There are many methods to treat keloid, including various excision operations, laser, injection and radiotherapy. However, few studies have explored the effectiveness of single-hole punch excision in keloid treatment. This study aimed to investigate the efficacy and safety of lateral punch excision combined with intralesional steroid injection for keloid treatment through self-control trial. In this self-controlled trial, 50 patients meet the diagnosis of nodular keloid, and try to choose left-right symmetrical control, one skin lesion in the control group (50 skin lesionsin total) and the other in the observation group (50 skin lesions in total).The keloids in the treatment group were initially treated with punch excision combined with intralesional steroid injection, followed by injection treatment alone. Keloids in the control group received intralesional steroid injection alone. The Vancouver Scar Scale (VSS) of the keloid before and after the punch excision was evaluated; the keloid scores at different time points and the number of injection treatments required in both groups were compared, and adverse reactions were observed. The effective rate of the observation group was 86.0%, which was significantly higher than that of the control group (66.0%), and the recurrence rate of 22% was lower than that of the control group (χ2 = 4.141,63417), all of which were statistically significant (all P < 0.05). At the end of treatment, the VSS and total injection times in the observation group were significantly lower than those in the control group (t = 5.900,3.361), with statistical significance (P < 0.01). The combination of single-hole punch excision and intralesional steroid injection is an effective method to treat multiple nodular keloids, shortening the treatment course of tralesional steroid injection without obvious adverse reactions.

High-frequency deep transcranial magnetic stimulation (dTMS) targeting the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC) with an H-coil has received approval from the Food and Drug Administration for the treatment of obsessive-compulsive disorder (OCD). Nevertheless, there is limited evidence regarding the efficacy of a similar procedure performed using a double-cone coil or in an accelerated regimen. In this study, patients in the active TMS group (n = 14) underwent stimulation of the mPFC and ACC twice daily at a frequency of 20 Hz for three weeks, using a double-cone coil. The same procedure was applied to the control group (n = 15) using a placebo coil. Throughout the study, the patients continued their antidepressant and/or antipsychotic treatments at the same dose. Following treatment, the active TMS group exhibited a more significant reduction in Yale-Brown Obsessive-Compulsive Scale scores (pre-treatment: 25.36 ± 5.4, post-treatment: 18.43 ± 6.86) and Hamilton Anxiety Rating Scale scores (pre-treatment: 10.6 ± 3.5, post-treatment: 6.7 ± 2.7) compared to the sham TMS group. However, there was no statistically significant reduction in symmetry-related obsessive-compulsive symptoms in the TMS group compared to the sham TMS group. dTMS applied to the mPFC and ACC, using a double-cone coil at a 20-Hz frequency twice daily for three weeks, was found to be effective as an adjunctive treatment for treatment-resistant OCD.

BACKGROUND: Many dental treatments need exact knowledge of the anatomical location of the mental foramen (MF). This retrospective research uses orthopantomograph (OPG) to assess the MF of orthodontic patients in Saudi Arabia and their position, symmetry, shape, and connectivity.
METHODS: One hundred and eighty panoramic radiographs of patients having orthodontic treatment were analyzed for the location, form, symmetry, as well as bilateral preservation of the MF. The patients were of varied ages, genders, and degrees of malocclusion and were divided into three classes: Class I (60), Class II (60), and Class III (60). Chi-squared tests and other descriptive statistics were employed to examine the data for statistical significance.
RESULTS: When looking at the right side of the mouth, the most frequent location for MF was position 3 (between the apexes of the first and second premolars; 50.6%), whereas on the left side, it was location 4 (near the apical of the second premolar; 47.2%). The most typical form of MF has an irregular shape. MF location on the left side and continuity types differed significantly across malocclusion groups (p<0.05).
CONCLUSIONS:  OPGs of Saudi orthodontic patients demonstrated a significant variability of position and continuity of the MF across different classes of malocclusion. The third most frequent position was between the first and second premolars, while the shape of MF showed variation across the age of the patients. Hence, this precise comprehension of the anatomical and morphological diversity of the MF is of utmost significance for dental professionals.

Introduction Class II malocclusions are commonly associated with some muscle disharmony and imbalance. Diagnosis of muscle imbalance helps in treating the malocclusion as well as preventing relapse of the treatment. The aim of this study is to compare the muscle activity of masseter and temporalis in patients with skeletal Class II division 1 malocclusion with varying overjet using surface electromyography (sEMG). Materials and methods Ten subjects in the age range 18-35 years with skeletal Class II malocclusion and varying overjets who required orthodontic treatment were included in this study. Out of these 10 patients, five of them had a 2-4mm overjet and the other five had an overjet >4mm. A four-channel sEMG system was used to conduct the sEMG of muscles. Muscle activity, synergy, and symmetry of masseter and temporalis muscles were assessed and compared between the two groups with an Independent t-test. Results There were no significant differences in the muscle activities of the temporalis and masseter muscles in both groups. Symmetry and synergy of these muscles in the two groups also showed no significant difference (p>0.05) at rest and clenching. However, during chewing, the masseter muscle showed poor balance and activity. Conclusion The overjet in Class II division 1 malocclusions did not seem to affect the muscle activity at rest and during clenching. In patients with increased overjet, during chewing, masseter activity in terms of intensity and balance was poor.

UNASSIGNED: Secondary cleft rhinoplasty is a challenge due to the complex anatomy of the nose, with structural deformity and difficulty in surgical management. This study aimed to evaluate the effect of an anatomical-based approach on enhancing tip and alar symmetry in secondary unilateral cleft rhinoplasty using photogrammetric evaluation.
UNASSIGNED: The study was conducted on 57 adult patients seeking rhinoplasty after primary repair of congenital unilateral cleft lip deformity. All patients were operated upon using an external open rhinoplasty approach using an anatomical-based surgical technique. The cases were periodically followed up at three, six, 12 and 18 months for both aesthetic and functional outcomes with photogrammetric analysis of facial profile using the software Mirror Suite programme to compare before and after the surgical procedure.
UNASSIGNED: The photogrammetric analysis showed a significant improvement of facial angles (P = 0.05). The nasofrontal angle changed from a median of 146° to 132.5°, nasolabial angle of 73° to 95°, nasofacial angle of 21.5° to 32° and nasomental angle of 105° to 130°. The rotation angle of the nasal tip showed a significant cephalic rotation with a mean increase of the tip elongation of 1.8 cm achieved per lateralised millimetre.
UNASSIGNED: Secondary rhinoplasty in unilateral cleft deformities needs accurate evaluation of the anatomical and pathological abnormalities. Open approach is preferred with using costal cartilage graft allowing adequate columellar lengthening, maxillary enhancement and alar repositioning which leads to optimise the definition, projection and cephalic rotation with better stabilisation and symmetry of the nasal tip.

UNASSIGNED: The purpose of this paper is to compare the differences in the features of multifrequency electrical impedance tomography (MFEIT) images of human heads between healthy subjects and patients with brain diseases and to explore the possibility of applying MFEIT to intracranial abnormality detection.
UNASSIGNED: Sixteen healthy volunteers and 8 patients with brain diseases were recruited as subjects, and the cerebral MFEIT data of 9 frequencies in the range of 21 kHz - 100 kHz of all subjects were acquired with an MFEIT system. MFEIT image sequences were obtained according to certain imaging algorithms, and the area ratio of the ROI (AR_ROI) and the mean value of the reconstructed resistivity change of the ROI (MVRRC_ROI) on both the left and right sides of these images were extracted. The geometric asymmetry index (GAI) and intensity asymmetry index (IAI) were further proposed to characterize the symmetry of MFEIT images based on the extracted indices and to statistically compare and analyze the differences between the two groups of subjects on MFEIT images.
UNASSIGNED: There were no significant differences in either the AR_ROI or the MVRRC_ROI between the two sides of the brains of healthy volunteers (p > 0.05); some of the MFEIT images mainly in the range of 30 kHz - 60 kHz of patients with brain diseases showed stronger resistivity distributions (larger area or stronger signal) that were approximately symmetric with the location of the lesions. However, statistical analysis showed that the AR_ROI and the MVRRC_ROI on the healthy sides of MFEIT images of patients with unilateral brain disease were not significantly different from those on the affected side (p > 0.05). The GAI and IAI were higher in all patients with brain diseases than in healthy volunteers except for 80 kHz (p < 0.05).
UNASSIGNED: There were significant differences in the geometric symmetry and the signal intensity symmetry of the reconstructed targets in the MFEIT images between healthy volunteers and patients with brain diseases, and the above findings provide a reference for the rapid detection of intracranial abnormalities using MFEIT images and may provide a basis for further exploration of MFEIT for the detection of brain diseases.

BACKGROUND: The importance of early diagnosis of pediatric malocclusion and early intervention has been emphasized. Without use of radiation, 3D imaging holds the potential to be an alternative for evaluating facial features in school-aged populations.
METHODS: Students aged 9 and 10 years were recruited. We performed annual 3D stereophotogrammetry of the participants\' heads. A total of 37 recognizable anatomical landmarks were identified for linear, angular, and asymmetric analyses using the MATLAB program.
RESULTS: This study included 139 healthy Taiwanese children with a mean age of 9.13, of whom 74 had class I occlusion, 50 had class II malocclusion, and 15 had class III malocclusion. The class III group had lower soft-tissue convexity (p = 0.01) than the class II group. The boys with class II malocclusion had greater dimensions in the anteroposterior position of the mid-face (p = 0.024) at age 10. Overall asymmetry showed no significance (p > 0.05). Heat maps of the 3D models exhibited asymmetry in the mid-face of the class II group and in the lower face of the class III group.
CONCLUSIONS: Various types of malocclusion exhibited distinct facial traits in preadolescents. Those with class II malocclusion had a protruded maxilla and convex facial profile, whereas those with class III malocclusion had a less convex facial profile. Asymmetry was noted in facial areas with relatively prominent soft-tissue features among different malocclusion types.

Symmetry is critical in perceived attractiveness, especially in female faces. The palate determines the teeth\' alignment and supports facial soft tissues. Therefore, the study aimed to assess the effects of sex, orthodontic treatment, age, and heritability on the directional, anti-, and fluctuational asymmetry in the digital palatal model.
The palate of 113 twins, 86 female and 27 male subjects, with and without previous orthodontic treatment, were scanned by the Emerald (Planmeca) intraoral scanner. Three lines were constructed horizontally in the digital model, one between the right and left first upper molars and two between the first molars and incisive papilla. Two observers calculated the left and right angles between the mid-sagittal plane and molar-papilla lines. The intraclass correlation coefficient was used to assess the inter-observer absolute agreement. The directional symmetry was determined by comparing the mean left and right angles. The antisymmetry was estimated from the distribution curve of the signed side difference. The fluctuating asymmetry was approximated from the magnitude of the absolute side difference. Finally, the genetic background was assessed by correlating the absolute side difference between monozygotic twin siblings.
The right angle (31.1 degrees) was not significantly different from the left one (31.6 degrees). The signed side difference followed a normal distribution with a mean of -0.48 degrees. The absolute side difference (2.29 degrees, p < 0.001) was significantly different from zero and negatively correlated (r=-0.46, p < 0.05) between siblings. None of the asymmetries was affected by sex, orthodontic treatment or age.
The palate illustrates neither directional asymmetry nor antisymmetry, indicating that most people\'s palates are symmetric. However, the significant fluctuating asymmetry suggests that some subject has considerable asymmetry but is not influenced by sex, orthodontic treatment, age, and genetics. The proposed digital method is a reliable and non-invasive tool that could facilitate achieving a more symmetrical structure during orthodontic and aesthetic rehabilitation.
The Clinicatrial.gov registration number is NCT05349942 (27/04/2022).

An atropisomerism of large cycloarylenes was studied using [n]cyclo-4,10-pyrenylenes (n=6-21) as an illustrative example with two simple assumptions: (1) alternating configurations (R,S,R,S,…) are thermodynamically most stable, and (2) three consecutive identical configurations (R,R,R or S,S,S) are prevented. Ni-mediated coupling of a 5,9-diiodopyrene gave a series of directly-linked cyclic pyrene oligomers in one-pot reaction. As-synthesized cyclic hexamer was assigned as an (R,S,S,R,R,S) structure, converted into an (R,S,R,S,R,S)-form upon heating. Cyclic heptamer consists of two types of C2 symmetric structures predicted from assumption (2), one of which was convergent to one another by heating. Three atropisomers of cyclic octamer were analyzed from the possible five candidates by means of 1 H nuclear magnetic resonance (NMR) spectroscopy, and the conversion process to (R,S,R,S,R,S,R,S) configurations upon heating was investigated. In total, according to two simple rules, the analysis of atropisomerism could be performed smoothly.

Endovascular mechanical thrombectomy (MT) has now evolved to become the standard treatment for acute ischemic stroke due to large vessel occlusion. Arterial perforation is a potential complication of MT, and the risk of this event during blind crossing the occlusion site has been elucidated. The intracranial arterial system shows morphological structural symmetry, so we investigated the utility of the bilateral symmetry of the proximal middle cerebral artery (MCA) as a preprocedural evaluation to predict hidden running course distal to the thrombus.
This study retrospectively analyzed 191 consecutive patients (mean age, 67.5 ± 15.5 years; 100 women) who underwent time-of-flight-magnetic resonance angiography in our institution. Four landmarks of the MCA were assessed: division pattern, early branching pattern, length, and course pattern. Each geometric property was compared between cerebral hemispheres. Frequencies of symmetry and symmetry breaking were assessed.
In 91% (bifurcation type, 87%; trifurcation type, 4%), branching patterns of the left and right M1 were symmetrical. Early frontal and/or temporal branches were observed in 31%, and the presence/absence of early branches was symmetrical in 70% cases. In 19%, M1 was classified as short M1, and classifications were identical between hemispheres in 74%. Running course of the M1 was symmetrical in 63%. Two or more parameters were symmetrical in 181 cases (95%).
The symmetry of bilateral M1-2 structures was demonstrated in most cases from the perspectives of 4 parameters. The MCA symmetry can predict the running course of the MCA before crossing the occlusion site and shows potential benefits for neurointerventionalists.