UNASSIGNED: Lipid hemihypertrophy should be considered in the differential diagnosis of neonatal asymmetry. Early recognition and further evaluation for associated disorders are important for appropriate management and surveillance of potential complications.
UNASSIGNED: We present the case of a 5-day-old female neonate who presented with a visibly enlarged right thigh, right labia majora, and below the right mandible. This case report highlights the importance of early identification, comprehensive evaluation, and multidisciplinary management in neonates with lipid hemihypertrophy to optimize their long-term outcomes and quality of life.

OBJECTIVE: To explore and describe older persons\' unique experiences of care encounters with home care nurses in a real-life context.
BACKGROUND: The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of \"hospitals at home\" where care encounters occur in a person\'s private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.
METHODS: Multiple-case study.
METHODS: The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.
RESULTS: The cross-analysis emerged in three categories: \"Nursing routine rules the care encounters\", \"Lack of knowledge and information\" and \"Dependency on support from others\".
CONCLUSIONS: Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.
UNASSIGNED: Findings were reported using COREQ guidelines.
UNASSIGNED: Patients were interviewed and contributed with data for this study.
UNASSIGNED: This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.

UNASSIGNED: In Paralympic powerlifting competitions, movement execution symmetry is a technical requirement influenced by individual athlete characteristics and motor strategies. Identifying the elements associated with individual motor strategies can offer valuable insight for improving sport performance. Therefore, this case series study aimed to explore muscle activation symmetry and its intra- and inter-individual variability to determine the muscles mostly related to individual motor strategies in elite Paralympic powerlifters.
UNASSIGNED: Bilateral electromyographic activation of the anterior deltoid (AD), pectoralis major (PM), latissimus dorsi (LD), triceps (TRI) and external oblique (EO) muscles were analysed in five elite Paralympic powerlifters while performing four sets of one-repetition maximum of Paralympic bench press. Muscle activation symmetry indexes (SI) were obtained and transformed to consider individual-independent evaluation. The coefficient of variation (CV), variance ratio (VR), and mean deviation (MD) were computed to assess inter- and intra-individual variability in electromyographic waveforms and SI.
UNASSIGNED: Both transformed and non-transformed SI indicated overall symmetric activation in DA, PM, TRI, and LD. Transformed SI revealed asymmetrical muscle activation of EO when grouping data (mean bilateral difference: 10%). Athletes exhibited low intra-individual SI variability in all analysed muscles (CV < 10%) and low inter-individual variability in DA, PM, LD, and TRI (CV < 10%; VR: 4%-11%; MD: 29%-43%). In contrast, higher inter-individual variability was observed in EO (CV: 23%; VR: 23%; MD: 72%-81%).
UNASSIGNED: The highest variability and asymmetry in abdominal muscle activation among athletes emphasize the importance of personalized training approaches for targeting these muscles due to their role in individualizing motor strategies.

Mandibular fractures are the most common trauma cases that we often come across in our day-to-day practice of oral and maxillofacial surgery. Various factors can lead to deformities and make those cases more challenging, which includes a delay in surgical treatment, resulting in non-union or malunion of the fracture site causing occlusal disturbances and functional abnormalities in the temporomandibular joint.

UNASSIGNED: Tuberculosis of the Temporomandibular joint (TMJ) in a neonate is a rare entity. Undiagnosed/mismanaged tuberculosis can disseminate and be life-threatening to the patient. The purpose is to present a case of tubercular osteomyelitis of TMJ in a neonate with eleven years of follow-up.
UNASSIGNED: A one-and-a-half-month-old male neonate presented with a firm swelling in front of the left ear for the past 20 days. Ultrasound presented an avascular, hypoechoic lesion of 34*25*25mm. Irregular margins of underlying bone could suggest erosion. Aspiration revealed pus. ZN staining of pus revealed Mycobacterium tuberculosis. After draining the pus, the patient underwent antitubercular therapy. He revisited at ten years of age with a complaint of asymmetry. Although the patient got cured of his tuberculosis, investigations rose to a diagnosis of condylar hypoplasia with ipsilateral coronoid enlargement. A distraction of the mandible improved facial symmetry.
UNASSIGNED: Although pus revealed the presence of Acid-fast bacilli, it is not evident until there is a significant bacterial load. Escalation of tests with higher sensitivity is needed to diagnose tubercular osteomyelitis of TMJ. Patients must be made aware of possible sequelae of tubercular osteomyelitis of TMJ and need appropriate management. Oblique osteotomy at the angle and distraction improves both horizontal and vertical components of the mandible and thus improves symmetry. To the best of the author\'s knowledge, the following is the first case of primary tuberculosis of TMJ in a neonate and with such an extended follow-up.

The outbreak of the COVID-19 pandemic has once again made the impacts of natural disasters a hot topic in academia. The environmental impacts of natural disasters, however, remain unsettled in the existing literature. This study aims to investigate the impact of natural disasters on CO2 emissions. For this purpose, we employ a panel dataset covering 138 countries over the period 1990-2018 and two dynamic panel estimation methods. Then, considering the differences in CO2 emissions across various countries, we run a panel quantile regression to examine the asymmetry in the nexus between natural disasters and CO2 emissions. We also discuss the mediating effects of energy consumption between natural disasters and CO2 emissions. After conducting a series of robustness checks, we confirm that our results are stable and convincing. The empirical results indicate that natural disasters significantly reduce CO2 emissions. Nevertheless, the impact of natural disasters on CO2 emissions is asymmetric across different quantiles of CO2 emissions. Furthermore, the technology level serves as an important moderating factor between natural disasters and CO2 emissions. The mediating effect results reveal that natural disasters not only directly reduce CO2 emissions but also indirectly promote carbon reduction by restraining energy consumption. Finally, several policy implications are provided to reduce CO2 emissions and the damage caused by natural disasters.

BACKGROUND: Not much is known about developmental motor disorders in the first year of life of children diagnosed with idiopathic scoliosis (IS).
OBJECTIVE: This study aimed to compare the occurrence of asymmetry or muscle tone disorders in the first year of life in adolescents with IS and their healthy counterparts.
METHODS: The parents of adolescents with IS and without scoliosis completed a survey on the occurrence of asymmetry, abnormal muscle tone, and physiotherapy in their children in the first year of life. Pearson\'s chi square test and Cramer\'s coefficient were used.
RESULTS: The final analysis included 527 surveys completed by parents of adolescents with idiopathic scoliosis (150) and without scoliosis (377). A significantly higher frequency of asymmetry (p= 0.001) and muscle tone disorders (p= 0.001) was noted in adolescents with idiopathic scoliosis. The results also revealed a significant association between scoliosis and asymmetry (p= 0.001), as well as muscle tone (p= 0.001).
CONCLUSIONS: Developmental asymmetry or improper muscle tone in the first year of life could be considered a potential factor in the development of scoliosis; however, this hypothesis should be confirmed in future studies. Infants diagnosed with developmental disorders require systematic observation.

BACKGROUND: Ethambutol-induced optic neuropathy (EON) most commonly manifests as bilateral symmetrical loss of vision and often cause serious and irreversible visual impairment because of the lack of early detection and effective treatment. We followed a case of EON with rare binocular asymmetric clinical manifestations and observed the changes of visual function and retinal structure after drug withdrawal, so as to further understand the clinical characteristics of this disease.
METHODS: A 54-year-old man complained of gradual visual decline in the left eye. The patient presented with best-corrected visual acuity of 20/20 in the right eye and 20/50 in the left eye. Color vision examination revealed difficulty in reading green color plates in the left eye. The visual field manifested as concentric contraction in the left eye. After nearly a month of drug withdrawal, the right eye had a similar decline in visual function. At the last visit, 19 mo after drug withdrawal, the visual function significantly recovered in both eyes. During follow-up optical coherence tomography (OCT) examination, both eyes manifested the thickness of the retinal nerve fiber layer from mild thickening to thinning and finally temporal atrophy, and the ganglion cell-inner plexiform layer showed significant thinning. The difference was that a reversible structural disorder in the outer retina of the nasal macula was detected in the left eye by macular high-definition OCT.
CONCLUSIONS: Nephropathy and high blood pressure, which damage the retinal microcirculation, may cause damage to the outer layer of the retina. Ethambutol may influence photoreceptor as well as retinal ganglion cells.

Class II malocclusion cases possess a constant challenge to orthodontists since time immemorial. Mandibular retrusion is the most common feature of class II malocclusion, rather than maxillary prognathism. Association of class II with asymmetry, a condition called asymmetric mandibular retrognathia (AMR), gives a tougher challenge to orthodontists for management. The following case presents effective management of AMR using differential loading technique. A young boy aged 12 years presented with mandibular retrognathia associated with facial asymmetry. He was treated with a differential force loading technique using a fixed functional appliance.
RESULTS: Improved facial profile with increased mandibular length achieved. A significant reduction in facial asymmetry was also appreciable.
CONCLUSIONS: Differential force loading technique using fixed functional appliance while being least troublesome for the patient may prove beneficial to harness excellent and satisfactory results with minimal efforts in such cases of mandibular retrusion with facial asymmetries and also decrease the need for surgical correction.
UNASSIGNED: Parihar AV, Angamuthu KP, Sahoo R, et al. Management of Asymmetric Mandibular Retrognathia with Differential Loading Technique: A Case Report. Int J Clin Pediatr Dent 2021;14(S-1):S107-S113.

OBJECTIVE: Current return-to-sport decisions are primarily based on elapsed time since surgery or injury and strength measures. Given data that show rates of successful return to competitive sport at around 55%, there is strong rationale for adopting tools that will better inform return to sport decisions. The authors\' objective was to assess reactive strength as a metric for informing return-to-sport decisions.
METHODS: Case-control design.
METHODS: Fifteen elite athletes from national sports teams (23 [6.0] y) in the final phase of their return-to-sport protocol following a unilateral knee injury and 16 age-matched control athletes (22 [4.6] y) performed a unilateral isometric strength test and 24-cm drop jump test. Pairwise comparisons were used to determine differences between legs within groups and differences in interleg asymmetry between groups.
RESULTS: Strength measures did not distinguish the control from the rehabilitation group; however, clear differences in the degree of asymmetry were apparent between the control and rehabilitation groups for contact time (Cohen d = 0.56; -0.14 to 1.27; 8.2%; P = .113), flight time (d = 1.10; 0.44 to 1.76; 16.0%; P = .002), and reactive strength index (d = 1.27; 0.50 to 2.04; 22.4%; P = .002).
CONCLUSIONS: Reactive strength data provide insight into functional deficits that persist into the final phase of a return-to-sport protocol. The authors\' findings support the use of dynamic assessment tools to inform return-to-sport decisions to limit potential for reinjury.