p><strong>Methods: </strong>Ten completely edentulous subjects of either sex with a mean age range of 50-70 years, fulfilling the inclusion criteria were included in this study. All the participants received three sets of dentures, followed by assessment of speech using photo articulation test, speech intelligibility and acoustic analysis in edentulous state and subsequently after insertion of conventional denture, denture with customized rugae, and denture with customized metallic base.</p><p><strong>Results:</strong> The data collected was subjected to statistical analysis using SPSS 24.0 version and GraphPad Prism version 5. The statistical analysis was carried using ANOVA and student t-test. On evaluating the error patterns, distortion was maximum followed by substitutions. These errors were maximum in edentulous state and decreased subsequently, with the least errors in customized rugae dentures. A statistically significant positive correlation (p&lt;0.0001) was found.</p><p><strong>Conclusions: </strong>Apart from retention, stability and support, equal amount of emphasis has to be laid down on phonetical aspects to improve the overall psychological well-being and social upliftment for patients. The improvement in verbal proficiency for completely edentulous patients can be minimized considerably by customizing the palatal portions.</p>

AN EXPLORATION OF NABHI AS AN ANATOMICAL LANDMARK IN AYURVEDA

Ayurveda is a scientific text which covers all aspects of Rachana Sharir and Kriya Sharir. This Sharir is now-a-days modernized as Anatomy and Physiology. To understand anatomy the primary knowledge of anatomical landmarks is essential. Reference points located by visual inspection, palpation, or computer assistance are useful in localizing structures on or within the human body are called Anatomical landmarks. These are frequently used by Anatomists and clinicians to guide both diagnosis and treatment. In Ayurveda, the concept of Anatomical landmark is already present but in scattered manner. The concept of Nabhi in Ayurveda is many folded concept which needs more exploration. It can be considered as Koshthanga, as Marma, as Sira & Dhamani Prabhava Sthana, as an anatomical landmark and many more. In this paper an attempt has been made to collect references related to Nabhi from various Samhitas indicating it as an anatomical landmark and by analyzing these references logically, the concept of Nabhi as an important landmark has been established and reconstructed in accordance with modern Anatomical landmark categories.

Ecumenical Mysticism: On Conversion in the Eastern Tradition of Ordene de Chevalerie

Historians celebrate the Old French Ordene de Chevalerie as an important landmark in the history of French nobility. The version of Ordene that most scholars have studied showcases Saladin’s interest in Christian chivalry but stops short of his actual dubbing. An often-neglected prose recension of this tale that first appeared in an oriental history of Outremer goes a step further, imagining the sultan to have truly become a knight “in the Christian fashion.” This version of the story, I argue, portrays Christian dubbing not only as a ceremony through which young aristocrats were admitted into a society of warriors, but also as an instrument for spiritual ascent that non-Christians could experience without renouncing their own faith. As such, the story echoes the widespread near-eastern trope of ecumenical mysticism, in which members of various faiths were seen to partake in mystical practices that belonged to neighboring traditions.

Lingual Foramen of the Mandible on Cone-Beam Computed Tomography Scans: A Study of Anatomical Variations in an Iranian Population

Objectives: Lingual foramen (LF) is an important landmark of the mandible, which should be considered in presurgical assessment. The purpose of this study was to assess the anatomical variations of the LF using cone-beam computed tomography (CBCT). Materials and Methods: The study was conducted on 200 CBCT scans of Iranian adults. The lingual foramina (LFs) were classified into two groups by their location in the mandible namely the medial LFs (MLFs) and the lateral LFs (LLFs). The frequency of both the MLFs and the LLFs and their distance from the inferior border of the mandible were evaluated. Additionally, the diameter of the MLFs and the location of the LLFs were assessed. Data were analyzed separately for males and females. Results: All 200 participants had at least one LF. Totally, 257 LFs were detected on 200 CBCT scans, including 223 MLFs (86.6%) and 34 LLFs (13.3%). The LLF was detected in 23 patients (11.5%). The prevalence of the LLF was higher in males and in the second premolar region. The diameter of the MLFs was less than 1mm in 81% of the cases, and males had a larger MLF. Conclusion: There was a significant variability in the anatomy and location of the mandibular LF in Iranian adults. CBCT is recommended for preoperative imaging to determine the exact location and size of the LFs in the mandible to prevent possible surgical complications.

HTN Learning via Transfer Learning of Domain Landmarks

Hierarchical Task Network (HTN) planning uses task-subtask relationships to break complex problems into more manageable subtasks, similar to how human problem-solvers plan. However, one limitation of HTN planning is that it requires domain knowledge in the form of planning methods to perform this task decomposition. Recent work has partially alleviated this knowledge engineering requirement by learning HTN methods from traces of observed behavior. Although this greatly reduces the amount of knowledge that must be encoded by a domain expert, it requires a large collection of traces in order to infer important landmark states that are used during trace segmentation and method learning. In this paper we present a novel method for landmark inference that transfers knowledge of landmarks from previously encountered environments to new environments without requiring any traces from the new environment. We evaluate our work in a logistics planning domain and show that our approach performs comparably to the existing landmark inference method but requires far fewer traces.

#ImNotAChickFlick: Neoliberalism and Post-feminism in Veere Di Wedding (My Friend’s Wedding, 2018)

Released in 2018, Shashanka Ghosh’s Veere Di Wedding ( VDW; My Friend’s Wedding), dubbed as India’s answer to Sex and the City, evoked mixed responses. While many reviews of the film denounced it for its vulgarity and tawdriness, frivolity, flippant vision of women’s liberation and as a threat to Indian values, others, however, celebrated it for its frank depiction of female desires. This article undertakes a close study of the film to argue that while the focus on female desire and sexuality is rare in Hindi cinema, and thus VDW marks an important landmark, the film is not a feminist film, and it does not offer a radical politics of female solidarity. On the contrary, by locating it within its neoliberal and postfeminist politics and aesthetics, we will argue that it haphazardly borrows and superimposes tropes from the ‘bromance’ and ‘the buddy road movie’ genres onto its vision of what feminine choices entail and enable. Its casual evocation of elite lifestyles, denigration of working-class women’s life struggles, and sexual humour jeopardise a radical reworking of patriarchal and heteronormative frameworks, and it encourages us to settle for a future in which ‘women playing the same games as men do’ is the only mode of radicalism or emancipation on offer. While it is undeniably refreshing to watch the film’s push back against the repressive taboos surrounding women’s sexuality and desire, these are articulated only within neoliberal renditions of heterosexuality, matrimony, motherhood and consumerism.